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1.
Christoph Nikendei Hans Martin BosseKatja Hoffmann Andreas MöltnerRabea Hancke Corinna ConradSoeren Huwendiek Georg F. HoffmannWolfgang Herzog Jana JüngerJobst-Hendrik Schultz 《Patient education and counseling》2011,82(1):94-99
Objective
Communication skills represent an essential component of clinical competence. In the field of pediatrics, communication between physicians and patients’ parents is characterized by particular difficulties. To investigate the effects of a parent-physician communication skills training program on OSCE performance and self-efficacy in a group control design.Methods
Parallel to their daily work in the outpatient department, intervention-group experienced clinicians in practice (n = 14) participated in a communication training with standardized parents. Control-group physicians (n = 14) did not receive any training beyond their daily work. Performance was assessed by independent video ratings of an OSCE. Both groups rated their self-efficacy prior to and following training.Results
Regarding OSCE performance, the intervention group demonstrated superior skills in building relationships with parents (p < .024) and tended to perform better in exploring parents’ problems (p < .081). The communication training program led to significant improvement in self-efficacy with respect to the specific training objectives in the intervention group (p < .046).Conclusion
Even in physicians with considerable experience, structured communication training with standardized parents leads to significant improvement in OSCE performance and self-efficacy.Practise implications
Briefness and tight structure make the presented communication training program applicable even for experienced physicians in daily clinical practice. 相似文献2.
Kim van Bastelaar Pim Cuijpers François PouwerHeleen Riper Frank J. Snoek 《Patient education and counseling》2011,84(1):49-55
Objectives
There is an urgent need for more effective and efficient depression treatments in diabetes. We developed a diabetes-specific version of the Dutch web-based ‘Coping with Depression’ (CWD) course. Here, we report on the development, reach, patients’ reasons for choosing our intervention and their characteristics.Methods
The CWD programme was amended for use in diabetes patients with co-morbid depression. Data were collected using a telephone interview, self-report questionnaires, and medical records.Results
Adding diabetes-specific topics to an effective web-based depression programme resulted in an 8-lesson intervention (“www.diabetergestemd.nl”), with minimal guidance by coaches. In the framework of a randomised trial, the intervention attracted serious interest of 540 patients. After screening, 255 depressed diabetes patients were enrolled. Less than half had a history of depression treatment; 80% reported the diabetes-specific approach to be an important reason for signing up.Conclusion
We successfully developed a diabetes-specific version of the web-based CWD course, which attracted a large group of patients. Our results affirm the importance of addressing diabetes-specific issues in the context of depression treatment.Practice implications
Our intervention could be implemented on a large scale at low costs, and may serve as a model on how to develop other illness-specific online self-help interventions. 相似文献3.
Silvia NeubertCarla Sabariego Marita Stier-JarmerAlarcos Cieza 《Patient education and counseling》2011,84(2):e13
Objective
To describe the development of an ICF-based patient education program, to present the results of its pilot test and to present the adaptations and final version of the program.Methods
The education program was developed in five steps: (1) definition of relevant areas of functioning, (2) development of strategies to enhance self-efficacy in these areas, (3) development of material and instructions, (4) definition of modules and setting and (5) performance of a pilot test targeting acceptability and feasibility of the program.Results
Eleven stroke patients were enrolled in the pilot test. The intervention was well accepted on the part of participants. The developed patient education program is structured in three modules. Module 1 targets to increase patients’ understanding of their current level of functioning. Module 2 targets to identify concrete problems and corresponding solutions regarding limited areas. Module 3 is a refresher session.Conclusion
Feasibility and acceptability of the intervention were verified and a final version of the patient education program was developed. The effectiveness of the program will be evaluated in a randomized controlled trial.Practice implications
Due to the universality of the ICF and availability of ICF tools, it is possible to adapt the intervention to different chronic conditions. 相似文献4.
