Search

Your search keyword '"Epstein, Ronald M."' showing total 615 results
Start Over Author "Epstein, Ronald M." Language english
615 results on '"Epstein, Ronald M."'

16. Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers

Author

Hoerger, Michael, Epstein, Ronald M, Winters, Paul C, Fiscella, Kevin, Duberstein, Paul R, Gramling, Robert, Butow, Phyllis N, Mohile, Supriya G, Kaesberg, Paul R, Tang, Wan, Plumb, Sandy, Walczak, Adam, Back, Anthony L, Tancredi, Daniel, Venuti, Alison, Cipri, Camille, Escalera, Gisela, Ferro, Carol, Gaudion, Don, Hoh, Beth, Leatherwood, Blair, Lewis, Linda, Robinson, Mark, Sullivan, Peter, and Kravitz, Richard L

Abstract

Abstract Background Communication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers. Methods/design The Values and Options in Cancer Care (VOICE) Study is a National Cancer Institute sponsored randomized controlled trial conducted in the Rochester/Buffalo, NY and Sacramento, CA regions. A total of 40 oncologists, approximately 400 patients with advanced cancer, and their family/friend caregivers (one per patient, when available) are expected to enroll in the study. Drawing upon ecological theory, the intervention uses a two-pronged approach: oncologists complete a multifaceted tailored educational intervention involving standardized patient instructors (SPIs), and patients and caregivers complete a coaching intervention to facilitate prioritizing and discussing questions and concerns. Follow-up data will be collected approximately quarterly for up to three years. Discussion The intervention is hypothesized to enhance patient-centered communication, quality of care, and patient outcomes. Analyses will examine the effects of the intervention on key elements of physician-patient-caregiver communication (primary outcomes), the physician-patient relationship, shared understanding of prognosis, patient well-being, and health service utilization (secondary outcomes). Trial registration Clinical Trials Identifier: NCT01485627

Published
2013

19. Feeling labeled, judged, lectured, and rejected by family and friends over depression: Cautionary results for primary care clinicians from a multi-centered, qualitative study

Author

Y-Garcia, Erik, Duberstein, Paul, Paterniti, Debora A, Cipri, Camille S, Kravitz, Richard L, and Epstein, Ronald M

Abstract

Abstract Background Family and friends may help patients seek out and engage in depression care. However, patients’ social networks can also undermine depression treatment and recovery. In an effort to improve depression care in primary care settings, we sought to identify, categorize, and alert primary care clinicians to depression-related messages that patients hear from friends and family that patients perceive as unhelpful or detrimental. Methods We conducted 15 focus groups in 3 cities. Participants (n = 116) with a personal history or knowledge of depression responded to open-ended questions about depression, including self-perceived barriers to care-seeking. Focus group conversations were audio-recorded and analyzed using iterative qualitative analysis. Results Four themes emerged related to negatively-received depression messages delivered by family and friends. Specifically, participants perceived these messages as making them feel labeled, judged, lectured to, and rejected by family and friends when discussing depression. Some participants also expressed their interpretation of their families’ motivations for delivering the messages and described how hearing these messages affected depression care. Conclusions The richness of our results reflects the complexity of communication within depression sufferers’ social networks around this stigmatized issue. To leverage patients’ social support networks effectively in depression care, primary care clinicians should be aware of both the potentially beneficial and detrimental aspects of social support. Specifically, clinicians should consider using open-ended queries into patients’ experiences with discussing depression with family and friends as an initial step in the process. An open-ended approach may avoid future emotional trauma or stigmatization and assist patients in overcoming self-imposed barriers to depression discussion, symptom disclosure, treatment adherence and follow-up care.

Published
2012

22. Storylines of family medicine IV: perspectives on practice--lenses of appreciation.

Author

Ventres, William B., Stone, Leslie A., Akhtar, Radeeb, Ring, Jeffrey M., Candib, Lucy M., Messias, Erick, Epstein, Ronald M., Tunzi, Marc, Lee, Amy L., Morley, Christopher P., Brown, Carina M., Slawson, David, Konkin, Jill, Campbell, David G., Couper, Ian, Williams, Susan, Brooks, Robert, and Walters, Lucie

