Patient-centered professionalism

Introduction: Although the concept of patient-centered professionalism has been defined in the literature and adopted to some extent by key health care regulatory bodies, there has been little research that has identified what the concept means to professionals and patients. Aim: The purpose of this paper is to identify the key concepts of patient-centered professionalism as identified in the literature and to discuss these within the context of existing research across a variety of health care settings. Findings: Key documents have been identified from within nursing, medicine, and pharmacy, which outline what is expected of professionals within these professional groups according to their working practices. Although not defined as patient-centered professionalism, the principles outlined in these documents mirror the definitions of patient-centered professional care defined by Irvine and the Picker Institute and are remarkably similar across the three professions. While patients are identified as being at the heart of health care and professional working practice, research within the fields of community nursing and community pharmacy suggests that patient and professional views diverge as regards what is important, according to different group agendas. In addition, the delivery of patient-centered professional care is often difficult to achieve, due to numerous challenges to the provision of patient-centric care. Conclusion: According to the literature, patient-centered professionalism means putting the patient at the heart of care delivery and working in partnership with the patient to ensure patients are well informed and their care choices are respected. However, limited research has examined what the concept means to patients and health care professionals working with patients and how this fits with literature definitions. Further work is needed to identify aspects of the concept as regards the importance placed on patient-centered professionalism and a mechanism is required for dissemination and integration of the findings to key monitoring and regulatory bodies. Major aspects of the concept, once identified within the various health care arenas, should be incorporated into heath care professional curricula and continued professional development.11 page(s

The experiences of patients and carers in the daily management of care at the end of life

Background Home is the preferred location for most people with an advanced disease and at the end of life. A variety of care professionals work in community settings to provide support to this population. Patients and their spouses, who also care for them (spouse-carers), are rarely accompanied by these sources of support at all times, and have to manage independently between their contact with care professionals. Aim To explore how patients and spouse-carers manage their involvement with care professionals in the community setting. Method Interpretive phenomenology informs the design of the research, whereby 16 interviews were conducted with the patients and spouse-carers. Interviews were recorded and transcribed verbatim. Data were analysed using phenomenological techniques including template analysis. Findings Patients and spouse-carers were interdependent and both parties played a role in co-ordinating care and managing relationships with professional care providers. The patients and spouse-carers actively made choices about how to manage their situation, and develop and modify managing strategies based on their experiences. Conclusions When daily management is effective and care professionals acknowledge the dyadic nature of the patient and spouse-carer relationship, people have confidence in living with advanced disease

The synthesis of potential antimalarials. Derivatives of pantoyltaurine

The general hypothesis as to the mode of action of chemotherapeutic agents, which has been formulated by Fildes, Woods, McIlwain, and others (2), offers a rational and useful guide to the design of new drugs. Thus, bacteriostasis is pictured as caused by the blocking of reactions essential to growth by an inhibiting substance which has a structure similar to that of one of the normal enzymes or metabolites essential to the growth of the organism

Qualitative research within trials: developing a standard operating procedure for a clinical trials unit

<p>BACKGROUND: Qualitative research methods are increasingly used within clinical trials to address broader research questions than can be addressed by quantitative methods alone. These methods enable health professionals, service users, and other stakeholders to contribute their views and experiences to evaluation of healthcare treatments, interventions, or policies, and influence the design of trials. Qualitative data often contribute information that is better able to reform policy or influence design.</p> <p>METHODS: Health services researchers, including trialists, clinicians, and qualitative researchers, worked collaboratively to develop a comprehensive portfolio of standard operating procedures (SOPs) for the West Wales Organisation for Rigorous Trials in Health (WWORTH), a clinical trials unit (CTU) at Swansea University, which has recently achieved registration with the UK Clinical Research Collaboration (UKCRC). Although the UKCRC requires a total of 25 SOPs from registered CTUs, WWORTH chose to add an additional qualitative-methods SOP (QM-SOP).</p> <p>RESULTS: The qualitative methods SOP (QM-SOP) defines good practice in designing and implementing qualitative components of trials, while allowing flexibility of approach and method. Its basic principles are that: qualitative researchers should be contributors from the start of trials with qualitative potential; the qualitative component should have clear aims; and the main study publication should report on the qualitative component.</p> <p>CONCLUSIONS: We recommend that CTUs consider developing a QM-SOP to enhance the conduct of quantitative trials by adding qualitative data and analysis. We judge that this improves the value of quantitative trials, and contributes to the future development of multi-method trials.</p&gt

Gender Specific Disruptions in Emotion Processing in Younger Adults with Depression

Background: One of the principal theories regarding the biological basis of major depressive disorder (MDD) implicates a dysregulation of emotion-processing circuitry. Gender differences in how emotions are processed and relative experience with emotion processing might help to explain some of the disparities in the prevalence of MDD between women and men. This study sought to explore how gender and depression status relate to emotion processing. Methods: This study employed a 2 (MDD status) × 2 (gender) factorial design to explore differences in classifications of posed facial emotional expressions (N=151). Results: For errors, there was an interaction between gender and depression status. Women with MDD made more errors than did nondepressed women and men with MDD, particularly for fearful and sad stimuli (Ps Ps P=.01). Men with MDD, conversely, performed similarly to control men (P=.61). Conclusions: These results provide novel and intriguing evidence that depression in younger adults (years) differentially disrupts emotion processing in women as compared to men. This interaction could be driven by neurobiological and social learning mechanisms, or interactions between them, and may underlie differences in the prevalence of depression in women and men. Depression and Anxiety, 2009. Published 2008 Wiley-Liss, Inc

Wider consultation on Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease

In this article we examine whether an innovative mixed method approach could highlight the positive and challenging effects of a Pulmonary Rehabilitation Programme (PRP) on the Quality of Life (QOL) of patients with Chronic Obstructive Pulmonary Disease (COPD). In 2012, we conducted three consultation workshops in Mid-West Wales, UK, with COPD patients that participated in a PRP, their significant others (e.g. spouses and partners), and healthcare professionals who delivered the PRP. We found that there was a resounding enthusiasm for the content and impact of the programme, particularly in the areas of: increased patient activity, enhanced patient control and confidence, a greater willingness to self-manage treatment, and an increased sense of group belonging. Seven key themes mattered most to our study participants: the patient, physical health, mental health, the programme, professionals and significant others, knowledge and education, and the future. We used these themes to craft a best-practice outcomes document (template) of the benefits and challenges of the PRP to inform and support future service evaluation and delivery.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs150179En este artículo examinamos si un innovador enfoque de método mixto podría poner de relieve los efectos positivos y desafiantes de un Programa de Rehabilitación Pulmonar (PRP) en la calidad de vida (CDV) de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC). En 2012, realizamos tres talleres de consulta en el centro-oeste de Gales, Reino Unido, con pacientes con EPOC que participaron en un PRP, con personas importantes para ellos (por ejemplo, cónyuges y parejas), y profesionales de la salud que atienden el PRP. Encontramos que había un entusiasmo muy fuerte por el contenido e impacto del programa, en particular en las áreas de: aumento de la actividad del paciente, mayor control y confianza del paciente, una mayor disposición a autogestionar el tratamiento , y un mayor sentido de pertenencia al grupo. Siete temas importaron más a nuestros participantes del estudio: el paciente, la salud física, la salud mental, el programa, los profesionales y otras personas importantes, conocimientos y educación, y el futuro. Utilizamos estos temas para elaborar una plantilla de las mejores prácticas de los beneficios y desafíos de la PRP, para informar y apoyar la futura evaluación y provisión del servicio.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs150179In diesem Beitrag beschäftigen wir uns mit einem innovativen Mixed-Methods-Ansatz zur Bewertung der positiven und problematischen Effekte eines Rehabilitationsprogramms, das eine verbesserte Lebensqualität von Patient/innen mit chronisch obstruktiver Lungenerkrankung zum Ziel hatte. Hierzu führten wir 2012 drei Konsultationsworkshops in West-Wales durch mit Patient/innen, die an einem solchen Programm teilgenommen hatten, deren Angehörigen und mit Professionellen, die in dem Programm tätig gewesen waren. Die Resonanz war vergleichsweise enthusiastisch, sowohl was Inhalte und was den Impact des Programms angeht, und zwar vor allem mit Blick auf eine vermehrte Aktivität der Patient/innen, auf deren Kontrollgefühl, Zuversicht und Bereitschaft einer verbesserten Selbstfürsorge sowie ein erhöhtes Zusammengehörigkeitsgefühl. Sieben Schlüsselthemen konnten als besonders relevant für die Untersuchungsteilnehmer/innen herausgearbeitet werden: die Patient/innen, physische Gesundheit, psychische Gesundheit, das Programm, Professionale und Angehörige, Wissen und Bildung sowie die Zukunft. Ausgehend hiervon entwickelten wir einen Best-Practice-Vorschlag für die Konzeption und Durchführung von Folgeprogrammen und -Dienstleistungen.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs15017