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In Europe diabetes mellitus vs diabetes ketoacidosis buy cheap cozaar 25 mg on-line, the prevalence ranges from 14% in Greece to 75% among Italian patients [79]. A recent survey of patients in a large cancer center in the United States [80] indicated that 83% of patients had used at least one complementary or alternative 334 Supportive care approach, the most common of these being spiritual practices, followed by vitamins and herbs, then movement and physical therapies. This differs somewhat from practices in European and Asian countries, where more herbs and supplements are used. Patients report that they engage in complementary therapies to increase their hope or to enhance their sense of control by participation in their treatment. In some cases, the use of complementary cancer treatments may be a marker for increased patient distress or may be associated with a delay in seeking treatment. Few cancer patients use alternative treatments in lieu of conventional cancer treatment, however. Only a relatively small percentage of patients discuss use of these treatments with their oncologist, even though some therapies may interact unfavorably with cancer drugs. Patients may feel that it is not important or that their doctor is not interested. It is recommended, therefore, that oncologists routinely ask patients about their use of complementary and alternative medicines. Adjuvant chemotherapy for breast cancer: how presentation of recurrence risk influences decision-making. Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease. Physician-patient communication: the relationship with malpractice claims among primary care physicians and surgeons. Role of health-related quality of life in palliative chemotherapy treatment decisions. The Cancode interaction analysis system in the oncological setting: reliability and validity of video and audio tape coding. One suggested model is composed of seven stages of communication research, the goal of which is to provide a guiding structure for bringing coherence to oncology communication [81]. The stages in this model are: (1) identification of communication difficulties; (2) documentation of patient and clinician views; (3) identification of practices associated with better outcomes; (4) development of evidence-based guidelines and interventions; (5) testing of the effectiveness of the intervention in changing current practice and improving patient outcomes; (6) dissemination of the effective interventions; and (7) broad adoption of the intervention.

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