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Patient Relationships (patient + relationships)
Selected AbstractsCulturally diverse patient,nurse interactions on acute care wardsINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2006Jane Cioffi RN PhD The nurse,patient interaction is central to providing nursing care. This qualitative study explores nurses' and culturally diverse patients' experiences within nurse,patient relationships in acute care wards. Eight nurses and their respective patients volunteered to join the study and were interviewed. The three themes identified in relationships between nurses and culturally diverse patients were shared tension, perceived difference and held awareness. It is concluded from the study that relationships between nurses and culturally diverse patients in acute care wards during short episodes of hospitalization are not easy for nurses and need to receive deeper consideration as to how they can be developed more effectively. It is recommended that educational support be provided to develop more effective interactions between nurses and patients with research being carried out to investigate factors that can strengthen culturally diverse patient,nurse interactions in acute care settings. [source] Telemedicine: barriers and opportunities in the 21st centuryJOURNAL OF INTERNAL MEDICINE, Issue S741 2001B. Stanberry Abstract. Stanberry B (Centre for Law Ethics and Risk in Telemedicine, Cardiff, Wales, UK). Telemedicine: barriers and opportunities in the 21st century (Internal Medicine in the 21st Century). J Intern Med 2000; 247: 615,628. This paper aims to examine how health telematics will develop in the first 10 years of the new millennium and, in particular, to assess what operational, ethical and legal barriers may lie in the way of this development. A description of the key principles and concepts involved in telemedicine and a short historical overview of telemedicine's evolution over the past century are followed by consideration of why empirical research into ,info-ethics' and other deontological and legal issues relating to telemedicine is being necessarily catalysed by, amongst others, the European Commission. Four evolving health telematics applications are examined in some detail: electronic health records; the transmission of visual media in disciplines such as teleradiology, teledermatology, telepathology and teleophthalmology; telesurgery and robotics and the use of call centres and decision-support software. These are discussed in the light of their moral, ethical and cultural implications for clinicians, patients and society at large. The author argues that telemedicine presents unique opportunities for both patients and clinicians where it is implemented in direct response to clear clinical needs, but warns against excessive reliance upon technology to the detriment of traditional clinician,patient relationships and against complacency regarding the risks and responsibilities , many of which are as yet unknown , that distant medical intervention, consultation and diagnosis carry. [source] Telemedicine: barriers and opportunities in the 21st centuryJOURNAL OF INTERNAL MEDICINE, Issue 6 2000B. Stanberry Abstract. Stanberry B (Centre for Law Ethics and Risk in Telemedicine, Cardiff, Wales, UK). Telemedicine: barriers and opportunities in the 21st century (Internal Medicine in the 21st Century). J Intern Med 2000; 247: 615,628. This paper aims to examine how health telematics will develop in the first 10 years of the new millennium and, in particular, to assess what operational, ethical and legal barriers may lie in the way of this development. A description of the key principles and concepts involved in telemedicine and a short historical overview of telemedicine's evolution over the past century are followed by consideration of why empirical research into ,info-ethics' and other deontological and legal issues relating to telemedicine is being necessarily catalysed by, amongst others, the European Commission. Four evolving health telematics applications are examined in some detail: electronic health records; the transmission of visual media in disciplines such as teleradiology, teledermatology, telepathology and teleophthalmology; telesurgery and robotics and the use of call centres and decision-support software. These are discussed in the light of their moral, ethical and cultural implications for clinicians, patients and society at large. The author argues that telemedicine presents unique opportunities for both patients and clinicians where it is implemented in direct response to clear clinical needs, but warns against excessive reliance upon technology to the detriment of traditional clinician,patient relationships and against complacency regarding the risks and responsibilities , many of which are as yet unknown , that distant medical intervention, consultation and diagnosis carry. [source] Medical Error and Patient Safety: Understanding Cultures in ConflictLAW & POLICY, Issue 2 2002Joanna Weinberg Evidence documenting the high rate of medical errors to patients has taken a prominent place on the health care radar screen. The injuries and deaths associated with medical errors represent a major public health problem with significant economic costs and erosion of trust in the health care system. Between 44,000 and 98,000 deaths due to preventable medical errors are estimated to occur each year, making medical errors the eighth leading cause of death in the United States. However, the recent prominence of the issue of safety or error does not reflect a new phenomenon or sudden rift in the quality of health care (although it is a system fraying at the edges). Rather, the prominence of the issue reflects a radical change in the culture of health care, and in how relationships within the health care system are structured and perceived. In this paper, I discuss the multiple factors responsible for the change in the culture of health care. First, the culture has shifted from a clinician cantered system, in which decision making is one,sided, to a shared system of negotiated care between clinician and patient, and, often, between administrator or payer. Second, the nature of quality in health care has changed due to the geometric increase in the availability of technological and pharmaceutical enhancements to patient care. Third, the health care culture continues to rely on outdated models of conflict resolution. Finally, the regulatory structure of health system oversight was set in place when fee,for,service care governed physician,patient relationships and where few external technologies were available. In the current health care culture, that structure seems inadequate and diffuse, with multiple and overlapping federal and state regulatory structures that make implementation of patient safety systems difficult. [source] Explorations of a trust approach for nursing ethicsNURSING INQUIRY, Issue 1 2001Elizabeth Peter Explorations of a trust approach for nursing ethics Trust has long been acknowledged as central to nurse,patient relationships. It, however, has not been fully explored nor-matively. That is, trust must be examined from a perspective that encompasses not only reliability and competence, but also good will within nursing relationships. In this paper, we explore how a trust approach, based on Annette Baier's work on trust in feminist ethics, could help inform future