共查询到20条相似文献，搜索用时 31 毫秒
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Chloe Grimmett Karen Pickett Jonathan Shepherd Karen Welch Alejandra Recio-Saucedo Elke Streit Helen Seers Anne Armstrong Ramsey I. Cutress D. Gareth Evans Ellen Copson Bettina Meiser Diana Eccles Claire Foster 《Patient education and counseling》2018,101(5):779-788
Objective
Identify existing resources developed and/or evaluated empirically in the published literature designed to support women with breast cancer making decisions regarding genetic testing for BRCA1/2 mutations.Methods
Systematic review of seven electronic databases. Studies were included if they described or evaluated resources that were designed to support women with breast cancer in making a decision to have genetic counselling or testing for familial breast cancer. Outcome and process evaluations, using any type of study design, as well as articles reporting the development of decision aids, were eligible for inclusion.Results
Total of 9 publications, describing 6 resources were identified. Resources were effective at increasing knowledge or understanding of hereditary breast cancer. Satisfaction with resources was high. There was no evidence that any resource increased distress, worry or decisional conflict. Few resources included active functionalities for example, values-based exercises, to support decision-making.Conclusion
Tailored resources supporting decision-making may be helpful and valued by patients and increase knowledge of hereditary breast cancer, without causing additional distress.Practice implications
Clinicians should provide supportive written information to patients where it is available. However, there is a need for robustly developed decision tools to support decision-making around genetic testing in women with breast cancer. 相似文献3.
Kathleen M. Grant Lance Brendan Young Kimberly A. Tyler Jamie L. Simpson R. Dario Pulido Christine Timko 《Patient education and counseling》2018,101(1):79-84
Objective
A multisite field trial testing whether improved outcomes associated with intensive referral to mutual help groups (MHGs) could be maintained after the intervention was adapted for the circumstances and needs of rural veterans in treatment for substance use disorder (SUD).Methods
In three Veterans Affairs treatment programs in the Midwest, patients (N = 195) received standard referral (SR) or rural-adapted intensive referral (RAIR) and were measured at baseline and 6-month follow-up.Results
Both groups reported significant improvement at 6-months, but no significant differences between SR and RAIR groups in MHG participation, substance use, addiction severity, and posttraumatic stress symptoms. Inconsistent delivery of the intervention resulted in only one-third of the RAIR group receiving the full three sessions, but this group reported significantly greater 6-month abstinence from alcohol than those receiving no sessions.Conclusion
Further research should explore implementation problems and determine whether consistent delivery of the intervention enhances 12-step facilitation.Practice implications
The addition of rural-specific elements to the original intensive referral intervention has not been shown to increase its effectiveness among rural veterans. 相似文献4.
Jenna Petersen Cathryn Koptiuch Yelena P. Wu Ryan Mooney Ashley Elrick Kathryn Szczotka Megan Keener Lisa Pappas Priyanka Kanth Andrew Soisson Wendy Kohlmann Kimberly A. Kaphingst 《Patient education and counseling》2018,101(11):2011-2017
Objectives
To explore patterns of communication among families with a Lynch syndrome diagnosis and understand what resources could facilitate family communication.Methods
127 probands (i.e., first person in family with identified mutation) and family members participated in semi-structured interviews about: how they learned about the Lynch syndrome diagnosis, with whom they shared genetic test results, confidence in sharing results with other family members, and helpfulness of educational resources.Results
Both probands and family members were most likely to share genetic test results with parents and siblings, and least likely to share results with aunts, uncles, and cousins. Most participants felt very confident sharing their test results with family members, but reported that certain topics such as cancer risk were challenging to convey. Probands reported the most helpful resources to be access to a specialty clinic or website, while family members described general printed materials as most helpful.Conclusions
Families affected by Lynch syndrome may experience barriers to communication with more distant relatives, and may benefit from receiving specific resources (e.g., websites about Lynch syndrome, print materials) to facilitate family communication.Practice implications
Providers could emphasize the need to share information with more distant family members and provide appropriate supportive resources. 相似文献5.
