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1.
Hamideh Salimzadeh Roghaye Khabiri Maryam Khazaee-pool Somayeh Salimzadeh Alireza Delavari 《Patient education and counseling》2018,101(6):1082-1087
Objective
To measure the impact of motivational interviewing (MI) on cancer knowledge and screening practice among first degree relatives (FDRs) of patients with colon cancer.Methods
This randomized controlled trial targeted patients with colon cancer first to recruit their possible FDRs. Digit randomization of the eligible index patients into intervention or control groups resulted in allocating their belonging FDRs to the same study arm. FDRs (n?=?120) in intervention arm received MI counseling on phone by a trained oncology nurse and FDRs (n?=?120) in control group received standard generic information by a physician on phone. Primary outcome was the rate of documented colonoscopy in FDRs within six months after the baseline.Results
A total of 227 FDRs were followed up, 115 in the intervention and 112 in the control group. At follow-up, the uptake of screening colonoscopy in the intervention group was 83.5% versus 48.2% in controls (crude odds ratio, 5.4; 95% confidence interval, 2.9–10.0, P?<?.001).Conclusion
This was the first randomized controlled trial in Iran that confirmed the efficaciousness of a phone-based MI counseling in improving colonoscopy uptake among family members of patients with colon cancer.Practice implications
Phone-based motivational counseling that involves trained nurses or health providers seems to be feasible approach in Iran health system and enhances screening for colon cancer. 相似文献2.
Jennifer Viberg Johansson Pär Segerdahl Ulrika Hösterey Ugander Mats G. Hansson Sophie Langenskiöld 《Patient education and counseling》2018,101(3):422-427
Objective
It is well known that research participants want to receive genetic risk information that is about high risks, serious diseases and potential preventive measures. The aim of this study was to explore, by qualitative means, something less well known: how do healthy research participants themselves make sense of genetic risk information?Method
A phenomenographic approach was chosen to explore research participants’ understanding and assessment of genetic risk. We conducted four focus-group (N = 16) interviews with participants in a research programme designed to identify biomarkers for cardiopulmonary disease.Results
Among the research participants, we found four ways of understanding genetic risk: as a binary concept, as an explanation, as revealing who I am (knowledge of oneself) and as affecting life ahead.Conclusion
Research participants tend to understand genetic risk as a binary concept. This does not necessarily imply a misunderstanding of, or an irrational approach to, genetic risk. Rather, it may have a heuristic function in decision-making.Practical implications
Risk communication may be enhanced by tailoring the communication to the participants’ own lay conceptions. For example, researchers and counselors should address risk in binary terms, maybe looking out for how individual participants search for threshold figures. 相似文献3.
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4.
Adeline Bernier Adam Yattassaye Dominic Beaulieu-Prévost Joanne Otis Emilie Henry Jorge Flores-Aranda Lyne Massie Marie Préau Bintou Dembélé Keita 《Patient education and counseling》2018,101(2):248-255
Objective
The objective of this study was to assess the short-term effects of Gundo-So—a program aimed at empowering Malian women living with HIV (WLHIV) regarding serostatus disclosure management.Methods
A pre-experimental study with two measures (one week before and four weeks after Gundo-So) was carried out. A 35-item questionnaire was administered to a convenience sample of 210 WLHIV. Six outcomes were considered: ability to decide whether or not to disclose HIV status, self-efficacy to keep HIV status a secret, self-efficacy to disclose HIV status, feeling crushed by the weight of secrecy, perceived physical health, and perceived psychological health. For each outcome, temporal changes associated with the intervention were assessed using linear regressions with random intercepts.Results
Statistically significant change was observed for all six outcomes between the pre- and post-intervention measures. Furthermore, several variables were associated with the baseline levels of the outcomes and the intervention effect.Conclusion
The results suggest that Gundo-So empowers Malian WLHIV with regard to serostatus disclosure management, thus improving their perceived physical and psychological health.Practical implications
These results highlight the need for programs to empower WLHIV regarding serostatus disclosure, so that WLHIV can make free and informed decisions regarding serostatus disclosure. 相似文献5.
