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Realistic Expectations (realistic + expectation)
Selected AbstractsPatients undergoing total hip arthroplasty: a perioperative pain experienceJOURNAL OF CLINICAL NURSING, Issue 4 2006Margareta Warrén Stomberg PhD Aim., The aim was to evaluate patient's perioperative pain experience after total hip replacement and patients' satisfaction with pain management. Background., Total hip arthroplasty is a common surgical procedure intended to reduce pain and return patients to better function. Realistic expectations about total hip arthroplasty is important for optimal postoperative recovery and the information must be adapted to fit the individual patient. Methods., A descriptive design was used comparing patients outcome data. Pitman's test was used for statistical analyses. Adult patients (n = 112) undergoing surgical hip replacement procedures answered a 17-item questionnaire on the fourth postoperative day. The questionnaire included given alternatives and visual analogue scales (0,100 mm) for the pain assessment. Result., The patients' postoperative pain experience after hip replacement surgery was in average low, 33·1 mm on a 100 mm visual analogue scale. Patient's pain experience was reported to be highest on the first postoperative day for most of the patients. The preoperative pain experience tends to be higher than the postoperative pain experience. Older patients reported less average pain level postoperatively. Satisfaction with pain management was high. Conclusion., The pain experience tends to be higher preoperatively than postoperatively. Patients who reported a higher pain experience postoperatively reported that their pain experience was significant higher than preoperative expected. Relevance to practice., It is important for the postoperative outcome measure that the patients have a realistic expectation of pain experiences after total hip arthroplasty. The nurse is one of the staff members responsible for information to the individual patient. [source] Is optimal foraging a realistic expectation in orb-web spiders?ECOLOGICAL ENTOMOLOGY, Issue 4 2009WILL EDWARDS Abstract 1.,Explanations for web relocation invoking optimal foraging require reliable differentiation between individual sites and overall habitat quality. We characterised natural conditions of resource variability over 20 days in artificial webs of the orb-web spider Gasteracantha fornicata to examine this requirement. 2.,Variability in catch success was high. Day-to-day catch success in 90% (18/20) catch sites fitted negative binomial distributions, whereas 10% fitted Poisson distributions. Considered across trap sites (overall habitat), variance in catch success increased proportionally faster than the mean (i.e. Taylor's Power Law, variance = 0.54mean1.764). 3.,We compared the confidence intervals for the expected cumulative catch in randomly drawn sequential samples from a frequency distribution representing the overall habitat (based on the parameters for Taylor's power law) and the frequency distribution of expected cumulative catch within each individual catch site [via randomisation based on the mean and negative binomial exponent (k)]. 4.,In all cases and across all sample sizes, median values for the power to differentiate habitat and catch sites never exceeded 0.2, suggesting that principles involved in optimal foraging, if operating, must be accompanied by a very high degree of uncertainty. 5.,Under conditions of high resource variability, many days must be spent in a single catch site if movement decisions are based on an ability to differentiate current catch site from overall habitat. Empirical evidence suggests this is never met. This may explain why proximal mechanisms that illicit quickly resolved behavioural responses have been more successful in describing web relocation patterns than those associated with optimal foraging. [source] Differences in attitudes between patients with primary colorectal cancer and patients with secondary colorectal cancer: is it reflected in their willingness to participate in drug trials?EUROPEAN JOURNAL OF CANCER CARE, Issue 2 2005G. GARCEA mrcs Recruitment of patients into drug trials is essential in order to evaluate new treatments. Knowing why patients enter drug trials and their fears regarding them can be used in future research to ensure good recruitment and provide a supportive atmosphere for patients. Forty patients with colorectal cancer and 30 patients with colorectal liver metastases were asked to participate in a drug trial involving the oral consumption of a diet-derived agent of unknown therapeutic action. All patients agreeing or refusing to participate were asked to complete a short questionnaire with a series of options detailing the reasons behind their decision. Patients with colorectal hepatic metastases were motivated by altruism in entering the trial (e.g. helping others, helping the investigator) and displayed a realistic expectation that the drug would give little direct benefit to them. Patients with primary colorectal tumours were motivated by more ,selfish' reasons such as helping themselves and displayed an unrealistic expectation concerning any therapeutic benefit from the trial drug. Over 90% of all patients polled stated that their decision was made after reading the patient information leaflet. Patients with different stages of the same disease have very different