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1.
J Plast Reconstr Aesthet Surg ; 87: 405-407, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37939645

RESUMO

Orthognathic surgery, a multidisciplinary treatment for dentofacial deformities, presents complex preoperative preparations and follow-up procedures. This study aims to evaluate the effectiveness of ChatGPT-4, an artificial intelligence-based language model, as a supportive tool during patient consultations for orthognathic surgery. Nine critical questions that candidates for orthognathic surgery should ask during a consultation were identified and posed to ChatGPT-4. The responses were subsequently assessed by experienced plastic surgeons and collaborating orthodontists at a leading orthognathic surgery center. Evaluations focused on the accuracy, clarity, and comprehensibility of the information provided. ChatGPT-4 generated comprehensive, clear, and accurate responses, offering critical technical information to guide patients through the complexities of orthognathic surgery. However, it consistently underscored the necessity of individualized responses and emphasized that specialized medical consultation is crucial for treatment and follow-up plans. While ChatGPT-4 shows promise as a reliable informational resource, it cannot fully replace the nuanced physician-patient relationship, particularly in situations requiring emotional intelligence and specialized expertise. ChatGPT-4 can serve as an informative and guiding assistant during the consultation process for orthognathic surgery, although it cannot substitute for direct medical consultation. This tool could be an asset for both patients and physicians in managing the intricate treatment process of orthognathic surgery.


Assuntos
Deformidades Dentofaciais , Cirurgia Ortognática , Cirurgiões , Humanos , Inteligência Artificial , Encaminhamento e Consulta
3.
Artigo em Inglês | MEDLINE | ID: mdl-36231685

RESUMO

The COVID-19 epidemic put pressure on the traditional healthcare system and offline consultation methods. Telemedicine platforms provide a more convenient and safer channel for online health communication. Based on the signaling theory, our study explores the impacts of three dimensions of physicians' service quality (need fulfillment, security, and responsiveness) on online patient consultation on telemedicine platforms. A negative binomial model was used to test cross-sectional data of 2982 physicians obtained from Haodf.com. The results show the following: (1) the need fulfillment dimension variables positively affect online patient consultation; (2) the security dimension variables positively affect online patient consultation; (3) the responsiveness dimension variables positively affect online patient consultation. Our results contribute to the theoretical aspect of signaling theory and service quality in the context of telemedicine platforms and have several practical implications for telemedicine platform physicians and platform operators.


Assuntos
COVID-19 , Telemedicina , COVID-19/epidemiologia , Estudos Transversais , Humanos , Pandemias , Encaminhamento e Consulta , Telemedicina/métodos
4.
BMC Complement Med Ther ; 22(1): 212, 2022 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-35933449

RESUMO

BACKGROUND: Complementary Medicine (CM) is widely used internationally but there is limited understanding of the forms of knowledge CM practitioners use in their clinical practice and how they use this knowledge in interactions with patients. This review aims to synthesise the existing evidence on the forms of knowledge that are mobilised, and the role of this knowledge in the interactions between practitioners and patients during CM consultations. It considered a diverse range of CM practice areas to develop a classification of CM practitioners' knowledge use in consultations. METHODS: Systematic searches of health and sociology databases were conducted using core concepts, including complementary and alternative medicine, practitioners, and knowledge. Articles were included where they reported on data from recorded CM practitioner and patient consultations and offered insights into the types and applications of knowledge used in these consultations. 16 unique studies were included in the review. Data were extracted, coded and analysed thematically. RESULTS: Results demonstrate that diverse sources of knowledge were mobilised by practitioners, predominantly derived from the patients themselves -their bodies and their narratives. This reflected principles of patient-centredness. The use of discipline specific forms of knowledge and references to biomedical sources illustrated ongoing efforts towards legitimacy for CM practice. CONCLUSION: CM practitioners are navigating tensions between what some might see as competing, others as complementary, forms of knowledge. The classification system provides a useful tool for promoting critically reflective practice by CM practitioners, particularly in relation to self-assessment of knowledge translation and patient interactions.


