共查询到20条相似文献,搜索用时 15 毫秒
1.
Peter Scalia Marie-Anne Durand Julia L. Berkowitz Nithya P. Ramesh Marjan J. Faber Jan A.M. Kremer Glyn Elwyn 《Patient education and counseling》2019,102(5):817-841
Objective
To determine the effect of encounter patient decision aids (PDAs) as evaluated in randomized controlled trials (RCTs) and conduct a narrative synthesis of non-randomized studies assessing feasibility, utility and their integration into clinical workflows.Methods
Databases were systematically searched for RCTs of encounter PDAs to enable the conduct of a meta-analysis. We used a framework analysis approach to conduct a narrative synthesis of non-randomized studies.Results
We included 23 RCTs and 30 non-randomized studies. Encounter PDAs significantly increased knowledge (SMD?=?0.42; 95% CI 0.30, 0.55), lowered decisional conflict (SMD= -0.33; 95% CI -0.56, -0.09), increased observational-based assessment of shared decision making (SMD?=?0.94; 95% CI 0.40, 1.48) and satisfaction with the decision-making process (OR?=?1.78; 95% CI 1.19, 2.66) without increasing visit durations (SMD= -0.06; 95% CI -0.29, 0.16). The narrative synthesis showed that encounter tools have high utility for patients and clinicians, yet important barriers to implementation exist (i.e. time constraints) at the clinical and organizational level.Conclusion
Encounter PDAs have a positive impact on patient-clinician collaboration, despite facing implementation barriers.Practical implications
The potential utility of encounter PDAs requires addressing the systemic and structural barriers that prevent adoption in clinical practice. 相似文献2.
Andrea M. Russell Deesha A. Patel Laura M. Curtis Kwang-Youn A. Kim Michael S. Wolf Megan E. Rowland Danielle M. McCarthy 《Patient education and counseling》2019,102(4):749-752
Objective
To determine the reliability of the Newest Vital Sign (NVS) administered via telephone by examining test-retest properties of the measure.Methods
Data were obtained from a randomized controlled trial promoting opioid safe use. Participants were 18 or older and English-speaking. NVS assessment occurred in-person at baseline and in-person or via telephone at follow-up. Intraclass correlation coefficients (ICCs) were used to assess the test-retest reliability using raw NVS scores by mode of administration of the second NVS assessment. Kappa statistics were used to examine test-retest agreement based on categorized NVS score. Internal consistency was measured with Cronbach’s alpha.Results
Data from 216 patients (70 completing follow-up in-person and 146 via telephone) were included. Reliability was high (ICCs: in-person?=?0.81, phone?=?0.70). Agreement was lower for three category NVS score (Kappas: in-person?=?0.58, 95% CI [0.39-0.77]; phone?=?0.52, 95% CI [0.39-0.65]) compared to two category NVS (Kappas: in-person?=?0.65, 95% CI [0.46-0.85]; phone?=?0.64, 95% CI [0.51-0.78]). Correlations decreased as time between administrations increased. Internal consistency was moderately high (baseline NVS in-person (α?=?0.76), follow-up NVS in-person (α?=?0.76), and phone follow-up (α?=?0.78).Conclusion
The test-retest properties of the NVS are similar by mode of administration.Practice implications
This data suggests the NVS measure is reliably administered by telephone. 相似文献3.
Menglan Li Qianyun Deng Lei Zhang Siying He Jialing Rong Fang Zheng 《Pathology, research and practice》2019,215(1):5-11
Background
The lymphocyte to monocyte ratio (LMR), a novel systematic biomarker of inflammation, has been reported to be associated with the progression and prognosis of many malignant cancers. However, the relationship between LMR and survival outcome of urological cancers (UCs) remains controversial. Herein, we conducted a meta-analysis to identify the prognostic value of pretreatment LMR in patients with UCs.Methods
A literature search was performed in PubMed, Web of Science, Embase, Cochrane Library, Cochrane Central Register of Controlled Trials, Scopus, and CINAHL databases up to July 2018. The pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the association of LMR with survival outcome and clinicopathological characteristics in UCs.Results
A total of 17 articles containing 5552 patients were included in our study. The synthesized analysis showed that elevated pretreatment LMR level could predict favorable overall survival (OS) of UCs patients (pooled HR?=?0.82, 95%CI: 0.77-0.87). Additionally, the decreased LMR level was correlated with tumor stage (OR?=?1.72, 95%CI: 1.15–2.55), lymph node metastasis (OR?=?1.46, 95%CI:1.06-1.99), grade (OR?=?1.79, 95%CI:1.41–2.27), tumor size (OR?=?2.21, 95%CI:1.81–2.68) and necrosis (OR?=?1.71, 95%CI:1.36–2.16).Conclusion
The high pretreatment LMR was associated with favorable prognosis, and could be a potential prognostic biomarker in patients with UCs. 相似文献4.
Richard Wagland Johana Nayoan Lauren Matheson Carol Rivas Jo Brett Amy Downing Sarah Wilding Hugh Butcher Anna Gavin Adam W. Glaser Eila Watson 《Patient education and counseling》2019,102(4):797-803
Objectives
To explore experiences of treatment decision-making (TDM) amongst men diagnosed with stage 1–3 prostate cancer.Methods
Mixed-methods study incorporating UK-wide cross-sectional postal survey of men 18–42 months post-diagnosis and semi-structured interviews with a subsample (n?=?97), including men who received both radical treatments and active surveillance. Interview data was analysed using a Framework approach.Results
Within the context of TDM, 'drivers' included men's intra-personal preferences for decision-making responsibility or clinical direction, relative treatment intrusiveness or desire for excision, and work, personal and social life priorities; 'facilitators' were inter-personal mechanisms such as information and communication with clinicians to enact, but also sometimes challenge drivers. Drivers and facilitators can conflict, challenging patient empowerment. Men frequently undertook greater TDM responsibility than desired, without clinical recommendations; others received conflicting recommendations. Information on potential side-effects was often reportedly inadequate. Unchallenged preferences, absence of clinical recommendations and inadequate preparation for side-effects sometimes led to decision regret.Conclusions
Men are not empowered when expected to take more TDM responsibility than desired, when provided with conflicting recommendations, or when their potentially inappropriate preferences are unchallenged.Practice implications
TDM should involve men exercising preferences and priorities in discussion with clinicians. Clinicians should ensure patients do not receive conflicting recommendations. 相似文献5.
Angelika Eisele Daniela Schagg Lena Violetta Krämer Jürgen Bengel Wiebke Göhner 《Patient education and counseling》2019,102(1):25-36
Objective
To identify Behaviour Change Techniques (BCTs) applied in interventions to enhance physical activity (PA) adherence in patients with chronic musculoskeletal conditions and to investigate the effectiveness of these interventions in increasing PA adherence.Methods
A systematic search of seven databases was conducted. We included (cluster/quasi-) randomised controlled trials comparing behaviour change interventions to no/placebo/minimal interventions or usual care and involving at least a three-month post-intervention follow-up. Methodological quality was assessed, study characteristics and BCTs were narratively summarised and a meta-analysis was conducted.Results
Across 22 included studies, we coded 8–18 BCTs (mean?=?11.2) in intervention and 0–12 (mean?=?3.5) in control groups. Common BCTs were “graded tasks”, “goal setting”, “self‐monitoring”, “problem solving” and “feedback”. Meta-analyses of 17 studies revealed a small medium-term effect (3–6 months post-intervention, standardised mean difference (SMD)?=?0.20, 95% CI 0.08–0.33) and no long-term effect (7–12 months post-intervention, SMD?=?0.13, 95% CI ?0.02 to 0.28). Subgroup analysis yielded a higher effect (SMD?=?0.29, 95% CI 0.19–0.40) for interventions using a greater number of BCTs.Conclusion
There is moderate quality evidence that interventions using BCTs are effective to enhance medium-term physical activity adherence.Practice implication
While superiority of single BCTs was not shown, it is likely that using more BCTs results in better adherence. 相似文献6.