fears and anticipations of drug trials, which need to be addressed specifically. The importance of the initial contact is demonstrated. Unrealistic expectations regarding the trial drug are common despite clear information to the contrary. [source] Patients undergoing total hip arthroplasty: a perioperative pain experienceJOURNAL OF CLINICAL NURSING, Issue 4 2006Margareta Warrén Stomberg PhD Aim., The aim was to evaluate patient's perioperative pain experience after total hip replacement and patients' satisfaction with pain management. Background., Total hip arthroplasty is a common surgical procedure intended to reduce pain and return patients to better function. Realistic expectations about total hip arthroplasty is important for optimal postoperative recovery and the information must be adapted to fit the individual patient. Methods., A descriptive design was used comparing patients outcome data. Pitman's test was used for statistical analyses. Adult patients (n = 112) undergoing surgical hip replacement procedures answered a 17-item questionnaire on the fourth postoperative day. The questionnaire included given alternatives and visual analogue scales (0,100 mm) for the pain assessment. Result., The patients' postoperative pain experience after hip replacement surgery was in average low, 33·1 mm on a 100 mm visual analogue scale. Patient's pain experience was reported to be highest on the first postoperative day for most of the patients. The preoperative pain experience tends to be higher than the postoperative pain experience. Older patients reported less average pain level postoperatively. Satisfaction with pain management was high. Conclusion., The pain experience tends to be higher preoperatively than postoperatively. Patients who reported a higher pain experience postoperatively reported that their pain experience was significant higher than preoperative expected. Relevance to practice., It is important for the postoperative outcome measure that the patients have a realistic expectation of pain experiences after total hip arthroplasty. The nurse is one of the staff members responsible for information to the individual patient. [source] Seeking balance in graduate school: A realistic expectation or a dangerous dilemma?NEW DIRECTIONS FOR STUDENT SERVICES, Issue 115 2006Chris Peterson Brus DirectorArticle first published online: 25 SEP 200 With the significant increase in graduate students characterized as nontraditional, challenges associated with balance have become more prominent. The author explores issues of work-life balance, institutional ownership, and the chilly climate, each of which can contribute to negative academic outcomes. [source] Modeling the Effects of a Service Guarantee on Perceived Service Quality Using Alternating Conditional Expectations (ACE),DECISION SCIENCES, Issue 3 2002Chee-Chuong Sum ABSTRACT This paper addresses the dearth of empirical research on the relationship between service guarantee and perceived service quality (PSQ). In particular, we examine the moderating effects of a service guarantee on PSQ. While a recent study provided empirical evidence that service quality is affected by service guarantee and employee variables such as employee motivation/vision and learning through service failure, the nature and form of the relationships between these variables remain unclear. Knowledge of these relationships can assist service managers to allocate resources more judiciously, avoid pitfalls, and establish more realistic expectations. Data was obtained from employees and customers of a multinational hotel chain that has implemented a service guarantee program in 89 of its hotels in America and Canada. As the employee variables could affect performance in a non-linear fashion, we relaxed the assumption of model linearity by using the Alternating Conditional Expectations (ACE) algorithm to arrive at a better-fitting, non-linear regression model for PSQ. Our findings indicate the existence of significant non-linear relationships between PSQ and its determinant variables. The ACE model also revealed that service guarantee interacts with the employee variables to affect PSQ in a non-linear fashion. The non-linear relationships present new insights into the management of service guarantees and PSQ. Explanations and managerial implications of our results are presented and discussed. [source] The Art of Repair in Surgical Hair Restoration Part I: Basic Repair StrategiesDERMATOLOGIC SURGERY, Issue 9 2002Robert M. Bernstein MD background. An increasingly important part of many hair restoration practices is the correction of hair transplants that were performed using older, outdated methods, or the correction of hair transplants that have left disfiguring results. The skill and judgment involved in these repair procedures often exceed those needed to operate on patients who have had no prior surgery. The use of small grafts alone does not protect the patient from poor work. Errors in surgical and aesthetic judgment, performing procedures on noncandidate patients, and the failure to communicate successfully with patients about realistic expectations remain major problems. objective. This two-part series presents new insights into repair strategies and expands upon several techniques previously described in the hair restoration literature. The focus is on creative aesthetic solutions to solve the supply/demand limitations inherent in most