共查询到20条相似文献，搜索用时 953 毫秒
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Maarten Vermorgen Aline De Vleminck Luc Deliens Dirk Houttekier Nele Spruytte Chantal Van Audenhove Joachim Cohen Kenneth Chambaere 《Patient education and counseling》2018,101(8):1378-1384
Objective
Deaths from chronic illness are often preceded by a potentially life-shortening end-of-life decision (ELD). Involving family in these ELDs may have psychosocial benefits for them and the dying person. This study aims to examine how often ELDs are discussed with relatives of the dying person and which characteristics determine their involvement in those ELDs.Methods
A questionnaire survey was conducted in 2013 among physicians attending a large, stratified and representative sample of deaths (n?=?6188) in Flanders.Results
In 72.3% of ELDs preceding death, family of the dying person were involved. Discussion of an ELD with family members was more likely when the decision was also discussed with the dying person, the ELD was made with the explicit intention to shorten life, specialized palliative care was provided or death occurred in an ICU.Conclusions
Involving family in end-of-life decision making appears to be related to the type of formal care services involved, communication with the dying person and the motives behind the decision.Practice implications
Our findings suggest a need to further expand a palliative care approach with a focus on both the dying person and their family within and across a variety of health care services. 相似文献3.
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4.
Carma L. Bylund Smita C. Banerjee Philip A. Bialer Ruth Manna Tomer T. Levin Patricia A. Parker Elizabeth Schofield Yuelin Li Abraham Bartell Alexander Chou Shira A. Hichenberg Maura Dickler David W. Kissane 《Patient education and counseling》2018,101(11):1924-1933
Objective
Integrating education about physician-patient communication into oncology specialists’ education is important to improve quality of care. Our aim was to rigorously evaluate a 4-year institutionally-based patient communication skills program for oncology post-graduate trainees.Methods
Trainees from 10 specialties in the U.S. participated in patient communication skills modules tailored to sub-specialties. The program was evaluated by comparing pre-post scores on hierarchical outcomes: course evaluation, self-confidence, skills uptake in standardized and real patient encounters, and patient evaluations of satisfaction with communication. We examined breadth of skill usage as key outcome. Generalized estimating equations were used in data analysis.Results
Two hundred and sixty-two trainees’ data were analyzed, resulting in 984 standardized and 753 real patient encounters. Participants reported high satisfaction and demonstrated significant skill growth with standardized patients, but transfer of these skills into real patient encounters was incomplete. Participants with lower baseline scores had larger improvements with both standardized and real patients.Conclusion
The program was well received and increased participant skills in the simulated setting without effective transfer to real patient encounters.Practice Implications
Future work should allocate proportionally greater resources to trainees with lower baseline scores and measure breadth of participant skill usage as an outcome. 相似文献5.
Rebekah Laidsaar-Powell Phyllis Butow Frances Boyle Ilona Juraskova 《Patient education and counseling》2018,101(6):970-982
Objective
Family caregivers regularly attend medical consultations and are often involved in decision-making; however, there are few practical strategies to guide effective communication for the clinician-patient-family trio. We aimed to develop and evaluate the first comprehensive guidelines for oncology physicians and nurses, on how to positively and effectively involve family caregivers of adult patients in consultations and patient care (TRIO Guidelines-1) and how to manage challenging interactions with family caregivers (TRIO Guidelines-2).Methods
The TRIO Guidelines were based on a comprehensive literature review and input from an expert advisory group (n?=?10). They underwent two rounds of formal evaluation via an online Delphi consensus process involving international experts (n?=?35), and a subset were piloted with 24 breast cancer clinicians in a workshop format.Results
TRIO Guidelines-1 incorporate strategies and sub-strategies on facilitating collaborative and effective family involvement (6 topics). Example wording, behaviours, and level of evidence are provided throughout. All 24 clinicians rated the guidelines as helpful after the pilot workshop.Conclusion
These guidelines will be a useful educational tool for clinicians and medical/nursing students.Practice implications
By equipping clinicians with strategies to facilitate effective and collaborative family engagement, the TRIO Guidelines have the potential to transform communication in clinical practice. 相似文献6.
