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1.
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2.
Jana L. Wardian Joshua Tate Irene Folaron Sky Graybill Mark True Tom Sauerwein 《Patient education and counseling》2018,101(8):1490-1495
Objective
We hypothesized that diabetes-related distress would vary by type of diabetes and medication regimen [Type 1 diabetes (T1DM), Type 2 diabetes with insulin use (T2DM-i), Type 2 diabetes without insulin use (T2DM)]. Thus, the aim of this study was to identify groups with elevated diabetes-related distress.Methods
We administered the 17-item Diabetes-related Distress Scale (DDS-17) to 585 patients. We collected demographics, medications, and lab results from patient records.Results
Patients were categorized by type of diabetes and medication: T1DM (n?=?149); T2DM-i (n?=?333); and T2DM (n?=?103). ANOVA revealed significant differences in sample characteristics. ANCOVA were conducted on all four DDS-17 domains [Emotional Burden (EB); Physician-related Distress (PD); Regimen-related Distress (RD); and Interpersonal Distress (ID)]; covariates included in the models were sex, age, duration of diabetes, BMI, and HbA1c. EB was significantly lower in T1DM than T2DM-i, p?<?0.05. In addition, RD was significantly lower in T1DM than either T2DM-i, p?<?0.05 and T2DM, p?<?0.05.Conclusions
EB and RD are higher for those with type 2 diabetes. Thus, interventions to reduce EB and RD need to be considered for patients with type 2 diabetes.Implications
DDS-17 is useful in identifying diabetes-related distress in patients with diabetes. Efforts need to be made to reduce EB and RD. 相似文献3.
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4.
Sherina Mohd-Sidik Mehrnoosh Akhtari-Zavare Ummavathy Periasamy Lekhraj Rampal Siti Irma Fadhilah Rozi Mahmud 《Patient education and counseling》2018,101(5):862-871
Objectives
The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the “Managing Patients on Chemotherapy” module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia.Methods
A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the “Managing Patients on Chemotherapy” module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted.Results
Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P?<?0.0001). Also, among those with depression and anxiety at baseline, there was reduction in depression and anxiety scores after the 1st, 2nd and 3rd follow-ups after counselling (p?<?0.05).Conclusion
Repetitive counselling by pharmacists based on the “Managing Patients on Chemotherapy” module had positive effect on improving self-esteem and psychological affect of cancer patients undergoing chemotherapy in Peninsular Malaysia.Practice implications
This module can be used for all Malaysian cancer patients undergoing chemotherapy to improving self-esteem and psychological affect. 相似文献5.
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
Objectives
The aim was to determine the impact of a telephone counseling service, provided bi-monthly by pharmacist, on patients’ beliefs about antihypertensive medicines and blood pressure (BP) control.Methods
Either hypertensive patients were randomly assigned to a control group (CG, usual care) or an intervention group (IG). All patients had BP values registered and filled in the Italian version of the Belief Medicine Questionnaire (BMQ). After 12 months, patients filled in the BMQ again and had their self-reported BP registered. The intervention consisted of an educational/counseling session based on patients’ needs assessment provided bi-monthly by a pharmacist for one year via telephone.Results
80 CG and 84 IG patients were recruited. After 12 months, there were significant differences between IG and CG for both BMQ’s Necessity and Concern score (p?<?0.001; p?<?0.001 respectively) and a significant reduction in BP values in IG (p?<?0.001).Conclusions
The intervention improves BP control by modifying patients’ perception about treatments and involving patients as participants in the management of their health.Practice implications
This paper could serve as a guideline for other studies to confirm the effectiveness of this intervention in modifying health behavior, and the role of hospital pharmacist. 相似文献6.
Anita Amundsen Svein Bergvik Phyllis Butow Martin H.N. Tattersall Tore Sørlie Tone Nordøy 《Patient education and counseling》2018,101(9):1594-1600
Objective
To document the effect of a cancer specific question prompt list (QPL) on patients question asking and shared decision-making (SDM), and to evaluate the combined effect of the QPL and consultation audio recording (CAR) on patient outcomes.Method
This exploratory study compared two groups of patients receiving either a QPL or combined QPL/CAR, to a control group. Measurements included number/types of questions asked, and physician SDM behavior (OPTION score). Questionnaire data included anxiety/depression and quality of life (QoL).Results
A total of 93 patients participated (31 Control, 30 QPL and 32 Combined). Patients in the intervention groups asked more questions concerning prognosis (p?<?.0001), the disease (p?=?.006) and quality of treatment (p?<?.001) than patients in the control group, but no impact was found on the OPTION score. An increase in mean consultation length was observed in the intervention groups compared to the control group (44 vs. 36?min; p?=?.028). Patients rated both interventions positively.Conclusion
Provision of the QPL facilitates patients to ask a broader range of questions, but does not increase physician SDM behavior.Practical implementation
The combination of QPL and CAR seems feasible and should be tested in an implementation study following the disease trajectory. 相似文献7.
