Items in AFP with MESH term: Patient-Centered Care
ABSTRACT: Pulmonary rehabilitation is a nonpharmacologic therapy that has emerged as a standard of care for patients with chronic obstructive pulmonary disease. It is a comprehensive, multidisciplinary, patient-centered intervention that includes patient assessment, exercise training, self-management education, and psychosocial support. In the United States, pulmonary rehabilitation is usually given in outpatient, hospital-based programs lasting six to 12 weeks. Positive outcomes from pulmonary rehabilitation include increased exercise tolerance, reduced dyspnea and anxiety, increased self-efficacy, and improvement in health-related quality of life. Hospital admissions after exacerbations of chronic obstructive pulmonary disease are also reduced with this intervention. The positive outcomes associated with pulmonary rehabilitation are realized without demonstrable improvements in lung function. This paradox is explained by the fact that pulmonary rehabilitation identifies and treats the systemic effects of the disease. This intervention should be considered in patients who remain symptomatic or have decreased functional status despite optimal medical management. Medicare now covers up to 36 sessions of pulmonary rehabilitation in patients with moderate, severe, and very severe chronic obstructive pulmonary disease.
Keys to High-Functioning Office Teams - Feature
ABSTRACT: The physician-patient relationship is part of the patient’s larger social system and is influenced by the patient’s family. A patient’s family member can be a valuable source of health information and can collaborate in making an accurate diagnosis and planning a treatment strategy during the office visit. However, it is important for the physician to keep an appropriate balance when addressing concerns to maintain the alliance formed among physician, patient, and family member. The patient-centered medical home, a patient care concept that helps address this dynamic, often involves a robust partnership among the physician, the patient, and the patient’s family. During the office visit, this partnership may be influenced by the ethnicity, cultural values, beliefs about illness, and religion of the patient and his or her family. Physicians should recognize abnormal family dynamics during the office visit and attempt to stay neutral by avoiding triangulation. The only time neutrality should be disrupted is if the physician suspects abuse or neglect. It is important that the patient has time to communicate privately with the physician at some point during the visit.
NCCN and ACS Collaborate on a Patient's Version of the NCCN Practice Guidelines for Breast Cancer - Special Medical Reports