Nguyen Toan Tran Wambi Maurice M. Yameogo Félicité Langwana Seni Kouanda Blandine Thieba Désiré Mashinda Rachel Yodi Jean Nyandwe Kyloka Tieba Millogo Abou Coulibaly Souleymane Zan Brigitte Kini Bibata Ouedraogo Fifi Puludisi Asa Cuzin-kihl Suzanne Reier James Kiarie Mary Eluned Gaffield 《Patient education and counseling》2018,101(10):1871-1875
Objectives
Postpartum family planning (PPFP) is essential for maternal and newborn health but is often not systematically addressed before or after childbirth. This article describes the development and field-testing of a PPFP counseling tool to support providers and women.Methods
Participatory action research involving women, men, providers, policymakers, researchers, and contraceptive experts from Burkina Faso and the Democratic Republic of Congo.Results
The tool consists of an A4-size flipchart with illustrations on the client side and clinical information and counseling tips on the provider side, and can be used during visits of the antenatal-delivery-postnatal care continuum. Qualitative results suggest that the tool is easily understandable, user-friendly, relevant, and useful with regard to providing PPFP information to clients, and respectful of clients’ rights and choices. It may have a positive influence on clients’ attitudes towards PPFP and their decision to use contraception.Conclusions
The tool holds promise in guiding a systematic discussion on birth spacing options among providers and clients. Its impact on contraceptive uptake requires further research.Practice implications
If proven effective, the tool could be disseminated to Ministries of Health and local, regional, and global partners to strengthen national family planning and maternal and child health strategies in low-resource countries. 相似文献6.
Ming Li Tse-Yang Huang Jia Ye Shixi Zhao Lei-Shih Chen 《Patient education and counseling》2018,101(5):926-931
Objective
Autism Spectrum Disorders (ASD) have a significant genetic predisposition. The recurrence risk of ASD ranges from 3% to 18.7% for parents having one affected child. As recurrence risk perceptions have important implications for family planning, prenatal preparation, and future children managements, absolute and relative recurrence risk perceptions of having another affected child among Taiwanese parents of children with ASD were assessed.Methods
This study collected quantitative survey data from 415 Taiwanese parents who had one child with ASD.Results
Participants reported their absolute recurrence risk of having another child with ASD was 33.4%. Compared to other parents with normally-developing children, merely 49.8% of participants perceived higher relative recurrence risk. By controlling for the sociodemographic characteristics, participants’ absolute recurrence risk perceptions were significantly predicted by their perceived genetic causes of ASD and family history of ASD. Yet, participants’ relative recurrence risk perceptions were significantly associated with only the perceived genetic etiology.Conclusion
Taiwanese parents of children diagnosed with ASD had an incorrect understanding of their absolute and relative recurrence risks.Practice implications
To facilitate informed decision-making in family planning, healthcare providers should discuss absolute and relative recurrence risks as well as genetic causes of ASD with this particular group. 相似文献7.
Objective
To investigate i) how the patient’s participation in interaction occurs in interpreter-mediated consultations (IMCs) when the doctor provides information to the patient or tries to elicit information from them; ii) how the interpreter’s presence in the consultation influences the patient’s participation.Method
We analyzed 20 authentic video-recorded IMCs using the A.R.T. framework, an analytical tool for the study of participation in video recorded interpreter-mediated interactions.Results
We coded 521 doctor utterances through which doctors either provided information or tried to elicit information from the patient. In 448 of them, the interpreter established a participation and engagement framework (PEF) with the patient while translating the doctor’s utterances. In 48 cases the interpreter established a PEF with the doctor and in 25 cases the interpreter avoided establishing a PEF with either of the participants while translating the doctor’s utterances.Conclusion
When the interpreter established a PEF with either of the participants, they used verbal and nonverbal means that created the conditions in interaction in order to enable and/or rectify the patient’s participation.Practice implications
Doctors and interpreters should become more aware of their own and each other’s actions in interaction and their influence on the patient’s participation in the consultation. 相似文献8.
9.
