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Let's sit down and talk: The art of breaking bad news 让我们坐下来谈谈:打破坏消息的艺术
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-01 DOI: 10.4103/1947-489X.320358
A. Ghellai, Kafia M Elhafi, Maram Ghellai, Mamoon A Ghellai
Physicians often are uncomfortable when communicating bad or difficult news. In the absence of much effective training, many doctors find that breaking bad news is one of the most difficult, demanding, and stressful tasks. A significantly negative relationship can form between the patient and their medical staff if poor communication is used. Most patients want the truth, but how bad news is delivered can substantially influence a patient's emotions, satisfaction, subsequent psychological adjustments, and attitudes toward treatment. Moreover, values in certain cultures can become barriers that can limit or pressure a physician in ethically approaching the patient. Disclosing bad news is a complex communicational task that requires time, compassion, and empathy. Although breaking bad news will never be easy, communicating well is a skill that can be learned. The SPIKES protocol provides a simple and easily learnable strategy for communicating bad news.
医生在传达坏消息或困难消息时常常感到不舒服。在缺乏有效培训的情况下,许多医生发现突发坏消息是最困难、最苛刻、压力最大的任务之一。如果沟通不畅,患者和医护人员之间可能会形成明显的负面关系。大多数患者都想要真相,但坏消息的传递方式会对患者的情绪、满意度、随后的心理调整和治疗态度产生重大影响。此外,某些文化中的价值观可能会成为障碍,限制或迫使医生在道德上接近患者。披露坏消息是一项复杂的沟通任务,需要时间、同情心和同理心。尽管突发坏消息从来都不是一件容易的事,但良好的沟通是一项可以学习的技能。SPIKES协议为传达坏消息提供了一种简单易学的策略。
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引用次数: 0
An assessment of pharmacy practice in Libya measured against international standards 对照国际标准评估利比亚的药学实践
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-01 DOI: 10.4103/1947-489X.320352
Mohammed Ali, Amal Y. Benkorah
Introduction: Practicing pharmacy in Libya is still limited to the dispensing roles. However, pharmacists have started to work proactively to advance modern practices by expanding their roles in different practice settings. Objective: This study aims to evaluate the status of pharmacy practice in Libya through self-assessing competencies of hospital and community pharmacists. Materials and Methods: This is a cross-sectional online survey study of community and hospital pharmacists. The survey questionnaire was based upon the “Global Competency Framework for Pharmacists̶ and the Joint FIP/WHO guidelines on good pharmacy practice. Results: A total of 199 responses were received with 93% response rate. 47.0% were community pharmacists, 39.4% worked both in hospital and community, and 13.6% practiced exclusively in hospitals. 10% of respondents graduated in 1980–1989; 15% graduated in 1990–1999. 30% graduated in 2000–2009, and 45% graduated in the past 8 years before the study (2010–2017). The overall pharmacy competency indicators were reportedly met consistently by 45.3% of respondents, usually by 25% of responders and only sometimes or rarely by 15.9% or 13.8% of respondents, respectively. Conclusions: Pharmacy practice in Libya is more population and system-focused than being professional and patient-focused. Significant amendments in pharmacy education curricula are required to include modern teaching methods, knowledge, skills, and competencies. Continuous professional development programs are also needed for established pharmacists to modernize pharmacy practice in the country.
简介:在利比亚执业的药房仍然局限于配药的角色。然而,药剂师已经开始积极主动地工作,通过扩大他们在不同实践环境中的作用来推进现代实践。目的:本研究旨在通过对医院和社区药剂师能力的自我评估来评估利比亚的药学实践状况。材料和方法:这是一项针对社区和医院药剂师的横断面在线调查研究。调查问卷基于“药剂师全球能力框架”和FIP/neneneba世界卫生组织良好药学实践联合指南。结果:共收到199份回复,回复率93%。47.0%为社区药剂师,39.4%在医院和社区工作,13.6%仅在医院工作。10%的受访者毕业于1980-1989年;15%毕业于1990-1999年。30%毕业于2000-2009年,45%毕业于研究前的8年(2010-2017年)。据报道,45.3%的受访者始终符合总体药房能力指标,通常为25%的受访者,15.9%或13.8%的受访者有时或很少符合。结论:利比亚的药学实践更多地以人口和系统为中心,而不是以专业和患者为中心。需要对药学教育课程进行重大修订,以纳入现代教学方法、知识、技能和能力。为了使国家的药学实践现代化,老牌药剂师还需要持续的专业发展计划。
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引用次数: 0
From diagnosticians to “triageologists:” The transformation of modern physicians through the lens of a pathologist! 从诊断学家到“分诊专家”:从病理学家的视角看现代医生的转变!
