Waiting it out: Consultation delays prolong in-patient length of stay
Postgraduate Medical Journal
View details for DOI 10.1136/postgradmedj-2018-136269
Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities.
Asian American Pacific Islander (AAPI) sexual and gender minorities (SGM) face unique challenges in mental health and accessing high-quality health care.The objective of this study was to identify barriers and facilitators for shared decision making (SDM) between AAPI SGM and providers, especially surrounding mental health.Interviews, focus groups, and surveys.AAPI SGM interviewees in Chicago (n=20) and San Francisco (n=20). Two focus groups (n=10) in San Francisco.Participants were asked open-ended questions about their health care experiences and how their identities impacted these encounters. Follow-up probes explored SDM and mental health. Participants were also surveyed about attitudes towards SGM disclosure and preferences about providers. Transcripts were analyzed for themes and a conceptual model was developed.Our conceptual model elucidates the patient, provider, and encounter-centered factors that feed into SDM for AAPI SGM. Some participants shared the stigma of SGM identities and mental health in their AAPI families. Their AAPI and SGM identities were intertwined in affecting mental health. Some providers inappropriately controlled the visibility of the patient's identities, ignoring or overemphasizing them. Participants varied on whether they preferred a provider of the same race, and how prominently their AAPI and/or SGM identities affected SDM.Providers should understand identity-specific challenges for AAPI SGM to engage in SDM. Providers should self-educate about AAPI and SGM history and intracommunity heterogeneity before the encounter, create a safe environment conducive to patient disclosure of SGM identity, and ask questions about patient priorities for the visit, pronouns, and mental health.
View details for DOI 10.1097/MLR.0000000000001212
View details for PubMedID 31567862
Assessment of readability and content of patient-initiated google search results for epidermolysis bullosa.
Epidermolysis bullosa describes a group of conditions commonly characterized by fragile skin and blistering of the mucosal membranes. Due to the complex and rare nature of the disease, we sought to evaluate the quality and readability of epidermolysis bullosa information available online. Analysis of the top 50 search results on Google demonstrated that information by non-dermatologists was of a lower reading level and more accessible when compared to information by dermatologists, even though dermatologist written information was more likely to be useful and medically comprehensive. There is an increasing need for dermatologists to provide useful and medically comprehensive EB information that is accessible to patients and patient families.
View details for DOI 10.1111/pde.13975
View details for PubMedID 31468562
Emerging technologies for health information in dermatology: opportunities and drawbacks of web-based searches, social media, mobile applications, and direct-to-consumer genetic testing in patient care.
Seminars in cutaneous medicine and surgery
2019; 38 (1): E57?E53
Emerging technology is fundamentally changing how individuals interact with the health care system. Web-based searches, mobile applications, social media, and directto- consumer genetic testing companies are facilitating information exchange at a higher rate than ever before, creating a macroscopic shift in the mechanisms by which individuals seek health information. The visual nature of skin disease enables individuals to browse, share, and search based on images, adding another dimension to how dermatological information is transferred. These trends carry important implications on user health care behavior, and so it is vital for health care professionals to stay attuned to the morphing characteristics of their patients' health management in order to continue to provide high-quality, patient-centered care.
View details for PubMedID 31051025
Navigating Controversy: A Critical Element of Medical Education.
Academic medicine : journal of the Association of American Medical Colleges
2018; 93 (12): 1750
View details for PubMedID 30489297
Shared Decision Making Among Clinicians and Asian American and Pacific Islander Sexual and Gender Minorities: An Intersectional Approach to Address a Critical Care Gap
2016; 3 (5): 327-334
Shared decision making (SDM) is a model of patient-provider communication. Little is known about the role of SDM in health disparities among Asian American and Pacific Islander (AAPI) sexual and gender minorities (SGM). We illustrate how issues at the intersection of AAPI and SGM identities affect SDM processes and health outcomes. We discuss experiences of AAPI SGM that are affected by AAPI heterogeneity, SGM stigma, multiple minority group identities, and sources of discrimination. Recommendations for clinical practice, research, policy, community development, and education are offered.
View details for DOI 10.1089/lgbt.2015.0143
View details for Web of Science ID 000384689500002
View details for PubMedID 27158858
Addressing Barriers to Shared Decision Making Among Latino LGBTQ Patients and Healthcare Providers in Clinical Settings
2016; 3 (5): 335-341
Effective shared decision making (SDM) between patients and healthcare providers has been positively associated with health outcomes. However, little is known about the SDM process between Latino patients who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ), and their healthcare providers. Our review of the literature identified unique aspects of Latino LGBTQ persons' culture, health beliefs, and experiences that may affect their ability to engage in SDM with their healthcare providers. Further research needs to examine Latino LGBTQ patient-provider experiences with SDM and develop tools that can better facilitate SDM in this patient population.
View details for DOI 10.1089/lgbt.2016.0014
View details for Web of Science ID 000384689500003
View details for PubMedID 27617356