共查询到20条相似文献，搜索用时 31 毫秒
1.
Jayanthi J. Chandar David A. Ludwig Juan Aguirre Adela Mattiazzi Malgorzata Bielecka Marissa Defreitas Alan M. Delamater 《Patient education and counseling》2019,102(5):1035-1039
Objective
The objective of this study was to facilitate functional health literacy (FHL) with a modified “Teach Back” method. A computer-based program was developed for adolescent and young adult kidney transplant recipients (KTR) to knowledgeably answer questions about their medical condition, medications, and create a simple synopsis of their personal health record with the help of the heath care provider (HCP).Methods
In a pre-post quasi-experimental design, 16 patients received the computer intervention in which they navigated questionnaires and brief informational video clips. Knowledge scores were assessed at baseline and 3 months. The binomial sign test was used to evaluate change in knowledge and purpose of medications.Results
Mean age was 17.3?±?2.4 years and 94% were non-Caucasian. Seven of 16 patients were academically below grade level. Twelve of 16 patients improved their overall knowledge (P?=?0.0002) and purpose of medications (P?=?0.0017).Conclusions
A Modified “Teach Back” during clinic visits was associated with improvements in FHL.Practice Implications
This modified ‘teach back’ program has the potential to improve FHL which could contribute to long-term preservation of kidney transplants. 相似文献2.
Dana Ragouzeos Julie Gandrup Beth Berrean Jing Li Marie Murphy Laura Trupin Jinoos Yazdany Gabriela Schmajuk 《Patient education and counseling》2019,102(3):503-510
Objective
Use of patient reported outcomes (PROs) in the routine care of rheumatoid arthritis (RA) has been shown to improve health outcomes, However, integration of PROs into the clinical visit is inconsistent. We aimed to develop a “dashboard” for RA patients to display relevant PRO measures for discussion during a routine RA clinical visit.Methods
Patients (N?=?45) and providers (N?=?12) were recruited from rheumatology clinics at a university center and a safety net hospital. Using a human-centered design process involving patients, clinicians, designers, and health-IT experts, we performed interviews, clinic observations, and focus groups, which subsequently guided an iterative phase of prototype testing.Results
RA patients and their providers shared the goals of assessing wellbeing and developing a personalized treatment plan. We found conflicting views of which data were most important for guiding decision-making and for answering the patient’s overarching question of “Am I OK?”Conclusion
The final dashboard simplified the display of PRO data and correlated it longitudinally to the patient’s medication regimen. It also included laboratory values relevant for RA care.Practice implications
By presenting data graphically, the dashboard may provide a platform for patients and providers to communicate around PROs and shared goals. 相似文献3.
Johanna Granhagen Jungner Elisabet Tiselius Klas Blomgren Kim Lützén Pernilla Pergert 《Patient education and counseling》2019,102(4):656-662
Objectives
The objective of this study was to explore interpreters’ perceived strategies in the interaction in interpreter-mediated consultations between healthcare personnel and patients/families with limited Swedish proficiency in pediatric oncology care.Methods
This study had an inductive approach using an exploratory qualitative design. A total of eleven semi-structured interviews were performed with interpreters who had experience interpreting in pediatric oncology care.Results
The interpreters' perceived strategies were divided into four generic categories; strategies for maintaining a professional role, strategies for facilitating communication, strategies for promoting collaboration, and strategies for improving the framework of interpreting provision. These four generic categories were then merged into the single main category of carrying the bilingual conversation.Conclusions
The interpreters stretch their discretionary power in order to carry the bilingual conversation by using strategies clearly outside of their assignment.Practical implications
The study contributes to the understanding of the interpreter-mediated consultation in pediatric oncology care, and this can be used to improve the care of patients and families in pediatric oncology care with limited knowledge of a country’s majority language. 相似文献4.