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-01 DOI: 10.4103/1947-489X.320355
S. Kahwash
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引用次数: 0
Steroid-Induced acute psychosis in an 8-year-old child with inflammatory bowel disease 类固醇诱发的8岁儿童炎症性肠病急性精神病
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-01 DOI: 10.4103/1947-489X.320362
Om-Elkhair Elbanoni, Adel Altawaty
We present a case of an 8-year-old male child diagnosed with Crohn's disease, and he experienced a steroid-induced psychosis during induction of remission with corticosteroid therapy. This study aims to report a steroid-induced psychosis in the pediatric age group and add this case to the limited number of reported pediatric patients who developed a steroid-induced psychosis with a focused review of the literature.
我们报告了一例8岁的男性儿童,他被诊断为克罗恩病,在皮质类固醇治疗的缓解期,他经历了类固醇诱导的精神病。本研究旨在报告儿童年龄组的类固醇诱导性精神病,并将该病例添加到有限数量的报告儿童患者中,重点回顾文献。
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引用次数: 0
Plasmacytoma of the ovary 卵巢浆细胞瘤
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.4103/ijmbs.ijmbs_132_20
Jamila S. Elamouri, AdelYounus Shaffouh, Fairouz Torjman
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引用次数: 0
Attitudes of physicians and scientists to peer reviewing for biomedical journals: A survey from the Middle East and Africa 医生和科学家对生物医学期刊同行评审的态度:来自中东和非洲的调查
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.4103/ijmbs.ijmbs_141_20
S. Beshyah, K. Ali, Khadija Hafidh
Introduction: Peer review is vital to the scientific publishing process. However, the present system has been criticized and accused of bias, lack of transparency, and failure to detect significant breakthroughs. Peer reviewers usually work pro bono, and their efforts are not formally acknowledged. Some journals have difficulty finding appropriate reviewers who can complete timely reviews, resulting in significant publication delay. Materials and Methods: An online survey of a convenience sample of clinicians and biomedical scientists from the Middle East (107) and Africa (69) was conducted to explore why reviewers decline to review and to ascertain their opinions on reviewer incentives. Items were scored on 5-point Likert scales, with low scores indicating low importance or low agreement. Results: One hundred and seventy two respondents provided adequate responses for analysis. Factors rated most highly in importance for the decision to accept to review a paper included contribution of the paper to the subject area (69.8%), the relevance of the topic to own work (66.0%), and desire to keep up to date with research (63.8%). The most highly rated factor that was important in the decision to decline to review was conflict with other workloads (69.4%), followed by low quality of submissions and tight time scale (65.8% for both), and lack of interest (65.1%). Most respondents agreed that financial incentives would not be effective when time constraints are prohibitive. However, reviewers agreed that nonfinancial incentives might encourage reviewers to accept requests to review: annual acknowledgment on the journal's website (78.5%), more feedback about the outcome of the submission (74.3%) and quality of the review (73.0%), appointment of reviewers to the journal's editorial board (69.1%), and being offered free subscription to the journal content (68.7%). Conclusions: Reviewers are more likely to accept to review a manuscript when it is relevant to their area of interest. Lack of time is the principal factor in the decision to decline. Reviewing should be formally recognized by academic institutions, and journals should acknowledge reviewers' work.
