共查询到20条相似文献，搜索用时 31 毫秒
1.
Alexander Jenson Debra L. Roter Harran Mkocha Beatriz Munoz Sheila West 《Patient education and counseling》2018,101(6):1075-1081
Objective
Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage.Methods
In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA – villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012.Results
58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p?=?0.009).Conclusion
Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA.Practice implications
Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers. 相似文献2.
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3.
4.
Objective
Patient-clinician communication (PCC) may generate or reduce healthcare disparities. This paper is based on the 2017 International Conference on Communication in Healthcare keynote address and reviews PCC literature as a research area for the National Institute on Minority Health and Health Disparities (NIMHD).Methods
A narrative review of selected evidence on disparities in PCC experienced by race and ethnic minorities, associations between PCC and poor health outcomes, and patient and clinician factors related to PCC.Results
Factors associated with poor quality PCC on the patient level include being a member of racial/ethnic minority, having limited English proficiency, and low health and digital literacy; on the clinician level, being less culturally competent, lacking communication skills to facilitate shared decision-making, and holding unconscious biases. Recommendations include offering patient- and/or clinician-targeted interventions to guard against unconscious biases and improve PCC, screening patients for health literacy and English proficiency, integrating PCC in performance processes, and leveraging health information technologies to address unconscious biases.Conclusion
EffectivePCC is a pathway to decrease health disparities and promote health equity.Practice implications
Standardized collection of social determinants of health in the Electronic Health Record is an importantfirst step in promoting more effective PCC. 相似文献5.
Robert C. Smith Heather Laird-Fick Francesca C. Dwamena Laura Freilich Brian Mavis Katelyn Grayson-Sneed Dale D’Mello Mark Spoolstra David Solomon 《Patient education and counseling》2018,101(12)
Objective
We tested the hypothesis that trained medical faculty can train residents effectively in a mental health care model.Methods
After the authors trained medical faculty intensively for 15 months in primary care mental health, the newly trained faculty taught medical residents intensively. Residents were evaluated pre- and post-residency and compared to non-equivalent control residents in another city. Using ANOVA, the primary endpoint was residents’ use of a mental health care model with simulated patients. Secondary endpoints were residents’ skills using models for patient-centered interviewing and for informing and motivating patients.Results
For the mental health care model, there was a significant interaction between study site and time (F?=?33.51, p?<?.001, Eta2?=?.34); mean pre-test and post-test control group scores were 8.15 and 8.79, respectively, compared to 7.44 and 15.0 for the intervention group. Findings were similarly positive for models of patient-centered interviewing and informing and motivating.Conclusions
Training medical faculty to teach residents a mental health care model offers a new educational approach to the widespread problem of poor mental health care.Practice Implications
While the models tested here can provide guidance in conducting mental health care, further evaluation of the train-the-trainer program for preparing residents is needed. 相似文献6.
Mollie A. Ruben Mark Meterko Barbara G. Bokhour 《Patient education and counseling》2018,101(2):209-213
Objectives
Patient-provider communication is an important component of the medical interaction yet little research has examined the relationships between perceptions of communication and health outcomes or the mechanisms by which communication may ameliorate the pain experience. This is the first study to examine the relationships between patients’ perceptions of provider communication, pain intensity and self-efficacy for managing chronic disease.Methods
The total sample contained 1027 (85.8% male) Veteran patients. Patients responded to surveys about their experiences and outcomes of care, including measures of patient-provider communication, self-efficacy and pain outcomes including pain intensity and pain interference.Results
Results showed more positive perceptions of provider communication were related to lower levels of pain intensity and pain interference and that this relationship was significantly mediated by higher levels of self-efficacy for managing chronic disease.Conclusion
More positive provider communication was related to higher levels of self-efficacy, which in turn was related to lower levels of pain intensity and pain interference.Findings suggest that providers may be able to elicit higher levels of self-efficacy in their patients by providing patient-centered communication, which in turn will reduce pain intensity and interference in their patient’s lives. 相似文献7.
Objective
To explore the relationships between self-reported Empathy and the patient-centered communication patterns of physician trainees.Methods
“Eighty-four 3rd year medical students completed the Jefferson Scale of Empathy (JSE – student version) and had recordings of a single OSCE analyzed using the Roter Interactional Analysis System (RIAS). Correlation and regression were employed to explore the relationships among JSE total score, 3 JSE subscales, 10 composite codes of provider communication, and a summary ‘patient centered communication’ ratio, reflecting the balance of psychosocial and emotional to biomedical communication of the simulated patient and student.Results
Results indicate that controlling for other elements of student communication, the RIAS composite of codes reflecting ‘emotional responsiveness’ (characterized by empathy statements, legitimization, showing concern, partnership statements and medically relevant provider self-disclosure) was positively related to the JSE Total Score while student ‘question asking’ and ‘biomedical counseling’ were negatively related to the JSE Score. RIAS-coded communication variables accounted for 32.4% of the JSE Total score.Conclusion
The relationship between student expressions of emotional responsiveness and predicted self-reported empathy provides concurrent validation evidence for the JSE.Practice implications
Further research is needed in order to elaborate and further explore a Patient-Centeredness latent variable. 相似文献8.