Lorraine M. Noble Wesley Scott-Smith Bernadette O’Neill Helen Salisbury 《Patient education and counseling》2018,101(9):1712-1719
Objectives
Clinical communication is a core component of undergraduate medical training. A consensus statement on the essential elements of the communication curriculum was co-produced in 2008 by the communication leads of UK medical schools. This paper discusses the relational, contextual and technological changes which have affected clinical communication since then and presents an updated curriculum for communication in undergraduate medicine.Method
The consensus was developed through an iterative consultation process with the communication leads who represent their medical schools on the UK Council of Clinical Communication in Undergraduate Medical Education.Results
The updated curriculum defines the underpinning values, core components and skills required within the context of contemporary medical care. It incorporates the evolving relational issues associated with the more prominent role of the patient in the consultation, reflected through legal precedent and changing societal expectations. The impact on clinical communication of the increased focus on patient safety, the professional duty of candour and digital medicine are discussed.Conclusion
Changes in the way medicine is practised should lead rapidly to adjustments to the content of curricula.Practice implications
The updated curriculum provides a model of best practice to help medical schools develop their teaching and argue for resources. 相似文献7.
Kristina Luhr Marie Holmefur Kersti Theander Ann Catrine Eldh 《Patient education and counseling》2018,101(6):1137-1142
Objective
Patient participation is facilitated by patients’ ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF); the aim was to describe if and how a self-management programme in primary healthcare influenced patient participation.Methods
Patients who had participated in a self-management programme were interviewed in nine focus groups (36 patients). Data was analysed using qualitative content analysis.Results
Patients described equality in personal interactions, opportunities to share and discuss, and a willingness to share and learn to facilitate patient participation in a self-management programme. Consequently, patient participation was promoted by a match between the individuals’ personal traits and the context.Conclusion
Features facilitating patient participation by means of sharing and assimilating knowledge and insights should be included in self-management programmes and in the care for patients with COPD and CHF.Practice implications
A self-management programme can complement regular primary care regarding enhanced understanding of one’s disease and support patient participation and the patient’s own resources in self-management. 相似文献8.
Ikuko Noro Debra L. Roter Satoko Kurosawa Yasuhiko Miura Masato Ishizaki 《Patient education and counseling》2018,101(2):227-232
Objective
This study was designed to address significant gaps in the predominantly western-centric research literature by examining the influence of gender concordance in medical communication and patient satisfaction within the Japanese context.Methods
New primary care patients (54 male and 49 female) were randomly assigned to study internists (6 males and 5 females). Recorded visits were coded with the Roter Interaction Analysis System (RIAS). Post-visit, patients completed a Japanese version of the Medical Interview Satisfaction Scale (MISS).Results
Female concordant visits showed higher levels of patient-centeredness than all other gender combinations. Female physicians substantially modified their communication based on patient gender while male physicians did not. Gender concordance was associated with higher female, but lower male patient satisfaction relative to gender discordant visits.Conclusion
Contrary to normative experience of medicine as a male dominated profession in Japan, and gender-based power differentials, male-gendered clinical communication is less likely to satisfy male than female patients, while female-gendered communication is positively associated with female patient satisfaction.Practice implications
Patient satisfaction ratings reflect greater gender flexibility in terms of acceptable physician behavior than Japanese norms would suggest. 相似文献9.
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10.
