Health Services Research Commons^™

Creating A Common Trajectory: Shared Decision Making And Distributed Cognition In Medical Consultations, Katherine D. Lippa, Valerie L. Shalin

Patient Experience Journal

The growing literature on shared decision making and patient centered care emphasizes the patient’s role in clinical care, but research on clinical reasoning almost exclusively addresses physician cognition. In this article, we suggest clinical cognition is distributed between physicians and patients and assess how distributed clinical cognition functions during interactions between medical professionals and patients with Multiple Sclerosis (MS). A combination of cognitive task analysis and discourse analysis reveals the distribution of clinical reasoning between 24 patients and 3 medical professionals engaged in MS management. Findings suggest that cognition was distributed between patients and physicians in all major tasks except …

A Tool To Cost Environmental Health Services In North Carolina Local Health Departments, Nancy L. Winterbauer, Simone Singh, Ashley Tucker, Lisa M. Harrison

Frontiers in Public Health Services and Systems Research

Introduction: The cost of providing a basic set of public health services necessary not been well-described. Recent work suggests public health practitioners are unlikely to have the empirically-based financing information necessary to make informed decisions regarding practice. The purpose of this paper is to describe the development of a costing tool used to collect primary data on the number of services provided, staff employed, and costs incurred for two types of mandated environmental health services: food and lodging inspections and onsite water services.

Methods: The tool was iteratively reviewed, revised, and piloted with local health department (LHD) environmental health and …

An Identification Of The Social And Emotional Needs Of People Living With Post-Lingual Hearing Loss, Dianne Briffa, Fiona Davidson, Danielle Ferndale Ms

JADARA

Hearing loss is associated with challenges in achieving effective communication which can constrain an individual’s ability to participate in social and work environments, affecting their social and emotional well-being. Through a thematic analysis of focus groups, interview and survey responses from 41 people experiencing post-lingual hearing loss, we identified an overarching theme of adjusting to impaired communication and three sub-themes in which we were able to identify the unmet social and emotional needs of people who are hard of hearing. In light of our analysis we discuss and offer recommendations specific to meeting the needs of this population.