Anna Udvardi 《Patient education and counseling》2019,102(2):388-393
Objective
The aim of the study is to show how qualitative, linguistic analysis can be purposefully integrated into health communication research, based on the functions and outcomes of medical communication proposed by de Haes and Bensing 2009 [1].Methods
This article proposes a theoretical framework advancing health communication research and does not present primary research. The cited papers were selected on the basis of their relevance to the current purpose of the study, without the intention of being exhaustive.Results
Linguistic and conversation analytic research supports the legitimacy of commonly recommended patient-centered communication skills. However, research that directly relates linguistic analysis to certain functions and outcomes of the medical interview is sparse.Conclusion
Integrating linguistics into health communication research enhances the evidence base of healthcare communication and helps to develop effective communication training materials.Practice implications
Future research designs should purposefully and directly connect linguistic analysis with the functions and the outcomes of the medical interview. 相似文献9.
Objective
This paper is based on a 2017 Baltimore International Conference on Communication in Healthcare (ICCH) plenary presentation by the first author and addresses how female and male physicians' communication is perceived and evaluated differently. Female physicians use patient-centered communication which is the interaction style clearly preferred by patients. Logically, patients should be much more satisfied with female than male physicians. However, research shows that this is not the case.Methods
This article provides an overview on how female and male physician communication is evaluated and perceived differently by patients and discusses whether and how gender stereotypes can explain these differences in perception and evaluation.Results
Male physicians obtain good patient outcomes when verbally expressing patient-centeredness while female physicians have patients who report better outcomes when they adapt their nonverbal communication to the different needs of their patients.Conclusion
The analysis reveals that existing empirical findings cannot simply be explained by the adherence or not to gender stereotypes. Female physicians do not always get credit for showing gender role congruent behavior. All in all, female and male physicians do not obtain credit for the same behaviors.Practice Implications
Physician communication training might put different accents for female and male physicians. 相似文献10.
Shrinkhala Dawadi Janet Takefman Phyllis Zelkowitz 《Patient education and counseling》2018,101(10):1852-1858
Objectives
To examine the provision of information by health care providers (HCPs) to fertility patients about accessing psychological resources.Methods
This study utilized data from a cross-sectional survey of 659 male and female patients seeking fertility treatment at clinics in Toronto and Montreal. Regression analyses were used to assess if sociodemographic and treatment variables were associated with the receipt of information, the desire for information, the helpfulness of the information, and the likelihood that participants had sought counselling.Results
The majority of respondents (79.8%) said that their HCP had not given them information about accessing psychological resources. Of the patients who did not receive this information, most (60%) said that they wanted it. Regression analysis revealed that immigrants, women, and patients with higher perceived stress scores were significantly more likely to desire this information. Furthermore, having received this information was associated with increased odds of counselling seeking (odds ratio?=?3.31, p?=?0.013).Conclusion
Fertility patients demonstrated an unmet need for information about accessing psychological resources, and HCPs may play an integral role in bridging this information gap.Practice Implications
To improve the patient-centeredness of fertility care, HCPs should be proactive in informing all patients about how to access psychological resources. 相似文献11.
Jill Yamasaki 《Patient education and counseling》2018,101(5):830-835
Objective
This study examines a personal pet hospital visitation program dedicated to preserving the human-animal bond during chronic, critical, or terminal illness to understand the novel ways companion pets facilitate meaningful communication between patients, providers, and families in hospital settings.Methods
I thematically analyzed data collected through a variety of qualitative methods, including participant observation, informal and semi-structured interviews, and a review of organizational materials.Results
The presence of a patient’s personal pet prompted stories and behaviors characterized by (1) compassion, (2) connection, and (3) response between patients, providers, and family members.Conclusion
Personal pet hospital visits facilitate storied conversations, foster healing relationships, and offer alternative ways of knowing that can promote greater understandings of the patient’s psychosocial context for more personalized care and improved well-being.Practice implications
Patient-centered critical care requires meaningful consideration of a patient’s health, well-being, and comfort. When appropriate, the therapeutic benefits of companion animals and the deep personal bonds between patients and their pets should be acknowledged and provided as part of this care. 相似文献12.
