Health Care Professionals Face Research Articles

Evaluation of a Multidisciplinary Professional Development Activity to Enhance Communication Skills Based on Calgary Cambridge Model

Communication skills are essential for all categories of health care workers. The Calgary Cambridge Model of communication is accepted as a doctor patient communication model in Europe and Canada. It has world-wide recognition and is now used as a model for teaching communication in disciplines like nursing and veterinary science. Since the value of an interdisciplinary approach in continuous professional development has been recognised and all categories of health care professionals face similar challenges with regards to communication with patients an educational activity was developed to facilitate the learning of communication skills as a multidisciplinary team. Feedback on this program was accessed by means of observations, questionnaire and focus group discussions. Results revealed that there was positive feedback on this approach as a means of communications skills training.

Zoonotic Diseases—Fostering Awareness in Critical Audiences

Zoonotic diseases are infectious diseases that are shared between humans and other vertebrate animals. Extension professionals often serve as consultants and educators to individuals at high risk of zoonotic diseases, such as participants in 4-H livestock projects. Effective education about zoonotic diseases begins with an awareness of the multitude of challenges that health care professionals face in diagnosing zoonotic disease. This review describes the factors that influence diagnosis of these diseases, as well as potential methods that the Extension professional can use to convert those challenges into effective educational messages.

Using children as informal interpreters in pediatric consultations

Purpose– Health care professionals (HCPs) face numerous barriers in providing services to limited English proficient (LEP) patients and their families. The purpose of this paper is to explore and expand on the limited scholarship concerning HCPs’ experiences using children as informal interpreters in pediatric consultations.Design/methodology/approach– Ten HCPs from five different fields participated in this study. They were interviewed over the phone and replied to follow-up correspondence about their knowledge on policies for communicating with LEP patients and/or their families when providing medical care.Findings– Using a thematic analysis five themes emerged across all cases: cultural awareness, communication quality, live interpreters as a solution, use of child language brokers (CLBs), and the norm of child language brokering. Through the development of the aforementioned themes, HCPs’ limited awareness of implications when using CLBs and of the established policies related to this phenomenon were apparent.Originality/value– This lack of knowledge, acknowledged by HCPs, provides a platform from which to create awareness of the need for further education about the potential risks CLBs face when interpreting medical information and of the negative impact this process can have on the overall medical outcome of a patient. Furthermore, it allows the authors to address the ignorance within the health care system that has allowed vulnerabilities to LEP individuals being treated in health care facilities.

Current and emerging Legionella diagnostics for laboratory and outbreak investigations.

Legionnaires' disease (LD) is an often severe and potentially fatal form of bacterial pneumonia caused by an extensive list of Legionella species. These ubiquitous freshwater and soil inhabitants cause human respiratory disease when amplified in man-made water or cooling systems and their aerosols expose a susceptible population. Treatment of sporadic cases and rapid control of LD outbreaks benefit from swift diagnosis in concert with discriminatory bacterial typing for immediate epidemiological responses. Traditional culture and serology were instrumental in describing disease incidence early in its history; currently, diagnosis of LD relies almost solely on the urinary antigen test, which captures only the dominant species and serogroup, Legionella pneumophila serogroup 1 (Lp1). This has created a diagnostic "blind spot" for LD caused by non-Lp1 strains. This review focuses on historic, current, and emerging technologies that hold promise for increasing LD diagnostic efficiency and detection rates as part of a coherent testing regimen. The importance of cooperation between epidemiologists and laboratorians for a rapid outbreak response is also illustrated in field investigations conducted by the CDC with state and local authorities. Finally, challenges facing health care professionals, building managers, and the public health community in combating LD are highlighted, and potential solutions are discussed.

Seven Guiding Commitments: Making the U.S. Healthcare System More Compassionate.