引言:同行评审对科学出版过程至关重要。然而,目前的制度受到了批评和指责,存在偏见、缺乏透明度以及未能发现重大突破。同行评审员通常无偿工作,他们的努力没有得到正式认可。一些期刊很难找到能够及时完成评论的合适的审稿人,导致出版延迟。材料和方法:对来自中东(107)和非洲(69)的临床医生和生物医学科学家的便利样本进行了一项在线调查,以探讨评审员拒绝评审的原因,并确定他们对评审员激励的意见。项目采用5分Likert量表进行评分,低分表示重要性低或一致性低。结果:172名受访者提供了足够的回答进行分析。在决定接受审查论文时,被评为最重要的因素包括论文对主题领域的贡献(69.8%)、主题与自己工作的相关性(66.0%)和跟上研究进度的愿望(63.8%)。在决定拒绝审查时,最重要的被评为重要的因素是与其他工作量的冲突(69.4%),其次是提交的材料质量低、时间紧迫(两者均为65.8%),以及缺乏兴趣(65.1%)。大多数受访者都认为,如果时间限制过大,财政激励措施将无效。然而,评审员一致认为,非财务激励可能会鼓励评审员接受评审请求:期刊网站上的年度认可(78.5%),对提交结果(74.3%)和评审质量(73.0%)的更多反馈,期刊编委会评审员的任命(69.1%),以及免费订阅期刊内容(68.7%)。结论:当稿件与他们感兴趣的领域相关时,审稿人更有可能接受审稿。时间不够是决定拒绝的主要因素。评审应得到学术机构的正式认可,期刊应认可评审员的工作。
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引用次数: 1
Knowledge, attitudes, and practices about hepatitis B among medical and dental students of Karachi 卡拉奇医科和牙科学生对乙型肝炎的知识、态度和做法
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.4103/ijmbs.ijmbs_140_20
N. Khan, Saba Asghar, Hassaan Ahmed, Muhammad Khan
Objective: The objective of the study was to assess the knowledge, attitude, and practices (KAP) about Hepatitis B virus (HBV) among the students of medical and dental colleges of Karachi. Methodology: The cross-sectional study was conducted in five medical and dental colleges of Karachi. Students of the 3rd, 4th, and final year were invited to join the study. The questionnaire included sociodemographic information followed by three sections evaluating the knowledge, attitudes, and practices regarding HBV. Twenty-nine questions were related to knowledge, 11 for attitude, and 4 for practices. Pearson's Chi-square test/Fisher's Exact test and Spearman correlation were utilized to find the association and correlation of knowledge, attitudes, and practices with independent variables. Results: Three hundred and seventy-nine students participated in the study. Two hundred and nine of them (78.9%) were females and 253 (66.8%) students were medical students. Ninety-five percent of the students correctly responded of the causative organism of HBV. Knowledge of MBBS and BDS students for transmission of HBV were significantly different for the questions: “mother to child,” coughing and sneezing' and “kissing.” Almost all the responses regarding complications due to HBV (respiratory failure, stroke, congestive heart failure liver, cirrhosis, colorectal cancer, and spine and bone fracture) received more than 90% of correct answers. In response to contraindication factors for HBV, only “extreme of ages” showed a significant difference between the genders. The percentage of poor, moderate, and good knowledge were 17.4%, 53%, and 29.6% respectively. About 60% of students indicated that they have gone through screening for HBV. About 20% of students indicated that they had experience of needle injury and only 43% of them taken postexposure prophylactic measures. Conclusion: Study revealed that the KAP of medical and dental students of Karachi are satisfactory and have been improved. However, few elements need to be focused in curricula and workshops for further improvement.