Objective
To obtain understanding of how patients with rheumatic diseases experienced participation in an emotion-focused group intervention in terms of influences on their emotional well-being and coping behavior and the processes whereby these influences arose.Methods
The intervention, Vitality Training (VTP), was conducted in 10 group sessions over 4 months. Qualitative data were collected from 10 focus group interviews (n = 69) two weeks after the intervention. Data were analyzed with a qualitative content analysis approach.Results
Five categories were identified from the analyses: (1) recognizing oneself as both ill and healthy, (2) recognizing own emotions, (3) awareness of own needs, (4) being part of a community and (5) being recognized as a credible patient.Conclusion
The VTP addressed participants’ awareness of emotional and bodily reactions in a process-oriented and supportive group. The program had enhanced participants’ recognition of their disease-related emotions and helped them to more actively relate to their own needs.Practical implications
This study has highlighted how a process-oriented group intervention that combines topics related to life, rather than disease, and learning methods that enhance emotional awareness and adaptive emotional expression can enhance emotional well-being and coping behavior in patients with rheumatic diseases. 相似文献5.
Visser A Schoolmeesters A van den Berg M Schell N de Gelder R van den Borne B 《Patient education and counseling》2011,82(3):325-334
Objective
Methodological reflection on the content, results and limitations of three body-mind intervention studies with cancer patients (CPs) in order to improve the quality of studies on body-mind interventions and to raise the potential value for CPs.Methods
A secondary analysis of a study on haptotherapy and two studies applying relaxing face massage, using a variety of well-being effect measures. Six methodological themes are discussed: (1) drop-out; (2) characteristics of participating patients, (3) participation of patients in other complementary interventions; (4) satisfaction of participants; (5) effects of the three interventions, and (6) role of response shift.Results
The three interventions showed limited effects after controlling for relevant confounding factors. They are mainly the small sample sizes, the low intensity of the intervention, the possible inadequate measure moments and the use of other CAM that may be responsible for the absence of effects.Conclusions
Body-mind interventions require more methodological reflections to develop attractive and effective interventions for CPs. Attention needs to be paid to measuring short term effects, practically fitting research designs, and response shift.Practice implications
Interventions should be intensive, repeated and not too short. The implementation of interventions requires attention to several organizational factors in the health care. 相似文献6.
Alexander G. Fiks Angela Gafen Cayce C. Hughes Kenya F. Hunter Frances K. Barg 《Patient education and counseling》2011,84(2):236-244
Objective
To compare and contrast notions of ADHD among pediatricians and parents of affected children to understand the perspectives they bring to shared decision making (SDM).Methods
In this freelisting study, 60 parents of children with ADHD and 30 primary care pediatricians listed words reflecting their understanding of (1) Attention Deficit Hyperactivity Disorder (ADHD), (2) getting/offering help for ADHD, (3) talking to doctors/families about ADHD, and (4) “mental health.” Smith's salience score established terms that were salient and cultural consensus analysis identified variation within subgroups of participants.Results
Parents’ terms reflected ADHD's effects on the child and family, while clinicians often mentioned school. Lists suggested differing needs and goals for clinicians and subgroups of parents in SDM: “time” for clinicians, “learning” and “understanding” for non-college educated parents, and “comfort” and “relief” for college educated parents. Neither parents nor clinicians framed ADHD in the same way as “mental health.”Conclusion
Parents and clinicians, who conceptualize ADHD differently, should negotiate a shared understanding of ADHD as a basis for SDM. Treatment discussions should be tailored to encompass families’ varied emotional and educational needs.Practice implications
Fostering SDM in primary care is consonant with notions of ADHD as distinct from mental health. 相似文献7.