Purpose
Probiotics and prebiotics have become an object of intense research, to identify methods of mitigating oxidative stress. Over the past few years, the number of in vitro and in vivo studies, related to antioxidant properties of probiotics/prebiotics has significantly increased. The aim of the present study was to assess whether probiotic in combination with prebiotic influences the level of human 4-hydroxynonenal, 8-isoprostane and glutathione reductase activity.Material/methods
Experiments were carried out on healthy volunteers (male and female). All oxidative stress markers were measured in blood plasma pre- and post-administration of synbiotic.Results
The administration of synbiotic resulted in a significant decrease in 4-hydroxynonenal in the female-synbiotic group (p?<?0.05), 8-isoprostanes in the female-synbiotic group and male-synbiotic group (p?<?0.05) and non-significant increase in the activity of glutathione reductase (p?>?0.05) vs. control.Conclusions
The present results show that supplementation of synbiotics contributed to the decrease in oxidative stress parameters in the female patients. 相似文献8.
Sanbao Chai Baoting Yao Lin Xu Danyang Wang Jianbin Sun Ning Yuan Xiaomei Zhang Linong Ji 《Patient education and counseling》2018,101(8):1427-1432
Objective
The purpose of this study was to evaluate the efficacy of self-management education on psychological outcomes and glycemic control in type 2 diabetes mellitus.Methods
Patients were randomly assigned to education group and control group. Education group received professional education and control group received routine outpatient education.Results
A total of 118 patients were randomly assigned to two groups (education group, n?=?63; control group, n?=?55). Compared with control group, the anxiety score (36.00 vs. 42.50, P?<?0.05) and depression score (35.50 vs. 44.00, P?<?0.05) significantly decreased at the sixth month in education group, respectively. Compared with control group, fasting blood glucose (6.78?mmol/L vs. 7.70?mmol/L, P?<?0.00), postprandial blood glucose (7.90?mmol/L vs. 10.58?mmol/L, P?<?0.00) and glycosylated haemoglobin A1C level [6.20 (5.80, 6.60)% vs. 6.70 (6.40, 7.30)%, P?<?0.01] significantly decreased after the sixth month in education group.Conclusion
The psychological status and blood glucose of patients with diabetes receiving self-management education were significantly improved. Practice Implications: Type 2 diabetes mellitus has been usually linked to increased prevalence and risk of depression and anxiety, which can affect blood glucose levels. Through education, the mood of newly diagnosed patients with diabetes improved, resulting in better blood glucose control. 相似文献9.
Ola A. Harb Mariem A. Elfeky Basant Sh El Shafaay Heba F. Taha Gamal Osman Ibtsam Shehta Harera Loay M. Gertallah Doaa Metwaly Abdelmonem Ahmed Embaby 《Pathophysiology》2018,25(4):335-345
Background
Clear cell renal cell carcinoma (cc-RCC), is a serious cancer regarding; its fatality, liability for metastases and chemoresistance, so identification of recent therapeutic targets to improve the patients prognosis is needed. SPOP is a BTB/POZ domain containing speckle-type POZ protein, has been identified as an E3 ubiquitin ligase component. ZEB1 is an essential epithelial mesenchymal transition (EMT) activator; E-cadherin is a cell adhesion protein that had been detected in normal epithelial cells membrane.Aim
Was to assess the tissue protein markers SPOP, ZEB1 & E-cadherin expressions in benign areas of neoplastic kidney specimens and in cc-RCC patients, then correlating their expression levels with patients clinicopathological and prognostic data.Methods
We evaluated SPOP, ZEB-1 & E-cadherin expression using immunohistochemistry in samples from 50 cc-RCC and 20 benign areas of neoplastic kidney specimens, then we followed our patients for 5 years and finally we have analyzed correlations between the levels of markers expressions with patients clinicopathological and prognostic criteria in cc-RCC.Results
Positive expression of SPOP & ZEB1 in addition to negative E- cadherin expression was detected in cc-RCC more than benign areas of neoplastic kidney specimens (p?=?0.004 and p?<?0.001 respectively). In cc-RCC Positive expression of SPOP, ZEB1 and negative E- cadherin expression was associated with higher grade (p?=?0.006, 0.007 & <0.001 respectively), advanced AJCC stage (p?=?0.013, 0.023 & <0.001 respectively), presence of L.N metastases (p?=?0.002?=?0.010 and <0.001 respectively), distant metastases (p?=?0.001, 0.003 & 0.035 respectively), poor PFS and OS rates (p?<?0.001 and p?=?0.013 respectively).Conclusion
Positive expression of SPOP& ZEB1 in addition to negative E- cadherin are associated with poor prognosis in cc-RCC patients. 相似文献10.
