Emotions In Patients Research Articles

Perioperative management of wounds with nanosilver dressing after neoadjuvant chemotherapy for breast cancer

Neoadjuvant chemotherapy (NAC) can improve the success rate of breast cancer surgery; however, most patients have obvious negative thoughts about NAC. Failure to effectively relieve these negative emotions or thoughts will adversely affect the quality of life of the patients after treatment. Therefore, a majority of nursing staff are committed toward reducing patients’ negative emotions through good perioperative management as well as improving the treatment effects and postoperative quality of life of patients. A good perioperative management of breast cancer should include postoperative wound and patient psychological care. This study found that patients using nanosilver dressings have greatly reduced total wound drainage, drainage tube removal time, and postoperative complications within four days after surgery and that the rate of wound healing was obviously improved. This suggests that nanosilver dressings can improve the rate of wound healing and reduce the risk of complications. At the same time, we found that postoperative negative emotions of patients receiving comprehensive care were effectively relieved and their mental flexibility was also improved. In addition, the quality of sleep, quality of life, and nursing satisfaction of patients receiving comprehensive care were significantly higher than those receiving traditional care models. This shows that the comprehensive care model is capable of reducing the negative emotions of patients during the perioperative period and also helps to improve the quality of life of patients after surgery. Therefore, this study demonstrates that the use of nanosilver dressings as a comprehensive care model can reduce the risk of negative emotions and complications in addition to improving the rate of wound healing and postoperative quality of life.

AI inspired EEG-based spatial feature selection method using multivariate empirical mode decomposition for emotion classification.

Classification of human emotions based on electroencephalography (EEG) is a very popular topic nowadays in the provision of human health care and well-being. Fast and effective emotion recognition can play an important role in understanding a patient’s emotions and in monitoring stress levels in real-time. Due to the noisy and non-linear nature of the EEG signal, it is still difficult to understand emotions and can generate large feature vectors. In this article, we have proposed an efficient spatial feature extraction and feature selection method with a short processing time. The raw EEG signal is first divided into a smaller set of eigenmode functions called (IMF) using the empirical model-based decomposition proposed in our work, known as intensive multivariate empirical mode decomposition (iMEMD). The Spatio-temporal analysis is performed with Complex Continuous Wavelet Transform (CCWT) to collect all the information in the time and frequency domains. The multiple model extraction method uses three deep neural networks (DNNs) to extract features and dissect them together to have a combined feature vector. To overcome the computational curse, we propose a method of differential entropy and mutual information, which further reduces feature size by selecting high-quality features and pooling the k-means results to produce less dimensional qualitative feature vectors. The system seems complex, but once the network is trained with this model, real-time application testing and validation with good classification performance is fast. The proposed method for selecting attributes for benchmarking is validated with two publicly available data sets, SEED, and DEAP. This method is less expensive to calculate than more modern sentiment recognition methods, provides real-time sentiment analysis, and offers good classification accuracy.

Let's sit down and talk: The art of breaking bad news

Physicians often are uncomfortable when communicating bad or difficult news. In the absence of much effective training, many doctors find that breaking bad news is one of the most difficult, demanding, and stressful tasks. A significantly negative relationship can form between the patient and their medical staff if poor communication is used. Most patients want the truth, but how bad news is delivered can substantially influence a patient's emotions, satisfaction, subsequent psychological adjustments, and attitudes toward treatment. Moreover, values in certain cultures can become barriers that can limit or pressure a physician in ethically approaching the patient. Disclosing bad news is a complex communicational task that requires time, compassion, and empathy. Although breaking bad news will never be easy, communicating well is a skill that can be learned. The SPIKES protocol provides a simple and easily learnable strategy for communicating bad news.

Illness perception in patients with Alopecia areata under topical immunotherapy.

