Information autour du dépistage organisé du cancer du sein. L’INCa et Cancer Rose répondent-ils aux critères des outils d’aide à la décision ?

BackgroundControversies around organized breast cancer screening emphasize the need for information for women. In France, the institute of cancer (INCa) is in charge of conveying this information. Cancer Rose's website (CR) provides complementary information considering INCa's incomplete. The objective of this study was to identify if these informations meet criteria for decision aid.MethodsInformation documents were selected and analyzed using International Patient Decision Aid Standards (IPDAS). Each item was noted A (absent), P (present) or I (present but incomplete).ResultsInformation booklet and press kit for INCa and studies section for CR were the document meeting most criteria. The document meeting fewer criteria were the INCa's video and information leaflet for CR. Videos are more accessible tools for people with lower levels of health literacy. INCa's video did not present the risks of screening and CR's emphasized the risks.ConclusionThese documents have not been evaluated for intelligibility, clarity and readability. Addressing these criteria limits social inequities and improves health literacy.     

Communication practices in conversations about sexual health in medical healthcare settings: A systematic review

ObjectiveMany healthcare professionals experience difficulties in discussing sexual health with their patients. The aim of this review was to synthesize results of studies on communication practices in interactions about sexual health in medical settings, to offer healthcare professionals suggestions on how to communicate about this topic.MethodsWe searched for studies using five databases. Reference lists and specialist bibliographies were searched to identify additional studies. We included discourse analytic studies that used recordings of medical consultations.ResultsWe identified five studies that met the inclusion criteria. Findings were synthesized into seven categories of practices deployed by patients and healthcare professionals when talking about sexual health: avoiding delicate terms (1), delaying potentially delicate words and issues (2), using assumptive talk (3), generalized advice-giving (4), deploying patients’ talk (5), depersonalization (6), and patient-initiated advice (7).ConclusionPractices indicate the delicacy associated with discussing sexual health issues, but results also shed light on practices that can help professionals to deal with this delicacy, and to be responsive to patients’ needs and concerns.Practice implicationsFindings will assist healthcare professionals in broaching topics related to sexual health so they can help patients deal with challenges that affect their sexual health and overall well-being.     

Epidemiology of Connectional Silence in specialist serious illness conversations

ContextHuman connection can reduce suffering and facilitate meaningful decision-making amid the often terrifying experience of hospitalization for advanced cancer. Some conversational pauses indicate human connection, but we know little about their prevalence, distribution or association with outcomes.PurposeTo describe the epidemiology of Connectional Silence during serious illness conversations in advanced cancer.MethodsWe audio-recorded 226 inpatient palliative care consultations at two academic centers. We identified pauses lasting 2+ seconds and distinguished Connectional Silences from other pauses, sub-categorized as either Invitational (ICS) or Emotional (ECS). We identified treatment decisional status pre-consultation from medical records and post-consultation via clinicians. Patients self-reported quality-of-life before and one day after consultation.ResultsAmong all 6769 two-second silences, we observed 328 (4.8%) ECS and 240 (3.5%) ICS. ECS prevalence was associated with decisions favoring fewer disease-focused treatments (OR_adj: 2.12; 95% CI: 1.12, 4.06). Earlier conversational ECS was associated with improved quality-of-life (p = 0.01). ICS prevalence was associated with clinicians' prognosis expectations.ConclusionsConnectional Silences during specialist serious illness conversations are associated with decision-making and improved patient quality-of-life. Further work is necessary to evaluate potential causal relationships.Practice implicationsPauses offer important opportunities to advance the science of human connection in serious illness decision-making.     

Parental Communication Not to Smoke and Adolescent Cigarette Smokers' Readiness to Quit: Differences by Age

There is limited information on the relationship between parental practices that specifically discourage current cigarette smoking and adolescent cessation, and how this relationship varies by age. Among 1629 adolescent smokers, self-reported receipt of parental communication not to smoke was significantly and positively associated with readiness to quit. The strength and significance of this association decreased from early to middle adolescence and was not significant in late adolescence.     

新时期我国人学研究综述

改革开放以来 ,我国的人学研究有两条发展道路 :一是执政党的指导思想中以人为本、促进人的全面发展的观念日益清晰。二是学界围绕人道主义与异化问题、人的本质与人的价值问题、人的现代化、人的主体性等问题把对人学问题的研究逐步推向深入 ,二者相互促进 ,使人学作为一门独立的学科展现出广阔的发展前景。进入新的世纪 ,我国人学研究的重点转向人的全面发展 ,学术界就人的全面发展的丰富内涵以及在社会主义初级阶段如何从发展先进生产力、进行制度创新、加强先进文化建设、扩大交往等方面促进人的全面发展进行了全方位的深入的探讨。同时 ,学术界提出要高度关注“马克思的问题域” ,处理好发展社会主义市场经济与促进人的全面发展的关系。另外 ,学术界还从人与环境、人的实践的自发性与自觉性的关系等方面尝试总结关于人的发展的规律 ,这从一个更高的层面推进了我国的人学的研究