Jack K.H. Pun E. Angela Chan Sophie Wang Diana Slade 《Patient education and counseling》2018,101(7):1193-1206
Objective
To provide an integrative review of literature on health communication in East Asia and detail culturally-specific influences.Methods
Using PRISMA model, search of PubMed, PsychInfo, Web of Knowledge, ERIC and CINAHL databases were conducted for studies between January 2000 and March 2017, using the terms ‘clinician/health professional-patient', ‘nurse/doctor-patient, ‘communication' and ‘Asia'.Results
38 studies were included: Mainland China, Hong Kong, Japan, South Korea, and Taiwan. The existing body of research on clinician patient communication in East Asia can be classified:1) understanding the roles and expectations of the nurse, clinician, patient, and family in clinician-patient consultations: a) nurse-patient communication; b) doctor-patient communication; c) the role of family member; and 2) factors affecting quality of care: d) cultural attitudes towards death and terminal illnesses; e) communication preferences affecting trust, decision-making and patient satisfaction; f) the extent to which patient centred care is being implemented in practice; and g) communication practices in multilingual/multi-disciplinary environments.Conclusion
The review detailed the complexity and heterogeneity of clinician-patient communication across East Asia. The studies reviewed indicate that research in East Asia is starting to move beyond a preference for Western-based communication practices.Practice implications
There is a need to consider local culture in understanding and interpreting medical encounters in East Asia. The paper highlights the need for a specific culturally-appropriate model of health communication in East Asia which may significantly improve relationships between clinicians and patients. 相似文献11.
Sarina R. Isenberg Rebecca A. Aslakson James N. Dionne-Odom Katherine Clegg Smith Sarabdeep Singh Susan Larson John F.P. Bridges Thomas J. Smith Jennifer L. Wolff Debra L. Roter 《Patient education and counseling》2018,101(6):1066-1074
Objective
To examine the association between family companion presence during pre-surgical visits to discuss major cancer surgery and patient-provider communication and satisfaction.Methods
Secondary analysis of 61 pre-surgical visit recordings with eight surgical oncologists at an academic tertiary care hospital using the Roter Interaction Analysis System (RIAS). Surgeons, patients, and companions completed post-visit satisfaction questionnaires. Poisson and logistic regression models assessed differences in communication and satisfaction when companions were present vs. absent.Results
There were 46 visits (75%) in which companions were present, and 15 (25%) in which companions were absent. Companion communication was largely emotional and facilitative, as measured by RIAS. Companion presence was associated with more surgeon talk (IRR 1.29, p?=?0.006), and medical information-giving (IRR 1.41, p?=?0.001). Companion presence was associated with less disclosure of lifestyle/psychosocial topics by patients (IRR 0.55, p?=?0.037). In adjusted analyses, companions’ presence was associated with lower levels of patient-centeredness (IRR 0.77, p 0.004). There were no differences in patient or surgeon satisfaction based on companion presence.Conclusion
Companions’ presence during pre-surgical visits was associated with patient-surgeon communication but was not associated with patient or surgeon satisfaction.Practice implications
Future work is needed to develop interventions to enhance patient-companion-provider interactions in this setting. 相似文献12.
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13.
Jette Ammentorp Maiken Wolderslund Connie Timmermann Henry Larsen Karina Dahl Steffensen Annegrethe Nielsen Marianne E. Lau Bodil Winther Lars Henrik Jensen Elisabeth Assing Hvidt Niels Christian Hvidt Pål Gulbrandsen 《Patient education and counseling》2018,101(4):639-646
Objective
This paper aims to demonstrate how the use of participatory action research (PAR) helped us identify ways to respond to communication challenges associated with shared decision-making (SDM) training.Methods
Patients, relatives, researchers, and health professionals were involved in a PAR process that included: (1) two theatre workshops, (2) a pilot study of an SDM training module involving questionnaires and evaluation meetings, and (3) three reflection workshops.Results
The PAR process revealed that health professionals often struggled with addressing existential issues such as concerns about life, relationships, meaning, and ability to lead responsive dialogue. Following the PAR process, a communication programme that included communication on existential issues and coaching was drafted.Conclusion
By involving multiple stakeholders in a comprehensive PAR process, valuable communication skills addressing a broader understanding of SDM were identified. A communication programme aimed to enhance skills in a mindful and responsive clinical dialogue on the expectations, values, and hopes of patients and their relatives was drafted.Practical implications
Before integrating new communication concepts such as SDM in communication training, research methods such as PAR can be used to improve understanding and identify the needs and priorities of both patients and health professionals. 相似文献14.
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15.
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16.