Alopecia areata (AA) is a chronic autoimmune-mediated disorder. There is little research on how AA patients conceptualize their disease. The purpose of this study was to investigate the perception and attitude of patients with AA about their illness. The cross-sectional study was performed on 102 patients with AA referred to our alopecia clinic. Patients between 16 and 60 years were enrolled in the study. A questionnaire including demographic and clinical characteristics and Illness Perception Questionnaire-Revised (IPQ-R) was administered to each patient. More than half of patients (55%) experienced their illness as a long-lasting (17.3 ± 5.5, median reference score = 18), and timely variable (13.4 ± 2.8, median reference score = 12) disorder. Patients perceived that their illness negatively affects their lives (18.9 ± 4.8, median reference score = 18) and are considered an effective role for themselves in controlling disease (20.3 ± 4.9, median reference score = 18). Moreover, patients had a fairly good accepting of their illness (13.4 ± 2.8, median reference score = 15). We observed significant negative effects of illness on the patient's emotions (21.5 ± 5.5, median reference score = 18). We also found that men had a stronger belief in personal control compared with women (21.5 ± 4.8 vs 19.5 ± 4.8; P = .03). A positive correlation was observed between educational status and illness coherence (r = .21; P = .03). Most patients with AA considered undesirable consequences of their illness. High scores of negative affective symptoms indicate the harmful effects of this disease on patients' lives leading to problems of mental health.

Association of Medical Student Characteristics and Empathy After a Communication Workshop.

Medical education values patient-centered communication skills of responding to patient's emotions, however, guidance is limited on how to provide a well-rounded curriculum. This study examines the effect of a 90-minute communication workshop on the level of empathy of the 116 medical students who participated in the workshop. We used three psychometric categories from the Jefferson Scale of Empathy (JSE) as dependent variables. We conducted mixed analysis of variance (ANOVA) analyses to determine the change in empathy scores after the workshop, the main effects for gender and medical specialty, and their interaction with time. We found an increase in perspective taking and compassionate care scales, although no changes on walking in patients’ shoes scale. Female and people-oriented specialty students scored higher on all scales. Some gender-specialty groups showed an empathy decrease: people-oriented specialty females on compassionate care scale and people-oriented and other specialty males on walking in patients’ shoes scale. We concluded that communication training requires a multidimensional approach to target various areas of building empathy. Standardization of training should be embedded with empathy development within medical education curriculum.

An ethnomusicologist's perspective: A potential experimental model to revive long‐term memories of the Alzheimer's patient through individualized music and the amygdala pathway

AbstractBackgroundSince a significant symptom of Alzheimer's is memory loss caused through the aggregation of beta‐amyloid, the ethnomusicologist is in a unique position to potentially recover some long‐term memories by developing the personalized music history one patient at a time. The idea is to bypass the amyloid aggregates, accessing the amygdala, therefore using the patient's emotions to recover their memories through their own music and their associative strengths. A song or a strain of music can transport anybody in the world with the functional hearing ability to a place in time retrieving those memories. Instead of sedating a patient, their own music may be better. My case study involved one individual diagnosed with dementia. Being familiar with the patient for a few decades, I pieced together her music history which I treated as a part of her medical history since the music memory resides in the brain. Her cognition and joy increased significantly over the year, according to her and her family. I videotaped some sessions. More research is needed to establish whether my method of individualized music history and memory recollection increases the quality of life of the patient or not. For further research, I propose inviting an ethnomusicologist to build a music profile of a number of Alzheimer's patients the neurologists are treating at a clinic. The music profile will include a playlist of songs or instrumental music that transports the patient to particular memories. The sound database could also include non‐musical sounds that generate memories e.g. the sounds of a drill, a barking dog, etc.. To access the patients’ memories the ethnomusicologist would need to do extensive interviews with the patients, family members, and friends, and look at their music collections. The process of building a music profile of the Alzheimer’s patient for treatment by a neurologist can, therefore, be done globally where the ethnomusicologist teams up with the medical staff.

