Search

While there is high patient acceptance for clinical staff discussing issues regarding spirituality with hospital inpatients, it is not clear which staff member patients prefer for these discussions. This unique exploratory study investigated inpatient preferences regarding which staff member should raise the topic of spirituality. A cross-sectional survey was conducted with inpatients at six hospitals in Sydney, Australia (n = 897), with a subset invited to participate in qualitative interviews (n = 41). Pastoral care staff (32.9%) were the preferred staff members with whom to discuss spiritual issues, followed by doctors (22.4%). Qualitative findings indicated that individual characteristics of the staff member are more important than their role. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluates a pilot implementation of the Liverpool Care Pathway (LCP), a clinical tool used to guide the care of dying patients in the last days of life, on the end-of-life care for dying patients in three regions in rural Australia.Methods: The LCP was implemented at 13 participating sites: nine hospitals (general wards), one community-based palliative care service, and three in-hospital palliative care units. To evaluate the implementation of the LCP, 415 eligible patient records were examined: 223 pre-implementation and 192 post-implementation (116 on the LCP and 76 receiving usual care). The primary analysis compared all patients pre-implementation of the LCP versus all patients post-implementation.Results: Increases were found post-implementation for communication with other health professionals and with patients or family (pre-69 %, post-87 %; p ≤ 0.000), use of palliative medications (pre-87 %, post-98 %; p ≤ 0.000) and frequency of symptom assessments (pre-66 %, post-82 %; p ≤ 0.000). Fewer blood and radiological investigations were conducted and venous access devices used in the post-implementation groups than in the pre-implementation period.Conclusions: This study suggests that when rigorously implemented, the LCP improves important components of end-of-life care for dying patients and their families. [ABSTRACT FROM AUTHOR]

This study developed a new scale, The Medical Social Self-efficacy Scale (MSSES), to assess social self-efficacy within a medical context for patients of diverse cultural and linguistic backgrounds. Validation of the MSSES with a sample of 113 persons indicated that the scale has good internal consistency, with a Cronbach's alpha coefficient of .85. A factor analysis yielded two factors ( confidence in seeking medical information, confidence in stating my view) which accounted for 64 % of the total variance. Split-half reliability of the MSSES was .84. Predictive validity of the MSSES and its factorial structure was found for the mental component summary and general health subscale of the 12-item Short-Form Health Survey. Evidence of concurrent validity was found with the active coping, planning and positive reframing subscales of the Brief COPE. Concurrent validity was also found for the MSSES and its factors, in regard to the emotion-focused coping composite subscale of the Brief COPE. The results indicate that the MSSES appears to be a psychometrically sound instrument. [ABSTRACT FROM AUTHOR]

While doctors generally enjoy considerable status, some believe that this is increasingly threatened by consumerism, managerialism, and competition from other health professions. Research into doctors' perceptions of the changes occurring in medicine has provided some insights into how they perceive and respond to these changes but has generally failed to distinguish clearly between concerns about 'status,' related to the entitlements associated with one's position in a social hierarchy, and concerns about 'respect,' related to being held in high regard for one's moral qualities. In this article we explore doctors' perceptions of the degree to which they are respected and their explanations for, and responses to, instances of perceived lack of respect. We conclude that doctors' concerns about loss of respect need to be clearly distinguished from concerns about loss of status and that medical students need to be prepared for a changing social field in which others' respect cannot be taken for granted. [ABSTRACT FROM AUTHOR]