Articles: interviews.
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Subacromial pain syndrome (SAPS), the most common cause of shoulder pain, can be treated through different treatments with similar effects. Therefore, in terms of deciding on the right treatment fit, patient preferences need to be understood. We aimed to identify treatment characteristics that delineate interventions (attributes) and corresponding sets of specific categorical range (attribute-levels) for SAPS. ⋯ This study identified attributes and attribute levels for the treatment of SAPS. There was a discrepancy in the frequency of the represented attributes between the literature and interviews. This study may improve the understanding of patient preferences for the treatment of SAPS and help individualize care. Our study informs a future discrete choice experiment and supports shared decision-making in clinical practice.
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Prior literature has demonstrated barriers to successful residency matching, including sex, medical school background, and international medical graduate status. Our aim is to characterize the recent trends in successfully-matched residents, with particular attention to geography and academic productivity. ⋯ Geographical factors, reported sex, and graduation status have influenced how resident candidates are perceived. Understanding these trends is vital for future resident matching. Addressing gender and educational diversity is essential to foster inclusivity and research-driven environments in neurosurgery residency programs.
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Review Meta Analysis
The Effect of Coaching Programs on Physical Activity and Pain in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Coaching programs are used to achieve continuity in physical activity and reduce pain severity in patients with rheumatoid arthritis. Our aim was to examine the effects of coaching programs on physical activity and pain in patients with rheumatoid arthritis through randomized controlled trials. ⋯ Face-to-face sessions and telephone interviews are recommended as part of a coaching program for the maintenance of physical activity and pain management in patients with rheumatoid arthritis. Coaching programs can improve patients' functional status. There is a need to determine effective strategies by increasing awareness of the coaching programs implemented by nurses.
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Review
Call to action: equity, diversity, and inclusion in emergency medicine resident physician selection.
This call to action seeks to improve emergency care in Canada for equity-deserving communities, enabled by equitable representation among emergency physicians nationally. Specifically, this work describes current resident selection processes and makes recommendations to enhance the equity, diversity, and inclusion (EDI) of resident physician selection in Canadian emergency medicine (EM) residency programs. ⋯ We call on Canadian EM training programs to implement these eight recommendations to strengthen EDI practices in EM resident physician selection and, in doing so, help to improve the care that patients from equity-deserving groups receive in Canada's emergency departments (EDs).
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Annals of family medicine · Apr 2022
ReviewPresence for racial justice: disrupting racism through physician-patient communication.
Context: Anti-Black racism is firmly rooted in US healthcare, but many clinicians do not have the tools and language to question their biases and address racism in clinical practice, eg biased communication practices such as "non-compliance" in medical documentation. Objective: Presence 5 for Racial Justice (P5RJ) leverages the Presence 5 patient-provider communication framework to identify anti-racism communication practices that support trusting relationships between physicians and Black patients and empower Black individuals in clinical care. Study design: For this multi-phased community-based participatory research (CBPR) overseen by an advisory board of clinicians and patients at four community clinics, we conducted a literature review, interviews with Black patients, clinician small-group discussions, and design thinking interviews with non-medical professionals. ⋯ Outcomes: Strategies on how providers, through communication and connection in the clinical visit, can navigate and address structural, institutional, and personally mediated forms of racism faced by Black patients. Results: P5RJ practices included: 1) Prepare with intention by reflecting on identity, bias, and power dynamics; and creating structures to address emergent bias and social determinants of health; 2) Listen intently and completely by using focused interpersonal listening without interruption and deep listening for racism impacts; give patients time and space to tell their story; 3) Agree on what matters most by having explicit conversations about patient goals, treatment comfort, consent, and referral planning; 4) Connect with the patient's story by acknowledging socio-political factors influencing patient health and focusing on positive efforts/events to encourage patient agency; 5) Explore emotional cues by noticing and naming patient emotions and considering how racial trauma might influence these emotions. Conclusion: P5RJ practices offer strategies to reflect on clinician biases, address racism and known gaps in care for Black patients and promote health equity in their clinical care.