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[PMID]:29304180
[Au] Autor:Berglas NF; Battistelli MF; Nicholson WK; Sobota M; Urman RD; Roberts SCM
[Ad] Endereço:Advancing New Standards in Reproductive Health, University of California, San Francisco (UCSF), Oakland, California, United States of America.
[Ti] Título:The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.
[So] Source:PLoS One;13(1):e0190975, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements. The extent to which facility requirements have an impact on patient outcomes-for any procedure-is unclear. METHODS AND FINDINGS: We conducted a systematic review to examine the effect of outpatient facility type (ASC vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient experience and service availability in non-hospital-affiliated outpatient settings. To identify relevant research, we searched databases of the published academic literature (PubMed, EMBASE, Web of Science) and websites of governmental and non-governmental organizations. Two investigators reviewed 3049 abstracts and full-text articles against inclusion/exclusion criteria and assessed the quality of 22 identified articles. Most studies were hampered by methodological challenges, with 12 of 22 not meeting minimum quality criteria. Of 10 studies included in the review, most (6) examined the effect of facility type on patient safety. Existing research appears to indicate no difference in patient safety for outpatient procedures performed in ASCs vs. physician offices. Research about specific facility characteristics is insufficient to draw conclusions. CONCLUSIONS: More and higher quality research is needed to determine if there is a public health problem to be addressed through facility regulation and, if so, which facility characteristics may result in consistent improvements to patient safety while not adversely affecting patient experience or service availability.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/organização & administração
Hospitais/normas
Segurança do Paciente
Pacientes/psicologia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[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:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190975


  2 / 16965 MEDLINE  
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[PMID]:29237595
[Au] Autor:Bressan RA; Iacoponi E; Candido de Assis J; Shergill SS
[Ad] Endereço:Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK rodrigo.bressan@kcl.ac.uk.
[Ti] Título:Hope is a therapeutic tool.
[So] Source:BMJ;359:j5469, 2017 12 13.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Esperança
Pacientes/psicologia
Relações Médico-Paciente
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5469


  3 / 16965 MEDLINE  
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[PMID]:28452558
[Au] Autor:Abreu A
[Ad] Endereço:Department of Cardiology, Santa Marta Hospital, CHLC, Lisbon, Portugal.
[Ti] Título:Cardiac rehabilitation in cardiac valve surgery patients: Beyond cost-effectiveness.
[So] Source:Eur J Prev Cardiol;24(11):1145-1147, 2017 07.
[Is] ISSN:2047-4881
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Reabilitação Cardíaca
Análise Custo-Benefício
[Mh] Termos MeSH secundário: Implante de Prótese de Valva Cardíaca/reabilitação
Valvas Cardíacas/cirurgia
Seres Humanos
Pacientes
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1177/2047487317706180


  4 / 16965 MEDLINE  
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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


  5 / 16965 MEDLINE  
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[PMID]:29284256
[Au] Autor:Godycki-Cwirko M; Panasiuk L; Brotons C; Bulc M; Zakowska I
[Ad] Endereço:Centre for Family and Community Medicine, Medical University of Lodz, Kopcinskiego 20, 90-153 Lodz, Poland. maciekgc@uni.lodz.pl.
[Ti] Título:Perception of preventive care and readiness for lifestyle change in rural and urban patients in Poland: a questionnaire study.
[So] Source:Ann Agric Environ Med;24(4):732-738, 2017 Dec 23.
[Is] ISSN:1898-2263
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION AND OBJECTIVE: The idiosyncrasies of rural health demand further research to instigate rural health initiatives and to monitor progress in rural health care. In 2008, a study examined health-related behaviour, perception of importance of preventive interventions, readiness to change lifestyle and willingness to receive support from GPs, according to gender and place of residence. MATERIAL AND METHODS: A cross-sectional survey was conducted among patients who visited any of ten randomly-selected general practices in Poland. RESULTS: Four hundred patients were enrolled: 50% from rural areas, 50.3% were females; 23.8% declared a primary level of education (35% rural vs. 12.5% urban) respondents; the median age was 50 years (IQR=18), The predicted means for prevention importance scores for rural residents were 0.623 and for urban residents - 0.682. Place of residence had a significant effect on the importance of prevention (p<0.05; ICC=0.048). Area and gender have a statistically significant effect on preventive behaviour importance scores (p<0.05; ICC=0.0526). Patient expectations of individual counselling by GPs were highest for eating habits - 35.5% rural vs. 16% urban residents (p<0.0001). CONCLUSIONS: Patient importance scores for prevention were associated with residence and gender. The villagers attached less importance to prevention. They also declared less willingness to change their lifestyle. Women had higher scores regarding prevention than men. More rural respondents would like to receive individual counselling from their GP regarding eating habits, physical activity, body weight, giving up smoking and safe alcohol use. Urban respondents were more likely to expect leaflets from their GPs on normalizing body weight.
[Mh] Termos MeSH primário: Estilo de Vida
Pacientes/psicologia
Percepção
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos Transversais
Exercício
Feminino
Seres Humanos
Masculino
Meia-Idade
Polônia
Medicina Preventiva
População Rural
Inquéritos e Questionários
População Urbana
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE


  6 / 16965 MEDLINE  
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[PMID]:29218975
[Au] Autor:Bohra M; Novak M
[Ti] Título:Opportunities and challenges caring for young adults on hemodialysis awaiting transplant.
[So] Source:CANNT J;24(3):25, 2014 Jul-Sep.
[Is] ISSN:1498-5136
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Atitude Frente à Saúde
Transplante de Rim/psicologia
Recursos Humanos de Enfermagem no Hospital/psicologia
Pacientes/psicologia
Diálise Renal/enfermagem
Diálise Renal/psicologia
Insuficiência Renal/terapia
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Feminino
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


  7 / 16965 MEDLINE  
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[PMID]:29218977
[Au] Autor:Mehta S; Cameron K; Battistella M
[Ti] Título:Motivational interviewing: Application to end stage renal disease patients.
[So] Source:CANNT J;24(4):19-22, 2014 Oct-Dec.
[Is] ISSN:1498-5136
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Atitude Frente à Saúde
Promoção da Saúde/métodos
Entrevista Motivacional
Pacientes/psicologia
Insuficiência Renal Crônica/enfermagem
Insuficiência Renal Crônica/psicologia
[Mh] Termos MeSH secundário: Educação Continuada em Enfermagem
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


  8 / 16965 MEDLINE  
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[PMID]:29218963
[Au] Autor:Jacob S; Munro I; Taylor BJ; Griffiths D
[Ti] Título:Mental health recovery: A review of the peer-reviewed published literature.
[So] Source:Collegian;24(1):53-61, 2017.
[Is] ISSN:1322-7696
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:The concept of mental health recovery promotes collaborative partnership among consumers, carers and service providers. However views on mental health recovery are less explored among carers and service providers. The aim of this review was to analyse contemporary literature exploring views of mental health consumers, carers and service providers in relation to their understanding of the meaning of mental health recovery and factors influencing mental health recovery. The literature review questions were: How is mental health recovery and factors influencing mental health recovery viewed by consumers, carers and service providers? What are the differences and similarities in those perceptions? How can the outcomes and recommendations inform the Australian mental health practices? A review of the literature used selected electronic databases and specific search terms and supplemented with manual searching. Twenty-six studies were selected for review which included qualitative, mixed method, and quantitative approaches and a Delphi study. The findings indicated that the concept of mental health recovery is more explored among consumers and is seldom explored among carers and service providers. The studies suggested that recovery from mental illness is a multidimensional process and the concept cannot be defined in rigid terms. In order to achieve the best possible care, the stakeholders require flexible attitudes and openness to embrace the philosophy.
[Mh] Termos MeSH primário: Cuidadores/psicologia
Transtornos Mentais/terapia
Recuperação da Saúde Mental
Serviços de Saúde Mental/organização & administração
Pacientes/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Austrália
Feminino
Grupos Focais
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


