Annals (Royal College of Physicians and Surgeons of Canada)最新文献

Learning from the experience of others: ethical issues surrounding the use of clinical data for teaching and other professional activities. 从他人的经验中学习:在教学和其他专业活动中使用临床数据的伦理问题。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-12-01

Kathleen Cranley Glass, Franco A Carnevale

引用次数: 0

Ethics in qualitative health research. 定性健康研究中的伦理学。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-12-01

Kathleen M Oberle

{"title":"Ethics in qualitative health research.","authors":"Kathleen M Oberle","doi":"","DOIUrl":"","url":null,"abstract":"Background: Since the release of the Tri-Council Policy Statement (TCPS), there has been a growing interest in research ethics concommitant with an increase in the use of qualitative design for health research. Qualitative studies present unique ethical problems that may be poorly understood by researchers and research ethics boards (REBs).Objective: To describe the ethical problems in qualitative research, and to make recommendations that will help researchers develop ethical qualitative proposals, and help REBs review these proposals.Method: Review of literature and philosophical analysis.Results and conclusion: Qualitative studies raise unique issues with respect to methods, protection from harm, informed consent, privacy, and confidentiality, all of which are central to the principles of the TCPS. The problems are partly inherent, as the design tends to emerge as the study proceeds, and the research question may change. Researchers and REBs must become more aware, through education and critical reflection, of the types of problems that might arise in these studies, and of the approaches that might be taken to minimize risk to participants.","PeriodicalId":80483,"journal":{"name":"Annals (Royal College of Physicians and Surgeons of Canada)","volume":"35 8 Suppl.","pages":"563-6"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40836939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Considerations for research ethics boards in evaluating qualitative studies: lessons from an ethnographic study with adolescent females. 评价定性研究时研究伦理委员会的考虑:来自青少年女性民族志研究的经验教训。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-12-01

Elizabeth Banister

引用次数: 0

Interactions of staff and residents with pharmaceutical industry: a survey of psychiatric training program policies. 医务人员和住院医师与制药业的互动:精神病学培训计划政策的调查。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-12-01

A Chakrabarti, W P Fleisher, D Staley, L Calhoun

{"title":"Interactions of staff and residents with pharmaceutical industry: a survey of psychiatric training program policies.","authors":"A Chakrabarti, W P Fleisher, D Staley, L Calhoun","doi":"","DOIUrl":"","url":null,"abstract":"Objectives: In response to perceived controversies regarding interactions between physicians and the pharmaceutical industry, we undertook a study to look at the relationship between Canadian psychiatry training programs and the pharmaceutical industry.Methods: The authors distributed a survey to the residency program directors and chief residents of the 16 psychiatry training programs in Canada.Results: Of respondents, 75 per cent were either unaware of or noted an absence of policies or guidelines regarding interactions with the pharmaceutical industry in their training programs; 70 per cent viewed staff psychiatrists and residents to be at least 50 per cent familiar with the Canadian Medical Association's policy summary; and 74 per cent were unaware of any structural teaching regarding potential conflicts of interest between psychiatry and the pharmaceutical industry. A significant number of respondents perceived occasional excessive influence by the pharmaceutical industry on residents' training.Conclusions: Despite concerns about potential conflicts of interest, there are a few guidelines in most psychiatry training programs in Canada regarding the relationship between physicians and the pharmaceutical industry.","PeriodicalId":80483,"journal":{"name":"Annals (Royal College of Physicians and Surgeons of Canada)","volume":"35 8 Suppl.","pages":"541-6"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40836938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical-ethics teaching in Canadian physical medicine and rehabilitation residency training programs. 加拿大物理医学和康复住院医师培训项目中的医学伦理学教学。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-12-01

