Journal of general internal medicine
-
Moral injury affects a variety of populations who make ethically complex decisions involving their own and others' well-being, including combat veterans, healthcare workers, and first responders. Yet little is known about occupational differences in the prevalence of morally injurious exposures and outcomes in nationally representative samples of such populations. ⋯ Results from these nationally representative samples of three high-risk populations suggest that exposure to PMIEs is common and a sizable minority report clinically meaningful moral injury.
-
Deprescribing, intentional medication discontinuation or dose reduction, can reduce potentially inappropriate medication use and medication-related harms. Engaging patients in deprescribing discussions may increase likelihood of deprescribing and promote shared decision-making. ⋯ Patient characteristics and brochure engagement were associated with deprescribing discussions. Patient-centered deprescribing brochures can foster patient engagement and inclusion of patient perspectives into deprescribing decisions. Future studies should explore implementation strategies that promote greater deprescribing reach and adoption among patients with lower health literacy.
-
Oropharyngeal dysphagia (dysphagia) is a common (up to 86%) and devastating syndrome in hospitalized older adults with dementia. ⋯ Our study highlights the need for standardizing dysphagia management best practices in hospitalized patients with dementia, the importance of addressing goals of care, and provider education on the risks and benefits of dysphagia diets and artificial nutrition via PEG tube.
-
Increasingly, health systems are collecting and using social needs data, yet there is limited information about individuals' preferences for how social needs information is shared among providers for treatment purposes. ⋯ Individuals' preferences regarding social needs information sharing for treatment purposes, as well as experience of discrimination, trust in healthcare, quality of care, and patient-provider communication, should be considered in health system efforts to capture social needs information.