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52. Sources of Clinician Burnout in Providing Care for Underserved Patients in a Safety-Net Healthcare System.

Author

Welles, Christine C., Tong, Allison, Brereton, Elinor, Steiner, John F., Wynia, Matthew K., Powe, Neil R., Chonchol, Michel, Hasnain-Wynia, Romana, and Cervantes, Lilia

Subjects
SAFETY-net health care providers, PSYCHOLOGICAL burnout, MEDICAL personnel, SOCIAL workers, OCCUPATIONAL therapists, PHYSICAL therapists
Abstract

Background: Burnout among clinicians is common and can undermine quality of care, patient outcomes, and workforce preservation, but sources of burnout or protective factors unique to clinicians working in safety-net settings are less well understood. Understanding these clinician experiences may inform interventions to reduce burnout. Objective: To describe clinician perspectives on sources of burnout in a safety-net healthcare system. Design: Semi-structured interviews were conducted with clinicians from multiple disciplines who provided care at a safety-net healthcare system from October 2018 to January 2019. Transcripts were analyzed using thematic analysis. Participants: Forty clinicians (25 female and 15 male; mean [SD] age, 41 [9.1]) participated, including physicians, social workers, advanced practice providers, nurses, psychologists, physical and occupational therapists, and other healthcare professionals. Main Outcomes and Measures: Themes and subthemes that reflected clinician experiences, burnout, and workload expectations. Key Results: Five themes emerged: limited resources (entrenched social injustices, brokenness of the US healthcare system, precarious discharge options, and "revolving door" readmissions), barriers to building trust with patients (chasm of communication, addressing fear and mistrust, and being exposed to threats), administrative requirements (criticism hampering meaningful care, assuming extra workloads, bureaucratic burden), compassion fatigue (confronting traumatic situations, persistent worry about patient safety and welfare, witnessing mistreatment and stigmatization, overextending and overinvesting, withdrawing and shutting down, blaming self and career crisis), and advocacy as a counterbalance to burnout (solidarity when helping underserved communities, fervent advocacy, and patient gratitude). Conclusions: Among clinicians who provide care in a safety-net healthcare system, sources of burnout included limited resources, barriers to building trust with patients, administrative requirements, and compassion fatigue, but clinicians remained driven by their desire to advocate for patients. Policy-level interventions which increase funding to safety-net healthcare systems to bolster existing resources and staffing, create peer-support and wellness programs, and support advocacy efforts may mitigate burnout. [ABSTRACT FROM AUTHOR]

Published
2023
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54. Experiences and values of Latinos with end stage renal disease: a systematic review of qualitative studies

Author

Cervantes, Lilia, Zoucha, Jeff, Jones, Jacqueline, and Fischer, Stacy

Subjects
Latin Americans -- Health aspects, Chronic kidney failure -- Research -- Risk factors, Medical care -- Quality management, Health
Abstract

Patients with end stage renal disease (ESRD) experience a high symptom burden and poor quality of life as part of their advanced illness. Latinos experience a higher prevalence of ESRD compared to non-Latino whites; however, they are underrepresented in existing ESRD literature. We conducted a systematic review of qualitative studies that include Latino patients with ESRD and their caregivers in the United States. Of694 citations published through August 2014, six met inclusion criteria. Four major themes emerged: 1) Losses, 2) Heightened awareness of death, 3) Barriers to quality communication and care, and 4) Mediating Latino traditions and values. A thematic schema was developed. Key Words: End stage renal disease, palliative care, qualitative, Latino, quality of life., Latinos, the fastest growing minority in the United States (U.S.), are expected to grow from 17.4% in 2014 to 28.6% of the U.S. population by 2060 (Colby & Ortman, 2015). [...]

Published
2016

55. Perspectives of patients, family members, health professionals and the public on the impact of COVID-19 on mental health

Author

Gardiner, Evangeline, primary, Baumgart, Amanda, additional, Tong, Allison, additional, Elliott, Julian H., additional, Azevedo, Luciano Cesar, additional, Bersten, Andrew, additional, Cervantes, Lilia, additional, Chew, Derek P., additional, Cho, Yeoungjee, additional, Crowe, Sally, additional, Douglas, Ivor S., additional, Evangelidis, Nicole, additional, Flemyng, Ella, additional, Horby, Peter, additional, Howell, Martin, additional, Lee, Jaehee, additional, Lorca, Eduardo, additional, Lynch, Deena, additional, Marshall, John C., additional, Gonzalez, Andrea Matus, additional, McKenzie, Anne, additional, Manera, Karine, additional, Mehta, Sangeeta, additional, Mer, Mervyn, additional, Morris, Andrew Conway, additional, Nseir, Saad, additional, Povoa, Pedro, additional, Reid, Mark, additional, Sakr, Yasser, additional, Shen, Ning, additional, Smyth, Alan R., additional, Snelling, Tom, additional, Strippoli, Giovanni F. M, additional, Teixeira-Pinto, Armando, additional, Torres, Antoni, additional, Viecelli, Andrea K., additional, Webb, Steve, additional, Williamson, Paula R., additional, Woc-Colburn, Laila, additional, Zhang, Junhua, additional, and Craig, Jonathan C., additional

