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1.
Catherine A. Grodensky Carol E. Golin Allison P. Pack Audrey Pettifor Michele Demers Cecelia Massa Gift Kamanga Kevin McKenna Amy Corneli 《Patient education and counseling》2018,101(6):1103-1109
Objective
Individuals diagnosed with acute HIV infection (AHI) are highly infectious and require immediate HIV prevention efforts to minimize their likelihood of transmitting HIV to others. We sought to explore the relevance of Motivational Interviewing (MI), an evidence-based counseling method, for Malawians with AHI.Methods
We designed a MI-based intervention called “Uphungu Wanga” to support risk reduction efforts immediately after AHI diagnosis. It was adapted from Options and SafeTalk interventions, and refined through formative research and input from Malawian team members and training participants. We conducted qualitative interviews with counselors and participants to explore the relevance of MI in this context.Results
Intervention adaptation required careful consideration of Malawian cultural context and the needs of people with AHI. Uphungu Wanga's content was relevant and key MI techniques of topic selection and goal setting were viewed positively by counselors and participants. However, rating levels of importance and confidence did not appear to help participants to explore behavior change as intended.Conclusion
Uphungu Wanga may have provided some added benefits beyond “brief education” standard of care counseling for Malawians with AHI.Practice implications
MI techniques of topic selection and goal setting may enhance prevention education and counseling for Malawians with AHI. 相似文献2.
3.
Objective
To assess whether mode of communication and patient centered communication (PCC) with physicians were associated with the likelihood of deaf smokers inquiring about lung cancer screening.Methods
An accessible health survey including questions about PCC, modes of communication, smoking status and lung cancer screening was administered in American Sign Language (HINTS-ASL) to a nationwide sample of deaf adults from February to August 2017. Of 703 deaf adults who answered the lung screening question, 188 were 55–80 years old.Results
The odds ratio of asking about a lung cancer screening test was higher for people with lung disease or used ASL (directly or through an interpreter) to communicate with their physicians. PCC was not associated with asking about a lung cancer screening test.Conclusion
Current or former smokers who are deaf and use ASL are at greater risk for poorer health outcomes if they do not have accessible communication with their physicians.Practice implications
Optimal language access through interpreters or directly in ASL is critical when discussing smoking cessation or lung cancer screening tests. Counseling and shared decision-making will help improve high-risk deaf patients' understanding and decision-making about lung cancer screening. A video in American Sign Language is available here. 相似文献4.
Antoine Chéret Christine Durier Nicolas Noël Katia Bourdic Chantal Legrand Catherine D’Andréa Evelyne Hem Cécile Goujard Patrick Berthiaume Silla M. Consoli 《Patient education and counseling》2018,101(11):1934-1941
Objective
To evaluate the impact of brief training in motivational interviewing (MI) from a non-specialist professional for medical students.Methods
Students (n?=?20) received three four-hour sessions of MI training over one week. They interviewed caregivers acting as patients in two standardised medical situations, six weeks before and three weeks after training. Global scores from the MITI-3.1.1 code, including “MI- Spirit”, were attributed to the audiotaped interviews by two independent coders, blind the pre- or post-training status of the interview. Secondary outcomes were: caregivers’ perception of students’ empathy (CARE questionnaire), students’ evaluation of self-efficacy to engage in a patient-centred relationship (SEPCQ score), and students’ satisfaction with their own performance (analogue scale).Results
MI-Spirit score increased significantly after training (p?<?0.0001, effect size 1.5). Limited improvements in CARE score (p?=?0.034, effect size 0.5) and one of the SEPCQ dimensions (sharing information and power with the patient; p?=?0.047, effect size 0.5) were also noted. Students’ satisfaction score was unaffected (p?=?0.69).Conclusion
These findings suggest that brief MI training can improve communication skills in medical students.Practice implications
Such an intervention is feasible and could be generalised during medical studies. 相似文献5.
