Abstract:
OBJECTIVE:To direct attention to the concept of vulnerability, how it affects interactions in subtle ways and is difficult to detect in studies of clinical dialogues. METHODS:A reflection on three everyday examples of what seems like insignificant details in physician-patient interaction, enlightened by readings with an emphasis on unacknowledged shame, illness and social bonds, and the physician's role. RESULTS:Physicians are aware of patients' vulnerability as risk and susceptibility to harm under certain circumstances, but often miss the vulnerability related to perceived or anticipated loss of social bonds. The latter may elicit unacknowledged shame, which leads to subtle behavioral changes that are easy to overlook. Typical reactions are silence or lack of relevant response to questions. Physicians are rarely aware of their own vulnerability. Slight behavioral changes from a clinician may reduce or increase a patient's ability to partake actively in problem solving and decision-making. CONCLUSION:When physicians or patients are touching upon unacknowledged shame as part of being vulnerable, subtle changes in the interaction may hamper efficient communication. PRACTICE IMPLICATIONS:We need studies that add participants' unprompted and prompted reflections on encounter videos, with an emphasis on micro-events and their explanation and impact on the interaction.
journal_name
Patient Educ Counsjournal_title
Patient education and counselingauthors
Gulbrandsen Pdoi
10.1016/j.pec.2018.07.025subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1990-1994issue
11eissn
0738-3991issn
1873-5134pii
S0738-3991(18)30444-0journal_volume
101pub_type
杂志文章abstract:OBJECTIVE:to evaluate the impact of a communication skills course for nurses on how to handle difficult communication situations in their daily work. METHODS:a 7-h course was developed using a construct of "Awareness, Feelings, Listen, Solve" (AFLS). A pedagogy of experiential, learner-centered learning was adopted. T...
journal_title:Patient education and counseling
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.pec.2010.02.013
更新日期:2011-01-01 00:00:00
abstract::This paper provides an overview of prevalence, types, effects and treatment for affective disorders, with particular emphasis on educational and psychoeducational interventions. It reviews several models of psychoeducation including the approaches used in various programs at the Psychiatric hospital in which the autho...
journal_title:Patient education and counseling
pub_type: 杂志文章,评审
doi:10.1016/0738-3991(92)90195-o
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:In facilitating informed decision making about PSA screening, men are often asked to consider the potential consequences of the test, including a diagnosis of prostate cancer and how they would want to be treated. However, there is no empirical evidence thus far demonstrating that men are able to consider th...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2005.02.002
更新日期:2006-04-01 00:00:00
abstract::Seeking to end violence and distress in their relationship is the goal of women abused by intimate partners. The theoretical framework guiding development of the domestic violence survivor assessment (DVSA) was Landenburger's theory of entrapment and recovery. Social context and need to balance care for others and her...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/s0738-3991(01)00216-6
更新日期:2002-03-01 00:00:00
abstract::Knowledge of health care professionals' different understandings of diabetes care is important when preparing such professionals in patient education. For patients to manage illness effectively, the actions of health care professionals are crucial. Patients' understanding of their condition should be taken as the poin...
journal_title:Patient education and counseling
pub_type: 杂志文章,多中心研究
doi:10.1016/s0738-3991(02)00212-4
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:Shared decision making (SDM) is recommended when offering lung cancer screening (LCS)-which presents challenges with tobacco-related cancer survivors because they were excluded from clinical trials. Our objective was to characterize head and neck cancer (HNC) survivors' knowledge, attitudes, and beliefs towar...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2018.04.012
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To identify and describe the extent to which theory or theoretical frameworks informed the development and evaluation of decision support technologies (DSTs). METHODS:The analysis was based on the decision technologies used in studies included in the Cochrane systematic review of patient decision aids for pe...
journal_title:Patient education and counseling
pub_type: 杂志文章,评审
doi:10.1016/j.pec.2007.12.004
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:To evaluate how limited English proficiency affects treatment outcome in head and neck cancer (HNC) patients treated with curative intent radiation therapy (RT). METHODS:From 2004 to 2010, 131 patients with HNC underwent RT. Patient's self-reported primary language and race/ethnicity were obtained at hospita...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2014.07.031
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:Determine treatment adherence in patients with multiple chronic conditions (MCC). METHODS:A random patient sample ≥ 15 years, discharged from hospital with ≥1 chronic conditions (CC) was interviewed after 6-12 months. Analysis included variables in 5 dimensions (WHO): socio-demographics, disease, treatment, ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2009.12.012
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To test whether the coping in deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer. METHODS:We performed a systematic literature search to identify issues important t...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2014.07.004
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:To assess patients' preferences and trade-offs for mode of delivery in case of breech presentation at term. METHODS:Eighty women (40 with a foetus in breech presentation and 40 with a foetus in cephalic presentation) with a gestational age from 36 weeks onwards were offered scenarios of vaginal and caesarean...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2008.04.008
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:The role of the consultation in mediating improved clinical outcomes has been demonstrated in both conventional and complementary medicine but to date no depth study has explored how complementary medical consultations achieve such benefits. This study explored rheumatoid arthritis (RA) patients' perceptions ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2011.11.008
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To evaluate existing measures of health numeracy using item response theory (IRT). METHODS:A cross-sectional study was conducted. Participants completed assessments of health numeracy measures including the Lipkus expanded health numeracy scale (Lipkus), and the Medical Data Interpretation Test (MDIT). The L...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2009.03.035
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the impact that role-playing two pre/post standardized patient scenarios within a tobacco cessation training program had on pharmacists' counseling skills. Second, to analyze the validity of the observation coding tool used to evaluate pharmacist's role-play performance. METHODS:Pharmacists perf...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2010.12.010
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:The presentation of risks and benefits in clinical practice is common particularly in situations in which treatment recommendations involve trade-offs. The treatment of breast cancer risk with selective estrogen receptor modulators (SERMs) is such a decision. We investigated the influence of health care prov...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2017.06.033
更新日期:2017-12-01 00:00:00
abstract::We must humbly acknowledge that the healthcare system is less and less about empathy despite interacting with patients is a prerequisite for care: shared decision making is the cornerstone for compliance to treatment and therefore its -effectiveness. Empathy is not about tricks, it is about "client-centred therapy" a ...