Ming Li Tse-Yang Huang Jia Ye Shixi Zhao Lei-Shih Chen 《Patient education and counseling》2018,101(5):926-931
Objective
Autism Spectrum Disorders (ASD) have a significant genetic predisposition. The recurrence risk of ASD ranges from 3% to 18.7% for parents having one affected child. As recurrence risk perceptions have important implications for family planning, prenatal preparation, and future children managements, absolute and relative recurrence risk perceptions of having another affected child among Taiwanese parents of children with ASD were assessed.Methods
This study collected quantitative survey data from 415 Taiwanese parents who had one child with ASD.Results
Participants reported their absolute recurrence risk of having another child with ASD was 33.4%. Compared to other parents with normally-developing children, merely 49.8% of participants perceived higher relative recurrence risk. By controlling for the sociodemographic characteristics, participants’ absolute recurrence risk perceptions were significantly predicted by their perceived genetic causes of ASD and family history of ASD. Yet, participants’ relative recurrence risk perceptions were significantly associated with only the perceived genetic etiology.Conclusion
Taiwanese parents of children diagnosed with ASD had an incorrect understanding of their absolute and relative recurrence risks.Practice implications
To facilitate informed decision-making in family planning, healthcare providers should discuss absolute and relative recurrence risks as well as genetic causes of ASD with this particular group. 相似文献6.
Annemiek J. Linn Liset van Dijk Julia C.M. van Weert Beniam G. Gebeyehu Ad. A. van Bodegraven Edith G. Smit 《Patient education and counseling》2018,101(8):1419-1426
Objective
Improving adherence is a challenge and multiple barriers are likely to explain non-adherence. These barriers differ per patient and over course of the regimen. Hence, personalized interventions tailored to the specific barriers are needed. In a theoretical and evidence-based Tailored Multimedia Intervention, technology (online preparatory assessment, text messaging) was used as an add-on to a tailored counseling session (learned during a communication skills training), with the expectation of synergistic effects.Methods
A cluster randomized controlled trial was conducted in six hospitals, eight nurses and 160 chronic patients. Patient satisfaction with communication, beliefs about medication, self-efficacy and medication adherence were assessed at initiation of the treatment and after six months.Results
Intervention effects were found for patient satisfaction with nurses’ affective communication and self-efficacy at the initiation of treatment. The effect on self-efficacy remained after six months.Conclusion
By combining tailored counseling with technology, this intervention resulted in positive changes in important prerequisites of medication adherence.Practical implications
Technology can contribute significantly to health care providers’ ability to tailor information to the patients’ needs. 相似文献7.
Catherine A. Grodensky Carol E. Golin Allison P. Pack Audrey Pettifor Michele Demers Cecelia Massa Gift Kamanga Kevin McKenna Amy Corneli 《Patient education and counseling》2018,101(6):1103-1109
Objective
Individuals diagnosed with acute HIV infection (AHI) are highly infectious and require immediate HIV prevention efforts to minimize their likelihood of transmitting HIV to others. We sought to explore the relevance of Motivational Interviewing (MI), an evidence-based counseling method, for Malawians with AHI.Methods
We designed a MI-based intervention called “Uphungu Wanga” to support risk reduction efforts immediately after AHI diagnosis. It was adapted from Options and SafeTalk interventions, and refined through formative research and input from Malawian team members and training participants. We conducted qualitative interviews with counselors and participants to explore the relevance of MI in this context.Results
Intervention adaptation required careful consideration of Malawian cultural context and the needs of people with AHI. Uphungu Wanga's content was relevant and key MI techniques of topic selection and goal setting were viewed positively by counselors and participants. However, rating levels of importance and confidence did not appear to help participants to explore behavior change as intended.Conclusion
Uphungu Wanga may have provided some added benefits beyond “brief education” standard of care counseling for Malawians with AHI.Practice implications
MI techniques of topic selection and goal setting may enhance prevention education and counseling for Malawians with AHI. 相似文献8.
Christine M. Gunn Tracy A. Battaglia Michael K. Paasche-Orlow Amanda K. West Nancy R. Kressin 《Patient education and counseling》2018,101(6):1123-1129
Objective
Currently, 30 US states mandate that radiologists notify women when dense breast tissue is found on mammography. Little is understood about how notifications are perceived by recipients. This qualitative study sought to understand how dense breast notifications (DBNs) impact women’s perceptions and their participation in follow-up care.Methods
We assessed rates of DBN recall and conducted semi-structured telephone interviews with 30 English-speaking women ages 40 to 74 after receiving a DBN from a Massachusetts hospital. Content coding characterized women’s recall of the notification content, perceptions of breast density, and planned or actual participation in follow-up care.Results
Most women (81%) recalled receiving a DBN, but few could recall specific content. Women described struggling to understand the meaning of breast density and created their own explanatory models of dense breasts that differed from medical explanations. Many women planned to or did talk with their doctors about breast density as a result of receiving the notification.Conclusions
Women receiving DBNs have limited knowledge and many misperceptions about the implications of having dense breasts.Practice implications
Educational support is needed to promote informed decision- making about breast cancer screening that incorporates personal risk in the setting of dense breast legislation. 相似文献9.
Juliana Chen Luke Gemming Rhona Hanning Margaret Allman-Farinelli 《Patient education and counseling》2018,101(4):750-757
Objective
To provide dietitians with practical guidance on incorporating smartphone applications (apps) in the nutrition care process (NCP) to optimize patient education and counseling.Methods
The current evidence-base for mobile health (mHealth) apps was searched using PubMed and Google Scholar. Where and how apps could be implemented by dietitians across the four steps of the NCP is discussed.Results
With functionality to automatically convert patient dietary records into nutrient components, nutrition assessment can be streamlined using nutrition apps, allowing more time for dietitians to deliver education and nutrition counseling. Dietitians could prescribe apps to provide patients with education on nutrition skills and in counseling for better adherence to behavior change. Improved patient-provider communication is also made possible through the opportunity for real-time monitoring and evaluation of patient progress via apps. A practical framework termed the ‘Mobile Nutrition Care Process Grid’ provides dietitians with best-practice guidance on how to use apps.Conclusions
Including apps into dietetic practice could enhance the efficiency and quality of nutrition care and counseling delivered by dietitians.Practice implications
Apps should be considered an adjunct to enable dietetic counseling and care, rather than to replace the expertise, social support and accountability provided by dietitians. 相似文献10.
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Jill Yamasaki 《Patient education and counseling》2018,101(5):830-835
Objective
This study examines a personal pet hospital visitation program dedicated to preserving the human-animal bond during chronic, critical, or terminal illness to understand the novel ways companion pets facilitate meaningful communication between patients, providers, and families in hospital settings.Methods
I thematically analyzed data collected through a variety of qualitative methods, including participant observation, informal and semi-structured interviews, and a review of organizational materials.Results
The presence of a patient’s personal pet prompted stories and behaviors characterized by (1) compassion, (2) connection, and (3) response between patients, providers, and family members.Conclusion
Personal pet hospital visits facilitate storied conversations, foster healing relationships, and offer alternative ways of knowing that can promote greater understandings of the patient’s psychosocial context for more personalized care and improved well-being.Practice implications
Patient-centered critical care requires meaningful consideration of a patient’s health, well-being, and comfort. When appropriate, the therapeutic benefits of companion animals and the deep personal bonds between patients and their pets should be acknowledged and provided as part of this care. 相似文献14.
Evelyn Y. Ho Joseph Acquah Cewin Chao Genevieve Leung Don C. Ng Maria T. Chao Abby Wang Shannon Ku Wanyi Chen Choi Kwun Yu Shuwen Xu Melissa Chen Jane Jih 《Patient education and counseling》2018,101(12):2202-2208
Objectives
Current cardiovascular disease (CVD) nutrition guidelines do not take into account Chinese medicine (CM) principles. We created a heart healthy integrative nutritional counseling (H2INC) curriculum consistent with CM principles and current nutrition guidelines.Methods
We conducted three phases of semi-structured interviews with key stakeholders (CM and biomedical providers and Chinese American (CAs) patients with CVD) followed by iterative development of H2INC. First, we interviewed licensed CM providers (n?=?9) and laypeople with CM foods expertise (n?=?1). Second, we interviewed biomedical providers (n?=?11) and licensed CM providers (n?=?3). Third, we conducted four focus groups with CAs (n?=?20) with CVD.Results
Stakeholders emphasized different principles for creating H2INC. Phase one emphasized alignment of CM diagnoses to biomedical CVD conditions. Phase two overlaid CM concepts like the nature of foods and constitution (hot/neutral/cool) with heart healthy nutrition recommendations such as MyPlate, and avoiding excess salt, fat, and sugars. Phase three demonstrated patient acceptability.Conclusion
By integrating CM foods principles with biomedical nutrition, this integrative approach yields culturally relevant health education for an underserved population.Practice Implications
Integrative nutritional counseling shows promise for CAs and could support biomedical providers with little knowledge about patients’ use of CM for CVD. 相似文献15.
Blair P. Golden Bruce L. Henschen Lauren A. Gard Elizabeth R. Ryan Daniel B. Evans Jennifer Bierman Kenzie A. Cameron 《Patient education and counseling》2018,101(11):2018-2024
Objective
To understand how medical students perceive their roles in early longitudinal primary care clerkships.Methods
Medical students enrolled in one of two longitudinal primary care clerkships – Education-Centered Medical Home (ECMH) or Individual Preceptorship (IP) – participated in semi-structured interviews. Interviews were recorded, transcribed, and analyzed using a grounded theory and constant comparative approach.Results
Students (N?=?35) in both clerkships perceived benefits of early clinical exposure, reflecting positively on having time to interact with patients. Identified roles ranged from shadower to collaborator to diagnostician; a progression from position-centered to more patient-centered roles emerged. ECMH students also identified as health educators, care managers, and mentors. IP students described the clerkship primarily as an opportunity to acquire clinical knowledge and practice skills, expressing perceptions of being a transient “visitor” in the clinic, whereas ECMH students reported taking an active role in continuity care of patients.Conclusion
Students identified benefits of early longitudinal outpatient primary care clerkships, supporting the inclusion of these experiences within medical school curricula. Clerkships with an emphasis on longitudinal and team-based care may further promote student participation in patient care and professional development.Practice Implications
Longitudinal, team-based early clinical experiences may best promote student involvement in patient care. 相似文献16.
Natalie Guerrero Alissa L. Small Rebecca J. Schwei Elizabeth A. Jacobs 《Patient education and counseling》2018,101(4):653-658
Objectives
To describe physician perceptions of differences in limited English proficient (LEP) pediatric encounters and the behavioral adaptations they make to provide quality care to LEP pediatric patients.Methods
We conducted 30 min, semi-structured interviews with 6 family physicians and 5 pediatricians in one health system. Audiotapes from each interview were transcribed verbatim then coded using content analysis.Results
Multiple aspects of the LEP pediatric encounter were perceived by physicians as different from other encounters: trust and relationship between physician and LEP child/child’s family, continuity of care, encounter’s structure and flow, patient assessment, and communication barriers. Within each of these themes, physicians identified how they adapt their behavior to improve the quality of care provided to LEP children and families.Conclusions
Physicians’ made both positive and negative adaptations in LEP pediatric encounters that may impact the quality of care provided to these patients.Practice implications
By identification of specific positive and negative behavioral adaptations, this study emphasizes intervention targets, such as demonstrating interest in an LEP pediatric patient’s family story and individuality and using common niceties in conversations with LEP children. 相似文献17.
Noralie H. Geessink Eirik H. Ofstad Marcel G.M. Olde Rikkert Harry van Goor Jürgen Kasper Yvonne Schoon 《Patient education and counseling》2018,101(10):1767-1774
Objective
To identify determinants of older patients’ perceptions of involvement in decision-making on colorectal (CRC) or pancreatic cancer (PC) treatment, and to compare these with determinants of observers' perceptions.Methods
Patients’ perceptions of involvement were constructed by the 9-item SDM questionnaire (SDM-Q-9) and a Visual Analogue Scale for Involvement (VAS-I). Observers’ perceptions were constructed by the OPTION5, OPTION12, and MAPPIN’SDM. Convergent validities were calculated between the patient-sided and observer instruments using Spearman’s correlation coefficient. Linear regression was used to identify determinants per criterion.Results
58 CRC and 22 PC patients were included (mean age: 71.8?±?5.2 years, 45.0% female). No significant correlations were found between the patient-sided and observer instruments. Patients’ impression of involvement was influenced by patient characteristics such as quality of life and satisfaction, while observers’ perceptions mainly referred to encounter characteristics such as the mean duration of consultations and general communication skills.Conclusion
Due to evident differences in determinants, older CRC/PC patients’ and observers’ perceptions of involvement should both be collected in evaluating the quality of medical decision-making.Practice Implications
General communication skills should be integrated in SDM training interventions. New SDM measurement tools for patients are needed to sufficiently discriminate between the constructs of involvement and satisfaction. 相似文献18.
Anika L. Hines Debra Roter Bri K. Ghods Dinoso Kathryn A. Carson Gail L. Daumit Lisa A. Cooper 《Patient education and counseling》2018,101(2):233-240
Objective
We examined the prevalence and extent of informed decision-making (IDM) and patient-centered decision-making (PCDM) in primary care visits of African Americans with depression.Methods
We performed a cross-sectional analysis of audiotaped clinical encounters and post-visit surveys of 76 patients and their clinicians. We used RIAS to characterize patient-centeredness of visit dialogue. IDM entailed discussion of 3 components: the nature of the decision, alternatives, and pros/cons. PCDM entailed discussion of: lifestyle/coping strategies, knowledge/beliefs, or treatment concerns. We examined the association of IDM and PCDM with visit duration, overall patient-centeredness, and patient/clinician interpersonal ratings.Results
Approximately one-quarter of medication and counseling decisions included essential IDM elements and 40% included at least one PCDM element. In high patient-centered visits, IDM was associated with patients feeling respected in counseling and liking clinicians in medication decisions. IDM was not related to clinician ratings. In low patient-centered visits, PCDM in counseling decisions was positively associated with patients feeling respected and clinicians respecting patients.Conclusions
The associations between IDM and PCDM with interpersonal ratings was moderated by overall patient-centeredness of the visit, which may be indicative of broader cross-cultural communication issues.Practice implications
Strengthening partnerships between depressed African Americans and their clinicians may improve patient-engaged decision-making. 相似文献19.
Michelle P. Lin Marc A. Probst Michael A. Puskarich Erin Dehon Damon R. Kuehl Ralph C. Wang Erik P. Hess Katie Butler Michael S. Runyon Hao Wang D. Mark Courtney Brandon Muckley Cherri D. Hobgood Cassandra L. Hall Jeffrey A. Kline 《Patient education and counseling》2018,101(4):717-722
Objective
We assessed emergency department (ED) patient perceptions of how physicians can improve their language to determine patient preferences for 11 phrases to enhance physician empathy toward the goal of reducing low-value advanced imaging.Methods
Multi-center survey study of low-risk ED patients undergoing computerized tomography (CT) scanning.Results
We enroled 305 participants across nine sites. The statement “I have carefully considered what you told me about what brought you here today” was most frequently rated as important (88%). The statement “I have thought about the cost of your medical care to you today” was least frequently rated as important (59%). Participants preferred statements indicating physicians had considered their “vital signs and physical examination” (86%), “past medical history” (84%), and “what prior research tells me about your condition” (79%). Participants also valued statements conveying risks of testing, including potential kidney injury (78%) and radiation (77%).Conclusion
The majority of phrases were identified as important. Participants preferred statements conveying cognitive reassurance, medical knowledge and risks of testing.Practice implications
Our findings suggest specific phrases have the potential to enhance ED patient perceptions of physician empathy. Further research is needed to determine whether statements to convey empathy affect diagnostic testing rates. 相似文献20.
Nguyen Toan Tran Wambi Maurice M. Yameogo Félicité Langwana Seni Kouanda Blandine Thieba Désiré Mashinda Rachel Yodi Jean Nyandwe Kyloka Tieba Millogo Abou Coulibaly Souleymane Zan Brigitte Kini Bibata Ouedraogo Fifi Puludisi Asa Cuzin-kihl Suzanne Reier James Kiarie Mary Eluned Gaffield 《Patient education and counseling》2018,101(10):1871-1875