Showing items related by title, author, creator and subject.

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  PATIENTS Day 2019: What Motivates People with Substance Use Disorders to Pursue Treatment? A Patient-Centered Approach to Understanding Patient Experiences and Patient-Provider Interactions

  Gressler, Laura E.; Natafgi, Nabil; DeForge, Bruce R.; Robinson-Shaneman, Barbarajean; Welsh, Christopher; Shaya, Fadia T. (2019-05-31)
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  Healthcare Provider Communication with Young Adults: Patient-Centered Communication, Patient Satisfaction, Patient Trust, Social Support, Self-Care Skills, and Emotional Well-Being

  Nichols, Helen M.; Sacco, Paul; 0000-0002-6782-0869 (2018)

  Patient-centered communication is critical to the delivery of quality healthcare services. Although numerous health outcomes have been connected to patient-provider communication, there is limited research that has explored the processes and pathways between communication and health. Research among young adults (ages 26-39 years) is even more scarce, despite findings that health communication does vary with age. This study used data from the 2014 Health Interview National Trends Survey to (1) test a scale of seven items measuring patient-centered communication among young adults age 26 to 39 and (2) explore the relationship between patient-centered communication, patient trust, patient satisfaction, social support, self-care skills, and emotional well-being among young adults age 26 to 39. Exploratory and confirmatory factor analyses were conducted and results showed that a one-factor model of patient-centered communication among young adults fit the data well. In the final regression model, income, history of depression diagnosis, patient-centered communication, patient trust, social support, and patient self-efficacy (self-care skills) were all significantly related to emotional well-being. Post-hoc analyses showed that self-efficacy and patient trust modify the association between general health and emotional well-being. Among respondents who reported poor overall health, increases in self-efficacy and trust in their provider are associated with corresponding improvement in their predicted emotional well-being. This is in contrast to respondents who reported excellent overall health, for whom an improvements in self-efficacy and trust did not have the same effect on predicted emotional well-being. There was a significant interaction between depression and self-efficacy, as respondents who reported being diagnosed with depression showed a stronger relationship between self-efficacy and greater predicted well-being. Post-hoc analyses also showed significant interactions between patient-centered communication, satisfaction, and social support. Respondents who reported lower levels of PCC, showed decreased predicted emotional well-being as their satisfaction and perceived social support increased. These findings suggest the need to explore the means through which communication can impact emotional well-being, specifically among young adults who are in poor health or have a history of depression. Future research should also include longitudinal studies, in order to determine causality and directionality among constructs.
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  The epidemiology of patient to patient transmission of MRSA among critical care patients

  Adediran, Timileyin; Harris, Anthony D.; Thom, Kerri (2021)

  Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterial pathogen that leads to an increase in morbidity and mortality. To decrease the spread of MRSA, there is a need to elucidate factors that lead to patient-to-patient transmission in critical care settings. Objectives: Aim 1: To understand if patient-to-patient transmission via HCP mediator differs between high-risk activities by determining the odds of MRSA contamination of the patient from the gown and gloves of the health care personnel (HCP). Aim 2: To determine if isolates found on the gown and gloves of HCP are similar to patient isolates after performing an HCP-patient interaction, using comparative genomic techniques. Methods: Aim 1: This was an observational study of MRSA-positive patients and the HCP who cared for them. We conducted a simulation study of patient-to-patient transmission of MRSA from a HCP vector to a manikin (proxy for the subsequent patient). Using a generalized linear mixed model, we determined the odds of manikin contamination after performing HCP-patient interactions. Aim 2: We selected 95 patient MRSA isolates and their co-isolated HCP gown or glove MRSA isolates using a stratified sampling method. Comparative genomics analyses such as phylogenetic analysis, spa-typing, multi-locus sequence typing (MLST), large-scale blast score ratio (LSBSR), and single nucleotide variant (SNV) analysis were used to achieve this aim’s objective. Results: Aim 1: We observed 103 HCP-patient interactions with 65 MRSA-positive patients and found that subsequent transmission of MRSA from HCP gown and gloves to the manikin proxy occurred 10.7% of the time. There was no association between high-contact patient care activities and MRSA contamination of the manikin following patient care activity (p-value=0.1). Aim 2: Using multiple typing methods, we found that the majority of our isolates were genetically similar. The phylogenetic analysis revealed that 85.2% of paired isolates were similar, and the spa-typing and the LSBSR found that more than 75% of our paired isolates were concordant. However, SNV and MLST identified more than 40% of our paired isolates as discordant. Conclusion: The studies conducted demonstrated patient-to-patient transmission of MRSA via HCP vector, indicating the importance of contact precautions and infection control practices.