developments in nursing ethics. We discuss the limitations of other approaches such as those based on contracts, paternalism, and care. By drawing out central features of Baier's theory, we demonstrate how it can help overcome the problems of these previous models. In doing so, we emphasise the importance of combining the ethics of care and justice, acknowledging vulnerability and the potential for evil in nursing relationships, and politically situating the ethical concerns of nursing. [source] Needs, closeness and responsibilities.NURSING PHILOSOPHY, Issue 2 2001An inquiry into some rival moral considerations in nursing care Abstract The first part of this paper seeks to clarify how interpersonal relationships are generally rooted in considerations about trust, vulnerability and interpersonal dependence. However, for nurse,patient relationships, and from the point of view of justice and fair rationing, it is essential to investigate their distinct moral nature. Hence, the second part of the paper argues that nurse,patient relationships, as a special kind of interpersonal relationship, raise particular normative issues. I will discuss dilemmas facing nurses and professional care-givers in general who are torn between their obligations to existing patients and more general and impartial considerations regarding the distribution of nursing care. This discussion concerning the normative claims of immediacy and mercy vs. fairness in health care is a pressing issue for nursing care. The claims that arise from particular relationships in nursing care are typically associated with closeness to a person's vulnerabilities. The pressing issue is how considerations of mercy and protection of individual patients can be safeguarded within today's nursing and health-care practices in which distributivist considerations are crucial. [source] Perspectives on Prescribing: Pioneers' Narratives and AdvicePERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2002Ann Hales PhD PURPOSE. To recount "pearls of wisdom" concerning prescriptive privileges of the psychiatric nursing pioneers. METHODS. A thematic analysis of documented "stories" from 32 psychiatric APNs concerning acquisition of and having prescriptive privileges. FINDINGS. A thematic analysis of psychiatric APN stories revealed five major themes related to prescriptive authority: acquisition of knowledge, professional and patient relationships, legislative logistics, balance within the role, and management of anxiety and the sense of responsibility. CONCLUSIONS. Prescriptive authority offers broad opportunities for advanced practice psychiatric nurses. Educational programs include competencies and skills for prescribing, but another learning tool is the use of collective practical knowledge and wisdom offered by psychiatric nurses who are pioneers in the prescribing arena. [source] A construct validity study of clinical competence: A multitrait multimethod matrix approachTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 1 2010Lubna Baig MBBS, PhD Managing Director, Professor of Community Medicine Abstract Introduction: The purpose of the study was to adduce evidence for estimating the construct validity of clinical competence measured through assessment instruments used for high-stakes examinations. Methods: Thirty-nine international physicians (mean age = 41 + 6.5 y) participated in high-stakes examination and 3-month supervised clinical practice to determine the practice readiness of physicians. Three traits,doctor,patient relationship, clinical competence, and communication skills,were assessed with objective structured clinical examinations, in-training evaluation reports, and clinical assessments. These traits were intercorrelated in a multitrait multimethod matrix (MTMM). Results: The reliability of assessments ranged from moderate to high (Cronbach's ,: 0.58,0.98; Ep2 = 0.79). There is evidence for both convergent and divergent validity for clinical competence, followed by doctor,patient relationships, and communications (validity coefficients = 0.12,0.85). The correlations between the same methods but different traits indicate that there is substantial method specificity in the assessment accounting for nearly one-quarter of the variance (23.7%). Discussion: There is evidence for the construct validity of all 3 traits across 3 methods. The MTMM approach, currently underutilized, could be used to estimate the degree of evidence for validating complex constructs, such as clinical competence. [source] Development of atopic dermatitis-specific communication tools: Interview form and question and answer brochureTHE JOURNAL OF DERMATOLOGY, Issue 3 2007Sachiko OGAWA ABSTRACT At first consultation, it is sometimes difficult for patients to decide which questions they want to ask most. We investigated whether an improvement in interview forms would identify the questions that patients want to ask doctors and help patients express their needs. First, we developed a two-part interview form specifically for atopic dermatitis (AD) patients. The first part was related to diagnosis. In the second part, we determined the most frequently asked questions by patients in daily AD clinics and included these in a prompt interview form, which we called "Questions You May Want to Ask". We compared this new interview form with the standard interview one used in our hospital. Then we made a brochure with answers to those questions. Finally, we evaluated the usefulness of these communication tools. The usefulness of the AD-specific interview form and the answer brochure was validated by patients and/or their surrogates. The majority of them recognized the necessity for and usefulness of these tools to communicate appropriately with their doctors. The answer brochure significantly increased their understanding of AD. The AD-specific interview form and the answer brochure are useful communication tools to improve doctor,patient relationships. [source] Towards a more place-sensitive nursing research: an invitation to medical and health geographyNURSING INQUIRY, Issue 4 2002Gavin J. Andrews During recent years, nursing research has adopted and integrated perspectives and theoretical frameworks from a range of social science disciplines. I argue however, that a lack of attention has been paid in past research to the subdiscipline of medical geography. Although this may, in part, be attributed to a divergence between research priorities and foci, traditional ,scientific' geographical approaches may still be relevant to a wide range of nursing research. Furthermore, a recasting, redirecting and broadening of medical geography in the 1990s, towards what is termed health geography, has enhanced the discipline and provided a more cultural and expansive recognition of health, and a more comprehensive understanding of the dynamic relationship between people, health and place. Given the increasing range of places where health-care is provided and received, and some recent linkages made between nursing and place by nurse-theorists, these newer perspectives and concepts may be particularly useful for interpreting nurses' and patients' relationships both within and with a variety of healthcare settings and living spaces. Indeed, although a more place-sensitive nursing research is potentially a trans-disciplinary academic endeavor, a range of geographical approaches would be central to such a project. [source] | ||||||||||