Science topic

Patient Participation - Science topic

Patient involvement in the decision-making process in matters pertaining to health.
Questions related to Patient Participation
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I am working on patient participation in decision-making processes in the dimension of hospital organization. Which scales can I use for this topic?
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Personally I'm familiar with SDM-Q-9 scale which is pretty compact questionnaire to measure the extent to which patients are involved in decision-making in healthcare. I'll paste a link for you here to the page of the developers of the scale: https://www.patient-als-partner.de/index.php?article_id=20&clang=2
There are however other scales as well.
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I am working on patient participation in decision-making processes at the hospital organization level. can you suggest an article or thesis?
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Although I do not know of a published paper on this subject, I suggest you look at the website of the Dana-Farber Cancer Center in Boston: https://www.dana-farber.org/about/quality-safety/culture
A few decades ago, after a serious patient safety problem emerged, the Dana-Farber decided to build patient and family members into several of its organizational processes.
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I want to use the PAM-13 in a study, but I'm challenged as to how I calculate the score. Different article states that I should:
To calculate the total PAM score, the raw score is divided by the number of items answered (excepting non-applicable items) and multiplied by 13. Then, this score is transformed to a scale with a theoretical range 0–100, based on calibration tables, with higher PAM scores indicating higher patient activation
The raw scores can be converted into four activation levels: 1 (≤47.0) not believing activation important, 2 (47.1–55.1) a lack of knowledge and confidence to take action, 3 (55.2–67.0) beginning to take action and 4 (≥67.1) taking action. ( )
The problem is that if I take the maximum raw score (52) and as instructed devide it by the number og items answered (13) and then multiplie that number by 13 i reach 52 again and would be in the activation level categorized as level 2. So I guess there must be a step I'm missing.
Do anyone know how to get the calbration table? Maybe that is what I'm missing.
Kind regards
Anna
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Thank you for your suggestion, I will try that too:-)
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I have found the PAM but that doesn't focus on mental health. I have also found SESP, AQoL, SQoL-18, LQoLI, and ICF Checklist, but none of these seem to focusing on empowering clients and assessing this and their participation. Thanks in advance!
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You may have found it already, but there is actually a PAM for mental health (even though the original measure was intended to be generic for use in mental and physical health). Link to the paper is here:
Best wishes,
Beth
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I will be conducting a research study to investigate the feasibility and utility of using a digital translation technology in clinical practice in promoting interpersonal relationships, therapeutic communication, patient engagement, and supporting mental health recovery and well-being.
Peplau's Interpersonal Relationships in Nursing will be used as the theoretical framework for the study.
Thank-you.
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Hi James, has a look at these links.
Measuring patient engagement: Development and psychometric p...
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WHAT IS YOUR THOUGHT?
Here is some question
In the context of patient-centred teaching, today’s obligations raise many questions that may result in reshaping medical education.
For example:
- How can we train future physicians during the limitations of social distancing?
- In addition to web-based learning and digital content, can we simulate virtual patient experiences?
- How should we protect students who may feel obligated to care for Covid-19 (or similar) patients regarding supervisory and grading aspect?
- How do we determine who are essentially in need of personal protective equipment during medical education?
- What are the implications of avoiding infected patient engagement for medical students?
- Are there any responsibilities of medical students as junior members of health-care teams in unprecedented times?
- How can medical schools help their residents to tackle the challenges of this pandemic as competent graduate physicians?
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I think the Medical Education need to go more disciplinary and share more lessons learned. Please refer to our papers on our book
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Infection with coronavirus SARS-CoV-2 has affected every aspect of our life including scientific research. It is evident that all aspects of human subject research are potentially affected by the situation since recruitment and inclusion of participants/patients may be disturbed, characteristics of participants in ongoing studies may have changed and overall study protocols may have been flawed.
I would like the scientific community to reflect on these aspects including (but not limited to) the following:
How has the COVID-19 pandemic affected your research?
Has there been a focus shift in general interest, financial or otherwise?
Would it be necessary for studies to report in publications if and how the study was affected by the situation?
Which aspects need to be considered in the different fields of human subject research including (but not limited to) medicine, biology, psychology, and sports sciences?
Which statistical aspects need to be considered and how can we solve potential problems?
How were researchers themselves affected and do we see impact on other sciences?
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Dear Marie-Madeleine Bernard, I appreciate your contribution, also with respect to mentioning the importance of monitoring side effects. I also agree that political interest has already affect research on COVID-19, some of these forcing premature data presentation/interpretation with strong effects on the final results.
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Patient psychology is at the core of successful patient engagement, yet there is no separate entity in the undergraduate medical curriculum. Do you think that the time has come to include this subject with its appropriate concern? Does only "communication skill" suffice it?
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Surely during M.B.B.S course Psychiatry should be equally important as important
as Pharmacology . A Good Doctor specially surgeon should be a better councilling
capability to transfer the pateint to O.T without anxiety .
