***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A clinical r and omized study ( posttest design ) was conducted to examine whether patient-centered care ( PCC ) impacts  patient satisfaction , perception of nursing care , and quality of care . Differences were seen in 2 of 3 subscales within the Baker and Taylor Measurement Scale .  The PCC group rated satisfaction ( P = .04 ) and quality of services ( P = .03 ) higher than controls .  PCC may impact patients ' perception of the level of satisfaction and quality of care received Abstract OBJECTIVE : There is a well-documented gap between diabetes care guidelines and the services received by patients in almost all health care setting s. This project reports initial results from a computer-assisted , patient-centered intervention to improve the level of recommended services received by patients from a wide variety of primary care providers . DESIGN AND SETTING S : Eight hundred eighty-six patients with type 2 diabetes under the care of 52 primary care physicians participated in the Diabetes Priority Program . Physicians were stratified and r and omized to intervention or control conditions and evaluated on 2 primary outcomes : number of recommended laboratory screenings and recommended patient-centered care activities completed . Secondary outcomes were evaluated using the Problem Areas in Diabetes scale and the Patient Health Question naire (PHQ)-9 depression scale , and the RE- AIM framework was used to evaluate potential for dissemination . RESULTS : The program was well-implemented and significantly improved both number of recommended laboratory assays ( 3.4 vs 3.1 ; P<.001 ) and patient-centered aspects of diabetes care patients received ( 3.6 vs 3.2 ; P<.001 ) compared to those in r and omized control practice s. Activities that were increased most were foot exams ( follow-up rates of 80 % vs 52 % ; P<.003 ) and nutrition counseling ( 76 % vs 52 % ; P<.001 ) . CONCLUSIONS : Patients are very willing to participate in a brief computer-assisted intervention that is effective in enhancing quality of diabetes care . Staff in primary care offices can consistently deliver an intervention of this nature , but most physicians were unwilling to participate in this translation research study BACKGROUND Recent studies have suggested that there is a positive impact of patient-centered care ( PCC ) on both the patient-physician relationship and subsequent patient health-related behaviors . One recent prospect i ve study reported a significant relationship between the degree of PCC experienced by patients during their hospitalization for acute myocardial infa rct ion ( AMI ) and their postdischarge cardiac symptoms . A limitation of this study , however , was a lack of information regarding the technical quality of the AMI care , which might have explained at least part of the differences in outcomes . The present study was undertaken to test the influence of both PCC and technical care quality on outcomes among AMI patients . METHODS We analyzed data from a national sample of 1,858 veterans hospitalized for an initial AMI in a Department of Veterans Affairs medical center during fiscal years 2003 and 2004 for whom data had been compiled on evidence -based treatment and who had also completed a Picker question naire assessing perceptions of PCC .  Cox proportional hazards models were used to estimate the relationship between  PCC  and survival 1-year postdischarge , controlling for technical quality of care , patient clinical condition and history , admission process characteristics , and patient sociodemographic characteristics . We hypothesized that better PCC would be associated with a lower probability of death 1-year postdischarge , even after controlling for patient characteristics and the technical quality of care . RESULTS Better PCC was associated with a significantly but modestly lower hazard of death over the 1-year study period ( hazard ratio 0.992 , 95 percent confidence interval 0.986 - 0.999 ) . CONCLUSIONS Providing PCC may result in important clinical benefits , in addition to meeting patient needs and expectations BACKGROUND Patient-centered Assessment and Counseling on Exercise plus nutrition ( PACE+ ) is an intervention based in primary care setting s to help patients change physical activity and dietary behaviors . METHODS One hundred seventy-three adults were assessed before and after a 4-month intervention . All patients completed a computerized assessment and created tailored " action plans " to change one physical activity and one nutrition behavior that they then discussed with their provider . After the visit , subjects were r and omized to one of four extended intervention conditions : control , mail only , infrequent phone and mail , and frequent phone and mail . Self-report of five target behaviors ( moderate and vigorous physical activity stage of change , dietary fat , fruit/vegetable intake , and overeating behaviors ) was collected at baseline and 4 months . Acceptability measures were also taken . RESULTS Participants in all conditions improved on all behaviors over time , supporting the utility