repairs. This article is written to serve as a guide for surgeons who perform repairs in their daily practices. methods. The repairs are performed by excision with reimplantation and/or by camouflage. Follicular unit transplantation is used for the restorative aspects of the procedure. results. Using punch or linear excision techniques allows the surgeon to relocate poorly planted grafts to areas that are more appropriate. In special situations, removal of grafts without reimplantation can be accomplished using lasers or electrolysis. The key elements of camouflage include creating a deep zone of follicular units, angling grafts in their natural direction, and using forward and side weighting of grafts to increase the appearance of fullness. The available donor supply is limited by hair density, scalp laxity, and scar placement. conclusion. Presented with significant cosmetic problems and severely limited donor reserves, the surgeon performing restorative hair transplantation work faces distinct challenges. Meticulous surgical techniques and optimal utilization of a limited hair supply will enable the surgeon to achieve the best possible cosmetic results for patients requiring repairs. [source] Couples with Schizophrenia "Becoming like Others" in South Korea: Marriage as Part of a Recovery ProcessFAMILY PROCESS, Issue 3 2009MYUNG-YEE YU PH.D. Very little is known about the married life of couples with schizophrenia. In this paper, authors report perceptions and experiences of 5 married couples with schizophrenia on their strategies in forming and maintaining healthy marriage. Our data reveal that participants had realistic expectations of marriage, and recognized benefits as well as obstacles in their marriages with respect to their recovery. This paper examines the importance of extended family members, mental health professionals, and the larger society's attitudes toward marriage as a factor in the recovery process for persons with schizophrenia. The authors identify implications for mental health professionals regarding the respect of client dignity and the applicability of a strengths perspective when working with couples with schizophrenia. The authors argue that mental health professionals' decisions regarding the balance between respecting a client's self-determination and protecting a client from risks associated with cohabitation and marriage should no longer be a dilemma for those working with people with mental illness. RESUMEN Se sabe muy poco de la vida matrimonial de las parejas que padecen esquizofrenia. En este trabajo, los autores informan sobre las percepciones y las experiencias de 5 parejas casadas que padecen esquizofrenia y sus estrategias para constituir y mantener un matrimonio sano. Nuestros datos revelan que los participantes tuvieron expectativas realistas en relación con el matrimonio, y reconocieron los beneficios y los obstáculos de sus matrimonios con respecto a su recuperación. Este artículo analiza la importancia de los familiares, de las actitudes de los profesionales de la salud mental y de la sociedad en general hacia el matrimonio como factor en el proceso de recuperación para las personas con esquizofrenia. Los autores identifican las implicancias para los profesionales de la salud mental con respecto a la dignidad del paciente y la aplicabilidad de una perspectiva de énfasis en las virtudes cuando se trabaja con parejas que padecen esquizofrenia. Los autores sostienen que las decisiones de los profesionales de la salud mental con respecto al equilibrio entre respetar la autodeterminación de un paciente y proteger a un paciente de los riesgos asociados con la convivencia y el matrimonio ya no debería ser un dilema para aquellos que trabajan con personas que tienen enfermedades mentales. Palabras clave: preservación del matrimonio, esquizofrenia, coreano, recuperación, dignidad del paciente, perspectiva de énfasis en las virtudes [source] How do hydraulic vibrators work?GEOPHYSICAL PROSPECTING, Issue 1 2010A look inside the black box ABSTRACT In order to have realistic expectations of what output is achievable from a seismic vibrator, an understanding of the machine's limitations is essential. This tutorial is intended to provide some basics on how hydraulic vibrators function and the constraints that arise from their design. With these constraints in mind, informed choices can be made to match machine specifications to a particular application or sweeps can be designed to compensate for performance limits. [source] Development and evaluation of a breast cancer prevention decision aid for higher-risk womenHEALTH EXPECTATIONS, Issue 1 2003CON(C), Dawn Stacey RN Abstract Objective, To develop and evaluate the effectiveness of a breast cancer prevention decision aid for women aged 50 and older at higher risk of breast cancer. Design, Pre-test,post-test study using decision aid alone and in combination with counselling. Setting, Breast Cancer Risk Assessment Clinic. Participants, Twenty-seven women aged 50,69 with 1.66% or higher 5-year risk of breast cancer. Intervention, Self-administered breast cancer prevention decision aid. Main outcome measures, Acceptability; decisional conflict; knowledge; realistic expectations; choice predisposition; intention to improve life-style practices; psychological distress; and satisfaction with preparation for consultation. Results, The decision aid alone, or in combination with counselling, decreased