Despite the current focus on patient centeredness, healthcare professionals face numerous challenges that impede their ability to provide compassionate care that ameliorates concerns, distress, or suffering. These include fragmentation and discontinuity of care, technologies that both help and hinder communication and relationship-building, burgeoning operational and administrative requirements, inadequate communication skills training, alarming rates of burnout, and increased cost and market pressures. A compassionate healthcare system begins with compassionate people, but the organizations in which they train and work must reliably enable them to express and act on their compassion rather than impede it. We present a set of guiding commitments and recommendations to foster a more compassionate healthcare system. We urge healthcare organizations to adopt these commitments and take action to embed compassionate care in all aspects of training, research, patient care and organizational life.

Will I stay or can I go? Assisted suicide in prison.

Assisted suicide (AS) is a controversial practice with which physicians and nurses are confronted more and more often. In Switzerland, it is available for Swiss residents and in certain cases for foreigners. Prisoners meet the same prerequisites for AS as the general population and should therefore be eligible for it. Ethical issues, such as informed choice and the autonomy of prisoners, and organizational questions need to be addressed. They must not lead to a denial of this practice. Even though prisons constitute a special area of work for medical staff, it is important to address the possibility of AS in prison openly. This can raise awareness of the difficulties health-care professionals face working in closed institutions.

Disclosing the Truth: A Dilemma between Instilling Hope and Respecting Patient Autonomy in Everyday Clinical Practice

While medical ethics place a high value on providing truthful information to patients, disclosure practices are far from being the norm in many countries. Transmitting bad news still remains a big problem that health care professionals face in their every day clinical practice. Through the review of relevant literature, an attempt to examine the trends in this issue worldwide will be made. Various electronic databases were searched by the authors and through systematic selection 51 scientific articles were identified that this literature review is based on. There are many parameters that lead to the concealment of truth. Factors related to doctors, patients and their close environment, still maintain a strong resistance against disclosure of diagnosis and prognosis in terminally ill patients, while cultural influences lead to different approaches in various countries. Withholding the truth is mainly based in the fear of causing despair to patients. However, fostering a spurious hope, hides the danger of its' total loss, while it can disturb patient-doctor relationship.

Disclosing the Truth: A Dilemma between Instilling Hope and Respecting Patient Autonomy in Everyday Clinical Practice

Background:While medical ethics place a high value on providing truthful information to patients, disclosure practices are far from being the norm in many countries. Transmitting bad news still remains a big problem that health care professionals face in their every day clinical practice.Aims:Through the review of relevant literature, an attempt to examine the trends in this issue worldwide will be made.Method:Various electronic databases were searched by the authors and through systematic selection 51 scientific articles were identified that this literature review is based on.Results:There are many parameters that lead to the concealment of truth. Factors related to doctors, patients and their close environment, still maintain a strong resistance against disclosure of diagnosis and prognosis in terminally ill patients, while cultural influences lead to different approaches in various countries. Withholding the truth is mainly based in the fear of causing despair to patients. However, fostering a spurious hope, hides the danger of its’ total loss, while it can disturb patient-doctor relationship.

Provider Experiences with Negative-Pressure Wound Therapy Systems

MedWatch, the Food and Drug Administration's (FDA's) nationwide adverse event reporting system, serves to monitor device performance after a medical device is approved or cleared for market. Through the MedWatch adverse event reporting system, the FDA receives Medical Device Reports of deaths and serious injuries with negative-pressure wound therapy (NPWT) systems, many of which are used in homes and in extended-care facilities. In response to reported events, this study was conducted to obtain additional information about device issues that healthcare professionals face in these settings, as well as challenges that caregivers might encounter using this technology at home. The study was exploratory and descriptive in nature. The FDA surveyed wound care specialists and professional home healthcare providers to learn about users' experiences with NPWT. In the first phase of the study, a semistructured questionnaire was developed for telephone interviews and self-administration. In the second phase, a web-based survey was adapted from the semistructured instrument. Respondent concerns primarily centered on issues not directly related to the NPWT devices: NPWT prescription, provider education in addition to patient training and appropriate wound management practices, notably ongoing wound assessment, and patient monitoring. Overall, respondents thought that there was a definite benefit to NPWT, regardless of the care setting, and that it was a safe therapy when prescribed and administered appropriately.