Jeff Blackmer

{"title":"Medical-ethics teaching in Canadian physical medicine and rehabilitation residency training programs.","authors":"Jeff Blackmer","doi":"","DOIUrl":"","url":null,"abstract":"Background: Medical-ethics education is a required component of all Royal College residency training programs in Canada. There have been no studies to determine how and to what extent this teaching is done in physical medicine and rehabilitation training programs.Objective: To assess the state of medical-ethics teaching in Canadian physical medicine and rehabilitation residency training programs.Methods: A six-question survey was faxed to the program directors of the 10 physiatry residency training programs in Canada. We asked whether medical-ethics teaching is being done, who is doing the teaching, which pedagogic methods is used, how many hours are dedicated to the topic, which topics are taught, and what evaluation method is used.Results: The response rate was 90 per cent. The study confirmed that medical-ethics teaching is done in all Canadian physiatry training programs. However, the person doing the teaching, the number of hours allocated to ethics education, the pedagogic method used, and the topics being taught vary from program to program.Conclusion: Although medical-ethics teaching is done in all programs, there is a need for more standardization in the curriculum and in evaluation. The curriculum should focus on ethical issues that are most likely to be encountered in daily physiatric practice. Small-group, case-based teaching should be used for maximum effectiveness. Whenever possible, teaching should be done by a physiatrist.","PeriodicalId":80483,"journal":{"name":"Annals (Royal College of Physicians and Surgeons of Canada)","volume":"35 8 Suppl.","pages":"574-8"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40836943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatricians' knowledge, perceptions, and attitudes towards providing health care for lesbian, gay, and bisexual adolescents. 儿科医生对为女同性恋、男同性恋和双性恋青少年提供卫生保健的知识、观念和态度。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-10-01

Suji M Lena, Tannis Wiebe, Sara Ingram, Mona Jabbour

{"title":"Pediatricians' knowledge, perceptions, and attitudes towards providing health care for lesbian, gay, and bisexual adolescents.","authors":"Suji M Lena, Tannis Wiebe, Sara Ingram, Mona Jabbour","doi":"","DOIUrl":"","url":null,"abstract":"Background: Pediatricians are often the first health-care contacts for gay, lesbian, and bisexual adolescents who are developing their sexual orientation.Objective: This study investigated pediatricians' attitudes and practices towards gay, lesbian, and bisexual adolescents.Method: We sent anonymous self-administered questionnaires to 112 pediatricians in the Ottawa area.Results: Of those who responded, 36 per cent reported having treated lesbian, gay, or bisexual patients, and 70 per cent reported not addressing the issue of sexual orientation. Reservations in discussing sexual orientation were due to fears of offending patients, and a lack of knowledge regarding their needs. Furthermore, 59 per cent of these pediatricians were unfamiliar with community resources for homosexual youths, and 78 per cent reported wanting more information with regards to the care of this population.Conclusion: Many pediatricians experience difficulties in discussing issues of sexual orientation, and generally feel inadequately prepared to address issues pertaining to the health-care needs of these adolescents. While certain issues remain controversial, the overall attitude of pediatricians towards homosexually oriented patients is positive in that they are interested in becoming more aware of issues of homosexual orientation, to better serve this population.","PeriodicalId":80483,"journal":{"name":"Annals (Royal College of Physicians and Surgeons of Canada)","volume":"35 7","pages":"406-10"},"PeriodicalIF":0.0,"publicationDate":"2002-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22443548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric residents' knowledge, perceptions, and attitudes towards homosexually oriented youth. 儿科住院医师对同性恋青少年的认识、认知和态度。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-10-01

Suji M Lena, Tannis Wiebe, Sara Ingram, Mona Jabbour

{"title":"Pediatric residents' knowledge, perceptions, and attitudes towards homosexually oriented youth.","authors":"Suji M Lena, Tannis Wiebe, Sara Ingram, Mona Jabbour","doi":"","DOIUrl":"","url":null,"abstract":"Background: Pediatric residents must have clinical exposure and specific training to meet the health-care needs of gay, lesbian, and bisexual adolescents. Homosexually oriented youths have medical and psychosocial needs that these future pediatricians must fulfil.Objective: This study investigated the knowledge and attitudes of pediatric residents in the management of gay, lesbian, and bisexual youth and related health-care issues.Method: Twenty-nine pediatric residents at the University of Ottawa were sent a survey questionnaire.Results: Many respondents indicated that they experience difficulties in discussing issues of sexual orientation, and feel inadequately prepared to address the health-care needs of homosexual youth. Furthermore, respondents showed a lack of awareness regarding resources available to gay, lesbian, and bisexual youth in the community.Conclusion: While knowledge is limited, residents' attitudes towards homosexual youth are generally positive. Also, most respondents indicate an interest in continuing education, and in gaining more information to better serve their homosexually oriented adolescent patients.","PeriodicalId":80483,"journal":{"name":"Annals (Royal College of Physicians and Surgeons of Canada)","volume":"35 7","pages":"401-5"},"PeriodicalIF":0.0,"publicationDate":"2002-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22441683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Culture and physician-patient communication: a qualitative exploration of residents' experiences and attitudes. 文化与医患沟通:住院医师经验与态度的质性探讨。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-09-01

L Lingard, S Tallett, J Rosenfield

{"title":"Culture and physician-patient communication: a qualitative exploration of residents' experiences and attitudes.","authors":"L Lingard, S Tallett, J Rosenfield","doi":"","DOIUrl":"","url":null,"abstract":"Background: Increasing evidence suggests that communication plays a central role in effective clinical care. To facilitate effective instruction in this domain, this study seeks to understand how pediatric residents approach the challenge of cross-cultural communication.Methods: A convenience sample of 29 pediatric residents participated in five focus groups that were jointly facilitated by a clinical and a process expert. Discussion was stimulated using two video scenarios of pediatric cross-cultural communication challenges.Results: Seven dominant categories were evident in the discussions: characteristics of culture, beliefs about culture, attitudes towards culture, opinions about how to build expertise in communication, cultural conflict, insights regarding prejudice, and comments about interview technique. Residents tended to view culture and difference as residing in patients (not in themselves), reflecting their assumption that western medicine is acultural.Conclusions: Residents believe that lack of knowledge about other cultures causes their communication difficulties. Our findings suggest, however, that more basic issues may underlie their difficulties. Residents may recognize prejudice in the abstract but fail to see it in their environment, and they may spend minimal time reflecting on their professional culture and beliefs.","PeriodicalId":80483,"journal":{"name":"Annals (Royal College of Physicians and Surgeons of Canada)","volume":"35 6","pages":"331-5"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22441682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breaking bad news: a clinician's view of the literature. 坏消息:一个临床医生对文献的看法。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-08-01

Leon L Phipps, John D Cuthill

{"title":"Breaking bad news: a clinician's view of the literature.","authors":"Leon L Phipps, John D Cuthill","doi":"","DOIUrl":"","url":null,"abstract":"In daily practice, a clinician may have to break bad news to patients and their families. How the patient responds depends largely on the manner in which the messenger conveys the news. The clinician may harbour fears of the patient's unpredictable emotional reactions, his or her own display of emotions, and a revival of bad news that he or she may have received. He or she may also feel ineffectual about an inability to deal with the patient's expectations for cure. He or she may use distancing tactics in discussing emotionally charged topics. The ensuing anxiety fosters an uneasy alliance in such situations. Moreover, the patient may question the information. This should be seen as a need for more information, and not as a challenge to the messenger's integrity or the validity of the news. Denial on the part of patients and families may indicate their inability to accept the news. The paucity of medical education in this area dictates more emphasis in teaching communication skills to medical students and postgraduate trainees. Receiving the news is the start of an adaptation process for a patient. He or she must know that there will be difficulties ahead. The patient and family will face them together with the clinician. The doctor will be available as necessary throughout the process to answer questions and provide support. This entails spending time to listen, hear, acknowledge the patient's emotions, and advocate on the patient's behalf. It is always possible to help the patient frame his or her fears. When the shadow of death approaches, life and time become more precious. Deeper meanings and clearer priorities often emerge for the dying person. He or she is forced to examine what makes a life meaningful. By sharing burdens, insight, and support, patients and professionals can pursue these discoveries together.","PeriodicalId":80483,"journal":{"name":"Annals (Royal College of Physicians and Surgeons of Canada)","volume":"35 5","pages":"287-93"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22441680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality end-of-life care. 高质量的临终关怀。

Annals (Royal College of Physicians and Surgeons of Canada) Pub Date : 2002-06-01

R W Dunn

引用次数: 0