Maslow’s hammer in integrative medicine: one size will never fit all

doi:10.1016/j.aimed.2020.07.002

Cited by 3 publications

(1 citation statement)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Middle Meningeal Artery (MMA) embolization and other experimental nonsurgical treatments are emerging management strategies for CSDH [ 37 ] and were not explored by patient resources, despite their increasing usage by some centres [ 37 ]. This would align with a preference for evidence or knowledge to inform educational content, rather than the clinical need [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Is information provided within chronic subdural haematoma education resources adequate? A scoping review

et al. 2023

View full text Add to dashboard Cite

Background Chronic subdural haematoma (CSDH) is becoming increasingly prevalent, due to an aging population with increasing risk factors. Due to its variable disease course and high morbidity, patient centred care and shared decision making are essential. However, its occurrence in frail populations, remote from specialist neurosurgeons who currently triage treatment decisions, challenges this. Education is an important component of enabling shared decisions. This should be targeted to avoid information overload. However, it is unknown what this should be. Objectives Our objectives were to conduct analysis of the content of existing CSDH educational materials, to inform the development of patient and relative educational resources to facilitate shared decision making. Methods A literature search was conducted (July 2021) of MEDLINE, Embase and grey literature, for all self-specified resources on CSDH education, and narrative reviews. Resources were classified into a hierarchical framework using inductive thematic analysis into 8 core domains: Aetiology, epidemiology and pathophysiology; natural history and risk factors; symptoms; diagnosis; surgical management; nonsurgical management; complications and recurrence; and outcomes. Domain provision was summarised using descriptive statistics and Chi-squared tests. Results 56 information resources were identified. 30 (54%) were resources designed for healthcare professionals (HCPs), and 26 (46%) were patient-orientated resources. 45 (80%) were specific to CSDH, 11 (20%) covered head injury, and 10 (18%) referenced both acute and chronic SDH. Of 8 core domains, the most reported were aetiology, epidemiology and pathophysiology (80%, n = 45) and surgical management (77%, n = 43). Patient orientated resources were more likely to provide information on symptoms (73% vs 13%, p<0.001); and diagnosis (62% vs 10%, p<0.001) when compared to HCP resources. Healthcare professional orientated resources were more likely to provide information on nonsurgical management (63% vs 35%, p = 0.032), and complications/recurrence (83% vs 42%, p = 0.001). Conclusion The content of educational resources is varied, even amongst those intended for the same audience. These discrepancies indicate an uncertain educational need, that will need to be resolved in order to better support effective shared decision making. The taxonomy created can inform future qualitative studies.

show abstract

Section: Discussionmentioning

confidence: 99%

Is information provided within chronic subdural haematoma education resources adequate? A scoping review

et al. 2023

View full text Add to dashboard Cite

show abstract

Integrative health needs to engage with effective public health interventions on merit, not oppose them on them on principle

Wardle

2021

Advances in Integrative Medicine

View full text Add to dashboard Cite

When Less is More: A Caring Physician's Dilemma

Gelfman

2021

The American Journal of Medicine

View full text Add to dashboard Cite

Recently, an instructive commentary in The American Journal of Medicine discussed what qualities are needed to be a "good" physician. Empathy, kindness, and a good knowledge base were emphasized. 1 About the same time, another commentary discussed the appropriateness of treating some patients with stable coronary artery disease with intense medical therapy and avoiding referral for coronary stenting. It discussed the findings of many trials demonstrating the effectiveness of medical intervention alone, summarizing data from the COURAGE, ORBITA, and ISCHEMIA clinical trials. 2 The argument of this second paper is based on an important ability of a good physician: the capacity to recognize when potentially indicated medical intervention should not be pursued. The ability to recognize the lack of need for action and then to withhold a specific therapy requires the integration of the above qualities, empathy, kindness, and knowledge; plus, it requires something more. Reflecting on my experiences in over 40 years in medicine, I realize that not acting by not doing the more aggressive intervention, even though others might, is very difficult. This applies to any intervention, including those that are mundane like adding a medication, to those that are very dramatic, like coronary artery stenting. A very current issue concerns trying to avoid endotracheal intubation in patients with coronavirus disease with respiratory failure, which has potential benefits, but is not without risk. 3 Understanding why the conscious act of appropriate inaction is so difficult to perform is worth discussing, because it is not easily understood nor often discussed. This could be helpful for both physicians and patients. Interestingly, although there is significant literature on the general topic of the process of medical decision-making, I could only find limited information on the specific topic of why deliberate appropriate inaction is difficult.Inaction is often more difficult than action, especially when treating potentially life-threatening diseases. I recognized this soon after starting private practice treating Funding: None.

show abstract

Maslow’s hammer in integrative medicine: one size will never fit all

Cited by 3 publications

References 7 publications

Is information provided within chronic subdural haematoma education resources adequate? A scoping review

Is information provided within chronic subdural haematoma education resources adequate? A scoping review

Integrative health needs to engage with effective public health interventions on merit, not oppose them on them on principle

When Less is More: A Caring Physician's Dilemma

Contact Info

Product

Resources

About