Objective
To evaluate the efficacy of ongoing group based diabetes self-management education (DSME) for patients with type 2 diabetes.Methods
146 patients were randomised to either group education or waiting list control. Primary outcomes were A1C and patient activation measured with patient activation measure (PAM).Results
There were no differences in the primary outcomes between the groups at 12 months, but the control group had an increase in A1C of 0.3% points during follow-up. Diabetes knowledge and some self-management skills improved significantly in the intervention group compared to the control group. A sub group analysis was conducted for the quartile with the highest A1C at baseline (>7.7, n = 18 in both groups). There were significant improvements within the intervention group at 12 month follow-up for both A1C and PAM and a trend for better outcome in the intervention group compared to the control.Conclusions
The locally developed ongoing diabetes self-management education programs prevented an increase in A1C and can have an effect on A1C in patients with higher A1C level.Practice implications
Locally developed programs may be less effective than programs developed for studies. 相似文献8.
Gretchen A. Piatt Thomas J. SongerMaria M. Brooks Robert M. AndersonDavid Simmons Trevor J. OrchardLinda M. Siminerio Mary T. KorytkowskiJanice C. Zgibor 《Patient education and counseling》2011,82(2):266-270
Objective
To determine which patient factors contribute to improvements in the ABCs of diabetes following a multi-faceted diabetes care intervention.Methods
A multi-level, cluster design, randomized controlled trial examined the effectiveness of a Chronic Care Model (CCM) intervention in an underserved community (n = 119).Results
Improvements in glycemic control were experienced among older subjects (p = 0.02), those with higher scores on the WHO-10 Quality of Well-Being Subscale 1 (p = 0.05), and those in the CCM group (p = 0.04). Insulin use was associated with greater improvements in SBP and DBP. Those taking insulin (p = 0.07), and those more satisfied with their diabetes care and ready to make a behavior change (p = 0.08) experienced larger improvements in Non-HDLc. Medication treatment intensification (TI) did not significantly impact the ABCs.Conclusion
Psychosocial and sociodemographic factors explained more of the variation in the ABCs than TI, and are important contributors to clinical improvement.Practice Implications
Providers may be able to identify and intervene on patients who are at risk for developing diabetes complications and improve the consistency, quality, and effectiveness of patient care. 相似文献9.
Objective
To review empirical studies on families created by new reproductive technologies (NRT) in which only one parent has a genetic link to the child.Methodology
Literature search was conducted among computerized databases. Inclusion criteria were that studies should focus on childrearing or parenting, as well as on the psychological adjustment of children in: heterosexual families formed through artificial insemination with donated semen (AID), single-mother AID families, oocyte-donation families, planned lesbian-mother families, planned gay-father families, and partial surrogacy families.Results
Compared to natural-conception parents, parents in these NRT families have better relationships with their children, and their children are functioning well.Conclusion
Although several studies show that parents in NRT families are more emotionally involved in their parenting than are parents in naturally conceived families, no empirical evidence was found that the psychological adjustment of children in NRT families differs from that of their counterparts in natural-conception families.Practical implication
The results inform counselors and infertile couples that concerns regarding the use of NRT in relation to negative consequences for the parent-child relationship or the psychological adjustment of the child are till now unfounded. 相似文献10.
Köpke S Richter T Kasper J Mühlhauser I Flachenecker P Heesen C 《Patient education and counseling》2012,86(1):91-97
Objective
To study the implementation of a patient education program on relapses and relapse therapy into routine care.Methods
31 health care professionals took part in a one day train-the-trainer program (TTTP) and subsequently 261 persons with MS (pwMS) took part in the education program. Evaluation was carried out in trainers and pwMS.Results
Participants (health professionals) in the TTTP understood the program's main goals and reported that the TTTP enabled them to successfully perform the program. The majority of participants in the program (pwMS) understood the core messages. Also, they showed increased risk knowledge and increased decision autonomy preferences. Treatment decisions were reported as autonomous or as “informed choice” in 49%, and as “shared decisions” by 45%. Overall, effects were less marked compared to the results of the underlying randomized-controlled trial.Conclusion
PwMS! appreciate evidence-based information about relapse management and view the unbiased presentation of scientific uncertainty as a chance for decision autonomy.Practice implications
The implementation study confirms the program's transferability into clinical practice. 相似文献11.