some dimensions of decisional conflict, increased knowledge (P < 0.01), and created more realistic expectations (P < 0.01). The aid in combination with counselling, significantly reduced decisional conflict (P < 0.01) and psychological distress (P < 0.02), helped the uncertain become certain (P < 0.02), and increased intentions to adopt healthier life-style practices (P < 0.03). Women rated the aid as acceptable, and both women and practitioners were satisfied with the effect it had on the counselling session. Conclusion, The decision aid shows promise as a useful decision support tool. Further research should compare the effect of the decision aid in combination with counselling to counselling alone. [source] Establishing contact and gaining trust: an exploratory study of care avoidanceJOURNAL OF ADVANCED NURSING, Issue 2 2010Gert Schout schout g., de jong g. & zeelen j. (2010) Establishing contact and gaining trust: an exploratory study of care avoidance. Journal of Advanced Nursing 66(2), 324,333. Abstract Title.,Establishing contact and gaining trust: an exploratory study of care avoidance. Aim., This paper is a report of a study conducted to explore the competencies , especially deep-rooted personal qualities , of care providers who succeed in making contact and gaining trust with clients who are inclined to avoid the care they need. Background., Demands, thresholds and fragmentation of services hinder the accessibility of health care, such that some severe mentally ill people do not receive the treatment they need or avoid healthcare services. Methods of establishing contact and gaining trust in mental health care include practical assistance, realistic expectations, establishing long-term goals, empathy and a client-centred and flexible approach. Method., A public mental healthcare practice in The Netherlands with outstanding performance was studied from 2002,2007 using participant observation, interviews with experienced care providers and interviews with clients with a long history of avoiding care facilities, conflicts and troubled relationships with care providers. Findings., A number of personal qualities are vital for establishing contact and gaining trust with these clients: altruism, a degree of compassion, loyalty, involvement, tenacity, a critical attitude to the mainstream, flexibility, optimism, diplomacy, patience, creativity, and a certain degree of immunity to stress. Conclusion., Care providers who establish contact and win trust employ ,non-judgemental appreciation'. They start from the acceptance of what is and try to connect with the client and their world. These professionals use their initial actions to identify and praise qualities and achievements of clients. This style of work is supported by a set of deep-rooted personal qualities we can summarize as ,empathy'. [source] An evaluation of a GP out-of-hours service: meeting patient expectations of careJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2004Kate Thompson MSc Abstract Background, The reorganized out-of-hours general practitioner (GP) service, resulting in the creation of out-of-hours cooperatives has been widely welcomed by the medical profession. However, GP satisfaction remains only one aspect of this reorganized service and patients' views and levels of satisfaction must have a contribution to make to the organization and delivery of the service. Aim, To assess patient satisfaction at two out-of-hours cooperatives in Northern Ireland. Method, A sample of 4466 patients contacting the out-of-hours service was surveyed by postal questionnaires using a previously validated patient satisfaction instrument. Results, Patients who initially requested to be seen at the out-of-hours centre were more likely to receive the contact they requested than those who requested telephone advice or a home visit. Only 41.8% of patients requesting a home visit actually received one. Patients were generally satisfied with the service provided and most satisfied with the ,doctor's manner' and the ,explanation and advice' received. Patients who received the contact they initially requested were more satisfied with all aspects of the service than other patients. The type of contact actually received had little effect on the satisfaction levels reported by patients who received the contact they initially requested. Conclusion, The population should be made fully aware of the services provided by out-of-hours cooperatives to enable them to have realistic expectations. With realistic expectations, patients are more likely to receive the medical contact they request and consequently will be more satisfied with the service provided. High satisfaction level is an important outcome measure of any out-of-hours service as it increases patient confidence and compliance and ultimately clinical outcome. [source] Tattoo removal by non-professionals , medical and forensic considerationsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2010S Karsai Abstract Tattoos are common phenomena in the western world and the demand for their removal has become widespread in the recent years. The introduction of quality-switched lasers has provided an effective removal method that is increasingly being exploited by tattoo studios themselves. Dermatologists, however, are frequently confronted with complications and side effects of tattoo removals that were performed by non-professionals. The objective of this study is to