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1.
Cody Goessl Paul Estabrooks Wen You Denise Britigan Armando DeAlba Fabio Almeida 《Patient education and counseling》2019,102(5):968-975
Objective
This study evaluates the effectiveness of technology versus in-person, group-initiated diabetes prevention to enhance comprehension of learning objectives between patients with differing health literacy (HL).Methods
Evidence-based content through either a DVD (n?=?217) or in-person, group class (n?=?225) to initiate the intervention. A teach-back call was used to assess comprehension of, and reinforce, learning objectives. Chi-squared was used to determine differences between conditions (DVD vs Class) and HL levels (High n?=?361 vs. Low n?=?81) and regression analyses were used to examine relationships.Results
DVD participants performed significantly better across teach back questions (15.4?±?2.5 v. 14.8?±?2.6, p?<?0.01), demonstrated comprehension in fewer teach-back rounds (1.9?±?0.7 v. 2.1?±?0.7, p?<?0.01), and answered more questions correctly on the first try (4.2?±?1.6 v. 3.4?±?1.8, p?<?0.01). Models for HL levels and modality by HL level were statistically significant (p?<?0.01) favoring the DVD.Conclusion
Initiating a diabetes prevention program with the use of a DVD appears to be a superior option to in-person, class sessions. Teach-back and teach-to-goal strategies enables participants of both high and low health literacy levels to receive and confirm mastery of diabetes prevention objectives.Practice Implications
A teach-back call may improve information uptake increasing the likelihood of health behavior uptake. 相似文献2.
Nae Yu Kim Jung-Soo Pyo Dong-Wook Kang Seung-Min Yoo 《Pathology, research and practice》2019,215(3):580-585
Objective
The aim of this study was to elucidate the clinicopathological significance and prognostic role of loss of claudin-1 in colorectal cancer (CRC).Methods
The correlations between claudin-1 expression and clinicopathological characteristics, including survival rates, were assessed using immunohistochemistry on 260 archival, paraffin-embedded CRC tissues. In addition, the correlations between cludin-1 and nuclear factor-kappa B (NF-κB), epithelial-mesenchymal transition markers and tumor-infiltrating lymphocytes were investigated.Results
Claudin-1 expression was markedly lost in 42.7% of the 260 CRCs analyzed. Loss of claudin-1 expression significantly correlated with larger tumor size, vascular invasion, higher pT stage, and high metastatic lymph node ratio. In addition, loss of claudin-1 expression significantly correlated with NF-κB activation (P?<?0.001), high SNAI (P?<?0.001), and low E-cadherin (P?<?0.001) expressions. Patients with high immunoscores showed significantly lower rates of claudin-1 expression loss (P?=?0.020). In detail, loss of claudin-1 expression were frequently found in CRCs low CD3- and CD8-positive lymphocytes. There were significant correlations between claudin-1 expression loss and poor overall and recurrence-free survivals (P?<?0.001 and P?<?0.001, respectively).Conclusion
Taken together, our results suggest that the loss of claudin-1 expression significantly correlates with aggressive tumor behaviors, high SNAI expression, lower immunoscore, and poor prognoses. 相似文献3.
Shun Wang Jun Jiang Chao Zhang Xuhua Zhang Chuanxin Wang 《Pathology, research and practice》2019,215(4):779-783
Background
LincRNA-p21 is involved in the initiation and progression of many human diseases. We aimed to investigate the expression of LincRNA-p21 in different types of liver diseases.Methods
Serum from patients with primary liver diseases (chronic HBV or HCV infection, hepatitis B virus-related cirrhosis, hepatitis B virus-related HCC, non-HBV/HCV-related HCC, alcoholic liver disease) and HBV negative liver metastatic cancer and control healthy individuals was collected and serum lincRNA-p21 levels were determined by RT-qPCR. Clinicopathological characteristics of the patients were also recorded.Results
Serum lincRNA-p21 levels in patients with chronic HBV infection, hepatitis B cirrhosis, hepatitis B virus-related HCC, chronic hepatitis B virus infection, non-HBV/HCV-related HCC, and alcoholic liver disease were higher than those in the control individuals (P?<?0.001, P?<?0.001, P?<?0.001, P?<?0.001, P?<?0.001 and P?=?0.002, respectively). The serum lincRNA-p21 level was not significantly different between patients with HBV negative liver metastatic cancer and the normal control (P?=?0.80). LincRNA-p21 level was negatively correlated with HBV DNA (P?=?0.02), ALT (P?=?0.01) and AST (P?=?0.01) in patients with liver disease, but not correlated with gender (P?=?0.24), age (P?=?0.11) and AFP level (P?=?0.84). Serum lincRNA-p21 in hepatocellular carcinoma patients was higher than that in liver metastatic cancer patients (P?<?0.001).Conclusion
Serum lincRNA-p21 may serve as a potential biomarker for liver cell damage in patients with hepatitis virus infection, hepatitis B cirrhosis, HBV-related HCC and alcoholic liver disease. 相似文献4.
