1
|
Hughes AM, Riska K, Farmer MJS, Krishnakumar D, Shea CM, Hess DR, Lindenauer PK, Stefan MS. Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation. J Interprof Care 2023; 37:576-587. [PMID: 36264072 PMCID: PMC10983066 DOI: 10.1080/13561820.2022.2118681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 12/24/2022]
Abstract
Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared cognitive tasks in interprofessional teams using NIV for patients with COPD exacerbation. We used a cognitive task analysis approach (CTA) to engage nurses, rapid response team members, respiratory therapists, and physicians involved in the use of NIV to treat patients with COPD exacerbation. Clinicians participated in a semi-structured interview (n = 21) that elicited cognitions needed to treat COPD exacerbation. Three shared cognitive tasks were identified: Complete a thorough assessment, Formulate a care plan, and Continuously monitor patient status. Findings attest to the importance of having access to up-to-date information and expertise necessary to make accurate clinical inferences for patient assessment. Shared understanding of the formulated care plan among all members of the care team was important to its execution. Continuous monitoring was crucial; however, this cognitive task relied on patient assessment skills and ongoing collaboration within the clinical care team. Application of NIV for patients with COPD exacerbation may require enhancing collaboration through nontechnical skills and interprofessional training.
Collapse
Affiliation(s)
- Ashley M Hughes
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago
- Center for Innovations in Chronic, Complex Healthcare, Edward Hines JR VA Medical Center, Hines
| | - Karen Riska
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School - Baystate, Springfield
| | - Mary Jo S Farmer
- Department of Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield
- Division of Pulmonary and Critical Care, Department of Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield
| | | | - Christopher M Shea
- Department of Health Policy and Management, Gilling's School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Dean R Hess
- College of Professional Studies, Respiratory Care Leadership, Northeastern University, Boston MS, United States
- Department of Respiratory Care, Massachusetts General Hospital, Boston, MS, United States
| | - Peter K Lindenauer
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School - Baystate, Springfield
- Department of Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MS, United States
| | - Mihaela S Stefan
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School - Baystate, Springfield
- Department of Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield
| |
Collapse
|
2
|
McBain SA, Stoycos S, Doenges T. Breaking Silos to Address Medical Trauma: The Need for Integration of Trauma and Health Psychology Training. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09897-2. [PMID: 35841442 DOI: 10.1007/s10880-022-09897-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
Posttraumatic Stress Disorder (PTSD) following a traumatic injury is a significant public health concern impacting approximately a third of traumatically injured patients. In 2018, the American College of Surgeons (ACS) Committee on Trauma recommended implementation of PTSD screening and brief intervention in level 1 trauma centers to meet the mental health needs of this underserved population. In March 2022, ACS revised its standards to include a requirement for mental health screening and referral process in level 1 and level 2 trauma centers. However, implementation of these programs has been limited. One barrier to implementation has been the lack of cross-trained trauma and health psychologists to support the development and implementation of trauma-focused programs in acute and critical care settings. This paper is a call to action to bring together experts in the fields of trauma and health psychology to effectively address training gaps in post-injury PTSD and medical traumatic stress. Through development of trauma and health psychology cross-training models, the field of psychology can collaborate to meet the increasing demand for trauma-focused psychologists in acute and critical care settings.
Collapse
Affiliation(s)
- Sacha A McBain
- Departments of Psychiatry & Surgery, College of Medicine, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR, 72205, USA.
| | - Sarah Stoycos
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Tim Doenges
- Lyda Hill Institute for Human Resilience, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| |
Collapse
|
3
|
Chen L, Tang H, Guo Y. Effect of Patient-Centered Communication on Physician-Patient Conflicts from the Physicians' Perspective: A Moderated Mediation Model. JOURNAL OF HEALTH COMMUNICATION 2022; 27:164-172. [PMID: 35579286 DOI: 10.1080/10810730.2022.2071505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Physician-patient conflicts are detrimental to doctor-patient relationship and sustainable healthcare delivery. In China, the status quo of the doctor-patient relationship is in great tension. Based on the uncertainty reduction theory (URT), the present study examined the relationship between patient-centered communication (PCC) and medical conflict, as well as the roles of perceived patients' trust, doctors' empathy, and expertise from physicians' perspectives. In March 2020, 509 physicians in China were recruited to participate in an online survey. The results revealed that PCC was negatively associated with physician-patient conflicts and that patient trust mediated the relationship. Additionally, doctors' empathy moderated PCC on patient trust, while expertise positively predicted physician-patient conflicts. Theoretical and practical implications for improving doctor-patient relationships were discussed.
Collapse
Affiliation(s)
- Liang Chen
- School of Journalism and Communication, Tsinghua University, Beijing, Haidian, China
| | - Hongjie Tang
- School of Journalism and Communication, Tsinghua University, Beijing, Haidian, China
| | - Yu Guo
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macau, Taipa, China
| |
Collapse
|