Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

ABSTRACT
PURPOSE Dementia case management (CM) in primary care is a complex intervention
aimed at identifying the various needs of patients with dementia and
their caregivers, as well as the organization and coordination of care. A key element
of CM is the collaboration of family physicians with case managers. We
conducted a systematic mixed-studies review to identify the needs of the patientcaregiver
dyad and the effects of CM.
METHODS We searched MEDLINE, PsycINFO, and EMBASE up to October 2014,
regardless of the study design. Our main outcomes were needs of patients and
their caregivers and the effects of CM on these needs. We used narrative syntheses
to develop a taxonomy of needs and to describe the effects of CM on those
needs. We used meta-analysis to calculate the prevalence of needs and the standardized
mean differences to evaluate the effects of CM on the needs identified.
RESULTS Fifty-four studies were included. We identified needs of the patientcaregiver
dyad and needs of the patient and caregiver individually. CM
addressed the majority of the identified needs. Still, some very common needs
(eg, early diagnosis) are overlooked while other needs (eg, education on the disease)
are well addressed. Fully establishing the value of CM is difficult given the
small number of studies of CM in primary care.
CONCLUSIONS There is good evidence that case managers, in collaboration with
family physicians, have a pivotal role in addressing the needs of the patientcaregiver
dyad.
Ann Fam Med 2016;14:166-177. doi: 10.1370/afm.1898.

Should family physicians be empathetic? YES

When we answer the question “Should family physicians be empathetic?” in the affirmative, we are saying yes to empathy as it is defined by Hojat et al,¹ who state that the concept of empathy must be limited to its cognitive and behavioural dimensions. They define it as “a cognitive attribute that involves the ability to understand the patient’s inner experiences and perspective and a capability to communicate this understanding.”

Contextualizing SEGUE: Evaluating Residents’ Communication Skills Within the Framework of a Structured Medical Interview

Abstract

Background

The SEGUE (Set the stage, Elicit information, Give information, Understand the patient's perspective, and End the encounter) Framework is a checklist-style rating scale to facilitate the teaching and assessment of communication skills in medical learners. It has been used for over 15 years, and it is recommended in the Accreditation Council for Graduate Medical Education toolbox of assessment methods for resident training. When it was developed, its ability to provide objective scoring was a substantial improvement over global ratings.

Methods

In this article we describe the strengths and weaknesses of the SEGUE Framework. We highlight one residency program's experience with using the SEGUE Framework to evaluate residents' communication skills. Specifically, we cite previous studies and describe our own analysis of resident interviewing performance that demonstrates how the SEGUE Framework did not distinguish between different levels of interviewing skill level in our sample.

Results

Two case examples illustrate how the SEGUE Framework is not an ideal instrument to measure either the quality or the process of medical interviews.

Conclusion

Therefore, we propose a new method of contextualized assessment that builds on the SEGUE Framework. Our system evaluates discrete interviewing behaviors within the context of an ambulatory medical interview. We describe our interview structure, as well as a new instrument (the Wy-Mii, pronounced “why me”), to assess both communication and interpersonal skills. We expect that our new method of contextualized assessment will better differentiate between beginning and advanced levels of medical interviewing skills for residents.

Perceptions of gender-based discrimination during surgical training and practice

ABSTRACT

Background: Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women’s perceptions of gender-based discrimination in the surgical training and working environment.

Methods: Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons.

Results: We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men.

Conclusions: The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons.

Empathize me, Doctor- Έλα στη θέση μου, Γιατρέ

“Empathize me, Doctor!” is an experiential training program aiming at improving empathic understanding in healthcare providers. Its duration is 60 hours distributed in three 20-hour workshops. It is not about learning a technique but it is mostly about being introduced in a whole new way of being.


Empathize me, Doctor!” is based in the principles of Person- Centered Approach (PCA), founded by Carl Rogers (1902- 1987), one of the most influential psychotherapists of his century. Empathy is cornerstone in the terms of PCA and does not constitute a technique but a way of acting, being, behaving.
The training program contains theory, personal growth and skills development. Presentations, encounter groups, role- plays, study groups, experiential exercises through art and play are only some of the “tools” used to teach healthcare professionals, how to be empathic.

empathize me doctor

Yes to one thing… no to the others.

Wellcome Library, London

One of the perennial problems that faces doctors who are in direct contact with patients is time management.  It is the one resource we all have to allocate, and with the multitude of different roles we all have to play – parent / sibling / doctor / teacher / friend / spouse / club captain / society president / charity trustee / or anything else for that matter – it can be difficult.

Brain Basics

National Institute of Mental Health (USA)
Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, and ongoing research that helps us better understand and treat disorders.

Brain Basics will introduce you to some of this science, such as:

• How the brain develops
• How genes and the environment affect the brain
• The basic structure of the brain
• How different parts of the brain communicate and work with each other
• How changes in the brain can lead to mental disorders, such as depression.

Κάντε ‘κλίκ’ στην εικόνα για να συνδεθείτε στο “Brain basics”

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