5.
Objectives
The aim of this study was to investigate the link between perceived dimensions of patient centred care and the satisfaction of adolescents and young adults within the UK, USA, Australian, Italian, and Chinese healthcare systems.Methods
One thousand and thirty-four participants (212 from China,206 from Australia,208 from UK, 202 from USA, and 206 from Italy) answered a self-report questionnaire assessing the perceived dimensions of patient centred care. Factor analysis (PFA) was conducted on the data to identify relevant dimensions. One-way ANOVAs were run to identify differences between country samples related to perceived dimensions of patient centredness, and a multi-level multiple regression model was computed to assess the link between satisfaction and dimensions of patient centred care.Results
Countries’ mean scores on ‘Satisfaction with Care’ (PF1) and on ‘Psychosocial Context’ (PF2) were statistically significant by inspecting the ANOVAs (p?<?.05). Satisfaction with care was predicted by PF2 and clinical utilization.Conclusion
An online survey collected meaningful data on perceptions of healthcare received by respondents from five countries. This initial international study highlights important associations worthy of closer investigation.Practice implications
Healthcare providers should assess comprehensively the psychosocial context of young patients during consultations. 相似文献6.
Lifeng Yu Lin Zhao Zhen Jia Jia Bi Qian Wei Xinyue Song Longyang Jiang Shu Lin Minjie Wei 《Pathology, research and practice》2019,215(3):490-498
Background
MFG-E8(Milk fat globule-EGF factor 8), a secreted glycoprotein, plays an exceptional role in various diseases. MFG-E8 overexpression is found in a variety of cancers. However, it remains unclear whether MFG-E8 overexpression is associated with the clinicopathological characteristics and prognosis of human breast cancer.Materials and methods
In this study, we detected the expression and localization of MFG-E8 protein in breast cancer and cancer-adjacent tissues using immunohistochemical staining, Western blot analysis and immunofluorescence. We analyzed the association between MFG-E8 expression and clinical characteristics and outcomes of breast cancer patients with different HR and HER2 statuses.Results
Our results confirmed that MFG-E8 expression increased significantly in breast cancer compared with cancer-adjacent tissues by immunohistochemical staining (P?<? 0.001). Similarly, the Western blot results further confirmed the increased expression of MFG-E8 in breast cancer compared with cancer-adjacent tissues (P?=? 0.001). Immunofluorescence staining showed that MFG-E8 was mainly localized in the cytoplasm and membrane of tumor cells, consistent with the immunohistochemical staining results. The high expression levels of MFG-E8 showed a greater association with lymph node metastasis, TNM stage and histological grade (P < 0.001). Moreover, high MFG-E8 expression was related to a shortened overall survival (OS) (P?<? 0.001) and disease-free survival (DFS) (P?<? 0.001). Bioinformatics analysis with a Kaplan-Meier plotter also demonstrated a strong association of MFG-E8 mRNA overexpression with a short OS and DFS compared with low MFG-E8 expression (P?=? 0.040, P?=? 0.005).Conclusions
Our findings indicate that MFG-E8 may be a potential marker for poor prognosis and survival in breast cancer. 相似文献7.
