共查询到20条相似文献，搜索用时 15 毫秒
1.
Maryam Peimani Fateme Monjazebi Robabeh Ghodssi-Ghassemabadi Ensieh Nasli-Esfahani 《Patient education and counseling》2018,101(3):460-466
Objective
This study aims to assess the effectiveness of a peer support intervention, in which patients with T2DM were provided ongoing self-management support by trained peers with diabetes directed at improving self-care behaviors, self-efficacy and life quality.Methods
In this randomized controlled trial, 200 patients referred to a diabetes specialty clinic were allocated to peer support or control group. Participants in both groups received usual education by diabetes educators.Intervention participants worked with the trained volunteer peers who encouraged participants to engage in daily self-management and to discuss and share their experiences and challenges of diabetes management. The primary outcomes were HbA1c, BMI, self-care behaviors, self-efficacy and life qualityResults
After 6 months, patients in the peer support group experienced a significant decline in mean A1c value (P = 0.045). Also, mean diabetes self-management scores, mean self-efficacy scores and mean quality of life scores significantly improved in peer support group compared to control group (P values <0.001).Conclusion
Peer support activities can be successfully applied in diabetes self-management, especially in areas with a shortage of professionals and economic resources.Practice implications
Peer support strategies should be integrated into our healthcare system to meet minimum needs of people with T2DM in Iran. 相似文献2.
Jin Hui Joo Seungyoung Hwang Joseph J. Gallo Debra L. Roter 《Patient education and counseling》2018,101(4):665-671
Objective
The objective of this pilot study was to describe peer communication in meetings with depressed elders, associate their relationship with working alliance and depression and assess congruence of communication with training.Methods
Three peers with a history of depression, in recovery, received 20 h of training in peer mentoring for depression as part of an 8-week pilot program for 23 depressed older adults. Each peer-client meeting was recorded; a sample of 69 recorded meetings were chosen across the program period and coded with the Roter Interaction Analysis System, a validated medical interaction analysis system. Generalized linear mixed models were used to examine peer talk during meetings in relation to working alliance and client depression.Results
Peers used a variety of skills congruent with their training including client-centered talk, positive rapport building and emotional responsiveness that remained consistent or increased over time. Client-centered communication and positive rapport were associated with increased working alliance and decreased depressive symptoms (all p < 0.001).Conclusion
Trained peer mentors can use communication behaviors useful to older adults with depression. Specifically, client-centered talk may be important to include in peer training.Practice implications
Peer mentors can be a valuable resource in providing depression counseling to older adults. 相似文献3.
Introduction
Patients are increasingly accessing online health information and have become more participatory in their engagement with the advent of social media (SM). This study explored how patients’ use of SM impacted their interactions with healthcare professionals (HCPs).Methods
Focus groups (n = 5) were conducted with 36 patients with chronic conditions and on medication who used SM for health-related purposes. The discussions lasted 60–90 min, were audio-recorded, transcribed verbatim, and thematically analysed.Results
Participants did not interact with HCPs on SM and were not expecting to do so as they used SM exclusively for peer interactions. Most reported improvement in the patient-HCP relationship due to increased knowledge, better communication, and empowerment. Participants supplemented HCP-provided information with peer interactions on SM, and prepared themselves for consultations. They shared online health information with HCPs, during consultations, to validate it and to actively participate in the decision-making. Although some participants reported HCP support for their online activities, most perceived overt or tacit opposition.Conclusion
Participants perceived that their SM use positively impacted relationships with HCPs. They felt empowered and were more assertive in participating in decision-making.Practice implications
HCPs should be aware of patients’ activities and expectations, and support them in their online activities. 相似文献4.
L.J. Graven G. Gordon J.Grant Keltner L. Abbott J. Bahorski 《Patient education and counseling》2018,101(2):266-275
Objective
The purpose of this study was to examine the preliminary effects of a coping partnership intervention comprised of social support and problem-solving on HF self-care maintenance, management, and confidence.Methods
A 3-group randomized controlled pilot study was conducted. The intervention group received 1 home visit, weekly (month 1), and biweekly (months 2 and 3) telephone calls. The attention group received telephone calls starting at week 2, following a similar pattern. The control group received usual care only. The Self-care of Heart Failure Index, was administered at baseline, 5, 9, and 13 weeks. Linear mixed modeling examined intervention effect on study outcomes.Results
A total of 66 participants completed the study. The participants were mean age 61 years; 54.2% male; 56% Non-Caucasian; and 43.9% New York Heart Association HF Class II. Significant treatment-by-time interaction effects were noted for self-care maintenance (F = 4.813; p = 0.010) and self-care confidence (F = 4.469; p = 0.014). There was no significant treatment-by-time interaction effect on self-care management.Conclusions
Coping partnership interventions that strengthen support and social problem- solving may improve self-care maintenance and confidence in individuals with HF.Practice implications
Clinicians should consider including these components in HF patient education and clinical follow-up. 相似文献5.
Veerle Duprez Dimitri Beeckman Sofie Verhaeghe Ann Van Hecke 《Patient education and counseling》2018,101(2):276-284
Objective
To explore nurses’ self-perceived behavior of supporting patients’ self-management, and its association with person-related and socio-structural factors.Methods
Correlational study in a sample of nurses from nine general hospitals, three community healthcare organizations, and six private community practices. Nurses with >50% of their patients living with a chronic condition were eligible to participate. Data were collected at two time-points. Self-management support behavior was measured by the SEPSS-36 instrument. The person-related and socio-structural associated factors were derived from behavioral theories and measured by validated questionnaires.Results
Nurses (N = 477) scored overall low on self-management support behavior. Nurses lacked mainly competencies in collaborative goalsetting, shared decision making and organizing follow-up. Factors predicting nurses’ behavior in supporting patients’ self-management were self-efficacy, priority, perceived supervisor support and training in self-management support. This model explained 51.7% of the variance in nurses’ behavior.Conclusion
To date, nurses do not optimally fulfil their role in supporting patients’ self-management. Self-management support is practiced from a narrow medical point of view and primarily consists of informing patients, which is the lowest level of patient participation.Practice implications
It is essential to better prepare and support nurses ? and by extend all healthcare professionals ? for the challenges of supporting patients’ self-management. 相似文献6.
Amy Scheel Andrea Beaton Emmy Okello Chris T. Longenecker Isaac Omara Otim Peter Lwabi Craig Sable Allison R. Webel Twalib Aliku 《Patient education and counseling》2018,101(1):119-123
Objective
To assess the impact of a peer-support group on knowledge, quality of life, and social support for children with rheumatic heart disease (RHD).Methods
Children diagnosed with RHD and receiving 4-weekly injectable penicillin were invited to participate in a monthly support group for 6 months. Pre- and post-intervention assessments included a baseline RHD knowledge assessment, a measure of health related quality of life (HRQOL) (PedsQLTM4.0), and a measure of social support (Hawthorne Friendship Scale). Groups incorporated elements of cooperative play and team building, RHD education, and emotional support.Results
42 participants attended ≥3 groups and were included in the analyses. Attending support groups resulted in increased total HRQOL scores (60.3 v 70.2, p < 0.001), as well as the following HRQOL sub-scores (physical functioning 55.3 v 68.6 (p < 0.001), social functioning 64.2 v 75.8 (p < 0.001) and school functioning 59.2 v 69.1 (p = 0.001)). Significant increases in Friendship Scale scores (15.4 v 19.7, p < 0.001) and RHD Knowledge scores were observed (3.6 v 6.4, p < 0.001).Conclusions
Peer-support groups may be effective at normalizing decreased HRQOL scores and increasing RHD disease knowledge and social support.Practical implications
Peer-support groups implemented in conjunction with RHD screening can minimize the negative psychosocial effects associated with early RHD detection. 相似文献7.
Objective
We examine whether patients have a preference for affective (i.e., focused on patient’s emotions) or cognitive (i.e., focused on the process that led to the error) apologies that are dependent on the apologizing physician’s gender. We hypothesize patients will prefer gender-congruent apologies (i.e., when females offer affective apologies and males offer cognitive apologies).Methods
We randomly assigned analogue patients (APs: participants instructed to imagine they were a patient) to read a scenario in which a female or male physician makes an error and provides a gender-congruent or incongruent apology. APs reported on their perceptions of the physician and legal intentions.Results
An apology-type and gender congruency effect was found such that APs preferred apologies congruent with the gender of the apologizing physician. An indirect effect of congruency on legal intentions through physician perceptions was confirmed (b = ?0.24, p = 0.02).Conclusion
Our results suggest that physician gender plays a role in patient reactions to different apology types.Practice implications
Apology trainings should incorporate how physician characteristics can influence how patients assess and respond to apologies. 相似文献8.
Michelle L. Litchman Erin Rothwell Linda S. Edelman 《Patient education and counseling》2018,101(3):518-523
Objective
The use of the diabetes online community (DOC) is growing across all age groups. The aim of this exploratory study was to describe why older adults participated in the DOC, and how DOC users interacted with their healthcare providers.Methods
Telephone interviews (N = 20) were conducted with older adult DOC users (born between 1946 and 1964) living in the United States. Interviews were analyzed using qualitative content analysis adhering to rigor and reproducibility standards.Results
Themes that emerged from the data related to DOC participation included: information to improve self-care, emotional support, belonging to a community, validation of information, cause for concern and interaction with healthcare providers. Participants used the DOC for day to day diabetes management advice and healthcare providers for medical information and care.Conclusion
Participants highly valued the DOC and regarded their participation as a way to increase knowledge to improve self-care and reciprocate emotional support with others for diabetes management. The DOC filled gaps in knowledge and support participants were not able to get elsewhere.Practice implications
The DOC serves as an important source of information and support for individuals with diabetes and may be a cost-effective strategy to augment standard diabetes care. 相似文献9.
Objective
Synthesize quantitative empirical evidence on the role of health literacy in predicting adherence to dietary recommendations.Methods
A systematic search of 13 online databases resulted in 1498 articles eligible for screening. Of those, 20 met the predefined inclusion criteria and, together with 6 studies retrieved from their reference lists, were included for review. Screening of full-texts, data extraction and quality appraisal were independently performed by two reviewers. Inconsistencies regarding eligibility were resolved through discussion.Results
Of the 26 reviewed articles, 17 involved patients and 9 the general population. Overall, 35 associations between health literacy and various nutrition behaviours were observed. A significant direct positive association was reported in 5 cases, all of them concerning the general population. An insignificant association was reported in 20 cases, 15 of which were related to patients. The remaining associations were negative (n = 2), partially mediated (n = 1) or entirely mediated (n?=?7).Conclusion
Health literacy was scarcely determinant of dietary adherence and other nutrition behaviours, especially among patients.Practice implication
Patients’ dietary adherence is likely to be unaffected by interventions based on health literacy. Empowering approaches are expected to be more beneficial. 相似文献10.
Kathleen M. Grant Lance Brendan Young Kimberly A. Tyler Jamie L. Simpson R. Dario Pulido Christine Timko 《Patient education and counseling》2018,101(1):79-84
Objective
A multisite field trial testing whether improved outcomes associated with intensive referral to mutual help groups (MHGs) could be maintained after the intervention was adapted for the circumstances and needs of rural veterans in treatment for substance use disorder (SUD).Methods
In three Veterans Affairs treatment programs in the Midwest, patients (N = 195) received standard referral (SR) or rural-adapted intensive referral (RAIR) and were measured at baseline and 6-month follow-up.Results
Both groups reported significant improvement at 6-months, but no significant differences between SR and RAIR groups in MHG participation, substance use, addiction severity, and posttraumatic stress symptoms. Inconsistent delivery of the intervention resulted in only one-third of the RAIR group receiving the full three sessions, but this group reported significantly greater 6-month abstinence from alcohol than those receiving no sessions.Conclusion
Further research should explore implementation problems and determine whether consistent delivery of the intervention enhances 12-step facilitation.Practice implications
The addition of rural-specific elements to the original intensive referral intervention has not been shown to increase its effectiveness among rural veterans. 相似文献11.
Gwendolyn P. Quinn Rebecca D. Pentz Teresita Muñoz-Antonia Theresa A. Boyle Matthew B. Schabath Christie L. Pratt Andrea Shaffer Luisa F. Duarte Meghan Bowman-Curci Scott J. Antonia Alberto A. Chiappori Benjamin C. Creelan Jhanelle E. Gray Charles C. Williams Eric B. Haura 《Patient education and counseling》2018,101(4):703-710
12.
Marieke J. de Jonge Martijn A.H. Oude Voshaar Anita M.P. Huis Mart A.F.J. van de Laar Marlies E.J.L. Hulscher Piet L.C.M. van Riel 《Patient education and counseling》2018,101(1):67-73
Objective
To develop a Disease and treatment associated Knowledge in RA item bank (DataK-RA) based on item response theory.Methods
Initial items were developed from a systematic review. Rheumatology professionals identified relevant content trough a RAND modified Delphi scoring procedure and consensus meeting. RA patients provided additional content trough a focus group. Patients and professionals rated readability, feasibility and comprehensiveness of resulting items. Cross-sectional data were collected to evaluate psychometric properties of the items.Results
Data of 473 patients were used for item reduction and calibration. Twenty items were discarded based on corrected item-total point biserial correlation <0.30. Confirmatory factor analysis with weighted least squares estimation on the polychoric correlation matrix suggested good fit for a unidimensional model for the remaining 42 items (CFI 0.97 TLI = 0.97, RMSEA = 0.02, WRMR = 0.97), supporting the proposed scoring procedure. Scores were highly reliable and normally distributed with minimal ceiling (1.8%) and no floor effects. 75% of tested hypotheses about the association of DataK-RA scores with related constructs were supported, indicating good construct validity.Conclusion
DataK-RA is a psychometrically sound item bank.Practice implications
DataK-RA provides health professionals and researchers with a tool to identify and target patients’ information needs or to assess effects of educational efforts. 相似文献13.
Paul R. Duberstein Michael Chen Benjamin P. Chapman Michael Hoerger Fahad Saeed Elizabeth Guancial Jennifer W. Mack 《Patient education and counseling》2018,101(1):113-118
Objective
Understanding socioeconomic disparities in the care of patients with incurable cancer is a high priority. We hypothesized that patients without a high school education are more likely to believe that they could be cured and we explored the role of fatalism.Methods
We studied 977 patients with advanced, incurable cancer. Two logistic regression analyses were conducted. Model One examined the effect of education on beliefs about curability. Model Two added fatalism.Results
The significant association between having less than a high school education and the belief that advanced cancer can be cured (OR = 2.55; 95% CI: 1.09–5.96) in Model One was attenuated by 39% and rendered nonsignificant in Model Two. Fatalism was associated with the belief that advanced cancer can be cured. Whites were less likely to believe they could be cured than Blacks and Asians/Pacific Islanders. Beliefs about curability were not associated with income or insurance status.Conclusions
People who do not complete high school are more likely to believe that their advanced cancer is curable, in part because they are more likely to hold fatalistic worldviews.Practice implications
Interventions to help oncologists care for patients with fatalistic beliefs could mitigate socioeconomic disparities in end-of-life care. 相似文献14.
Jennifer Viberg Johansson Pär Segerdahl Ulrika Hösterey Ugander Mats G. Hansson Sophie Langenskiöld 《Patient education and counseling》2018,101(3):422-427
Objective
It is well known that research participants want to receive genetic risk information that is about high risks, serious diseases and potential preventive measures. The aim of this study was to explore, by qualitative means, something less well known: how do healthy research participants themselves make sense of genetic risk information?Method
A phenomenographic approach was chosen to explore research participants’ understanding and assessment of genetic risk. We conducted four focus-group (N = 16) interviews with participants in a research programme designed to identify biomarkers for cardiopulmonary disease.Results
Among the research participants, we found four ways of understanding genetic risk: as a binary concept, as an explanation, as revealing who I am (knowledge of oneself) and as affecting life ahead.Conclusion
Research participants tend to understand genetic risk as a binary concept. This does not necessarily imply a misunderstanding of, or an irrational approach to, genetic risk. Rather, it may have a heuristic function in decision-making.Practical implications
Risk communication may be enhanced by tailoring the communication to the participants’ own lay conceptions. For example, researchers and counselors should address risk in binary terms, maybe looking out for how individual participants search for threshold figures. 相似文献15.
Rachael Glassey Moira O’Connor Angela Ives Christobel Saunders Sarah J. Hardcastle 《Patient education and counseling》2018,101(2):318-323
Objective
The objective of this study was to explore the influences on decision-making of younger women (<35) undergoing or considering bilateral prophylactic mastectomy (BPM).Methods
Qualitative interviews guided by interpretative phenomenological analysis (IPA) were conducted with forty-six women who had a strong family history of breast cancer (BC) who had either undergone (n = 26) or were considering (n = 20) BPM. Participants were recruited from Australia and New Zealand (NZ) via hospitals, a genetics clinic, a research cohort, a registry and online.Results
Four themes underpinning the influences on decision-making were identified: fear and anxiety, children, personal experiences with BC, health professional’s influence.Conclusions
The decision to undergo BPM for younger women ( < 35) was multifaceted, however, it appeared that fear and anxiety were the main influence. Younger women appear more anxious than previous research with older women. There appears to be few differences between those with confirmed BRCA1/2 mutations and those with no known mutation and this is clinically significant.Practice implications
These findings have important practice implications, particularly improving communication of risk statistics, especially to those with no known mutation. Health professionals need to take into account the way younger women perceive information given to them when discussing risk. 相似文献16.
Winny Setyonugroho Thomas Kropmans Ruth Murphy Peter Hayes Jan van Dalen Kieran M. Kennedy 《Patient education and counseling》2018,101(1):147-151
Background
Comparing outcome of clinical skills assessment is challenging. This study proposes reliable and valid comparison of communication skills (1) assessment as practiced in Objective Structured Clinical Examinations (2). The aim of the present study is to compare CS assessment, as standardized according to the MAAS Global, between stations in a single undergraduate medical year.Methods
An OSCE delivered in an Irish undergraduate curriculum was studied. We chose the MAAS-Global as an internationally recognized and validated instrument to calibrate the OSCE station items. The MAAS-Global proportion is the percentage of station checklist items that can be considered as ‘true’ CS. The reliability of the OSCE was calculated with G-Theory analysis and nested ANOVA was used to compare mean scores of all years.Results
MAAS-Global scores in psychiatry stations were significantly higher than those in other disciplines (p < 0.03) and above the initial pass mark of 50%. The higher students' scores in psychiatry stations were related to higher MAAS-Global proportions when compared to the general practice stations.Conclusion
Comparison of outcome measurements, using the MAAS Global as a standardization instrument, between interdisciplinary station checklists was valid and reliable.Practice implications
The MAAS-Global was used as a single validated instrument and is suggested as gold standard. 相似文献17.
Kim Beernaert Chloë Haverbeke Simon Van Belle Luc Deliens Joachim Cohen 《Patient education and counseling》2018,101(1):132-138
Objective
We assessed information provision and information needs about illness course, treatments, palliative care and euthanasia in cancer patients.Methods
Cancer patients consulting a university hospital (N = 620) filled out a questionnaire. Their cancer related data were collected through the treating oncologist. This study is performed in Belgium, where “palliative care for all” is a patient’s right embedded in the law and euthanasia is possible under certain conditions.Results
Around 80% received information about their illness course and treatments. Ten percent received information about palliative care and euthanasia. Most information about palliative care and euthanasia was given when the patient had a life expectancy of less than six months. However, a quarter of those in earlier phases in their illness trajectory, particularly those who experienced high pain, fatigue or nausea requested more information on these topics.Conclusion
Many patients want more information about palliative care and euthanasia than what is currently provided, also those in an earlier than terminal phase of their disease.Practice implications
Healthcare professionals should be more responsive, already from diagnosis, to the information needs about palliative care and possible end-of-life decisions. This should be patient-tailored, as some patients want more and some patients want less information. 相似文献18.
Lee Ellington Margaret F. Clayton Maija Reblin Gary Donaldson Seth Latimer 《Patient education and counseling》2018,101(3):414-421
Objective
First, to describe communication of home hospice nurse visits to cancer patient-caregiver dyads. Second, to assess change in communication related to domains of care over the course of visits.Methods
Multi-site prospective observational longitudinal study of audio-recorded home hospice visits (N = 537 visits; 101 patient-caregiver dyads; 58 nurses). Communication was coded using the Roter Interaction Analysis System to describe content and process. Conversation representing three care domains (physical, psychosocial/daily life, and emotional) was calculated from RIAS categories across speakers and analyzed to assess change in communication over time.Results
On average, nurses spoke 54% of total utterances, caregivers 29%, and patients 17%. For all participants, the predominant conversational focus was on physical care. Linear mixed effects models indicated that combined participant emotional talk showed a small systematic decrease over time; however, the results for all domains indicated variability unexplained by time or speaker effects.Conclusions
Home hospice conversations are predominantly focused on physical care. Systematic change in communication versus responsiveness to the dynamic effects of patient death and family response over time are discussed.Practice implications
Communication strategies already in use by hospice nurses could be leveraged and expanded upon to better facilitate family competence and confidence. 相似文献19.
Ida J. Korfage Erik W. de Kwaadsteniet Arno van Voorst Anne M. Stiggelbout Marieke de Vries Arwen H. Pieterse 《Patient education and counseling》2018,101(2):310-317
Objectives
Implicit associations influence behaviour, but their impact on cancer screening intentions is unknown.Methods
We assessed implicit associations with cervical cancer screening using an evaluative priming task. Participants were shown primes (‘Pap test’, neutral or non-word) followed by positive or negative target words. The test is based on the assumption that response times are shorter if primes and targets are strongly associated in the participant's mind. The Dutch screening program targets women aged 30–60, 226 of them completed online assessments twice. Prior to the second assessment participants were randomized to reading versus not reading the leaflet about the cervical screening program.Results
After controlling for knowledge and screen history, response times for ‘Pap test’ no longer differed between positive and negative targets. Implicit associations were not correlated with explicit attitudes or screening intentions. Reading the screening leaflet resulted in improved knowledge levels (p < 0.001), but implicit associations, explicit attitudes, and screening intentions remained similar.Conclusion
Cervical cancer screening intentions were related to explicit attitudes, but not to implicit associations. The screening leaflet did not affect screening intentions.Practice implications
We recommend achieving a deepened interest in the screening program among risk groups, e.g. by adapting the information leaflet. 相似文献20.
Wolfgang Gaissmaier Helge Giese Mirta Galesic Rocio Garcia-Retamero Juergen Kasper Ingo Kleiter Sven G. Meuth Sascha Köpke Christoph Heesen 《Patient education and counseling》2018,101(1):74-78