of the computer and provider counseling components . The extended intervention did not produce differential results with respect to mode ( phone or mail ) or intensity ( frequent or infrequent ) . However , for each behavior , participants who targeted the behavior to change improved significantly more than those who did not target the behavior . Acceptability of the intervention was high . CONCLUSIONS Primary care-based , interactive health communication to improve physical activity and dietary behavior is feasible and has promising initial results The aim of this paper is to assess whether patient-centred consultations are more effective than the usual style of consultations used by general practitioners with patients suffering from benign chronic musculoskeletal pain and fibromyalgia . It also seeks to evaluate the differential characteristics of these two clinical groups of symptoms . The study was design ed as a cluster r and omised and simple blind trial . Twenty general practitioners took part and 110 patients were recruited . Compared with patients who received the usual treatment from their family physician , those who received a patient-centred approach showed greater improvement after 1 year in terms of psychological distress ( anxiety ) and number of tender points , as well as showing positive trends in some important outcomes such as pain intensity . Significantly better results were observed in those patients suffering chronic pain than in those with fibromyalgia , particularly as regards associated symptoms , self-rated pain and physical mobility as measured by the Nottingham health profile OBJECTIVE To study the effects of a comprehensive discharge planning protocol , design ed specifically for the elderly and implemented by nurse specialists , on  patient and caregiver outcomes and cost of care . DESIGN R and omized clinical trial . SETTING Hospital of the University of Pennsylvania . PATIENTS 276 patients and 125 caregivers . Patients were 70 years and older and were placed in selected medical and surgical cardiac diagnostic-related groups . MEASUREMENTS Group differences in patient outcomes ( length of initial hospital stay , length of time between initial hospital discharge and readmission , and rehospitalization rates ) and charges for care ( charges for initial hospitalization , rehospitalizations , health services after discharge , and nurse specialist services ) were measured 2 , 6 , and 12 weeks after discharge . RESULTS From the initial hospital discharge to 6 weeks after discharge , patients in the medical intervention group had fewer readmissions , fewer total days rehospitalized , lower readmission charges , and lower charges for health care services after discharge . No differences in these outcomes were found between the surgical intervention and control groups during this period . CONCLUSIONS Study findings support the need for comprehensive discharge planning design ed for the elderly and implemented by nurse specialists to improve their outcomes after hospital discharge and to achieve cost savings . The findings also suggest that this intervention had its greatest effect in delaying or preventing rehospitalization of patients in the medical intervention group during the first 6 weeks after discharge In a r and omised trial , general practitioners and nurses in 21 practice s were trained in patient-centred consulting and use of material s for people with Type 2 diabetes ( GPs 0.5 days ; nurses 1.5 days ; two optional follow-up half-days ) . Twenty practice s formed the comparison group . Professional beliefs , attitudes and behaviour were measured ( pre-trial , close-of-course and end-of-trial ) , supported by patient reports of  nurse behaviour ( 141 trained : 108 comparison patients , 1 year after diagnosis ) . A total of 49 practice nurses responded ( 29 trained ; 20 comparison ) . Trained nurses rated relative importance of patient-centred to professional-centred care as greater than comparison nurses . Trained nurses became less keen on the approach during the trial , and perceived time constraints persisted . Patients diagnosed later in the study were less likely to recognise intervention material s. Trained nurses rated delivery of important aspects of care and satisfaction with style of care as lower than comparison nurses , but patients were more positive about delivery of care from trained than comparison nurses . Although nurses rated patient-centred care as important , whether or not they had been trained as part of the trial , the short , generalizable training programme significantly reduced nurse perceptions of their ability to deliver it . Nonetheless , patients reported that important aspects of diabetes care were delivered more if their nurses had been trained in patient-centred consulting . This raises issues concerning measurement scales completed by trained professionals Background : Among breast cancer patients , tamoxifen use is associated with reduced risk of disease relapse and death , but it is often difficult for women to sustain therapy during the 5 years required to obtain maximum benefit . Objectives : We sought to examine the influence of patient-centered care activities on ongoing tamoxifen use 4 years after initiation , we examined key components of patient-centered care and rates of ongoing tamoxifen . Methods : Using a prospect i ve cohort study that included observational data from the National Initiative for Cancer Care Quality ( NICCQ ) , we studied 881 patients with stage I-III breast cancer who were registered with an initial diagnosis in 1998 by an American College of Surgeons-approved hospital cancer registry in 1 of 5 metropolitan areas , who initiated tamoxifen treatment .  