A forced swim-based rat model of premenstrual depression: effects of hormonal changes and drug intervention.

Premenstrual dysphoric disorder (PMDD), a form of premenstrual syndrome (PMS), is a severe health disturbance that affects a patient’s emotions; it is caused by periodic psychological symptoms, and its pathogenesis remains unclear. As depression-like symptoms are found in a majority of clinical cases, a reliable animal model of premenstrual depression is indispensable to understand the pathogenesis. Herein, we describe a novel rat model of premenstrual depression, based on the forced swimming test, with a regular estrous cycle. The results showed that in the estrous cycle, the depression-like behavior of rats occurred in the non-receptive phase and disappeared in the receptive phase. Following ovariectomy, the depression-like symptoms disappeared and returned after a hormone priming regimen. Moreover, fluoxetine, an anti-depressant, could reverse the behavioral symptoms in these model rats with normal estrous cycle. Further, the model rats showed significant changes in the serum levels of estrogen and progesterone, hippocampal levels of allopregnanolone, 5-hydroxytryptamine, norepinephrine, and γ-aminobutyric acid (GABA), and in the expression of GABAA receptor 4α subunit, all of which were reversed to physiological levels by fluoxetine. Overall, we established a reliable and standardized rat model of premenstrual depression, which may facilitate the elucidation of PMS/PMDD pathogenesis and development of related therapies.

The Role of Emotion in Cancer Surgery Decisions: Applying Concepts From Decision Psychology.

The Role of Emotion in Cancer Surgery Decisions: Applying Concepts From Decision Psychology.

The Emergence of a Stereotypic Movement During Intensive Short-Term Dynamic Psychotherapy in a Patient with Obsessive Compulsive Disorder: A Case Report

No previous research has investigated the emergence of stereotypic movements in patients during psychotherapeutic sessions, nor have such movements been mentioned in the numerous articles on Habib Davanloo's technique of intensive short-term dynamic psychotherapy. In this article, we present two clinical vignettes from early intensive short-term dynamic psychotherapy sessions, using Davanloo's technique, with a patient who was observed to have an emerging stereotypic movement. These vignettes, extracted from the videotaped sessions using audiovisual technology, concern a young woman who is known to have treatment-resistant obsessive-compulsive disorder. By presenting this case report, we aim to highlight the possibility of the occurrence of such a movement in response to specific interventions, and propose its clinical significance. We interpret this movement as being a tension-releasing mechanism that manifests in response to the therapist's exploration of the patient's emotions. We propose that the purpose of this stereotypic movement is to defend against the patient's actual experience of her repressed feelings. Clinical outcome of this case suggests that psychodynamic psychotherapy could be an effective intervention for patients with treatment-resistant obsessive-compulsive disorder.

Narrowing the empathy gap between doctors and patients using emotion forecasting

We investigated the differences between medical students' affective forecasting for self and their forecasting of patients' affective responses. To do this, we developed an affective forecasting situation questionnaire and tested its validity with a sample of 272 Chinese medical students and 66 patients. Results showed that there was a significant correlation between medical students' affective forecasting for self and their forecasting of patients' emotions. Medical students who were calmer (vs. less calm) during affective forecasting for themselves were more accurate in forecasting the patient's emotions. We suggest that emotional intelligence training should be highlighted in Chinese medical education to improve students' ability to forecast their own and others' emotions.

