This study explored the association of disagreement in the perception of patient disability between patients and family caregivers with physical and psychological quality of life (QOL) in both ...parties.
A cross-sectional analysis of data collected from male stroke patients and family caregivers was conducted. Physical and psychological QOL in patients and caregivers were measured using the WHOQOL BREF. Perceptions of patient disability were measured using the 12-item WHO Disability Assessment Schedule 2.0 (DAS). Using DAS scores reported independently by patients and caregivers, dyads were categorized into one of four groups representing agreement or disagreement about patient disability. Generalized estimating equations were used to examine the associations between WHOQOL scores in patients and caregivers and these four groups.
Among 56 dyads enrolled, approximately 52% were categorized into 'agreement' groups and 48% were categorized into 'disagreement' groups. The disagreement in perception about patient disability were significantly associated with poor patient physical QOL. However, the disagreement in perception were not significantly associated with caregiver QOL.
Findings suggest the association of disagreement with QOL differs between patients and caregivers. Further research is needed to carefully appraise the relationship and interaction between patient and caregiver.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Artificial intelligence has become an increasingly powerful technological instrument in recent years, revolutionizing many sectors, including public health. Its use in this field will inevitably ...change clinical practice, the patient-caregiver relationship and the concept of the diagnosis and treatment pathway, affecting the balance between the patient's right to self-determination and health, and thus leading to an evolution of the concept of informed consent. The aim was to characterize the guidelines for the use of artificial intelligence, its areas of application and the relevant legislation, to propose guiding principles for the design of optimal informed consent for its use.
A classic review by keywords on the main search engines was conducted. An analysis of the guidelines and regulations issued by scientific authorities and legal bodies on the use of artificial intelligence in public health was carried out.
The current areas of application of this technology were highlighted, divided into sectors, its impact on them, as well as a summary of current guidelines and legislation.
The ethical implications of artificial intelligence in the health care system were assessed, particularly regarding the therapeutic alliance between doctor and patient, and the balance between the right to self-determination and health. Finally, given the evolution of informed consent in relation to the use of this new technology, seven guiding principles were proposed to guarantee the right to the most informed consent or dissent.
Introduction
Patients who are diagnosed with high-grade gliomas (HGG) have poor prognoses and often experience rapid declines in functional and cognitive status, which makes caring for them ...particularly stressful. We conducted a prospective study to investigate the factors influencing the quality of life of HGG patients and their informal caregivers and analyzed their reciprocal impacts. Based on our results, we elaborated a screening model to identify patients and caregivers in need of psychooncological support.
Methods
A total of 45 matched HGG patient–caregiver dyads completed the Multidimensional Mood State Questionnaire, the 12-Item Short Form Medical Outcome Questionnaire and the Center for Epidemiology Studies Depression Scale. A subsequent semi-structured interview was performed with each individual.
Results
We found a significant relationship between the mood and depression scores of patients and caregivers, with a third of them displaying symptoms of a major depressive episode. Our screening model showed that 73% of the dyads exhibited signs of severe emotional strain with the need of psychooncological support. Beneficial factors that helped patients and caregivers cope with the illness included mutual respect, good communication, caregiver mastery and resilience.
Conclusions
For a more comprehensive understanding of patient–caregiver interactions, we recommend using a combination of standardized psychometric tests and a semi-structured interview. The high percentage of emotional strain and depression found in patients and their caregivers facing HGG highlights the necessity of methodical screening for warning signs and consequent initiation of psycho-oncological interventions.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This paper has three objectives: first, to examine the historical foundations of the social representation of French physiotherapy; second, to explore the holistic dimension of physiotherapy care ...addressed by physiotherapists in our survey; third, to disseminate the research design in social science. A literary text by a founder of French physiotherapy was transcribed and examined by lexicometry. The analysis revealed the avant‐garde philosophy of care developed by Dolto in the 70s: a merged model of care and a unique evidence of systems thinking that distinguishes the empirical practice of professionals working according to a functional rehabilitation logic. We argue that the introduction of systems theory into the initial or continuing education of these practitioners could make its bio‐psycho‐social application more effective. This calls for further research on rehabilitation practices in other cultural contexts and provides a theoretical basis and argument for the development of lexicometry in the social sciences.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The bonds and relationships that direct care workers in the home setting (DCWHs) develop with their elderly or disabled home care patients may put them at risk for patient violence. This study used a ...data-driven approach, latent class analysis, to identify distinct underlying patterns of DCWH–patient relationships and then assessed how DCWH–patient class membership was associated with patient violence. This study analyzed survey data obtained from 964 DCWHs working in two not-for-profit home care agencies. Four classes of DCWH–patient relationships emerged: Non-familial (40% of the sample), Overly Concerned (14%); Boundary-keeping (22%), and Overly Involved (24%). DCWHs in the Overly Involved class were more likely to experience physical violence from their patients relative to those in the Non-familial class (probability = 0.11 vs. 0.04, p = 0.01). Building a positive relationship with boundaries between caregivers and patients may have a potential to reduce patient violence toward the caregivers and ultimately improve the quality of care.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK, ZRSKP
Incidents of violence against health care professionals are on the increase. The policy and management of health care facilities can go part way to explaining them, as can the various psychological ...mechanisms inherent to the patient-caregiver relationship. It is through words and listening that caregivers can find solutions.