Assuntos
Terapias Complementares , Pessoal de Saúde , Humanos , Estudos Longitudinais , Encaminhamento e Consulta
5.
Res Involv Engagem ; 8(1): 27, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725640

RESUMO

BACKGROUND: Scoping reviews of health research are increasing in popularity. However, only a minority of scoping reviews in this sector engage patients and caregivers as co-producers of the research. Despite developments in scoping review methodology, which insist that stakeholder consultation is essential, no guiding methods exist to instruct the conduct of this stage. Thus, it is necessary to understand how patients and caregivers have been engaged as part of scoping reviews, toward a unifying methodology. METHODS: We have developed a protocol for a scoping review of methods used to engage patients and caregivers in scoping reviews of health research. The search strategy will comprise two phases: the first will involve a secondary analysis of retrieved articles from a prior scoping review, and the second will identify articles that cite Levac et al.'s update to the original scoping review framework by Arksey and O'Malley. Titles and full texts of retrieved articles will be screened in duplicate. Inclusion will be limited to articles related to heath research that follow the six-stage scoping review framework by Arksey and O'Malley and that report patient engagement activities during at least one stage. The method of analysis of charted variables will be decided once data have been collected. Two patients will be engaged as collaborators throughout this review. We will also consult with patients, caregivers, and researchers upon completion of preliminary analyses. DISCUSSION: We anticipate that our scoping review will provide guidance for researchers seeking to involve health care stakeholders as co-producers of scoping reviews.


A "scoping review" is a type of study that collects and summarizes published and unpublished research reports to better understand the amount and types of information available on a particular topic. There is a well-known framework for how to conduct a scoping review, which involves six stages. The sixth stage is optional, and involves consulting with people who have an interest in the research results (i.e., people who the research is "about" or who it will affect the most). Very few scoping reviews actually include this stage, potentially due to a lack of practical guidance on how to perform it. For scoping reviews related to health research, it is important to consult or more widely engage patients and caregivers in the scoping review's conduct because these individuals have a unique type of knowledge that comes from their experience of a health issue, which can yield valuable insights. Therefore, we have designed a scoping review that will identify the ways in which patients and caregivers have been engaged in scoping reviews of health research in the past. We hope to produce recommendations to make it easier for other researchers to engage patients and caregivers in scoping reviews.

6.
J Med Internet Res ; 24(2): e23354, 2022 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-35142620

RESUMO

BACKGROUND: The internet has now become part of human life and is constantly changing people's way of life. With the increasing popularity of online health information (OHI), it has been found that OHI can affect the physician-patient relationship by influencing patient behaviors. OBJECTIVE: This study aims to systematically investigate the impact of OHI-seeking behavior on the physician-patient relationship. METHODS: Literature retrieval was conducted on 4 databases (Web of Science, PubMed, China National Knowledge Infrastructure, SinoMed), and the time limit for literature publication was before August 1, 2021. RESULTS: We selected 53 target papers (42 [79%] English papers and 11 [21%] Chinese papers) that met the inclusion criteria. Of these, 31 (58%) papers believe that patients' OHI behavior can enable them to participate in their own medical care, improve patient compliance, and improve the physician-patient relationship. In addition, 14 (26%) papers maintain a neutral attitude, some believing that OHI behavior has no significant effect on doctors and patients and others believing that due to changes in the factors affecting OHI behavior, they will have a negative or a positive impact. Furthermore, 8 (15%) papers believe that OHI search behavior has a negative impact on doctors and patients, while 6 (11%) papers show that OHI reduces Chinese patients' trust in doctors. CONCLUSIONS: Our main findings showed that (1) OHI-seeking behavior has an impact on patients' psychology, behavior, and evaluation of doctors; (2) whether patients choose to discuss OHI with doctors has different effects on the physician-patient relationship; and (3) the negative impact of OHI on China's internet users is worthy of attention. Due to the low quality of OHI, poor health information literacy, short physician-patient communication time, and various types of negative news, patients' trust in doctors has declined, thus affecting the physician-patient relationship. Improvement of people's health information literacy and the quality of OHI are important factors that promote the positive impact of OHI on the physician-patient relationship.


