Patient education and counseling
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To identify, describe and characterize the patient and physician participation in content production in medication-related exchanges during primary care consultations. ⋯ The proposed concepts offer a unique vocabulary and conceptual framework to help physicians master the necessary content and process skills required to discuss medications with patients.
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There is considerable interest in the influences on patients' ratings of physicians. ⋯ Learning environments could be created to reinforce certain traits and corresponding habits of mind that enhance patient satisfaction. Such a shift in the culture of medical education and practice could have implications for patient care.
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In this study among patients with cancer in the palliative phase, we analysed whether assessing the symptom, which is causing the most trouble in the patient's every day life ('most troublesome' symptom) had added value apart from the presence and severity of symptoms, which are most commonly assessed in clinical practice. ⋯ We recommend not only to assess the presence and severity of symptoms, but furthermore to assess the patient's 'most troublesome' symptom in addition.
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The impact of breast cancer is immense for all women, but the literature reveals an even greater impact on women of color and among socially and economically disadvantaged populations. Persistent differences in incidence and outcome are undoubtedly due to multiple factors, but one element in poor outcome may be treatment choice. Those treatments shown to be related to best outcomes are less likely to be chosen by certain groups of women. The effects of economic and cultural factors on breast cancer treatment choice have not been thoroughly explored; these factors must be understood if health care professionals are to intervene effectively to address disparities and improve breast cancer outcomes for all women. ⋯ Optimal breast cancer outcomes for all women depend on culturally and ethnically appropriate professional support.
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Aggregation (i.e., meta-ethnography or meta-synthesis) of qualitative studies remains relatively rare and controversial. We have attempted this procedure within an investigation of patient priorities and evaluations of primary care in order to triangulate an instrument development process as well as explore associated dilemmas. ⋯ An instrument to assess the quality of qualitative work within the context of aggregation efforts is described. Calculating inter-rater reliability in this framework can support future quality assessments. A method of breaking a heterogeneous collection of included papers into sub-categories to enable aggregation of qualitative studies is applied and demonstrates its feasibility and potential usefulness.