“Like No One Is Listening to Me”: A Qualitative Study of Patient–Provider Discordance Between Global Assessments of Disease Activity in Rheumatoid Arthritis

Kvrgic, Zoran; Asiedu, Gladys B.; Crowson, Cynthia S.; Ridgeway, Jennifer L.; Davis, John M.

doi:10.1002/acr.23501

Cited by 28 publications

(23 citation statements)

References 34 publications

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“…Our findings are consistent with studies aiming to elucidate patient experiences in other chronic rheumatic diseases such as systemic sclerosis (SSc) (12), rheumatoid arthritis (RA) (32, 33), and multiple sclerosis (MS) (34). Overlapping themes include dealing with uncertainty (SSc, RA, MS), poor communication with physicians (MS), inadequate physician validation (SSc), role changes (SSc, RA), and poor availability of disease information (SSc).…”

Section: Discussionsupporting

confidence: 90%

“…Not Having the Real Support That We Need”: Patients’ Experiences With Ambiguity of Systemic Lupus Erythematosus and Erosion of Social Support

Leung

Baker

et al. 2019

ACR Open Rheumatology

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Objective: The patient-specific experience of living with SLE is underreported, particularly when studying factors associated with health-related quality of life (HRQOL). Recent work has suggested that biomedical interventions are only partially predictive of HRQOL measures. A qualitative analysis of patient-specific experiences can uncover additional root causes of impaired HRQOL in SLE populations beyond the scope of quantitative questionnaires. Methods: Consented adult patients with American College of Rheumatology- or Systemic Lupus International Collaborating Clinics-classified SLE were recruited. Ten semi-structured interviews were conducted across six participants. Interviews were audio recorded, transcribed, and analyzed using an iterative process. Findings were presented to an interactive public forum with SLE patients family members and friends of patients, and health care professionals to assess accuracy. Results: Four themes emerged from the interviews: 1) ambiguity, inconsistency, and lack of symptom predictability due to SLE disease courses, 2) poor communication with family/friends/partners, and poor bi-directional communication between health care providers and patients (informational support), 3) lack of validation for patients’ experiences (appraisal support), and 4) problematic aspects of social support including negative support and patients’ inability to reciprocate support due to role changes. Data also indicate a reciprocal association between appraisal and informational sources of support. Conclusion: Findings indicate that inadequate appraisal and informational support from informal and formal sources are salient factors influencing HRQOL among SLE patients. Findings also point to the necessity of integrating community organizations, physicians, and friends and family of SLE patients into capacity building interventions aimed at enhancing these sources of social support.

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Section: Discussionsupporting

confidence: 90%

“…Not Having the Real Support That We Need”: Patients’ Experiences With Ambiguity of Systemic Lupus Erythematosus and Erosion of Social Support

Leung

Baker

et al. 2019

ACR Open Rheumatology

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“…Disease activity assessment. Sixty-nine percent (n = 9) of the RA studies included evaluated the discrepancies in disease activity assessment [2,16,[18][19][20][22][23][24]26].…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

“…Two out of the nine studies explored the factors that patients considered relevant for the PD in disease activity [20,23]. Through focus groups interviews, seven themes came out: perceived stress, balancing activities and rest, medication intake, social stress, relationship with professionals, comorbidity, and physical fitness [23].…”

Section: Plos Onementioning

confidence: 99%

Patient-physician discrepancy in the perception of immune-mediated inflammatory diseases: rheumatoid arthritis, psoriatic arthritis and psoriasis. A qualitative systematic review of the literature

et al. 2020

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Introduction Recommendations on chronic diseases management emphasise the need to consider patient perspectives and shared decision-making. Discrepancies between patients and physicians' perspectives on treatment objectives, disease activity, preferences and treatment have been described for immune-mediate inflammatory diseases. These differences could result on patient dissatisfaction and negatively affect outcomes. Objective To describe the degree of patient-physician discrepancy in three chronic immune-mediated inflammatory diseases (rheumatoid arthritis [RA], psoriatic arthritis [PsA] and psoriasis [Ps]), identifying the main areas of discrepancy and possible predictor factors. Methods Qualitative systematic review of the available literature on patient and physician discrepancies in the management of RA, PsA and Ps. The search was performed in international (Medline/PubMed, Cochrane Library, ISI-WOK) and Spanish electronic databases (MEDES, IBECS), including papers published from April 1, 2008 to April 1, 2018, in English or Spanish, and conducted in European or North American populations. Study quality was assessed by the Oxford Centre for Evidence-Based Medicine criteria. Results A total of 21 studies were included (13 RA; 3 PsA; 4 Ps; 1 RA, Ps, and Axial Spondyloarthritis). A significant and heterogeneous degree of discrepancy between patients and

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“…(5). A perceived lack of good listening skills and empathy can also make patients feel their physicians are falling short during many interactions (9). Problems include failing to ask questions, an inability to listen empathically, or failing to notice a patients' emotional reaction.…”

Section: Introductionmentioning

confidence: 99%

Improving Critical Listening skills in EMT Students

Armstrong

Ferrari-Bridgers

2020

Irish J Para

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Introduction: Although the importance of EMT students utilizing critical listening skills is apparent, there is little research focused on EMT students or EMTs and critical listening. Ensuring EMT students develop critical listening skills can be an asset that reaches beyond the goal of improving their education. It also has the potential to improve the quality of care they go on to deliver. EMTs may have the only verbal contact with the patient while they are still conscious, or with bystanders that witnessed the incident, or family members/health aides that can give vitally important information on the patient’s condition. If an EMT is not adept at critical listening, vital information may be lost, and the repercussions can be serious. This project was designed to determine whether EMT student critical listening ability and class performance would improve from engaging in critical listening exercises.Methods: Critical listening exercises were emphasized during an EMT course by assessing student knowledge of the Patient Assessment module through two listening exercises modelled after the Ferrari, Lynch, and Vogel Listening Test that measures for critical listening skills. The Patient Assessment module was assessed twice within four weeks in a test-retest design.Results: The data analysis of a total of n = 51 students’ performance in the pre and post-assessments yielded positive results and showed students significantly improved their listening ability within the four-week period. An overall score increase of 34.50 % was found between the pre and the post assessment results. Moreover, the data analysis showed that as the result of the listening exercises, students scored significantly higher in the section of the certifying exam that included critical listening exercises than in all other sections.Conclusion: The results suggest performing critical listening exercises and assessments can help EMT students properly develop critical listening skills and improve performance.

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“Like No One Is Listening to Me”: A Qualitative Study of Patient–Provider Discordance Between Global Assessments of Disease Activity in Rheumatoid Arthritis

Cited by 28 publications

References 34 publications

“…Not Having the Real Support That We Need”: Patients’ Experiences With Ambiguity of Systemic Lupus Erythematosus and Erosion of Social Support

“…Not Having the Real Support That We Need”: Patients’ Experiences With Ambiguity of Systemic Lupus Erythematosus and Erosion of Social Support

Patient-physician discrepancy in the perception of immune-mediated inflammatory diseases: rheumatoid arthritis, psoriatic arthritis and psoriasis. A qualitative systematic review of the literature

Improving Critical Listening skills in EMT Students

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