Assuntos
Comportamento de Busca de Informação , Médicos , Humanos , Internet , Relações Médico-Paciente , Inquéritos e Questionários , Confiança
7.
BMC Med Inform Decis Mak ; 21(1): 346, 2021 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-34903230

RESUMO

BACKGROUND: Online doctor-patient consultation is a new option for orthopedic patients in China to obtain a diagnosis and treatment advice. This study explores the factors associated with online consultation to formulate operational guidelines for managing online consultations in an online medical community (OMC). METHODS: An empirical model was developed to identify the factors that influence online orthopedic doctor-patient consultations in an OMC while focusing on the perceived value of and perceived trust in online consultations. The moderating effects of different risk categories of orthopedic diseases were also considered. Data from 339 feedback surveys from orthopedic patients who used online consultation services and Stata software version 14.0 were used to estimate the model parameters and test the robustness of the empirical model. RESULTS: Of those who completed the feedback surveys, 53.42% were female patients, 82.27% were between 18 and 60 years old, and 61.98% sought consultations online more than 2 times per year. Model analysis demonstrated that the regression coefficients of the perceived value of and perceived trust in online consultations are 0.489 (p < 0.01) and 0.505 (p < 0.01), respectively. The interaction coefficient between disease risk and perceived value is 0.336 (p < 0.01), and the interaction coefficient between disease risk and perceived trust is - 0.389 (p < 0.01). CONCLUSIONS: Orthopedic patients' perceived value of and perceived trust in online consultations in an OMC can significantly influence their intention to seek online disease diagnosis and treatment consultations. The effects of perceived value and perceived trust on patients' intention to consult vary significantly across different disease risk categories. Therefore, enhancing the perceived value and perceived trust of orthopedic patients is an important component of OMC operation and management.


Assuntos
Relações Médico-Paciente , Confiança , Adolescente , Adulto , Feminino , Humanos , Intenção , Pessoa de Meia-Idade , Encaminhamento e Consulta , Inquéritos e Questionários , Adulto Jovem
8.
Br J Nurs ; 30(21): 1232-1236, 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34839692

RESUMO

Advanced clinical practitioner (ACP) roles require a broad range of knowledge of both medical and surgical areas and the ability to work autonomously in a variety of settings. Despite around half of the UK adult population presenting with a skin condition requiring attention at some point, this is an area many ACPs feel unprepared to manage. However, due to the complexity and large number of potential diagnoses, it is imperative that ACPs develop their knowledge of skin conditions so that they can confidently conduct consultations with patients. This clinical review presents the key elements of patient consultation, history taking and assessment of the skin. This is designed to support novice ACPs, whether working in acute hospital settings or primary care, to develop an understanding of the key points that should be included when consulting with and assessing the skin of patients outwith the dermatology setting.


Assuntos
Profissionais de Enfermagem , Dermatopatias , Adulto , Humanos , Atenção Primária à Saúde , Encaminhamento e Consulta , Dermatopatias/diagnóstico , Dermatopatias/terapia
9.
J Med Internet Res ; 23(6): e25367, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34081008

RESUMO

BACKGROUND: With the rapid development of information technology and web-based communities, a growing number of patients choose to consult physicians in online health communities (OHCs) for information and treatment. Although extant research has primarily discussed factors that influence the consulting choices of OHC patients, there is still a lack of research on the effects of log-in behaviors and web reviews on patient consultation. OBJECTIVE: This study aims to explore the impact of physicians' log-in behavior and web reviews on patient consultation. METHODS: We conducted a longitudinal study to examine the effects of physicians' log-in behaviors and web reviews on patient consultation by analyzing short-panel data from 911 physicians over five periods in a Chinese OHC. RESULTS: The results showed that the physician's log-in behavior had a positive effect on patient consultation. The maximum number of days with no log-ins for a physician should be 20. The two web signals (log-in behavior and web reviews) had no complementary relationship. Moreover, the offline signal (ie, offline status) has different moderating effects on the two web signals, positively moderating the relationship between web reviews and patient consultation. CONCLUSIONS: Our study contributes to the eHealth literature and advances the understanding of physicians' web-based behaviors. This study also provides practical implications, showing that physicians' log-in behavior alone can affect patient consultation rather than complementing web reviews.


