Patients' Preferences Matter

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Publisher :
ISBN 13 : 9781857176377
Total Pages : 64 pages
Book Rating : 4.1/5 (763 download)

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Book Synopsis Patients' Preferences Matter by : Albert G. Mulley

Download or read book Patients' Preferences Matter written by Albert G. Mulley and published by . This book was released on 2012-05 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report discusses patient preference and challenges the NHS to stop 'the silent misdiagnosis' and take more account of patient preferences. It argues that by doing so it will improve not only the service offered to patients but also the performance of the health system as a whole.

Improving Diagnosis in Health Care

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Publisher : National Academies Press
ISBN 13 : 0309377722
Total Pages : 473 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis Improving Diagnosis in Health Care by : National Academies of Sciences, Engineering, and Medicine

Download or read book Improving Diagnosis in Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2015-12-29 with total page 473 pages. Available in PDF, EPUB and Kindle. Book excerpt: Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Crossing the Quality Chasm

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Publisher : National Academies Press
ISBN 13 : 0309132967
Total Pages : 359 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Crossing the Quality Chasm by : Institute of Medicine

Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Improving the Quality of Health Care for Mental and Substance-Use Conditions

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Publisher : National Academies Press
ISBN 13 : 0309133661
Total Pages : 528 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Improving the Quality of Health Care for Mental and Substance-Use Conditions by : Institute of Medicine

Download or read book Improving the Quality of Health Care for Mental and Substance-Use Conditions written by Institute of Medicine and published by National Academies Press. This book was released on 2006-03-29 with total page 528 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

Best Care at Lower Cost

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Publisher : National Academies Press
ISBN 13 : 0309282810
Total Pages : 437 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Best Care at Lower Cost by : Institute of Medicine

Download or read book Best Care at Lower Cost written by Institute of Medicine and published by National Academies Press. This book was released on 2013-05-10 with total page 437 pages. Available in PDF, EPUB and Kindle. Book excerpt: America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

Achieving Person-Centred Health Systems

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Publisher : Cambridge University Press
ISBN 13 : 1108803725
Total Pages : 421 pages
Book Rating : 4.1/5 (88 download)

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Book Synopsis Achieving Person-Centred Health Systems by : Ellen Nolte

Download or read book Achieving Person-Centred Health Systems written by Ellen Nolte and published by Cambridge University Press. This book was released on 2020-08-06 with total page 421 pages. Available in PDF, EPUB and Kindle. Book excerpt: The idea of person-centred health systems is widely advocated in political and policy declarations to better address health system challenges. A person-centred approach is advocated on political, ethical and instrumental grounds and believed to benefit service users, health professionals and the health system more broadly. However, there is continuing debate about the strategies that are available and effective to promote and implement 'person-centred' approaches. This book brings together the world's leading experts in the field to present the evidence base and analyse current challenges and issues. It examines 'person-centredness' from the different roles people take in health systems, as individual service users, care managers, taxpayers or active citizens. The evidence presented will not only provide invaluable policy advice to practitioners and policymakers working on the design and implementation of person-centred health systems but will also be an excellent resource for academics and graduate students researching health systems in Europe. This title is available as Open Access on Cambridge Core.

Understanding Racial and Ethnic Differences in Health in Late Life

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Publisher : National Academies Press
ISBN 13 : 0309165865
Total Pages : 184 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Understanding Racial and Ethnic Differences in Health in Late Life by : National Research Council

Download or read book Understanding Racial and Ethnic Differences in Health in Late Life written by National Research Council and published by National Academies Press. This book was released on 2004-09-08 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.

Registries for Evaluating Patient Outcomes

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Publisher : Government Printing Office
ISBN 13 : 1587634333
Total Pages : 385 pages
Book Rating : 4.5/5 (876 download)

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Book Synopsis Registries for Evaluating Patient Outcomes by : Agency for Healthcare Research and Quality/AHRQ

Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Finding What Matters Most to Patients

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Publisher : CRC Press
ISBN 13 : 042980430X
Total Pages : 163 pages
Book Rating : 4.4/5 (298 download)

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Book Synopsis Finding What Matters Most to Patients by : Thom Walsh

Download or read book Finding What Matters Most to Patients written by Thom Walsh and published by CRC Press. This book was released on 2019-01-10 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: Research shows that the importance of patient-reported outcomes, improved decision support, and care coordination is growing rapidly as new payment models transform healthcare delivery. This has led to the use of new measures and communication techniques, including shared decision-making and motivational interviewing. Using patient-reported outcomes at the point of service helps providers identify what matters most to the patient in front of them now. Describing treatment options and deciphering a patient’s preferences effectively is a process, which has been likened to arriving at a diagnosis. Providers make a medical diagnosis by discerning a patient’s primary complaints, past history, exam findings, and test results. A preference diagnosis can be thought of similarly. Providers work with their patients to identify what matters most to them, discuss the risks and benefits of the available treatment options, and support the patient as needed through the decision-making process. Once informed of their options, patients frequently chose treatments that require modifying their habits. Motivational interviewing helps patients and providers understand what matters most now and design care plans that provide appropriate support. While many healthcare providers and leaders may be familiar with patient-reported outcomes from research articles, and have heard of shared decision-making and motivational interviewing, few have experience using them. Fewer still understand how each relates to the other. This book helps leaders and healthcare providers better understand how to use patient-reported data to their advantage at the point of service. The book provides the background for developing shared knowledge and shared language, along with extensive examples of dialogue between providers and patients. In addition, the book contains personal interviews of subject matter experts who have significant experience using these measures. The result is a comprehensive understanding of how these measures and techniques can help providers, organizations, and patients navigate this modern healthcare management opportunity.

Measuring and Valuing Health Benefits for Economic Evaluation

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Publisher : Oxford University Press
ISBN 13 : 0198725922
Total Pages : 373 pages
Book Rating : 4.1/5 (987 download)

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Book Synopsis Measuring and Valuing Health Benefits for Economic Evaluation by : John Brazier

Download or read book Measuring and Valuing Health Benefits for Economic Evaluation written by John Brazier and published by Oxford University Press. This book was released on 2017 with total page 373 pages. Available in PDF, EPUB and Kindle. Book excerpt: There are not enough resources in health care systems around the world to fund all technically feasible and potentially beneficial health care interventions. Difficult choices have to be made, and economic evaluation offers a systematic and transparent process for informing such choices. A key component of economic evaluation is how to value the benefits of health care in a way that permits comparison between health care interventions, such as through costs per quality-adjusted life years (QALY). Measuring and Valuing Health Benefits for Economic Evaluation examines the measurement and valuation of health benefits, reviews the explosion of theoretical and empirical work in the field, and explores an area of research that continues to be a major source of debate. It addresses the key questions in the field including: the definition of health, the techniques of valuation, who should provide the values, techniques for modelling health state values, the appropriateness of tools in children and vulnerable groups, cross cultural issues, and the problem of choosing the right instrument. This new edition contains updated empirical examples and practical applications, which help to clarify the readers understanding of real world contexts. It features a glossary containing the common terms used by practitioners, and has been updated to cover new measures of health and wellbeing, such as ICECAP, ASCOT and AQOL. It takes into account new research into the social weighting of a QALY, the rising use of ordinal valuation techniques, use of the internet to collect data, and the use of health state utility values in cost effectiveness models. This is an ideal resource for anyone wishing to gain a specialised understanding of health benefit measurement in economic evaluation, especially those working in the fields of health economics, public sector economics, pharmacoeconomics, health services research, public health, and quality of life research.

Critical Challenges For Health Care Reform In Europe

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Publisher : McGraw-Hill Education (UK)
ISBN 13 : 0335199704
Total Pages : 442 pages
Book Rating : 4.3/5 (351 download)

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Book Synopsis Critical Challenges For Health Care Reform In Europe by : Saltman , Richard B.

Download or read book Critical Challenges For Health Care Reform In Europe written by Saltman , Richard B. and published by McGraw-Hill Education (UK). This book was released on 1998-10-01 with total page 442 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume explores the central issues driving the present process of healthcare reform in Europe. 17 chapters written by scholars and policy makers from all parts of Europe draw together the available evidence from epidemiology and public health, economics, public policy, organizational behaviour and management theory as well as real world policy making experience, laying out the options that health sector decision-makers confront. Through its cross-disciplinary, cross-national approach, the book highlights the underlying trends that now influence health policy formulation across Europe. An authoritative introduction provides a broad synthesis of present trends and strategies in European health policy.

Health Professions Education

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Publisher : National Academies Press
ISBN 13 : 030913319X
Total Pages : 191 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Health Professions Education by : Institute of Medicine

Download or read book Health Professions Education written by Institute of Medicine and published by National Academies Press. This book was released on 2003-07-01 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Making Healthcare Safe

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Publisher : Springer Nature
ISBN 13 : 3030711234
Total Pages : 450 pages
Book Rating : 4.0/5 (37 download)

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Book Synopsis Making Healthcare Safe by : Lucian L. Leape

Download or read book Making Healthcare Safe written by Lucian L. Leape and published by Springer Nature. This book was released on 2021-05-28 with total page 450 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.

Responsibility in Health Care

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Publisher : Springer Science & Business Media
ISBN 13 : 9400978316
Total Pages : 294 pages
Book Rating : 4.4/5 (9 download)

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Book Synopsis Responsibility in Health Care by : G.J. Agich

Download or read book Responsibility in Health Care written by G.J. Agich and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 294 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicine is a complex social institution which includes biomedical research, clinical practice, and the administration and organization of health care delivery. As such, it is amenable to analysis from a number of disciplines and directions. The present volume is composed of revised papers on the theme of "Responsibility in Health Care" presented at the Eleventh Trans Disciplinary Symposium on Philosophy and Medicine, which was held in Springfield, illinois on March 16-18, 1981. The collective focus of these essays is the clinical practice of medicine and the themes and issues related to questions of responsibility in that setting. Responsibility has three related dimensions which make it a suitable theme for an inquiry into clinical medicine: (a) an external dimension in legal and political analysis in which the State imposes penalties on individuals and groups and in which officials and governments are held accountable for policies; (b) an internal dimension in moral and ethical analysis in which individuals take into account the consequences of their actions and the criteria which bear upon their choices; and (c) a comprehensive dimension in social and cultural analysis in which values are ordered in the structure of a civilization ([8], p. 5). The title "Responsibility in Health Care" thus signifies a broad inquiry not only into the ethics of individual character and actions, but the moral foundations of the cultural, legal, political, and social context of health care generally.

Patient Safety and Quality

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Author :
Publisher : Department of Health and Human Services
ISBN 13 :
Total Pages : 592 pages
Book Rating : 4.:/5 (318 download)

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Book Synopsis Patient Safety and Quality by : Ronda Hughes

Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Delivering High-Quality Cancer Care

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Publisher : National Academies Press
ISBN 13 : 9780309286602
Total Pages : 0 pages
Book Rating : 4.2/5 (866 download)

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Book Synopsis Delivering High-Quality Cancer Care by : Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population

Download or read book Delivering High-Quality Cancer Care written by Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population and published by National Academies Press. This book was released on 2014-01-10 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine--having increased to $125 billion in 2010 from $72 billion in 2004--and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older--the group most susceptible to cancer--is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.

Health Professional/patient Interaction

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Author :
Publisher : W.B. Saunders Company
ISBN 13 :
Total Pages : 308 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Health Professional/patient Interaction by : Ruth B. Purtilo

Download or read book Health Professional/patient Interaction written by Ruth B. Purtilo and published by W.B. Saunders Company. This book was released on 1984 with total page 308 pages. Available in PDF, EPUB and Kindle. Book excerpt: