Journal of evaluation in clinical practice
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In the context of adjusting to life with a permanent colostomy, this study explored how perceived social support from family, friends and others influences patients' self-efficacy in managing their stoma and engaging with their social lives. ⋯ Stronger perceived social support was linked to higher stoma self-efficacy in permanent colostomy patients.
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This study aimed to investigate the influential factors of adherence to inhalation drug therapy (IDT) in patients with stable chronic obstructive pulmonary disease (COPD). ⋯ Dose adherence was predominantly influenced by COPD health literacy, mMRC grading, duration of COPD, utilisation of support and marital status. Inhalation technical standardisation was substantially limited by age, mMRC grading, social support, mode of residence, number of acute exacerbations in the past year and literacy.
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Review
Dual process models of clinical reasoning: The central role of knowledge in diagnostic expertise.
Research on diagnostic reasoning has been conducted for fifty years or more. There is growing consensus that there are two distinct processes involved in human diagnostic reasoning: System 1, a rapid retrieval of possible diagnostic hypotheses, largely automatic and based to a large part on experiential knowledge, and System 2, a slower, analytical, conscious application of formal knowledge to arrive at a diagnostic conclusion. However, within this broad framework, controversy and disagreement abound. In particular, many authors have suggested that the root cause of diagnostic errors is cognitive biases originating in System 1 and propose that educating learners about the types of cognitive biases and their impact on diagnosis would have a major influence on error reduction. ⋯ The two processing modes are better understood as a consequence of the nature of the knowledge retrieved, not as independent processes.
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In the context of a major health crisis, health professionals must first compare patients' recovery prospects, thus giving priority to the goal of saving the greatest number of lives. ⋯ The authors' proposed protocol has advantages over the other two protocols due to its greater practicality and capacity to account for egalitarian and consequentialist principles simultaneously. It aims at saving as many lives as possible within the constraints of fairness. Furthermore, the proposed protocol avoids discrimination against people with disabilities without, at the same time, promoting discrimination against the elderly.