共查询到20条相似文献，搜索用时 31 毫秒
1.
Eden G. Robertson Claire E. Wakefield Christina Signorelli Richard J. Cohn Andrea Patenaude Claire Foster Tristan Pettit Joanna E. Fardell 《Patient education and counseling》2018,101(7):1157-1174
Objective
We conducted a systematic review to identify the strategies that have been recommended in the literature to facilitate shared decision-making regarding enrolment in pediatric oncology clinical trials.Methods
We searched seven databases for peer-reviewed literature, published 1990–2017. Of 924 articles identified, 17 studies were eligible for the review. We assessed study quality using the ‘Mixed-Methods Appraisal Tool’. We coded the results and discussions of papers line-by-line using nVivo software. We categorized strategies thematically.Results
Five main themes emerged: 1) decision-making as a process, 2) individuality of the process; 3) information provision, 4) the role of communication, or 5) decision and psychosocial support. Families should have adequate time to make a decision. HCPs should elicit parents’ and patients’ preferences for level of information and decision involvement. Information should be clear and provided in multiple modalities. Articles also recommended providing training for healthcare professionals and access to psychosocial support for families.Conclusion
High quality, individually-tailored information, open communication and psychosocial support appear vital in supporting decision-making regarding enrollment in clinical trials. These data will usefully inform future decision-making interventions/tools to support families making clinical trial decisions.Practice implications
A solid evidence-base for effective strategies which facilitate shared decision-making is needed. 相似文献2.
Rebecca Schweier Gesine Grande Cynthia Richter Steffi G. Riedel-Heller Matthias Romppel 《Patient education and counseling》2018,101(7):1283-1290
Objective
To investigate the use of lebensstil-aendern.de (“lifestyle change”), a website providing peer narratives of experiences with successful lifestyle change, and to analyze whether peer model characteristics, clip content, and media type have an influence on the number of visitors, dwell time, and exit rates.Methods
An in-depth statistical analysis of website use with multilevel regression analyses.Results
In two years, lebensstil-aendern.de attracted 12,844 visitors. The in-depth statistical analysis of usage rates demonstrated that audio clips were less popular than video or text-only clips, longer clips attracted more visitors, and clips by younger and female interviewees were preferred. User preferences for clip content categories differed between heart and back pain patients. Clips about stress management drew the smallest numbers of visitors in both indication modules.Conclusions
Patients are interested in the experiences of others. Because the quality of information for user-generated content is generally low, healthcare providers should include quality-assured patient narratives in their interventions. User preferences for content, medium, and peer characteristics need to be taken into account.Practice implications
If healthcare providers decide to include patient experiences in their websites, they should plan their intervention according to the different needs and preferences of users. 相似文献3.
Joe Jabbour Haryana M. Dhillon Heather L. Shepherd Puma Sundaresan Chris Milross Jonathan R. Clark 《Patient education and counseling》2018,101(10):1736-1740
Objective
Is there a relationship between decision-making preferences and psychological distress?Methods
Patients who had received treatment for head and neck cancer (HNC) at four institutions within NSW, Australia were invited to complete a single questionnaire.Results
Five hundred and ninety-seven patients completed the questionnaire. The majority of patients (308, 54%) preferred shared decision making. Significant predictors of a preference towards active decision making were education level (OR 2.1 for tertiary, p?<?0.001), primary cancer site (OR 1.9 for thyroid compared to salivary gland, p?=?0.024) and gender (OR 1.4 for female, p?=?0.028). Mean psychological distress score on Kessler 6 (K6) was 9 (Range: 0–28). Significant predictors of psychological distress were age (p?<?0.001), gender (p?<?0.001), primary site (p?<?0.01), and decision preference (p?<?0.01).Conclusion
HNC patients who are either tertiary educated or female are more likely to prefer active involvement in decision-making. Psychological distress is more likely in patients actively involved in decision making, younger patients, and in females.Practice implications
: Patients experienced paternalistic decision-making, but most preferred active or a shared approached. Clinicians need to be aware of potential for psychological distress in active decision-makers and refer patients for psychosocial support. 相似文献4.