Informed consent in plastic surgery, evaluation of its effectiveness for mutual satisfaction of patient and doctor: Comparison of methods

The acquisition of signed informed consent is not always enough to ensure adequate medical protection. Particularly, in plastic surgery, improving the doctor-patient relationship by understanding the patient's emotions and expectations becomes a determining factor when choosing the best therapeutic strategy for the subject in question, which may also include nonsurgical eligibility. Ninety patients with various plastic surgery disabilities were recruited and randomly divided into three groups: Patients in the first group underwent the ``traditional'' clinical interview, those in the second underwent the clinical approach called Shared Decision Making (SDM), and those in the third group received both the SDM and a questionnaire evaluating patient expectations (Expectation Questionnaire-Pgm). At the end of each interview, a specialist physician in Plastic, Reconstructive and Aesthetic Surgery was asked to fill in a questionnaire regarding his/her satisfaction with the method used. Likewise, the patient filled in a questionnaire on his/her satisfaction with the interview. For the doctors, the third method was superior in investigating patient expectations, emotions, and personal preferences. For the patients, the third method scored significantly higher than the first one for overall satisfaction and ability to evaluate personal preferences and needs and higher than the first and second methods in assessing expectations. For doctors, the SDM coupled with the Expectation Questionnaire-Pgm proved to be the most useful tool to understand patient expectations and emotions and thus improve the medical-patient relationship through shared decision-making. The third method therefore aims for better patient coverage and improved informed consent, thereby reducing the likelihood of litigation and better assessing nonfitness for operation.

Coming in Warm: Qualitative Study and Concept Map to Cultivate Patient-centered Empathy in Emergency Care.

Increased empathy may improve patient perceptions and outcomes. No training tool has been derived to teach empathy to emergency care providers. Accordingly, we engaged patients to assist in creating a concept map to teach empathy to emergency care providers. We recruited patients, patient caretakers and patient advocates with emergency department experience to participate in three separate focus groups (n=18 participants). Facilitators guided discussion about behaviors that physicians should demonstrate to rapidly create trust; enhance patient perception that the physician understood the patient's point of view, needs, concerns, and fears; and optimize patient/caregiver understanding of their experience. Verbatim transcripts from the three focus groups were read by the authors, and by consensus, five major themes with 10 minor themes were identified. After creating a codebook with thematic definitions, one author reviewed all transcripts to a library of verbatim excerpts coded by theme. To test for inter-rater reliability, two other authors similarly coded a random sample of 40% of the transcripts. Authors independently chose excerpts that represented consensus and strong emotional responses from participants. Approximately 90% of opinions and preferences fell within 15 themes, with five central themes: provider transparency, acknowledgment of patient's emotions, provider disposition, trust in physician, and listening. Participants also highlighted the need for authenticity, context, and individuality to enhance empathic communication. For empathy map content, patients offered example behaviors that promote perceptions of physician warmth, respect, physical touch, knowledge of medical history, explanation of tests, transparency, and treating patients as partners. The resulting concept map was named the "Empathy Circle." Focus group participants emphasized themes and tangible behaviors to improve empathy in emergency care. These were incorporated into the Empathy Circle, a novel concept map that can serve as the framework to teach empathy to emergency care providers.

The Association between Symptom Accommodation and Emotional Coregulation in Couples with Binge Eating Disorder.

Intense negative emotions and maladaptive behavioral strategies to reduce emotional distress occur not only in patients with various forms of psychopathology but also in their committed partners. One common strategy to reduce distress is for partners to accommodate to the symptoms of the disorder, which reduces distress short term but maintains symptoms long term. Accommodation is believed to be motivated by the partner reacting behaviorally to the patient's emotions, but the emotions of the partner in this context have yet to be examined. This pilot study examined how partner accommodation related to specific patterns of emotional coregulation between patients with binge eating disorder (BED) and their partners, before and after a couple-based intervention for BED. Vocally encoded emotional arousal was measured during couples' (n=11) conversations about BED. As predicted, partners' emotional reactivity to patients' emotional arousal was associated with high accommodation before treatment. Thus, partners may use accommodation as a strategy to reduce both the patients' and their own distress. After treatment, partners' arousal was no longer associated with the patients' emotional arousal; instead, partners showed greater emotional stability over time, specifically when accommodation was low. Additionally, patients were less emotionally aroused after treatment. Therefore, treatment may have decreased overall emotionality of patients and altered the association between accommodation and partners' emotional reactivity. If replicated, this understanding of the emotional context associated with accommodation in BED can inform couple-based treatment by targeting specific emotional precipitants of behaviors that maintain symptoms.

Communication skills training for healthcare professionals working with people who have cancer.

This is the third update of a review that was originally published in the Cochrane Library in 2002, Issue 2. People with cancer, their families and carers have a high prevalence of psychological stress, which may be minimised by effective communication and support from their attending healthcare professionals (HCPs). Research suggests communication skills do not reliably improve with experience, therefore, considerable effort is dedicated to courses that may improve communication skills for HCPs involved in cancer care. A variety of communication skills training (CST) courses are in practice. We conducted this review to determine whether CST works and which types of CST, if any, are the most effective. To assess whether communication skills training is effective in changing behaviour of HCPs working in cancer care and in improving HCP well-being, patient health status and satisfaction. For this update, we searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 4), MEDLINE via Ovid, Embase via Ovid, PsycInfo and CINAHL up to May 2018. In addition, we searched the US National Library of Medicine Clinical Trial Registry and handsearched the reference lists of relevant articles and conference proceedings for additional studies. The original review was a narrative review that included randomised controlled trials (RCTs) and controlled before-and-after studies. In updated versions, we limited our criteria to RCTs evaluating CST compared with no CST or other CST in HCPs working in cancer care. Primary outcomes were changes in HCP communication skills measured in interactions with real or simulated people with cancer or both, using objective scales. We excluded studies whose focus was communication skills in encounters related to informed consent for research. Two review authors independently assessed trials and extracted data to a pre-designed data collection form. We pooled data using the random-effects method. For continuous data, we used standardised mean differences (SMDs). We included 17 RCTs conducted mainly in outpatient settings. Eleven trials compared CST with no CST intervention; three trials compared the effect of a follow-up CST intervention after initial CST training; two trials compared the effect of CST and patient coaching; and one trial compared two types of CST. The types of CST courses evaluated in these trials were diverse. Study participants included oncologists, residents, other doctors, nurses and a mixed team of HCPs. Overall, 1240 HCPs participated (612 doctors including 151 residents, 532 nurses, and 96 mixed HCPs).Ten trials contributed data to the meta-analyses. HCPs in the intervention groups were more likely to use open questions in the post-intervention interviews than the control group (SMD 0.25, 95% CI 0.02 to 0.48; P = 0.03, I² = 62%; 5 studies, 796 participant interviews; very low-certainty evidence); more likely to show empathy towards their patients (SMD 0.18, 95% CI 0.05 to 0.32; P = 0.008, I² = 0%; 6 studies, 844 participant interviews; moderate-certainty evidence), and less likely to give facts only (SMD -0.26, 95% CI -0.51 to -0.01; P = 0.05, I² = 68%; 5 studies, 780 participant interviews; low-certainty evidence). Evidence suggesting no difference between CST and no CST on eliciting patient concerns and providing appropriate information was of a moderate-certainty. There was no evidence of differences in the other HCP communication skills, including clarifying and/or summarising information, and negotiation. Doctors and nurses did not perform differently for any HCP outcomes.There were no differences between the groups with regard to HCP 'burnout' (low-certainty evidence) nor with regard to patient satisfaction or patient perception of the HCPs communication skills (very low-certainty evidence). Out of the 17 included RCTs 15 were considered to be at a low risk of overall bias. Various CST courses appear to be effective in improving HCP communication skills related to supportive skills and to help HCPs to be less likely to give facts only without individualising their responses to the patient's emotions or offering support. We were unable to determine whether the effects of CST are sustained over time, whether consolidation sessions are necessary, and which types of CST programs are most likely to work. We found no evidence to support a beneficial effect of CST on HCP 'burnout', the mental or physical health and satisfaction of people with cancer.