Pritesh Rathod Lydia Ould Brahim Eric Belzile Sylvie Lambert 《Patient education and counseling》2019,102(5):952-960
Objective
To evaluate online depression self-management (SM) resources based on their readability, suitability, and quality to determine their appropriateness for use by patients.Methods
A Google search using patients’ most frequently searched terms was conducted. Resources were evaluated using readability indices, the Suitability Assessment of Materials (SAM), and the DISCERN tool. The number of SM skills and other contributing factors (e.g., resource format) were also evaluated.Results
The mean readability score across the sample was grade 10 (SD 1.5, range 8–14) and 22.2% of resources (n?=?6) met the criteria for superior suitability. The mean sample scores were 58.8% (SD 11.6, range 36%–81%) for the DISCERN and 4.4 for SM skills (SD 1.6, range 2–8). SAM and DISCERN scores were found to be significantly correlated (Pearson correlation-coefficient 0.70). A cluster analysis of SAM and DISCERN scores suggested two groups that were significantly different (t-test, P?<? 0.001): 8 resources in a “high quality” cluster and 19 resources in a “medium/low” quality cluster.Conclusion
Eight publicly available online resources scored highly. However, the readability of all the resources evaluated exceeded recommended levels.Practice implications
Resources that are accessible to people with lower literacy levels and increased user-friendliness are needed. 相似文献5.
Andrea S. Wallace Nicole L. Pierce Erica Davisson Kirstin Manges Toni Tripp-Reimer 《Patient education and counseling》2019,102(3):542-549
Objective
To evaluate an interactive tool designed to help patients communicate their social resources supportive of home recovery to health care providers.Methods
Seventy medical and surgical inpatients completed the D-CEGRM social resource interview, demographic queries, and discharge readiness surveys (RHDS) at discharge. Two weeks later, patients completed post-discharge coping difficulty surveys (PDCDS). Nurses unassociated with patients’ clinical care reviewed structured clinical notes created from the D-CEGRM and categorized patients as likely to have “inadequate” or “adequate” supportive resources for home self-management. Nurse decision making was tracked using an adjudication process, and post-hoc comparisons in patient characteristics, RHDS, and PDCDS were conducted.Results
Nurses categorized 36 patients (51%) as having inadequate resources. Number and accessibility of supports, presence of negative relationships, and previous struggles meeting health-related needs were important decision-making factors. Post-hoc comparisons revealed significant differences in demographic risk factors and discharge readiness ratings for those with inadequate vs. adequate resources.Conclusion
The D-CEGRM may be an efficient tool for patients to communicate access to social resources, and an effective facilitator of transitional care planning.Practice Implications: The D-CEGRM may provide a useful assessment of patients’ home context and guide for transitional care planning. 相似文献6.
Eli Bjørnøy Urke Silje Søbye Asta Ellingvåg Gisle Langslet Kjetil Retterstøl Margareta Wandel 《Patient education and counseling》2019,102(5):1005-1012
Objectives
Familial hypercholesterolemia (FH) is a hereditary and usually asymptomatic condition characterized by elevated blood cholesterol and increased risk of premature cardiovascular disease. It is treated with dietary modifications and lipid lowering drugs. The objective was to learn about young FH patients’ perceptions and choices regarding treatment.Methods
Data were collected through in-depth interviews with 24 patients (ages 16–35), and analysed according to Grounded Theory.Results
The findings are presented as theoretical concepts describing the participants’ way of handling their condition. The core category was identified as “Thoughts of consequences vs. Postponing thoughts of consequences”, which could be described through the following subcategories: 1. Normalising the condition, 2. Belittling of treatment vs. Committed to treatment and 3. Trust in advice vs. Avoid unnecessary interference. The participants’ position regarding these categories was described to affect motivation and challenges with treatment.Conclusions
Participants who postpone the thoughts of consequences, belittle the treatment and avoid unnecessary interference represent a challenge to health care practitioners.Practical implications
Practitioners should explore aspects such as thoughts of consequences, view of treatment and the feeling of interference to be able to better understand illness behaviour, adjust their communication and hopefully improve adherence. 相似文献7.
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8.
9.
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10.
