Journal of general internal medicine
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Helping patients make decisions about their preferences for cardiopulmonary resuscitation (i.e., code status) is an important way to respect patient autonomy in the hospital. There is a gap in understanding which framework of discussion patients prefer for this decision-making. ⋯ Patients, in line with palliative care experts, largely support a patient values-centered framework to CPR, including a recommendation made by the clinician based on the patient's expressed values.
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Shared decision-making (SDM) is crucial in healthcare to facilitate effective communication between providers and patients, aiding in making optimal medical decisions. Communication skills training (CST) can improve physicians' ability in SDM. However, SDM CST for medical students in Taiwan is scarce, and research comparing online versus in-person CST outcomes is lacking. ⋯ This study has demonstrated that both online and face-to-face SDM CST effectively enhance the SDM decision-making proficiency and communication skills of medical students. The effectiveness of online CST is on par with face-to-face CST. It is recommended to use online CST when face-to-face classes are not feasible, especially during epidemics or budget constraints. Future research should explore the long-term impacts of these CST methods on students' skills, considering additional follow-up time points.
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Social determinants of health (SDOH) are associated with poor health outcomes among individuals with prevalent diseases. ⋯ In this study of community-dwelling US adults without major chronic diseases, social risks were more strongly associated with mortality than healthcare access. Our findings challenge the conventional healthcare-centric approach to preventative care, emphasizing the need for proactive public health interventions targeting SDOH.