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Clinical Resources (clinical + resource)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Harnessing experience: exploring the gap between evidence-based medicine and clinical practice

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2008
M. Cameron Hay PhD
Abstract Rationale, aims and objectives, There is mounting evidence of a gap between Evidence-based Medicine (EBM) and physician clinical practice, in part because EBM is averaged global evidence gathered from exogenous populations which may not be relevant to local circumstances. Local endogenous evidence, collected in particular and ,real world' patient populations may be more relevant, convincing and timely for clinical practice. Evidence Farming (EF) is a concept to provide such local evidence through the systematic collection of clinical experience to guide more effective practice. Methods, We report on the findings of a pilot study of 29 individual and three focus group (n = 10) interviews exploring physicians' evaluations how they use multiple sources of information in clinical decision making and their thoughts on EF. Results, Physicians recognize a gap in translating EBM to practice. Physicians reported that when making clinical decisions, they more often rely on clinical experience, the opinions of colleagues and EBM summarizing electronic clinical resources rather than refer directly to EBM literature. Confidence in making decisions based on clinical experience increases over time, yet few physicians reported having systems for tracking their clinical experience in designing treatment plans and patient outcomes. Most physicians saw EF as a promising way to track experience, thereby making scientific evidence more relevant to their own clinical practices. Conclusion, Clinical experience is relatively neglected by the EBM movement, but if that experience were systematically gathered through an approach such as EF, it would meet a need left unfulfilled by EBM. [source]

Spirituality and nursing: a reductionist approach

NURSING PHILOSOPHY, Issue 1 2008
John Paley MA
Abstract, The vast majority of contributions to the literature on spirituality in nursing make extravagant claims about transcendence, eternity, the numinous, higher powers, higher levels of existence, invisible forces, cosmic unity, the essence of humanity, or other supernatural concepts. Typically, these assertions are made without the support of argument or evidence; and, as a consequence, alternative ways of theorizing ,spirituality' have been closed off, while the lack of consistent scholarship has turned the topic into a metaphysical backwater. In this paper, I adopt a different premise, rejecting unsupported claims, and surveying the ,spirituality' terrain from a naturalistic and reductionist perspective. I argue that, if we rid ourselves of non-naturalistic assumptions, we will discover theoretical and clinical resources in health psychology, social psychology, neuropsychology, and pharmacopsychology , resources which confirm that it is possible to conceptualize the study of existential concerns, and how health professionals might respond to them, in a properly scientific manner. In order to illustrate the potential usefulness of these resources, I will take palliative care as an example. [source]

Guiding Mothers' Management of Health Problems of Very Low Birth-Weight Infants

PUBLIC HEALTH NURSING, Issue 3 2006
F.A.A.N., Karen A. Pridham Ph.D.
ABSTRACT Objective: Explore the feasibility, usefulness, and outcomes of a pilot program to support mothers in developing competencies for managing health problems of their very low birth-weight (VLBW) infants in partnership with the primary care clinician (PCC). Design: In a randomized study, mothers who received guided participation (GP) and printed guidelines for managing VLBW infant health problems were compared with mothers who received only the guidelines and standard care (GL group). Sample: All mothers (GP=20; GL=11) were at least 18 years old and English speaking. Infants were all VLBW (,1,500 g). Intervention: GP began during the infant's neonatal intensive care unit stay and continued with public health nurses (PHNs) and a family service clinician through the infant's first 4 postterm months. Measurements: Intervention feasibility and usefulness were assessed with maternal and clinician feedback. Outcomes included maternal and clinician appraisal of mothers' use of clinical resources and mothers' perceptions of primary-care quality and the family-PCC relationship. Results: Intervention feasibility and usefulness were supported. GP and GL groups did not differ significantly on outcomes. Conclusions: Findings indicate a longer intervention period, GP organized by infant problem episodes, and enhancement of the PHN role in the context of interdisciplinary and interagency collaboration. [source]

Advances in the basic and clinical science of migraine,

ANNALS OF NEUROLOGY, Issue 5 2009
Andrew Charles MD
Migraine continues to be an elephant in the room of medicine: massively common and a heavy burden on patients and their healthcare providers, yet the recipient of relatively little attention for research, education, and clinical resources. Its visibility is gradually increasing, however, as advances in genetics, imaging, epidemiology, and pharmacology produce a more definitive understanding of the condition, and identify more specific and effective treatments. Rapid evolution of concepts regarding its prevalence, pathophysiology, and clinical management is leading to growing recognition of migraine as a fundamentally important disorder of the nervous system. Ann Neurol 2009;65:491,498 [source]