Search

Aim: Interprofessional collaboration between medical professionals is an essential aspect of caring for Japan's super‐aging population, but studies on the subject have been geographically limited in scope. Therefore, we aimed to determine the factors necessary for pharmacists to achieve interprofessional collaboration in home‐based care in Japan. Methods: Our online questionnaire survey was conducted from February 1, 2023 to February 15, 2023. The Japan Pharmaceutical Association introduced this survey to their membership, and survey letters were sent to hospitals and community pharmacies that were not included in this association. Results: The study involved 1156 and 36 participants working in a community pharmacy and a hospital, respectively. These participants were divided into the collaboration group and the non‐collaboration group. Enough time for visiting patients and for preparing the first visiting plan was important to achieve interprofessional collaboration in home‐based care for a hospital pharmacist. More than 5 years of experience working in home‐based care and participation in pre‐visit conferences, discharge conferences, meetings with persons in charge of services were independent factors in collaborating with other medical staff for a community pharmacist. Conclusion: Hospital pharmacists with enough time to prepare and visit for home‐based care and community pharmacists working in home‐based care for more than 5 years and who share information on home‐based care with medical staff achieved interprofessional collaboration in home‐based care. Geriatr Gerontol Int 2024; 24: 1008–1014. [ABSTRACT FROM AUTHOR]

Numerous studies have demonstrated that our healthcare systems and medical education programs are fundamentally flawed. In North America and Europe, most systems were built upon values and structures that have historically benefitted middle and upper class males of European descent in the global north. As a result, there continue to be systemic biases that are pervasive throughout our healthcare systems and medical education programs. This has led to inequities in health outcomes and clinical reasoning practices which marginalize several communities. These biases are perpetuated as we continue to lead medical education research and practice with traditional values and views of evidence. To address these issues, we proposed a 'flipped' conference in which three interdisciplinary writing teams, comprised of both junior and senior academics, clinicians, and researchers, were invited to rethink the foundations of clinical reasoning. In the months leading up to the conference, each writing team explored a specific topic related to clinical reasoning and racial equity. The papers, presented during the virtual conference are now available in this issue of the Journal for the Evaluation of Clinical Practice. In addition, 6 more publications were added to this special topic to showcase new evidence and theory that builds on the recommendations in the three core papers. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the process of implementing an evidence-based goal-setting package into five rehabilitation services across the continuum of rehabilitation. This study used a mixed methods approach guided by Medical Research Council (MRC) recommendations for conducting process evaluations, the RE-AIM framework, and the Theoretical Domains Framework (TDF). This study will evaluate the reach, adoption, implementation, and maintenance of the goal-setting package over six months. Environmental context and resources, the clinician's social and professional role and identity, social influences and clinician beliefs about goal-setting consequences and individuals' capabilities were all identified as barriers or enablers throughout the implementation process. Community rehabilitation services faced challenges implementing paper-based resources, whilst inpatient rehabilitation sites faced challenges engaging nursing staff in the interdisciplinary approach to goal-setting. Social influences were an enabler in two sites that used the case conference format to facilitate setting common goals. Clinicians in all sites continued to express difficulties implementing shared decision-making with people who had cognitive impairments or were no longer progressing in their rehabilitation. A team-based approach to implementing the goal-setting interventions centred around the case conference format appeared to be the most successful mode for implementing interdisciplinary person-centred goal-setting. The rehabilitation case conference forum can be used to facilitate teams to set interdisciplinary common goals. Rehabilitation teams should add further consideration to how they can involve clients as a member of the rehabilitation team throughout the rehabilitation process. Embedding changes into existing process and using structured templates and tools can enhance the process of goal-setting in rehabilitation. Strong leadership, dedicated facilitation, audit and feedback can enhance team's success in implementing elements of the goal-setting implementation package. [ABSTRACT FROM AUTHOR]

Family group conferences (FGCs) in child welfare share decision-making with family members by bringing the immediate and wider family together to make a plan to meet a child's needs. This paper reports survey findings on FGC provision in the UK in 2022 and explores whether in England the presence of an FGC service and the rate of FGC provision is associated with the rate of children in care, entering care, in kinship foster care and leaving care. Seventy-nine per cent (n  = 167) of local authorities in the UK provided FGCs to families, and 14 per cent (n  = 29) did not. Services that were more established offered a more diverse range of FGCs. The introduction of FGCs in English local authorities was associated with a higher rate of children in care, but also higher rates of kinship foster care, a key goal of FGCs where it is not possible for children to stay with their parents. Higher rates of FGCs were associated with more children leaving care, possibly due to reunification with birth families. To understand in more detail, the circumstances of children in and leaving care in local authorities with FGCs, individual data linkage studies are needed. [ABSTRACT FROM AUTHOR]

Family Group Conference (FGC) is a participatory decision‐making process for families with children at risk, for whom concerns were recognized by the family, the professionals and/or the community. In its initial stages, FGC is organized, and the families are accompanied, by independent coordinators. The study used a qualitative, action‐oriented methodology to explore what practices coordinators use to foster FGC's family‐led dynamic. The data collection included 13 semi‐structured, in‐depth interviews and two research group discussions with coordinators to learn about their perspectives and practices. The study found that these practices were guided by three main principles of action: to affirm the family's control and responsibility, to highlight the family's ability and to orient the family towards the future. The article explores how these practices contribute to the family‐led dynamic of FGC and situates them within the context of the welfare system and the positioning of the coordinators as 'outsiders‐within' to both the family and the welfare services. This study contributes to the body of knowledge on participatory child welfare models and agentic practices and offers implications for policy and implementation of FGC in a manner that recognizes and respects families' agency. [ABSTRACT FROM AUTHOR]