journal_title:Patient education and counseling
pub_type: 评论,信件
doi:10.1016/j.pec.2020.03.024
更新日期:2020-09-01 00:00:00
abstract::Much research has explored the interaction between doctor and patient in the consultation and patient centredness has generally emerged as the preferred mode of consultation style. The present study aimed to examine and compare general practitioners' (GPs) and patients' beliefs about the importance of the different as...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/s0738-3991(01)00200-2
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:Surgeons and psychiatrists have been described as two contrary groups, the one healing by hands and the other by words. Empathy is needed in every physician-patient relationship. We tested whether (1) surgeons and psychiatrists show different levels of cognitive and emotional empathy; (2) measurements of cogn...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2014.01.013
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:Professional appearance is easily modifiable, and might alter the effects of a clinical encounter. We aimed to determine whether professional attire influences a patient's perception of treatment credibility. METHODS:We performed a single-blind randomized controlled study on 128 patients with acute non-speci...
journal_title:Patient education and counseling
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.pec.2016.08.009
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:A challenging but main task for clinicians is to identify patients' concerns related to their medical conditions. The study aim was to validate a new coding scheme for identifying patients' cues and concerns. METHODS:12 videotaped consultations between nurses and pain patients were coded according to the Ver...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2010.04.036
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Knowledge relevant to women's peri- and postmenopausal health decisions has been evolving rapidly. Web-based decision supports can be rapidly updated and have the potential to improve the quality of patients' decisions. We developed and tested a web-based decision support for peri- and postmenopausal health d...
journal_title:Patient education and counseling
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.pec.2006.12.004
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:The research findings reported here describe the importance and various functions of physician listening according to patients. METHODS:Fifty-eight patients of the McGill University Health Centre were interviewed using a qualitative, interpretive design approach. RESULTS:Patients explained why listening was...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2011.01.028
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:Patient-provider communication is critical in primary care. Canada's unique health system, population distribution, and cultural context suggest there is value in addressing the topic in the Canadian context. We conducted a scoping review to synthesize recent Canadian literature to inform practice in primary ...
journal_title:Patient education and counseling
pub_type: 杂志文章,评审
doi:10.1016/j.pec.2017.11.008
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:Next generation sequencing (NGS) may aid in tumor classification and treatment. Barriers to shared decision-making may influence use of NGS. We examined, from oncologists' perspectives, whether barriers to involving patients/families in decision-making were associated with NGS use. METHODS:Using data from th...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2020.03.001
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:Results of third year medical students' attitudes and stress levels towards the acquisition of communication skills before and after a Communication and Clinical Skills Course (CCSC) at the Faculty of Medicine of the University of Porto (FMUP), Portugal, are presented. METHODS:115 students attending third-ye...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2011.07.005
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To determine the literacy skill sets of patients in the context of graphical interpretation of interactive dashboards. METHODS:We assessed literacy characteristics of prostate cancer patients and assessed comprehension of quality of life dashboards. Health literacy, numeracy and graph literacy were assessed ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2015.09.009
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:Investigate the effects of disease management program (DMP) implementation on physical activity, smoking, and physical quality of life among chronically ill patients. METHODS:This study used a mixed-methods approach involving qualitative (35 interviews with project managers) and quantitative (survey of patie...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2013.12.017
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To validate a hypothesized model exploring the influencing pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycosylated hemoglobin (HbA1c) levels in patients with type 2 diabetes (T2DM). METHODS:Overall, 295 patients with T2DM were recruited from five endocrine...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2015.08.021
更新日期:2016-02-01 00:00:00
abstract::Determinants of compliance with a 6-month diet and exercise program were studied among 118 healthy middle-aged men with risk factors for coronary heart disease (CHD). Data were gathered via medical examinations, interviews and questionnaires. Smoking, high levels of hostility, perception of barriers to diet change and...
journal_title:Patient education and counseling
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0738-3991(96)00917-2
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:Primary care providers (PCPs) are encouraged to counsel their obese patients about weight loss. We used focus groups to explore how PCPs communicate with patients about weight management. METHODS:During the summer of 2010, we conducted five focus groups of community-based PCPs who had patients enrolled in a ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2012.06.033
更新日期:2012-10-01 00:00:00