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[PMID]:29360183
[Au] Autor:Izumi S; Barfield PA; Basin B; Mood L; Neunzert C; Tadesse R; Bradley KJ; Tanner CA
[Ad] Endereço:Oregon Health & Science University School of Nursing, Portland, Oregon.
[Ti] Título:Care coordination: Identifying and connecting the most appropriate care to the patients.
[So] Source:Res Nurs Health;41(1):49-56, 2018 02.
[Is] ISSN:1098-240X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although nurses are increasingly expected to fulfill the role of care coordinator, the knowledge and skills required to be an effective care coordinator are not well understood. The purpose of this study was to describe the knowledge and skills required in care coordination practice using an interpretive phenomenological approach. Fifteen care coordinators from 10 programs were interviewed over a 6-month period. Semi-structured face-to-face interviews were audio recorded, transcribed, and analyzed using interpretive phenomenology. The central theme of care coordination practice was bridging the patient and the healthcare systems. To bridge, care coordinators needed to have knowledge of the patient and healthcare system as well as the skills to identify and negotiate treatments appropriate for the patient. The most salient finding and new to this literature was that care coordinators who used their medical knowledge about available treatment options to discern and negotiate for the most appropriate care to the patient made differences in patient outcomes. Nurses with medical and healthcare system knowledge, combined with the skills to navigate and negotiate with others in an increasingly complex healthcare system, are well situated to be care coordinators and generate optimal outcomes. Further investigations of critical care coordinator competencies are needed to support nurses currently enacting the role of care coordinator and to prepare future nurses to fulfill the role.
[Mh] Termos MeSH primário: Equipe de Assistência ao Paciente/organização & administração
Assistência Centrada no Paciente/organização & administração
Qualidade da Assistência à Saúde/organização & administração
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Colaboração Intersetorial
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1002/nur.21843


  2 / 15179 MEDLINE  
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[PMID]:29292946
[Au] Autor:Osmancevic A; Ståhle M
[Ad] Endereço:Sahlgrenska Universitetssjukhuset - Hudkliniken Göteborg, Sweden Sahlgrenska Universitetssjukhuset - Hudkliniken Göteborg, Sweden.
[Ti] Título:Behandling av psoriasis: från tjära till biologiska läkemedel - Terapiarsenalen har förändrats dramatiskt ­ nya läkemedel kan ge helt läkt hud till fler patienter..
[So] Source:Lakartidningen;114, 2017 Nov 21.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Ab] Resumo:Treatment of psoriasis: before and now  Psoriasis is a multisystem inflammatory disease primarily affecting the skin. Despite its prevalence and considerable effect on quality of life, psoriasis is still underdiagnosed and undertreated. Many patients seek initial evaluation and treatment at primary care level and therefore it is important to know that treatment of psoriasis has advanced tremendously in recent years. Decisions on psoriasis management should be based on assessment of disease severity and phenotype, the existence of physical and psychological comorbidities, the need for referral to dermatologist for specialist care, the patient's preferences and, when possible, identification and elimination of psoriasis trigger factors. Individual treatment goals should be agreed with the patient and treatment should aim to achieve these goals. An individualized, patient centered approach based on the potential of current treatments and a good interpersonal communication between patient and doctor, is essential for effective management of psoriasis.
[Mh] Termos MeSH primário: Fármacos Dermatológicos/uso terapêutico
Psoríase/tratamento farmacológico
[Mh] Termos MeSH secundário: Terapia Biológica
Fármacos Dermatológicos/economia
Estilo de Vida Saudável
Seres Humanos
Assistência Centrada no Paciente
Guias de Prática Clínica como Assunto
Medicina de Precisão
Psoríase/diagnóstico
Psoríase/terapia
Qualidade de Vida
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dermatologic Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