Queer Patients and the Health Care Professional—Regulatory Arrangements Matter

This paper discusses a number of critical ethical problems that arise in interactions between queer patients and health care professionals attending them. Using real-world examples, we discuss the very practical problems queer patients often face in the clinic. Health care professionals face conflicts in societies that criminalise same sex relationships. We also analyse the question of what ought to be done to confront health care professionals who propagate falsehoods about homosexuality in the public domain. These health care professionals are more often than not motivated by strong religious convictions that conflict with mainstream medical opinion on homosexuality. We argue that they ought to be held accountable for their conduct by their professional statutory bodies, given that they abuse their professional standing to propagate sectarian views not representative of their profession. Lastly, we propose that medical schools have special responsibilities in training future health care professionals that will enable them to respond professionally to queer patients seeking health care.

Anti-diabetic properties of flavonoid compounds isolated from Hyphaene thebaica epicarp on alloxan induced diabetic rats

Background:Diabetes mellitus, becoming the third killer of mankind after cancer and cardiovascular diseases, is one of the most challenging diseases facing health care professionals today. That is why; there has been a growing interest in the therapeutic use of natural products for diabetes, especially those derived from plants.Aim:To evaluate the anti-diabetic activity together with the accompanying biological effects of the fractions and the new natural compounds of Hyphaene thebaica (HT) epicarp.Materials and Methods:500 g of coarsely powdered of (HT) fruits epicarp were extracted by acetone. The acetone crude extract was fractionated with methanol and ethyl acetate leaving a residual water-soluble fraction WF. The anti-diabetic effects of the WF and one of its compounds of the acetone extract of the (HT) epicarp were investigated in this study using 40 adult male rats.Results:Phytochemical investigation of active WF revealed the presence of ten different flavonoids, among which two new natural compounds luteolin 7-O-[6”-O-α-Lrhamnopyranosyl]-β-D-galactopyranoside 3 and chrysoeriol 7-O-β-D-galactopyranosyl(1→2)-α-L-arabinofuranoside 5 were isolated. Supplementation of the WF improved glucose and insulin tolerance and significantly lowered blood glycosylated hemoglobin levels. On the other hand, compound 5 significantly reduced AST and ALT levels of liver, respectively. Likewise, the kidney functions were improved for both WF and compound 5, whereby both urea and creatinine levels in serum were highly significantConclusion:The results justify the use of WF and compound 5 of the (HT) epicarp as anti-diabetic agent, taking into consideration that the contents of WF were mainly flavonoids

P3-125 - Simultaneous Detection of Multicytotoxic Drugs on Occupational Environment by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Analysis

ABSTRACT Backgroud Cytotoxic drugs are widely used in cancer therapy, whereas healthcare professionals face with health hazards from these drugs. Despite the existence of safety standards for handling cytotoxic drugs, several studies in western countries have reported low-level contamination of these drugs on occupational environment. In Japan, the occupational exposure to cytotoxic drugs has been rarely reported. We investigated for environmental contamination with cytotoxic drugs at National Cancer Center Hospital East in Japan. Objective To evaluate the surface contamination in occupational environment, we establish the LC-MS/MS method to detect multicytotoxic drugs from surface wipe samples. Methods This study was carried out in the following cytotoxic drugs: cytarabine (Ara-C), gemcitabine (GEM), methotrexate (MTX), etoposide (ETP), ifosfamide (IFO), cyclophosphamide (CPA), irinotecan (CPT-11), doxorubicin (ADR) and epirubicin (Epi-ADM). These drugs were determined with a LC-MS/MS from AB Sciex Inc. Separations were done on a ZORBAX SB-C18 RR 2.1 × 100-mm, 3.5-mmcolumn from Agilent Technologies. Results Retention times of these drugs were Ara-C (m/z 244.0/112.0) 1.20 min, GEM (m/z 264.0/112.0) 2.20 min, MTX (m/z 455.1/308.2) 6.21 min, ETP (m/z 691.0/691.0) 9.51 min, IFO (m/z 261.1/92.2) 11.5 min, CPA (m/z 261.1/92.2) 12.3 min, CPT-11 (m/z 587.3/167.2) 7.34 min, ADR (m/z 544.1/130.1) 7.64 min and EPI (m/z 544.1/130.1) 8.15 min, respectively. The same molecular weight compounds (m/z: 554.1 ADR and EPI, m/z: 261.1 IFO and CPA) were separated by the reverse-phase LC gradient. Conclusions We established the method to detect multicytotoxic drugs from wipe samples on occupational environment. In the future, we will investigate for environmental exposure to cytotoxic drugs in the various hospitals.

