Factors affecting empathetic patient care behaviour among medical doctors and nurses: an integrative literature review.

BACKGROUND: Healthcare professionals' empathic behaviour is an important component of quality health care. Patients' reports suggest that empathy is often lacking. Specific factors that may facilitate or inhibit empathetic behaviour have not been extensively examined. In Qatar, empathy may be affected by a completely multicultural, multilinguistic setting where healthcare professionals and patients interact. AIM: The purpose of this integrative literature review is to provide the latest evidence on factors that influence the demonstration of empathetic behaviour of nurses and physicians toward patients and to draw general conclusions that increase understanding. METHODS: A literature search was conducted in CINAHL, Medline (Ovid), PsycINFO, Psychology and Behavioral Sciences Collection, Middle Eastern and Central Asian Studies, Education Research Complete, ERIC, Health Source: Nursing/ Academic databases, and Google Scholar to identify relevant studies. A total of 18 quantitative and qualitative studies that satisfied the inclusion criteria were selected to be included in the review. RESULTS: Three high order factors are described: organizational, personal and interpersonal, and demographic factors. Seven subfactors included: burnout, increased workload, lack of organizational support, training workshops, patient behaviour, inappropriate role modelling, and informal, experiential learning. CONCLUSION: The organizational culture is strongly implicated in inhibiting empathy. Healthcare providers' empathetic responses to patients are linked and connected to a well-resourced, collegial, professional organizational environment that builds empathy towards everyone (not only patients).

A new management strategy for puncture wounds of the foot. A case report.

This is a case report of persistent foot infection after a deep puncture wound caused by a bolt which went through a sandal and into the foot. An occult rubber foreign body was missed by X-ray and MRI. On the basis of persistence of infection the foot was explored. A small dorsal skin incision converted a deep track into a tunnel, through which irrigation and curettage were done. With the rinse came a piece of rubber. The patient made a complete recovery. By converting the tract into a tunnel instead of extensive dissection, management was improved considerably. This strategy has not hitherto been reported.

Prevalence of neuropathic pain among patients with chronic low-back pain in the Arabian Gulf Region assessed using the leeds assessment of neuropathic symptoms and signs pain scale.

This prospective, multicentre, epidemiological study was designed to assess the prevalence of neuropathic pain among adults with chronic low-back pain (LBP) in the Arabian Gulf region. A total of 1134 patients recruited from the outpatient medical setting were assessed using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale. A LANSS Pain Scale score ≥ 12 was used to differentiate between patients with a neuropathic contribution to their pain and those with nociceptive pain only. Using this criterion, 628 patients (55%) were classified as having neuropathic pain. Factors associated with neuropathic pain included advanced age, female gender and diabetes with or without hypertension. It was concluded that neuropathic pain is a major contributor to chronic LBP in the Gulf region, and that the LANSS Pain Scale is a practical and rapidly administered screening test for distinguishing the relative contributions of neuropathic and nociceptive pain in patients with chronic LBP that resulted in the use of a more appropriate treatment.

Antegrade Rush nailing for fractures of the distal humerus. A case series.

A single antegrade Rush nail was used to treat 37 fractures of the distal humerus extending to the olecranon fossa and up to 6.5 cm proximal to it. In order to stabilise the fracture, the bent tip of the Rush nail was directed into the lateral epicondylar ridge. This gave immediate stability. All the fractures united without residual stiffness of the shoulder or elbow.

Percutaneous extra-articular excision of femoral neck osteoid osteoma: report of a new method.

A simple new way for excision of intramedullary osteoid osteoma from the femoral neck without going through the hip joint is described. A trephine hole starting distal to the great trochanter with fluoroscopy guidance is used. This procedure (for such a lesion) has not been reported in the literature.