Background Patients with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and dementia are underrepresented in specialist palliative home care (SPHC). However, the complexity of their conditions requires collaboration between general practitioners (GPs) and SPHC teams and timely integration into SPHC to effectively meet their needs. Objective To facilitate joint palliative care planning and the timely transfer of patients with advanced chronic non-malignant conditions to SPHC. Methods A two-arm, unblinded, cluster-randomised controlled trial. 49 GP practices in northern Germany were randomised using web-based block randomisation. We included patients with advanced CHF, COPD and/or dementia. The KOPAL intervention consisted of a SPHC nurse–patient consultation followed by an interprofessional telephone case conference between SPHC team and GP. The primary outcome was the number of hospital admissions 48 weeks after baseline. Secondary analyses examined the effects on health-related quality of life and self-rated health status, as measured by the EuroQol 5D scale. Results A total of 172 patients were included in the analyses. 80.4% of GP practices had worked with SHPC before, most of them exclusively for cancer patients. At baseline, patients reported a mean EQ-VAS of 48.4, a mean quality of life index (EQ-5D-5L) of 0.63 and an average of 0.80 hospital admissions in the previous year. The intervention did not significantly reduce hospital admissions (incidence rate ratio = 0.79, 95%CI: [0.49, 1.26], P  = 0.31) or the number of days spent in hospital (incidence rate ratio = 0.65, 95%CI: [0.28, 1.49], P  = 0.29). There was also no significant effect on quality of life (∆ = −0.02, 95%CI: [−0.09, 0.05], P  = 0.53) or self-rated health (∆ = −2.48, 95%CI: [−9.95, 4.99], P  = 0.51). Conclusions The study did not show the hypothesised effect on hospitalisations and health-related quality of life. Future research should focus on refining this approach, with particular emphasis on optimising the timing of case conferences and implementing discussed changes to treatment plans, to improve collaboration between GPs and SPHC teams. [ABSTRACT FROM AUTHOR]

Simple Summary: Older adults with cancer are often the subject of much discussion at multidisciplinary cancer conferences (MCCs), yet little is known about the language used to describe frailty and other geriatric considerations at these meetings. Our objective was to explore how MCC presentations depict older patients. We found that MCCs frequently referred to comorbidity burden and projected treatment tolerance on the basis of subjective evaluations, rather than comprehensive geriatric assessments. We also noted that mentions of surrogate measures for frailty, such as chronological age and performance status, varied between tumour sites, presenter specialties, and presenter training levels. Overall, our results suggest that MCCs predominantly rely on age-based descriptions and, thus, engender risk of age-biased decision making. This work may guide future efforts aimed at standardizing the language at MCCs to include more objective terms and validated tools for considering different geriatric domains when discussing older adults with cancer. Older adults with cancer often present with distinct complexities that complicate their care, yet the language used to discuss their management at multidisciplinary cancer conferences (MCCs) remains poorly understood. A mixed methods study was conducted at a tertiary cancer centre in Toronto, Canada, where MCCs spanning five tumour sites were attended over six months. For presentations pertaining to a patient aged 75 or older, a standardized data collection form was used to record their demographic, cancer-related, and non-cancer-related information, as well as the presenter's specialty and training level. Descriptive statistics and thematic analysis were employed to explore MCC depictions of older patients (n = 75). Frailty status was explicitly mentioned in 20.0% of presentations, but discussions more frequently referenced comorbidity burden (50.7%), age (33.3%), and projected treatment tolerance (30.7%) as surrogate measures. None of the presentations included mentions of formal geriatric assessment (GA) or validated frailty tools; instead, presenters tended to feature select GA domains and subjective descriptions of appearance ("looks to be fit") or overall health ("relatively healthy"). In general, MCCs appeared to rely on age-focused language that may perpetuate ageism. Further work is needed to investigate how frailty and geriatric considerations can be objectively incorporated into discussions in geriatric oncology. [ABSTRACT FROM AUTHOR]

Background: Clinician empathy positively impacts patient outcomes. Few studies have assessed the effects of different types of empathic expression. Objective: To describe how families respond when clinicians express empathy in different ways. Design: Prospective, mixed-methods cohort. Setting/Subjects: English and interpreted pediatric inpatient care conferences at a U.S. quaternary hospital between January 1, 2018 and January 1, 2021. Measurements: Directed content analysis of clinician empathic statements and family responses. Results: Of 29 patient-family dyads, 11 (39%) used language interpretation. In response to 80 clinician empathic statements, families expressed agreement or shared more 84% (67/80) of the time. Families shared more about their perspective in response to explore statements 71.4% (10/14) of the time, in response to validate statements 61% (17/28) of the time, and in response to respect/support statements 39% (11/28) of the time. Conclusion: Certain types of empathic statements may be more effective at prompting families to share more about their perspective, a key element of shared decision-making. [ABSTRACT FROM AUTHOR]

Objective: The UK Medical Licensing Assessment curriculum represents a consensus on core content, including ENT-related content for newly qualified doctors. No similar consensus exists as to how ENT content should be taught at medical school. Method: A virtual consensus forum was held at the 2nd East of England ENT Conference in April 2021. A syllabus of ENT-related items was divided into 'Presentations', 'Conditions' and 'Practical procedures'. Twenty-seven students, 11 foundation doctors and 7 other junior doctors voted via anonymous polling for the best three of nine methods for teaching each syllabus item. Results: For 'Presentations' and 'Conditions', work-based or clinical-based learning and small-group seminars were more popular than other teaching methods. For 'Practical procedures', practical teaching methods were more popular than theoretical methods. Conclusion: Students and junior doctors expressed a clear preference for clinical-based teaching and small-group seminars when learning ENT content. E-learning was poorly favoured despite its increasing use. [ABSTRACT FROM AUTHOR]