13.
Elaine Wittenberg Betty Ferrell Joy Goldsmith Sandra L. Ragan Haley Buller 《Patient education and counseling》2018,101(3):467-474
Objective
The COMFORT Communication Course for Oncology Nurses is a train-the-trainer program funded by the National Cancer Institute (R25) that provides nationwide communication training to improve patient-centered communication in cancer care. The purpose of this article is to provide an overview of the program and present an evaluation of three courses.Methods
The curriculum contains seven modules addressing palliative care communication. Pre-course survey of needs, post-course feedback, and follow-up at 6 and 12 months were used to evaluate the program.Results
To date, three courses have been presented to 269 nurses from 34 states and Washington D.C. Post-course evaluations showed high satisfaction with course design, content, and faculty. At 12 months, course participants had implemented institution-wide system changes and communication skill building. On average, each nurse trained 37 other healthcare providers.Conclusions
The COMFORT communication course provides the essential communication skills and tools oncology nurses need to provide quality care across the cancer continuum.Practice implications
Training is needed to prepare oncology nurses with the skills to provide patient-centered communication across the cancer continuum. These skills include training others in communication and implementing process improvement. The COMFORT communication train-the-trainer model is an effective approach to meet this need. 相似文献14.
Carma L. Bylund Smita C. Banerjee Philip A. Bialer Ruth Manna Tomer T. Levin Patricia A. Parker Elizabeth Schofield Yuelin Li Abraham Bartell Alexander Chou Shira A. Hichenberg Maura Dickler David W. Kissane 《Patient education and counseling》2018,101(11):1924-1933
Objective
Integrating education about physician-patient communication into oncology specialists’ education is important to improve quality of care. Our aim was to rigorously evaluate a 4-year institutionally-based patient communication skills program for oncology post-graduate trainees.Methods
Trainees from 10 specialties in the U.S. participated in patient communication skills modules tailored to sub-specialties. The program was evaluated by comparing pre-post scores on hierarchical outcomes: course evaluation, self-confidence, skills uptake in standardized and real patient encounters, and patient evaluations of satisfaction with communication. We examined breadth of skill usage as key outcome. Generalized estimating equations were used in data analysis.Results
Two hundred and sixty-two trainees’ data were analyzed, resulting in 984 standardized and 753 real patient encounters. Participants reported high satisfaction and demonstrated significant skill growth with standardized patients, but transfer of these skills into real patient encounters was incomplete. Participants with lower baseline scores had larger improvements with both standardized and real patients.Conclusion
The program was well received and increased participant skills in the simulated setting without effective transfer to real patient encounters.Practice Implications
Future work should allocate proportionally greater resources to trainees with lower baseline scores and measure breadth of participant skill usage as an outcome. 相似文献15.
Objective
To assess whether mode of communication and patient centered communication (PCC) with physicians were associated with the likelihood of deaf smokers inquiring about lung cancer screening.Methods
An accessible health survey including questions about PCC, modes of communication, smoking status and lung cancer screening was administered in American Sign Language (HINTS-ASL) to a nationwide sample of deaf adults from February to August 2017. Of 703 deaf adults who answered the lung screening question, 188 were 55–80 years old.Results
The odds ratio of asking about a lung cancer screening test was higher for people with lung disease or used ASL (directly or through an interpreter) to communicate with their physicians. PCC was not associated with asking about a lung cancer screening test.Conclusion
Current or former smokers who are deaf and use ASL are at greater risk for poorer health outcomes if they do not have accessible communication with their physicians.Practice implications
Optimal language access through interpreters or directly in ASL is critical when discussing smoking cessation or lung cancer screening tests. Counseling and shared decision-making will help improve high-risk deaf patients' understanding and decision-making about lung cancer screening. A video in American Sign Language is available here. 相似文献16.
Jette Ammentorp Maiken Wolderslund Connie Timmermann Henry Larsen Karina Dahl Steffensen Annegrethe Nielsen Marianne E. Lau Bodil Winther Lars Henrik Jensen Elisabeth Assing Hvidt Niels Christian Hvidt Pål Gulbrandsen 《Patient education and counseling》2018,101(4):639-646
Objective
This paper aims to demonstrate how the use of participatory action research (PAR) helped us identify ways to respond to communication challenges associated with shared decision-making (SDM) training.Methods
Patients, relatives, researchers, and health professionals were involved in a PAR process that included: (1) two theatre workshops, (2) a pilot study of an SDM training module involving questionnaires and evaluation meetings, and (3) three reflection workshops.Results
The PAR process revealed that health professionals often struggled with addressing existential issues such as concerns about life, relationships, meaning, and ability to lead responsive dialogue. Following the PAR process, a communication programme that included communication on existential issues and coaching was drafted.Conclusion
By involving multiple stakeholders in a comprehensive PAR process, valuable communication skills addressing a broader understanding of SDM were identified. A communication programme aimed to enhance skills in a mindful and responsive clinical dialogue on the expectations, values, and hopes of patients and their relatives was drafted.Practical implications
Before integrating new communication concepts such as SDM in communication training, research methods such as PAR can be used to improve understanding and identify the needs and priorities of both patients and health professionals. 相似文献17.
