User:Allibsusss/Patient advocacy

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 * Context: This article literally says "This article has multiple issues. Please help improve it or discuss these issues on the talk page.". She is indeed a mess, so I spent a lot of time refining existing content and adding citations.
 * I am adding a subsection to the Roles section (2): Healthcare Navigation and Support (2.1) and editing the history section. I have reframed some of the main ideas and added additional citations.

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 * note: There are a lot of citations from the already existing content that I did not properly add to this sandbox when I copied the text from the page. If it is italicized, the content was not my work and is (probably) properly cited on the actual page.

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1. History
Patient advocacy emerges in the 1950s and in the context of cancer research and treatment ***cite****. In these early days of cancer treatment, patients and their families raised ethical concerns around the tests, treatment practices, and clinical research being conducted. For instance, they expressed concern to the National Institute of Health (NIH) about the cruelty of the repeated collection of blood samples (for blood marrow examination) and raised questions about whether this was more harmful than beneficial to the patient. Sidney Farber, a Harvard physician and cancer researcher, coined the term "total care", to describe the treatment of children suffering from leukemia. Under total care, a physician "treated the family as a whole, factoring in its psychosocial and economic needs", rather than focusing purely on physical health concerns. Previous researchers had dealt with concerns raised by families, because physicians emphasized patient physical health rather than the inclusion of bedside manners with the families. The practice of practice advocacy emerged to support and represent patients in this medico-legal and ethical discussion.

The 1970s were also an important time for patient advocacy as the Patient Rights movement grew. As a major advocacy organization during the time, the National Welfare Rights Organization's (NWRO) materials for a patient's bill of rights influenced many additional organizations and writings, including hospital accreditation standards for the Joint Commission in 1970 and the American Hospital Association's Patient Bill of Rights in 1972.

'''Below is the original version of this section. Note: a majority of this material was directly copied from Peter Keating and Alberto Cambrosio's book, Cancer on Trial: Oncology as a New Style of Practice.'''

''The origin of patient advocacy, in its current form, can be traced to the early days of cancer research and treatment, in the 1950s. It is part of the notion of Total Care, a term coined by Sidney Farber, a Harvard physician and cancer researcher, referring to the treatment of children suffering from leukemia. "Total care signified that the cancer clinician treated the family as a whole," and "[t]he concept of Total Care subordinated clinical investigation to patient welfare...." This is "...because clinical investigation in the field of cancer may be carried out only as part of the total care of the patient." In the 1950s, clinicians recruited cancer patients for studies, and suspicion reigned at the National Institutes of Health (NIH) as researchers had to convince doctors and patients they were not harming people to conduct experiments. To properly represent patients in this medico-legal and ethical discussion, patient advocacy came into being.''

Healthcare Navigation and Support (2.1)
Examples of patient advocate work include:


 * Educating and walking patients through the management of their disease or chronic illnesses. The social determinants of health can vary greatly {significantly/ may be a better fit than greatly} from patient to patient, and it {remove and/ add a . It } is the role of the patient advocate to cater to the patient's needs and assist with these factors, such as where to find treatment to manage their illness, assisting with healthcare access due to socioeconomic barriers, or helping find additional health services . Assistance {managing there illness...} with the management of their illnesses or disease can also include assisting with cooperative purchases of health care materials.
 * Establishing a network of contacts. Examples of contacts patient advocates can assist in connecting patients to include: in the public sector (political and regulatory), in public and private health insurance, in the sector of medical service providers, with medical practitioners, and with pharmaceutical and medical research to (provide patients with help){helps patients} in the care and management of their diseases.
 * Providing emotional support in dealing with their health concerns, illnesses, chronic conditions. According to the National Institute of Mental Health, individuals with chronic illnesses are at a higher risk of depression of than patients with other mental health conditions . When managing their illnesses, patients and survivors suffer from the direct effect of the consequences their disease has on their quality of life, and my also go through difficult phases of adaptation of their daily routine and lifestyle to accommodate the disease . Part of the role of patient advocates can include providing emotional support for patients or connecting them to mental health resources.
 * Attending appointments with a patient. Patients can find doctor's appointments intimidating, but also difficult to understand. Issues may stem from differences in language proficiency, educational background, or background in health literacy . A patient advocate's presence can ensure that patient's concerns are highlighted and (properly) {adequately} addressed by physicians. Patient advocates may also be responsible for assisting with scheduling additional appointments as well.
 * Assisting with health insurance and other financial aspects of healthcare. The Institute of Medicine in the United States says fragmentation of the U.S. health care delivery and financing system is a barrier to accessing care. Within the financing system, health insurance plays a significant role. According to a United Health survey, only 9% of Americans surveyed understood health insurance terms, which presents a significant issue for patients, given the importance of health insurance in terms of providing access to healthcare . The patient advocate may help with researching or choosing health insurance plans.
 * (content to possibly research more: wrongful medical bill expungement, bankruptcy due to medical bills)