Saraswathi Vedam Kathrin Stoll Daphne N. McRae Mo Korchinski Raquel Velasquez Jessie Wang Sarah Partridge Lorna McRae Ruth Elwood Martin Ganga Jolicoeur 《Patient education and counseling》2019,102(3):586-594
Objective
The Changing Childbirth in British Columbia study explored women’s preferences and experiences of maternity care, including women’s role in decision-making.Methods
Following content validation by community members, we administered a cross-sectional online survey exploring novel topics, including drivers for interventions, and experiences of autonomy, respect, or mistreatment during maternity care. Using the Mothers Autonomy in Decision-Making (MADM) scale as an outcome measure in a mixed-effects analysis, we examined differential experiences by socio-demographic and prenatal risk profile, type of care provider, interventions received, and nature of communication with care providers.Results
A geographically representative sample of Canadian women (n?=?2051) reported on 3400 pregnancies. Most women (95.2%) preferred to be the lead decision-maker during care. Patients of physicians had significantly lower autonomy (MADM) scores than midwifery clients as did women who felt pressured to accept interventions. Women who had a difference in opinion with their provider, and those who felt their provider seemed rushed reported the lowest MADM scores.Conclusion
Women’s autonomy is significantly altered by model of maternity care, the nature of interactions with care providers, and women’s ability for self-determination.Practice Implications
If health professionals acquire skills in person-centred decision-making experience of autonomy among pregnant women may improve. 相似文献11.
12.
Karolien Aelbrecht Lise Hanssens Jens Detollenaere Sara Willems Myriam Deveugele Peter Pype 《Patient education and counseling》2019,102(4):776-781
Aim
The value of patient-centredness, of which effective physician–patient communication is one key element, has been established within medicine. However, research shows social differences in medical communication according to the patient’s social background. This study examines the role of the patient’s ethnicity, educational background and language proficiency in relation to physician-patient interaction in 31 countries.Method
More than fifty thousand patients were given a standardized questionnaire to gain insights into the professional behaviour of their family physician and their own expectations and actions.Results
While no effect of ethnicity was found, there was a significant effect of patients’ language proficiency and educational level. Patients with lower language proficiencies were more likely to experience more negative interactions with their physicians. Second-generation migrants who did not fill in the questionnaire in an official language were more negative about the patient–physician interaction. Patients who had a greater chance of having a positive patient–physician interaction were more likely to be higher educated.Conclusion
Despite the shift towards patient-centred care in medicine, physician–patient communication is still determined by the patient’s educational background and language proficiency.Practice Implication
GPs should primarily be trained to tailor their communication styles to match patients’ backgrounds. 相似文献13.
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14.
15.
Mariëtte N. Verkissen Kathleen Leemans Lieve Van den Block Luc Deliens Joachim Cohen 《Patient education and counseling》2019,102(4):768-775
Objective
To explore how individuals with cancer and bereaved relatives evaluate information provision by specialist palliative care services (PCSs).Methods
A cross-sectional survey was conducted within four multidisciplinary palliative homecare teams (HCTs), 17 hospital-based palliative care units (PCUs) and 13 hospital-based mobile palliative support teams (PSTs) in Belgium. During four measurement periods, structured questionnaires were administered to people being guided by PCSs and relatives of patients who had died while under the care of PCSs.Results
In total, 628 patients (80%) and 980 relatives (55%) responded; 73–82% and 75–77% respectively reported having received the right amount of information. Compared with those receiving care within a PCU, those being supported by a PST were more likely to report suboptimal information provision and decision-making. Relatives of those who had died while under the guidance of a PST were also more likely to report suboptimal information provision than their PCU counterparts.Conclusion
Although information provision to cancer patients and relatives being supported by PCSs is generally evaluated positively, evaluations depend on the type of service.Practice implications
Information provided within PCUs offering highly personalised, continuous care appears to both groups more satisfactory than that provided by palliative care teams mainly supporting care staff. 相似文献16.
