Abstract：
:Moral distress is the experience of cognitive-emotional dissonance that arises when one feels compelled to act contrary to one's moral requirements. Moral distress is common, but under-recognized in medical education and training, and this relative inattention may undermine educators' efforts to promote empathy, ethical practice, and professionalism. Moral distress should be recognized as a feature of the clinical landscape, and addressed in conjunction with the related concerns of negative role modeling and the goals and efficacy of medical ethics curricula.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Berger JTdoi
10.1007/s11606-013-2665-0subject
Has Abstractpub_date
2014-02-01 00:00:00pages
395-8issue
2eissn
0884-8734issn
1525-1497journal_volume
29pub_type
杂志文章,评审abstract：PURPOSE:Recent reports have emphasized the importance of delivery systems in improving health care quality. However, few prior studies have assessed differences in primary care quality between physician groups that differ in size and organizational configuration. We examined whether larger physician group size and affi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0234-0
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:To address concerns that the Hospital Readmissions Reduction Program (HRRP) unfairly penalized safety net hospitals treating patients with high social and functional risks, Medicare recently modified HRRP to compare hospitals with similar proportions of high-risk, dual-eligible patients ("peer group hospital...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06222-1
更新日期：2020-12-01 00:00:00
abstract：PURPOSE:To compare the effects of three methods of values clarification (VCM): balance sheet; rating and ranking; and a discrete choice experiment (DCE) on decision-making about colorectal cancer (CRC) screening among adults in the US and Australia. METHODS:Using online panels managed by a survey research organization...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-013-2701-0
更新日期：2014-03-01 00:00:00
abstract：BACKGROUND:The Medicare Accountable Care Organization (ACO) programs encourage integration of providers into large groups and reward provider groups for improving quality, but not explicitly for reducing health care disparities. Larger group size and better overall quality may or may not be associated with smaller disp...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-014-2900-3
更新日期：2014-09-01 00:00:00
abstract：:To evaluate the performance of serum iron studies as a diagnostic test for iron-deficiency anemia in a county hospital, the authors identified retrospectively all general medicine patients who had had bone-marrow aspirates for the work-up of non-macrocytic anemias from 1978 through 1983. Re-reading a sample of aspirat...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02596144
更新日期：1987-05-01 00:00:00
abstract：BACKGROUND:Length of stay at US acute care hospitals has been steadily decreasing since 1960, and there is ongoing concern that increasing financial pressures on hospitals with high proportions of Medicaid patients may be causing unduly short lengths of stay. OBJECTIVE:To study temporal trends in hospital utilization ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1370-5
更新日期：2010-09-01 00:00:00
abstract：:We conducted a telephone survey of patients in a university-based medical practice to determine if there was a difference across payer class in patients' willingness to have supervised housestaff physicians function as their primary care providers. Overall, commercial managed care patients were more likely to object t...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1998.00100.x
更新日期：1998-05-01 00:00:00
abstract：BACKGROUND:Studies on forgoing treatment often ignore treatments that are continued until death. OBJECTIVE:To investigate how often specific treatments are withdrawn or withheld before death and to describe the associated patient, physician, and care characteristics. DESIGN:National mortality follow-back study in Swi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05344-5
更新日期：2020-01-01 00:00:00
abstract：OBJECTIVE:To characterize the patterns of health-related messages in consumer advertising from U.S. magazines. DESIGN:Observational survey of advertisements occupying a third of a page or more from the January 1994 issues of the 11 most popular consumer magazines. MEASUREMENTS AND MAIN RESULTS:Health messages were pr...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02602397
更新日期：1995-09-01 00:00:00
abstract：BACKGROUND:The three-item Brief Health Literacy Screen (BHLS) has been validated in research settings, but not in routine practice, administered by clinical personnel. OBJECTIVE:As part of the Health Literacy Screening (HEALS) study, we evaluated psychometric properties of the BHLS to validate its administration by cl...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-013-2568-0
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:Many have called for ambulatory training redesign in internal medicine (IM) residencies to increase primary care career outcomes. Many believe dysfunctional, clinic environments are a key barrier to meaningful ambulatory education, but little is actually known about the educational milieu of continuity clini...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1437-3
更新日期：2011-01-01 00:00:00
abstract：:Implementation science is focused on developing and evaluating methods to reduce gaps between research and practice. As healthcare organizations become increasingly accountable for equity, quality, and value, attention has been directed to identifying specific implementation strategies that can accelerate the adoption...
journal_title：Journal of general internal medicine
pub_type： 社论
doi：10.1007/s11606-020-06169-3
更新日期：2020-09-11 00:00:00
abstract：:Elderly veterans who visit our Veterans Affairs (VA) Medical Center primary care clinic often mention they are enrolled in HMOs. Approximately 20% of patients hospitalized at our facility report health insurance coverage. Of 1,000 hospitalizations during a 6-month period in which veterans reported insurance coverage, ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1997.012004247.x
更新日期：1997-04-01 00:00:00
abstract：BACKGROUND:Leaders play a crucial role in implementing and sustaining changes in clinical practice, yet there is limited evidence on the strategies to engage them in team problem solving and communication. OBJECTIVE:Examine the impact of an intervention focused on facilitating leadership during daily huddles on optimi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06487-6
更新日期：2021-01-26 00:00:00
abstract：BACKGROUND:The Department of Veterans Affairs (VA) mandates disclosure of large-scale adverse events to patients, even if risk of harm is not clearly present. Concerns about past disclosures warranted further examination of the impact of this policy. OBJECTIVE:Through a collaborative partnership between VA leaders, po...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-014-3034-3
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:Many primary care physicians (PCPs) are ill-equipped to provide screening and counseling for inherited breast cancer. OBJECTIVE:To evaluate the outcomes of an interactive web-based genetics curriculum versus text curriculum for primary care physicians. DESIGN:Randomized two-group design. PARTICIPANTS:121 ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-014-3113-5
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Sudden death is a public health problem with major impact on society. Coronary artery disease (CAD) is believed to underlie 60-80% of these deaths. While deaths from CAD have decreased in the recent decades, sudden death rates remain unacceptably high. OBJECTIVE:We aimed to assess the prevalence of CAD and ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05486-6
更新日期：2020-02-01 00:00:00
abstract：BACKGROUND:Decisions to limit use of life-sustaining treatment occur frequently during hospitalizations, and portable medical orders (also known as Portable Orders for Life-Sustaining Treatment (POLST)) can ensure that patient preferences regarding resuscitation are followed after discharge. OBJECTIVE:To determine the...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05698-1
更新日期：2020-07-01 00:00:00
abstract：BACKGROUND:Maintenance of certification examination performance is associated with quality of care. We aimed to examine relationships between electronic medical knowledge resource use, practice characteristics and examination scores among physicians recertifying in internal medicine. METHODS:We conducted a cross-secti...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-012-2017-5
更新日期：2012-08-01 00:00:00
abstract：:Errors in telephone communication can result in outcomes ranging from inconvenience and anxiety to serious compromises in patient safety. Although 25% of interactions between physicians and patients take place on the telephone, little has been written about telephone communication and medical mishaps. Similarly, train...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2005.0199.x
更新日期：2005-10-01 00:00:00
abstract：OBJECTIVE:To develop a patient-based classification system to describe the clinical content of ambulatory medicine practices. DESIGN:A system of 100 diagnosis clusters was developed based on retrospective review of computerized problem lists of patients from a university practice, and then applied to the problem lists...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599394
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVE:To lay the groundwork for a better understanding of patient views on medical confidentiality. DESIGN:Studies were found by searching medline, bioethicsline, and selected bibliographies. Articles concerning physician perspectives or implications of legal and administrative regulations were excluded. Only peer...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1046/j.1525-1497.2003.20823.x
更新日期：2003-08-01 00:00:00
abstract：:The authors conducted an observational study of attending rounds to determine the current status of this form of clinical teaching in a university-based internal medicine department. Using two forms of measurement, questionnaires and timed observations, we found that 63% of attending physician time was spent in the co...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599208
更新日期：1992-11-01 00:00:00
abstract：:Starfield and colleagues have suggested four overarching attributes of good primary care: "first-contact access for each need; long-term person- (not disease) focused care; comprehensive care for most health needs; and coordinated care when it must be sought elsewhere." As this series on reinventing primary care highl...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-016-3945-2
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:Although hip fractures in older adults are associated with a high degree of mortality and disability, the use of advance care planning (ACP) in this population is unknown. OBJECTIVE:To determine the prevalence of ACP and need for surrogate decision-making prior to death in older adults with hip fracture and...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05644-1
更新日期：2020-07-01 00:00:00
abstract：OBJECTIVE:To measure and compare patient satisfaction with care in resident and attending physician internal medicine ambulatory care clinics. DESIGN:A cross-sectional survey using a questionnaire derived from the Visit-Specific Satisfaction Questionnaire (VSQ) and Patient Satisfaction Index (PSI) distributed from Mar...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2001.91005.x
更新日期：2001-11-01 00:00:00
abstract：BACKGROUND:Many academic hospitals have implemented overnight hospitalists to supervise house staff and improve outcomes, but few studies have described the impact of this role. OBJECTIVE:To investigate the effect of an overnight academic hospitalist program on patient-level outcomes. Secondary objectives were to desc...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-015-3389-0
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:It is unclear how lack of health insurance or otherwise being underinsured contributes to observed racial disparities in health outcomes related to cardiovascular disease. OBJECTIVE:To determine the relative risk of death associated with insurance and race after hospital admission for an acute cardiovascula...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-012-2147-9
更新日期：2012-10-01 00:00:00
abstract：BACKGROUND:Medicare has selected 10 hospital-acquired conditions for which it will not reimburse hospitals unless the condition was documented as "present on admission." This "no pay for errors" rule may have a profound effect on the clinical practice of physicians. OBJECTIVE:To determine how physicians might change t...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-010-1395-9
更新日期：2010-10-01 00:00:00
abstract：:The management of patients who have HIV disease, particularly those in early, asymptomatic disease stages, has recently improved. Clinical trials with zidovudine have demonstrated efficacy and greatly reduced toxicity when the drug is used for asymptomatic HIV-infected persons who have fewer than 500 CD4+ cells/mm3. A...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/BF02599251
更新日期：1991-01-01 00:00:00
