Medicine and Health Sciences Commons^™

Beyond Patient-Centered Care: Enhancing The Patient Experience In Mental Health Services Through Patient-Perspective Care, Timothy A. Carey Prof

Patient Experience Journal

Delivering mental health services as patient-centered care has been an international priority for more than 50 years. Despite its longevity there is still not widespread agreement regarding how it should be defined or how it should guide the delivery of services. Generally, though, prioritizing the patient’s values and preferences seem to be at the core of this particular approach. It is not clear, however, that services attend to patient values and preferences as closely as they should. Terms such as “treatment resistant” and “noncompliant” seem to belie an attitude where the therapist’s opinion is privileged rather than the patients. To …

Young Adult Perspectives On The Selection Of Pharmaceuticals For Mental Health Treatment, Alaina N. Talboy, Angela M. Aylward, Daniel Lende, Rodney P. Guttmann

Patient Experience Journal

Shared decision making places an emphasis on patient understanding and engagement. However, when it comes to treatment selection, research tends to focus on how doctors select pharmaceutical treatments. The current study is a qualitative assessment of how patients choose among three common treatments that have varying degrees of scientific support and side effects. We used qualitative data from 157 undergraduates (44 males, 113 females; mean age = 21.89 years) that was collected as part of a larger correlational study of depression and critical thinking skills. Qualitative analysis revealed three major themes: shared versus independent decision making, confidence in the research …

Why Do They Do That?: Looking Beyond Typical Reasons For Non-Urgent Ed Use Among Medicaid Patients, Cynthia J. Sieck, Jennifer L. Hefner, Randy Wexler, Chris A. Taylor, Ann S. Mcalearney

Patient Experience Journal

Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences …

Uninsured Free Clinic Patients’ Experiences And Perceptions Of Healthcare Services, Community Resources, And The Patient Protection And Affordable Care Act, Akiko Kamimura, Jeanie Ashby, Ha Trinh, Liana Prudencio, Anthony Mills, Jennifer Tabler, Maziar Nourian, Fattima Ahmed, Justine Reel

Patient Experience Journal

Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. There has been a paucity of free clinic research with the few studies employing a quantitative design. The purpose of this study is to conduct an in-depth qualitative exploration of free clinic patients’ experience and perceptions of healthcare services, community resources, and the Patient Protection and Affordable Care Act (ACA). Free clinic adult patients (n=35) participated in four focus groups between June and July 2014 (one Spanish group in June, and two English groups and one Spanish group in July) …

Why Human Resources Policies And Practices Are Critical To Improving The Patient Experience, Shari Berman

Patient Experience Journal

While providing patient-centered care seems to be a goal for many organizations, delivering on this goal requires practices which are embedded in the organization, which incent patient-centered behavior. The author argues Human Resources (HR) policies, procedures and programs are key to supporting an organizations’ vision and culture. This means an HR executive partnering with the CEO who sets the vision and HR builds programs to support the vision. As the organization understands what is important to patients and how to best serve them, HR can build patient care improvement into every aspect of the organization. The author describes how competency …

‘First, Do No Harm’: Shifting The Paradigm Towards A Culture Of Health, Karen Luxford

Patient Experience Journal

Over the past 17 years since the release of the Institute of Medicine report ‘To Err is Human’,¹ health services and agencies around the world have increasingly focused on improving the safety and quality of health care. Historically, the commitment by health care professionals to ‘first do no harm’ has produced a focus on the absence of interventions that may cause adverse outcomes. This clinical approach links to the Hippocratic Oath which includes the promise "to abstain from doing harm". The Oath reminds clinicians to first consider the possible harm that any intervention might do. This approach to interactions …

The Experience Era Is Upon Us, Jason A. Wolf Phd

Patient Experience Journal

In this moment in healthcare, the challenges for those in the system are dynamically shifting and the perspectives, desires and needs of the healthcare consumer are putting positive and lasting pressures on how healthcare works that will shift healthcare from where it has been to where it must go. At the heart of this transition are the ideas framing an experience era, where collaborative, consumer-focused and purposeful actions can and will lead to a healthcare system returning to its fundamental calling, that of human beings caring for human beings. In doing so we can change the nature of healthcare and …

Rules Of Evidence In Cases Involving Lack Of Discretion, Msgr. Joseph G. Goodwine

The Catholic Lawyer

No abstract provided.

Discretion And Consent In Marriage, John B. Scanlan, M.D.

The Catholic Lawyer

No abstract provided.

Home Visiting Programs For Families Of Children Who Are Deaf Or Hard Of Hearing: A Systematic Review, Nannette Nicholson, Patti Martin, Abby Smith, Sheila Thomas, Ahmad A. Alanazi M.Aud.

Journal of Early Hearing Detection and Intervention

Prelingual hearing loss greatly restricts a child’s language development, hindering his or her behavioral, cognitive and social functioning. Although technology such as hearing aids and cochlear implants are an option for providing access to sound, they fail to teach the child how to listen or attend, how to process language (whether visual or spoken), or how to produce language and communicate. Home visiting is widely recognized as a cost-effective intervention service delivery model. Home visiting programs for promoting language development in children who are diagnosed as deaf or hard of hearing have been in existence for over 50 years, yet …

Translating Myplate Into Food Selections That Meet Dietary Guidelines Recommendations, Jessica Bachman, Joanne Christaldi, Amy Tomasko, Diana Cuy Castellanos

Journal of Human Sciences and Extension

The objective was to determine if individuals could plan a diet that met the Dietary Guidelines (DG) using MyPlate as a guide. Participants (n=73) were 38.9±17.0 years of age, with 97% being Non-Hispanic White, 95% having some college education, and Body Mass Index (BMI) of 26.7±5.9. Participants used MyPlate to plan a one-day menu using food models. Nutrition literacy, nutrition scanning behavior, and nutrition information-seeking experience were assessed. Menus were analyzed using Nutrition Data Systems for Research and were compared to individualized DG recommendations. A multiple linear regression examined what characteristics predicted energy difference scores (difference between energy from menu …

Singled In Later Life: Interaction Effects On Family Relations And Health, Hyunsook Kang Ph.D.

Journal of Human Services: Training, Research, and Practice

This study examines the interaction effects on health and family relations of singled and non-singled older adults. In this study, family relations comprised family criticism and family demands. Data from the National Social Life, Health, and Aging Project (NSHAP) survey were used (57-85 years of age (n=3005). This current study reflects a secondary analysis of the NSHAP data and hypothesized that life-long singled older adults’ health differentially influenced family relation such as family criticism and demands. This study, built on the Convoy Model to account for how singled older adults’ health, is differentially associated with their family criticism …

Full Issue, Volume 4, Number 3, Donna J. Peterson

Journal of Human Sciences and Extension

No abstract provided.

College Health Care Providers’ Student-Centered Care, Cheryl Ann Lambert, Julie Donovan

The Qualitative Report

Patient care in the university setting is indelibly connected to college health care providers. College health care providers adapt to a specific set of circumstances unique to the university context in their patient care roles. The authors therefore sought to investigate the patient care phenomenon from college health care providers’ lived experiences. The patient care phenomenon was explored via in-depth interviews with 11 college health care providers at universities in the Midwest and Northeast regions of the United States. The phenomenological theoretical framework of the study revealed five themes of patient care during data analysis: health education, behavioral health, student …

Academic Medicine Responds To The Opioid Crisis, John Prescott

Marshall Journal of Medicine

Opioid dependence has devastated communities across the nation particularly in rural states and academic medicine has responded in a variety of ways. Through its tripartite mission of education, research, and clinical care, creative solutions are being implanted. Medical schools and teaching hospitals are partnering with public health and law enforcement agencies, as well as local healthcare providers to address the clinical, social, and rehabilitative challenges. Academic medicine continues to adapt to the needs of the nation and teach, train, and prepare the next generation of physicians to be at their best when things are at their worst.

Professional Action Sport Athletes’ Experiences With And Attitudes Toward Concussion: A Phenomenological Study, Caroline E. Faure, John M. Fitzpatrick

The Qualitative Report

This study examined the lived experiences and subsequent attitudes of freestyle BMX and motocross athletes relative to suffering concussions. Eleven professional athletes were interviewed using a semi-structured protocol. All cited a significant personal history with concussion and those personal accounts, along with their observations of others who experienced similar head injuries, shaped the athletes’ attitudes towards concussion. Both intrinsic and extrinsic factors contributed to each athlete’s acceptance of concussion risk inherent in their respective sport. Generally, athletes accepted concussion risk as part of their sport, but were largely unfamiliar with what concussion was and what long-term effects could result from …

Assessing Feasibility And Readiness To Address Obesity Through Policy In American Indian Reservations, Valarie Blue Bird Jernigan, Gail Boe, Carolyn Noonan, Leslie Carroll, Dedra Buchwald