Continuity, but at what cost? The impact of telemonitoring COPD on continuities of care: a qualitative study

Continuity of care is widely regarded as an important marker of quality in the management of patients with long-term conditions. New services that integrate telemonitoring into care pathways have potential to change aspects of continuity in both positive and negative ways. A telemonitoring service for patients with chronic obstructive pulmonary disease (COPD) was introduced in Lothian, Scotland, in 2009. A qualitative study, nested within the TELESCOT COPD randomised control trial, was undertaken to explore the views of patients and professionals on telemonitoring. The perceived impact of telemonitoring on continuity of care was investigated as part of the research. Semi-structured interviews were undertaken with 38 patients (47% male, mean age 67.5 years). A maximum variation sample in relation to age, sex, socio-economic background, disease severity, and compliance with telemonitoring was recruited. Thirty-two stakeholders (healthcare professionals and managers) were interviewed. Transcribed coded data were analysed thematically using the framework approach. Interpretation was supported by multidisciplinary discussion. Patients and healthcare professionals considered that relationship-based continuity of care was important in the delivery of telemonitoring services. Managers placed emphasis on improved continuity of clinical management as a means of reducing healthcare costs. However, professionals described many operational challenges arising from the 'bolting-on' of telemonitoring provision to existing usual care provision which, they considered, resulted in the proliferation of additional managerial discontinuities. Managers and healthcare professionals face major challenges in meeting demands for both relationship continuity and continuity of clinical management in the development of telemonitoring services.

The Need for Screening, Assessment, and Treatment for Cognitive Dysfunction in Multiple Sclerosis

Cognitive dysfunction is observed in about half of people with multiple sclerosis (MS), and MS health-care professionals face the challenge of screening, assessing, and treating patients for cognitive problems. Considering the inconsistent or limited empirical evidence to assist in this task, a multidisciplinary consensus conference of MS experts, sponsored by the Consortium of Multiple Sclerosis Centers (CMSC), was held on September 24, 2010, to address these issues. Key articles from the literature on these topics were distributed prior to the meeting, and CMSC member professionals were surveyed on clinical practices related to screening, assessment, and treatment for cognitive problems. The purpose of the meeting was threefold: 1) to achieve a multidisciplinary perspective on practices for screening, monitoring, evaluating, and treating MS patients for cognitive problems; 2) to propose consensus candidate measures for screening and/or monitoring for cognitive problems in MS that neurologists or nurses might administer on a regular basis; and 3) to propose consensus treatment approaches from a multidisciplinary perspective. This article summarizes the conclusions of the conference participants and provides preliminary suggestions for screening and brief assessment.

“I have to Turn Myself Inside Out”

In multicultural societies, health care professionals encounter immigrant families of children with asthma. They play an important role in supporting these families, but few studies have focused on this phenomenon. The aim of the present study is to gain a broader understanding of the challenges health care professionals face in their encounters with non-Western immigrant parents of children with asthma. Seventeen professional caregivers were interviewed, and their narratives were analyzed using qualitative content analysis. The results show that health care professionals' main challenges when encountering immigrant parents can be described by the theme, "Turning oneself inside out." This theme is characterized by five categories: gender and professional issues, impact on professional relationships, communication challenges, unfamiliar disease and treatment perceptions, and time issues. The results highlight the importance of providing health care professionals with support and organizational conditions that increase opportunities to understand the unique situation of these families.

