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A diagnostic label can have harms and benefits, particularly when provided following routine health screening tests. Whether these are discussed in clinical encounters is unknown.
Aims
To investigate whether potential impacts of diagnostic labelling are discussed before routine screening for non-cancer health conditions and explore the perceived value of such discussions by general practitioners (GPs) and healthcare consumers.
Method
Eleven semi-structured interviews with GPs and two focus groups with eight consumers were conducted. Interviews and focus groups were audio-recorded, transcribed and analysed using thematic analysis methods based on framework analysis.
Results
Prior to routine screening, most GPs did not discuss the potential consequences of diagnostic labelling, and no consumer recalled discussions of this nature. In contrast, many GPs provided information regarding the screening procedure and possible test limitations. Both GPs and consumers identified that it would be valuable to discuss the potential impacts of a diagnostic label; however, preferences varied as to the content and timing (i.e. before or after screening) of this discussion. Six themes that examine the utility of discussing the consequences of diagnostic labelling were identified: patient empowerment, patient variability, condition-specific information, GP and patient interactions and relationship, GP role and responsibilities, and characteristics of screening.
Conclusions
The practice and perceived value of discussing diagnostic labelling consequences were recognised as important by both GPs and consumers. However, preferences regarding the content of discussions and whether these occurred in clinical encounters before or after screening varied.
Choosing ART treatment is a major life decision. Patients have a fundamental right to patient-centered healthcare that respects their unique needs, preferences and values.
At the heart of a patient’s question about success rates is the need to know whether they can be assured of the best chance of taking home a healthy baby.However, choosing a clinic based solely on reported success rates can create unrealistic expectations, as pregnancy rates vary tremendously, depending on the type of treatment, the age and cause of infertility. ‘League Tables’ comparing the performance of one clinic to another can be misleading.More than 25 years’ experience from patients’ organizations suggest that many pursue ART without fully understanding the risks and potential complications. The format of ART surveillance reports varies considerably and are usually written for a scientific audience.
Therefore, ART surveillance data should be available in a format that is unbiased, understandable and meaningful.
Pediatric acute gastroenteritis (AGE) is a common condition with high health care utilization, persistent practice variation, and substantial family burden. An initial approach to resolve these issues is to understand the patient/caregiver experience of this illness. The objective of this study was to describe caregivers’ experiences of pediatric AGE and identify their information needs, preferences, and priorities.
Methods
A qualitative, descriptive study was conducted. Caregivers of a child with AGE were recruited for this study in the pediatric emergency department (ED) at a tertiary hospital in a major urban centre. Individual interviews were conducted (n=15), and a thematic analysis of interview transcripts was completed using a hybrid inductive/deductive approach.
Results
Five major themes were identified and described: 1) caregiver management strategies; 2) reasons for going to the ED; 3) treatment and management of AGE in the ED; 4) caregivers’ information needs; and 5) additional factors influencing caregivers’ experiences and decision-making. A number of subthemes within each major theme were identified and described.
Conclusions
This qualitative descriptive study has identified caregiver information needs, preferences, and priorities regarding pediatric AGE. This study also identified inconsistencies in the treatment and management of pediatric AGE at home and in the ED that influence health care utilization and patient outcomes related to pediatric AGE.
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