5.
Mónica Pérez Jolles Pey-Jiuan Lee Joyce R. Javier 《Patient education and counseling》2018,101(10):1753-1760
Objectives
Test the relationship between shared decision-making (SDM) and parental report of frustration with efforts to get services for their child and to address unmet health needs; assess SDM’s influence on minority parents’ service experiences.Methods
Performed secondary analysis using the 2009–2010 National Survey of Children with Special Health Care Needs (n?=?40,242). Used multivariate logistic regressions to test the association between SDM and parent-reported service experiences, and whether SDM influenced the association between minorities and negative service experiences. Propensity scores accounted for observed selection bias.Results
Families engaged in SDM had lower odds of reporting service dissatisfaction. Fewer minority parents reported SDM engagement compared with Whites (between 62% and 66% versus 74%). Blacks engaged in SDM had higher odds of reporting negative service experiences compared with SDM-engaged Whites. This disparity was no longer significant after adjusting for covariates.Conclusion
SDM is associated with lower reports of parental service dissatisfaction. Stratified analyses showed that SDM seems to be experienced differently across minority groups.Practice implications
SDM may be a promising engagement strategy to improve parental service experiences. The role of SDM on increasing Black parents’ reports of service dissatisfaction, perhaps due to increased awareness of service challenges, should be investigated. 相似文献6.
Rosa Geurtzen Jos Draaisma Rosella Hermens Hubertina Scheepers Mallory Woiski Arno van Heijst Marije Hogeveen 《Patient education and counseling》2018,101(12)
Objective
To investigate experienced and preferred prenatal counseling among parents of extremely premature babies.Methods
A Dutch nationwide, multicenter, cross-sectional study using an online survey. Surveys were sent to all parents of extremely premature babies born between 2010 and 2013 at 24+0/7–24+6/7 weeks of gestation.Results
Sixty-one out of 229 surveys were returned. A minority (14%) had no counseling conversation. Conversations were done more often by neonatologists (90%) than by obstetricians (39%) and in 37% by both these experts. Supportive material was rarely used (19%). Mortality (92%) and short-term morbidity (88%) were discussed the most, and more frequently than long-term morbidity (65%), practical items (63%) and delivery mode (52%). Most decisions on active care or palliative comfort care were perceived as decisions by doctor and parents together (61%). 80% felt they were involved in decision-making. The preferred way of involvement in decision-making varied among parents.Conclusion
The vast majority of parents were counseled: mostly by neonatologists, and mainly about mortality and short-term morbidity. Parents wanted to be involved in the decision-making process but differed on the preferred extent of involvement.Practice implications Understanding of shared decision-making may contribute to meet the various preferences of parents. 相似文献7.
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8.
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9.
Lisa Hyde Lisa Mackenzie Allison W. Boyes Tiffany-Jane Evans Michael Symonds Rob Sanson-Fisher 《Patient education and counseling》2018,101(10):1814-1822
Objective
Responsiveness to information preferences is key to high-quality, patient-centred care. This study examined the top ten preparatory information items not delivered in accordance with medical imaging outpatients’ preferences, and patient characteristics associated with reporting a greater number of unmet information preferences.Methods
Magnetic resonance imaging and computed tomography outpatients were recruited consecutively in one major public hospital waiting room. Participants self-administered a touchscreen computer questionnaire assessing their sociodemographic and scan characteristics, and unmet preferences for 33 guideline-endorsed preparatory information items.Results
Of 317 eligible patients, 280 (88%) consented to participate. Given equal rankings, the top ten unmet information preferences included 13 items which were endorsed by at least 25% of participants, and commonly related to receiving ‘too little’ information. One item related to the pre-scan period, seven items to the scan period and five items to the post-scan period. None of the patient characteristics examined were significantly associated with reporting a greater number of unmet information preferences.Conclusion
There is room to improve responsiveness to medical imaging outpatients’ preparatory information preferences. Improvements should be targeted at individuals, rather than groups defined by sociodemographic or scan characteristics.Practice Implications
A standardised approach to addressing individual patient’s information preferences is needed. 相似文献10.
