A systematic review outlining the impact of education on patients and physicians in gastroenterology.

Functional gastrointestinal symptoms (FGIDs) refer to a noticeable change in the body that is reported by the patient as being different from normal. FGIDs can have a significant impact on the patient's quality of life by interfering with daily functioning. The primary objective of the current paper was to identify short-term educational interventions for patients diagnosed with FGIDs and medically unexplained symptoms. This is with the aim of assessing its effectiveness on patient's quality of life and symptom severity. The second objective was to establish the current educational programmes and training opportunities available for physicians working with this subgroup of patients. This is in order to ascertain if these could change negative physician beliefs and attitudes. Databases such as PubMed and Google Scholar were searched from November to February 2018. A total of eight interventions were found which were evaluated using the Behavioural Change Techniques Taxonomy. Short-term educational programmes combining the use of lectures and practical sessions were found to be the most effective in improving patient quality of life and symptom severity. Managing patient exposure through the use of problem-based learning was considered the most effective teaching method for trainee physicians and could help to prevent the internalisation of negative attitudes. Definite conclusions about the effectiveness of patient and physician interventions are difficult to ascertain due to the small number of studies found and the high risk of bias. Future research should focus on providing a more unified approach to the management of this subgroup of patients.

Incongruent Views of Functioning between Patients and Gastroenterologists: A Mixed Methods Study.

Gastrointestinal patients, especially those diagnosed with functional digestive disorders (FGIDs), usually present a complex clinical picture that poses a challenge for their management in primary care. The main objective of the current research was to examine the relationship of the congruence of the perception of severity and quality of life between gastroenterologists and their patients with psychological distress and the helping attitude experienced by the latter attended in primary care centres. Additionally, we wanted to explore patients' and practitioners' perceptions. We performed a cross-sectional study with a total of 2261 patients (1562 analysed) that attended three primary care centres. Patients completed questionnaires that measured physical functioning, distress, and perception of helping attitude. Gastroenterologists registered the functional status of each participating patient. Patients were then invited to take part in the qualitative part of the study if they were considered to have incongruent views on their functioning with their gastroenterologist. In total, 52 patients took part in one of eight focus groups. Additionally, four individual interviews were carried out with three gastroenterologists and one consultation-liaison psychiatrist specialised in FGIDs. Both incongruence and functional diagnosis correlated with distress. However, incongruent views between patients and gastroenterologists explained more variance. Statistically significant differences in patients' helping attitude perception were detected between diagnostic but no incongruence groups. In the second stage of the study, a total of five themes were identified from the patient focus groups and the gastroenterologist interviews: illness-emotional and personal problems, disease-health system interaction, health system, intervention, and patients. The current research allowed us to confirm that incongruence in the perception of severity and quality of life between gastroenterologists and patients is related to psychological distress and that this occurs in a multifactorial context where the characteristics of the disorder interact with those of the health system.

Design, Development and Functionality of a Haptic Force-Matching Device for Measuring Sensory Attenuation.

In this paper we describe the design, development and functionality of a haptic force-matching device. This device measures precise sensorimotor perception by determining a subject's ability to successfully attenuate incoming sensory signals. Sensory attenuation provides a novel method of investigating psychophysical aspects of perception and may help to formulate neurocognitive models that may account for maladaptive interoceptive processing. Several similar custom-made devices have been reported in the literature; however, a clear description of the mechanical engineering necessary to build such a device is lacking. We present, in detail, the hardware and software necessary to build such a device. Subjects (N = 25) were asked to match a target force on their right index finger, first by pressing directly on their finger with their other hand, then by controlling the device through an external potentiometer to control the force (indirectly) though a torque motor. In the direct condition, we observed a consistent overestimation of the force reproduced; mean force error 0.50 newtons (standard error = 0.04). In the slider condition we observed a more accurate, yet small, underestimation of reproduced force: -0.30 newtons (standard error = 0.03).