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1.
Willem Eijzenga Eveline de Geus Cora M. Aalfs Fred H. Menko Rolf H. Sijmons Hanneke C.J.M. de Haes Ellen M.A. Smets 《Patient education and counseling》2018,101(9):1611-1619
Objective
In hereditary and familial cancer, counselees are requested to inform their at-risk relatives. We developed an intervention to support counselees in this task.Methods
A randomized controlled trial was conducted aimed at improving cancer genetic counselees’ i) knowledge, ii) motivation to disclose information, and ii) self-efficacy in this regard. Eligible participants were randomized to telephonic counseling (n?=?148), or standard care (n?=?157) and assessed at baseline, 1 week post-intervention, and 4 months after study enrolment.Results
No between-group differences were found in participants’ knowledge, motivation, and self-efficacy. Knowledge concerning which second-degree relatives to inform was lower compared to first-degree relatives. About 60% of the participants was of the opinion that they needed to inform more relatives than stated in their summary letter and only about 50% were correctly aware of which information to disclose. Of note, at baseline, almost 80% of the participants had already correctly informed their at-risk relatives.Conclusions
Since, unexpectedly, counselees already informed most of their relatives before the intervention was offered, efficacy of the intervention could not convincingly be determined. Counselees’ knowledge about whom to inform about what is suboptimal.Practice Implications
Future interventions should target a more homogeneous sample and address counselees’ understanding and recall. 相似文献2.
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3.
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4.
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5.
Objective
To explore the relationships between self-reported Empathy and the patient-centered communication patterns of physician trainees.Methods
“Eighty-four 3rd year medical students completed the Jefferson Scale of Empathy (JSE – student version) and had recordings of a single OSCE analyzed using the Roter Interactional Analysis System (RIAS). Correlation and regression were employed to explore the relationships among JSE total score, 3 JSE subscales, 10 composite codes of provider communication, and a summary ‘patient centered communication’ ratio, reflecting the balance of psychosocial and emotional to biomedical communication of the simulated patient and student.Results
Results indicate that controlling for other elements of student communication, the RIAS composite of codes reflecting ‘emotional responsiveness’ (characterized by empathy statements, legitimization, showing concern, partnership statements and medically relevant provider self-disclosure) was positively related to the JSE Total Score while student ‘question asking’ and ‘biomedical counseling’ were negatively related to the JSE Score. RIAS-coded communication variables accounted for 32.4% of the JSE Total score.Conclusion
The relationship between student expressions of emotional responsiveness and predicted self-reported empathy provides concurrent validation evidence for the JSE.Practice implications
Further research is needed in order to elaborate and further explore a Patient-Centeredness latent variable. 相似文献6.
Johanna Granhagen Jungner Elisabet Tiselius Marika Wenemark Klas Blomgren Kim Lützén Pernilla Pergert 《Patient education and counseling》2018,101(9):1661-1668
Objective
To develop a valid and reliable questionnaire addressing the experiences of healthcare personnel of communicating over language barriers and using interpreters in paediatric healthcare.Methods
A multiple- methods approach to develop and evaluate the questionnaire, including focus groups, cognitive interviews, a pilot test and test-retest. The methods were chosen in accordance with questionnaire development methodology to ensure validity and reliability.Results
The development procedure showed that the issues identified were highly relevant to paediatric healthcare personnel and resulted in a valid and reliable Communication over Language Barriers questionnaire (CoLB-q) with 27 questions.Conclusion
The CoLB-q is perceived as relevant, important and easy to respond to by respondents and has satisfactory validity and reliability.Practice implications
The CoLB-q can be used to map how healthcare personnel overcome language barriers through communication tools and to identify problems encountered in paediatric healthcare. Furthermore, the transparently described process could be used as a guide for developing similar questionnaires. 相似文献7.
Vincent Kalumire Cubaka Michael Schriver Peter Vedsted Gregory Makoul Per Kallestrup 《Patient education and counseling》2018,101(9):1601-1610
Objective
To identify, adapt and validate a measure for providers’ communication and interpersonal skills in Rwanda.Methods
After selection, translation and piloting of the measure, structural validity, test-retest reliability, and differential item functioning were assessed.Results
Identification and adaptation: The 14-item Communication Assessment Tool (CAT) was selected and adapted.Validity and reliability testing
Content validation found all items highly relevant in the local context except two, which were retained upon understanding the reasoning applied by patients. Eleven providers and 291 patients were involved in the field-testing. Confirmatory factor analysis showed a good fit for the original one factor model. Test-retest reliability assessment revealed a mean quadratic weighted Kappa?=?0.81 (range: 0.69–0.89, N?=?57). The average proportion of excellent scores was 15.7% (SD: 24.7, range: 9.9–21.8%, N?=?180). Differential item functioning was not observed except for item 1, which focuses on greetings, for age groups (p?=?0.02, N?=?180).Conclusion
The Kinyarwanda version of CAT (K-CAT) is a reliable and valid patient-reported measure of providers’ communication and interpersonal skills. K-CAT was validated on nurses and its use on other types of providers may require further validation.Practice implication
K-CAT is expected to be a valuable feedback tool for providers in practice and in training. 相似文献8.
