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101.
Mary G. Rhodes Kathlyn E. Fletcher Francois Blumenfeld-Kouchner Elizabeth A. Jacobs 《Patient education and counseling》2021,104(8):1978-1984
ObjectiveProfessional medical interpreters facilitate patient understanding of illness, prognosis, and treatment options. Facilitating end of life discussions can be challenging. Our objective was to better understand the challenges professional medical interpreters face and how they affect the accuracy of provider-patient communication during discussions of end of life.MethodsWe conducted semi-structured interviews with professional Spanish medical interpreters. We asked about their experiences interpreting end of life discussions, including questions about values, professional and emotional challenges interpreting these conversations, and how those challenges might impact accuracy. We used a grounded theory, constant comparative method to analyze the data. Participants completed a short demographic questionnaire.ResultsSeventeen Spanish language interpreters participated. Participants described intensive attention to communication accuracy during end of life discussions, even when discussions caused emotional or professional distress. Professional strains such as rapid discussion tempo contributed to unintentional alterations in discussion content. Perceived non-empathic behaviors of providers contributed to rare, intentional alterations in discussion flow and content.ConclusionWe found that despite challenges, Spanish language interpreters focus intensively on accurate interpretation in discussions of end of life.Practice ImplicationsProvider training on how to best work with interpreters in these important conversations could support accurate and empathetic interpretation. 相似文献
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Eisenman DP Meredith LS Rhodes H Green BL Kaltman S Cassells A Tobin JN 《Journal of general internal medicine》2008,23(9):1386-1392
Background Little is known about how Latinos with post-traumatic stress disorder (PTSD) understand their illness and their preferences
for mental health treatment.
Objective To understand the illness beliefs and treatment preferences of Latino immigrants with PTSD.
Design Semi-structured, face-to-face interviews.
Participants Sixty foreign-born, Latino adults recruited from five primary care centers in New York and New Jersey and screened for PTSD.
Approach Content analytic methods identified common themes, their range, and most frequent or typical responses.
Results Participants identified their primary feelings as sadness, anxiety, nervousness, and fear. The most common feeling was “sad”
(triste). Other words frequently volunteered were “angry” (enojada), “nervous” (nerviosa), and “scared” (miedo). Participants viewed their PTSD as impairing health and functioning. They ascribed their somatic symptoms and their general
medical problems to the “stress” from the trauma and its consequences on their lives. The most common reason participants
volunteered for their work and school functioning being impaired was their poor concentration, often due to intrusive thoughts.
Most expressed their desire to receive mental health treatment, to receive it within their primary care center, and preferred
psychotherapy over psychotropic medications. Among participants who did not report wanting treatment, most said it was because
the trauma was “in the past.”
Conclusions Clinicians may consider enquiring about PTSD in Latino patients who report feeling sad, anxious, nervous, or fearful. Our
study suggests topics clinicians may include in the psychoeducation of patients with PTSD. 相似文献
106.
Judd A Hutchinson S Wadd S Hickman M Taylor A Jones S Parry JV Cameron S Rhodes T Ahmed S Bird S Fox R Renton A Stimson GV Goldberg D 《Journal of viral hepatitis》2005,12(6):655-662
Our aim was to compare the prevalence of antibody to hepatitis C virus (anti-HCV) among recently initiated injecting drug users (IDUs) in London and Glasgow, and to identify risk factors which could explain differences in prevalence between the cities. Complementary studies of community recruited IDUs who had initiated injection drug use since 1996 were conducted during 2001-2002. Data on HCV risk behaviours were gathered using structured questionnaires with identical core questions and respondents were asked to provide an oral fluid specimen which was tested anonymously for anti-HCV but was linked to the questionnaire. Sensitivities of the anti-HCV assays for oral fluid were 92-96%. Prevalence of anti-HCV was 35% (122/354) in London and 57% (207/366) in Glasgow (P < 0.001). Multifactorially, factors significantly associated with raised odds of anti-HCV positivity were increasing length of injecting career, daily injection, polydrug use, having had a needlestick injury, and having served a prison sentence. In addition lower odds of anti-HCV positivity were associated with non-injection use of crack cocaine and recruitment from drug agencies. After adjustment for these factors, the increased odds of anti-HCV associated with being a Glasgow IDU were diminished but remained significant. HCV continues to be transmitted among the IDU population of both cities at high rates despite the availability of syringe exchange and methadone maintenance. Effectiveness of harm reduction interventions may be compromised by inadequate coverage and failure to reduce sufficiently the frequency of sharing different types of injecting equipment, as well as the high background prevalence of HCV, and its high infectivity. Comprehensive action is urgently required to reduce the incidence of HCV among injectors. 相似文献
107.
BACKGROUND: Scleroderma renal crisis is one of the most life threatening complications of scleroderma. Enteric hyperoxaluria complicates extensive disease or resection of the small intestine in the presence of an intact colon, and is associated with calcium oxalate nephrolithiasis. This cause of renal failure may be underestimated and should be considered in all patients with malabsorption and renal failure. CASE REPORT: A 78 year old woman with systemic sclerosis affecting the bowel developed acute renal failure caused by oxalate nephropathy. RESULTS: The patient's renal failure improved on an oxalate free diet. 相似文献
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Sudeep Tanwar Freya Rhodes Ankur Srivastava Paul M Trembling William M Rosenberg 《World journal of gastroenterology : WJG》2020,26(2):109-133
At present chronic liver disease(CLD),the third commonest cause of premature death in the United Kingdom is detected late,when interventions are ineffective,resulting in considerable morbidity and mortality.Injury to the liver,the largest solid organ in the body,leads to a cascade of inflammatory events.Chronic inflammation leads to the activation of hepatic stellate cells that undergo transdifferentiation to become myofibroblasts,the main extra-cellular matrix producing cells in the liver;over time increased extra-cellular matrix production results in the formation of liver fibrosis.Although fibrogenesis may be viewed as having evolved as a“wound healing”process that preserves tissue integrity,sustained chronic fibrosis can become pathogenic culminating in CLD,cirrhosis and its associated complications.As the reference standard for detecting liver fibrosis,liver biopsy,is invasive and has an associated morbidity,the diagnostic assessment of CLD by non-invasive testing is attractive.Accordingly,in this review the mechanisms by which liver inflammation and fibrosis develop in chronic liver diseases are explored to identify appropriate and meaningful diagnostic targets for clinical practice.Due to differing disease prevalence and treatment efficacy,disease specific diagnostic targets are required to optimally manage individual CLDs such as non-alcoholic fatty liver disease and chronic hepatitis C infection.To facilitate this,a review of the pathogenesis of both conditions is also conducted.Finally,the evidence for hepatic fibrosis regression and the mechanisms by which this occurs are discussed,including the current use of antifibrotic therapy. 相似文献
110.