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[PMID]: 28466684 [Au] Autor: Spalding R; Kozlov E; Carpenter BD [Ad] Endereço: 1 Washington University in St. Louis, MO, USA. [Ti] Título: Words Matter. [So] Source: Int J Aging Hum Dev;85(1):123-130, 2017 06. [Is] ISSN: 1541-3535 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Palliative care consultation teams (PCCTs) provide input to other health-care providers working with patients who have life-limiting disease. This study examines whether the diction and phrasing of consultation recommendations in the electronic health record influence their implementation. We reviewed 288 verbatim PCCT recommendations that were made for 111 unique patients in a Veterans Affairs hospital and available in the electronic health record. Recommendations were coded for linguistic features, such as the presence of conditionals (e.g., "could") and tentative phrasing (e.g., "would suggest"). Each patient's subsequent treatment was followed in the medical record to determine whether PCCT recommendations were implemented. Only 57% of the consultation recommendations were eventually implemented. Recommendations that included a conditional word or phrase were significantly less likely to be implemented. In particular, recommendations that included the words "could" and "consider" were less likely to be implemented. PCCTs may enhance their effectiveness by attending to the subtle pragmatics of how they communicate with other health-care providers, particularly in electronic communication where nonverbal features of communication are unavailable. [Mh] Termos MeSH primário: Comunicação Registros Eletrônicos de Saúde/estatística & dados numéricos Cuidados Paliativos/estatística & dados numéricos Relações Profissional-Paciente Encaminhamento e Consulta/estatística & dados numéricos Comportamento Verbal [Mh] Termos MeSH secundário: Seres Humanos Assistência de Longa Duração [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170504 [St] Status: MEDLINE [do] DOI: 10.1177/0091415016685328

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[PMID]: 29348197 [Au] Autor: Blustein J; Weinstein BE; Chodosh J [Ad] Endereço: Department of Health Policy, Robert F Wagner Graduate School of Public Service, New York University. 295 Lafayette Street, New York, NY, USA jan.blustein@wagner.nyu.edu. [Ti] Título: Tackling hearing loss to improve the care of older adults. [So] Source: BMJ;360:k21, 2018 01 18. [Is] ISSN: 1756-1833 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Perda Auditiva/psicologia Pessoas com Deficiência Auditiva/psicologia Relações Profissional-Paciente [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Comunicação Meio Ambiente Auxiliares de Audição/psicologia Perda Auditiva/etiologia Seres Humanos Qualidade da Assistência à Saúde Percepção da Fala [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180306 [Lr] Data última revisão: 180306 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180120 [St] Status: MEDLINE [do] DOI: 10.1136/bmj.k21

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[PMID]: 29364356 [Au] Autor: Monguilhott JJDC; Brüggemann OM; Freitas PF; d'Orsi E [Ad] Endereço: Departamento Acadêmico de Saúde e Serviços, Instituto Federal de Educação, Ciência e Tecnologia de Santa Catarina, Florianópolis, SC, Brasil. [Ti] Título: Nascer no Brasil: the presence of a companion favors the use of best practices in delivery care in the South region of Brazil. [So] Source: Rev Saude Publica;52:1, 2018. [Is] ISSN: 1518-8787 [Cp] País de publicação: Brazil [La] Idioma: por; eng [Ab] Resumo: OBJECTIVE To analyze if the presence of a companion favors the use of best practices in the delivery care in the South region of Brazil. METHODS This is a cross-sectional analysis of the longitudinal study Nascer no Brasil. We analyzed data from 2,070 women from the South region of Brazil who went into labor. The data were collected between February and August 2011, by interviews and medical records. We performed a bivariate and multivariate analysis, calculating the crude and adjusted prevalence ratios using Poisson regression with robust variance estimation. The level of significance adopted was 5%. RESULTS Most women had a companion during labor (51.7%), but few remained during delivery (39.4%) or cesarean section (34.8%). Less than half of the women had access to several recommended practices, while non-recommended practices continue to be performed. In the model adjusted for age, education level, source of payment for the delivery, parity, and score of the Brazilian Association of Market Research Institutes, the presence of a companion was statistically associated with a greater supply of liquids and food (aPR = 1.34), dietary prescription (aPR = 1.34), use of non-pharmacological methods for pain relief (aPR = 1.37), amniotomy (aPR = 1.10), epidural or spinal analgesia (aPR = 1.84), adoption of non-lithotomy position in the delivery (aPR = 1.77), stay in the same room during labor, delivery, and postpartum (aPR = 1.62), skin-to-skin contact in the delivery (aPR = 1.81) and cesarean section (PR = 2.43), as well as reduced use of the Kristeller maneuver (aPR = 0.67), trichotomy (aPR = 0.59), and enema (aPR = 0.49). CONCLUSIONS In the South region of Brazil, most women do not have access to the best practices in addition to undergoing several unnecessary interventions. The presence of a companion is associated with several beneficial practices and the reduction in some interventions, although other interventions are not impacted. [Mh] Termos MeSH primário: Parto Obstétrico/normas Humanismo Trabalho de Parto/psicologia Serviços de Saúde Materna/normas Guias de Prática Clínica como Assunto [Mh] Termos MeSH secundário: Adolescente Adulto Brasil Criança Comparação Transcultural Estudos Transversais Parto Obstétrico/psicologia Família Feminino Conhecimentos, Atitudes e Prática em Saúde Seres Humanos Direitos do Paciente Segurança do Paciente/normas Gravidez Relações Profissional-Paciente Fatores Socioeconômicos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180228 [Lr] Data última revisão: 180228 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180125 [St] Status: MEDLINE