Wei Wei Lee Maria L. Alkureishi J. Harry Isaacson Mark Mayer Richard M. Frankel Daniel A. London Kristen E. Wroblewski Vineet M. Arora 《Patient education and counseling》2018,101(12)
Objective
Despite rapid EHR adoption, few faculty receive training in how to implement patient-centered communication skills while using computers in exam rooms. We piloted a patient-centered EHR use training to address this issue.Methods
Faculty received four hours of training at Cleveland Clinic and a condensed 90-minute version at the University of Chicago. Both included a lecture and a Group-Objective Structured Clinical Exam (GOSCE) experience. Direct observations of 10 faculty in their clinical practices were performed pre- and post-workshop.Results
Thirty participants (94%) completed a post-workshop evaluation assessing knowledge, attitude, and skills. Faculty reported that training was important, relevant, and should be required for all providers; no differences were found between longer versus shorter training. Participants in the longer training reported higher GOSCE efficacy, however shorter workshop participants agreed more with the statement that they had gained new knowledge. Faculty improved their patient-centered EHR use skills in clinical practice on post- versus pre-workshop ratings using a validated direct-observation rating tool.Conclusion
A brief lecture and GOSCE can be effective in training busy faculty on patient-centered EHR use skills.Practice Implications
Faculty training on patient-centered EHR skills can enhance patient-doctor communication and promotes positive role modeling of these skills to learners. 相似文献18.
Stacey L. Sheridan Katrina E. Donahue Alison T. Brenner 《Patient education and counseling》2019,102(2):238-252
Objective
To create a shared vision for the content, delivery, measurement, and sustainment of patient-centered high value care.Methods
We performed a scoping review and translated findings into toolkit for system leaders. For our scoping review, we searched Medline, 2005-November 2015, for literature on patient-centered care (PCC) and its relationship to a high value care change model. We supplemented searches with key author, Google Scholar, and key website searches. One author reviewed all titles, abstracts, and articles for inclusion; another reviewed a random 20%. To develop our toolkit, we translated evidence into simple, actionable briefs on key topics and added resources. We then iteratively circulated briefs and the overall toolkit to potential users, making updates as needed.Results
In our scoping review, we found multiple interventions and measures to support the components of PCC and our change model. We found little on the overall effects of PCC or how PCC creates value. Potential users reported our toolkit was simple, understandable, thorough, timely, and likely to be globally useful.Conclusions
Considerable evidence supports patient-centered high value care and a toolkit garnered enthusiasm.Practice Implications
The toolkit is ready for use, but needs comparison to other approaches. 相似文献19.
Objective
Develop a reliable coding method of a Behavioral Health Treatment Model for patients with Medically Unexplained Symptoms (BHTM-MUS).Methods
Two undergraduates trained for 30 h coded videotaped interviews from 161 resident-simulated patient (SP) interactions. Trained on 45 videotapes, coders coded 33 (20%) of 161 study set tapes for the BHTM-MUS. Guetzkow’s U, Cohen’s Kappa, and percent of agreement were used to measure coders’ reliability in unitizing and coding residents’ skills for eliciting: education and informing (4 yes/no items), motivating (2), treatment statements (5), commitment and goals (2), negotiates plan (8), non-emotion patient-centered skills (4), and patient-centered emotional skills (8).Results
60 items were dichotomized a priori from analysis of the BHTM-MUS and were reduced to 33 during training. Guetzkow’s U ranged from .00 to .082. Kappa ranged from 0.76 to 0.97 for the 7 variables and 33 individual items. The overall kappa was 0.87, and percent of agreement was 95.7%. Percent of agreement by item ranged from 85 to 100%.Conclusions
A highly reliable coding method is recommended to evaluate medical clinicians’ behavioral care skills in patients with unexplained symptoms.Practice implications
A way to rate behavioral care in patients with unexplained symptoms 相似文献20.
Annemiek J. Linn Liset van Dijk Julia C.M. van Weert Beniam G. Gebeyehu Ad. A. van Bodegraven Edith G. Smit 《Patient education and counseling》2018,101(8):1419-1426