Objective
Patient education on high-risk medications such as warfarin is important, and they require quick follow-up after initiation to maximize efficacy and safety. In our Anticoagulation Clinic, two 60-minute new patient appointments are available each day, contributing to prolonged lead-time. We instituted standardized warfarin video education to shorten in-clinic-room visit time, to potentially increase new patient appointments.Methods
Patients viewed the video in the waiting area with a goal to decrease visit times by 15?min (25%), before pharmacists completed their visit. Data collected included time spent in the clinic room, education comprehension, and patient feedback.Results
Ninety patient visits were evaluated in one pre-intervention and two post-intervention phases. Patients who received video education spent less time in the clinic room versus those who had not (52.4 vs 39.4?min, p?=?0.001), and two-thirds of all post-intervention visits achieved 25% reduction in visit time. There were no significant differences in education comprehension and patient satisfaction.Conclusion
Video education significantly decreased in-clinic-room visit time, and most patients achieved a goal of 25% reduction in time spent, without a change in comprehension or patient satisfaction.Practice implications
Implementation of video education can reduce clinic times in many patients without significantly impacting patient satisfaction. 相似文献8.
Binnari Kim Yun-jeong Jang Sujin Park Jung-Il Lee Hong Kwan Kim Joungho Han 《Pathology, research and practice》2019,215(4):807-815
Background
Studies have shown that 30–50% of non-small cell lung cancer (NSCLC) patients develop brain metastasis (BM). Since BM shortens overall survival and decreases the quality of life, early detection and treatment of BM are vital. While data are available for clinical risk factors of NSCLC with BM, histopathological factors are not well understood. Therefore, we evaluated the histopathological related factors which will help early detection and selection of effective treatment options.Materials and methods
A total of 117 surgical lung specimens diagnosed as NSCLC with BM were included as a study group. We included 237 cases without BM as a control group. One pathologist reviewed H&E slides and analyzed the histopathologic factors of all cases.Results
In pulmonary adenocarcinoma, vascular invasion, N stage, micropapillary pattern and necrosis were significantly associated with BM in multivariate analysis (vascular invasion, p?=?0.009; micropapillary pattern, p?=?0.024; others, p?<?0.001). Tumor with extensive necrosis had higher hazard ratio and shorter time to BM (p?<?0.001).Conclusion
Our findings suggest that necrosis is a new predictive factor of BM in pulmonary adenocarcinoma. Short term follow-up is needed especially when extensive necrosis is present. 相似文献9.
Patient knowledge and attitudes toward cervical cancer screening after the 2012 screening guidelines
Jayanti M. Clay Joanne K. Daggy Sunetris Fluellen Brownsyne Tucker Edmonds 《Patient education and counseling》2019,102(3):411-415
Objective
To assess women’s attitudes and preferences related to recent changes in cervical cancer screening guidelines.Methods
We distributed 380 surveys in three University based and Community clinics. Study participants anonymously completed surveys, which included questions related to demographics, cervical cancer, screening practices, risk perception and attitudes towards changing practices.Results
315 women agreed to participate (83%). 60% (185/310) of participants had some college education or higher and 12% (36/305) worked in the medical field. On average, participants answered 4.1 (SD?=?1.3) of the 8 knowledge questions correctly. Knowledge scores significantly increased with education level (Kruskal-Wallis test p-value?<?0.001). The majority (72%, n?=?228) reported that they should be screened annually, and that screening should be initiated with the onset of sexual activity (63%, n?=?197). Participants that were more knowledgeable of current screening practices were more comfortable extending screening intervals (Kruskal-Wallis test p?<?0.001).Conclusion
Even among a relatively highly educated population of women, participants had limited knowledge of cervical cancer and current screening guidelines. Many participants reported discomfort with less frequent screening intervals.Practice implications
This study supports the need for improvement in cervical cancer prevention education especially with regards to the new screening guidelines. 相似文献10.
