Journal of evaluation in clinical practice
-
To establish an enhanced Youden's index with net benefit, as a scientific method for optimal-threshold determination in shared decision making. ⋯ The enhanced Youden's index can establish the optimal-thresholds from the perspective of maximization of patients' net benefit and provide a quantifiable method for shared decision making.
-
Review Meta Analysis
Strategies for implementing shared decision making in elective surgery by health care practitioners: A systematic review.
To summarize relevant international scientific evidence on strategies aimed at facilitating or improving health care practitioners' adoption of shared decision making in elective surgery. The review evaluated the effectiveness of these strategies and described the characteristics of identified strategies. ⋯ The use of well-developed educational information provided through interactive multimedia, computer or DVD based, may enhance the decision-making process. The evidence suggests that such multimedia can be used prior to the surgical consultation, presenting medical and surgical information relevant to the upcoming consultation. A decision and communication aid also appears to be an effective method to support the surgeon in patient participation and involvement in the decision-making process.
-
When approaching medicine, phenomenology has at least two meanings that need to be distinguished in order to become relevant in its application to medical practice. Up to now, these two meanings have been overlapped by most of the scholarly literature. Therefore, the purpose of the article is to differentiate between them, thus endorsing their potential use in medical practice. ⋯ It is important to clarify the consequences of applying each of the two understandings of phenomenology to medicine in the context of its current development. Our present inquiry concerns not merely the disentanglement of the status of what today's scholarly literature calls phenomenology of medicine in relation to meanings of phenomenology, but also the limits of applying phenomenology to the field of medicine.
-
An increasing number of patients are on sick leave from work due to fatigue- and pain-related symptoms that could indicate burnout. The aetiology is unknown, and recently, it has been considered whether burnout should be a distinct medical diagnosis or "just" a form of depression. Little attention has been given to these individuals' experiences. Therefore, we conducted a phenomenological study to explore burnout from a first person perspective. The aim of the study was to obtain a deeper understanding of burnout as phenomenon. ⋯ The findings indicate that lack of recognition of the interviewees' illness may have affected the healing process. When understanding burnout as an intersubjective, lived, contextual, and temporal experience, it is important to take the implications of such factors into consideration for both medical theory and clinical practice. On the basis of our findings, we argue that reducing burnout to a form of depression will neither solve the problem of its unknown aetiology nor provide for meaningful individual health care.
-
While shared decision-making (SDM) training programmes for health professionals have been developed in several countries, few have been evaluated. In Norway, a comprehensive curriculum, "klar for samvalg" (ready for SDM), for interprofessional health-care teams was created using generic didactic methods and guidance to tailor training to various contexts. The programmes adapted didactic methods from an evidence-based German training programmes (doktormitSDM). The overall aim was to evaluate two particular SDM modules on facilitating SDM implementation into clinical practice. ⋯ The two SDM training modules met the basic requirements for use in a broader SDM implementation strategy and can even improve knowledge.