  3 / 15179 MEDLINE  
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[PMID]:28463635
[Au] Autor:O'Hare AM; Song MK; Kurella Tamura M; Moss AH
[Ad] Endereço:1 Department of Medicine, University of Washington and Veterans Affairs Puget Sound Healthcare System , Seattle, Washington.
[Ti] Título:Research Priorities for Palliative Care for Older Adults with Advanced Chronic Kidney Disease.
[So] Source:J Palliat Med;20(5):453-460, 2017 May.
[Is] ISSN:1557-7740
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Older adults with advanced chronic kidney disease (CKD) often have multiple comorbid conditions, a high symptom burden, and limited life expectancy. There is mounting concern that the intensive patterns of care that many of these patients receive at the end of life are discordant with their values and preferences. The nephrology community has recognized that there are significant unmet palliative care needs in this population. In this article, we identify three broad areas of knowledge deficit where more evidence is needed to support the "best care possible" for this population: (1) what matters most to older adults with advanced CKD and their caregivers near the end of life; (2) how the nephrology community can best support older adults with advanced CKD to navigate complex treatment decisions throughout their illness; and (3) how the healthcare system should be reconfigured to promote patient- and family-centered care for older adults with advanced CKD. Research priorities include identifying opportunities for improving the end-of-life experience of older adults with CKD and their caregivers; developing and testing communication interventions before and during dialysis to ensure that treatment decisions reflect patients' preferences; and assessing the effectiveness of palliative care in improving quality of life for patients and caregivers, satisfaction with care, and aligning treatment decisions with patient goals and preferences.
[Mh] Termos MeSH primário: Diálise/métodos
Enfermagem Geriátrica/métodos
Cuidados Paliativos/métodos
Preferência do Paciente
Assistência Centrada no Paciente/métodos
Insuficiência Renal Crônica/enfermagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Tomada de Decisões
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1089/jpm.2016.0571


  4 / 15179 MEDLINE  
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[PMID]:29400938
[Ti] Título:A Provider's Condensed Resource for Revenue Cycle, Coding Tools, and More.
[So] Source:J AHIMA;88(1):44-7, 2017 Jan.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Codificação Clínica
Medicare/economia
Guias de Prática Clínica como Assunto
[Mh] Termos MeSH secundário: Tomada de Decisões
Documentação/normas
Definição da Elegibilidade
Seres Humanos
Medicare Access and CHIP Reauthorization Act of 2015
Patient Protection and Affordable Care Act
Assistência Centrada no Paciente
Estados Unidos
Aquisição Baseada em Valor
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE


  5 / 15179 MEDLINE  
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[PMID]:28449612
[Au] Autor:Schattner A
[Ad] Endereço:a The Faculty of Medicine , Hadassah Medical School, Hebrew University , Jerusalem , Israel.
[Ti] Título:Residents' responsibilities: Adopting a wider view.
[So] Source:Med Teach;39(12):1286-1289, 2017 Dec.
[Is] ISSN:1466-187X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Current ACGME regulations have limited residents' weekly hours and continuous working hours, a marked change, despite its uncertain effects on physician well-being and quality of care. Although residency programs in internal medicine and family medicine have adapted schedules to conform to these regulations, increasing evidence is accumulating to suggest that these training experiences are not adequately preparing the next generation of practicing primary care and hospital-based physicians. Data from an array of sources continue to demonstrate significant deficiencies in six areas of residents' responsibilities towards their patients: diminished patient "face time" and direct patient care; focus on patients' "reason for hospitalization" or "reason for visit" at the expense of possible neglect of patients' "secondary" medical problems; limited attention to patients' emotional or contextual problems and limited empathy; deficient implementation of the essential constituents of patient-centered care; neglect of habitual "reflective practice"; and excessive distinction between inpatient and outpatient responsibilities, leading to missed opportunities for inpatient residents to be aware of and attend to patients' post-discharge course although new information and readmissions related to the index hospitalization are prevalent. Thus, redesigning residency programs to widen residents' outlook and cover these inseparable components of high-quality care, may infuse the often fatigued and burnt-out residents with purpose and fulfillment, finally incorporating the missing elements of patient-centered care as integral parts of patients' admissions and therefore, of physicians' future careers.
[Mh] Termos MeSH primário: Competência Clínica
Empatia
Internato e Residência/organização & administração
Assistência Centrada no Paciente/organização & administração
Estudantes de Medicina/psicologia
[Mh] Termos MeSH secundário: Emoções
Seres Humanos
Internato e Residência/normas
Alta do Paciente
Assistência Centrada no Paciente/normas
Admissão e Escalonamento de Pessoal
Qualidade da Assistência à Saúde/organização & administração
Fatores de Tempo
[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:170429
[St] Status:MEDLINE
[do] DOI:10.1080/0142159X.2017.1319916