S. Soloukey Tbalvandany A. P.W.M. Maat R. Cornelissen J. J.M.E. Nuyttens J. J.M. Takkenberg 《Patient education and counseling》2018,101(6):1088-1094
Objective
Malignant Mesothelioma (MM) is a rare asbestos related disease mostly diagnosed in low-skilled patients. The decision-making process for MM treatment is complicated, making an adequate provision of information necessary. The objective of this study is to assess the content and quality of online informational resources available for Dutch MM patients.Methods
The first 100 hits of a Google search were studied using the JAMA benchmarks, the Modified Information Score (MIS) and the International Patient Decision Aid Standard Scoring (IPDAS).Results
A total of 37 sources were included. Six of the 37 resources were published by hospitals. On average, the informational resources scored 37 points on the MIS (scale 0–100). The resources from a (bio)medical sources scored the best on this scale. However, on the domain of use of language, these resources scored the worst.Conclusions
The current level of medical content and quality of online informational resources for patient with MM is below average and cannot be used as decision-aids for patients.Practice implications
The criteria used in this article could be used for future improvements of online informational resources for patients, both online, offline and through health education in the care path. 相似文献11.
Kristen E. Pecanac Roger. L. Brown Jay Steingrub Wendy Anderson Michael A. Matthay Douglas B. White 《Patient education and counseling》2018,101(11):1957-1965
Objective
To assess the psychometric properties of the 16-item Decisional Conflict Scale (DCS) in surrogate decision makers.Methods
With a sample of 472 surrogates from intensive care units in five academic medical centers across the United States, we performed the analysis in five phases to 1) model the congeneric structure with confirmatory factor analysis and assess 2) internal consistency reliability, 3) the unidimensional or global assessment, 4) factorial invariance across surrogate gender, and 5) individual item influence on the domains.Results
The congeneric model fit the data, with all factor loadings (0.577–0.955) statistically significant at p?<?0.05. All subdomains had acceptable internal consistency (0.751–0.981). The bifactor model supported the sub-domains or the global construct as appropriate measurement models. The DCS demonstrated invariance for use across surrogate genders. The most difficult item for surrogates to complete was “This decision is easy for me to make” [MNSQ Infit/Outfit: 2.37/3.27] and the easiest item was “I have enough advice to make a choice” [0.70/0.67].Conclusions
Overall, the DCS demonstrated good fit, and can be considered a valid and reliable tool to use with the surrogate population.Practice Implications
Measuring surrogate decisional conflict could be especially useful to determine how to improve the decision-making process. 相似文献12.
Ting Liu Hong Zhang Xuesong Yang Xiaojie Li Yi Shi Weidong Niu Tingjiao Liu 《Pathology, research and practice》2018,214(2):296-302
Objective
The aim of this study is to investigate the expressions of p16 and HPV16/18(E6) in oral lichen planus (OLP) and malignant transformed OLP (MT-OLP).Study design
The expression of p16 and HPV16/18(E6) in 40 cases of OLP and 6 MT-OLP was assessed by immunohistochemical staining. Twenty four cases of normal oral mucosa were used as controls.Results
Compared to normal oral mucosa, the expression of p16 and HPV16/18(E6) protein increased in OLP and MT-OLP. And there was a correlation between p16 expression and HPV infection in OLP and OLP malignant lesions (p?<?0.0001).Conclusions
The expression of p16 protein might predict HPV16/18 infection in OLP. And HPV16/18(E6) infection might contribute to OLP malignant transformation. 相似文献13.
