Patient education and counseling
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To measure rapport between medical students and standardized patients using observer ratings; to relate these ratings to students' emotional awareness and to behavior within the medical interaction; and to assess the relative validity of using excerpts of different lengths for the measurement of rapport. ⋯ Clinicians, researchers, and educators should focus on rapport building, even very early in the medical visit.
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Comparative Study
From patient talk to physician notes-Comparing the content of medical interviews with medical records in a sample of outpatients in Internal Medicine.
An increasing number of consultations are delivered in group practices, where a stable 1:1 relationship between patient and physician cannot be guaranteed. Therefore, correct documentation of the content of a consultation is crucial to hand over information from one health care professional to the next. ⋯ Patient involvement should be advocated not only to medical decision making but also to the way physicians document the content of a consultation. It is a joint responsibility of patient and health care professional to decide, which information should be kept and thus be communicated to another health care professional in future consultations.
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Medical errors occur frequently in routine health care. Historically, many of these errors were not disclosed to patients but increasingly there are calls for frank and open disclosure of errors to patients and families. This article provides an overview of what information should be disclosed about errors, what patients want to be told, the attitudes and skills of physicians in disclosure, and the barriers to effective disclosure. This article also includes a description of the changing policy environment in North America that is encouraging and mandating disclosure of errors.
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To identify factors influencing patient involvement in decision-making in the context of chronic kidney disease (CKD) and effective interventions to support their decision-making needs. ⋯ Patients with CKD have decision-making needs across the trajectory of their illness. Although little is known about supporting patients with CKD decision-making, support could be provided with protocols and tools that have been developed for other chronic illness situations. Development of CKD-specific clinical practice guidelines that include decision support best practices could benefit CKD patients. Research priorities include development and evaluation of CKD focused decision support tools and processes.
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Patients with sickle cell disease (SCD) often perceive negative provider attitudes, which may affect the quality of patient-provider communication and care during vaso-occlusive crises (VOCs). This study investigated the validity and reliability of a scale to measure provider attitudes toward patients with acute VOC. ⋯ Future studies should examine the validity of PASS in other cohorts of patients with SCD and their providers. With further evidence, PASS may prove useful for investigating the impact of provider attitudes on the quality of communication and care provided to these patients.