assess potential risks and pitfalls of laser tattoo removal when performed by medical laymen. The methods followed are systematic and evidence-based review of the literature. Four major problem areas were identified: rare but potentially severe allergic or toxic effects of decomposition products of the tattoo pigments; bodily harm caused by out-of-specification usage of the laser devices; malignant disease that is obscured within the area of a tattoo and requires meticulous dermatological diagnosis; and insufficient pre-operative consultation of patients about the risks, side effects and realistic expectations on the therapeutic outcome. We came to a conclusion that tattoo laser removal by medical laymen is unacceptable from the point of view of patient safety and the laws need to ban this practice swiftly. [source] Australian occupational therapy practice in acute care settingsOCCUPATIONAL THERAPY INTERNATIONAL, Issue 3 2001Dr Susan D. Griffin Lecturer, Faculty of Health Sciences Abstract A national sample of occupational therapists was surveyed to explore the nature of Australian occupational therapy practice in acute care settings. Self-care was the major client need that therapists reported they addressed, with an initial interview being the most common assessment procedure. Client education was the most frequently used intervention. The most important skills therapists reported for effective practice in acute care were time management, quick clinical reasoning and lateral thinking. Important workplace characteristics included a cooperative health-care team and early referral. Therapists reported that their most important resources were supportive senior therapists and a well-resourced equipment pool. Three attitudinal factors emerged. Therapists in interdisciplinary teams and those with more experience had more positive attitudes. Younger therapists experienced more concern about not being able to do more for their patients. Results suggest a need for graduates to be better prepared in some skill areas and to have more realistic expectations of practice in this area. Department managers need to ensure younger therapists receive adequate support from senior therapists. Further research is needed to determine how best to provide this support and to further examine the influence of the education experience on practice expectations. Copyright © 2001 Whurr Publishers Ltd. [source] Linking Product Development Outcomes to Market Valuation of the Firm: The Case of the U.S. Pharmaceutical Industry,THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 5 2004Anurag Sharma The purpose of this research was to examine empirically the effects of new product development outcomes on overall firm performance. To do so, first product development and finance literature were connected to develop three testable hypotheses. Next, an event study was conducted in order to explore whether the changes in the stock market valuation of firms are influenced by the outcomes of efforts to develop new products. The pharmaceutical industry was chosen as the empirical context for the present study's analysis largely because the gate-keeping role played by the Food and Drug Administration (FDA) provides a specific event date on which to focus the event study methodology. As such, this study's events were dates of public announcements of the FDA decisions to approve or to reject the New Drug Applications submitted by the sponsoring firms. Consistent with the efficient market hypothesis, this study's results show that market valuations are responsive strongly and cleanly to the success or failure of new product development efforts. Hence, one of this study's key results suggests that financial markets may be attuned sharply to product development outcomes in publicly traded firms. This study also finds that financial market losses from product development failures were much larger in magnitude than financial market gains from product development successes,indicating an asymmetry in the response of financial markets to the success and failure of new product development efforts. Hence, another implication of this study's results is that managers should factor in a substantial risk premium when considering substantial new development projects. The present study's results also imply that managers should refrain from hyping new products and perhaps even should restrain the enthusiasm that the financial community may build before the product fully is developed. The effect on firm value is severe when expectations about an anticipated new product are not fulfilled. Managers in effect should take care to build reasonable and realistic expectations about potential new products. [source] The total percentage of biopsy cores with cancer improves the prediction of pathological stage after radical prostatectomyBJU INTERNATIONAL, Issue 6 2004Mathias H. Winkler OBJECTIVE To examine whether the simple variable ,percentage of cancer-positive biopsy cores' is a significant predictor of true pathological stage after radical prostatectomy and can be used to improve pathological stage prediction by simple means. PATIENTS AND METHODS In all, 375 patients had a radical prostatectomy for localized prostate cancer in two UK centres; 260 had complete preoperative staging information. Logistic regression was used and predicted probability graphs constructed to assess predictors of pathological stage. RESULTS In this study, only