Chan EC McFall SL Byrd TL Mullen PD Volk RJ Ureda J Calderon-Mora J Morales P Valdes A Kay Bartholomew L 《Patient education and counseling》2011,84(2):e44-e51
Objective
We assessed the short-term effects of a community-based intervention for Hispanic men to encourage informed decision making (IDM) about prostate cancer screening with prostate specific antigen (PSA).Methods
All senior social and housing centers in El Paso, TX were randomized to intervention, a group-based Spanish language educational program facilitated by promotores (12 centers; 161 men) [I's], or to control, promotores-facilitated diabetes video and discussion (13 centers; 160 men) [C's].Results
Participants had low levels of schooling and baseline knowledge; 44% reported previous PSA testing. At post-test, the I's made large knowledge gains, increased their understanding that experts disagree about testing, shifted toward more active decision making roles, were more likely to believe that it is important to weigh the advantages and disadvantages of screening and to anticipate potential screening outcomes in making a decision, and were less likely to consider the screening decision easy. The I's did not change in their screening intention or the belief that choosing not to be screened could be a responsible choice.Conclusions
A community-based intervention to support IDM for prostate cancer screening can increase knowledge and may promote more active involvement in decision making about prostate cancer screening. Such an approach can increase knowledge and may promote more active involvement in decision making about prostate cancer screening.Practice implications
It is feasible to develop and implement a community-based intervention program to promote IDM for prostate cancer screening. 相似文献12.
A computerized education module improves patient knowledge and attitudes about appropriate antibiotic use for acute respiratory tract infections 总被引:1,自引:0,他引:1
Price EL Mackenzie TD Metlay JP Camargo CA Gonzales R 《Patient education and counseling》2011,85(3):493-498
Background
Over-use of antibiotics for acute respiratory infections (ARIs) increases antimicrobial resistance, treatment costs, and side effects. Patient desire for antibiotics contributes to over-use.Objective
To explore whether a point-of-care interactive computerized education module increases patient knowledge and decreases desire for antibiotics.Methods
Bilingual (English/Spanish) interactive kiosks were available in 8 emergency departments as part of a multidimensional intervention to reduce antibiotic prescribing for ARIs. The symptom-tailored module included assessment of symptoms, knowledge about ARIs (3 items), and desire for antibiotics on a 10-point visual analog scale. Multivariable analysis assessed predictors of change in desire for antibiotics.Results
Of 686 adults with ARI symptoms, 63% initially thought antibiotics might help. The proportion of patients with low (1-3 on the scale) desire for antibiotics increased from 22% pre-module to 49% post-module (p < .001). Self-report of “learning something new” was associated with decreased desire for antibiotics, after adjusting for baseline characteristics (p = .001).Conclusion
An interactive educational kiosk improved knowledge about antibiotics and ARIs. Learning correlated with changes in personal desire for antibiotics.Practice implications
By reducing desire for antibiotics, point-of-care interactive educational computer technology may help decrease inappropriate use for antibiotics for ARIs. 相似文献13.
Sander R. Hilberink Johanna E. JacobsMarinus H.M. Breteler Hein de VriesRichard P.T.M. Grol 《Patient education and counseling》2011,83(1):120-124
Objective
To evaluate two counseling programs in general practice to help smokers with chronic obstructive pulmonary disease (COPD) to quit smoking.Methods
Cluster randomized controlled trial including 68 general practices (667 patients) using a randomly assigned intervention program with counseling and advice about nicotine replacement therapy (and additional bupropion-SR in one of the programs) or usual care. Usual care consisted of periodic regular check-ups and COPD information. The main outcome measure was biochemically verified point prevalence at 12 months.Results
The two intervention groups were treated as one in the analysis because they were equally effective. The intervention resulted in a significantly self-reported higher success rate (14.5%) compared to usual care (7.4%); odds ratio = 2.1, 95% confidence interval = 1.1-4.1. Biochemically verified quit rates were 7.5% (intervention) and 3.4% (usual care); odds ratio = 2.3, 95% confidence interval = 0.9-6.0.Conclusion
The program doubled the cessation rates (statistically nonsignificant). Too few participants used the additional bupropion-SR to prove its effectiveness.Practice implications
The protocols can be used for COPD patients in general practice, but expectations should be modest. If quitting is unsuccessful, a stepped care approach should be considered. 相似文献14.
Objective
Many patients with type 1 diabetes struggle to self-manage this chronic disease, often because they have a poor knowledge and understanding of the condition. However, little attention has been paid to examining the reasons for this poor knowledge/understanding. To inform future educational interventions, we explored patients’ accounts of the education and information they had received since diagnosis, and the reasons behind gaps in their diabetes knowledge.Methods
Semi-structured interviews were conducted with 30 type 1 diabetes patients enrolled on a structured education programme in the UK. Data were analysed using an inductive, thematic approach.Results
Patients’ accounts illustrated a number of knowledge deficits which were influenced by various lifecourse events. Reasons for deficits included: diagnosis at a young age and assumption of decision-making responsibility by parents; lack of engagement with information when feeling well; transitions in care; inconsistency in information provision; and, lack of awareness that knowledge was poor or incomplete.Conclusion
Patients’ knowledge deficits can arise for different reasons, at different points in the lifecourse, and may change over time.Practice implications
The delivery of individualised education should take account of the origins of patients’ knowledge gaps and be provided on a regular and on-going basis. 相似文献15.
Erik J. Groessl Kimberly R. WeingartAllen L. Gifford Steven M. Asch Samuel B. Ho 《Patient education and counseling》2011,83(2):252-255
Objective
Chronic hepatitis C infection (HCV) is a major health problem that disproportionately affects people with limited resources. Many people with HCV are ineligible or refuse antiviral treatment, but less curative treatment options exist. These options include adhering to follow-up health visits, lifestyle changes, and avoiding hepatotoxins like alcohol. Herein, we describe a recently developed self-management program designed to assist HCV-infected patients with adherence and improve their health-related quality of life (HRQOL).Methods
The development of the Hepatitis C Self-Management Program (HCV-SMP) was informed by scientific literature, qualitative interviews with HCV-infected patients, self-management training, and feedback from HCV clinical experts.Results
The Hepatitis C Self-Management Program (HCV-SMP) is a multi-faceted program that employs cognitive-behavioral principles and is designed to provide HCV-infected people with knowledge and skills for improving their HRQOL. The program consists of six 2-h workshop sessions which are held weekly. The sessions consist of a variety of group activities, including disease-specific information dissemination, action planning, and problem-solving.Conclusion
The intervention teaches skills for adhering to challenging treatment recommendations using a validated theoretical model. A randomized trial will test the efficacy of this novel HCV self-management program for improving HRQOL in a difficult to reach population. 相似文献16.
Marlyn Allicock Marci K. Campbell Jameta N. Barlow Andrea Meier 《Patient education and counseling》2010,81(1):37-42
Objective
Body & Soul, an evidence-based nutrition program for African Americans churches, is currently being disseminated nationally and free of charge by the National Cancer Institute. For dissemination feasibility, the peer counseling training is done via DVD rather than by live trainers. We describe implementation and process evaluation of the peer counseling component under real world conditions.Methods
The study sample included 11 churches (6 early intervention, 5 delayed intervention) in 6 states. Data sources included training observations, post-training debriefing sessions, coordinator interviews, and church participant surveys. Survey data analysis examined associations between exposure to peer counseling and change in dietary intake. Qualitative data were analyzed using the constant comparative method.Results
Eight of 11 churches initiated the peer counseling program. Recall of talking with a peer counselor was associated with significantly (p < .02) greater fruit and vegetable intake. Data indicate sub-optimal program execution after peer counselor training.Conclusion
Inconsistent implementation of the peer counseling intervention is likely to dilute program effectiveness in changing nutrition behaviors.Practice implications
Disseminating evidence-based programs may require added resources, training, quality control, and technical assistance for improving program uptake. Similar to earlier research phases, systematic efforts at the dissemination phase are needed for program success. 相似文献17.
Jonathan Silverman Julian ArcherSusan Gillard Rachel HowellsJohn Benson 《Patient education and counseling》2011,82(1):89-93
Objective
To evaluate the content validity, internal consistency and generalisability of EPSCALE, a new rating scale to measure communication skills in explanation and planning.Methods
Content validity: consensus exercise and expert review. Internal consistency and generalisability: 124 clinical students undertaking 4 OSCE stations with simulated patients, with one observer (hospital specialist, GP or communication specialist) per station, during finals examinations. Internal consistency estimated by coefficient alpha, generalisability estimated by generalisability coefficient and variance components using EPSCALE.Results
Content validity was supported by consensus exercise and expert review. Internal consistency was high with a coefficient alpha of greater than 0.8 for all four explanation and planning stations in the finals exam. Generalisability coefficient for 4 OSCE stations was 0.50.Conclusions
This paper provides initial evidence that EPSCALE has content validity and high internal consistency when used to assess explanation and planning skills in the consultation. It defines the generalisability of this new rating scale. Further work is needed to explore the scale's validity by a range of other measures. 相似文献18.
Garssen B Vos P de Jager Meezenbroek E de Klerk C Visser A 《Patient education and counseling》2011,82(3):377-383
Objective
When comparing the efficacy of different interventions for cancer patients, there should be certainty that these types are sufficiently different in the way they are actually presented. The aim of the present study is to develop a method for assessing differences between the content of social support groups and experiential-existential therapy groups.Methods
Independent and blind raters assessed video fragments of both intervention types, using a self-developed checklist of five questions. This checklist was first evaluated by a group of experts for appropriateness, importance, and rateability.Results
Three out of the five questions were selected on the basis of these experts’ evaluation and on inter-rater reliability. The scores on these questions were used to evaluate five social support groups and six experiential-existential therapy groups for breast cancer patients. According to the independent and blind raters the content of the two intervention forms appeared to be significantly different.Conclusion
The assessment method we developed appeared reliable and valid.Practice implications
Our assessment method is feasible as a check to compare the content of psycho-oncological interventions and can be easily adjusted into a test for other intervention types. 相似文献19.
Linda Jones Herbert Priya Mehta Hemant Sharma 《Annals of allergy, asthma & immunology》2017,118(3):345-350
Background
Food allergies are increasingly prevalent in the pediatric population. Balancing allergen avoidance with the promotion of healthy eating behaviors can be challenging for families.Objective
To characterize mealtime behaviors among parents of young children with food allergy.Methods
Seventy-four parents of young children with food allergies (≤7 years of age) completed measures of mealtime behavior, perceptions of food allergy risk and severity, pediatric parenting stress, and food allergy–related quality of life. Mealtime behavior reports were compared with published data regarding typically developing children, young children with type 1 diabetes, and children with diagnosed feeding disorders (with or without related medical factors).Results
Parents of young children with food allergies reported frequent mealtime concerns. Specifically, they reported significantly more mealtime behavioral concerns than typically developing peers, comparable mealtime behavioral concerns to young children with type 1 diabetes, and significantly fewer mealtime behavioral concerns than children with diagnosed feeding disorders. Parental mealtime concerns were positively correlated with other parent perceptions of food allergy, such as risk of allergen exposure, illness-related parenting stress, and food allergy–related quality of life.Conclusion
Young children with food allergy and their parents are more likely to exhibit mealtime behavioral concerns than typically developing peers and their parents. Future research should investigate the effect of food allergies and maladaptive mealtime behaviors on children's nutrition to provide clinical guidelines for parents who may benefit from psychosocial and/or nutritional support. 相似文献20.
Deborah L. Helitzer Marianna LaNoueBronwyn Wilson Brisa Urquieta de HernandezTeddy Warner Debra Roter 《Patient education and counseling》2011,82(1):21-29