Stephanie D. Brandhof Angela Fagerlin Sarah Hawley Esther Toes-Zoutendijk Lyndal Trevena Kirsten McCaffery Ida J. Korfage 《Patient education and counseling》2018,101(3):546-550
Objective
Properly informing target audiences is crucial in population-based screening programs. We aimed to evaluate the impact of information about CRC screening on attitudes and intended participation in a screening-naive population.Methods
614 persons (aged 55–75 years) received a survey. Information on CRC and screening was provided piece by piece, and per piece its impact on attitudes and intended participation was assessed. All persons received the same information content, but the sequence of information differed per condition: information on the high mortality rate of colorectal cancer was presented in the first or the second piece. Educational levels, the extent people considered future consequences, and value concordance between attitudes and intentions were assessed.Results
436 persons (response 71%) completed the survey. Overall most respondents reported positive attitudes towards CRC screening (78%) and intentions to participate in CRC screening (83%), independent of sequence of information provision. Intentions about participation were value concordant in the majority (88%). Results were similar in low educated groups.Conclusion
Providing balanced information about CRC screening (also addressing negative effects) did not impede value concordance and high rates of intended participation.Practice implications
High rates of screening intentions are possible without omitting threatening health information in communication materials. 相似文献6.
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7.
8.
Katherine K.W. Lam William H.C. Li O.K. Chung K.Y. Ho S.Y. Chiu H.S. Lam Godfrey C.F. Chan 《Patient education and counseling》2018,101(11):1947-1956
Objective
This study examined the effectiveness of an integrated programme in promoting physical activity, reducing fatigue, enhancing physical activity self-efficacy, muscle strength and quality of life among Chinese children with cancer.Methods
A randomised controlled trial was conducted in a Hong Kong public hospital. Seventy eligible children were randomly assigned to an experimental group (n?=?37) or a control group (n?=?33). The experimental group received an integrated programme with 28 home visits from coaches over a 6-month period. The control group received a placebo intervention. The primary outcome was fatigue at 9 months (3 months after intervention completion). Secondary outcomes were physical activity levels, physical activity self-efficacy, muscle strength and quality of life at 9 months, assessed at baseline, and 6 and 9 months after starting the intervention.Results
The experimental group reported significantly lower levels of cancer-related fatigue, higher levels of physical activity and physical activity self-efficacy, greater right- and left-hand grip strength and better quality of life than the control group at 9 months.Conclusion
The programme is effective and feasible to implement among children with cancer and offers an alternative means of ameliorating the healthcare burden.Practice implications
Healthcare professionals should build multidisciplinary partnerships to sustain such programmes. 相似文献9.
Willem Eijzenga Eveline de Geus Cora M. Aalfs Fred H. Menko Rolf H. Sijmons Hanneke C.J.M. de Haes Ellen M.A. Smets 《Patient education and counseling》2018,101(9):1611-1619
Objective
In hereditary and familial cancer, counselees are requested to inform their at-risk relatives. We developed an intervention to support counselees in this task.Methods
A randomized controlled trial was conducted aimed at improving cancer genetic counselees’ i) knowledge, ii) motivation to disclose information, and ii) self-efficacy in this regard. Eligible participants were randomized to telephonic counseling (n?=?148), or standard care (n?=?157) and assessed at baseline, 1 week post-intervention, and 4 months after study enrolment.Results
No between-group differences were found in participants’ knowledge, motivation, and self-efficacy. Knowledge concerning which second-degree relatives to inform was lower compared to first-degree relatives. About 60% of the participants was of the opinion that they needed to inform more relatives than stated in their summary letter and only about 50% were correctly aware of which information to disclose. Of note, at baseline, almost 80% of the participants had already correctly informed their at-risk relatives.Conclusions
Since, unexpectedly, counselees already informed most of their relatives before the intervention was offered, efficacy of the intervention could not convincingly be determined. Counselees’ knowledge about whom to inform about what is suboptimal.Practice Implications
Future interventions should target a more homogeneous sample and address counselees’ understanding and recall. 相似文献10.
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11.
