(Press-News.org) HANOVER, NH – Providing patient-centered care consistently in clinical practice requires practitioners who are able to recognize that different clinical situations require different approaches and are skilled enough to adapt.
Across the range of health-care problems, patient-centered care has been found to be associated with improved patient outcomes, including improved self-management, patient satisfaction, and medication adherence, and some studies have found evidence for improved clinical outcomes. Data from surveys and research indicate that clinicians often do not take patients' perspectives into account during the decision-making process. This is because clinicians are often challenged by the diversity of situations that arise.
Dr. Glyn Elwyn of the Dartmouth Center for Health Care Delivery Science is the principal investigator of a study in the current issue of Annals of Family Medicine. Elwyn said that practitioners could use or integrate two methods: shared decision making and motivational interviewing when discussing options for treatment with patients.
When patients face tough treatment decisions, shared decision making alone is appropriate. And where clinicians perceive a need to change behavior to improved health outcomes, motivational interviewing can be used. Many clinical consultations may require elements of both approaches.
"Clearly, different situations require different communication approaches," Elwyn said. "Each situation has different psychosocial, cultural and medical implications."
Shared decision making is a method where clinicians and patients make decisions together using the best available evidence. Patients are encouraged to consider available screening, treatment or management options and the likely benefits and harms of each. It is used to support patients in making health care decisions where there is more than one reasonable option.
Motivational interviewing is most often applied in situations that usually require some degree of behavioral change about which a patient feels ambivalent, such as lifestyle choices or adherence to medications. Originally developed for dealing with drug and alcohol addiction, the scope has widened to include how best to motivate behavior change across many domains.
Motivational interviewing recognizes that making behavioral change is difficult and that telling or persuading people to change will often meet with resistance. Clinicians should explore and resolve ambivalence and by doing so elicit and encourage a patient's own motives to change.
For motivational interviewing there is evidence for efficacy in treating addictions and mixed evidence in improving health outcomes of patients with diabetes, asthma, high blood pressure and heart disease.
The researchers acknowledge the challenge of implementing shared decision making and motivational interviewing into routine practice. "We believe, however, that we will see little progress in patient-centered care unless these approaches are valued as core elements of good practice; they should be taught, assessed and integrated into daily practice, then appropriately measured and rewarded."
INFORMATION:
To view the abstract in the Annals of Family Medicine, please go to http://annfammed.org/content/12/3/270.abstract.
Achieving patient-centered care across the spectrum
2014-05-13
ELSE PRESS RELEASES FROM THIS DATE:
Obsessive-compulsive disorder questionnaire may give clues to other mental health problems
2014-05-13
A shortened version of a questionnaire used by psychologists to assess risk factors for obsessive-compulsive disorder also may help determine the risk of depression and anxiety, according to a Baylor University study.
The revision may be a good fit for assessing the risk of mental health issues stemming from certain beliefs — such as seeing threats as greater than they are and feeling that things are not right unless they are perfect. Such dysfunctional beliefs are central to obsessive-compulsive disorder (OCD), said researcher Thomas Fergus, Ph.D., assistant professor ...
Women's empowerment and Olympic success
2014-05-13
ALLENDALE, Mich. — New research shows that nations with greater women's empowerment win more medals and send more athletes to the Summer Olympics. The effect of women's empowerment held for both men and women, although it was stronger for female athletes, according to a study by Grand Valley State University researchers. The findings were published in April 2014 in the Journal of Sports Economics.
The research, led by Aaron Lowen, associate professor of economics at Grand Valley State, provides evidence for the popular but previously untested hypothesis that women's empowerment ...
Fossil palm beetles 'hind-cast' 50-million-year-old winters
2014-05-13
Fifty-million-year-old fossil beetles that fed only on palm seeds are giving Simon Fraser University biologists Bruce Archibald and Rolf Mathewes new information about ancient climates.