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MEDLINE

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[PMID]: 29360832 [Au] Autor: Brenk-Franz K; Ehrenthal J; Freund T; Schneider N; Strauß B; Tiesler F; Schauenburg H; Gensichen J [Ad] Endereço: Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany. [Ti] Título: Evaluation of the short form of "Experience in Close Relationships" (Revised, German Version "ECR-RD12") - A tool to measure adult attachment in primary care. [So] Source: PLoS One;13(1):e0191254, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Attachment theory helps us to understand patients´ health behavior. Attachment styles might explain patient differences in coping behavior, self-treatment, or patient-provider relationships. In primary care time constrains are relevant. A short instrument may facilitate screening and assessment in daily medical practice. The aim of this study was to evaluate a 12-item short version of the Experience in Close Relationships-revised (ECR-R-D) to be used in primary care settings. We included 249 patients from ten general practices in central Germany into a cross-sectional study. Exploratory factor analysis was performed to evaluate the factor structure of the ECR-items. Cronbach's alpha was used to assess internal consistency. The results related to the short form of the ECR are in line with those of the German full-length version of the measure (ECR-RD 36). Internal consistencies were in an adequate range. The ECR short form can be recommended as a screening measure of attachment styles in primary care. [Mh] Termos MeSH primário: Atenção Primária à Saúde Relações Profissional-Paciente [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Idoso de 80 Anos ou mais Estudos Transversais Análise Fatorial Feminino Alemanha Comportamentos Relacionados com a Saúde Seres Humanos Masculino Meia-Idade Modelos Psicológicos Apego ao Objeto Inquéritos e Questionários Adulto Jovem [Pt] Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE; MULTICENTER STUDY [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180226 [Lr] Data última revisão: 180226 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180124 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191254

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MEDLINE

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[PMID]: 29369279 [Au] Autor: Zanotti JM [Ad] Endereço: Joan M. Zanotti is an ED nurse at the Valley Hospital in Ridgewood, N.J. [Ti] Título: Handle with care: Caring for children with autism spectrum disorder in the ED. [So] Source: Nursing;48(2):50-55, 2018 Feb. [Is] ISSN: 1538-8689 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Transtorno do Espectro Autista/terapia Serviço Hospitalar de Emergência Relações Profissional-Paciente [Mh] Termos MeSH secundário: Transtorno do Espectro Autista/psicologia Criança Comunicação Necessidades e Demandas de Serviços de Saúde Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180223 [Lr] Data última revisão: 180223 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 180126 [St] Status: MEDLINE [do] DOI: 10.1097/01.NURSE.0000529808.13784.bc