A patient survey and medical record abstract ion were used as measurements . Results : Among women who initiated tamoxifen , 79 % were still taking it 4 years later . Other than older age and the severity of side effects , other demographic , clinical and cancer characteristics , and treatments did not predict ongoing tamoxifen use . In contrast , after adjusting for these factors , the proportion of patients with ongoing tamoxifen use was lower for patients reporting less support than needed ( 82 % vs. 69 % , P = 0.0051 ) , less than wanted role in decision-making ( 80 % vs. 70 % , P = 0.0486 ) , decision-making about tamoxifen without doctor input ( 79 % vs. 64 % , P = 0.0182 ) , and for patients who were n't told about side effects in advance ( 82 % vs. 72 % , P = 0.0016 ) . Conclusions : Although age and the severity of side-effects remain important , patient-centered care was a primary mediator of patient adherence to ongoing cancer treatment with tamoxifen BACKGROUND Older persons frequently experience a decline in function following an acute medical illness and hospitalization . OBJECTIVE To test the hypothesis that a multicomponent intervention , called Acute Care for Elders ( ACE ) , will improve functional outcomes and the process of care in hospitalized older patients . DESIGN R and omized controlled trial . SETTING Community teaching hospital . PATIENTS A total of 1,531 community-dwelling patients , aged 70 or older , admitted for an acute medical illness between November 1994 and May 1997 . INTERVENTION ACE includes a specially design ed environment ( with , for example , carpeting and uncluttered hallways ) ; patient-centered care , including nursing care plans for prevention of disability and rehabilitation ; planning for patient discharge to home ; and review of medical care to prevent iatrogenic illness . MEASUREMENTS The main outcome was change in the number of independent activities of daily living ( ADL ) from 2 weeks before admission ( baseline ) to discharge . Secondary outcomes included re source use , implementation of orders to promote function , and patient and provider satisfaction . RESULTS Self-reported measures of function did not differ at discharge between the intervention and usual care groups by intention-to-treat analysis . The composite outcome of ADL decline from baseline or nursing home placement was less frequent in the intervention group at discharge ( 34 % vs 40 % ; P = .027 ) and during the year following hospitalization ( P = .022 ) . There were no significant group differences in hospital length of stay and costs , home healthcare visits , or readmissions . Nursing care plans to promote independent function were more often implemented in the intervention group ( 79 % vs 50 % ; P = .001 ) , physical therapy consults were obtained more frequently ( 42 % vs 36 % ; P = .027 ) , and restraints were applied to fewer patients ( 2 % vs 6 % ; P = .001 ) . Satisfaction with care was higher for the intervention group than the usual care group among patients , caregivers , physicians , and nurses ( P < .05 ) . CONCLUSIONS ACE in a community hospital improved the process of care and patient and provider satisfaction without increasing hospital length of stay or costs . A lower frequency of the composite outcome ADL decline or nursing home placement may indicate potentially beneficial effects on patient outcomes BACKGROUND We design ed this observational cohort study to assess the association between patient-centered communication in primary care visits and subsequent health and medical care utilization . METHODS We selected 39 family physicians at r and om , and 315 of their patients participated . Office visits were audiotaped and scored for patient-centered communication . In addition , patients were asked for their perceptions of the patient-centeredness of the visit . The outcomes were : ( 1 ) patients ' health , assessed by a visual analogue scale on symptom discomfort and concern ; ( 2 ) self-report of health , using the Medical Outcomes Study Short Form-36 ; and ( 3 ) medical care utilization variables of diagnostic tests , referrals , and visits to the family physician , assessed by chart review . The 2 measures of patient-centeredness were correl 
    Output:
    
Results found mixed relationships between  PCC and clinical outcomes , that is , some studies found significant relationships between specific elements of PCC and outcomes but others found no relationship .
There was stronger evidence for positive influences of PCC  on satisfaction and self-management .