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I'm investigating the benefits or pitfalls of including lay or plain-language summaries with clinical studies. There are a lot of arguments for it (see research piece:
Would you consider this good, bad, necessary ....? What should a lay summary include as a minimum to ensure the paper is correctly represented? Is a different skill set required to write a lay summary - should the author write it or should it be written by an objective reviewer?
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It might need an endorsement from the author(s). Using international validated tools as the guidelines on http://www.equator-network.org is a good way to create the check-list of the plain-language summaries. Hopefully one day the guidelines incorporate this on their checklist
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As a patient, I have questioned why it is so difficult to engage with NHS locally when we aren't able to access services that the NHS provides to other NHS England areas. Am told that is because the population is deemed to be healthier. But this is just because it is one of richest areas in UK, therefore a higher % make use of private medical care.
So why are those patients who come from lower-income households penalised by not being able to access medical care that is freely available in other areas?
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What are the differences between patient participation and patient engagement?
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Getting people to volunteer for research is always difficult and we cannot offer any inducement to participate.
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I follow answers
best regards
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Is there any guideline or recommendation that item generation should be carried through patient involvement, like patient interviews or focus groups? Can a consensus on item generation be made by a group of researchers only?
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A lot depends on how much prior research has been done in your area. If you are looking at a well studied area, such as patient satisfaction or quality of life, then you may well be able to adapt existing questionnaires without patient input. Alternatively, if you are looking something that is condition-specific or that applies to a unique group of patients, then it would be highly advisable to get their input.
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For example the Patient-specific index (Wright JG, Young NL).
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I would be interested in learning this as well.
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Does anybody know of any research exploring appointment management/attendance/adherence by patients attending hospices as outpatients?
I am interested in this area and currently researching the experiences of those who have missed appointments in order to explore how we can motivate attendance at such appointments, but I can't seem to find anything. I wonder if I'm maybe using limited search terms, or if there really is very little work surrounding the area. 
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You may find helpful the transtheoretical model approach by the Robert Wood Johnson foundation in the Diabetes Initiative program, in their studies the RWJF was able to design a model to increase patient attendance and medication adherence in their diabetes centers
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Patients will participate in a therapeutic education program designed to educate them about their disease and self-management strategies.  I'd like to assess patient satisfaction with the blended program, particularly the online component.  Is there a validated questionnaire to do this?
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Karen:
Perhaps, my conference paper on lessons learnt as a Blended Learning Champion for my School of Education may be helpful in answering your question:
many thanks,
Debra
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Specifically I want to know about how  characteristics, demographic, behavioral, health status etc of people who START a program predict their engagement with the program (sessions attended, number of posts, etc).   Many thanks
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Dear Kate,
Last month we published a paper in PLOSone on determinants of activation for self-management in 4 chronic diseases: COPD, DM-II, HF & Renal disease. The PAM-13 was used as a dependent variable and a large number of patient, disease and context variables as covariates. Although this does not specifically focused at engagement in programs/interventions this might provide some increased understanding on the variance in engagement for SM in general. 
Kind regards
Jaap 
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Is there any encouragement for the patient to participate in the decision making process about his/her treatment? Do physicians act in a faith of concordance with their patients?
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From a legal standpoint this falls under something called 'informed refusal.' A physician makes a clear recommendation to the patient [to take a drug, to have a test, etc]. Should the patient not follow that recommendation it is the physician's duty to make sure the patient knows the risks and consequences of not following that advice. There are as many styles as  physicians as to the emotional attachment a physician puts into encouraging a patient to anything. Above I've described the core [this is what I want you to do and these are the consequences if you don't do it]. As noted above non-compliance to some therapy is almost the rule.
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I am doing research for class and needed to develop ideas.
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Participatory decision making will in no dought improve the quality of healthcare and reduce defects. Consultations/discussion with peers leads to an appropriate decision taken being taken by a clinician. Discussing with patients as well about their treatment will improve on medication use and avoid any potential defects that may result in the absence of a clinician
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If a patient with Locked-In Syndrome, minimally concious state etc were able to self define as "not-living" (so, a being without meaningful life as opposed to biologically dead), what would the ethical implications be? Would this go some way to alleviate the taboo of euthanasia-as-murder, and could we use neuroimaging to determine whether the patient is "sure"?
Could we then extend this definition for physicians to apply to people in a PVS who have shown no signs (clinical or through neuroimaging) of awareness or "life" as defined by a society valuing personality and personal interactions? All for a theoretical Medical Ethics paper, not so much a practical medicine question!
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In this terms, terminal stages of dementia, for instance, are in similar conditions: "no meaningful life" . Or very severe oligophrenias -with no meaninful interactions, even with his or her parents- Neuroimaging will show in all cases severe structural brain damage but no image will draw the ethic limit or frontier .
If we define euthanasia as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering" in EVP, severe mental retarded, etc lack the demonstration of intractable suffering. Family and/or friends suffers and grieves, but the patients , we don´t know.