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PubMed · 10138699

Problem knowledge couplers: can they extend our ability to use practice guidelines?

L L Weed
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Abstract

New information tools enable us to leave behind a world of medical practice in which providers of all sorts have been allowed to operate in the face of avoidable ignorance of relevant details from the medical literature as well as details about a given patient. Furthermore, the new tools can assist providers and patients alike in trying to process vast amounts of information in the course of everyday medical care. In the following article, the author discusses some of these new tools and how they can best be utilized.

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CommunicationComputer SystemsDecision MakingHumansInformation SystemsPatient Education as TopicPatient ParticipationPhysician-Patient RelationsPractice Guidelines as TopicUnited StatesJournal Article

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L L Weed. 1994. Problem knowledge couplers: can they extend our ability to use practice guidelines?. https://pubmed.ncbi.nlm.nih.gov/10138699/

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Information-sharing among couples considering multifetal pregnancy reduction.

OBJECTIVE: To determine the information-sharing strategies of couples considering fetal reduction, and the impact of these strategies on the chances of encountering hostility in their social networks. DESIGN: Cross-sectional design of semistructured qualitative interviews, coded with respect to sharing strategies and level of personally directed hostility encountered. SETTING: Multiple Pregnancy Management Program, Comprehensive Genetics, New York, New York. PATIENT(S) AND INTERVENTION(S): Fifty women and their partners who were making a first visit to our maternal-fetal management facility, in order to consider the possibility of multifetal reduction as a pregnancy-management strategy. MAIN OUTCOME MEASURE(S): Development of information-sharing strategies, and the chances of encountering personally directed hostility regarding multifetal reduction associated with more and less selective strategies. RESULT(S): Four information-sharing strategies emerged from the analysis. Two of these strategies were relatively open (extended network, and both parents). Two other strategies were relatively selective (qualified family and friends, and defended relationship). The selective strategies were significantly less likely to encounter to encounter personally directed hostility (odds ratio, 3.88; 95% confidence intervals, 0.87-17.30). CONCLUSION(S): Selective sharing of information for couples considering multifetal prgnancy reduction is a potentially useful strategy for moderating potentially stressful relationships in their social networks. Clinics should find a way of integrating the discussion of selective sharing into their clinic's cultural repertoire of patient-support services.

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