Elizabeth J. Siembida Nina S. Kadan-Lottick Kerry Moss Keith M. Bellizzi 《Patient education and counseling》2018,101(9):1683-1689
Objectives
A lack of focus on variation in engagement among cancer populations of differing developmental stages led us to examine the associations between patient engagement, the patient-provider relationship, cognitive development, readiness to transition to adulthood (transitional readiness) and perceived quality of care.Methods
A sample of 101 adolescent cancer patients (diagnosed 10–20 years) completed survey items concerning patient engagement, dimensions of the patient-provider relationship, cognitive development, transitional readiness, and demographic characteristics using an iPad/tablet during a routine clinic visit.Results
Patient engagement was not significantly associated with perceived quality of care (b?=?.02, 95% CI: ?0.06, 0.11). Instead, adolescents with providers that supported their independence (b?=?.34, 95% CI: 0.17, 0.52) were significantly more likely to perceive higher quality care.Conclusion
Supportive patient-provider relationships are an integral part of adolescents’ perceptions of quality of care. Adolescents are still gaining important skills for navigating the medical system, and the patient-provider relationship may provide an important scaffolding relationship to help adolescents build independence in their treatment experience.Practice implications
Identifying potential mechanisms through which adolescents can provide their opinion, ask questions, and participate in their treatment plan will help in supporting adolescent independence and improve quality of care. 相似文献11.
Mary Boyde Jenny Rankin Jennifer A. Whitty Robyn Peters Julie Holliday Charmaine Baker Rita Hwang Donna Lynagh Dariusz Korczyk 《Patient education and counseling》2018,101(12)
Objective
To elicit patients' preferences for cardiac rehabilitation(CR).Methods
A Discrete Choice Experiment was used to quantify patients' preferences for the delivery of CR. This survey-based method elicited the relative importance of different characteristics of a program.Results
200 in-patients eligible to attend CR completed the survey. Over half of the patients strongly preferred a centre-based compared to a home-based program. Many but not all preferred a program starting within two rather than six weeks of discharge and exercise delivered in a group rather than individual setting, with exercise via the internet using telehealth strongly disliked. Some respondents preferred lifestyle information delivered one-to-one by a health professional, and there was an overall preference against delivery by smart phone Apps. Some preferred a program out of rather than within working hours and a shorter program (four weeks compared to eight weeks).Conclusions
This study provides further insight into patient preferences for a CR program. Although the strongest preferences were for centre-based programs with healthcare professionals facilitating exercise classes and one-on-one education, it is important to offer flexible delivery as one approach will not suit everyone.Practice Implications
There is the potential to improve CR programs by focusing on patient preferences. 相似文献12.
Melissa C.W. Vaanholt Marieke G.M. Weernink Clemens von Birgelen Catharina G.M. Groothuis-Oudshoorn Maarten J. IJzerman Janine A. van Til 《Patient education and counseling》2018,101(11):1982-1989
Objective
The objective of this study was to explore the perceived advantages and disadvantages of oral anticoagulant therapies (OAT), and the trade-offs patients make in choosing therapy and adhering to their drug regimen.Methods
Five focus group sessions were conducted across Europe among patients with atrial fibrillation to identify the most important factors impacting OAT‘s value and adherence.Results
The most frequently identified barriers to OAT were lack of knowledge; poor patient-physician relationships; distraction due to employment or social environment; prior bleeding event(s) or the fear of bleeding; and changes in routine. Factors identified as promoting adherence included patients' personality, motivation, attitudes, and medication-taking habits and routines, as well as good quality health services. Inconvenient aspects of vitamin-K antagonists, such as regular blood monitoring and diet restrictions, were not reported to influence adherence, but may trigger patients to switch to direct oral anticoagulants.Conclusion
Most patients reported that a mixture of modifiable and non-modifiable factors helps them to take their drugs as prescribed. Individual patients’ particular needs and preferences regarding OAT vary.Practice implications
OAT adherence can be promoted if therapies are tailored to patients’ needs and preferences. Patients should be supported to share their preferences with their clinician. 相似文献13.