According to their research, published online this week in The Proceedings of the National Academy of Sciences, these fossil beetles indicate that during a period of global warming in the geological past, there were mild, frost-free winters extended even in the uplands of ancient western North America.
Working with co-authors Geoffrey Morse of the University of San Diego, California, ...
Letting it go: Take responsibility, make amends and forgive yourself
2014-05-13
Forgiving ourselves for hurting another is easier if we first make amends — thus giving our inner selves a "moral OK," according to Baylor University psychology researchers.
The research, published in The Journal of Positive Psychology, is significant because previous studies show that the inability to self-forgive can be a factor in depression, anxiety and a weakened immune system, researchers said.
"One of the barriers people face in forgiving themselves appears to be that people feel morally obligated to hang on to those feelings. They feel they deserve to feel bad. ...
UT Dallas team creates flexible electronics that change shape inside body
2014-05-13
Researchers from The University of Texas at Dallas and the University of Tokyo have created electronic devices that become soft when implanted inside the body and can deploy to grip 3-D objects, such as large tissues, nerves and blood vessels.
These biologically adaptive, flexible transistors might one day help doctors learn more about what is happening inside the body, and stimulate the body for treatments.
The research, available online and in an upcoming print issue of Advanced Materials, is one of the first demonstrations of transistors that can change shape and ...
Radiation from early universe found key to answer major questions in physics
2014-05-13
Astrophysicists at UC San Diego have measured the minute gravitational distortions in polarized radiation from the early universe and discovered that these ancient microwaves can provide an important cosmological test of Einstein's theory of general relativity. These measurements have the potential to narrow down the estimates for the mass of ghostly subatomic particles known as neutrinos.
The radiation could even provide physicists with clues to another outstanding problem about our universe: how the invisible "dark matter" and "dark energy," which has been undetectable ...
Smart drugs pose special risks to the developing brain of young people
2014-05-13
Over a million American students misuse prescription drugs or take illegal stimulants to increase their attention span, memory, and capacity to stay awake. Such "smart drugs" become more and more popular due to peer pressure, stricter academic requirements, and the tight job market. But young people who misuse them risk long-term impairments to brain function, warn Kimberly Urban at the University of Delaware and Wen-Jun Gao at Drexel University College of Medicine, USA, in a NIH-funded review published in the open-access journal Frontiers in Systems Neuroscience.
The ...
The physics of ocean undertow
2014-05-13
WASHINGTON D.C. May 13, 2014 -- People standing on a beach often feel the water tugging the sand away from under their feet. This is the undertow, the current that pulls water back into the ocean after a wave breaks on the beach.
Large storms produce strong undertows that can strip beaches of sand. By predicting how undertows interact with shorelines, researchers can build sand dunes and engineer other soft solutions to create more robust and sustainable beaches.
"Formulation of the Undertow Using Linear Wave Theory," a new paper in the journal Physics of Fluids, clears ...
MEMS nanoinjector for genetic modification of cells
2014-05-13
WASHINGTON D.C. May 13, 2014 -- The ability to transfer a gene or DNA sequence from one animal into the genome of another plays a critical role in a wide range of medical research—including cancer, Alzheimer's disease, and diabetes.
But the traditional method of transferring genetic material into a new cell, called "microinjection," has a serious downside. It involves using a small glass pipette to pump a solution containing DNA into the nucleus of an egg cell, but the extra fluid can cause the cell to swell and destroy it—resulting in a 25 to 40 percent cell death rate.
Now, ...
Why athletes are more likely to need pacemakers in old age
2014-05-13
A new study by The University of Manchester has shed light on why athletes are more likely to have abnormal heart rhythms.
Elderly athletes with a lifelong history of training and competing in endurance events like marathons, triathlons and iron man challenges can have heart rhythm disturbances, known as arrhythmias.
The Manchester research in rodents, funded by the British Heart Foundation, shows molecular changes in the heart's pacemaker occur in response to exercise training.
The finding, reported in Nature Communications, overturns the commonly held belief that ...