Katherine Treiman Lauren McCormack Laura Wagner Nancy Roach Rebecca Moultrie Hannah Sanoff Carla Bann Richard L. Street Mahima Ashok Bryce B. Reeve 《Patient education and counseling》2018,101(9):1585-1593
Objective
This study assessed patient-centered communication (PCC) among newly diagnosed colorectal cancer patients. PCC, a key part of patient-centered care, contributes directly and indirectly to health-related quality of life, satisfaction with care, and other outcomes.Methods
We conducted a survey of patients in North Carolina, using a theoretically-based and validated measure that provides an overall PCC score and subscale scores for six PCC functions.Results
A total of 501 patients participated. The highest scores were for the PCC functions of Fostering Healing Relationships, Exchanging Information, and Making Decisions. The lowest scores were for the functions of Managing Uncertainty and Enabling Self-Management, yet these were functions respondents rated as most important. Respondents who thought about more than one health professional (versus oncologist) reported better communication. PCC also varied by treatment type, mental and physical health status, age, race, and education.Conclusion
Most patients reported good communication overall, however patients in poor physical health and mental health reported worse communication. The quality of communication varied across the PCC functions.Practice implications
Health professionals need to use a PCC approach that builds trust, respects the patient, provides salient information that patients can understand, provides emotional support, and facilitates the patient’s engagement in care. 相似文献17.
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Molly E. Waring David D. McManus Daniel J. Amante Chad E. Darling Catarina I. Kiefe 《Patient education and counseling》2018,101(11):1973-1981
Objective
To describe characteristics associated with online health information-seeking and discussing resulting information with healthcare providers among adults with acute coronary syndromes (ACS).Methods
Consecutive patients hospitalized with ACS in 6 hospitals in Massachusetts and Georgia who reported Internet use in the past 4 weeks (online patients) were asked about online health information-seeking and whether they discussed information with healthcare providers. Participants reported demographic and psychosocial characteristics; clinical characteristics were abstracted from medical records. Logistic regression models estimated associations with information-seeking and provider communication.Results
Online patients (N?=?1142) were on average aged 58.8 (SD: 10.6) years, 30.3% female, and 82.8% non-Hispanic white; 56.7% reported online health information-seeking. Patients with higher education and difficulty accessing medical care were more likely to report information-seeking; patients hospitalized with myocardial infarction, and those with impaired health numeracy and limited social networks were less likely. Among information-seekers, 33.9% discussed information with healthcare providers. More education and more frequent online information-seeking were associated with provider discussions.Conclusion
Over half of online patients with ACS seek health information online, but only 1 in 3 of these discuss information with healthcare providers.Practice implications
Clinician awareness of patient information-seeking may enhance communication including referral to evidence-based online resources. 相似文献19.
Shrinkhala Dawadi Janet Takefman Phyllis Zelkowitz 《Patient education and counseling》2018,101(10):1852-1858
Objectives
To examine the provision of information by health care providers (HCPs) to fertility patients about accessing psychological resources.Methods
This study utilized data from a cross-sectional survey of 659 male and female patients seeking fertility treatment at clinics in Toronto and Montreal. Regression analyses were used to assess if sociodemographic and treatment variables were associated with the receipt of information, the desire for information, the helpfulness of the information, and the likelihood that participants had sought counselling.Results
The majority of respondents (79.8%) said that their HCP had not given them information about accessing psychological resources. Of the patients who did not receive this information, most (60%) said that they wanted it. Regression analysis revealed that immigrants, women, and patients with higher perceived stress scores were significantly more likely to desire this information. Furthermore, having received this information was associated with increased odds of counselling seeking (odds ratio?=?3.31, p?=?0.013).Conclusion
Fertility patients demonstrated an unmet need for information about accessing psychological resources, and HCPs may play an integral role in bridging this information gap.Practice Implications
To improve the patient-centeredness of fertility care, HCPs should be proactive in informing all patients about how to access psychological resources. 相似文献20.
Elaine Wittenberg Betty Ferrell Joy Goldsmith Sandra L. Ragan Haley Buller 《Patient education and counseling》2018,101(3):467-474