Ida J. Korfage Erik W. de Kwaadsteniet Arno van Voorst Anne M. Stiggelbout Marieke de Vries Arwen H. Pieterse 《Patient education and counseling》2018,101(2):310-317
Objectives
Implicit associations influence behaviour, but their impact on cancer screening intentions is unknown.Methods
We assessed implicit associations with cervical cancer screening using an evaluative priming task. Participants were shown primes (‘Pap test’, neutral or non-word) followed by positive or negative target words. The test is based on the assumption that response times are shorter if primes and targets are strongly associated in the participant's mind. The Dutch screening program targets women aged 30–60, 226 of them completed online assessments twice. Prior to the second assessment participants were randomized to reading versus not reading the leaflet about the cervical screening program.Results
After controlling for knowledge and screen history, response times for ‘Pap test’ no longer differed between positive and negative targets. Implicit associations were not correlated with explicit attitudes or screening intentions. Reading the screening leaflet resulted in improved knowledge levels (p < 0.001), but implicit associations, explicit attitudes, and screening intentions remained similar.Conclusion
Cervical cancer screening intentions were related to explicit attitudes, but not to implicit associations. The screening leaflet did not affect screening intentions.Practice implications
We recommend achieving a deepened interest in the screening program among risk groups, e.g. by adapting the information leaflet. 相似文献12.
Objective
To examine men’s approaches to managing BRCA-related cancer risks.Methods
25 Qualitative interviews were conducted with men who are at risk for BRCA-related cancers. Thematic analysis was conducted using the constant comparison.Results
Qualitative analysis revealed two different approaches for how men managed their BRCA-related cancer risks. Men were engaged when: (1) initially seeking information, (2) uptake of genetic testing, and (3) population screening procedures. Men were passively avoidant for: (1) follow-up information seeking, (2) uptake of genetic testing, and (3) BRCA-specific screening. Men’s justifications for engaged risk management were to: (1) protect their family, (2) respond to encouragement from others, and (3) get knowledge for themselves. Their justifications for passively avoidant management were due to: (1) limited access to clear risk information, (2) little fear of cancer development, (3) barriers to testing/screening, and (4) reliance on incomplete illness representations.Conclusions
Men at risk for developing BRCA-related cancers approached risk management by primarily using a passive avoidance approach. That approach should be interpreted in context with the inconsistent information available to them, and the minimal NCCN guidelines for their risk surveillance.Practice implications
Findings may assist healthcare providers and family members in helping men manage their BRCA-related cancer risks. 相似文献13.
14.
Yelena P. Wu Elizabeth Nagelhout Lisa G. Aspinwall Kenneth M. Boucher Bridget G. Parsons Wendy Kohlmann Kimberly A. Kaphingst Sheila Homburger Ryan D. Perkins Douglas Grossman Garrett Harding Sancy A. Leachman 《Patient education and counseling》2018,101(3):452-459
Objective
To examine the acceptability of and preliminary effects associated with a novel educational intervention for children at elevated risk for melanoma. The intervention incorporated information on mechanisms through which melanoma preventive behaviors mitigate risk for melanoma and was delivered to parents and children concurrently.Methods
Twenty-two parents (with a personal history of melanoma or spouse with a history of melanoma) and 33 children (mean age 11.8 years) were asked to complete questionnaires immediately prior to and after an educational session and at a one-month follow-up.Results
Both parents and children endorsed that the educational materials were acceptable. Knowledge about melanoma risk and preventive and screening behaviors increased significantly. Children’s perceived risk for melanoma increased significantly, while parents’ perceptions of children’s risk started at a higher level and remained constant. There were significant increases in reported engagement in sun protective behaviors.Conclusion
The educational intervention shows promise in terms of its acceptability and effects on participant knowledge, perceived risk, and engagement in melanoma preventive behaviors.Practice implication
Children at elevated risk for melanoma and their parents may benefit from receiving educational information on their disease risk and strategies for prevention and screening. 相似文献15.
From facts to arguments: A study of the 2014 Swiss controversy over systematic mammography screening
Caroline Perrenoud Friedrich Stiefel Céline Bourquin 《Patient education and counseling》2018,101(6):1110-1115
Objective
The Swiss Medical Board (SMB) has recently revived the controversy over mammography screening by recommending to stop the introduction of new systematic mammography screening programs. This study aimed to examine the Swiss media coverage of the release of the SMB report.Methods
The dataset consisted of 25 newspaper and “medical magazine” articles, and TV/radio interviews. The analytic approach was based on argumentation theory.Results
Authority and community arguments were the most frequent types of arguments. With respect to authority arguments, stakeholders for instance challenged or supported the expertise of the SMB by referring to the competence of external figures of authority. Community arguments were based on common values such as life (saved thanks to systematic mammography screening) and money (costs associated with unnecessary care induced by systematic mammography screening).Conclusion
The efficiency of mammography screening which was the key issue of the debate appeared to be largely eluded, and the question of what women should do endures.Practice implications
While interpersonal and interprofessional communication has become a major topic of interest in the medical community, it appears that media communication on mammography screening is still rather ineffective. We call in particular for a more fact-based discussion. 相似文献16.
