Home About us Contact
|
Home About us Contact | ||
|
|
||
Team Discussions (team + discussion)
Selected AbstractsReflections on the process of change on acute psychiatric wards during the City Nurse ProjectJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2006C. FLOOD rn The intention of this paper is to discuss the process of therapeutic change on two acute psychiatric wards during a research project that aimed to reduce conflict and containment. Analysis of fieldwork notes, reflection, team discussion and supervision. The City Nurse Project successfully reduced patient aggression, self-harm and absconding. This paper reports on the reflections made over the course of the year as changes and developments to acute wards took place. Specifically discussed are the beneficial effects of an action research approach, the role of the City Nurse, support for ward managers, education and training, clinical supervision as well as difficulties and barriers to the overall process of change. At an interim stage of the project, the staff have shown a willingness to engage in efforts to change and improve two acute wards. This paper shows the potential to improve acute wards and produce positive outcomes using a working model. [source] Defining the surgical management of suspected early-stage ovarian cancer by estimating patient numbers through alternative management strategiesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2009J Warwick Objective, To establish the optimal management strategy for women with suspected stage 1 ovarian cancer. Design, We created a flowchart to illustrate each of six hypothetical management strategies. These considered two surgical approaches (systematic lymphadenectomy versus no lymph node dissection at all) in combination with three different policies for giving adjuvant chemotherapy. Setting, Gynaecological cancer centre, London, UK. Data sources, Patient data and published papers. Methods, We developed a deterministic model that uses information from multiple sources to estimate patient flow through each level of a hypothesised decision tree. Results, We estimated that for every 100 cases of suspected early-stage ovarian cancer, there would be 37 cases with ,apparent' stage 1 disease and that of these, two (6%) would be denied potentially life-saving adjuvant treatment if systematic lymphadenectomy was not performed. The number of women given chemotherapy would not, according to our estimates, differ greatly between the two surgical approaches, the 7% increase with systematic lymphadenectomy being because of cases identified as having nodal metastases. Conclusions, We present a model of the intraoperative decision-making process that determines the extent of the staging procedure to be performed within our department when early-stage ovarian cancer is suspected. Unless adjuvant chemotherapy is prescribed for all, systematic pelvic and para-aortic node dissection is required to optimise survival. However, in our department, this would result in 32% of women with suspected early-stage ovarian cancer undergoing systematic node dissection. This flexible focused model may facilitate multidisciplinary team discussion when this part of the surgical staging procedure is considered within the context of the population presenting to the team, the morbidity of the procedure within the department and the predictive values of frozen section within that department. As the model is not disease-specific, it may be useful for decision making in other medical disciplines. [source] A synergy between action-research and a mixed methods design for improving services and treatment for family members of heavy alcohol and drug usersJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 2 2010Caterina Arcidiacono Abstract Our project first explored the patterns of disempowerment within 113 Italian families facing the problem of a heavy alcohol or drug user in the family. It then provided therapeutic interventions for the members of a further fifty-two families, and thirdly, as a part of the diffusion of the results, it provided brief training for 1,011 professionals supplying services for those suffering from alcohol and drug addiction. Research undertaken in the UK, Mexico and Australia (Copello, Templeton, & Velleman, 2006; Orford et al., 2005a; Orford, Templeton, Velleman, & Copello, 2005b; Velleman & Templeton, 2003) on the impact of substance misuse on families, and on the development of effective interventions to assist those families, supplied the models for this participatory research in Italy. This article discusses the mobilization of health professionals in developing a participatory project within a cross-cultural framework, focusing on research that involved more than 70 researchers and other professionals all over Italy. Research team discussions, peer validation of gathered data and reflexivity all had a significant role. The paper illustrates various issues, which are often not explicitly mentioned in research reports, related to recruitment, cooperation between researchers, interactions between researchers and participants, information about decision-making and the actual modalities of execution of the project. Moreover, the careful descriptions of qualitative research principles within the action research approach and a mixed methods design should enhance the research competencies of psychologists and social scientists involved in the community. Copyright © 2009 John Wiley & Sons, Ltd. [source] Impact of decision-making in a multidisciplinary perinatal teamPRENATAL DIAGNOSIS, Issue 2 2007Hilmar H. Bijma Abstract Objectives (1)To describe the characteristics of decision-making about management of unborn infants with serious anomalies by a multidisciplinary perinatal team. (2)To evaluate the impact of multidisciplinary team discussions on the degree to which decisions about the management of unborn infants with serious anomalies are supported. (3)To evaluate the impact of the team discussions on the arguments used by physicians for their preferences concerning management. Methods Prospective analysis of 78 cases discussed within the multidisciplinary perinatal team of a tertiary centre by means of an anonymous one-page questionnaire with structured questions pertaining to the opinion of the responder on medical management of each case. Results We did not find systematic differences between specialties prior to the discussion of cases. However, discussion with the multidisciplinary perinatal team improved decision-making about management of unborn infants with serious anomalies by enhancing the degree of support for the decisions taken. The discussions of the team did not change the physicians' arguments mentioned for their preferences. Conclusion Multidisciplinary team discussions improve decision-making about management of unborn infants with serious congenital anomalies. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||