Effects of cognitive behavioral intervention on fear of disease progression and negative emotion in patients with glioma

Objective To explore the effects of cognitive behavioral intervention on fear of disease progression and negative emotionin patients with glioma. Methods A total of 60 eligible patients with glioma who were treated in neurosurgery department of the First Affiliated Hospital of Zhengzhou University from January to October 2016 were randomly divided into experimental group (n=30) and control group (n=30) according to random number table. The control group received routine care, and the experimental group patients received cognitive behavioral intervention for 12 weeks on the basis of routine care. Cognitive assessment and cognitive reconstruction were performed to achieve cognitive intervention by interviews, lectures and other forms. Behavioral intervention was achieved by musical relaxation training and personalized exercise programs for the patients. The patients were evaluated with the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) , Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) on the admission day, 1 week after surgery and 3 months after surgery to compare the fear of disease progression and negative emotion of the two groups. Results Repeated measurement analysis of variance showed that with the extension of time, the anxiety and depression scores of the two groups were decreased, and the score of the observation group was lower than that of the control group. The differences were statistically significant (P 0.05) . The score of the observation group was significantly lower than that of the control group at 3 months after intervention, with statistical difference (P<0.05) . Conclusions There were different degrees of fear of progression and negative emotions in patients with glioma at different stages of disease. Cognitive behavioral intervention can effectively alleviate the fear of disease progression, anxiety and depression in patients with glioma, and it is worthy of clinical promotion. Key words: Glioma; Anxiety; Depression; Fear of progression; Cognitive behavioral intervention

Interior Environment Enhancing Child Development

The environment has been a crucial factor in determining the effectiveness of medical treatment, especially for mentally related disorders. The study uses the autistic treatment environment as a case study to examine relevant environmental factors supporting the learning process of autistic children towards an environmental design model, the improvement in behaviour, and be able to stabilize the patient's emotions. Results from the study are useful for the prognostic study of autism. The final modelling could be applied as a part of special education programs to extenuate behavioural and emotional disorders and to improve the social skills of autistic children.

Managing a Dental Practice and How to Deal with the Patient’s Emotions

Managing a dental practice is not strictly limited to good administration, but also the efficient management of patient emotions. Therefore, in a contemporary society, a successful dental practice is one that manages to harmoniously combine the standard work of the medical staff with the help of a psychotherapist. Signing a cooperation agreement between the dentist and the psychotherapist does not only represent a managerial strategy but also a necessity. There are frequent situations when the dentist is faced with complex psychological pathologies that prevent performing the dental act correctly. In this case, the aid of a psychotherapist is mandatory. It is assumed that most individuals present anxiety over certain dental procedures. The psychotherapist is an authorized person that knows and is able to apply various methods which help in combating the fear of dentist. The dentist will use the art of communication and the development of a doctor-patient relationship, based on the affective component. In the case of the doctor-patient relationship, the patient's ability to tolerate pain will increase if their connection is a compatible one, based on empathy, respect and sincerity and affection. The psychotherapist plays a major role in the case of the patients dealing with anxieties caused by the dentist due to traumatic experiences. The psychotherapist is not only responsible of finding out the cause that led to the outbreak of this state but also of using an adequate approach in order to prevent the patient from ending up in a situation to deteriorate his/her health. How to cite: Busu, O. V. & Andrei, E. C. (2017). Managing a Dental Practice and How to Deal with the Patient's Emotions. Logos Universality Mentality Education Novelty, Section: Social Sciences, VI(1), 109-116. DOI: http://dx.doi.org/10.18662/lumenss.2017.0601.10

Lessons learned for reducing the negative impact of adverse events on patients, health professionals and healthcare organizations.

