Patients' experience of going through the diagnostic phase in hospital is apt to be overlooked by nurses and physicians; most of their inner preparative work for receiving the diagnosis is hidden because of the vulnerability of the situation. This paper discusses findings from a grounded theory study, of 18 in-depth interviews of 15 patients going through medical investigation at a gastric ward in a Norwegian university hospital. The interviews were conducted in 2002-2003. The generated 'Preparative Waiting Theory', which accounts for how patients in the diagnostic phase work to prepare themselves for receiving a diagnosis, is discussed in relation to the Danish theologian and philosopher Løgstrup's writings about the ethical demand and life utterances of trust, openness and the untouchable zone. The ethical demand from patients going through medical investigations is silent and radical, and thus challenging for nurses and physicians to judge how to best fulfil. Examples from the interviews are used to illustrate patients' vulnerability as they prepare to face the conclusion about their case. To the extent trust develops between patients and nurses/physicians, patients can reveal what is at stake in their lives without feeling exposed or embarrassed. Because of the power nurses and physicians have in the healthcare system, and because of laws, morals and conventions guiding practice, we have a professional responsibility to develop a culture that fosters the ability and willingness to take care of our patients.
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http://dx.doi.org/10.1111/j.1471-6712.2008.00595.x | DOI Listing |
Brain Behav Immun Health
February 2025
Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases-IRCAD, University of Eastern Piedmont, 28100, Novara, Italy.
Major Depressive Disorder (MDD) is a widespread psychiatric condition impacting social and occupational functioning, making it a leading cause of disability. The diagnosis of MDD remains clinical, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria, as biomarkers have not yet been validated for diagnostic purposes or as predictors of treatment response. Traditional treatment strategies often follow a one-size-fits-all approach obtaining suboptimal outcomes for many patients who fail to experience response or recovery.
View Article and Find Full Text PDFUnlabelled: Transparent and accurate reporting in early phase dose-finding (EPDF) clinical trials is crucial for informing subsequent larger trials. The SPIRIT statement, designed for trial protocol content, does not adequately cover the distinctive features of EPDF trials. Recent findings indicate that the protocol contents in past EPDF trials frequently lacked completeness and clarity.
View Article and Find Full Text PDFUnlabelled: Early phase dose-finding (EPDF) trials are key in the development of novel therapies, with their findings directly informing subsequent clinical development phases and providing valuable insights for reverse translation. Comprehensive and transparent reporting of these studies is critical for their accurate and critical interpretation, which may improve and expedite therapeutic development. However, quality of reporting of design characteristics and results from EPDF trials is often variable and incomplete.
View Article and Find Full Text PDFDiabetol Int
January 2025
Department of Endocrinology, Metabolism and Diabetes, Faculty of Medicine, Kindai University, 377-2, Ohnohigashi, Osaka-Sayama, Osaka 589-8511 Japan.
Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non-insulin-dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase.
View Article and Find Full Text PDFIntroduction: -mutant NSCLC is associated with low mutation burden and low levels of PD-L1 expression. We conducted a phase 2 trial to determine the efficacy of durvalumab, tremelimumab, and platinum-pemetrexed in mutant NSCLC after progression with EGFR tyrosine kinase inhibitors (TKIs).
Methods: Participants were treated with induction durvalumab, tremelimumab, and platinum-pemetrexed, followed by durvalumab-pemetrexed maintenance.
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