North Carolina medical journal 

About: North Carolina medical journal is an academic journal published by North Carolina Medical Society Foundation's Community Practitioner Program. The journal publishes majorly in the area(s): Health care & Poison control. It has an ISSN identifier of 0029-2559. It is also open access. Over the lifetime, 3228 publications have been published receiving 16001 citations. The journal is also known as: NCMJ & North Carolina medical journal for doctors and their patients.

Moral Injury: An Intersection for Psychological and Spiritual Care.

Abstract: An Afghanistan veteran who I treated years ago relayed to me an experience from one of his deployments wherein he came upon a rural village shortly after enemy forces had brutally killed many civilians there, including young children. The veteran reported that this event spurred him to begin going outside of his official duties to, as he put it, “hunt down the monsters” responsible for the atrocities he had seen. Treatment with prolonged exposure was effective in reducing some of his key symptoms of post-traumatic stress disorder, such as re-experiencing and avoidance. However, since the patient ceased attending therapy sessions after experiencing these improvements, it remained unclear how well treatment affected his moral wounds: his sense of turning into a monster himself, his view of others as fundamentally immoral, his sense of being betrayed by the military, and his loss of the spiritual framework that had guided his sense of morality prior to service. Mental health professionals who care for veterans commonly see such patients, and these patients are beginning to have aspects of their experience described with a new term—moral injury. The concept of moral injury was originally introduced by psychiatrist Johnathan Shay in his 1994 book Achilles in Vietnam [1]. Shay defined moral injury as consisting of 3 elements: 1) a betrayal of what is right, 2) by someone who holds legitimate authority, 3) in a high-stakes situation [2]. More recent definitions of moral injury conceptualize it as a broader phenomenon than that captured by Shay's definition. Psychologist…

The US Preventive Services Task Force What Is It and What Does It Do

Abstract: The US Preventive Services Task Force (USPSTF) is an independent body comprised of national experts in prevention and evidence-based medicine. The primary audience for the USPSTF's work is primary care clinicians, and many consider the Task Force's recommendations to be definitive standards for preventive services.

The relationship between patient's perceived waiting time and office-based practice satisfaction.

Abstract: Background The amount of waiting time a patient experiences in a primary care or specialty care outpatient setting may have an effect on patient satisfaction and may depend on other visit characteristics. We sought to investigate and quantify the association between waiting time and satisfaction outcomes in clinics belonging to the Wake Forest University Baptist Medical Center and assess how this relationship varies by time spent with the provider. Methods Cross-sectional survey data was collected at point of care from 18 primary and specialty care clinics at the Center Overall satisfaction with provider care, the office ratings, and willingness to return were each rated on a 0-to-10-point scale. Multivariate and logistic regressions were performed to examine the relationship between waiting time and outcomes. Covariates included visit time spent with physician, patient care processes, visit convenience, and demographics. Results 2,444 cases were analyzed Waiting time significantly predicted provider ratings. When time spent with the physician was five minutes or less, provider ratings decreased by 0.3 rating points for each 10-minute increase in waiting time. When time spent with the physician was greater than five minutes, provider ratings decreased by 0.1 rating points for each 10-minute increase in waiting time. The association between waiting time and office satisfaction showed a similar pattern; increased waits also decreased willingness to return (odds decrease by 2% per minute). Limitations Results may be affected by unreliability of the measures used and from possible selection bias. There is also concern over missing confounders. Conclusions Our findings confirm that reduced waiting time may lead to increased patient satisfaction and greater willingness to return in primary and specialty care outpatient settings. Furthermore, increased waiting time combined with reduced time spent with the physician coincide with noticeable drops in patient satisfaction.

Physical and Mental Health Among Cancer Survivors Considerations for Long-Term Care and Quality of Life

Abstract: The physical and mental health of cancer patients needs to be addressed not only during active treatment but also throughout the continuum of survivorship care. This commentary provides an overview of issues pertinent to cancer survivors, with an emphasis on mental health issues and recommendations for annual clinical screening and monitoring using recently published guidelines from the American Society of Clinical Oncology.