Journal of evaluation in clinical practice
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Multicenter Study
Empathy and burnout: A multicentre comparative study between residents and specialists.
The prevalence of burnout among medical doctors and its negative effect on empathy can influence therapeutic success. The aim of this study was to compare the levels of empathy and burnout between residents and specialists as well as to study the correlation between empathy and burnout. ⋯ Our findings suggest that there is a significant difference in burnout subscales scores between residents and specialists and that these have a negative correlation with empathy level. These exploratory results draw attention to the importance of preventing burnout in hospital and health care centres professionals, in particular in residents, through the implementation of individual and organizational structured measures.
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Multicenter Study
Difficulty of the decision-making process in emergency departments for end-of-life patients.
In emergency departments, for some patients, death is preceded by a decision of withholding or withdrawing life-sustaining treatments. This concerns mainly patients over 80, with many comorbidities. The decision-making process of these decisions in emergency departments has not been extensively studied, especially for noncommunicating patients. ⋯ There is little anticipation in end-of-life decisions. Discussion with patients concerning their end-of-life wishes and the writing of advance directives, especially for patients with chronic diseases, must be encouraged early.
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Multicenter Study
Characteristics of shared decision making in Romania from the patient perspective: A cross-sectional multicentric study.
Shared decision making (SDM) is very important from patients' perspective. This process has not yet been evaluated in Romania. The study aims to evaluate SDM from the patients' perspective and to evaluate patients' characteristics that associate with SDM. ⋯ In our study, full anonymity was associated with significantly lower scores for the SDM process. The patients with higher education were most influenced by this condition, while those with the lowest education were the most critical.
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Multicenter Study
A multicenter cross-sectional study of episiotomy practice in Romania.
The aim of this study was to focus attention on episiotomy practice in Romanian maternity units in order to identify factors associated with the very high rate of the procedure in Romania and to consider strategies to reduce it. ⋯ In conclusion, routine episiotomy is the norm in Romanian maternity units, with episiotomy rates among the highest in Europe. Episiotomy use is mainly driven by local professional norms, experiences, previous training, and practitioners' decisions rather than evidence, guidelines, or variations in patient needs at the time of vaginal birth.
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Randomized Controlled Trial Multicenter Study
The Systematic Tool to Reduce Inappropriate Prescribing (STRIP): Combining implicit and explicit prescribing tools to improve appropriate prescribing.
Inappropriate prescribing is a major health care issue, especially regarding older patients on polypharmacy. Multiple implicit and explicit prescribing tools have been developed to improve prescribing, but these have hardly ever been used in combination. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) combines implicit prescribing tools with the explicit Screening Tool to Alert physicians to the Right Treatment and Screening Tool of Older People's potentially inappropriate Prescriptions criteria and has shared decision-making with the patient as a critical step. ⋯ In conclusion, the STRIP helps health care providers to systematically identify potentially inappropriate prescriptions and medication-related problems and to change the patient's medication regimen in accordance with the patient's needs and wishes. This article describes the STRIP and the available evidence so far. The OPERAM study is investigating the effect of STRIP use on clinical and economic outcomes.