Patient Prefer Adher
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Patient Prefer Adher · Jan 2012
Structural equation modeling of the proximal-distal continuum of adherence drivers.
Nonadherence to prescription medications has been shown to be significantly influenced by three key medication-specific beliefs: patients' perceived need for the prescribed medication, their concerns about the prescribed medication, and perceived medication affordability. Structural equation modeling was used to test the predictors of these three proximal determinants of medication adherence using the proximal-distal continuum of adherence drivers as the organizing conceptual framework. ⋯ Testing the proximal-distal continuum of adherence drivers shed light on specific areas where adherence dialogue and enhancement should focus. Our results can help to inform the design of future adherence interventions as well as the content of patient education materials and adherence reminder letters. For long-term medication adherence, patients need to autonomously and intrinsically commit to therapy and that, in turn, is more likely to occur if they are both informed (disease and medication knowledge and rationale, disease severity, consequences of nonadherence, and side effects) and motivated (engaged in their care, perceive a need for medication, and believe the benefits outweigh the risks).
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Patient Prefer Adher · Jan 2012
Safety threats and opportunities to improve interfacility care transitions: insights from patients and family members.
To explore patients' and family members' perspectives on how safety threats are detected and managed across care transitions and strategies that improve care transitions from acute care hospitals to complex continuing care and rehabilitation health care organizations. ⋯ Study findings provide patients' and family members' perspectives on key safety threats and how to improve care transitions. Of particular importance is the need for patients and family members to play a more active role in their care transition planning and self-care management.
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Patient Prefer Adher · Jan 2012
Fentanyl transmucosal tablets: current status in the management of cancer-related breakthrough pain.
Breakthrough pain is a newly recognized pain category that was first described by Portenoy and Hagen in 1990. The term describes pain that increases in intensity to "break through" chronic pain that is being controlled by a scheduled opioid regimen. The development of fluctuations in pain intensity is challenging due to their unpredictable nature, rapid onset, and need for rapid treatment intervention. ⋯ Problems with bioavailability have led to a search for newer formulations of transmucosal delivery. Newer formulations, such as fentanyl transmucosal tablets, have been developed to ensure superior delivery for the patient suffering from breakthrough pain. The purpose of this paper is to discuss the current status of transmucosal tablet formulations for cancer breakthrough pain.
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The objective was to examine how body image affects quality of life in an eating-disorder (ED) clinical sample, a non-ED clinical sample, and a nonclinical sample. We hypothesized that ED patients would show the worst body image quality of life. We also hypothesized that body image quality of life would have a stronger negative association with specific ED-related variables than with other psychological and psychopathological variables, mainly among ED patients. On the basis of previous studies, the influence of gender on the results was explored, too. ⋯ Body image quality of life was affected not only by specific pathologies related to body image disturbances, but also by other psychopathological syndromes. Nevertheless, the greatest effect was related to ED, and seemed to be more negative among men. This finding is the opposite of that found in other groups studied previously.
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This paper, the second of two, reports the results of a systematic writing program used as a tool in the grief process. The study was based on a specifically developed program, which has been described and discussed previously in Part 1. ⋯ We have discussed handling grief with a unique process. Our findings reveal a great breadth and variation in the experiences associated with different writing forms, ways of writing, and writing situations. This implies that flexibility and individualization are important when implementing grief management programs like this. We believe that a structured writing program can be helpful in promoting thought activity and as a tool to gain increased coherence and understanding of the grief process. This writing program may be a valuable guide for program development and future research.