Objective
Information overload can negatively impact positive health behaviors such as cancer screening. The 8-item Cancer Information Overload (CIO) scale appears to be the only validated measure of health-related information overload. The present study assesses the validity of the CIO scale when modified for use in patients with atrial fibrillation (AF) residing in Australia.Methods
We conducted a secondary analysis of data from a study of adult Australian patients with AF (N?=?386) in which a modified version of the CIO scale was used. In the present study, we examined the construct (convergent and divergent) validity and performed an exploratory factor analysis for the modified scale.Results
All items on the modified-CIO scale appear to load onto a single factor. As predicted, higher education levels (rs=-.24, p?<?.001) and higher oral anticoagulant knowledge (rs=-.17, p?=?.001) were significantly associated with lower modified-CIO scores; no other demographic characteristics were significantly associated with CIO scores.Conclusion
When adapted to the AF context, the modified-CIO scale appears to be a valid measure of information overload.Practice Implications
A valid scale is required to measure information overload accurately. Knowledge of the interplay between information overload and various health behaviors help focus future efforts to support patient empowerment. 相似文献11.
Objective
To examine the effects of presentation formats on consumers’ performance and perceptions in the use of personal health records (PHRs) and to compare the effects between older and young adults.Methods
A two-factor, mixed design experiment was conducted, where 36 older and 36 young participants were presented with hypothetical PHRs. The PHRs were randomly presented by six presentation formats: three tables and three line graphs, varying by visual cues. Participants’ performance and perceptions in the use of PHRs were measured.Results
Presentation formats affected participants’ performance and perceptions. Visual cue-enhanced line graphs and tables yielded less time and fewer errors, were considered easier and more useful in information comprehension, and resulted in higher confidence in correct comprehension of PHRs (all p's < 0.01), compared with their basic counterparts. There were age-related differences in task performance (all p's < 0.05), while young and older adults had similar perceptions for the six formats. Line graph with colored background was most preferred by both groups.Conclusion
Visual cue-enhanced presentation formats appear effective in facilitating comprehension and eliciting favorable perceptions of PHRs for both young and older adults.Practice implications
Consumer-facing displays of PHRs could use visual cue-enhanced presentation formats to facilitate comprehension. 相似文献12.
Silvia Freira Helena Fonseca Geoffrey Williams Marta Ribeiro Fernanda Pena Maria do Céu Machado Marina Serra Lemos 《Patient education and counseling》2019,102(4):718-725
Objective
To compare motivational interviewing (MI) with conventional care regarding the health-related quality-of-life (HRQoL) of adolescents with overweight/obesity.Methods
RCT with parallel design, involving two groups: intervention group (MI group [MIG]) and control group (conventional intervention group [CIG]). The intervention included three 30-minute interviews 3 months apart.Outcome
Change in Pediatric Quality of Life Inventory (PedsQL) scores. A mixed repeated-measures analysis of variance was used to assess group versus time interactions.Results
Eighty-three participants finished the protocol (82% girls). MIG participants showed a significant average increase (+4.7) on the Psychosocial (t[41] = -2.388, p = .022, d = .37) and Emotional Subscales (+5.1) (t[41] = 5.733, p < .001, d = .88). CIG participants showed a significant average decrease on the Psychosocial (-6.1) (t[40] = 5.733, p < .001, d = .90), Emotional (-14.1) (t[40] = 7.249, p < .001, d = 1.13) and Social Subscales (-3.8) (t[40] = 3.782, p = .001, d = .59) and on the Total Score (–4.4) (t[40] = 3.535, p = .001, d = .55)Conclusion
MI improved HRQoL among overweight adolescents participating in a weight management program.Practice implications
MI increases HRQoL and has the potential to benefit weight management programs for adolescents. 相似文献13.
Nahed A. Soliman Shaimaa M. Yussif Abdelhadi M. Shebl 《Pathology, research and practice》2019,215(5):977-982
Introduction
Syndecan-1 is heparan sulfate proteoglycans (HSPGs) that is used as coreceptors for signaling of growth factors. The comprehensive effect of syndecan-1 is to augment receptor stimulation at little ligand concentrations.The goal of this research
is to study syndecan-1 expression in breast carcinoma and its value in predicting the prognosis in comparison to other clinicopathological parameters.Material &methods
immunohistochemistry study for syndecan-1 is done on 103 cases of invasive breast carcinoma. Its expression is assessed and correlated to other clinicopathological parameters and prognosis.Results
overexpression was significantly related to high histologic grade (p?=?0.001), large tumor size (p?=?0.043), HER2-positive status (p?=?0.001), and ER&PR-negative status (p?=?0.001). It was also have a negative impact on the overall survival (p=0.012) and disease free survival (p?=?0.009). Syndecan-1 expression showed weak positive correlation with Her 2 expression (Correlation Coefficient (co): 0.332, p?=?0.001).Conclusion
syndecan-1 is a good predictor of poor overall survival and recurrence/ metastasis free survival. It is associated with aggressive phenotype as HER2 enriched and Triple negative rather than luminal subtypes of breast carcinoma. So it can be added to the hormonal receptors and HER 2 assay in the routine management of invasive breast cancer after confirmation on a more larger study. 相似文献14.
Claudia Martinez-Tapia Florence Canoui-Poitrine Philippe Caillet Sylvie Bastuji-Garin Christophe Tournigand Elias Assaf Gwénaëlle Varnier Frederic Pamoukdjian Etienne Brain Florence Rollot-Trad Marie Laurent Elena Paillaud 《Patient education and counseling》2019,102(3):429-435
Objective
To compare the preferences of older (≥70 years old) versus younger (<70 years old) cancer patients regarding surrogate designation and decision making.Methods
A cross-sectional survey. Patient characteristics and information about surrogacy and involvement in decision making were collected. Associations between patient characteristics and preferences were examined.Results
The study included 130 patients aged ≥70 years (mean age 80 years) and 102 patients aged <70 years (mean age 55) and. Factors independently associated with surrogate knowledge (66%): younger age, more children living nearby, high income; factors associated with having already designated a surrogate (62%): younger age, decreased number of daily medications; factors associated with designating a surrogate after questionnaire administration (40%): low education, metastasis. Patients requiring an informed consent for any intervention was associated with older age (adjusted OR [aOR]per year?=?1.04[95% confidence interval 1.00–1.08]), not living alone (aOR?=?2.52[1.00–6.36]), and having children (aOR?=?4.49[1.13–17.81]).Conclusion
All cancer patients, wanted to be fully informed and 72% wanted to be involved in medical decisions. Preferences for decision control vary between age groups, depending on family members’ presence and living alone.Practice implications
Sharing complete and clear information should be an important key in the process of cancer patients’ care, regardless of patient age. 相似文献15.
Sucharita Kher Hillary Landau Stephanie M. Hon Janis L. Breeze Nadine Al-Naamani Jessica K. Paulus Andrew Martin Rosemary Tsacoyianis 《Patient education and counseling》2019,102(5):932-936
Objective
Identify inhaler use characteristics among English (ESP) and non-English speaking patients (NSP) to develop quality improvement efforts.Methods
Outpatients were surveyed for technique confidence, education, preferences and disease control. We compared characteristics between ESP and NSP.Results
Of 197 respondents, 75% were ESP, 25% were NSP. Compared to NSP, ESP responders were more likely female (57% vs 31%, p?=?0.001), used inhalers for a longer time (10 vs 6 years, p?=?0.008) and had higher rates of metered dose inhaler use (85% vs. 60%, p?<?0.001). Both language groups had similar confidence in inhaler use, after adjustment for age, gender and duration of use. Similar rates of inhaler technique education were reported by ESP and NSP at the initial visit. More NSP reported receiving education at subsequent visits (54% vs. 72%, p?=?0.03). Education for both groups was mostly performed by a clinician. Both language groups reported low internet use for learning proper technique, low interest in a separate education session, preferred an active learning method.Conclusions
These findings will be used to further develop quality inhaler education efforts at our institution.Practical implications
Local patient preferences should be considered when designing inhaler education programs. 相似文献16.
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17.
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18.
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19.
Yujie Dong Zhen Zhou Jianguo Wang Li Ma Zichen Liu Yuxuan Wang Jing Song Shucai Zhang Nanying Che 《Pathology, research and practice》2019,215(5):946-951