PubMed · 10124562
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C Bissen, J Fainter. 1993. Teaming up.. https://pubmed.ncbi.nlm.nih.gov/10124562/
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BACKGROUND: Increasing emphasis on patient-centered care and other recent developments should make patient expectations increasingly important in ophthalmology. Motivated by the pivotal role of patient expectations in quality-of-care assessments and by the limited knowledge about patients' expectations regarding eye care, we initiated a pilot study using focus groups to determine a relevant set of concerns that patients express as expectations. METHODS: A total of 6 focus groups were conducted with patients at Duke University Eye Center (Durham, NC). Focus groups ranged in size from 4 to 10 people. The average group size was 6. RESULTS: Content analysis of transcripts from the 6 focus groups yielded 22 areas of expectations for eye care, which were classified into 5 categories: communication, interpersonal manner, physician's skill, logistics, and other. The 6 areas that appeared to be of greatest importance to focus group participants were the following: (1) honesty, (2) information about diagnosis and prognosis, (3) explanation in clear language, (4) ophthalmologist's experience and reputation, (5) empathy, and (6) listening and addressing concerns. CONCLUSIONS: In general, ophthalmology patients in the focus groups emphasized expectations related to communication and interpersonal manner. In contrast to previous studies with primary care patients, however, ophthalmology patients expressed few expectations for technical interventions, such as medication prescriptions, physical examination, or diagnostic testing.
PROBLEM: This quasi-experimental field study examined the efficacy of a safety self-management process to increase safety-related work practices in mining operations. METHODS: After a 7-week baseline, 15 miners participated in a safety self-management training and education presentation. The participants in a prebehavior condition (n=8) recorded their intentions to engage in specific percentages of safety-related work behaviors before starting their shift for the day. In contrast, participants in a postbehavior condition (n=7) recorded their percentages of safety-related work behaviors after their shift for the day. RESULTS: During withdrawal (4 weeks), the miners did not complete any self-monitoring forms. Based on 10,905 behavioral observations, safety self-management was effective at increasing the frequency of safety-related behavior (p<.05). For the prebehavior condition, the mean percent safe score across three target behaviors increased 34.8% during intervention. Similarly, in the postbehavior condition, the mean percent safe score across three target behaviors increased 40.1% during intervention. IMPACT ON INDUSTRY: The results suggest that employees who work in relative isolation or have little oversight, compared to traditional industrial workers, may benefit from a process by which they can systematically observe themselves.
This paper explores the relationship between palliative medicine and the wider medical world. It draws on data from a focus group study in which doctors from a range of specialties talked about developing palliative care for patients with heart failure. In outlining views of the organisation of care, participants engaged in a process of negotiation about the roles and expertise of their own, and other, specialties. Our analysis considers the expertise of palliative medicine with reference to its technical and indeterminate components. It shows how these are used to promote and challenge boundaries between medical specialties and with nursing. The boundaries constructed on palliative medicine's technical contribution to care are regarded as particularly coherent within orthodox medicine. In contrast, its indeterminate expertise, represented by the 'holistic' and 'psychosocial' agendas, is potentially compromising in a medical world that prizes science and rationality. We show how the coherence of both kinds of expertise is contested by moves to extend palliative care beyond its traditional temporal (end-of-life) and pathological (cancer) fields of practice.