Objective: To identify the social psychological
factors affecting women’s evaluation of care provided in
Czech maternity hospitals using following criteria: satisfaction
with intrapartum and ...postpartum care, willingness
to return to a given hospital and to recommend the
hospital to others.
Methods: 762 women completed a 71-item original Czech
questionnaire KLI-P designed to measure the psychosocial
climate in both delivery and after-birth unit on six scales.
The sample was representative of the Czech parturients
population. Multivariate logistic regression was used to
investigate the predictive value of the questionnaire scales
for maternal satisfaction, willingness to return to and to
recommend a given hospital.
Results: For delivery unit, the satisfaction predictors were:
helpfulness and empathy of midwives (Χ2=48.9), communication
of information and availability of caregivers
(Χ2=16.6), helpfulness and empathy of physicians (Χ2=10.9),
symmetrical and respectful attitude of staff members
(Χ2=9.7) and physical comfort and services (Χ2=7.6). The
predictors of satisfaction with after-birth unit included
helpfulness and empathy of the staff (Χ2≥42.1), communication
of information and availability of caregivers
(Χ2=52.5), physical comfort and services (Χ2=30.6), control
and involvement in decision-making (Χ2=6.6) and parity
(Χ2=8.6). The factors influencing women’s willingness to return to and to recommend a hospital differed from the
predictors of general satisfaction.
Conclusions: The satisfaction factors revealed in this
research correspond predominantly to the results of
studies conducted in other countries (warm, non-formal
and supportive approach, sufficient and well-timed provision
of information and explanation, availability of caregivers,
physical environment). However, participation in
decision making, which has been repeatedly shown to be
among the strongest predictors of childbirth satisfaction,
was not important for the Czech parturients’ satisfaction
with intrapartal care. This finding can be explained by different
attitudes and expectations of both parturients and
caregivers in a post-totalitarian country.
Encounters in emergency departments have been described from different perspective and with different research approaches. On reviewing the literature, along with medical skills, interpersonal skills ...such as the ability to create a relationship with the patient was considered significant. Patients exposed to high-energy violence arrive at the emergency department in a vulnerable condition. Apart from their physical condition, they might be in shock and frightened by the experiences of the injury. The team at the emergency department is responsible for a complex situation and has to quickly establish rapport, gather information, assess the physical condition, and design a treatment plan.
The aim of this study was to explore trauma patients’ conceptions of the encounter with the trauma team.
A qualitative inductive design was used and data were collected by semi-structured interviews. The interviews were transcribed verbatim and analysed according to contextual analysis.
Twenty-three trauma patients with minor injuries, 17 from a university hospital and six from a county hospital with minor injuries, were included in the study.
The main findings were three main categories, labelled modes of being with the patients: the instrumental, the attentive and the uncommitted mode. All encounters contained the instrumental mode and mostly there were a combination of instrumental mode and attentive mode. The patients were satisfied with these modes, which created emotions of confidence, comfort and satisfaction. The uncommitted mode occurred in some encounters together and generated emotions of abandonment, dissatisfaction.
The main conclusion is that a high-quality encounter in trauma care is likely to be received from caregivers who can shift their mode of being with the patient between the instrumental and the attentive mode as the patient/situation demands. That is, flexibility between the physical and psycho-social care.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK
Notre expérience de prise en charge clinique des patients en éveil de coma qui dure depuis plus de six ans, nous a amené à nous interroger quant à la précarité subjective de ces patients. Dans cette ...clinique, se pose la question éthique de la continuité de l’existence subjective du patient. En nous appuyant, d’une part, sur ce qui est écrit sur la clinique et la neuropsychologie des patients en éveil de coma et, d’autre part, sur la relation particulière entre les soignants et les patients en éveil de coma, illustrée par une situation clinique, nous nous interrogerons sur les conditions dans lesquelles le patient peut avoir la chance d’être appréhendé comme sujet. Ces conditions dépendent, notamment, de la conduite éthique que le soignant doit avoir quand il est face à un patient en grande précarité subjective et que lui-même détient alors un certain pouvoir.
For the last six years, our clinical practice of patients in coma arousal care has led us to wonder about the subjective precariousness. In this clinical care, we must think about the ethical question of patient's subjective existence continuity. We wonder how the patient can be considered as a subject. On the one hand, it is based on the clinical and neuropsychological coma arousal care and on the other hand on particular patient–caregiver relationship, illustrated by a clinical situation. It seems that it depends on the ethical behaviour of the caregiver in front of a patient in an important subjective precariourness while the caregiver is powerful.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK