共查询到20条相似文献，搜索用时 15 毫秒
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Aisha T. Langford Binhuan Wang Natasha A. Orzeck-Byrnes Sneha R. Aidasani Lu Hu Melanie Applegate Dana N. Moloney Mary Ann Sevick Erin S. Rogers Natalie K. Levy 《Patient education and counseling》2019,102(3):520-527
Background
Insulin titration is typically done face-to-face with a clinician; however, this can be a burden for patients due to logistical issues associated with in-person clinical care. The Mobile Insulin Titration Intervention (MITI) used basic cell phone technology including text messages and phone calls to help patients with diabetes find their optimal basal insulin dose (OID).Objective
To evaluate sociodemographic and clinical correlates of reaching OID, text message response rate, and days needed to reach OID.Methods
Primary care providers referred patients to MITI and nurses delivered the program. Three multivariable regression models quantified relationships between various correlates and primary outcomes.Results
The sample included 113 patients from 2 ambulatory clinics, with a mean age of 50 years (SD?=?10), 45% female, 79% Hispanic, 43% unemployed, and 46% uninsured. In regression models, baseline fasting blood glucose (FBG) was negatively associated with odds of reaching OID and 100% text responses, and positively associated with days to reach OID, p?<?.05).Conclusions
Patients with higher baseline FBG levels were less successful across outcomes and may need additional supports in future mHealth diabetes programs.Practical Implications
Basic cell phone technology can be used to adjust patients’ insulin remotely, thereby reducing logistical barriers to care. 相似文献4.
Kristie B. Hadden Latrina Y. Prince Marty K. Bushmiaer Jamie C. Watson C. Lowry Barnes 《Patient education and counseling》2018,101(10):1823-1827
Objectives
This study assessed patients’ health literacy and expectations for total hip (THA) and total knee (TKA) replacement surgery, and compared health literacy levels of patients and their caregivers.Methods
A convenience sample of 200 THA/TKA participants, patients and their caregivers, participated in this study.Results
Results demonstrated no statistical difference in health literacy between patients and their caregivers. However, patients with lower health literacy had significantly lower expectations for walking after surgery.Conclusions
Practices should be aware that caregivers may not be any better equipped to consume and use complicated patient education materials than the patient they are assisting. Additionally, lower health literacy, rather than or in addition to race or social factors, may contribute to disparities in opting for THA/TKA because of lower expectations for walking after surgery.Practice implications
Healthcare practices should develop patient educational materials that are easy for all patients and caregivers to understand, especially those with low health literacy. Additional patient education and counseling may help patients with low health literacy realistically align their expectations and mitigate barriers to consenting to surgery due to low expectations. 相似文献5.
Mary M. Step Gretchen A. Ferber Catherine Downs-Holmes Paula Silverman 《Patient education and counseling》2019,102(1):77-84
Objective
To assess the feasibility of a team-based prognosis and treatment goal discussion for women living with advanced breast cancer.Methods
Female patients diagnosed with advanced breast cancer (n?=?25) participated in a mixed methods study that evaluated the feasibility and effects of a planned and structured prognosis discussion. Audio analysis of the intervention appointments was conducted to assess intervention feasibility. Patient self-reports of prognosis related beliefs and treatment preferences were compared across intervention and usual care groups.Results
Most patients found the T-PAT appointment challenging but worthwhile. Intervention uptake by clinicians was good, but some fidelity disruptions were noted. T-PAT participants were more likely to hold realistic beliefs about disease curability after the appointment.Conclusion
Productive prognosis discussions can be delivered effectively by a practice-based clinical team within a semi-structured patient education appointment. It was perceived by patients with advanced breast cancer as both valuable and acceptable. T-PAT clinicians found the intervention easy to deliver.Practice implications
Regular implementation of T-PAT may help clinicians’ build prognosis discussion communication skills. T-PAT documentation provides valuable information that can be used to tailor ongoing care. 相似文献6.
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Giulia Casu Paola Gremigni Marinella Sommaruga 《Patient education and counseling》2019,102(1):126-133
Objective
To investigate how patients evaluate the provision of patient-centered care (PCC) by healthcare professionals and psychometrically test a questionnaire to assess it. A tool previously developed for self-assessment of professionals’ provision of PCC was adapted into a patient-rated form, named Patient-Professional Interaction Questionnaire (PPIQ).Methods
A sample of 1139 patients from six hospitals completed the 16-item PPIQ and the questionnaire structure, reliability, susceptibility to social desirability, and associations with other variables were tested.Results
The PPIQ confirmed the original four-factor structure (effective communication, interest in the patient’s agenda, empathy, and patient involvement in care) and showed acceptable reliability and measurement invariance across both in-/out-patients and first/non-first encounter with the evaluated professional. Associations with patients’ social desirability were negligible and effective communication was rated the highest among the PPIQ dimensions. PPIQ scores varied according to patients’ educational level and type of professional evaluated, while associations between first/non-first encounter and PPIQ scores varied according to in-/out-patient.Conclusion
The PPIQ is a psychometrically sound patient-rated measure of the provision of PCC by healthcare professionals.Practice implications
The PPIQ has potential value in promoting quality patient-professional interactions in the hospital setting, as patients’ reported experience is an important dimension of the clinician’s performance. 相似文献8.
Özlem Örsal Pınar Duru Özgül Örsal Kazım Tırpan Abdullah Çulhacı 《Patient education and counseling》2019,102(2):376-382
Objective
The aim of the study was to examine the relationships between health literacy, primary care satisfaction levels and health awareness of the patients who were admitted to primary care centers (Family Health Centers).Methods
This is a cross-sectional study conducted on individuals who were admitted to Family Health Centers (n?=?1.055) in Eskisehir province. The study data were collected by using Turkish Health Literacy Scale, the European Patients Evaluate General/Family Practice Scale and Health Awareness Scale.Results
As health literacy of participants increases, health awareness and satisfaction with primary care also increases (for each, p?<?.001). Health awareness increases health literacy by 0.55 points, health literacy increases satisfaction in primary care by 0.26 points.Conclusion
In the province of Eskisehir, the health literacy level of 7 out of 10 patients, who admitted to the primary care institution, is inadequate or problematic. As health awareness of participants increases, their level of health literacy also increases. As health literacy of participants increases, their satisfaction with family physicians also increases.Practice implications
As an integral part of preventive health services, studies should be performed to increase and improve the level of health literacy of patients who are admitted to primary care services. 相似文献9.
Objective
To break new ground by directly examining how patients seek life-expectancy estimates, and how doctors support them in doing so.Methods
Conversation analytic examination of 10 recorded UK hospice consultations involving 3 palliative specialists.Results
Life-expectancy estimate episodes frequently begin after a doctor has given a patient an opportunity to shape the consultation agenda. Rather than posing direct questions, patients cautiously display their interest in receiving an estimate using statements. These often contain preparatory information about: what they already know about their prognosis, their perspective on it, and readiness to hear more. When patients do not provide this information, doctors invite it before giving an estimate. Patients’ companions also contribute to this preparatory work.Conclusion
Doctors, patients, and companions collaboratively work to prepare a conversational environment wherein emotional states and uncertainties have been addressed prior to delivery of the actual estimate. This helps manage both possible emotional distress, and prognostic uncertainty entailed in seeking and delivering estimates.Practice implications
Clinicians should be mindful that rather than overtly requesting estimates, patients may seek them more cautiously. Before delivering estimates, doctors can support patients to articulate their existing understanding and perspective regarding prognosis, and their readiness to hear more. 相似文献10.
Objective
This study aims to examine the impacts of gain vs. loss-framed messages and narrative messages on Chinese women’s intentions to get HPV vaccines for their children.Methods
A survey experiment was conducted among Chinese females (N?=?453) assessing their responses to 3 types of messages (i.e. gain-framed, loss-framed and narrative) designed to promote HPV vaccination.Results
No main effect was found for message types, but loss-framed message slightly increased vaccination intention. Time orientation moderated the relationship between message framing and vaccination intention.Conclusion
Narrative message works better among present-minded individuals, whereas gain-framed message was more persuasive for future-minded individuals. Integration of message frames (gain vs. loss) and message type (narrative vs. non-narrative) is recommended for future research.Practice Implications
Narrative persuasion could be an effective tool in promoting health behaviors especially among present-minded individuals, or when the consequences of health decisions are temporally distant. 相似文献11.
Cindy B. Matsen Sarah Lyons Melody S. Goodman Barbara B. Biesecker Kimberly A. Kaphingst 《Patient education and counseling》2019,102(1):155-161
Objective
To better understand decision role preferences in women diagnosed with breast cancer at a young age for return of results of genome sequencing in research and clinical settings.Methods
Participants were surveyed about communication and decision-making preferences related to genome sequencing results and factors that may affect these preferences. The primary outcome was decision role preference (Control Preference Scale) for selecting what results to receive within medical care or within a research study.Results
For results returned as part of medical care, most patients preferred a collaborative (N?=?481, 45%) or active (N?=?488, 45%) role with only 107 (10%) choosing a passive role. When making the decision as part of a research study, most patients preferred an active role (N?=?617, 57%), 350 (33%) choosing a collaborative role, and110 (10%) choosing a passive role.Conclusion
Most women in this study preferred to share in decision making. Participants had somewhat different role preferences for clinical and research contexts, with greater preference for active roles in the research context.Practice Implications
We advocate for practice guidelines that incorporate discussion of decision role as an integral part of patient centered care and shared decision-making and recognize that more work is needed to inform guidelines. 相似文献12.
Daniel Rojas-Bolivar Fitzgerald A. Arroyo-Ramírez Jhesvith Santos Christian Moruquilca Carlos Valdivia 《Educación Médica》2019
Objective
To evaluate medical students perception of the educational environment in the “San Fernando” School of Medicine of the National University of San Marcos of Lima, Peru.Materials and methods
A quantitative and cross-sectional study was performed using the Dundee Ready Educational Environment Measure. A total of 177 medical students from second to sixth year were tested.Results
The scores obtained from the DREEM demonstrate that medical student's perceptions were positive in learning (53.7%), teachers (7.5%), environment (66.1%), and academic situation (66.1%). However, there was a negative perception of their medical school (57.1%). The overall rating of the perception of the educational environment was positive (75.7%).Discussion
The medical student's perception of the medical school educational environment was positive. It is recommended to strengthen the medical student's social environment related to medical school. 相似文献13.
Angela L. Palmer-Wackerly Heather L. Voorhees Sarah D’Souza Edward Weeks 《Patient education and counseling》2019,102(4):804-809
Objective
To identify how and why infertility patients’ communication with health care providers relates to their continuity of care within infertility treatment.Method
A grounded theory analysis was conducted for 25 in-depth interviews across three coding phases, where we remained open to all themes present in the data, narrowed to most prominent themes, and found the connections between the themes.Results
Based on our identified themes, we created a conceptual model that explains why infertility patients (dis)continued care with one or more clinician. Through this model, we describe two infertility identity transitions for patients: Transition 1: “Infertility as Temporary” to “Infertility as Enduring”; and Transition 2: “Infertility as Enduring” to “Infertility as Integrated.”Conclusion
The study explains how and why patients’ view of their infertility affects their communication, and thus their continuity of care, with clinicians.Practice implications
To provide patient-centered care within infertility treatment, providers can recognize how patients’ view of their infertility, and thus their needs, goals, and expectations, shift throughout their infertility experience. 相似文献14.
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Florian Tille Julia Röttger Bernhard Gibis Reinhard Busse Adelheid Kuhlmey Susanne Schnitzer 《Patient education and counseling》2019,102(1):162-171
Objective
To identify overall levels of health system responsiveness and the associations with social determinants for ambulatory health care in Germany from a user perspective.Methods
This analysis drew on a 2016 health survey sample of 6113 adults in Germany. Responsiveness was measured for general practitioners (GPs) and specialists (SPs) along the domains trust, dignity, confidentiality, autonomy and communication. Bivariate and multivariate logistic regression techniques were applied.Results
Over 90% of all patients assessed their last GP and SP visit as good regarding trust, dignity, autonomy and communication, but only half for confidentiality in the doctor office (GP visits: 50.3%; SP visits: 52.4%). For GP visits, patients’ young age of 18–34 years showed most associations with poor assessment of the domains, for SP visits a current health problem as the reason for the last consultation.Conclusion
While overall responsiveness levels for ambulatory care are high, ratings of confidentiality are distressing. Particularly patients’ young age and bad health are associated with a poor assessment of responsiveness.Practice implications
Measures to improve doctor office infrastructure and to enhance responsiveness towards patients under the age of 35 years and those with health problems are vital to increase responsiveness. 相似文献16.
Michelle D. Dannenberg John Carlo M. Bienvenida Martha L. Bruce Theresa Nguyen Michelle Hinn James Matthews Stephen J. Bartels Glyn Elwyn Paul J. Barr 《Patient education and counseling》2019,102(3):555-563
Objective
Our aim was to gather community stakeholder input to inform the development of a digital system linking depression screening to decision support.Methods
Views and feature requirements were identified through (1) focus groups with patients and consumers with depression, and interviews with primary care clinicians and (2) usability sessions where patients and consumers used the current version of encounter decision aid (eDA) in a primary care waiting room. Qualitative data were analyzed using the framework method.Results
We conducted six focus groups with 15 participants, seven clinician interviews and 10 usability sessions. Patients were comfortable completing the Patient Health Questionnaire (PHQ-9) and receiving the electronic eDA in clinic. They felt this would allow patients to prepare for their visit and instill a sense of agency. Participants were comfortable receiving the PHQ-9 results and a subsequent eDA on a tablet in the waiting room.Conclusion
Patients with and without depression, as well as clinicians, viewed linking the PHQ-9, results, and eDA positively. Patients were comfortable doing this in the clinic waiting room.Practice implications
Linking depression decision support to screening was viewed positively by patients and clinicians, and could help overcome barriers to shared decision-making implementation in this population. 相似文献17.
Objectives
The use of groups is common in healthcare. There is a paucity of research which captures patient experiences of group participation. The aims of this study were to explore the perceptions and experiences of people with traumatic brain injury (TBI) about their participation in inpatient occupational therapy rehabilitation groups.Method
A phenomenological approach guided the study. Patients with a TBI who were participating in an inpatient occupational therapy group program were recruited. Data were collected through semi-structured interviews and analysed using content analysis.Results
Fifteen participants consented to the study. Three themes emerged from the data; 1) feeling normal, comfortable and connected; 2) learning by doing, seeing and sharing and; 3) practicalities of groups. Participants highlighted that groups facilitated opportunities to practice skills and prepared them for the real world. Opportunities for interaction and support were also emphasised as positive by participants.Conclusion
Perceptions of patients about participation in groups were generally positive, and as such a consumer-focused approach to healthcare would support the use of occupational therapy groups in TBI rehabilitation.Practice implications
Recommendations from the perspectives of patients include consideration of the selection of group participants, and meeting individual needs and goals within a group setting. 相似文献18.
Maarten Cuypers Romy E.D. Lamers Paul J.M. Kil Lonneke V. van de Poll-Franse Marieke de Vries 《Patient education and counseling》2019,102(3):424-428
Objective
To investigate the effect of including an online decision aid (DA) during prostate cancer treatment counseling on decisional regret and information satisfaction in a one-year follow-up.Methods
Within a cluster RCT, 18 Dutch hospitals were randomized to DA counseling or care-as-usual, patients (n?=?382) initially completed questionnaires directly after treatment decision making. Six and twelve months later regret (Decisional Regret Scale) and information satisfaction (SCIP-B) were assessed. Anxious and depressive symptoms (HADS) was included as possible covariate.Results
After 12 months, 43 participants (15%) regretted their treatment choice and 105 participants (36%) were dissatisfied with the information that was received at the time of decision-making, regardless of being exposed to the DA. Anxious and depressive symptoms at follow-up were associated with regret and information dissatisfaction.Conclusion
No long-term benefical effects emerged from DA usage compared to patients who underwent standard counseling.Practice implications
During PCa treatment counseling, healthcare providers should be aware of anxious and depressive symptoms. 相似文献19.
Andrea M. Russell Deesha A. Patel Laura M. Curtis Kwang-Youn A. Kim Michael S. Wolf Megan E. Rowland Danielle M. McCarthy 《Patient education and counseling》2019,102(4):749-752
Objective
To determine the reliability of the Newest Vital Sign (NVS) administered via telephone by examining test-retest properties of the measure.Methods
Data were obtained from a randomized controlled trial promoting opioid safe use. Participants were 18 or older and English-speaking. NVS assessment occurred in-person at baseline and in-person or via telephone at follow-up. Intraclass correlation coefficients (ICCs) were used to assess the test-retest reliability using raw NVS scores by mode of administration of the second NVS assessment. Kappa statistics were used to examine test-retest agreement based on categorized NVS score. Internal consistency was measured with Cronbach’s alpha.Results
Data from 216 patients (70 completing follow-up in-person and 146 via telephone) were included. Reliability was high (ICCs: in-person?=?0.81, phone?=?0.70). Agreement was lower for three category NVS score (Kappas: in-person?=?0.58, 95% CI [0.39-0.77]; phone?=?0.52, 95% CI [0.39-0.65]) compared to two category NVS (Kappas: in-person?=?0.65, 95% CI [0.46-0.85]; phone?=?0.64, 95% CI [0.51-0.78]). Correlations decreased as time between administrations increased. Internal consistency was moderately high (baseline NVS in-person (α?=?0.76), follow-up NVS in-person (α?=?0.76), and phone follow-up (α?=?0.78).Conclusion
The test-retest properties of the NVS are similar by mode of administration.Practice implications
This data suggests the NVS measure is reliably administered by telephone. 相似文献20.