The study findings highlight that white-collar employees welcome mental health and wellbeing initiatives at work, but are sceptical about the effectiveness of current measures, particularly against a backdrop of high job demands and unsupportive cultures. They also reveal a receptiveness towards greater psychological support provision in private sector occupational settings. Objective: The aim of the study is to explore white-collar corporate employee/manager experiences of current employer-led mental health and well-being initiatives. Methods: Twenty-five participants took part in semistructured interviews yielding over 19 hours of data. Thematic analysis of the interview transcripts was undertaken. Participants worked for organizations including investment banks, insurers, asset managers, consultants, public relations, marketing, and legal firms. Results: Many participants were skeptical of the effectiveness of current company-led mental health and well-being initiatives against a backdrop of high job demands and unsupportive cultures. A commonly expressed view was that organizations were paying lip service to the issue. Participants communicated that more leadership role modeling on mental health and well-being, supportive job designs, and accessible skills-focused psychological support would be beneficial. Conclusions: Corporate white-collar employees/managers welcome mental health and well-being initiatives but are skeptical about their current effectiveness. [ABSTRACT FROM AUTHOR]

Health professional programs can promote equitable healthcare delivery but few programs include disability in these efforts. Limited opportunities exist for health professional students to engage with disability education within the classroom or beyond. The Disability Advocacy Coalition in Medicine (DAC Med) is a national interprofessional student-led organization which hosted a virtual conference for health professional students in October 2021. We describe the impact of this single-day virtual conference on learning and the current state of disability education across health professional programs. This cross-sectional study utilized a 17-item post-conference survey. A 5-point Likert scale-based survey was distributed to conference registrants. Survey parameters included background in disability advocacy, curricular exposure to disability, and impact of the conference. Twenty-four conference attendees completed the survey. Participants were enrolled in audiology, genetic counseling, medical, medical scientist, nursing, prosthetics and orthotics, public health, and 'other' health programs. Most participants (58.3%) reported not having a strong background in disability advocacy before the conference, with 26.1% indicating they learned about ableism in their program's curriculum. Almost all students (91.6%) attended the conference to learn how to be a better advocate for patients and peers with disabilities, and 95.8% reported that the conference provided this knowledge. Eighty-eight percent of participants agreed that they acquired additional resources to better care for patients with disabilities. Few health professional students learn about disability in their curriculum. Single-day virtual, interactive conferences are effective in providing advocacy resources and empowering students to employ them. [ABSTRACT FROM AUTHOR]

As public health practitioners and program evaluators for a state health department, we look forward to public health conferences for the opportunity to hear from leaders in the field and inform our own practice. While we feel that most presentations describe the work and why it matters, many of us leave sessions thinking, "Now what?" In other words, how do we apply what we learned to public health practice? As American Public Health Association (APHA) looks to celebrate its 150th year in 2022, now is an ideal time to focus on expanding the impact of our work. We offer several suggestions for how conference presenters can make their work more applicable to public health practitioners. We ground our recommendations in John Driscoll's reflective model for health care practitioners. This framework guides the audience through three questions designed to move from a description of what happened ("what?") to the potential significance of their findings ("so what?") and finally to the actions we can take as a result ("now what?"). These strategies are meant to help presenters describe processes and implications in addition to outcomes and theory. We hope that public health professionals can continue to look to the APHA Annual Meeting and other public health conferences as not only sources of innovative research but also as forums for practitioners to share the practical applications of their work. [ABSTRACT FROM AUTHOR]

Since the COVID-19 pandemic, health equity has been placed front and center in the conversations surrounding healthcare as well other fields. This conversation has also been occurring in the field of lifestyle medicine with an intentional focus on developing solutions at the intersection of lifestyle medicine and health equity. Initiated by a call to action by ACLM Past President Dexter Shurney at the 2019 Lifestyle Medicine conference, the HEAL Initiative was created with that intention, to address health disparities and advance health equity through lifestyle medicine. Since 2019, the HEAL initiative has grown considerably in its work and impact, creating solutions aligned with the AMA strategic planning recommendations as well developing projects that are examples of community engaged-lifestyle medicine. The work of the HEAL initiative culminated in a full circle moment at the 2023 Lifestyle Medicine Conference which featured an interview (facilitated by Dr. Dexter Shurney) with former US Surgeon General Dr. Jerome Adams and review of HEAL's work over the past 3 years. This article will capture the key highlights of the HEALing our Nation opening session and the cumulative work of HEAL Initiative. [ABSTRACT FROM AUTHOR]

Background: Presenting at professional and scientific conferences can be an important part of an individual's career advancement, especially for researchers communicating scientific findings, and can signal expertise and leadership. Generally, women presenting at conferences are underrepresented in various science disciplines. We aimed to evaluate the gender of presenters at research-oriented chiropractic conferences from 2010 to 2019. Methods: We investigated the gender of presenters at conferences hosted by chiropractic organisations from 2010 to 2019 that utilised an abstract submission process. Gender classification was performed by two independent reviewers. The gender distribution of presenters over the ten-year period was analysed with linear regression. The association of conference factors with the gender distribution of presenters was also assessed with linear regression, including the gender of organising committees and abstract peer reviewers, and the geographic region where the conference was hosted. Results: From 39 conferences, we identified 4,340 unique presentations. Women gave 1,528 (35%) of the presentations. No presenters were classified as gender diverse. Overall, the proportion of women presenters was 30% in 2010 and 42% in 2019, with linear regression demonstrating a 1% increase in women presenting per year (95% CI = 0.4–1.6%). Invited/keynote speakers had the lowest proportion of women (21%) and the most stagnant trajectory over time. The gender of conference organisers and abstract peer reviewers were not significantly associated with the gender of presenters. Oceanic conferences had a lower proportion of women presenting compared to North America (27% vs. 36%). Conclusions: Overall, women gave approximately one-third of presentations at the included conferences, which gradually increased from 2010 to 2019. However, the disparity widens for the most prestigious class of keynote/invited presenters. We make several recommendations to support the goal of gender equity, including monitoring and reporting on gender diversity at future conferences. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has profoundly altered the ways in which health care professionals engage with continuing professional development (CPD), but the extent to which these changes are permanent remains unknown at present. This mixed-methods research aims to capture the perspectives of health professionals on their preferences for CPD formats, including the conditions that inform preferences for in-person and online CPD events and the optimum length and type of online and in-person events. Methods: A survey was used to gain a high-level perspective on health professionals’ engagement with CPD, areas of interest, and capabilities and preferences in relation to online formats. A total of 340 health care professionals across 21 countries responded to the survey. Follow-up semistructured interviews were conducted with 16 respondents to gain deeper insights into their perspectives. Results: Key themes include CPD activity before and during COVID, social and networking aspects, access versus engagement, cost, and time and timing. Discussion: Recommendations regarding the design of both in-person and online events are included. Beyond merely moving in-person events online, innovative design approaches should be adopted to capitalize on the affordances of digital technologies and enhance engagement. [ABSTRACT FROM AUTHOR]

A personal narrative is presented which explores the author's experience of dealing with 62-year-old black woman named Sarah during her internship in palliative care.