Allison A. Marshall Alessandra Zaccardelli Zhi Yu Maria G. Prado Xinyi Liu Rachel Miller Kroouze Sarah S. Kalia Robert C. Green Nellie A. Triedman Bing Lu Kevin D. Deane Maura D. Iversen Elizabeth W. Karlson Jeffrey A. Sparks 《Patient education and counseling》2019,102(5):976-983
Objective
To investigate the effect of providing comprehensive personalized risk information on concern for chronic disease development.Methods
Unaffected first-degree relatives (FDRs) of rheumatoid arthritis (RA) patients (n?=?238) were randomly allocated to: 1) disclosure of RA risk personalized to demographics, genetics, biomarkers, and behaviors using a web-based tool (PRE-RA arm, n?=?78); 2) PRE-RA with interpretation by a health educator (PRE-RA Plus arm, n?=?80); and 3) standard RA education (Comparison arm, n?=?80). Concern for developing RA was assessed at baseline and immediately, 6 weeks, 6 months, and 12 months post-intervention.Results
FDRs randomized to PRE-RA arms were less concerned about developing RA than the Comparison arm at all post-intervention assessments (p?<?0.05). Among those concerned about RA risk at baseline, the PRE-RA (OR?=?4.7, 95%CI 1.5–14.4) and PRE-RA Plus (OR?=?5.2, 95%CI 1.6–17.3) arms were more likely to have reassurance 6 months post-intervention than the Comparison arm.Conclusion
A comprehensive tool provided reassurance to those at risk for developing a chronic disease, with or without interpretation from a health educator, compared to standard education.Practice implications
Individuals may be more likely to be reassured using a personalized chronic disease risk disclosure tool than a standard non-personalized approach. 相似文献7.
Julia Seay Amanda Hicks Merry Jennifer Markham Matthew Schlumbrecht Meghan Bowman Jennifer Woodard Austin Kollefrath Daniela Diego Gwendolyn P. Quinn Matthew B. Schabath 《Patient education and counseling》2019,102(5):984-989
Objective
Despite substantial LGBT cancer health disparities, there are no LGBT cultural competency trainings tailored for oncologists. Here we describe the systematic development of a web-based, oncology-focused LGBT cultural competency training.Methods
A literature review regarding LGBT cancer outcomes and competency training was conducted to identify potential training content. An expert panel meeting, including LGBT cancer survivors, cultural competency experts, oncologists, a web designer, and an instructional designer, was held to solidify the training content focus. Following the panel, the training was developed in collaboration with an instructional designer, a web designer, and LGBT community members.Results
The training modules include: 1) LGBT Basics; 2) Inclusive Environments; 3) Initiating Oncology Care with LGBT Patients; and 4) Issues in Cancer Survivorship among LGBT Patients. Module content is interactive, and models effective communication.Conclusion
The process of collaboration with a diverse group of stakeholders and three cancer centers in Florida has resulted in a practical and efficient web-based resource for LGBT cultural competency training for oncologists.Practice implications
Feedback from stakeholders indicates that training in this area is needed and will be well-received by oncologists. We are currently conducting an evaluation of this training among oncologists and LGBT community members. 相似文献8.
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9.
Urawan Withidpanyawong Sanguan Lerkiatbundit Woranuch Saengcharoen 《Patient education and counseling》2019,102(1):85-92
Objectives
To investigate the effectiveness of family intervention for type 2 diabetes and to examine predictors of glycaemic control.Methods
This was a prospective randomised controlled trial. Participants with type 2 diabetes were randomly assigned to an intervention group (n?=?98) or a control group (n?=?98). A pharmacist delivered the educational sessions and encouraged family members to take an active role in self-management practices for the intervention patients. The control patients received usual care.Results
At the end of the study (9-month follow-up), greater reduction in glycosylated haemoglobin (HbA1c) occurred in the intervention group than in the control group (?1.37% and ?0.21%, respectively; P?<?0.001). Between-group differences in the improvements of low-density lipoprotein cholesterol (LDL-C) and blood pressure were found (P?<?0.05). Higher scores in diabetes knowledge of patients, family support, medication adherence, self-management and self-efficacy were seen in the intervention group than in the control group (P?<?0.05). Multivariable analysis showed family members who were spouses or women were strong predictors of improved glycaemic control.Conclusion
Family-involvement intervention is helpful in diabetes management, especially having spouses or women as caregivers.Practice implications
Family involvement should be encouraged in diabetes care. 相似文献10.
11.
Objetive The aim of the present study is to analyse the factors related to the scientific production of undergraduate students.
Materials and methods
A retrospective, relational study was designed and included 45 students of the Faculty of Dentistry at the National University of San Marcos who had published scientific articles from 2010 to 2017. The students were selected from a manual search of their articles in the databases: Scopus, PubMed, SciELO, LILACS, Google Scholar, and Cochrane. Each student completed a questionnaire that included items to assess the personal, work, academic, and institutional characteristics of each student. Each factor was related to the amount of scientific production.Results
It was found a scientific production of 10%, belonging to a Scientific Society (OR = 0.639 95% CI: 1.61-2.32), having participated in scientific congresses (OR = 0.583 IC95%: 0.65-1.64), having organized academic / scientific events (OR = 0.58 IC95%: 0.83-2.05), having taken courses on scientific writing (OR = 0.088 IC95%: -0.447-0.78), greater time spent on research (OR = 0.64 IC95%: 0.12-1.71) and being recognized by their teachers (OR = 0.88 IC95%: 0.64-1.57) were related to a higher scientific production.Conclusion
Personal and academic factors are mainly related to higher student scientific production, which is why their promotion into the university environment is needed. 相似文献12.
Dagoberto Cortez Douglas W. Maynard Toby C. Campbell 《Patient education and counseling》2019,102(2):216-222
Objectives
Analyze entire oncology clinical visits and examine instances in which oncologists have to break the bad news that patients’ treatments are no longer effective.Methods
Using conversation analysis we examine 128 audio recorded conversations between terminal cancer patients, their caregivers, and oncologists.Results
When oncologists break the bad news that a patient’s treatment is no longer effective, they often use a conversational device we call an “exhausted current treatment” (ECT) statement, which avoids discussing prognosis in favor of further discussing treatment options. Analysis suggests that improving and prioritizing patient-centered care and shared decision making is possible if we first understand the social organization of clinical visits.Conclusions
ECT statements and their movement towards discussing treatment options means that opportunities are bypassed for patients and caregivers to process or discuss scan results, and their prognostic implications.Practice Implications
When oncologists and patients, by fixating on treatment options, bypass opportunities to discuss the meaning of scan results, they fail to realize other goals associated with prognostic awareness. Talking about what scans mean may add minutes to that part of the clinic visit, but can create efficiencies that conserve overall time. We recommend that oncologists, after delivering scan news, ask, “Would you like discuss what this means?”. 相似文献13.
Cindy B. Matsen Sarah Lyons Melody S. Goodman Barbara B. Biesecker Kimberly A. Kaphingst 《Patient education and counseling》2019,102(1):155-161
Objective
To better understand decision role preferences in women diagnosed with breast cancer at a young age for return of results of genome sequencing in research and clinical settings.Methods
Participants were surveyed about communication and decision-making preferences related to genome sequencing results and factors that may affect these preferences. The primary outcome was decision role preference (Control Preference Scale) for selecting what results to receive within medical care or within a research study.Results
For results returned as part of medical care, most patients preferred a collaborative (N?=?481, 45%) or active (N?=?488, 45%) role with only 107 (10%) choosing a passive role. When making the decision as part of a research study, most patients preferred an active role (N?=?617, 57%), 350 (33%) choosing a collaborative role, and110 (10%) choosing a passive role.Conclusion
Most women in this study preferred to share in decision making. Participants had somewhat different role preferences for clinical and research contexts, with greater preference for active roles in the research context.Practice Implications
We advocate for practice guidelines that incorporate discussion of decision role as an integral part of patient centered care and shared decision-making and recognize that more work is needed to inform guidelines. 相似文献14.
Haochang Hu Cong Zhou Bin Li Yanfei Chen Jie Dai Yiyi Mao Tianyi Huang Hang Yu Min Chen Jun Zhao Shiwei Duan 《Pathology, research and practice》2018,214(10):1572-1578
Purpose
Ras association domain family 1 isoform A (RASSF1A), a member of Ras association domain family, plays an important role in tumorigenesis. The goal of our meta-analysis was to assess the diagnostic value of RASSF1A hypermethylation in colorectal cancer (CRC).Methods
PubMed, Embase, CNKI and Wanfang databases were used to conduct literature selection. The association between RASSF1A methylation and CRC risk was evaluated by odds ratios (ORs) and 95% confidence intervals (CIs). Summary receiver operating characteristics (SROC) test was used to estimate the diagnostic value of RASSF1A methylation for CRC.Results
A total of 22 articles among 1736 CRC and 811 non-tumor samples were included in the current meta-analysis. Our results showed that RASSF1A hypermethylation was found more frequently in CRC than non-tumor samples (OR?=?6.02, 95% CI?=?4.57–7.93, P?<? 0.001). Our SROC test showed that RASSF1A hypermethylation had an area under the curve (AUC) of 0.71 with a pooled sensitivity of 0.33 (95% CI?=?0.31–0.36), a pooled specificity of 0.86 (95% CI?=?0.84–0.89), a positive-likelihood ratio of 3.18 (95% CI?=?1.99–5.09), a negative-likelihood ratio of 0.71 (95% CI?=?0.63–0.80), and a diagnostic odds ratio of 5.53 (95% CI?=?3.40–9.00). Data mining study indicated that a trend of increased RASSF1A expression was found in the CRC cell line C2C12 after 5-AZA treatment.Conclusions
Our study established that RASSF1A hypermethylation might have a potential value in the clinical diagnosis of CRC. 相似文献15.
Mary M. Step Gretchen A. Ferber Catherine Downs-Holmes Paula Silverman 《Patient education and counseling》2019,102(1):77-84
Objective
To assess the feasibility of a team-based prognosis and treatment goal discussion for women living with advanced breast cancer.Methods
Female patients diagnosed with advanced breast cancer (n?=?25) participated in a mixed methods study that evaluated the feasibility and effects of a planned and structured prognosis discussion. Audio analysis of the intervention appointments was conducted to assess intervention feasibility. Patient self-reports of prognosis related beliefs and treatment preferences were compared across intervention and usual care groups.Results
Most patients found the T-PAT appointment challenging but worthwhile. Intervention uptake by clinicians was good, but some fidelity disruptions were noted. T-PAT participants were more likely to hold realistic beliefs about disease curability after the appointment.Conclusion
Productive prognosis discussions can be delivered effectively by a practice-based clinical team within a semi-structured patient education appointment. It was perceived by patients with advanced breast cancer as both valuable and acceptable. T-PAT clinicians found the intervention easy to deliver.Practice implications
Regular implementation of T-PAT may help clinicians’ build prognosis discussion communication skills. T-PAT documentation provides valuable information that can be used to tailor ongoing care. 相似文献16.
Stuart Ekberg Susan Danby Johanna Rendle-Short Anthony Herbert Natalie K. Bradford Patsy Yates 《Patient education and counseling》2019,102(2):198-206
Objective
To consider whether and how family members and clinicians discuss end of life during paediatric palliative care consultations.Methods
Nine naturally occurring paediatric palliative care consultations were video recorded and analysed using conversation analytic methods.Analysis
Focusing on three consultations in which end of life was treated as a certain outcome, analysis explored ways in which end of life was made either implicit or explicit within these consultations. Our analysis suggests that end of life was made explicit when: 1) ancillary to the current focus of discussion, 2) in relation to someone else’s child, or 3) specifically relevant to the local context of the discussion. More commonly, in all other instances in the data, end of life was made implicit during discussions relating to this matter.Conclusion
This preliminary research indicates that the local context of a conversation can influence how end of life is mentioned and discussed.Practice implications
Clinicians often are encouraged to promote honest and ‘open’ discussions about end of life. Our findings show that it is not necessary to explicitly mention end of life in order to discuss it. 相似文献17.
Zhenfeng Shi Aihemaiti Kadeer Mopei Wang Bin Wen Min Li Jinxing Huang Yang Gao Enwei Liu Donghong Liu Deyong Jia Chengyuan Liang 《Pathology, research and practice》2019,215(2):354-357
Background
MicroRNAs (miRNAs) are single-stranded, endogenous, non-coding RNAs that are increased or decreased in almost all cancer types, and they paly crucial roles in the tumorigenesis as well as development.Materials and methods
90 patients diagnosed with bladder cancer were enrolled in the present study. The bladder cancer tissues or adjacent normal tissues were obtained from the tumor area or adjacent normal zone. The expression level of miR-133b was examined by quantitative real-time polymerase chain reaction assay (qRT-PCR). Survival curves were displayed by the Kaplan-Meier method, and differences between two survival curves were calculated by the log-rank test.Results
The expression levels of miR-133b in bladder tissues were significantly decreased when compared with the matched adjacent normal bladder tissues (P?<?0.05). Moreover, miR-133b expression levels are significantly associated with lymphatic invasion (P?=?0.026), distant metastasis (P?=?0.025), tumor grade (P?=?0.038), as well as the muscle invasion status (P?<?0.001). The log-rank test indicated that patients with decreased miR-133b expression underwent poorer overall survival (P?=?0.007). Furthermore, multivariate Cox regression analysis showed that the expression level of miR-133b (P?=?0.024) was an independent factor for predicting the overall survival in patients with bladder cancer.Conclusions
The present study showed that miR-133b might be associated with bladder cancer progression, and its down-regulation might be a biomarker for poor prognosis of bladder cancer. 相似文献18.
Zu-xuan Chen Xiao-tong Peng Lin Tan Gao-qiang Zhai Gang Chen Ting-qing Gan Jian-jun Li 《Pathology, research and practice》2019,215(2):278-285
Objectives
Hepatobiliary system cancer, which includes hepatocellular carcinoma (HCC), cholangiocarcinoma, and gallbladder carcinoma, has an increase of incidence and mortality due to various risk factors. Epstein-Barr virus (EBV) is associated with various types of lymphomas and carcinomas, which is also acknowledged as the first-discovered human tumor virus. Despite this, there is no systematic analysis about the relationship between the infection of EBV and hepatobiliary system cancer. The aim of this meta-analysis is to explore the significance of EBV infection in the development of hepatobiliary system cancer by evaluating the EBV infection ratio.Methods
A systematic search of PubMed, Embase, Cochrane Library, as well as China National Knowledge Infrastructure (CNKI), Chongqing VIP, Wan Fang, and China Biology Medicine databases was conducted. The EBV infection ratio and 95% confidence intervals (CIs) in hepatobiliary system cancer was evaluated. The I2 statistic was used to represent heterogeneity. Through meta-regression, stratified analyses were applied to find out heterogeneity’s sources. Odds ratios (ORs), 95% CIs of EBV infection in case-control studies were calculated.Results
Altogether, 15 studies were included containing a total of 918 cases and 157 controls. The whole infection ratio of EBV was 23% (95% CI: 13%, 33%, I2?=?95.7%, P?<?0.001) among all the patients. Comparable EVB infection ratios were observed in hepatobiliary system cancer as divided into different subtypes. The five case-control studies were epitomized to a pooled OR of 9.35 (95%CI: 2.95, 29.61, I2?=?20.1%, P?<?0.286).Conclusion
EBV may be a potentially risk factor in the process of hepatobiliary system cancer. The prospective molecular mechanism remains to be explored. 相似文献19.
20.
Scott A. Davis Delesha M. Carpenter Susan J. Blalock Donald L. Budenz Charles Lee Kelly W. Muir Alan L. Robin Betsy Sleath 《Patient education and counseling》2019,102(5):937-943