  6 / 15179 MEDLINE  
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[PMID]:29206955
[Au] Autor:Rizzo VM; Rowe JM; Shier Kricke G; Krajci K; Golden R
[Ad] Endereço:Department of Social Work, Binghamton University, PO Box 6000, Binghamton, NY 13902; Department of Social Work, University of Wisconsin-Whitewater. Center for Health Care Studies, Northwestern University, Chicago. Health and Aging, Rush University Medical Center, Chicago.
[Ti] Título:AIMS: A Care Coordination Model to Improve Patient Health Outcomes.
[So] Source:Health Soc Work;41(3):191-195, 2016 Aug 01.
[Is] ISSN:0360-7283
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Assistência Centrada no Paciente/organização & administração
Serviço Social
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Administração de Caso/organização & administração
Comportamento Cooperativo
Feminino
Seres Humanos
Masculino
Meia-Idade
Equipe de Assistência ao Paciente/organização & administração
Satisfação do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/hsw/hlw029


  7 / 15179 MEDLINE  
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[PMID]:29369272
[Au] Autor:Ferguson R
[Ad] Endereço:Rita Ferguson is a clinical assistant professor at the University of Alabama in Huntsville College of Nursing, and was formerly director of nursing at the Hospice of Limestone County in Athens, Ala.
[Ti] Título:Care coordination at end of life: The nurse's role.
[So] Source:Nursing;48(2):11-13, 2018 Feb.
[Is] ISSN:1538-8689
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Enfermagem de Cuidados Paliativos na Terminalidade da Vida/organização & administração
Papel do Profissional de Enfermagem
Transferência de Pacientes/organização & administração
Assistência Terminal/organização & administração
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Insuficiência Cardíaca/enfermagem
Seres Humanos
Masculino
Estudos de Casos Organizacionais
Assistência Centrada no Paciente
[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.0000527610.70581.fa


  8 / 15179 MEDLINE  
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[PMID]:29222180
[Au] Autor:Montori VM
[Ad] Endereço:Mayo Clinic, Rochester, MN, USA.
[Ti] Título:Big Science for patient centred care.
[So] Source:BMJ;359:j5600, 2017 12 08.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Pesquisa Biomédica/métodos
Assistência Centrada no Paciente
[Mh] Termos MeSH secundário: Coleta de Dados/métodos
Seres Humanos
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171210
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5600