The article focuses on the consensus statement reached by editors of psychiatry journals published in India. Topics discussed include the expansion of the Indian Psychiatric Society (IPS) and the formation of various branches and journals, the need to improve the quality of publications and ethical standards, and issues related to cost, collaboration, and indexing of journals.

An introduction is presented in which the editor discusses articles in the issue on topics including, examining marginalized mortalities and ordinary deaths within the context of structural inequalities; and exploring the unnatural ways in which death is distributed and understood.

The author reflects on her experience of being part of a virtual Family Group Conference (FGC) in 2020 during the Covid-19 pandemic. The article explains the FGC model and its application in children's services and social work. Some of its potential outcomes, based on research and evidence, include reduction in the number of children entering state care, improve contact arrangements between children and families and better engagement in child protection services among children and families.

BACKGROUND AND OBJECTIVES: Clinician empathy is associated with improved communication and clinical outcomes. We hypothesized that, when clinicians express empathy, families are more likely to deepen discussions, and that clinicians express less empathy in care conferences with language interpretation. METHODS: Prospective, mixed methods cohort study of English and interpreted audio-recorded transcripts of care conferences for pediatric patients with serious illness hospitalized at a single urban, quaternary medical institution between January 2018 and January 2021. Directed content analysis identified empathic opportunities, clinician empathetic statements or missed opportunities, and family responses. Clinician empathic statements were "buried" if immediately followed by more clinician medical talk. Descriptive analyses summarized demographics and codes. χ² analyses summarized differences among language interpretation and family responses. RESULTS: Twenty-nine patient-family dyads participated. Twenty-two (81%) family members were female. Eleven (39%) used language interpretation (8 Spanish, 2 Vietnamese, 1 Somali). Families created 210 empathic opportunities. Clinicians responded with unburied empathy 80 times (38%, no differences for English versus interpreted care conferences, P = .88). When clinicians buried empathy or missed empathic opportunities, families responded with alliance (agreement, gratitude, or emotional deepening) 14% and 15% of the time, respectively. When clinicians responded with unburied empathy, families responded with alliance 83% of the time (P < .01). CONCLUSIONS: Our study suggests that clinician empathic expression does not differ when language interpretation is used in pediatric care conferences. Clinicians often miss opportunities to express empathy, or they bury it by medical talk. Although unburied empathy created opportunities for relationship-building and family-sharing, buried empathy negatively impacted these domains similarlyto no empathic expression. [ABSTRACT FROM AUTHOR]

Patient and family advisory councils (PFACs) represent one method of engaging patients and families in clinical program development and research, but existing practices too often exclude marginalized and minority voices. As a kidney palliative care team (KidneyPal) at a large academic medical center, we sought to create a PFAC that explicitly considered equity and inclusion in its approach to advisor recruitment. We developed two major innovations to reduce selection bias in our KidneyPal PFAC: adaptation to an entirely virtual process and alteration of the advisor recruitment and enrollment process. We eliminated several potential barriers to participation for our patients and their family members, a population with higher rates of advanced age, nonwhite ethnicity, and limited English proficiency than the local general population. We removed application requirements including lengthy online training modules, detailed employment history, a personal essay, and a criminal background check. The KidneyPal PFAC may act as a model for improving equity and inclusion in virtual patient advisory councils. [ABSTRACT FROM AUTHOR]

Introduction: Evaluations of knowledge obtained during conferences, whether in person or virtually, are rarely documented, in part because of the complexity of including an assessment, the pretesting involved, confidentiality concerns, and differences among attendees in terms of their education, language, and willingness to be evaluated. Objective: During a conference in the United States, we compared the recognition of developmental milestones using two different multimodal communication strategies (video vs. oral presentation) among three groups of childcare providers. Methods: Cross-sectional study with repeated measures. One hour before the conference completion, two groups (one virtual and one in-person) received an 8-minute multimodal presentation on child developmental milestones at 4 months (cartoon video); a control group, during the face-to-face conference, received an 8-minute multimedia presentation (oral via PowerPoint) on child developmental milestones at 4 months. The three groups responded twice to a scale to measure their recognition of developmental milestones before the lecture began and fifteen minutes before the end of the 2 ½ hours lecture. Results: Attendees, both in person and via the virtual modality, had significantly better recognition of developmental milestones at 4 months of age compared to the control group adjusted for age and education levels. Conclusion: These results suggest the advantages of a multimodal presentation using video versus an oral presentation during lectures to increase recognition of children's developmental milestones, which are complex and varied. Similarly, such a strategy may be effective regardless of the different characteristics related to the educational level or age of the set of participants attending a conference. [ABSTRACT FROM AUTHOR]

Aims: Diabetes case conferencing is where an endocrinologist visits a general practitioner (GP) to advise on the care of patients with diabetes. Past case conferencing studies have reported improved diabetes management and clinical outcomes in primary care. This study investigated the effectiveness of a diabetes case conferencing program in South Western Sydney, Australia. Methods: Complex diabetes cases were referred by general practitioners to a visiting endocrinologist for review after obtaining patient consent. The patient was not usually present. After the case discussion, a diabetes management plan was developed jointly by the general practice/specialist team. Clinical data were compared at baseline and each year up to three years (2017--2020) after the consultation using paired t-test. The primary outcome was HbA1c. Results: Clinical data were collected for 645/775 patients (mean age 64 ± 15(SD) years; 351 (54.4%) males from 40/43 general practices; 96.4% had type 2 diabetes; 6.5% were insulin treated, 54.3% non-insulin treated, 31.5% both insulin and noninsulin treated and 3.4% diet only. There were reductions in HbA1c by 1.0 ± 1.7% (11 ± 19 mmol/mol) (p < 0.001), systolic blood pressure 8.2 ± 18.1 mmHg (p < 0.001), diastolic blood pressure 2.7 ± 11.6 mmHg (p < 0.001), total cholesterol 0.2 ± 1.7 mmol/l (p = 0.007), low-density lipoprotein 0.2 ± 1.0 mmol/l (p < 0.001), weight 3.3 ± 10.1 kg (p < 0.001) and body mass index (BMI) 1.3 ± 3.5 kg/m2 (p < 0.001). Conclusions: Glycaemia, weight and cardiovascular risk factors improved following case conferencing consultations in a primary care setting. [ABSTRACT FROM AUTHOR]

Objective: to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. Method: a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. Results: 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. Conclusion: attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors. [ABSTRACT FROM AUTHOR]

Background: Collaborative clinical facilitation converges key players to guide students individually and within groups towards achieving clinical nursing competence. However, experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and nursing and midwifery students are often fragmented and have been largely unexplored in Ghana. Aim: To describe the experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and final year nursing and midwifery students in Northern Ghana. Setting: The study was conducted at two nursing and midwifery colleges and an academic hospital in Northern Ghana. Methods: A qualitative, descriptive, exploratory design was utilized. Forty-six participants comprising 16 nurse educators, 10 clinical preceptors, 10 nursing students and 10 midwifery students were purposively sampled. Focus groups and in-depth interviews were used to gather data and analysed thematically. Results: Three themes revealed facilitative experiences of collaborative clinical facilitation: team-based clinical mentorship and supervision, personalised preceptorship, and clinical conferences. Two themes emerged inhibitory to collaborative clinical facilitation: staff shortages and lack of timely communication. Conclusion: This study found that team mentorship, preceptorship and conferences fostered collaborative clinical partnerships for students' clinical learning. However, failure to engage in timeous communication in the midst of staff shortages hampered its smooth practice. Orientation workshops need to be organised for key players to share relevant updates and explore ways to navigate the challenges often experienced within the clinical training environment. Contribution: This paper provides insight into the collaborative nature of clinical facilitation; and highlights the need for coordinated clinical placements to enhance students' clinical learning. [ABSTRACT FROM AUTHOR]

(1) Background: Effective communication among couples in which one has been diagnosed with cancer is critical to improve their psychosocial adaptation to cancer. The objective of this review was to explore the characteristics and measurement outcomes of existing couple-based communication interventions in the cancer context. (2) Methods: Eight electronic databases were searched from database initiation to August 2022 to identify eligible articles. Hand searching was also performed on the included articles' reference lists and authors. (3) Results: A total of 14 intervention studies were eligible to be included in this review. Cancer couples with distress or communication problems before intervention were more likely to benefit from the couple-based communication interventions. Positive outcomes were reported, including an improvement in relationship functioning (including mutual communication, intimacy, and relationship satisfaction) and individual functioning (including a decline of anxiety, depression and cancer-related concerns, and an increase in psychological adjustment and quality of life). (4) Conclusions: These findings supported the importance of improving mutual communication behaviors to promote cancer patient–spousal caregiver dyads' psychosocial adaptation to cancer. While most included studies were conducted in western countries and the sample size was relatively small, more research is warranted to develop more efficacious couple-based communication interventions. [ABSTRACT FROM AUTHOR]

Can thwarted belongingness and perceived burdensomeness, risk factors for suicidal adolescents, be turned around by family group conferences? In this case study on Nick, a 17-year-old who undertook six suicide attempts, we (including Nick) share insights and learning opportunities on how family group conferences can be used. The thematic analysis suggests that family group conferences might be a promising intervention for suicidal adolescents. For Nick, the conference was a turning point in his life, correcting perceptions of being a burden, pushing back passiveness, and boosting connection with and support from the broad social network. [ABSTRACT FROM AUTHOR]

Background: In some breast and gynaecologic cancer centres in Germany, patients participate in their own case discussion in multidisciplinary tumour conferences (MTCs), where treatment recommendations are discussed and finalized. However, the extent to which patients in MTCs are involved in decision‐making on treatment recommendations remains largely unexplored. Hence, this study investigates how recommendations are communicated to patients and the extent to which the interactions with patients in MTCs are in line with shared decision‐making (SDM). Methods: In this observational study, we audio‐recorded MTCs with patient participation in three breast and gynaecologic cancer centres in Germany. We qualitatively analysed the data with regard to content and linguistic aspects. Results: We analysed 82 case discussions. Recommendations made during MTCs were regarding (i) treatment options, (ii) treatment initiation, (iii) next (treatment) steps and (iv) whether a treatment method should be initiated at all. The decision about recommendations depended in part on patients' preferences or further course/further outcomes. Although the purpose of MTCs is to provide recommendations, some recommendations were framed as the final decision. The majority of the decision‐making conversation could be characterized as option talk (78%), during which patients were mostly proposed only one (treatment) option. Conclusions: This study establishes limited SDM in MTCs with patient participation. By indicating choices and thereby creating awareness of choices among patients, MTCs with patient participation could be used to foster SDM implementation. Patient or Public Contribution: Two representatives of a large self‐help organization for patients with breast cancer assisted the research project, particularly, in discussing the results. [ABSTRACT FROM AUTHOR]

265 Background: Studies reveal a mismatch between the goals of care (GOC) of cancer patients and actual care received. The 10 members of the Alliance of Dedicated Cancer Centers (ADCC) convened the Improving Goal Concordant Care (IGCC) initiative to address system gaps. IGCC was led by palliative care and oncology experts, with guidance from patient and family advisors. Uniquely, the advisors were identified from patient family advisory councils (PFAC) at each center, forming a collaborative Advisory Group (AG) with the lived experience of each center and the knowledge of advocating for the patient/family voice locally. Methods: PFAC members were recruited from each site to serve on the AG. The 19 member AG met quarterly, with minutes shared with the IGCC oversight group, the Implementation Workgroup (IWG). In September 2023, all AG members were surveyed about perceptions of PFAC engagement and local impact of IGCC. In May 2024, 20 IWG members were surveyed about implementation successes and barriers, including items related to PFAC engagement. Results: AG evaluation and recommendations altered IGCC planned core implementation and evaluation actions meaningfully; for example in 1) selection of structured fields in electronic health record (EHR) and universally accessible GOC documentation and in 2) centering patients in the GOC measure set, including incorporating "Heard & Understood" survey into IGCC evaluation. Other AG guidance around direct patient engagement readiness for GOC conversations and implementing patient GOC surveys was left to individual sites to consider with variable adoption. AG Survey: 63% response rate. 80% noted that the GOC program was discussed with their local PFAC and 92% experienced changed routine patient care after GOC implementation. IWG Survey: 100% response rate. 68% agreed that their center sought guidance from their PFAC during GOC implementation and that leadership presented to their PFAC about their GOC implementation. 26% indicated reporting data to their PFAC; of those that did, 80% agreed that this positively impacted their GOC implementation. Conclusions: While PFACs are occasionally included in quality interventions, this model centered the patient/family voice by supporting a PFAC stakeholder feedback loop working collaboratively and locally to support implementation and evaluation of IGCC objectives. While not all AG recommendations were formally integrated into IGCC, all were considered and many adopted at individual centers. Despite ongoing IGCC-level involvement, center-specific engagement of PFACs varied. Future efforts can track this during process evaluation as local PFAC engagement was highly valued. Consensus building for national best practice implementation and evaluation by recruiting local experts including PFAC members into national collaborative efforts is a successful model for local change. [ABSTRACT FROM AUTHOR]

The article explores the clinical postconference intravenous (IV) pump challenge as a learning activity to be used by clinical instructors to help provide nursing students the opportunity to demonstrate proficiency in basic IV pump management.

Delays in communication are commonly experienced by young children who are not meeting developmental milestones. Early naturalistic developmental behavioral interventions are efficacious, and parents can successfully embed these communication strategies into playtime routines, including when coaching is delivered via telepractice. Video feedback is a strength-based coaching method that has been successfully applied to increase positive parenting behaviors (e.g., descriptive praise, responsivity). However, limited research exists on the use of video feedback as a coaching tool for parents of children with developmental delays for communication interventions. We evaluated the effects of a telepractice-based parent training followed by joint reflections and video feedback coaching on parent strategy use and child communication targets, using a concurrent multiple-baseline across three parent–child dyads design. Parent perceptions of the feasibility and appropriateness of the intervention were positive. We discuss implications and provide suggestions for future research and practice. [ABSTRACT FROM AUTHOR]

Researcher-initiated research often has little or no input from the groups who will be affected by the results of the research. The aim of this project was to describe practices of embracing patient-partners (i.e., individuals with aphasia and spouses/family members) in research. Six webinars were developed for both researchers and patient-partners that were required prior to participating in a joint conference that focused on collaborative research teams. The conference was designed based on an appreciative inquiry approach. Including patient-partners into research priorities and planning has been accomplished across various health domains in the United States, but this was the first organized national effort, in the United States, to support the inclusion of people with aphasia and their families as active partners in the research process. Consequently, it is hoped that future aphasia researchers also include patient-partner teams into their research process for more ecologically valid outcomes. [ABSTRACT FROM AUTHOR]

Public health nurses (PHNs) face difficulties supporting vulnerable individuals and families. On‐the‐job training (OJT) is essential for improving nurses' competencies. However, PHN managers lack the knowledge to systematically implement OJT. The aim of this study was to develop a hypothetical model to systematically promote OJT for PHNs through case conferences (CC). Literature review, based on an integrative approach, has three stages: (1) theoretical framework development, (2) literature review, and (3) modeling. Literature review from five databases (MEDLINE, CINAHL, PsycInfo, Cochrane Central Register of Controlled Trials, Japan Medical Abstract Society) was conducted to identify the OJT process, its outcomes, and the conditions associated with OJT according to the theoretical framework. Based on 18 articles, this model progressed from "OJT process through CC," comprising the CC design, implementation, and evaluation to OJT produced "outcomes through CC." Outcomes included staff perception and behavior changes, improvements in client's condition, and staff turnover reductions. The OJT model involved "conditions for implementing CC as OJT" and "individual and organizational conditions." Future research should incorporate the social, political, and historical contexts of specific practice situations into the hypothetical model to help refine the model to be used in practice. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate racial/ethnic disparities in patient care experiences (PCEs) among prostate cancer (PCa) survivors. Methods: This retrospective study used 2007–2015 National Cancer Institute Surveillance, Epidemiology and End Results registry data linked to Consumer Assessment of Healthcare Providers and Systems surveys. First survey ≥ 6 months post-PCa diagnosis was analyzed. We performed multivariable linear regression, adjusting for demographic and clinical covariates, to evaluate the association of race/ethnicity (non-Hispanic Whites (NHWs), non-Hispanic Black (NHBs), Hispanic, non-Hispanic Asian (NHAs), and other races) with PCE composite measures: getting needed care, doctor communication, getting care quickly, getting needed prescription drugs (Rx), and customer service. Results: Among 7319 PCa survivors, compared to NHWs, Hispanics, NHBs and NHAs reported lower scores for getting care quickly (ß = −3.69; p = 0.002, ß = −2.44; p = 0.021, and ß = −6.44; p < 0.001, respectively); Hispanics scored worse on getting needed care (ß = −2.16; p = 0.042) and getting needed Rx (ß = −2.93; p = 0.009), and NHAs scored worse on customer service (ß = −7.60; p = 0.003), and getting needed Rx (ß = −3.08; p = 0.020). However, NHBs scored better than NHWs on doctor communication (ß = 1.95, p = 0.006). No statistically significant differences were found between other races and NHWs. Conclusions: Comparing to NHWs, Hispanics and NHAs reported worse experiences on several PCE composite measures, while NHBs reported worse scores on one but better scores on another PCE composite measure. Further research is needed to understand the reasons behind these disparities and their influence on healthcare utilization and health outcomes among PCa survivors. [ABSTRACT FROM AUTHOR]