Published
2022
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67. Core Outcome Measures for Trials in People With Coronavirus Disease 2019: Respiratory Failure, Multiorgan Failure, Shortness of Breath, and Recovery

Author

Tong, Allison, Baumgart, Amanda, Evangelidis, Nicole, Viecelli, Andrea K, Carter, Simon A, Azevedo, Luciano Cesar, Cooper, Tess, Bersten, Andrew, Cervantes, Lilia, Chew, Derek P, Crowe, Sally, Douglas, Ivor S, Flemyng, Ella, Elliott, Julian H, Hannan, Elyssa, Horby, Peter, Howell, Martin, Ju, Angela, Lee, Jaehee, Lorca, Eduardo, Lynch, Deena, Manera, Karine E, Marshall, John C, Gonzalez, Andrea Matus, McKenzie, Anne, Mehta, Sangeeta, Mer, Mervyn, Morris, Andrew Conway, Needham, Dale M, Nseir, Saad, Povoa, Pedro, Reid, Mark, Sakr, Yasser, Shen, Ning, Smyth, Alan R, Simpson, A John, Snelling, Tom, Strippoli, Giovanni FM, Teixeira-Pinto, Armando, Torres, Antoni, Turner, Tari, Webb, Steve, Williamson, Paula R, Woc-Colburn, Laila, Zhang, Junhua, Craig, Jonathan C, COVID-19-Core Outcomes Set Investigators, Teixeira-Pinto, Armando [0000-0002-9389-2516], and Apollo - University of Cambridge Repository

Subjects
Clinical Trials as Topic, Dyspnea, Research Design, Multiple Organ Failure, Outcome Assessment, Health Care, Practice Guidelines as Topic, COVID-19, Humans, Reproducibility of Results, Recovery of Function, Respiratory Insufficiency
Abstract

OBJECTIVES: Respiratory failure, multiple organ failure, shortness of breath, recovery, and mortality have been identified as critically important core outcomes by more than 9300 patients, health professionals, and the public from 111 countries in the global coronavirus disease 2019 core outcome set initiative. The aim of this project was to establish the core outcome measures for these domains for trials in coronavirus disease 2019. DESIGN: Three online consensus workshops were convened to establish outcome measures for the four core domains of respiratory failure, multiple organ failure, shortness of breath, and recovery. SETTING: International. PATIENTS: About 130 participants (patients, public, and health professionals) from 17 countries attended the three workshops. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Respiratory failure, assessed by the need for respiratory support based on the World Health Organization Clinical Progression Scale, was considered pragmatic, objective, and with broad applicability to various clinical scenarios. The Sequential Organ Failure Assessment was recommended for multiple organ failure, because it was routinely used in trials and clinical care, well validated, and feasible. The Modified Medical Research Council measure for shortness of breath, with minor adaptations (recall period of 24 hr to capture daily fluctuations and inclusion of activities to ensure relevance and to capture the extreme severity of shortness of breath in people with coronavirus disease 2019), was regarded as fit for purpose for this indication. The recovery measure was developed de novo and defined as the absence of symptoms, resumption of usual daily activities, and return to the previous state of health prior to the illness, using a 5-point Likert scale, and was endorsed. CONCLUSIONS: The coronavirus disease 2019 core outcome set recommended core outcome measures have content validity and are considered the most feasible and acceptable among existing measures. Implementation of the core outcome measures in trials in coronavirus disease 2019 will ensure consistency and relevance of the evidence to inform decision-making and care of patients with coronavirus disease 2019.

Published
2020
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68. Experiences of Latinx Individuals Hospitalized for COVID-19

Author

Cervantes, Lilia, primary, Martin, Marlene, additional, Frank, Maria G., additional, Farfan, Julia F., additional, Kearns, Mark, additional, Rubio, Luis A., additional, Tong, Allison, additional, Matus Gonzalez, Andrea, additional, Camacho, Claudia, additional, Collings, Adriana, additional, Mundo, William, additional, Powe, Neil R., additional, and Fernandez, Alicia, additional

Published
2021
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69. Advancing Diversity, Equity, and Inclusion in Hospital Medicine