Jane McCusker Sylvie D. Lambert Jeannie Haggerty Mark J Yaffe Eric Belzile Antonio Ciampi 《Patient education and counseling》2019,102(3):571-577
Objectives
To examine: 1) whether patient characteristics predict perceived self-management support (usefulness of information and collaborative care planning) by primary care providers after six months, and 2) the association between perceived self-management support and patient activation at 6 monthsMethods
We conducted a secondary analysis among 120 primary care patients aged 40 and over with a chronic physical condition and comorbid depressive symptoms who participated in a randomized controlled trial of a coaching intervention for depression self-management. Activation was measured at baseline (T0) and 6 months (T1). Self-management support was captured at T1 for physical and mood problems.Results
The sample of analysis was 120 patients who completed all relevant measures. At T1, the perceived usefulness of information for mood self-management was independently associated with activation. More severe depressive symptoms at T0 predicted lower perceived usefulness of chronic condition self-management information at T1. Lower T0 mental health-related quality of life predicted lower perceived usefulness of mood self-management information at T1.Conclusions
Perceived informational support for mood self-management may contribute to increased activation. Patients with more severe mental health symptoms or impairment perceive that they receive less useful self-management information from their care team.Practice implications
Care teams should determine whether patients with mood problems need greater self-management support. 相似文献17.
18.
Nicole Saxby Sean Beggs Malcolm Battersby Sharon Lawn 《Patient education and counseling》2019,102(4):607-622
Objective
To articulate the components of educational interventions that help children learn about managing their asthma, cystic fibrosis, or diabetes, relevant to their age/developmental status.Methods
A systematic review of chronic condition self-management (CCSM) educational interventions that included age/developmentally appropriate components, published before 27 January 2018, including evidence level and quality assessments. Teaching approaches were extracted and translated into practical components.Results
Twenty education interventions were identified, published across 30 studies. Most studies (n?=?20/30) were based on the theories of Piaget and Bandura. Similar teaching approaches were used across conditions, incorporating sequenced curriculum and a variety of active elements. Age/developmentally appropriate interventions resulted in improvements in the CCSM capabilities of children. Outcomes were improved when compared with usual care.For very young children, educational interventions were directed at parents/families. As children reached school age, interventions increasingly became child-focused, promoting autonomy. Integrated play and reinforcement were common. Adolescent interventions placed greater emphasis on communication, problem-solving, and role division.Conclusion
Eight key components were identified: structured and sequenced curricula; reinforcement; active participation; collaboration; autonomy; feedback; multiple exposures; and, problem-solving. Different components are relevant to specific life stages.Practice implications
Clinicians require age/developmentally appropriate practical education tools to provide effective paediatric health care. 相似文献19.
U. Olivia Kim K. Barnekow S.I. Ahamed S. Dreier C. Jones M. Taylor Md.K. Hasan M.A. Basir 《Patient education and counseling》2019,102(4):701-708
Objective
To develop an educational mobile application (app) for expectant parents diagnosed with risk factors for premature birth.Methods
Parent and medical advisory panels delineated the vision for the app. The app helps prepare for preterm birth. For pilot testing, obstetricians offered the app between 18–22 weeks gestational age to English speaking parents with risk factors for preterm birth. After 4 weeks of use, each participant completed a questionnaire. The software tracked topics accessed and duration of use.Results
For pilot testing, 31 participants were recruited and 28 completed the questionnaire. After app utilization, participants reported heightened awareness of preterm birth (93%), more discussion of pregnancy or prematurity issues with partner (86%), increased questions at clinic visits (43%), and increased anxiety (21%). Participants reported receiving more prematurity information from the app than from their healthcare providers. The 15 participants for whom tracking data was available accessed the app for an average of 8?h.Conclusion
Parents with increased risk for preterm birth may benefit from this mobile app educational program.Practice implications
If the pregnancy results in preterm birth hospitalization, parents would have built a foundation of knowledge to make informed medical care choices. 相似文献20.
Megan Jarman Laura Adam Wendy Lawrence Mary Barker Rhonda C. Bell 《Patient education and counseling》2019,102(5):924-931