Journal of Health Disparities Research and Practice

The Institute of Medicine and Centers for Disease Control and Prevention (CDC) have identified policy and environmental strategies as critical to the prevention and control of obesity. However such strategies are rare in American Indian communities despite significant obesity-related disparities. Tribal policymaking processes differ by tribal nation and are often poorly understood by researchers and public health practitioners, hindering the dissemination, implementation, and successful scale-up of evidence-base obesity strategies in tribal communities. To address these gaps in knowledge we surveyed 138 diverse stakeholders in two American Indian reservations to assess the feasibility of and readiness to implement CDC-recommended obesity policy …

Women’S Experiences With Prenatal Care: A Mixed-Methods Study Exploring The Influence Of The Social Determinants Of Health, Karen A. D'Angelo, Janelle K. Bryan, Brenda Kurz

Journal of Health Disparities Research and Practice

Background & Purpose: Racial and ethnic disparities pervade birth outcomes in the United States and the state of Connecticut. While Connecticut’s infant mortality rate is less than the national average, rates for the state’s Black/African American and Hispanic/Latino communities exceed it. This study explored how prenatal care in Connecticut may be enhanced to address these disparities.

Methods: In spring 2013, seven focus groups and two semi-structured interviews were conducted (n=47). Participants also self-administered brief surveys. Recruited by local service providers, participants were 18 or older, pregnant and/or in the first year post-partum at the time. Most self-identified as …

Building Community-Campus Partnerships To Prevent Infant Mortality: Lessons Learned From Building Capacity In Four Us Cities, Renata Schiavo, Isabel Estrada-Portales, Elena Hoeppner, Denisse Ormaza, Radhika Ramesh

Journal of Health Disparities Research and Practice

Infant mortality rate (IMR) is an important indicator of progress toward health equity and socio-economic development. Despite progress, the US is ranked 45th among 192 countries in IMR, with non-Hispanic black IMR 2.2 times that of non-Hispanic white rates, and higher than average IMR in Native American populations. The Preconception Peer Educators (PPE) program of the U.S. DHHS Office of Minority Health Resource Center (OMHRC) aims to raise awareness about IMR disparities in African Americans, and to promote preconception health behaviors among women of childbearing age and sexually active men. Building upon this program, this report focuses on lessons learned …

Healthcare Providers’ Perceptions Of Socioeconomically Disadvantaged Patients With Chronic Pain: A Qualitative Investigation, Nicole A. Hollingshead, Marianne S. Matthias, Matthew Bair, Adam T. Hirsh

Journal of Health Disparities Research and Practice

Socioeconomically disadvantaged individuals are at-risk for chronic pain and disparate care. In this qualitative study, we explored providers’ experiences with socioeconomically disadvantaged patients, with a particular focus on providers’: (1) perceptions of socioeconomically disadvantaged patients’ barriers to pain care, (2) attitudes towards this patient population, and (3) chronic pain decisions for these patients. Individual interviews were conducted with twenty-four healthcare providers. Providers discussed several patient-level access barriers, such as not having health insurance, financial constraints, and scheduling difficulties. Providers believed socioeconomically disadvantaged patients were at-risk to misuse prescription opioids and were less comfortable prescribing opioids to these patients. This investigation …

Protocol To Increase Administration Of Herpes Zoster Vaccine In A Long-Term Care Facility, Stephen Mbola Dnp, Rn, Anp-Bc

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Although the herpes zoster (HZ) vaccine to decrease the incidence of Shingles was licensed for use in 2008, little coverage for HZ vaccination has occurred and stands nationally at 16%. At a targeted nursing home and assisted living facility, a protocol for including HZ along with state-mandated vaccinations was devised and used in screening incoming residents. Baseline data from chart reviews (n=122) showed that despite treatments given for the infection in the preceding 12 months, no vaccinations had occurred. During a 6-month implementation period, all new residents meeting eligibility criteria were offered the HZ vaccination. In this period, four residents …

Detangling The Interrelationships Between Self-Regulation And Ill-Structured Problem Solving In Problem-Based Learning, Xun Ge, Victor Law, Kun Huang

Interdisciplinary Journal of Problem-Based Learning

One of the goals for problem-based learning (PBL) is to promote self-regulation. Although self-regulation has been studied extensively, its interrelationships with ill-structured problem solving have been unclear. In order to clarify the interrelationships, this article proposes a conceptual framework illustrating the iterative processes among problem-solving stages (i.e., problem representation and solution generation) and self-regulation phases (i.e., planning, execution, and reflection). The dynamics of the interrelationships are further illustrated with three ill-structured problem-solving examples in different domains (i.e., information problem solving, historical inquiry, and science inquiry). The proposed framework contributes to research and practice by providing a new lens to examine …

Impact Of Interviews On Heterosexual Students' Expressions Of Cultural Competency, Carol Isaac, Linda Behar-Horenstein