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[PMID]: 27776589 [Au] Autor: Daftary A; Padayatchi N [Ad] Endereço: McGill International TB Centre, McGill University, Montreal, Canada; Centre for the AIDS Programme of Research in South Africa (CAPRISA), SA Medical Research Council Extramural TB Pathogenesis Research Unit, University of KwaZulu-Natal, Durban, South Africa. [Ti] Título: Provider perspectives on drug-resistant tuberculosis and human immunodeficiency virus care in South Africa: a qualitative case study. [So] Source: Int J Tuberc Lung Dis;20(11):1483-1488, 2016 Nov. [Is] ISSN: 1815-7920 [Cp] País de publicação: France [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To examine influences on health care workers' (HCWs') capacity to deliver health care for multi- and/or extensively drug-resistant tuberculosis (MDR/XDR-TB) and human immunodeficiency virus (HIV) infection in South Africa. DESIGN: Qualitative data were collected via group and individual interviews with a purposive sample of 17 HCWs at a centralised, tertiary TB facility and analysed using grounded theory. RESULTS: Four themes were identified: 1) personal infection control practices among HCWs may be weakened by a workplace culture comprising low motivation, disparate risk perceptions and practices across workforce hierarchies, physical discomfort, and problems managing patients with treatment-induced hearing loss. 2) Patient-provider interactions are likely stronger among nurses, and in HIV vs. MDR/XDR-TB service delivery, due to greater attention to patient empowerment and support. Stigma associated with MDR/XDR-TB, considered worse than HIV, may be perpetuated within non-specialised facilities less familiar with MDR/XDR-TB. 3) HCWs who struggle with the daily tedium of MDR/XDR-TB treatment supervision are becoming increasingly supportive of treatment literacy and self-administration. 4) Effective integration of HIV and MDR/XDR-TB services may be impeded by administrative restrictions, workplace norms and provider mindsets. CONCLUSION: Comprehensive, decentralised management of MDR/XDR-TB and HIV coinfection requires the creation of patient-provider trust and treatment literacy in MDR/XDR-TB programmes, and defying workplace norms that could provoke nosocomial TB exposure and fragmented service provision. [Mh] Termos MeSH primário: Assistência à Saúde/organização & administração Tuberculose Extensivamente Resistente a Medicamentos/epidemiologia Infecções por HIV/epidemiologia [Mh] Termos MeSH secundário: Antirretrovirais/uso terapêutico Antituberculosos/uso terapêutico Gerenciamento Clínico Tuberculose Extensivamente Resistente a Medicamentos/tratamento farmacológico Tuberculose Extensivamente Resistente a Medicamentos/prevenção & controle Infecções por HIV/tratamento farmacológico Infecções por HIV/prevenção & controle Alfabetização em Saúde Pessoal de Saúde Seres Humanos Transmissão de Doença Infecciosa do Paciente para o Profissional Relações Profissional-Paciente Pesquisa Qualitativa Fatores de Risco África do Sul/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Anti-Retroviral Agents); 0 (Antitubercular Agents) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180214 [Lr] Data última revisão: 180214 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161026 [St] Status: MEDLINE

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[PMID]: 29233057 [Au] Autor: Kim M; Koo DW; Shin DJ; Lee SM [Ad] Endereço: 1 University of Florida, Gainesville, USA. [Ti] Título: From Servicescape to Loyalty in the Medical Tourism Industry: A Medical Clinic's Service Perspective. [So] Source: Inquiry;54:46958017746546, 2017 Jan-Dec. [Is] ISSN: 1945-7243 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Medical tourism organizations have increasingly recognized that loyalty makes a medical clinic a marketing success. To increase understanding of the importance of medical clinics, this study examined the roles of servicescapes, emotions, and satisfaction in the development of customer loyalty toward medical clinics and destination. Data were collected among international medical tourists visiting Korea. Results identified that dimensions of medical clinics' servicescape (ie, medical clinic environment, medical treatment, staff, and doctor) influenced emotions and satisfaction among international medical tourists. Also, positive emotions and the 2 dimensions of satisfaction with a medical clinic and doctor mediate the influence of medical clinics' servicescapes on 2 types of loyalty (the medical clinic and Korea for medical care). Overall, these findings indicate that the interrelationship of servicescapes, positive emotion, and satisfaction is essential in influencing international medical tourists' loyalty to a medical clinic. [Mh] Termos MeSH primário: Emoções Turismo Médico Satisfação do Paciente [Mh] Termos MeSH secundário: Adulto Demografia Análise Fatorial Feminino Seres Humanos Masculino Meia-Idade Relações Profissional-Paciente Qualidade da Assistência à Saúde República da Coreia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 180214 [Lr] Data última revisão: 180214 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171214 [St] Status: MEDLINE [do] DOI: 10.1177/0046958017746546