Juliana Chen Luke Gemming Rhona Hanning Margaret Allman-Farinelli 《Patient education and counseling》2018,101(4):750-757
Objective
To provide dietitians with practical guidance on incorporating smartphone applications (apps) in the nutrition care process (NCP) to optimize patient education and counseling.Methods
The current evidence-base for mobile health (mHealth) apps was searched using PubMed and Google Scholar. Where and how apps could be implemented by dietitians across the four steps of the NCP is discussed.Results
With functionality to automatically convert patient dietary records into nutrient components, nutrition assessment can be streamlined using nutrition apps, allowing more time for dietitians to deliver education and nutrition counseling. Dietitians could prescribe apps to provide patients with education on nutrition skills and in counseling for better adherence to behavior change. Improved patient-provider communication is also made possible through the opportunity for real-time monitoring and evaluation of patient progress via apps. A practical framework termed the ‘Mobile Nutrition Care Process Grid’ provides dietitians with best-practice guidance on how to use apps.Conclusions
Including apps into dietetic practice could enhance the efficiency and quality of nutrition care and counseling delivered by dietitians.Practice implications
Apps should be considered an adjunct to enable dietetic counseling and care, rather than to replace the expertise, social support and accountability provided by dietitians. 相似文献17.
Pernille Urup Ruban Christian Nielsen Wulff Cecilie Dyg Sperling Mette Sandager Anders Bonde Jensen 《Patient education and counseling》2018,101(1):99-104
Objective
The purpose of this study was to determine how age influences the degree to which patients with breast cancer feel comfortable with standard follow-up and to assess their satisfaction with the contact to health professionals.Methods
Data was from a Danish population-based questionnaire survey from 2012 including adult cancer patients. 1120 patients with breast cancer returned the questionnaire (response rate: 73%). Age groups were decided before conducting analyses.Results
Overall, patients with breast cancer evaluated the follow-up programme positively. However, in five of six items of interest, patients aged 40–49 and 50–59 years differed statistically significantly from patients ≥70 years, by being less comfortable with the follow-up, less satisfied with the health care professionals’ ability to listen, and less satisfied with the health care professionals’ answers. Satisfaction with the length of consultations, and the number of involved health care professionals were also lower in these age groups compared to patients ≥70 years.Conclusion
Overall, satisfaction with follow-up was high, but considerable age-related variations were found.Practice implications
The findings suggest a potential for improving the services provided for patients aged 40–59 years with breast cancer. 相似文献18.
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19.
Codie R. Rouleau Kathryn M. King-Shier Lianne M. Tomfohr-Madsen Simon L. Bacon Sandeep Aggarwal Ross Arena Tavis S. Campbell 《Patient education and counseling》2018,101(11):1914-1923
Objectives
Cardiac rehabilitation (CR) is an effective treatment for cardiovascular disease, yet many referred patients do not participate. Motivational interviewing could be beneficial in this context, but efficacy with prospective CR patients has not been examined. This study investigated the impact of motivational interviewing on intention to participate in CR.Methods
Individuals recovering from acute coronary syndrome (n?=?96) were randomized to motivational interviewing or usual care, following CR referral but before CR enrollment. The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, barriers, self-efficacy, illness perception, social support, intervention acceptability, and CR participation.Results
Compared to those in usual care, patients who received the motivational intervention reported higher intention to attend CR (p?=?.001), viewed CR as more necessary (p?=?.036), had fewer concerns about exercise (p?=?.011), and attended more exercise sessions (p?=?.008). There was an indirect effect of the intervention on CR enrollment (b?=?0.45, 95% CI 0.04–1.18) and CR adherence (b?=?2.59, 95% CI 0.95–5.03) via higher levels of intention. Overall, patients reported high intention to attend CR (M?=?6.20/7.00, SD?=?1.67), most (85%) enrolled, and they attended an average of 65% of scheduled CR sessions.Conclusion
A single collaborative conversation about CR can increase both intention to attend CR and actual program adherence.Practice Implications
The findings will inform future efforts to optimize behavioral interventions to enhance CR participation. 相似文献20.
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