Assuntos
Médicos , Telemedicina , Humanos , Tecnologia da Informação , Internet , Estudos Longitudinais , Encaminhamento e Consulta
10.
Am J Clin Pathol ; 155(6): 887-894, 2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-33367493

RESUMO

OBJECTIVES: The aim of this multisite quality improvement study was to evaluate patients' experiences with the patient-centered pathology (PCP) consultation program and to determine whether PCP enhanced their care experience. METHODS: Patients were invited to attend PCP consultations to review their pathology report and slides and have their questions answered by the pathologist privately, with the option to attend the appointment with family members or friends for support. A patient experience questionnaire (PEQ) was administered to patients, who participated voluntarily in the PCP, and survey data were collected and stored in REDCap. Statistical analysis was performed using SAS 9.4 (SAS Institute). RESULTS: Sixty-seven patients (95.5% female) aged 18 to 84 years across 4 institutions completed the PEQ. Overall, 58% and 15.8% of patients had breast and brain tumors, respectively, and 59.7% of tumors were newly diagnosed. Most patients thought it was important for them to learn as much as they could about their health condition. However, the majority of patients reported some degree of difficulty learning about their health condition based on written information, despite 97% having completed high school and/or further education. The majority of patients rated their pathologist as "excellent" across communication metrics. Ultimately, 100% of respondents were satisfied, found their visits to be useful, and would recommend the PCP to other patients. CONCLUSIONS: Patients found that personalized clinical encounters with pathologists improved their understanding of their health condition and their satisfaction with their care experience. Patients thought pathologists communicated respectfully, effectively, and empathetically.


Assuntos
Neoplasias/terapia , Satisfação do Paciente , Melhoria de Qualidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Patologistas , Encaminhamento e Consulta , Inquéritos e Questionários , Adulto Jovem
11.
Patient Educ Couns ; 103(10): 2069-2077, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32471798

RESUMO

OBJECTIVE: Gaining insight into contextual factors and mechanisms supporting or hindering autonomy supportive consultation and into outcomes of such consultations. METHODS: We conducted a systematic review using the realist synthesis procedure according to RAMESES guideline. A search was performed in PubMed, Embase, PsycINFO and Cinahl from inception to March 2019 using the search terms: 'autonomy' AND 'support' AND 'consultation' OR 'communication' AND 'intervention'. The review process including paper selection, quality assessment, full text reading for data-extraction was conducted by two researchers independently. RESULTS: Of 2792 articles, 18 met our inclusion criteria. Contextual factors influencing an autonomy supportive consultation were: work organization and the attitude of professionals. An overarching supporting mechanism for AS was relationship building. In addition, each phase of the decision-making process seems to need supporting mechanisms fulfilling patients 'specific psychological needs in that phase. The outcome of AS is higher levels of patient well-being. CONCLUSION: Autonomy supportive consultation works under various contexts coupled with mechanisms that give rise to favourable-outcomes, of which relationship building, taking time and exploring patients' needs seem the most important. PRACTICE IMPLICATIONS: The results of our review facilitate professionals to reflect on their autonomy supportive consultation skills, which could improve their autonomy supportive behaviour.


Assuntos
Comunicação , Autonomia Pessoal , Encaminhamento e Consulta , Humanos
12.
Clin Sarcoma Res ; 10: 2, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31969978

RESUMO

BACKGROUND: To report on our experience using a simple optional form to facilitate communication on late effects between the patients and the oncologists during outpatient follow-up and to detail on the spectrum of challenges reported by sarcoma survivors. METHODS: The form was presented for the patients to complete before their consultation and covered topics related to late effects and unmet needs that the patient wished to discuss with the medical personnel. Logistic regression analysis examined how the distribution of the topics varied with age, gender, diagnosis and type of treatment received. RESULTS: The form was manageable in a busy outpatient clinic. Of the 265 patients that received the form, 236 (89%) returned it. Patients in a palliative setting and those with other diagnosis than bone sarcoma (BS) and soft-tissue sarcoma (STS) were excluded for subsequent analyses. The final study-cohort comprised 160 patients, 54 (34%) with BS and 106 (66%) with STS. Among these, 140 (88%) had late-effect topics they wanted to discuss with their oncologist. Fatigue was raised by 39% of the patients, pain by 29% and impaired mobility by 23%. BS patients raised fatigue more often (P < 0.005) than those with STS. Patients who had undergone multimodal treatment with chemotherapy raised fatigue more frequently (P < 0.001) than those who had only undergone surgery, radiotherapy or both. CONCLUSIONS: A simple form on the long-term consequences of sarcoma treatment achieved a high response rate, was feasible to use in an outpatient clinic and facilitated communication on these issues. Fatigue was the most frequent topic raised and it was raised significantly more often in patients who had undergone chemotherapy.

13.
J Taibah Univ Med Sci ; 14(1): 67-72, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31435392

RESUMO

OBJECTIVES: This study aimed to evaluate the satisfaction level of inquirers of an internet-based drug information centre along with the internet usage abilities and habits of individuals who had previously utilised services from an internet-based drug information centre in Turkey. METHODS: The first 100 individuals who received medication consultancy from the webpage entitled "www.ilacpedia.com" and consented to participate in the study were included in this study. This website is an internet-based drug information centre. Participants' data were collected using a participant data form and the Internet Self-efficacy Scale. RESULTS: The mean age of participants was 37.92 ± 12.32 years (71 female). It was found that 89% of the individuals who received pharmaceutical consultation from the internet-based drug information service believed that the information that they received was enough to solve their problem. The internet self-efficacy scale scores indicated the highest score on the decomposition subscale (20.94 ± 6.18) and the lowest on the communication subscale (9.77 ± 3.57). CONCLUSIONS: The present study revealed that the internet-based drug information service provided by clinical pharmacists contributed positively to users' satisfaction, thus indicating the importance of the involvement of clinical pharmacists in this process.

14.
Patient Educ Couns ; 101(10): 1795-1803, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29891103

RESUMO

OBJECTIVE: To assess European patients' preferences regarding seven aspects of doctor-patient communication. METHODS: 6049 patients from 31 European countries evaluated 21 doctor and 12 patient behaviours, through a patient-generated questionnaire (PCVq). Multilevel models explored the effects of patient characteristics, contextual and cultural dimensions on preferences. RESULTS: Patients attributed more responsibility to doctors, by giving greater importance to doctor than to patient factors, in particular to Treating the patient as a partner and as a person and Continuity of care. Gender, age, education, the presence of chronic illness and two of Hofstede's cultural dimensions, Individualism and Indulgence, showed differential evaluations among patients. Women gave greater importance to all seven communication aspects, older patients to being prepared for the consultation, lower educated patients to Treating patient as a person and Thoughtful planning. Patients from countries with an indulgent background rated all seven communication aspects of greater importance. A more individualistic orientation was related to lower importance regarding the four doctor's factors and the patient factor Open and Honest. CONCLUSIONS: Treating the patient as a person and providing continuity of care emerged as universal values. PRACTICE IMPLICATIONS: The findings should represent a landmark for the adaptation of patient-generated communication guidelines and programs in Europe.


Assuntos
Atitude do Pessoal de Saúde , Comunicação , Preferência do Paciente , Satisfação do Paciente/estatística & dados numéricos , Relações Médico-Paciente , Médicos/psicologia , Encaminhamento e Consulta , Adolescente , Adulto , Idoso , Atitude Frente a Saúde , Características Culturais , Europa (Continente) , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Patient Educ Couns ; 101(9): 1538-1548, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29598964

RESUMO

OBJECTIVE: To identify patient feedback questionnaires that assess the development of consultation skills (CSs) of practitioners. METHODS: We conducted a systematic search using seven databases from inception to January 2017 to identify self-completed patient feedback questionnaires assessing and enhancing the development of CSs of individual practitioners. Results were checked for eligibility by three authors, and disagreements were resolved by discussion. Reference lists of relevant studies and Open Grey were searched for additional studies. RESULTS: Of 16,312 studies retrieved, sixteen were included, describing twelve patient feedback questionnaires that were mostly designed for physicians in primary care settings. Most questionnaires had limited data regarding their psychometric properties, except for the Doctor Interpersonal Skills Questionnaire (DISQ). Most studies conducted follow-up, capturing positive views of practitioners regarding the process (n = 14). Feedback was repeated by only three studies, demonstrating different levels of improvement in practitioners' performance. CONCLUSION: Identified questionnaires were mainly focused on physicians, however, to support using patient feedback, questionnaires need to be validated with other practitioners. PRACTICE IMPLICATIONS: Several patient feedback questionnaires are available, showing potential for supporting practitioners' development. Valid questionnaires should be used with appropriate practitioners in developing more evidence for the impact they may have on actual consultations.


Assuntos
Comunicação , Retroalimentação , Avaliação de Resultados da Assistência ao Paciente , Relações Médico-Paciente , Médicos/psicologia , Encaminhamento e Consulta , Inquéritos e Questionários , Humanos , Atenção Primária à Saúde , Psicometria
16.
Patient Educ Couns ; 99(3): 462-469, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26554701

RESUMO

OBJECTIVES: To explore micro-cultural differences in patients' need for information provision, perceived participation in decision making, and related concepts during the doctor-patient consultation between French- and Italian-speaking patients in Switzerland. METHODS: In 2012, 153 French- and 120 Italian-speaking patients with chronic low back pain (cLBP) were surveyed on their need for information provision, perceived participation in decision making, cLBP knowledge, psychological empowerment, and trust in their doctor. T-tests and regression analyses with interaction terms were performed. RESULTS: Results show that French- and Italian-speaking patients significantly differed in their participation in decision making, with French-speaking patients reporting higher involvement. Need for information provision was related to empowerment among French- and to trust among Italian-speaking patients. For participation in decision making, trust was the only related concept among French-, and cLBP knowledge among Italian-speaking patients. Significant interaction terms indicate a moderation of micro-cultural background. CONCLUSION: Findings point towards differences in the relationships between individual patient characteristics (i.e. knowledge, empowerment) and relational doctor-patient characteristics (i.e. trust) and patients' need for information provision and participation in decision making between French- and Italian-speaking patients in Switzerland. PRACTICE IMPLICATIONS: Doctors should be aware of these differences when dealing with patients of different micro-cultural backgrounds.


Assuntos
Cultura , Tomada de Decisões , Conhecimentos, Atitudes e Prática em Saúde , Idioma , Participação do Paciente/psicologia , Relações Médico-Paciente , Confiança , Feminino , Humanos , Dor Lombar , Masculino , Percepção , Poder Psicológico , Inquéritos e Questionários , Suíça
17.
Patient Educ Couns ; 2015 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-26104993

RESUMO

OBJECTIVES: This review examines the use and effectiveness of Question Prompt Lists (QPL) as communication aids to enhance patient question asking, information provision to patients and patient participation in health and medical consultations. METHODS: A systematic search was undertaken to identify relevant literature concerning QPLs including academic databases, Google-based and snowball searching. Forty-two relevant studies reporting 50 interventions were identified. RESULTS: Although findings varied there was some evidence that a QPL endorsed by the physician increased total question asking. Using a QPL increased question asking concerning specific content areas (e.g. prognosis). There was some evidence that physicians provided more information during consultations. There were no consistent findings concerning effects on patient knowledge recall, anxiety and satisfaction or consultation time. Some interventions that increased question asking had longer consultation times. CONCLUSION: There is evidence that an appropriate QPL, endorsed by the physician and provided immediately before the consultation, may increase patient question asking and lead to more information being provided by the physician. PRACTICE IMPLICATIONS: There is increasing evidence to support QPL use in routine practice. Further trials might address the issues identified including an assessment of QPL optimal length and QPL adaptation for cultural and special needs groups.

