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Joanne Shaw Jane Young Phyllis Butow Suzanne Chambers Lorna O’Brien Michael Solomon 《Patient education and counseling》2013
Objectives
Telephone-based supportive care presents a potentially highly accessible means of addressing unmet supportive care needs for people with cancer. Identification of behaviours that facilitate communication is essential for development of training for telephone-based supportive care. The aim of this study was to describe communication behaviours within supportive care telephone calls in two contexts (1) a telephone outreach intervention and (2) cancer helpline calls, to identify potential areas for further training.Methods
50 recorded calls were analysed using two standardised coding systems: the RIAS and Verona-CoDES-C.Results
Mean call length was 21 min (304 utterances) for nurse-outreach calls and 23 min (355 utterances) for helpline calls. Closed questioning, verbal attentiveness and giving information/counselling were the most common communication behaviours identified. Emotional cues were most commonly responded to through non-explicit back-channelling, exploration of content or provision of reassurance or advice.Conclusions
This study confirmed the need to address the manner in which questions are framed to maximise patient disclosure. Responding to patent emotional cues was highlighted as an area for future training focus.Practice implications
Communication skills training that addresses each of these tasks is likely to improve the effectiveness of telephone-based delivery of supportive care. 相似文献2.
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Objective
This review examined the extent to which the information needs of partners and family members of cancer patients has been addressed in the literature.Methods
We conducted a systematic search of four databases for papers published between 1998 and 2008 which assessed the information needs of partners and/or family members of adult cancer patients.Results
Thirty-two papers were included in the review. Eleven categories of information need were identified. There was a predominant focus on breast or prostate cancer, leaving a knowledge gap in relation to other cancers. Few papers moved beyond the diagnosis and initial treatment phase, and most did not distinguish between met and unmet needs. Those that did, indicated that partners/family members are more likely to have unmet needs for information about supportive care than for medical information. The concept of ‘information need’ was generally poorly developed and theorised in the papers.Conclusion
Establishing the information needs of partners and family members of cancer patients is an important, but as yet neglected, area of research. In order to develop our understanding of this area more empirical research, with sound conceptual and theoretical foundations is required. 相似文献5.
Georgia K.B. Halkett Elizabeth A. Lobb Lynn Oldham Anna K. Nowak 《Patient education and counseling》2010
Objective
To understand patients’ experiences of High Grade Glioma and identify and describe information and support needs along the disease trajectory.Methods
Semi-structured interviews were conducted with 19 patients. Data was analysed using grounded theory and the constant comparative method.Results
Four major themes were identified: (1) feelings of uncertainty around prognosis and quality of life; (2) the need for individualised information; (3) dependence on carers due to cognitive deficits, loss of balance and inability to drive; and (4) communication with health professionals around prognostic uncertainty and disease progression with communication barriers due to complex language deficits.Conclusion
Previous studies in HGG pre-date the current combined modality standard of care, or examined a mixed population. This study has found that patients with HGG have needs that differ from other patients with terminal malignancy and that these needs change over time with disease progression.Practice implications
This study has identified that patients with brain tumours may have unique needs. Health professionals need to clarify patients’ information and support needs and be aware that these change over and within time. 相似文献6.
Kim Beernaert Chloë Haverbeke Simon Van Belle Luc Deliens Joachim Cohen 《Patient education and counseling》2018,101(1):132-138
Objective
We assessed information provision and information needs about illness course, treatments, palliative care and euthanasia in cancer patients.Methods
Cancer patients consulting a university hospital (N = 620) filled out a questionnaire. Their cancer related data were collected through the treating oncologist. This study is performed in Belgium, where “palliative care for all” is a patient’s right embedded in the law and euthanasia is possible under certain conditions.Results
Around 80% received information about their illness course and treatments. Ten percent received information about palliative care and euthanasia. Most information about palliative care and euthanasia was given when the patient had a life expectancy of less than six months. However, a quarter of those in earlier phases in their illness trajectory, particularly those who experienced high pain, fatigue or nausea requested more information on these topics.Conclusion
Many patients want more information about palliative care and euthanasia than what is currently provided, also those in an earlier than terminal phase of their disease.Practice implications
Healthcare professionals should be more responsive, already from diagnosis, to the information needs about palliative care and possible end-of-life decisions. This should be patient-tailored, as some patients want more and some patients want less information. 相似文献7.