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[PMID]: 29318281 [Au] Autor: Gallagher KC [Ad] Endereço: Vanderbilt University School of Medicine, Nashville, Tennessee. [Ti] Título: She Smiled as She Walked Away. [So] Source: JAMA;319(2):121-122, 2018 Jan 09. [Is] ISSN: 1538-3598 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Pessoal Técnico de Saúde/psicologia Relações Profissional-Paciente Sorriso Maus-Tratos Conjugais/psicologia Tortura/psicologia [Mh] Termos MeSH secundário: Criança Maus-Tratos Infantis Feminino Seres Humanos Medicina Militar [Pt] Tipo de publicação: JOURNAL ARTICLE; PERSONAL NARRATIVES [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180123 [Lr] Data última revisão: 180123 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180111 [St] Status: MEDLINE [do] DOI: 10.1001/jama.2017.19760

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[PMID]: 28449680 [Au] Autor: Hawkins M; Gill SD; Batterham R; Elsworth GR; Osborne RH [Ad] Endereço: Faculty of Health, Centre for Population Health Research, Deakin University, Geelong, Australia. melanie.hawkins@deakin.edu.au. [Ti] Título: The Health Literacy Questionnaire (HLQ) at the patient-clinician interface: a qualitative study of what patients and clinicians mean by their HLQ scores. [So] Source: BMC Health Serv Res;17(1):309, 2017 04 27. [Is] ISSN: 1472-6963 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: The Health Literacy Questionnaire (HLQ) has nine scales that each measure an aspect of the multidimensional construct of health literacy. All scales have good psychometric properties. However, it is the interpretations of data within contexts that must be proven valid, not just the psychometric properties of a measurement instrument. The purpose of this study was to establish the extent of concordance and discordance between individual patient and clinician interpretations of HLQ data in the context of complex case management. METHODS: Sixteen patients with complex needs completed the HLQ and were interviewed to discuss the reasons for their answers. Also, the clinicians of each of these patients completed the HLQ about their patient, and were interviewed to discuss the reasons for their answers. Thematic analysis of HLQ scores and interview data determined the extent of concordance between patient and clinician HLQ responses, and the reasons for discordance. RESULTS: Highest concordance (80%) between patient and clinician item-response pairs was seen in Scale 1 and highest discordance (56%) was seen in Scale 6. Four themes were identified to explain discordance: 1) Technical or literal meaning of specific words; 2) Patients' changing or evolving circumstances; 3) Different expectations and criteria for assigning HLQ scores; and 4) Different perspectives about a patient's reliance on healthcare providers. CONCLUSION: This study shows that the HLQ can act as an adjunct to clinical practice to help clinicians understand a patient's health literacy challenges and strengths early in a clinical encounter. Importantly, clinicians can use the HLQ to detect differences between their own perspectives about a patient's health literacy and the patient's perspective, and to initiate discussion to explore this. Provision of training to better detect these differences may assist clinicians to provide improved care. The outcomes of this study contribute to the growing body of international validation evidence about the use of the HLQ in different contexts. More specifically, this study has shown that the HLQ has measurement veracity at the patient and clinician level and may support clinicians to understand patients' health literacy and enable a deeper engagement with healthcare services. [Mh] Termos MeSH primário: Alfabetização em Saúde Pessoal de Saúde Inquéritos e Questionários [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Feminino Seres Humanos Masculino Meia-Idade Pacientes Relações Profissional-Paciente Psicometria Pesquisa Qualitativa Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 180117 [Lr] Data última revisão: 180117 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170429 [St] Status: MEDLINE [do] DOI: 10.1186/s12913-017-2254-8

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[PMID]: 29243899 [Au] Autor: Laaksovirta H [Ti] Título: Discussing a serious illness with a patient and family. [So] Source: Duodecim;133(11):1076-80, 2017. [Is] ISSN: 0012-7183 [Cp] País de publicação: Finland [La] Idioma: eng [Ab] Resumo: Learning of a serious illness is unique news. Nothing certain can be known about how it will affect the hearer's outlook on the future before a conception is established about the hearer's expectations and how he/she has understood the issue. For example, a person who has been expecting muscle tension to be an explanation for back pain but hearing that a cancer metastasis is the underlying cause, will inevitably be in shock. The healthcare system is not able to influence everything, but is usually given one possibility to make a good first impression when telling about a serious diagnosis. Various lists of issues to be taken into account have been devised to help this. They do not, however, replace effective interaction, which is a matter of skill but can also be practiced. It is possible to anticipate the reactions of the hearers, as long as they remember that feelings are feelings and facts are facts. [Mh] Termos MeSH primário: Relações Profissional-Família Relações Profissional-Paciente Revelação da Verdade [Mh] Termos MeSH secundário: Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180115 [Lr] Data última revisão: 180115 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171216 [St] Status: MEDLINE

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