Rachael Glassey Moira O’Connor Angela Ives Christobel Saunders Sarah J. Hardcastle 《Patient education and counseling》2018,101(2):318-323
Objective
The objective of this study was to explore the influences on decision-making of younger women (<35) undergoing or considering bilateral prophylactic mastectomy (BPM).Methods
Qualitative interviews guided by interpretative phenomenological analysis (IPA) were conducted with forty-six women who had a strong family history of breast cancer (BC) who had either undergone (n = 26) or were considering (n = 20) BPM. Participants were recruited from Australia and New Zealand (NZ) via hospitals, a genetics clinic, a research cohort, a registry and online.Results
Four themes underpinning the influences on decision-making were identified: fear and anxiety, children, personal experiences with BC, health professional’s influence.Conclusions
The decision to undergo BPM for younger women ( < 35) was multifaceted, however, it appeared that fear and anxiety were the main influence. Younger women appear more anxious than previous research with older women. There appears to be few differences between those with confirmed BRCA1/2 mutations and those with no known mutation and this is clinically significant.Practice implications
These findings have important practice implications, particularly improving communication of risk statistics, especially to those with no known mutation. Health professionals need to take into account the way younger women perceive information given to them when discussing risk. 相似文献14.
Objective
This study was conducted to examine the effect of education on quality of life and constipation severity in patients with primary constipation.Methods
This randomised controlled study was conducted with 80 patients who applied at the gastroenterology outpatient clinic of a university hospital. In the study, the Constipation Questionnaire, Constipation Quality-of-Life Questionnaire (PAC-QOL), and Constipation Severity Instrument (CSI) were used.Results
It was that found after 4 weeks of education, the total PAC-QOL mean score decreased to 60.85?±?5.65 and total CSI mean score decreased to 20.17?±?4.05 in the intervention group (p?<?0.001). No change was observed in the patients in the control group (p?>?0.05). After 4 weeks, a statistical difference was found between the two groups in PAC-QOL mean score and CSI mean score (p?<?0.05).Conclusion
It was determined that the education given to individuals with primary constipation decreased the constipation severity and increased the quality of life.Practice implications
Constipation education will make a contribution to the active use of follow-up forms by nurses in the clinic for the diagnosis of constipation, individual assessment of each patient, and their active role in constipation management. 相似文献15.
Gina Bravo Modou Sene Marcel Arcand Élodie Hérault 《Patient education and counseling》2018,101(7):1256-1261
Objective
To investigate how confidence in surrogates’ ability to make consistent decisions in the future change over time, in the context of an ACP intervention that did not improve surrogates’ ability to predict an older adult’s hypothetical treatment preferences.Methods
The study involved 235 older adults and surrogates, randomly allocated to an ACP or control intervention. At baseline, end of intervention, and six months later, participants were asked how confident they were in the surrogate making decisions in the future that would match the older adult’s wishes.Results
By the end of the intervention, confidence had increased among older adults and surrogates involved in ACP (OR?=?3.1 and 5.8 respectively, p?<?0.001), while less change occurred among controls. Over the following six months, confidence remained stable among older adults but decreased among surrogates (OR?=?0.5, p?=?0.005).Conclusion
ACP increases confidence in surrogates’ ability to make consistent decisions, which may lighten the burden of substitute decision making. Efforts to improve substitute decision-making must continue so that participants’ confidence is not based on the mistaken assumption that surrogates can make consistent decisions.Practice implications
Professionals involved in ACP should inform participants that confidence in the surrogate may increase in the absence of enhanced predictive ability. 相似文献16.
Anita Amundsen Tone Nordøy Kristine Emilie Lingen Tore Sørlie Svein Bergvik 《Patient education and counseling》2018,101(3):399-405
Objectives
To explore how cancer patients actively participate in consultations by asking questions and expressing emotional cues/concerns and to what extent this is associated with physician shared decision making (SDM) behavior.Methods
This observational study included audio recordings of 31 primary consultation with patients at the Oncology Outpatient Clinic at the University Hospital of North Norway. The content (topics) and frequency of health related questions from patients/caregivers were registered along with emotional cues and concerns (VR-CoDES) and observed shared decision-making (OPTION). Patient reported outcomes were measured before and one week after the consultation.Results
On average, 17 (SD 15) questions were asked, and 1.9 (SD 1.9) emotional cues and concerns were expressed by patients per consultation. The questions mainly pertained to treatment and practical issues. The mean OPTION score was 12 (SD 7.9) and was neither associated with questions nor emotional cues and concerns from patients.Conclusion
Although patients were active by asking questions, observed physician SDM behavior measured by OPTION was low and not associated with patient behavior during consultation.Practice implications
Further research on patient? influence on physician SDM behavior is needed. 相似文献17.
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18.
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19.
Objective
This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends.Method
The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted.Results
488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase.Conclusion
Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations.Practice implications
Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids. 相似文献20.
Panpan Li Hexuan Yin Fanling Meng Shuang Liu Haixia Liu Rong Ma 《Pathology, research and practice》2018,214(5):727-731