The Qualitative Report

The purpose of this qualitative study was to understand the effects of a cultural competency intervention on dental pre-doctoral students’ attitudes toward individuals of a different sexual orientation. 22 heterosexual students interviewed gay or lesbian individuals and wrote reflective text. Results illustrated that participants found that their interviewees had “surprisingly similar” beliefs and values – especially in the areas of religion and family. Because of their “similar values,” these students expressed respect toward their interviewees who were “so different” than themselves. This conclusion of “sameness” forced them to see homosexuals as people, rather than a stigmatized invisible outgroup, mitigating sexual …

Goals And Expectations Of Continuation High School Students Transitioning To Postsecondary Education, Chi-Kwan Shea, Gordon Muir Giles

The Open Journal of Occupational Therapy

Background: Students at a continuation high school (CHS) attended an occupational therapy program to acquire life skills in preparation for their transition from secondary education. Most of the students who participated in the OT program planned to pursue a postsecondary education (PSE), but the CHS students encountered many barriers in negotiating the requirements of PSE. Discernment of these barriers encountered by the CHS students may enable the occupational therapy practitioners to better prepare the students for PSE.

Method: This was a qualitative phenomenological study based on analyses of interview data. Semi-structured one-on-one interviews were conducted with eight CHS senior students …

Quality Improvement And Safety In Healthcare: Reflections On Essential Frameworks To Guide Applied Scholarship That Promotes Transformation And Innovation, Angelo P. Giardino Md, Phd, Mph

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The publication of the inaugural issue of the Journal of Nursing and Interprofessional Leadership in Quality and Safety (JONILQS) is a unique milestone that is the culmination of visionary leadership, scholarly effort, and keen attention to the many tasks necessary to launch a journal. The University of Texas Health Science Center at Houston’s School of Nursing launches this journal to address the focus on quality and safety initiatives and research that helps to make the health care we provide safer and better. This journal seeks to highlight practical work from the field that will change things for the better for …

Developing The Improving Post-Event Analysis And Communication Together (Impact) Tool To Involve Patients And Families In Post-Event Analysis, Madelene J. Ottosen Phd, Rn, Emily W. Sedlock Mph, Aitebureme O. Aigbe Drph, Jason M. Etchegaray Phd, Sigall K. Bell Md, Thomas H. Gallagher Md, Eric J. Thomas Md, Mph

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The analysis of harmful errors is typically led by a team within the hospital and includes clinicians and staff who were involved at the time of the event. However, the patient and family are often left out of this process and are not asked to participate in the investigation. Because little guidance is available for facilitating patient input, an interprofessional team convened to develop a semi-structured tool to be used in eliciting patient feedback. Some 72 persons who had experienced adverse events were interviewed. Using a thematic analysis approach, the team learned that 51% of the interviewees preferred to participate …

From The Editors-In-Chief, Joanne V. Hickey Phd, Rn, Acnp, Faan, Fccm, Eileen R. Giardino Phd, Rn, Aprn, Fnp

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The Co-editors in chief welcome The Journal of Nursing & Interprofessional Leadership in Quality and Safety to state what the purpose of the journal is and why it is important for this journal to start.

From The Handbook Of The Laszlo Institute Of New Paradigm Research And The Intelligence Of The Cosmos , Inner Traditions, September 2017, Ervin Laszlo

CONSCIOUSNESS: Ideas and Research for the Twenty-First Century

No abstract provided.

Consciousness: Where We Are At, Imants Barušs

CONSCIOUSNESS: Ideas and Research for the Twenty-First Century

It is useful every couple of years to take a bird’s eye view of consciousness studies and reflect on what we see. When I look, I still see two streams, one of which is the social and political framework for the study of consciousness, and the other of which is the substance of what we know about consciousness. The former is still largely defined by the extent to which the scientific study of consciousness has been freed from a materialist agenda. The latter includes recent research into the clarity of cognitive functioning in the absence of sufficient neurological support for …

Growth And Happiness In The Human Personality, Rien Havens, Allan Combs

CONSCIOUSNESS: Ideas and Research for the Twenty-First Century

This paper explores stages and styles of meaning making in a population at Kegan’s (1982) developmental levels 3 through 5. It is a qualitative study of the relationship between adult personality development and how individuals speak about meaning and well-being in their lives. Nineteen participants ranging widely in age and socioeconomic class were selected informally through connections with the researchers, and snowball sampling. They were chosen from an original group of 50, based on informal interviews suggesting that they had achieved Kegan’s developmental levels of “Socialized Mind” (stage 3), or especially “Self-Authoring Mind” (stage 4) or “Self-Transforming Mind” (stage 5). …