目的:本研究旨在评估卡拉奇医学院和牙科学院学生对乙型肝炎病毒(HBV)的知识、态度和行为(KAP)。方法:横断面研究在卡拉奇的五所医学和牙科学院进行。第三年、第四年和最后一年的学生被邀请参加这项研究。问卷包括社会人口统计信息,然后分三个部分评估有关HBV的知识、态度和实践。29个问题与知识有关,11个问题与态度有关,4个问题与实践有关。利用皮尔逊卡方检验/费雪精确检验和斯皮尔曼相关性来发现知识、态度和实践与自变量的关联和相关性。结果:379名学生参与了这项研究。其中女性299人(78.9%),医学生253人(66.8%)。百分之九十五的学生对乙肝病毒的病原体反应正确。MBBS和BDS学生对乙肝病毒传播的知识在“母婴”、“咳嗽和打喷嚏”和“接吻”等问题上有显著差异。几乎所有关于乙肝病毒并发症(呼吸衰竭、中风、充血性心力衰竭、肝、肝硬化、癌症、脊柱和骨折)的回答都获得了90%以上的正确答案。在对HBV禁忌症因素的反应中,只有“极端年龄”显示出性别之间的显著差异。知识贫乏、中等和良好的比例分别为17.4%、53%和29.6%。大约60%的学生表示他们已经通过了乙肝病毒筛查。约20%的学生表示他们有针头受伤的经历,只有43%的学生采取了暴露后的预防措施。结论:研究表明,卡拉奇医科和牙科学生的KAP状况良好,且有所改善。然而,在课程和讲习班中需要重点关注的内容很少,以便进一步改进。
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引用次数: 1
Memorizing medicine faster and better 更快更好地记忆药物
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.4103/ijmbs.ijmbs_19_21
I. Hajjaji
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引用次数: 0
Solid organ transplantation medicine in Arab countries: A Narrative Review Focused on Ethical Aspects 阿拉伯国家的实体器官移植医学:一个关注伦理方面的叙述性综述
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.4103/ijmbs.ijmbs_16_21
K. Bel’eed-Akkari, Khadija Hafidh, I. Hajjaji, S. Beshyah, E. Elkhammas
Introduction: Ethical issues have been at the center of transplantation medicine for the past 60 years. Arab countries are not without ethical concerns with living donations as the dominant type of organ source. There is no comprehensive review of the ethical consideration evolvement. This narrative review aims to examine the English medical literature over the past 25 years. Materials and Methods: This is a narrative review of the international literature from two online databases (PubMed and Scopus). The combined search term “Ethics and Transplantation” was coupled with the individual names of the countries of the Arab countries. Relevant literature was narrated in a concise thematic account. Results: The themes that emerged from the review process included global concern on transplantation ethics that touched on the Middle East and North Africa (MENA) region. Some reports on transplantation practice status in the MENA region address clinical practice, organization, and ethical considerations. Organ-specific reports focused on renal and liver transplantation. Several other researchers addressed the knowledge and attitudes of health-care professionals of transplantation and posttransplantation care. The ethics of transplantation medicine has focused on the donation and financially motivated provision of organs (mainly kidneys). A few authors have underscored the implications of the Istanbul declaration on the prevention of trafficking of human organs to the practice of transplant medicine. Being a Muslim-majority region, several authors addressed the ethical and medicolegal aspects of transplantation from an Islamic perspective. Conclusions: Ethical issues in transplantation are evolving in Arab countries. They are mostly related to religious and cultural backgrounds. A broader dialog between the medical community, Islamic scholars, and legislators must continue to align concepts such as brain death and donor compensation. Furthermore, a concerted effort is required to inform the public and further the transplant agenda.
在过去的60年里,伦理问题一直是移植医学的中心问题。对于以活体捐献作为主要器官来源,阿拉伯国家并非没有伦理上的担忧。对伦理考虑的演变没有全面的回顾。这篇叙事性综述旨在研究过去25年来的英国医学文献。材料和方法:这是一篇来自两个在线数据库(PubMed和Scopus)的国际文献的叙述性综述。“伦理与移植”的组合搜索词与阿拉伯国家的个别国家的名称结合在一起。有关文献以简明扼要的专题叙述。结果:审查过程中出现的主题包括全球对移植伦理的关注,涉及中东和北非(MENA)地区。一些关于中东和北非地区移植实践现状的报告涉及临床实践、组织和伦理考虑。器官特异性报告主要集中在肾和肝移植。其他几位研究人员讨论了卫生保健专业人员对移植和移植后护理的知识和态度。移植医学的伦理问题集中在器官(主要是肾脏)的捐赠和经济动机上。一些作者强调了《关于防止贩运人体器官的伊斯坦布尔宣言》对移植医学实践的影响。作为一个穆斯林占多数的地区,一些作者从伊斯兰的角度讨论了移植的伦理和医学方面的问题。结论:在阿拉伯国家,移植的伦理问题正在演变。它们大多与宗教和文化背景有关。医学界、伊斯兰学者和立法者之间的广泛对话必须继续使脑死亡和捐赠者赔偿等概念保持一致。此外,需要协调一致的努力来告知公众并进一步推动移植议程。
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引用次数: 0
A new year, a new index, and more hope 新的一年,新的指数,更多的希望
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.4103/ijmbs.ijmbs_25_21
S. Beshyah, I. Hajjaji, E. Elkhammas
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引用次数: 0
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Ibnosina Journal of Medicine and Biomedical Sciences
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