Author

del Pino-Jones, Amira, primary, Cervantes, Lilia, additional, Flores, Sonia, additional, Jones, Christine D, additional, Keach, Joseph, additional, Ngov, Li-Kheng, additional, Schwartz, David A, additional, Wierman, Margaret, additional, Anstett, Tyler, additional, Bowden, Kasey, additional, Keniston, Angela, additional, and Burden, Marisha, additional

Published
2021
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72. Prospective Comparison of Curbside Versus Formal Consultations

Author

Burden, Marisha, Sarcone, Ellen, Keniston, Angela, Statland, Barbara, Taub, Julie A., Allyn, Rebecca L., Reid, Mark B., Cervantes, Lilia, Frank, Maria G., Scaletta, Nicholas, Fung, Philip, Chadaga, Smitha R., Mastalerz, Katarzyna, Maller, Nancy, Mascolo, Margherita, Zoucha, Jeff, Campbell, Jessica, Maher, Mary P., Stella, Sarah A., and Albert, Richard K.

Published
2013
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80. Contributors

Author

Abbott, Jean, Adams, Daniel, Andersen, Forrest, Anderson, Arian, Auston, Darryl, Bacon, Anthony W., Badulak, Jenelle, Baker, Keith, Barrett, Whitney, Bebarta, Vik, Berman, Daniel, Blodgett, Maxwell, Blok, Barbara K., Boatright, Dowin, Bonney, Caitlin F., Bostwick, Thomas L., Brandehoff, Nick, Brant, Julia Aogaichi, Brookens, Andrew, Califf, Tom, Camarena-Michel, Alexa, Cantrill, Stephen V., Cohen, Mitchell Jay, Cao, James Dazhe, Cervantes, Lilia, Cetaruk, Edward W., Chuang, Ryan, Collado, Jeremy, Colwell, Christopher B., Curry, Ashley, Cushing, Tracy, Danzl, Daniel F., Davis, Chris, Davis, Hillary E., Dearstyne, Nadia Markovchick, Dingle, H. Evan, Druck, Jeff, Dubosh, Nicole, Easter, Joshua, Eutermoser, Morgan, Fernandes, Christopher M.B., Galust, Henrik, Grossman, Shamai A., Gubser, Sasha, Dalton Guillaume, Alexander Warren, Guptill, Mindi, Hall, Matthew M., Halmo, Laurie Seidel, Haukoos, Jason, Haycock, James D., Hinchey, Paul, Huecker, Martin, Ipaktchi, Kyros, Iwanicki, Janetta L., Jarou, Zachary J., Jouriles, Nicholas, Joynt, Patrick Y., Kaplan, Bonnie, Karp, Juliana, Keay, C. Ryan, Khoujah, Danya, King, Renee A., Klemisch, Robert, Klingenbjerg, Patricia, Knight, John G., Ko, Kelly J., Kolikof, Joshua, Lapidus, Daniel, Leccese, Paul, Legome, Eric, Lesser, Adriane E., Li, Benjamin, Lindberg, Daniel M., Lindsay, Erin, Ling, Louis J., Loureiro, Rodolfo, MacKenzie, Avery, Malik, Elizabeth N., Markovchick, Vincent J., McCann, Kent, McCormick, Taylor, McCullough, Chelsea, McPheeters, Rick A., Metz, Michelle, Mitchiner, James C., Montagna, Lori A., Moore, Ernest E., Morell, Sean, Morton, Alexander, Murphy, Ryan A., Nacht, Jacob, Noori, Monica, Norris, Donald, Olives, Travis D., Parsons, Melissa, Pedigo, Ryan, Phillips, Blake, Platnick, K. Barry, Rague, John, Rappaport, Lara D., Richards, David, Rodrigues, Kristine Knuti, Roe, Jedd, Roosevelt, Genie E., Rosen, Carlo L., Rowan, Sarah E., Royan, Regina, Sampsel, Kari, Sankoff, Jeffrey, Schimmel, Jonathan, Schmidt, Andrew, Selby, Sarah Tolford, Sheide, Marshall, Shockley, Lee, Simpson, Scott A., Slovis, Corey M., SooHoo, Jeffrey R., Stahel, Philip F., Sungar, W. Gannon, Taha, Jamal, Taira, Taku, Talati, Rakesh, Thiessen, Molly E.W., Tiyyagura, Gunjan, Tomberg, Spencer, Townsend, Ronald R., Trecartin, Kyle W., Trent, Stacy A., Varney, Shawn M., Vercollone, Christopher, Vinton, Deborah, Wang, George Sam, Watson, Brooke, Wheeler Hoffman, Jean McFall, White, Andrew M., Whitledge, James D., Willner, Daniel A., Zabadayev, Sophia, and Young, David

Published
2022
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89. Report of the Standardized Outcomes in Nephrology–Hemodialysis (SONG-HD) Consensus Workshop on Establishing a Core Outcome Measure for Hemodialysis Vascular Access