Adrien Galy Laura Ciaffi Geraldine Manirakiza Mberyo Pretty Mbouyap Hermine Abessolo Roselyne Toby Frida Essomba Geneviève Lamarre Angeline Bikié Olga Bell Sinata Koulla-Shiro Eric Delaporte 《Patient education and counseling》2018,101(7):1262-1269
Objectives
High adherence is needed to maintain antiretroviral therapy efficacy. Few attempts at therapeutic patient education (TPE) have been made in sub-Saharan Africa. We describe patients’ achievements before intervention and identified needs, TPE programme implementation and evaluation, and patients’ satisfaction.Methods
The TPE programme was proposed to patients in the ANRS-12286/MOBIDIP trial. Beforehand, a directory of competences to manage HIV infection was designed. Patients’ HIV-related knowledge and skills assessment was realised, leading to an educational contract. Evaluation was performed using a standardised collection form and a satisfaction survey.Results
Of 154 patients, 146 underwent TPE. During a median of 1.8 years, 47% of patients had ≥3 consultations. Educational assessment revealed limited knowledge about HIV disease. Conversely, patients had frequently managed issues of adherence or disclosure. A median of 12 objectives were considered per patient, and 75% were attained. Objectives from the cognitive domain were less frequently attained. Patients appeared satisfied with the intervention: more emphasis was placed on psycho-affective aspects or experience-sharing than on the acquisition of knowledge.Conclusion
Active listening, know-how and a space for discussion appear more important for patients than knowledge on disease or treatments.Practice implications
In HIV care, the directory of learning objectives should be revised to include more objectives concerning practical skills for disease management. 相似文献10.
Wei Wei Lee Maria L. Alkureishi J. Harry Isaacson Mark Mayer Richard M. Frankel Daniel A. London Kristen E. Wroblewski Vineet M. Arora 《Patient education and counseling》2018,101(12)
Objective
Despite rapid EHR adoption, few faculty receive training in how to implement patient-centered communication skills while using computers in exam rooms. We piloted a patient-centered EHR use training to address this issue.Methods
Faculty received four hours of training at Cleveland Clinic and a condensed 90-minute version at the University of Chicago. Both included a lecture and a Group-Objective Structured Clinical Exam (GOSCE) experience. Direct observations of 10 faculty in their clinical practices were performed pre- and post-workshop.Results
Thirty participants (94%) completed a post-workshop evaluation assessing knowledge, attitude, and skills. Faculty reported that training was important, relevant, and should be required for all providers; no differences were found between longer versus shorter training. Participants in the longer training reported higher GOSCE efficacy, however shorter workshop participants agreed more with the statement that they had gained new knowledge. Faculty improved their patient-centered EHR use skills in clinical practice on post- versus pre-workshop ratings using a validated direct-observation rating tool.Conclusion
A brief lecture and GOSCE can be effective in training busy faculty on patient-centered EHR use skills.Practice Implications
Faculty training on patient-centered EHR skills can enhance patient-doctor communication and promotes positive role modeling of these skills to learners. 相似文献11.
Karen Nieuwenhuijsen Carel T. Hulshof Judith K. Sluiter 《Patient education and counseling》2018,101(7):1291-1297
Objective
To study the influence of the presentation of results of a preventive medical examination on risk perception and willingness to seek help for work-related fatigue or being overweight.Methods
A factorial design experiment was conducted, presenting workers (n?=?82) with vignettes including eight scenarios of test results with and without an emphasis on the risk of a current or future health condition or a probe to seek help. Participants rated perceived risk and willingness to seek help (0–100 Visual Analogue Scale) as if these were their own results. Differences were tested with paired-sample t-tests.Results
In scenarios emphasizing the risk of a current or future disorder, participants perceived higher risk and were more willing to seek help (p-values?<?.00). Slightly higher willingness to seek help scores was observed in all scenarios that included probes (p?<?.00).Conclusion
Risk perception and willingness to seek help of workers participating in a preventive medical examination were higher when they were told that the test results indicate a risk of a current or future disorder and after being advised to seek help.Practice implications
Healthcare providers should take the potential effects on risk perception and help-seeking into account in preventive settings. 相似文献12.
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14.
Sharon A. Brown Alexandra A. García Julie A. Zuñiga Kimberly A. Lewis 《Patient education and counseling》2018,101(6):1036-1050
Purpose
The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM.Methods
Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017.Results
The number of participants represented by the 22 selected studies, excluding one large outlier, was 4243. On average, the samples were 57% female and ethnically diverse. Interventions—healthy eating behaviors, physical activity, and/or monitoring and self-managing diabetes and cardiovascular risk factors—were delivered in group sessions of fewer than 20 employees. Programs involved 1-h weekly sessions held during lunch hour or at other times during the workday for 12 to 24?weeks. Study outcomes, commonly measured at 6 and/or 12 months, were consistently positive.Conclusion
The literature search uncovered beginning evidence that workplace interventions hold promise for preventing diabetes and/or its complications. More rigorous, creatively designed, workplace studies, are needed for employees at high-risk for developing diabetes.Practice implications
Implications include the need for employer education about the benefits of employer support for such programs and attention to motivational strategies so employees will take full advantage of programs that are offered. 相似文献15.