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14.
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15.
Farina Kokab Sheila Greenfield Antje Lindenmeyer Manbinder Sidhu Lynda Tait Paramjit Gill 《Patient education and counseling》2018,101(4):619-630
Objective
The objective of this research was to synthesise qualitative literature about the perceived influence and experience of social support, in relation to cardiovascular disease (CVD) prevention in migrant Pakistani communities.Methods
Articles were systematically reviewed, critically appraised, and analysed using an adapted meta-ethnography approach.Results
Sixteen qualitative studies on health behaviours related to CVD prevention were included.Findings
include four sub-themes under two substantive thematic areas that focus on: 1) family dynamics and 2) community dynamics influenced by discrimination. For members of the Pakistani community, gendered family dynamics and discrimination from outside and within community networks influenced behaviour change.Conclusion
The authors of the synthesis developed multi-layered, contextualised interpretations of the care needs of an established multi-generational community. Future qualitative studies taking an intersectional approach to interpreting the role of social networks in migrant communities should take into account gender, identity, culture and faith.Practice implications
Health care providers should focus on cultural awareness and sensitivity during consultations. In particular, general practitioners can benefit from the insight they gain from patient experiences, allowing for more appropriate recommendations. 相似文献16.
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17.
Lindsay R. Duncan Erin S. Pearson Ralph Maddison 《Patient education and counseling》2018,101(3):375-388
Objective
This study systematically reviewed the literature to determine what type of cognitive-behavioral based interventions administered outside of formal school settings effectively prevent smoking initiation among children and adolescents.Methods
Applying the PRISMA guidelines we searched MEDLINE, PsycINFO, CINHAL, Pub Med, SCOPUS, and Sport Discus. Article review, data extraction, and assessment of risk of bias were conducted by two independent reviewers.Results
We included 16 studies administered in various settings: seven in health care; four informally during and outside of school hours; three in the home; and two in extra-curricular settings. Positive preventive effects in smoking behavior ranging from 3-months to 4-years were observed in eight studies. Social environmental influences (e.g., parental smoking, friends) are salient contributing factors.Conclusions
Effective approaches involved interventions conducted in health care settings as well as those employing interpersonal communication and support strategies (e.g., via peer leaders, parent support, physicians).Practice implications
Primary health care settings may be optimal for implementing cigarette smoking prevention interventions for children and adolescents. Providing tailored education and facilitating interpersonal discussions between health care providers and families about the risks of smoking/strategies to avoid uptake, as well as capitalizing on technology-based modalities may reduce rates among children and adolescents. 相似文献18.
Objective
This study investigated how health care provider communication of risk information, and women’s role in decision-making, influenced women’s preferences for mode of birth after a previous caesarean birth.Methods
Women (N?=?669) were randomised to one of eight conditions in a 2 (selectivity of risk information) × 2 (format of risk information) × 2 (role in decision making) experimental design. After exposure to a hypothetical decision scenario that varied information communicated by an obstetrician to a pregnant woman with a previous caesarean birth across the three factors, women were asked to decide their preferred hypothetical childbirth preference.Results
Women provided with selective information (incomplete/biased toward repeat caesarean) and relative risk formats (ratio of incidence being compared e.g. 2.5 times higher), perceived lower risk for caesarean and were significantly more likely to prefer repeat caesarean birth than those provided with non-selective information (complete/unbiased) and absolute risk formats (incidence rate e.g. 0.01 per 100). Role in decision-making did not significantly influence childbirth preferencesConclusions
Modifiable aspects of healthcare provider communication may influence women’s decision-making about childbirth preferencesPractice implications
Optimised communication about risks of all options may have an impact on over-use of repeat CS. 相似文献19.
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20.
Marise S. Kaper Jane Sixsmith Jaap A.R. Koot Louise B. Meijering Sacha van Twillert Cinzia Giammarchi Roberta Bevilacqua Margaret M. Barry Priscilla Doyle Sijmen A. Reijneveld Andrea F. de Winter 《Patient education and counseling》2018,101(1):152-158