Henselmans I Jacobs M van Berge Henegouwen MI de Haes HC Sprangers MA Smets EM 《Patient education and counseling》2012,88(1):138-146
Objective
Given the poor prognosis of esophageal cancer and the impact of surgery on health-related quality of life (HRQL), addressing patients’ postoperative information needs is important. This study aimed to examine (1) the content and type of patients’ information needs and (2) patient perceived facilitators and barriers to patient participation.Methods
Interviews were conducted with 20 purposefully selected esophageal cancer patients. Open and structured questions were alternated. The transcribed interviews were analysed inductively and deductively, using MAXqda.Results
Patients’ post-operative information needs concerned HRQL, medical care and prognosis, covering several sub-domains. Different types of needs were identified, e.g., requests for information about cause, course and self-management. Barriers to patient participation mostly reflected beliefs and skills, and could be categorized into agenda and communication barriers. Facilitators of patient participation reflected physician, patient and interaction characteristics, companion support and pre-visit preparation. Many patients saw merit in pre-visit preparation interventions; few endorsed skill-building interventions.Conclusion
This study listed the postoperative information needs of esophageal cancer patients. Moreover, it gained insight into patient-perceived barriers and facilitators of patient participation.Practice implications
The findings demonstrate what information physicians should have available and informs interventions to support patients in meeting their information needs. 相似文献8.
Objective
Effective communication between patients and clinicians is an essential aspect of supportive care for cancer patients, however many patients find this communication is inadequate. This study examined cancer patients’ perception of communication with their clinician during a supportive care screening and discussion process and the ways in which this process assisted communication.Methods
One hundred and fifty-four patients undertaking treatment for cancer in chemotherapy, radiotherapy and surgical units in six hospitals in Australia participated in a formal supportive care screening, discussion and referral process and were interviewed about their experiences.Results
The majority of patients interviewed felt that the process enhanced communication by encouraging them to reflect on their needs, assisting them to initiate a discussion with the clinician, validating their needs, encouraging them to seek help and support and focusing clinician attention on unmet needs.Conclusion
Patients perceived the formal process of supportive care improved communication between themselves and their clinicians.Practice implications
Undertaking a patient-centred process of supportive care can assist clinicians to meet the unmet needs of patients with cancer and can increase patient satisfaction. 相似文献9.
Lynda G. Balneaves Tracy L.O. Truant Marja J. Verhoef Brenda Ross Antony J. Porcino Margurite Wong Alison S. Brazier 《Patient education and counseling》2012
Objective
This paper describes the background, design and evaluation of a theory-informed education and decision support program for cancer patients considering complementary medicine (CM).Methods
The program was informed by the Shared Decision Making theory, the Ottawa Decision Support Framework and the Supportive Care Framework. Previous empirical evidence and baseline research were used to identify patients’ and health professionals’ (HPs) information and decision support needs related to CM.Results
To address the continuum of CM needs, a variety of education and decision support interventions were developed, including basic CM information and resources for patients and HPs, a group education program and one-on-one decision support coaching for patients, and an on-line education module for HPs. Evaluation of the program and individual interventions is underway.Conclusions
This education and decision support program addresses a significant gap in care and offers an evidence-informed framework in which to translate CM evidence to conventional care settings and promote communication about CM.Practice implications
Evidence-informed CM education and decision support interventions are needed to shift the culture around CM within conventional care settings and promote open communication that will lead to CM therapies being safely integrated into care. 相似文献10.
Objective
To gain understanding of radiology residents’ and women's experiences, concerns, information needs, coping strategies and perspectives about optimal communication during diagnostic mammography.Methods
Qualitative analysis of focus groups of radiology residents and women who had undergone diagnostic mammograms.Results
Five categories of themes emerged from our analysis: information needs, perspectives and ideals, emotional experiences and observations, working together, individual experiences, and others’ roles. Women preferred continuous orientation, clear explanations and emotional support by physicians and radiology technologists throughout diagnostic processes. Communication about diagnostic mammogram results evoked the threat of breast cancer and was experienced as “bad news” by women, but not necessarily by all radiology residents. Lack of collaboration among radiologists, technologists and other healthcare professionals engendered confusion and anxiety in patients. Radiology residents felt inadequately prepared to meet the communication challenges of providing information and emotional support tailored to women's needs in this context.Conclusion
Women's experiences are influenced by the extent to which they receive clear information and support, and perceive collaboration among professionals involved in the diagnostic mammography process.Practice implications
Radiology education must address communication with patients and among healthcare professionals involved in the care of patients undergoing diagnostic procedures and interventions. 相似文献11.
Willemjan Slort Annette H. Blankenstein Bart P.M. Schweitzer Luc Deliens Henriëtte E. van der Horst 《Patient education and counseling》2014
Objective
This study aimed to evaluate the effectiveness of a new palliative care ‘availability, current issues and anticipation’ (ACA) training programme to improve communication skills of general practice trainees (GPTs).Methods
In a controlled trial among third-year GPTs, we videotaped one 20-min consultation between each GPT and a simulated palliative care patient at baseline and at six months follow-up. We measured the number of issues discussed and the quality of communication skills and analysed between-group differences using linear mixed models and logistic regression.Results
Fifty-four GPTs were assigned to the intervention and 64 to the control group. We found no effect of the programme on the number of issues discussed or on the quality of GPT communicative behaviour. GPTs infrequently addressed ‘spiritual/existential issues’ and ‘unfinished business’. In a selection of the consultations, simulated patients brought up more issues than the GPTs did.Conclusion
The ACA training programme was not effective in the way it was carried out and evaluated in this trial.Practice implications
The ACA programme should focus on the issues that scored low in this trial. Future research on GPT–patient communication in palliative care should consider using real patients in a series of consultations to evaluate effectiveness. 相似文献12.
Objective
This literature review focuses on information and communication needs of parents of children admitted to the NICU and on their use of information sources in the illness trajectories at NICU.Methods
Literature search in 4 electronic databases (Ovid Medline, PsycINFO, CINAHL and Sociological Abstracts), covering 1990–March 2008.Results
The seventy-eight included articles revealed that NICU parents have high information needs. The illness trajectory mediates parental information needs and induces a changing pattern in information use and information needs. Most attention is paid to the prenatal and acute phases, while information behaviour in sudden events and later phases receives limited attention.Conclusions
In-depth studies on information needs and corresponding use of information sources are lacking. More longitudinal studies are needed, taking the illness trajectory into account and investigating the determinants and outcomes of the information and communication needs of NICU parents.Practice implications
Healthcare professionals should adapt their information provision along the illness trajectory. The development of guidelines of information provision during the illness trajectory at NICU would support all professionals. 相似文献13.
Lixin Song Jeannette T. Bensen Catherine Zimmer Betsy Sleath Bonny Blackard Elizabeth Fontham L. Joseph Su Christine S. Brennan James L. Mohler Merle Mishel 《Patient education and counseling》2013
Objective
To examine the multidimensional concept of patient-health care provider (HCP) communication, its effects on patient satisfaction with oncology care services, and related racial differences.Methods
The current analysis draws from a population-based survey sample of 1011 African American and 1034 Caucasian American men with newly diagnosed prostate cancer. The variables of satisfaction with health care services, interpersonal treatment, contextual knowledge of the patient, and prostate cancer communication were analyzed using multiple-group structural equation modeling.Results
Regardless of race, patient-HCP communication was related positively to interpersonal treatment by the HCP, HCP's contextual knowledge of the patient, and prostate cancer communication. More positive patient-HCP communication was related to more satisfaction with health care services. Racial differences were significant in the relationships between patient-HCP communication and prostate cancer communication.Conclusion
Content and interpersonal relationships are important aspects of patient-HCP communication and affect patient satisfaction with oncologic care for prostate cancer.Practice implications
HCPs need to integrate the transfer of information with emotional support and interpersonal connection when they communicate with men with newly diagnosed prostate cancer. 相似文献14.
E.A. Lobb D. Joske P. Butow L.J. Kristjanson P. Cannell G. Cull B. Augustson 《Patient education and counseling》2009,77(1):103-108
Objective
To determine patients’ information, emotional and support needs at the completion of treatment for a haematological malignancy.Methods
A self-report questionnaire was mailed to 113 adult patients.Results
Sixty-six questionnaires were returned. The most frequently endorsed patient needs related to care co-ordination and help to manage the fear of recurrence. The most frequently endorsed unmet needs included managing the fear of recurrence, the need for a case-manager and the need for communication between treating doctors. Predictors of unmet needs included younger patients (p = 0.01), marital status (p = 0.03) and employment (p = 0.03). Almost two-thirds of patients (59%) reported they would have found it helpful to talk with a health care professional about their experience of diagnosis and treatment at the completion of treatment and endorsed significantly more need in the arenas of Quality of Life (p = 0.03) and Emotional and Relationships (p = 0.04).Conclusion
This study provides valuable data on haematological cancer patients’ needs in the first 12 months of finishing treatment. It appears that many needs emerge or remain unresolved at this time.Practice implications
An opportunity for patients to talk with a health professional about making the transition from active treatment to extended survivorship may be helpful. 相似文献15.
Erin E. Kent Neeraj K. Arora Julia H. Rowland Keith M. Bellizzi Laura P. Forsythe Ann S. Hamilton Ingrid Oakley-Girvan Ellen B. Beckjord Noreen M. Aziz 《Patient education and counseling》2012
Objective
To investigate health information needs and their association with health-related quality of life (HRQOL) in a diverse, population-based sample of long-term cancer survivors.Methods
We analyzed health information needs from 1197 cancer survivors 4–14 years post-diagnosis drawn from two cancer registries in California. Multivariable regression models were used to identify factors associated with endorsement of total number and different categories of needs. The relationship between number of needs and HRQOL and effect modification by confidence for obtaining information was examined.Results
Survivors reported a high prevalence of unmet information needs in the following categories: side effects & symptoms: 75.8%; tests & treatment: 71.5%; health promotion: 64.5%; interpersonal & emotional: 60.2%; insurance: 39.0%; and sexual functioning & fertility: 34.6%. Survivors who were younger, non-White, and did not receive but wanted a written treatment summary reported a higher number of needs. Number of information needs was inversely related to mental well-being, particularly for those with low confidence for obtaining information (P < 0.05).Conclusion
These patterns suggest disparities in access to important health information in long-term survivors and that affect HRQOL.Practice Implications
Findings suggest a need for tailored interventions to equip survivors with comprehensive health information and to bolster skills for obtaining information. 相似文献16.
Sebastian Kohlmann Mara S. Kilbert Kristin Ziegler Karl-Heinz Schulz 《Patient education and counseling》2013
Objectives
Unmet medical needs are a focus in cardiovascular disorder (CVD) research. However, few studies have investigated patients’ perceived needs. The present study examined supportive care needs in patients with CVD and their relation to health characteristics.Methods
In total 260 in-patients with CVD were consecutively assessed with the supportive care needs survey. Primarily, frequency and content of unmet needs were examined. Secondarily, CVD-diagnoses were compared and correlations with risk factors, treatment characteristics, mood-state and quality of life were analyzed.Results
Supportive care needs were indicated by 21% of all patients: unmet health information (37%) and psychological (23%) needs were most frequent. The number of unmet needs did not differ between most CVD-diagnoses. Unmet needs were not related to cardiac risk factors. However, treatment characteristics (r = .17–.23, p < .01), anxiety (r = .44–.71, p < .01), depression (r = .38–.63, p < .01), physical (r = .21–.47, p < .01) and mental (r = .29–.65, p < .01) quality of life were associated with unmet needs.Conclusions
Supportive care needs are common in patients with CVD. They are based on patients’ treatment characteristics, emotions and subjective well-being rather than on cardiac factors.Practice implications
Needs assessments in patients with CVD could detect unmet needs, enhance patient education and communication and, therefore, effectively target patients’ perceived needs and medical needs. 相似文献17.
Robin K. Matsuyama Laura A. Kuhn Anthony Molisani Maureen C. Wilson-Genderson 《Patient education and counseling》2013
Objective
Cancer patients’ information needs about disease, diagnostic tests, treatments, physical care, and psychosocial resources during treatment are examined.Methods
Information needs of newly diagnosed, Stages II-IV cancer patients receiving treatment (N = 138) were studied over nine months. Information needs were assessed using The Toronto Informational Needs Questionnaire (TINQ). There are five subscales for the TINQ: disease, diagnostic tests, treatment, physical and psychosocial. Health literacy and amount of information wanted were also measured. A repeated measures, univariate two-level model for longitudinal data was analyzed. Separate models for each subscale were constructed and covariates were examined simultaneously for associations with information needs. Models were estimated using FIML.Results
Although significant reduction of needs was observed over time, total information needs remained high throughout. Gender (women), age (younger), race (African American), education (lesser), and marital status (married) were significantly associated with higher information needs over time. Cancer type and stage were not significantly associated.Conclusion
Cancer patients’ information needs decrease yet remain high over time. Patients’ information needs are highest near diagnosis and change throughout the course of their treatment.Practice implications
As patients obtain and understand information, they will continue to need information in new areas relevant to their care. 相似文献18.
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SL Lavela G Schectman J Gering SM Locatelli A Gawron FM Weaver 《Patient education and counseling》2012,88(3):420-426