Subjects
FAMILY medicine, MEDICAL teaching personnel, PHYSICIANS
Abstract

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'IV: perspectives on practice--lenses of appreciation', authors address the following themes: 'Relational connections in the doctor-patient partnership', 'Feminism and family medicine', 'Positive family medicine', 'Mindful practice', 'The new, old ethics of family medicine', 'Public health, prevention and populations', 'Information mastery in family medicine' and 'Clinical courage.' May readers nurture their curiosity through these essays. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

25. Self-Monitoring in Clinical Practice: A Challenge for Medical Educators

Author

Epstein, Ronald M., Siegel, Daniel J., and Silberman, Jordan

Abstract

Recent literature has described how the capacity for concurrent self-assessment--ongoing moment-to-moment self-monitoring--is an important component of the professional competence of physicians. Self-monitoring refers to the ability to notice our own actions, curiosity to examine the effects of those actions, and willingness to use those observations to improve behavior and thinking in the future. Self-monitoring allows for the early recognition of cognitive biases, technical errors, and emotional reactions and may facilitate self-correction and development of therapeutic relationships. Cognitive neuroscience has begun to explore the brain functions associated with self-monitoring, and the structural and functional changes that occur during mental training to improve attentiveness, curiosity, and presence. This training involves cultivating habits of mind such as experiencing information as novel, thinking of "facts" as conditional, seeing situations from multiple perspectives, suspending categorization and judgment, and engaging in self-questioning. The resulting awareness is referred to as "mindfulness" and the associated moment-to-moment self-monitoring as "mindful practice"--in contrast to being on" automatic pilot" or "mindless" in one's behavior. This article is a preliminary exploration into the intersection of educational assessment, cognitive neuroscience, and mindful practice, with the hope of promoting ways of improving clinicians' capacity to self-monitor during clinical practice, and, by extension, improve the quality of care that they deliver. (Contains 3 tables.)

Published
2008
Full Text
View/download PDF

28. Medical Family Therapy for a Woman with End-stage Crohn's Disease and Her Son.

Author

McDaniel, Susan H., Harkness, Jennifer L., and Epstein, Ronald M.

Abstract

Medical family therapy grew out of the experiences of family therapists working with other professionals to provide comprehensive, integrated healthcare for patients. This is the story of one such patient and provides an account of the experience through quotes from videotaped sessions and electronic mail communications that occurred throughout the course of therapy. (BF)

Published
2001

30. Toward Creating Physician-Healers: Fostering Medical Students' Self-Awareness, Personal Growth, and Well-Being.

Author

Novack, Dennis H., Epstein, Ronald M., and Paulsen, Randall H.

Abstract

To restore the humanism in medical care, medical education must espouse the creation of physician-healers. Personal development and well-being of the healer are neglected factors in healing care. Goals and objectives for medical education for promoting trainees' self-awareness, personal growth, and well-being are outlined, and ways to achieve and evaluate them are suggested. (Author/MSE)

Published
1999

33. Effect of a Patient-Centered Communication Intervention on Oncologist-Patient Communication, Quality of Life, and Health Care Utilization in Advanced Cancer: The VOICE Randomized Clinical Trial

Author

Epstein, Ronald M., Duberstein, Paul R., Fenton, Joshua J., Fiscella, Kevin, Hoerger, Michael, Tancredi, Daniel J., Xing, Guibo, Gramling, Robert, Mohile, Supriya, Franks, Peter, Kaesberg, Paul, Plumb, Sandy, Cipri, Camille S., Street, Richard L., Jr, Shields, Cleveland G., Back, Anthony L., Butow, Phyllis, Walczak, Adam, Tattersall, Martin, Venuti, Alison, Sullivan, Peter, Robinson, Mark, Hoh, Beth, Lewis, Linda, and Kravitz, Richard L.

Published
2017
Full Text
View/download PDF

44. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians

Author

Krasner, Michael S., Epstein, Ronald M., Beckman, Howard, Suchman, Anthony L., Chapman, Benjamin, Mooney, Christopher J., and Quill, Timothy E.

Subjects
Mindfulness meditation -- Analysis, Physicians -- Psychological aspects, Physicians -- Health aspects, Burn out (Psychology), Health promotion
Abstract

The study aims to evaluate whether there are any benefits of an educational program in mindfulness, communication and self-awareness in improving the wellbeing, burnout and psychological stress of primary care physicians. The results indicate that such programs were found to be beneficial in improving the health and wellbeing of physicians.

Published
2009

Catalog

Books, media, physical & digital resources
See catalog results