18.
Int J Technol Assess Health Care ; 31(3): 166-70, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26062904

RESUMO

OBJECTIVES: We sought to evaluate patient involvement (consultation and direct participation) in the assessment of alternative measures to restraint and seclusion among adults in short-term hospital wards (in psychiatry) and long-term care facilities for the elderly. METHODS: We conducted individual semi-structured interviews with thirteen stakeholders: caregivers, healthcare managers, patient representatives, health technology assessment (HTA) unit members, researchers, and members of the local HTA scientific committee. Data were collected until saturation. We carried out content analysis of two HTA reports and four other documents that were produced in relation with this HTA. We also used field notes taken during formal meetings and informal discussions with stakeholders. We performed thematic analysis based on a framework for assessing patient involvement in HTA. We then triangulated data. RESULTS: For the majority of interviewees, patient consultation enriched the content of the HTA report and its recommendations. This also made it possible to suggest other alternatives that could reduce the use of restraint and seclusion and helped confirm some views and comments from healthcare professionals consulted in this HTA. The direct participation of patient representatives enabled rephrasing of some findings so as to bring the patient perspective to the HTA report. CONCLUSIONS: Patient consultation was seen as having directly influenced the content of the HTA report while direct participation made it possible to rephrase some findings. This is one of few studies to assess the impact of patient involvement in HTA and more such studies are needed to identify the best ways to improve the input of such involvement.


Assuntos
Participação do Paciente/métodos , Avaliação da Tecnologia Biomédica/métodos , Humanos , Entrevistas como Assunto
19.
Chinese Journal of Urology ; (12): 881-885, 2015.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-491369

RESUMO

Objective To discuss the applications of 3D-printing technology in percutaneous nephrolithotomy (PCNL) and its function in preoperative consultation.Methods Fifteen patients of renal calculus in Tongji Hospital from April to June 2015 were selected in the present study.The preoperative CT scan of renal was processed by three-dimensional radiological software,the renal tissue and perirenal fat were deleted but the 12th rib was left with the renal calculi by the software,and the final models were made by photosensitive resin.Virtual operation based on the 3D-printed model of renal calculi and preoperative data were made preoperatively and compared with actual operation.The efficacy of the models in preoperative planning was evaluated.Operators were asked to fill the questionnaire after operation in order to investigate the efficacy of the renal calculi printed by 3D-printing technology in PCNL.By using the models in consultation before operation,the patients and their family members were asked to fill questionnaires and the efficacy of the models in doctor-patient communication was also evaluated.Results The 15 3D-printed models of renal calculi were set up well and all the operations were successful.The models clearly reflected the size and shape of the renal calculi and the position of the renal calculi and the 12th rib.The virtual puncture point and the renal calyx of puncture were basically corresponded to the actual operation,the puncture depth of virtual operations was (5.7 ± 0.6) cm,while the puncture depth of actual operations was (6.2 ± 0.7) cm,and there was no significant difference (P =2.04).The average evaluation score of the models given by operators was 7.5 ± 0.5,and the average score of the doctor-patient conversation before operation given by the patients or their family members was 8.7 ± 0.8.Conclusions The renal calculi models printed by 3D-printing technology can clearly reflect the size and shape of renal calculi,and the models also play a very important role in preoperative planning and operative process.Meanwhile,the models could be useful in the doctor-patient consultation.

20.
Geburtshilfe Frauenheilkd ; 74(2): 152-156, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24741126

RESUMO

Introduction: Modern tablet PCs as the iPad are becoming more and more integrated into medicine. The aim of this study was to evaluate the display quality of iPads regarding digital mammography. Materials and Methods: Three experienced readers compared the display quality of the iPad 2 and 3 with a dedicated 10 megapixel (MP) mammography liquid crystal display (LCD) screen in consensus using the standardized Contrast Detail Mammography (CDMAM) phantom. Phantom fields without agreement between the readers were classified as "uncertain", correct 2 : 1 decisions were classified as "uncertain/readable". In a second step display quality of the three reading devices was judged subjectively in a side by side comparison. Results: The 10 MP screen was superior to both iPads in 4 (phantom-)fields and inferior in 2 fields. Comparing the iPads, version 3 was superior in 4 fields and version 2 was superior in 1 field. However these differences were not significant. Total number of "uncertain" fields did not show significant differences. The number of "uncertain" fields was 15 with the 10 MP screen, 16 with the iPad 2 and 17 with the iPad 3 (p > 0.05), the number of "uncertain/readable" fields was 4, 7 and 8, respectively. Subjective image quality of the iPad 3 and the 10 MP screen was rated superior to the iPad 2. Conclusion: The evaluated iPads, especially in version 3, seem to be adequate to display mammograms in a diagnostic quality and thus could be useful e.g. for patient consultation, clinical demonstration or educational and teaching purposes. However primary mammogram reading should still be performed on dedicated large sized reading screens.

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