Author

Viecelli, Andrea K., primary, Tong, Allison, additional, O’Lone, Emma, additional, Ju, Angela, additional, Hanson, Camilla S., additional, Sautenet, Benedicte, additional, Craig, Jonathan C., additional, Manns, Braden, additional, Howell, Martin, additional, Chemla, Eric, additional, Hooi, Lai-Seong, additional, Johnson, David W., additional, Lee, Timmy, additional, Lok, Charmaine E., additional, Polkinghorne, Kevan R., additional, Quinn, Robert R., additional, Vachharajani, Tushar, additional, Vanholder, Raymond, additional, Zuo, Li, additional, Hawley, Carmel M., additional, Levin, Adeera, additional, Viecelli, Andrea, additional, Wang, Angela, additional, Porter, Anna, additional, Sautenent, Benedicte, additional, Reddy, Bharathi, additional, Hemmelgarn, Brenda, additional, Schiller, Brigitte, additional, Hanson, Camilla, additional, Hawley, Carmel, additional, Lok, Charmaine, additional, Wheeler, David, additional, Harris, David, additional, Johnson, David, additional, Schatell, Dori, additional, Lacson, Eduardo, additional, Bavlovlenkov, Elena, additional, O'Lone, Emma, additional, Caskey, Fergus, additional, Strippoli, Giovanni, additional, Feldman, Harold, additional, Apata, Ibironke, additional, Tordoir, Jan, additional, Flythe, Jennifer, additional, Gill, John, additional, Kusek, John, additional, Craig, Jonathan, additional, Polkinghorne, Kevan, additional, Abbott, Kevin, additional, Dember, Laura, additional, Cervantes, Lilia, additional, Moist, Louise, additional, Poole, Lynn, additional, Tonelli, Marcello, additional, Gallieni, Maurizio, additional, Elliot, Meghan, additional, Klusmeyer, Michael, additional, Josephson, Michelle, additional, Robbin, Michelle, additional, Riella, Miguel, additional, Evangelidis, Nicole, additional, Tugwell, Peter, additional, Kerr, Peter, additional, Ravani, Pietro, additional, Roy-Chaudhury, Prabir, additional, Mehrotra, Rajnish, additional, Quinn, Robert, additional, Pecoits-Filho, Roberto, additional, Crowe, Sally, additional, Evered, Sharrilyn, additional, Segerer, Stephan, additional, Fadem, Stephen, additional, McDonald, Stephen, additional, Sprague, Stuart, additional, Palmer, Suetonia, additional, Poma, Tammy, additional, Sikirica, Vanja, additional, Jha, Vivek, additional, van Biesen, Wim, additional, Winkelmayer, Wolfgang, additional, Mayers, Alison, additional, Bell, Barry, additional, Carter, Jane, additional, Hardy, Kimberly, additional, Ennis, Mary, additional, Johnson, Metarose, additional, Rouse, Noah, additional, Wright, Sarita, additional, Harris, Tess, additional, Muhammad, Uthman, additional, McNorton, Vanessa, additional, Mayers, David, additional, and Ennis, David, additional

Published
2018
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94. A call for civic engagement

Author

Cervantes, Lilia

Abstract

As witnesses to the health consequences of social discrimination, clinicians are uniquely positioned to build coalitions of stakeholders to address inequities and drive change. Such civic engagement is needed to ensure that all populations are given the opportunity to thrive.

Published
2024
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99. La profesionalidad pedagógica desde la matemática en las universidades pedagógicas

Author

Rodríguez, Osvaldo, Guerrier, Landy, and Cervantes, Lilia

Subjects
Dificultades, Educación Matemática desde otras disciplinas, Formación de profesores, Resolución de problemas
Abstract

El trabajo es resultado de la investigación realizada con vistas a la obtención del grado cientifico de Master en Enseñanza de la Matemática por el autor, defendido satisfactoriamente. Motivado por las dificultades que durante el proceso de enseñanza-aprendizaje de la matemática se presentaron en relación con la formación de la “Profesionalidad Pedagógica” de los estudiantes de primer año de Licenciatura en educación especialidad Física-Electrónica, se realizó un estudio relativo a la matemática y su enseñanza que derivó en consideraciones hacia la resolución de problemas y el uso de técnicas de trabajo grupal en función del fortalecimiento de cualidades de la personalidad del profesional en formación, se diseño una propuesta “Didáctica-Metodológica” para cuya aplicación se requirió de un análisis de los elementos teóricos abordados para el establecimiento, mediante un tratamiento diferente de los aspectos que conforman cada actividad docente, su aplicación mostró avances cualitativos de los componentes de la personalidad estudiados.

Published
2003

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