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[PMID]:28452911
[Au] Autor:Powell AM; DeVita JM; Ogburu-Ogbonnaya A; Peterson A; Lazenby GB
[Ad] Endereço:Department of Obstetrics and Gynecology, The Medical University of South Carolina, Charleston, SC.
[Ti] Título:The Effect of HIV-Centered Obstetric Care on Perinatal Outcomes Among a Cohort of Women Living With HIV.
[So] Source:J Acquir Immune Defic Syndr;75(4):431-438, 2017 08 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Elimination of perinatal transmission is possible but limited by missed care opportunities. Our objective was to investigate the effects of HIV-centered obstetric care (HCC) on missed care opportunities and perinatal HIV transmission in 2 obstetric cohorts at our institution from 2000 to 2014. METHODS: This was a retrospective cohort study of HIV-exposed mother-infant pairs delivering from 2000 to 2014, analyzed according to SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence) guidelines. Before 2009, women received care in high-risk obstetric care (HRC); subsequently, an HCC service was established. Women who received HRC vs HCC obstetric care were compared to determine differences in maternal and neonatal outcomes. Continuous variables were compared with Student t test and Wilcoxon rank sum tests. Categorical variables were compared using χ test and Fisher exact test. Logistic regression analyses were performed to determine factors associated with outcomes of interest. RESULTS: Over 14 years, 161 women delivered 217 HIV-exposed infants; 78 (36%) women received HCC. Two perinatal HIV transmissions (1.5%) occurred in HRC group compared with none in the HCC group (P = 0.3). Women in HCC were more likely to have HIV RNA viral load <1000 copies per milliliter at delivery (12% vs 26%, P = 0.02), have a contraception plan before delivery (93% vs 60%, P < 0.001), return for postpartum evaluation (80% vs 63%, P = 0.01), and have undetectable HIV viral load postpartum (50 copies per milliliter vs 2067, P < 0.0001). CONCLUSIONS: HCC can potentially reduce the risk of perinatal HIV transmission by improving maternal virologic control during pregnancy and postpartum and increasing postpartum contraceptive use.
[Mh] Termos MeSH primário: Infecções por HIV/tratamento farmacológico
Infecções por HIV/prevenção & controle
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Serviços de Saúde Materna
Assistência Centrada no Paciente/normas
Complicações Infecciosas na Gravidez/tratamento farmacológico
Qualidade da Assistência à Saúde/normas
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/uso terapêutico
Contagem de Linfócito CD4
Feminino
Seres Humanos
Recém-Nascido
Saúde Materna
Serviços de Saúde Materna/normas
Período Pós-Parto
Gravidez
Complicações Infecciosas na Gravidez/virologia
RNA Viral
Estudos Retrospectivos
Fatores de Risco
Estados Unidos/epidemiologia
Carga Viral
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents); 0 (RNA, Viral)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001432


  10 / 15179 MEDLINE  
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[PMID]:29351295
[Au] Autor:Spoorenberg SLW; Wynia K; Uittenbroek RJ; Kremer HPH; Reijneveld SA
[Ad] Endereço:University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, Groningen, The Netherlands.
[Ti] Título:Effects of a population-based, person-centred and integrated care service on health, wellbeing and self-management of community-living older adults: A randomised controlled trial on Embrace.
[So] Source:PLoS One;13(1):e0190751, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effects of the population-based, person-centred and integrated care service 'Embrace' at twelve months on three domains comprising health, wellbeing and self-management among community-living older people. METHODS: Embrace supports older adults to age in place. A multidisciplinary team provides care and support, with intensity depending on the older adults' risk profile. A randomised controlled trial was conducted in fifteen general practices in the Netherlands. Older adults (≥75 years) were included and stratified into three risk profiles: Robust, Frail and Complex care needs, and randomised to Embrace or care as usual (CAU). Outcomes were recorded in three domains. The EuroQol-5D-3L and visual analogue scale, INTERMED for the Elderly Self-Assessment, Groningen Frailty Indicator and Katz-15 were used for the domain 'Health.' The Groningen Well-being Indicator and two quality of life questions measured 'Wellbeing.' The Self-Management Ability Scale and Partners in Health scale for older adults (PIH-OA) were used for 'Self-management.' Primary and secondary outcome measurements differed per risk profile. Data were analysed with multilevel mixed-model techniques using intention-to-treat and complete case analyses, for the whole sample and per risk profile. RESULTS: 1456 eligible older adults participated (49%) and were randomized to Embrace (n(T0) = 747, n(T1) = 570, mean age 80.6 years (SD 4.5), 54.2% female) and CAU (n(T0) = 709, n(T1) = 561, mean age 80.8 years (SD 4.7), 55.6% female). Embrace participants showed a greater-but clinically irrelevant-improvement in self-management (PIH-OA Knowledge subscale effect size [ES] = 0.14), and a greater-but clinically relevant-deterioration in health (ADL ES = 0.10; physical ADL ES = 0.13) compared to CAU. No differences in change in wellbeing were observed. This picture was also found in the risk profiles. Complete case analyses showed comparable results. CONCLUSIONS: This study found no clear benefits to receiving person-centred and integrated care for twelve months for the domains of health, wellbeing and self-management in community-living older adults.
[Mh] Termos MeSH primário: Prestação Integrada de Cuidados de Saúde/organização & administração
Vida Independente
Assistência Centrada no Paciente
Qualidade de Vida
Autocuidado
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Idoso de 80 Anos ou mais
Feminino
Idoso Fragilizado
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190751



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