The Permanente journal最新文献

{"title":"A Qualitative Study on the Impact and Feasibility of a Simulation-Based Program for Shared Decision-Making in Non-Small Cell Lung Cancer Care.","authors":"Hasna Hakim, Catherine C Alexander, Elaine Rudell, Michele Ingram, Tarjani Agrawal, Patty Peterson, Marianne Davies, Kerin Adelson, Brant J Oliver","doi":"10.7812/TPP/23.152","DOIUrl":"10.7812/TPP/23.152","url":null,"abstract":"<p><strong>Background: </strong>In the pursuit of improved clinical outcomes and patient experience in health care, shared decision-making (SDM) stands as a pivotal concept garnering increasing attention, but SDM utilization varies widely, often leading to confusion regarding team members' roles. This study explores knowledge, skills, and attitudes of oncology clinicians engaged in a pioneering educational initiative at a comprehensive cancer care center, aimed at enhancing frontline SDM capabilities.</p><p><strong>Methods: </strong>Utilizing a prospective cohort qualitative approach, the team conducted interviews with 6 clinicians in a multidisciplinary oncology program who were engaged in an SDM continuing education program. In the program, participants were immersed in experiential learning activities including standardized didactic sessions and simulation-based SDM case role-play activities.</p><p><strong>Results: </strong>Thematic analysis of interview data revealed 5 major categories: 1) perceptions of SDM; 2) training; 3) patient-centered care; 4) challenges and constraints; and 5) leadership buy-in. Participants perceived benefits, including adopting a better approach to integrate SDM into their practice, heightened engagement, emphasizing team collaboration, and embracing a patient-centric care model.</p><p><strong>Conclusions: </strong>This study underscores the transformative impact of education and training on enhancing SDM capabilities among oncology clinicians and is not intended for generalizability. By promoting a basic understanding and application of SDM principles, practicing clinicians can be better empowered to improve health care outcomes and experience. Our findings contribute to the broader endeavor of embedding practical SDM principles within clinical practice, thereby fostering a more patient-centered and effective health care environment.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":"28 3","pages":"212-222"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Acute Pericarditis With Cardiac Tamponade Secondary to Pacer Lead Perforation 8 Years After Placement.","authors":"Georgette Nader, Kevin Watat, Enhua Wang, Akhil Sharma, Mhd Hussam Al Jandali","doi":"10.7812/TPP/24.044","DOIUrl":"10.7812/TPP/24.044","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"185-189"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case of Bullous Pemphigoid Masquerading as Adult-Onset Atopic Dermatitis.","authors":"Mai Nojima, Iesha L Ticknor, Payam Sazegar","doi":"10.7812/TPP/24.043","DOIUrl":"10.7812/TPP/24.043","url":null,"abstract":"<p><p>The majority of dermatitis cases in adults result from chronic or relapsing atopic dermatitis in childhood. Adult-onset atopic dermatitis, also known as idiopathic chronic eczematous eruption of aging (CEEA), is a phenomenon seen in adults 50 years and older with no prior history of atopic dermatitis. CEEA is often a diagnosis of exclusion after ruling out more serious causes of dermatitis including bullous pemphigoid (BP), allergic conditions, and hematologic malignancies. This report details the case of a 67-year-old woman with no history of atopy who presented with a persistent, eczematous dermatitis not responsive to traditional therapy, consistent with CEEA, but was later identified as BP.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"177-179"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to A Rare Case of Acute Pericarditis With Cardiac Tamponade Secondary to Pacer Lead Perforation 8 Years After Placement.","authors":"","doi":"10.7812/TPP/24.115","DOIUrl":"10.7812/TPP/24.115","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"194"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Value for Patients With Total Joint Replacement: A Model for Hospital-Based Same-Day Discharge in an Integrated Care Setting.","authors":"Adrian D Hinman, Heather A Prentice, Elizabeth W Paxton, Ronald A Navarro, Nithin C Reddy","doi":"10.7812/TPP/23.150","DOIUrl":"10.7812/TPP/23.150","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"163-167"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Specific Video Training for Primary Care Settings: Increasing Capacity and Motivation to Address Food Insecurity.","authors":"Andrea Nederveld, Kathryn Jantz, Margery Brennan, Macharnie Skalecki, Elena Broaddus-Shea","doi":"10.7812/TPP/24.062","DOIUrl":"10.7812/TPP/24.062","url":null,"abstract":"<p><strong>Background: </strong>Food insecurity (FI) is the most common health-related social need (HRSN) and is frequently identified in primary care through screening and referral. However, health care workers often do not have the knowledge, motivation, capability, or opportunity necessary to discuss FI with patients in patient-centered ways.</p><p><strong>Methods: </strong>An educational module for health care workers on FI was created using user-centered design and tested with health care workers, using the COM-B model as an evaluation framework.</p><p><strong>Results: </strong>Watching the module's video increased participant knowledge, capability, and motivation to address FI with patients.</p><p><strong>Discussion: </strong>This preliminary pilot study suggests that simple training modules could help with the effectiveness of efforts to address HRSNs, such as FI, by increasing health care workers' capacity to discuss, screen, and refer patients. Findings warrant expanded studies to assess the effectiveness of such modules on patient-level outcomes.</p><p><strong>Conclusion: </strong>This type of educational module on FI or other HRSNs holds promise as a time- and cost-efficient strategy for improving screening and referral processes, ultimately alleviating FI for more patients and improving health outcomes.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"152-156"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Shared Decision-Making: Integrating Coproduction, Learning Health Systems, Artificial Intelligence, and Workforce Development for Patient-Centered Care.","authors":"Kolu S Baysah Clark, Elaine Rudell, David Setiadi, Tarjani Agrawal, Brant J Oliver","doi":"10.7812/TPP/23.157","DOIUrl":"10.7812/TPP/23.157","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"284-288"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of Artificial Intelligence in Medicine: An Expert Panel Discussion.","authors":"John D Halamka, Susan R Kirsh, Vincent X Liu, Lynn Simon","doi":"10.7812/TPP/24.068","DOIUrl":"10.7812/TPP/24.068","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"3-12"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an Embedded Health Psychologist Intervention for Obstetric Patients With Adverse Childhood Experiences.","authors":"Carey R Watson, Julia Wei, Normelena Rios, Mary Staunton, Anna Koper, Jacqueline Shiels, Nina Lee, Kelly C Young-Wolff","doi":"10.7812/TPP/23.146","DOIUrl":"10.7812/TPP/23.146","url":null,"abstract":"<p><strong>Background: </strong>Screening for adverse childhood experiences (ACEs) and resilience in pregnancy is a promising practice for mitigating ACEs-related health complications. Yet, the best follow-up for pregnant patients with high ACEs and/or low resilience has not been established.</p><p><strong>Objective: </strong>This study evaluates referrals to and participation in an embedded health psychologist (EHP) intervention for pregnant patients with ACEs and/or low resilience.</p><p><strong>Materials and methods: </strong>Patients in 3 Kaiser Permanente Northern California medical centers with ACEs who had also received resilience screening during standard prenatal care and who were participating in an EHP intervention were included (N = 910). The authors used multivariable logistic regression to examine whether ACEs (0, 1-2, 3+) and resilience (high vs low) were associated with referrals to and participation in EHP intervention. They also evaluated the impact of EHP intervention through clinician (N = 53) and patient (N = 51) surveys.</p><p><strong>Results: </strong>Patients with 3+ vs 0 ACEs were more likely to receive an EHP referral (adjusted odds ratio [aOR] = 2.89, 95% confidence interval [CI]: 1.93-4.33) and were more likely to participate in EHP intervention (aOR = 2.85, 95% CI: 1.87-4.36). Those with low vs high resilience were also more likely to receive an EHP referral (aOR = 1.86, 95% CI: 1.32-2.62) and participate in EHP (aOR = 1.71, 95% CI: 1.19-2.44). When ACEs and resilience were combined, those with high ACEs and low resilience had the greatest odds of referrals and participation. Patients and clinicians reported positive experiences with EHP intervention.</p><p><strong>Conclusion: </strong>Patients with higher ACEs and lower resilience scores were more likely to be referred to and participate in EHP intervention, suggesting that at-risk patients can be successfully linked with a health psychologist when accessible within obstetric care.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"144-151"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Deficiency-Associated Neuropathic Pain Examined in a Chronic Pain Management Program.","authors":"Maxwell Li, Katharine W Lai","doi":"10.7812/TPP/24.026","DOIUrl":"10.7812/TPP/24.026","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"180-184"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}