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2 results

  • Chapter 12 - Dementia

  • from Part III - Common Clinical Conditions: The Relevance and Usefulness of a Values-Based Approach
  • Edited by Robert B. Dudas, Cambridgeshire and Peterborough NHS Foundation Trust
  • Book:
    Values in Psychiatry
    Published online:
    24 June 2025
    Print publication:
    10 July 2025, pp 174-196

  • Summary

    Dementia has certain features relevant to values-based medicine. It is a progressive condition, so that a person’s choices and preferences may change over time, and they may require increasing input from others over time. Furthermore, our perceptions of diseases like Alzheimer’s, which cause dementia, are changing over time, along with the philosophy of care. Although memory impairment is the commonest presenting feature of dementia, it is by no means the only issue that arises during the course of the condition. This chapter examines four broad themes in the dementia pathway: early dementia; changes in behaviour; legal and ethical issues; and advanced dementia and care. Vignettes are used to discuss some of the typical issues that arise in clinical situations and how these can be addressed through the application of both evidence- and values-based practice.

  • Voice recognition software: psychiatrist as transcriber

  • Malarvizhi Babu Sandilyan, Jonathan Darley
  • Journal:
    The Psychiatrist / Volume 37 / Issue 4 / April 2013
    Published online by Cambridge University Press:
    02 January 2018, pp. 130-134
    Print publication:
    April 2013
    • Article
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      • Open access
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  • Aims and method

    Voice recognition software is promoted to improve clinician efficiency and decrease overall costs. Our aim was to compare its efficiency against the traditional method of dictation and typing in an older people's community mental health team. We compared the time taken to dictate, edit and type letters, and the total number of days required to send them out after seeing the patient, using the two methods. We also correlated the time taken by one doctor to dictate and edit clinic letters with the actual days on which they were dictated.

    Results

    The voice recognition system reduced the time taken to turn around clinic letters but at the cost of increased doctor's time being spent on dictating and editing the letters. We found no increase in efficiency with experience.

    Clinical implications

    The benefits of faster letter production may be outweighed by the effect of the extra time spent by clinicians to the detriment of their other commitments. The narrative form of psychiatry letters may make them less suited to computer transcription than those in other specialties.