Background Family conferences are pre-planned meetings between the treatment team, patient, family members and representatives of other involved disciplines on an agreed topic. There is no review of family conferences in family medicine. The aim of the scoping review is to compile the available recommendations on the use, implementation and documentation of family conferences in family medicine and other medical fields that can be transferred to the family practice setting. Methods Systematic literature search in the databases PubMed, Scopus, Google Scholar and Cochrane Library. Articles published in German or English up to 31.12.2021 were included. The fields of family therapy, paediatrics and neonatology were excluded. Results The search yielded 1,557 hits; after deducting duplicates and reviewing the abstracts, 108 hits were used for the full-text review. Of these, 53 hits were included in the review. Many recommendations on the use, preparation and implementation of family conferences can be transferred to the FM setting. For successful family conferences, a structured procedure is recommended, which includes good preparation of all participants, a multi-stage procedure during the family conference itself, as well as good documentation and follow- up of the agreements. The use of proven patient-centred communication models is recommended. Conclusions Although there are no validated concepts for the procedure of family conferences in the FM setting, practice recommendations can be derived that should be empirically tested in practice and in studies. [ABSTRACT FROM AUTHOR]

RNs lead care planning in long-term-care (LTC), yet there are knowledge gaps regarding their communication with residents and families about end-of-life (EOL) care preferences. A sample of 10 LTC RNs were virtually interviewed to describe their EOL care communication experience. Using an interpretative phenomenological framework, narrative analysis within an interpretive constructivism paradigm yielded four concepts—Being Together, Becoming Clear to Become Comfortable, Advocacy to Honor Residents, and Unique Impact on Nurses—which are all part of RNs' commitment to a continuous, dynamic EOL care communication process. Nurses commit to ongoing whole-person assessment and education, becoming proactive advocates for resident-centered, goal-concordant care. Their knowledge was experientially derived, as their nursing education did not adequately prepare them for EOL care communication or complex, multidimensional relationships with residents and families. Further research is needed to evaluate the nature and interaction and relative contribution of the components of EOL care communication in LTC. [Journal of Gerontological Nursing, 48(11), 29–36.] [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic made creative problem-solving, a skill that nurses have long possessed, more observable and valued. This article presents a new professional practice model for nursing innovation that facilitates practice improvements and leverages skills, strengths, and values that are integral to nursing. This model integrates the nursing process with Design Thinking and Theory U change management processes. A clinical case study illustrates the model's components in a pediatric oncology ambulatory center. Using this practice model, nurse leaders can leverage "design thinking like a nurse," to enhance innovation in health-care settings. [ABSTRACT FROM AUTHOR]

In the UK, children are entitled to have their views, wishes and feelings conveyed to a child protection conference in person or through professional representation. This paper presents findings from a qualitative study undertaken in a local authority in England which explored perspectives of attending a conference in person and investigated how children's views were represented when they were absent. Findings emerged through interviews with four children, focus groups conducted with four social workers and four conference Chairs, and case record analysis of reports submitted to and generated in child protection conferences for twenty-eight children. Three interrelating discourses of childism, participation and autonomous professional practice emerged within an overarching conceptualisation of power and generational ordering. The findings support contemporary understandings of the privileging of protection rights over participatory rights within child protection practices and add to the limited international evidence base concerning the extent to which young children can express their views, wishes and feelings. They also suggest a need to evaluate the impact of strengths-based practice frameworks, and approaches for assessment and recording practices that promote authentic participation for children across all age ranges. [ABSTRACT FROM AUTHOR]

Purpose: This study was to identify how a nursing management practicum was operated during the COVID-19 pandemic in Korea. Methods: This study surveyed instructors teaching the nursing management practicum with a questionnaire covering five domains and 42 items. The data were analyzed using descriptive statistics and content analysis. Results: The practicum was performed mainly by mixed methods (40.8% and 38.5%), in hospitals only (30.8% and 60.4%), online only (19.8% and 1.1%) in 2020 and 2021, respectively. The mixed methods were most frequently used for instructor teaching and conferences (43.9% and 58.3%). and the average teaching time per week was 9.40 and 8.69 hours per week, respectively. Taking charge in one to three core nursing skill items, 87.8% and 90.1% of the respondents each year performed face to face evaluation for the skills. Four to six out of 12 POs were covered by 58.2% and 54.9% of the participants, respectively, in 2020 and 2021. The greatest difficulty under the pandemic was securing students' hospital assignments. Conclusion: The nursing management practicum needs to adopt various digital technologies, and create new education models including hybrid ones combining both contact and untact methods to improve the educational effect for the post COVID-19 era. [ABSTRACT FROM AUTHOR]

Background: Communication challenges in the neonatal intensive care unit include fragmented communication, challenges managing expectations amidst uncertainty, and navigating complex medical information. Social workers are well suited to mitigate these challenges. Objective: In this study, we aimed to characterize the extent and nature of social worker participation in family conferences for critically ill infants. Design: We used a longitudinal observational mixed-methods design, enrolling infants with a neurological condition, their parent(s), and their clinicians. All audio-recorded conferences were transcribed and de-identified. Emergent themes and subthemes were identified using conventional content analysis. Results: We enrolled 40 infants and 61 parents. Sixty-eight conferences were held and audio recorded for 24 infants. Social workers were present for 51 of these conferences (n = 51/68, 75%) across 18 cases (n = 18/24, 75%). We identified four themes, conceptualized as distinct roles played by social workers in family conferences: (1) Translator: social workers served as a communicative bridge between parents and the medical team; (2) Coordinator: social workers simplified logistics and connected parents to community resources, including home health agencies and financial assistance; (3) Expectation manager: social workers provided anticipatory guidance and helped parents conceptualize the remainder of the hospital stay, discharge, and life at home; and (4) Advocate: social workers validated parental values and concerns and provided immediate emotional support. Conclusions: Social workers participated in three-quarters of family conferences for critically ill infants. When they participated, they facilitated communication, coordinated care, managed expectations, and advocated for families. These findings underscore the important, varied, and concurrent roles social workers play in the care of critically ill infants. Future communication and family support interventions should leverage these distinct roles. [ABSTRACT FROM AUTHOR]

Background: Palliative family conference (PFC) was included in the reimbursement of National Health Insurance to promote palliative care in Taiwan in 2012. Objectives: This study aimed to evaluate the impact of PFC on death in intensive care unit (ICU) and receiving cardiopulmonary resuscitation (CPR) within three days before death. Design: This is a cross-sectional study. Subjects: All patients who died in a public hospital and were admitted to ICU within 30 days before death, from 2013 to 2018, were included. Measurements: The medical records were analyzed to identify information on causes of death, receiving PFC, receiving palliative care consultation, death in ICU, and receiving CPR within three days before death. Multivariate logistic regression was used to assess the independent effects of receiving PFC on the risk of death in ICU and receiving CPR within three days before death. Results: For patients who died and those who did not die in ICU, the proportion of receiving PFC was 45.8% (1818/3973) and 55.0% (808/1468), respectively. For patients who received and those who did not receive CPR within three days before death, the proportion of receiving PFC was 23.9% (140/585) and 51.2% (2486/4856), respectively. PFC was associated with a reduced risk of death in ICU (adjusted odds ratio [AOR]: 0.842; 95% confidence interval [CI]: 0.717–0.988) and a reduced risk of receiving CPR within three days before death (AOR: 0.361; 95% CI: 0.286–0.456). Conclusion: PFC reduces the risk of receiving nonbeneficial aggressive intervention and may improve the quality of end-of-life care. [ABSTRACT FROM AUTHOR]

Group therapy is a ubiquitous treatment modality. And its recent recognition as an APA specialty reflects both its empirical bases of support as a clinical intervention, as well as the decades of work that have gone into establishing competency standards for its practice. The present study seeks to add to this literature by examining how one develops into a group therapist, and how to best train group therapists to meet competencies. Specifically, for those who have achieved "expertness" in the practice of group work, this grounded theory (GT) study explores both how have they done so and how such practitioners, in turn, train and evaluate effectiveness in their group therapy trainees. Through analysis of in-depth interviews with nine peer-nominated expert group therapists, essential components of their development included an emphasis on experiential training, personal therapy, didactic coursework, participating in professional conferences, and simply enjoying group work. The study also identifies common competencies that these experts look for to determine effectiveness among their trainees, as well as how these experts determine their own level of effectiveness (and how these processes differ). Finally, the study proposes an emergent theoretical model as to how one develops a professional identity as a group therapist. Study limitations and implications for practice, training, advocacy, and research are discussed. [ABSTRACT FROM AUTHOR]

Hospital Patient and Family Advisory Councils have been around for over 40 years. Yet, their adoption is waning with only slightly more than 50% of hospitals fielding Councils, which are composed of patient and family volunteers, who provide feedback to hospital staff. Demonstrating the value of Councils is critically important to their success and sustainability. Hospitals can ensure Council success by adopting these initiatives: (1) Highlight the importance of measuring program impacts to Council liaisons and members, (2) Educate members and staff about the three types of impacts defined by the Agency for Healthcare Research Quality, (3) Describe the steps to ensure that the value of the Council is well documented, and (4) Provide tools and training for the Council and staff to conduct robust measurements and analysis. When Councils measure their impact, their value to hospitals and leadership will increase. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and 'face-to-face' clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions. [ABSTRACT FROM AUTHOR]

Background: Physician Assistants (PAs) are increasingly likely to work in clinical areas where family conference skills are needed, but there is currently a lack of family conference education in PA program curricula. Objectives: To (1) describe a novel interprofessional education (IPE) event for PA students and chaplain residents; (2) examine whether participating in the IPE event is associated with improvements in attitudes and knowledge regarding interprofessional teams; and (3) describe participant perceptions about the event. Design: Two cohorts of PA students and chaplain residents completed a required interprofessional simulation activity involving a critically ill patient and a family conference. All participants completed pre- and postsimulation activity questionnaires. Bivariate tests were utilized to analyze the quantitative data. Setting/Subjects: Over two years, 171 PA students and 20 chaplain residents completed the activity at a school of medicine in the United States. Measurements: Pre- and postactivity measurements included role-specific questions plus overlapping sections regarding roles and responsibilities of the other discipline, comfort facilitating end-of-life discussions, and the value of IPE. Results: For PA students, there was a statistically significant increase for all questionnaire items. The largest effect size increases were in PA students' confidence in provider–patient communication at the end of life (Cohen's d > 1.1). Chaplain data demonstrated increases in knowledge of the PA role and likelihood of consulting with PAs in the future. Conclusion: This simulation event improved participant attitudes and knowledge relating to interprofessional interactions in the setting of an end-of-life family conference, and may contribute to more effective collaboration between PAs and chaplains in the clinical setting. [ABSTRACT FROM AUTHOR]

The article discusses the parallels between football strategies and healthcare management, emphasizing the importance of collaborative planning for optimal patient care. Topics include establishing care plans for complex patients through interdisciplinary team conferences, highlighting the significance of effective communication and coordination among healthcare providers.