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9.
Inge A. Stortenbeker Juul Houwen Peter L.B.J. Lucassen Hugo W. Stappers Willem J.J. Assendelft Sandra van Dulmen Tim C. olde Hartman Enny Das 《Patient education and counseling》2018,101(9):1577-1584
Objective
Positive communication is advocated for physicians during consultations with patients presenting medically unexplained symptoms (MUS), but studies generally focus on what is said rather than how it is said. This study quantified language use differences of general practitioners (GPs), and assessed their relation to patient anxiety.Methods
Language use of 18 Dutch GPs during 82 consultations was compared for patients with MUS versus medically explained symptoms (MES). Message content (positive or negative) was differentiated from its directness (direct or indirect), and related to changes in patient’s state anxiety (abbreviated State Trait Anxiety Inventory; STAI).Results
In total, 2590 clauses were identified. GPs approached patients with MES with relatively more direct (vs. indirect) positive and indirect (vs. direct) negative messages (OR 1.91, 95% CI 1.42–2.59). Anxiety of both patient groups increased when GPs used more direct (vs. indirect) negative messages (b?=?0.67, 95% CI 0.07–1.27)Conclusions
GPs use different language depending on the content of messages for patients with MES, but not MUS. Direct negative messages relate to an increase in patient anxiety.Practice implications
GPs could manage patient’s state anxiety by expressing negative messages in an indirect rather than direct manner. 相似文献10.
Jin Hui Joo Seungyoung Hwang Joseph J. Gallo Debra L. Roter 《Patient education and counseling》2018,101(4):665-671
Objective
The objective of this pilot study was to describe peer communication in meetings with depressed elders, associate their relationship with working alliance and depression and assess congruence of communication with training.Methods
Three peers with a history of depression, in recovery, received 20 h of training in peer mentoring for depression as part of an 8-week pilot program for 23 depressed older adults. Each peer-client meeting was recorded; a sample of 69 recorded meetings were chosen across the program period and coded with the Roter Interaction Analysis System, a validated medical interaction analysis system. Generalized linear mixed models were used to examine peer talk during meetings in relation to working alliance and client depression.Results
Peers used a variety of skills congruent with their training including client-centered talk, positive rapport building and emotional responsiveness that remained consistent or increased over time. Client-centered communication and positive rapport were associated with increased working alliance and decreased depressive symptoms (all p < 0.001).Conclusion
Trained peer mentors can use communication behaviors useful to older adults with depression. Specifically, client-centered talk may be important to include in peer training.Practice implications
Peer mentors can be a valuable resource in providing depression counseling to older adults. 相似文献11.
Demian Glujovsky Carlos E. Sueldo Andrea Coscia Paula De Carvalho Stella Lancuba Gustavo Martinez Agustín Ciapponi 《Patient education and counseling》2018,101(5):945-950
Objectives
To evaluate motivations to perform an elective single embryo transfer (e-SET).Methods
Cross-sectional surveys to reproductive medicine specialists and to infertile patients undergoing assisted reproductive treatments.Results
In the physician’s survey (n?=?278), we found that the main reasons for not offering e-SET were the physicians’ belief that patients prefer optimizing the pregnancy rates regardless of the potential complications (57.1%). Regarding the decision making process, 76.7% of physicians thought that patients and doctors should make these decisions together and 93.3% would like to have a more formal decision-aid to help with counseling. In the patients’ survey (n?=?100), 21.3% chose e-SET, while 33% mentioned that complications associated to multiple pregnancies were insufficiently discussed. Among those patients, none chose to have e-SET, while 30% of those who had a full discussion selected e-SET (p?=?0.05).Conclusions
Most physicians did not offer e-SET based on potential patients’ negative feelings. Also, almost 30% take important decisions without the patient’s participation. Patients that discussed more thoroughly this topic, more frequently selected e-SET. Almost all the physicians surveyed agreed that decision-aids could help in this important shared-decision process.Practice implications
Decision aids about e-SET vs DET are needed to help patients in the decision making process. 相似文献12.
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14.
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15.
Victoria Siegrist Wolf Langewitz Rui Mata Dominik Maiori Ralph Hertwig Roland Bingisser 《Patient education and counseling》2018,101(12):2090-2096
Objective
We investigated the effects of information structuring and its potential interaction with pre-existing medical knowledge on recall in a simulated discharge communication.Methods
127 proxy-patients (i.e. students) were randomly assigned to one of four conditions. Video vignettes provided identical information, differing in means of information structuring only: The natural conversation (NC) condition was not explicitly structured whereas the structure (S) condition presented information organised by chapter headings. The book metaphor (BM) and the post organizer (PO) conditions also presented structured information but in addition included a synopsis, either at the beginning or at the end of discharge communication, respectively. Proxy-patients’ recall, perception of quality and pre-existing medical knowledge were assessed.Results
Information structuring (conditions: S, BM, PO) did not increase recall in comparison to NC, but pre-existing medical knowledge improved recall (p?<?.01). An interaction between medical knowledge and recall in the BM condition was found (p?=?.02). In comparison to the NC, proxy-patients in all information structuring conditions more strongly recommended the physician (p?<?.001).Conclusions
Structured discharge communication complemented by the BM is beneficial in individuals with lower pre-existing medical knowledge.Practice implications
The lower pre-existing medical knowledge, the more recipients will profit from information structuring with the BM. 相似文献16.
Aaron T. Seaman Kimberly Dukes Richard M. Hoffman Alan J. Christensen Nicholas Kendell Andrew L. Sussman Miriam Veléz-Bermúdez Robert J. Volk Nitin A. Pagedar 《Patient education and counseling》2018,101(10):1741-1747
Objective
Shared decision making (SDM) is recommended when offering lung cancer screening (LCS)—which presents challenges with tobacco-related cancer survivors because they were excluded from clinical trials. Our objective was to characterize head and neck cancer (HNC) survivors’ knowledge, attitudes, and beliefs toward LCS and SDM.Methods
Between November 2017 and June 2018, we conducted semi-structured qualitative interviews with 19 HNC survivors, focusing on patients’ cancer and smoking history, receptivity to and perceptions of LCS, and decision-making preferencesResults
Participants were receptive to LCS, referencing their successful HNC outcomes. They perceived that LCS might reduce uncertainty and emphasized the potential benefits of early diagnosis. Some expressed concern over costs or overdiagnosis, but most minimized potential harms, including false positives and radiation exposure. Participants preferred in-person LCS discussions, often ideally with their cancer specialist.Conclusion and Practice Implications
HNC survivors may have overly optimistic expectations for LCS, and clinicians need to account for this in SDM discussions. Supporting these patients in making informed decisions will be challenging because we lack clinical data on the potential benefits and harms of LCS for cancer survivors. While some patients prefer discussing LCS with their cancer specialists, the ability of specialists to support high-quality decision making is uncertain. 相似文献17.
José Pérez-Revuelta José María Villagrán-Moreno Luisa Moreno-Sánchez Juan Manuel Pascual-Paño Francisco González-Saiz 《Patient education and counseling》2018,101(8):1477-1482
Objective
The aim of this paper is to provide evidence of the validity and reliability of the COMRADE scale (Combined Outcome Measure for Risk communication And treatment Decision making Effectiveness) in patients suffering from schizophrenia spectrum disorders.Method
150 patients recruited at five mental health centers were assessed using a cross-sectional study design. The COMRADE, WAIS-S (therapeutic alliance) and TSQM (satisfaction with medication) scales were used.Results
Exploratory Factor Analysis identified three factors from the COMRADE (F1: “Risk communication”; F2: “Confidence in decision” and F3: “Knowledge of decisional balance”) which explain 45.2, 8.5 and 6% of the variance, respectively. Statistically significant correlations were observed between the scores of the COMRADE subscales with the subscales of the WAI-S and the TSQM. The internal consistency observed for each of the factorial scores of the COMRADE were (Cronbach’s alpha values) 0.90, 0.89 and 0.74, respectively.Conclusion
The COMRADE scale offers appropriate psychometric properties for its use as a measure of perceived patient involvement in the shared decision making process in antipsychotic treatment.Practice implications
The use of the COMRADE measure in psychiatric clinical practice and in research studies provides an outcome measure of interventions from the shared decision making model. 相似文献18.
Hamideh Salimzadeh Roghaye Khabiri Maryam Khazaee-pool Somayeh Salimzadeh Alireza Delavari 《Patient education and counseling》2018,101(6):1082-1087
Objective
To measure the impact of motivational interviewing (MI) on cancer knowledge and screening practice among first degree relatives (FDRs) of patients with colon cancer.Methods
This randomized controlled trial targeted patients with colon cancer first to recruit their possible FDRs. Digit randomization of the eligible index patients into intervention or control groups resulted in allocating their belonging FDRs to the same study arm. FDRs (n?=?120) in intervention arm received MI counseling on phone by a trained oncology nurse and FDRs (n?=?120) in control group received standard generic information by a physician on phone. Primary outcome was the rate of documented colonoscopy in FDRs within six months after the baseline.Results
A total of 227 FDRs were followed up, 115 in the intervention and 112 in the control group. At follow-up, the uptake of screening colonoscopy in the intervention group was 83.5% versus 48.2% in controls (crude odds ratio, 5.4; 95% confidence interval, 2.9–10.0, P?<?.001).Conclusion
This was the first randomized controlled trial in Iran that confirmed the efficaciousness of a phone-based MI counseling in improving colonoscopy uptake among family members of patients with colon cancer.Practice implications
Phone-based motivational counseling that involves trained nurses or health providers seems to be feasible approach in Iran health system and enhances screening for colon cancer. 相似文献19.
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20.
Daniela Scala Enrica Menditto Giuseppe Caruso Valeria Marina Monetti Valentina Orlando Francesca Guerriero Giuseppe Buonomo Domenico Caruso Maria D’Avino 《Patient education and counseling》2018,101(4):679-686