Medical image resources used by health care professionals

PurposeMedicine is heavily dependent on images and health care professionals use medical images for clinical, educational and research purposes. This paper aims to investigate the resources used by health care professionals while searching for medical images.Design/methodology/approachThe research is based on a qualitative study that uses the Straussian version of grounded theory and involved 29 health care professionals from various health and biomedical departments working within Sheffield Teaching Hospitals NHS (National Health Service) Foundation Trust. Data collection was carried out using semi‐structured interviews and think‐aloud protocols.FindingsThe findings show that health care professionals seek medical images in a variety of visual information sources, including those found online and from published medical literature. The research also identified a number of difficulties that health care professionals face when searching for medical images in various image resources.Originality/valueThere have been few studies that investigated the image resources used by health care professionals. Thus, this study contributes to the understanding of medical image resources and information needs of health care professionals. A clear understanding of the medical image information needs of health care professionals is also vital to the design process and development of medical image retrieval systems.

Peripheral arterial disease: Application of the Chronic Care Model

Management of chronic diseases is one of the greatest challenges facing health care professionals globally. With the aging population increasing worldwide, the number of patients afflicted with chronic diseases will increase. Peripheral Arterial Disease (PAD) is a common, chronic atherosclerotic vascular disease that is associated with a high risk of stroke, myocardial infarction and cardiovascular death. The objective of this study was to determine if a multidisciplinary Vascular Risk Management Clinic (VRMC) would improve risk factor management and health outcomes for patients with PAD with poorly-controlled risk factors. A multidisciplinary VRMC was established utilizing a novel application of the Chronic Care Model to meet the needs of PAD patients. Interventions included optimization of medical therapy, investigations for undiagnosed atherosclerosis in other vascular distributions, smoking cessation therapy, dietary assessment and counseling, and active involvement of patients in evaluating progress towards their risk factor target goals. Assessment of risk factor control was done at each clinic visit and included measures of symptom severity, blood pressure, fasting blood sugar (FBS), lipid profile, body mass index (BMI), and smoking status. Analysis of risk factors was performed for the first 103 patients followed in the clinic. Average follow-up time was 528 days, and statistically significant improvements were seen in blood pressure, LDL, HDL, total cholesterol (TC), and TC/HDL ratio, while BMI, FBS, and triglycerides remained stable. Participation in a specialized vascular risk management clinic resulted in significant improvement in risk factors for disease progression compared to baseline status.

Promoting exercise in Parkinson's disease through community-based participatory research.

Parkinson's disease (PD) is a chronic, progressive, as-of-yet incurable, neurodegenerative condition affecting the nigro-striatal dopaminergic system. Emerging evidence suggests the importance of exercise in improving the trajectory of PD. Yet few people with PD are physically active. One challenge that healthcare professionals face in the 21st century is how to deliver physical activity programs to the population of individuals living with PD. A novel approach to delivering physical activity to people with PD is introduced - termed community-based participatory research (CBPR) - which engages people with PD and patient advocates as co-researchers in the development and implementation of community-based exercise programs. The authors describe the CBPR approach and provide several recent examples of community exercise programs that are steps in the direction of developing the CBPR model. This is followed by a discussion of what a more fully realized CBPR model might look like. Finally, the authors describe some obstacles to conducting CBPR and suggest strategies for overcoming them. It is argued that people with PD are an integral component of delivering the exercise intervention.

Refocusing Knowledge Generation, Application, and Education: Raising Our Gaze to Promote Health Across Boundaries

Those educating healthcare professionals face the undeniable challenge that the current U.S. healthcare system is untenable.1 U.S. health care epitomizes low value, spending more than any other country while ranked 37th in the world—between Costa Rica and Slovenia—in its ability to equitably engender health.2 The September 14–15, 2010, conference on Patients and Populations: Public Health in Medical Education, sponsored by the Association of American Medical Colleges (AAMC) and the CDC, provided inspiring examples from those who are trying to show the healthcare professionals of the future a better way.

Of professionalism and health care strikes

Strike action is by no means an unfamiliar situation in the South African context. However, health care strikes are now emerging as a highly controversial topic. Current teaching of medical students does not adequately cover this unique ethical dilemma facing health care professionals. Only with a broader understanding of the subject can medical students’ future decisions on the matter be informed and based on the ethical principles governing the medical profession. I attempt to explore the issues surrounding health care strikes and assess whether or not this is compatible with true medical professionalism in the 21st century.