Journal of general internal medicine
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Multicenter Study
Empathy and life support decisions in intensive care units.
Although experts advocate that physicians should express empathy to support family members faced with difficult end-of-life decisions for incapacitated patients, it is unknown whether and how this occurs in practice. ⋯ Physicians vary considerably in the extent to which they express empathy to surrogates during deliberations about life support, with no empathic statements in one-third of conferences. There is an association between more empathic statements and higher family satisfaction with communication.
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Randomized Controlled Trial Multicenter Study
Does outpatient telephone coaching add to hospital quality improvement following hospitalization for acute coronary syndrome?
Telephone counseling in chronic disease self-management is increasing, but has not been tested in studies that control for quality of medical care. ⋯ Telephone coaching post-hospitalization for ACS was modestly effective in accomplishing short-term, but not long-term life-style behavior change. Previous positive results shown in primary care did not transfer to free-standing telephone counseling as an adjunct to care following hospitalization.
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Multicenter Study
Literacy, social stigma, and HIV medication adherence.
Prior studies have linked limited literacy to poorer HIV medication adherence, although the precise causal pathways of this relationship have only been initially investigated. ⋯ While low literacy was a significant risk factor for improper adherence to HIV medication regimens in our study, perceived social stigma mediated this relationship. Low literacy HIV intervention strategies may also need to incorporate more comprehensive psychosocial approaches to overcome stigma barriers.
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Multicenter Study
Quality of care for decompensated heart failure: comparable performance between academic hospitalists and non-hospitalists.
Hospitalists improve efficiency, but little information exists regarding whether they impact quality of care. ⋯ Academic hospitalists and non-hospitalists provide similar quality of care for heart failure patients, although hospitalists are paying more attention to longitudinal care. Future efforts to improve quality of care in decompensated heart failure may require attention towards system-level factors.