  9 / 16965 MEDLINE  
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[PMID]:27778321
[Au] Autor:Etchegaray JM; Ottosen MJ; Aigbe A; Sedlock E; Sage WM; Bell SK; Gallagher TH; Thomas EJ
[Ad] Endereço:RAND Corporation, Santa Monica, CA.
[Ti] Título:Patients as Partners in Learning from Unexpected Events.
[So] Source:Health Serv Res;51 Suppl 3:2600-2614, 2016 Dec.
[Is] ISSN:1475-6773
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:IMPORTANCE: Patient safety experts believe that patients/family members should be involved in adverse event review. However, it is unclear how aware patients/family members are about the causes of adverse events they experienced. OBJECTIVE: To determine whether patients/family members interviewed could identify at least one contributing factor for the event they experienced. Secondary objectives included understanding the way patients/family members became aware of adverse events, the types of contributing factors patients/family members identified for different types of adverse events, and recommendations provided by patients/family members to address the contributing factors. DESIGN: We interviewed patients/family members using semistructured interviews to understand their perceptions about why these adverse events occurred. The adverse events occurred between 1991 and 2014. SETTING: Participants described adverse events that occurred in various types of health care organizations (i.e., hospitals, ambulatory facilities/clinics, and dental clinics). PARTICIPANTS: We interviewed 72 patients and family members who each described a unique adverse event. Eligibility requirements were that patients/family members spoke English or Spanish and were aware of an adverse event that happened to them or a loved one. INTERVENTION(S) FOR CLINICAL TRIALS OR EXPOSURE(S) FOR OBSERVATIONAL STUDIES: N/A. MAIN OUTCOME(S) AND MEASURE(S): The main outcome was determining whether patients/family members could identify at least one contributing factor they perceived as related to the adverse event they described. RESULTS: Each participant identified at least one contributing factor and on average identified 3.67 contributing factors for their event. The most frequently mentioned contributing factors were Staff Qualifications/Knowledge (79 percent), Safety Policies/Procedures (74 percent), and Communication (64 percent). Participants knew about the contributing factors from personal observation only (32 percent), personal reasoning (11 percent), personal research (7 percent), record review (either their own medical records or reports they received in their own investigation; 6 percent), and being told by a physician (5 percent). Finally, patients/family members were able to provide recommendations that address each of the nine contributing factors we examined. CONCLUSIONS AND RELEVANCE: Patients/family members identified contributing factors related to their adverse event. Given that these contributing factors might not be known to health care organizations because most participants stated that they were not involved in the analysis process, opportunities for organizational learning from patients are potentially being missed. Health care organizations should interview patients/family about the event that harmed them to help ensure a full understanding of the causes of the event.
[Mh] Termos MeSH primário: Erros Médicos
Pacientes
[Mh] Termos MeSH secundário: Atitude Frente à Saúde
Família/psicologia
Feminino
Seres Humanos
Entrevistas como Assunto
Masculino
Erros Médicos/prevenção & controle
Erros Médicos/psicologia
Meia-Idade
Pacientes/psicologia
Relações Médico-Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171201
[Lr] Data última revisão:
171201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1111/1475-6773.12593


  10 / 16965 MEDLINE  
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[PMID]:29052704
[Au] Autor:Moore J; Bismark M; Mello MM
[Ad] Endereço:Faculty of Law, University of New South Wales, Sydney, Australia.
[Ti] Título:Patients' Experiences With Communication-and-Resolution Programs After Medical Injury.
[So] Source:JAMA Intern Med;177(11):1595-1603, 2017 Nov 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Dissatisfaction with medical malpractice litigation has stimulated interest by health care organizations in developing alternatives to meet patients' needs after medical injury. In communication-and-resolution programs (CRPs), hospitals and liability insurers communicate with patients about adverse events, use investigation findings to improve patient safety, and offer compensation when substandard care caused harm. Despite increasing interest in this approach, little is known about patients' and family members' experiences with CRPs. Objective: To explore the experiences of patients and family members with medical injuries and CRPs to understand different aspects of institutional responses to injury that promoted and impeded reconciliation. Design, Setting, and Participants: From January 6 through June 30, 2016, semistructured interviews were conducted with patients (n = 27), family members (n = 3), and staff (n = 10) at 3 US hospitals that operate CRPs. Patients and families were eligible for participation if they experienced a CRP, spoke English, and could no longer file a malpractice claim because they had accepted a settlement or the statute of limitations had expired. The CRP administrators identified hospital and insurer staff who had been involved in a CRP event and had a close relationship with the injured patient and/or family. They identified patients and families by applying the inclusion criteria to their CRP databases. Of 66 possible participants, 40 interviews (61%) were completed, including 30 of 50 invited patients and families (60%) and 10 of 16 invited staff (63%). Main Outcomes and Measures: Patients' reported satisfaction with disclosure and reconciliation efforts made by hospitals. Results: A total of 40 participants completed interviews (15 men and 25 women; mean [range] age, 46 [18-67] years). Among the 30 patients and family members interviewed, 27 patients experienced injuries attributed to error and received compensation. The CRP experience was positive overall for 18 of the 30 patients and family members, and 18 patients continued to receive care at the hospital. Satisfaction was highest when communications were empathetic and nonadversarial, including compensation negotiations. Patients and families expressed a strong need to be heard and expected the attending physician to listen without interrupting during conversations about the event. Thirty-five of the 40 respondents believed that including plaintiffs' attorneys in these discussions was helpful. Sixteen of the 30 patients and family members deemed their compensation to be adequate but 17 reported that the offer was not sufficiently proactive. Patients and families strongly desired to know what the hospital did to prevent recurrences of the event, but 24 of 30 reported receiving no information about safety improvement efforts. Conclusions and Relevance: As hospitals strive to provide more patient-centered care, opportunities exist to improve institutional responses to injuries and promote reconciliation.
[Mh] Termos MeSH primário: Comunicação
Família/psicologia
Hospitais
Doença Iatrogênica
Segurança do Paciente
Assistência Centrada no Paciente/organização & administração
Pacientes/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Compensação e Reparação
Feminino
Seres Humanos
Entrevistas como Assunto
Masculino
Meia-Idade
Negociação
Avaliação de Processos e Resultados (Cuidados de Saúde)
Gestão de Riscos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171021
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.4002



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