To summarize the knowledge about the aftermath of adverse events (AEs) and develop a recommendation set to reduce their negative impact in patients, health professionals and organizations in contexts where there is no previous experiences and apology laws are not present. Review studies published between 2000 and 2015, institutional websites and experts' opinions on patient safety. Studies published and websites on open disclosure, and the second and third victims' phenomenon. Four Focus Groups participating 27 healthcare professionals. Study characteristic and outcome data were abstracted by two authors and reviewed by the research team. Fourteen publications and 16 websites were reviewed. The recommendations were structured around eight areas: (i) safety and organizational policies, (ii) patient care, (iii) proactive approach to preventing reoccurrence, (iv) supporting the clinician and healthcare team, (v) activation of resources to provide an appropriate response, (vi) informing patients and/or family members, (vii) incidents' analysis and (viii) protecting the reputation of health professionals and the organization. Recommendations preventing aftermath of AEs have been identified. These have been designed for the hospital and the primary care settings; to cope with patient's emotions and for tacking the impact of AE in the second victim's colleagues. Its systematic use should help for the establishment of organizational action plans after an AE.

Comparison of community and hospital pharmacists' attitudes and behaviors on medication error disclosure to the patient: A pilot study

ObjectivesTo determine pharmacists' attitudes and behaviors on medication errors and their disclosure and to compare community and hospital pharmacists on such views. MethodsAn online questionnaire was developed from previous studies on physicians' disclosure of errors. Questionnaire items included demographics, environment, personal experiences, and attitudes on medication errors and the disclosure process. An invitation to participate along with the link to the questionnaire was electronically distributed to members of two Illinois pharmacy associations. A follow-up reminder was sent 4 weeks after the original message. Data were collected for 3 months, and statistical analyses were performed with the use of IBM SPSS version 22.0. ResultsThe overall response rate was 23.3% (n = 422). The average employed respondent was a 51-year-old white woman with a BS Pharmacy degree working in a hospital pharmacy as a clinical staff member. Regardless of practice settings, pharmacist respondents agreed that medication errors were inevitable and that a disclosure process is necessary. Respondents from community and hospital settings were further analyzed to assess any differences. Community pharmacist respondents were more likely to agree that medication errors were inevitable and that pharmacists should address the patient's emotions when disclosing an error. Community pharmacist respondents were also more likely to agree that the health care professional most closely involved with the error should disclose the error to the patient and thought that it was the pharmacists' responsibility to disclose the error. Hospital pharmacist respondents were more likely to agree that it was important to include all details in a disclosure process and more likely to disagree on putting a “positive spin” on the event. ConclusionRegardless of practice setting, responding pharmacists generally agreed that errors should be disclosed to patients. There were, however, significant differences in their attitudes and behaviors depending on their particular practice setting.

Recognizing Patients' Emotions: Teaching Health Care Providers to Interpret Facial Expressions.

Facial expressions are an important clue to a patient's emotions. The authors developed a 90-minute workshop in May 2011 to teach physicians and physicians-in-training to interpret facial expressions and to use that skill in the context of patient care. The workshop included a didactic presentation in which facial expression features were taught using progressively more difficult examples, followed by three interactive exercises. The authors presented the workshop at six separate venues in the United States in 2011 and 2012. To test the effectiveness of this workshop, the authors designed a comprehensive pre- and postworkshop evaluation which assessed participants' skill, knowledge, attitude (toward importance), and confidence. A total of 156 health care providers participated in the workshop and completed pre- and postworkshop evaluations. Participants showed substantial improvement in skill and knowledge (fact- and case-based) scores, as well as modest improvement in importance and confidence ratings. Faculty and medical students demonstrated similar baseline measures of skill, knowledge, and importance, though faculty reported a slightly higher confidence in their skills. No correlation was found between baseline ratings of confidence in abilities and any baseline measure of performance. Given the similar baseline performance of faculty and medical students, the ability to interpret facial expressions does not appear to be learned through routine clinical practice, highlighting the need for dedicated facial expression training. The authors were able to demonstrate that physicians and physicians-in-training could effectively learn to recognize emotion by interpreting facial expressions through a short workshop.