PSA (P = 0.004) and percentage cancer-positive biopsy cores (P < 0.001) were significant predictors of pathological stage. The final model was an acceptable classifier for pathological stage (area under the receiver operating characteristic curve 0.76, specificity 85%, sensitivity 47%). A patient with a PSA of 10 ng/mL and one of six cores positive for cancer would have a predicted probability of extraprostatic disease of 20%, whereas the same patient with all six biopsy cores positive would have a predicted probability of extraprostatic disease of 80%. CONCLUSIONS The percentage of cancer-positive biopsy cores significantly predicts the disease stage after radical prostatectomy. This variable is easy to obtain by the clinician and avoids the need to estimate the percentage of biopsy tissue infiltrated by cancer. This readily available information can easily be computed and may help to counsel patients about realistic expectations of organ-confined disease in relation to surgery as a treatment option. [source] Results from different patient populations using combined therapy with alprostadil and sildenafil: predictors of satisfactionBJU INTERNATIONAL, Issue 4 2000J.H. Mydlo Objective To evaluate the outcome of combined therapy (using intraurethral alprostadil and oral sildenafil) in private and clinic patients with erectile dysfunction, and thus assess predictors of satisfaction. Patients and methods In all, 360 men were treated for erectile dysfunction using single and/or combined therapy, comprising 214 private-practice and 166 clinic patients. Responses were evaluated using the International Index for Erectile Function (IIEF) questionnaire before and after treatment. Serum testosterone levels, education and socio-economic status were also assessed. Group 1a consisted of 33 private patients and Group 1b of 24 clinic patients who tried the maximum dose of intraurethral alprostadil monotherapy initially, followed by the maximum dose of sildenafil monotherapy, and remained dissatisfied. Group 2a consisted of 32 private patients and group 2b of 31 clinic patients who tried the maximum dose of sildenafil monotherapy initially, followed by the maximum dose of alprostadil monotherapy, and were also dissatisfied. These two groups of 65 private and 55 clinic patients then underwent combined therapy. Results The mean ( sd) score for erectile function was 24.1 (2) for combined therapy (a 123% improvement), and 19.8 (1.8) (83% improvement) and 15.2 (1.6) (41% improvement) for sildenafil and alprostadil monotherapies (P < 0.05 for both patient groups). The men also reported an improvement in their satisfaction with intercourse. However, at 18 months, 60 of the 65 private patients but only 40 of the 55 clinic patients continued with combined therapy; thus, the discontinuation rate was three times greater among clinic than among private patients. Furthermore, the private patients had an overall improvement in the satisfaction score of 128%, compared with 51% for the clinic patients. Conclusion Although there were no significant differences in erectile function improvement within the two satisfied combined therapy groups, the differences in overall satisfaction and long-term withdrawal rates suggests that other factors beside motivation must be involved for success, e.g. education, persistence, realistic expectations, and certain psychological factors. Combined therapy should be considered for those patients who have a suboptimal response to monotherapy and refuse or are not candidates for surgical options. Generally, those patients with a higher education, greater persistence and more realistic expectations were more satisfied with combined therapy. [source] ,Hitting you over the head': Oncologists' disclosure of prognosis to advanced cancer patientsBIOETHICS, Issue 2 2003Elisa J. Gordon The disclosure of prognosis to terminally ill patients has emerged as a recent concern given greater demands for patient involvement in medical decision-making in the United States. As part of the informed consent process, American physicians are legally and ethically obligated to provide information to such patients about the risks, benefits, and alternatives of all available treatment options including the use of experimental therapies. Although not legally required, the disclosure of a terminal prognosis is ethically justified because it upholds the principle of self-determination and enables patients to make treatment decisions consistent with their life goals. To understand oncologists' attitudes about disclosing prognostic information to cancer patients with advanced disease, we interviewed fourteen oncologists and conducted one focus group of medical fellows. Although oncologists reported to disclose prognosis in terms of cancer not being curable, they tend to avoid using percentages to convey prognosis. Oncologists' reported reluctance to disclosing prognosis was conveyed through the use of metaphors depicting the perceived violent impact of such information on patients. Oncologists' reluctance to disclose prognosis and preserve patient hope are held in check by their need to ensure that patients have ,realistic expectations' about therapy. We discuss these data in light of the cultural, ethical, and legal dimensions of prognosis disclosure, patient hope and the doctor,patient relationship, and recommend ways to enhance the communication process. [source] | |||||||||||||||||||||||||||||||