Maryam Peimani Fateme Monjazebi Robabeh Ghodssi-Ghassemabadi Ensieh Nasli-Esfahani 《Patient education and counseling》2018,101(3):460-466
Objective
This study aims to assess the effectiveness of a peer support intervention, in which patients with T2DM were provided ongoing self-management support by trained peers with diabetes directed at improving self-care behaviors, self-efficacy and life quality.Methods
In this randomized controlled trial, 200 patients referred to a diabetes specialty clinic were allocated to peer support or control group. Participants in both groups received usual education by diabetes educators.Intervention participants worked with the trained volunteer peers who encouraged participants to engage in daily self-management and to discuss and share their experiences and challenges of diabetes management. The primary outcomes were HbA1c, BMI, self-care behaviors, self-efficacy and life qualityResults
After 6 months, patients in the peer support group experienced a significant decline in mean A1c value (P = 0.045). Also, mean diabetes self-management scores, mean self-efficacy scores and mean quality of life scores significantly improved in peer support group compared to control group (P values <0.001).Conclusion
Peer support activities can be successfully applied in diabetes self-management, especially in areas with a shortage of professionals and economic resources.Practice implications
Peer support strategies should be integrated into our healthcare system to meet minimum needs of people with T2DM in Iran. 相似文献16.
Objective
We examine whether patients have a preference for affective (i.e., focused on patient’s emotions) or cognitive (i.e., focused on the process that led to the error) apologies that are dependent on the apologizing physician’s gender. We hypothesize patients will prefer gender-congruent apologies (i.e., when females offer affective apologies and males offer cognitive apologies).Methods
We randomly assigned analogue patients (APs: participants instructed to imagine they were a patient) to read a scenario in which a female or male physician makes an error and provides a gender-congruent or incongruent apology. APs reported on their perceptions of the physician and legal intentions.Results
An apology-type and gender congruency effect was found such that APs preferred apologies congruent with the gender of the apologizing physician. An indirect effect of congruency on legal intentions through physician perceptions was confirmed (b = ?0.24, p = 0.02).Conclusion
Our results suggest that physician gender plays a role in patient reactions to different apology types.Practice implications
Apology trainings should incorporate how physician characteristics can influence how patients assess and respond to apologies. 相似文献17.
Tanner Caverly Daniel Matlock Jocelyn Thompson Brandon Combs 《Patient education and counseling》2018,101(3):475-480
Objective
The Do No Harm Project is a novel reflective writing program that encourages medical trainees to reflect on and write up clinical narratives about instances of avoidable medical overuse. Our goal is to describe this program and to explore the effect of the program on those participating.Methods
Semi-structured interviews were conducted to explore how participating in the project influenced the thinking, attitudes, and behaviors of participating internal medicine residents. Interviews were conducted with 20 out of the 24 participants from the first 15 months of the program.Results
The following themes emerged from our analysis: 1) learning through reflection (with three sub-themes: empathy for the patient perspective, a critical approach to one’s own clinical practice, and awareness of the problem of overuse); 2) empowerment to discuss instances of overuse and act before it occurs; and 3) perceptions of enhanced evidence-based practice and shared decision-making.Conclusion
Trainees volunteering to complete a reflective writing exercise perceived improved ability to avoid overuse and improved self-efficacy to change clinical behaviors that do not align with optimal patient care.Practice implications
Reflective writing may help trainees recognize and avoid medical overuse. 相似文献18.
Leonie N.C. Visser Sanne Schepers Marieke S. Tollenaar Hanneke C.J.M. de Haes Ellen M.A. Smets 《Patient education and counseling》2018,101(7):1223-1231
Objective
This qualitative study examines patients’ and oncologists’ views on how to best address emotions during consultations, and explores oncologists’ opinions on their own communication and on strategies to improve oncologists’ response to patients’ emotions.Methods
Semi-structured interviews were conducted with 16 cancer patients and 13 oncologists, after watching videotaped consultations illustrating three communication strategies for addressing emotions.Results
Many participants preferred emotion-oriented speech to address patients’ emotions; this strategy was assumed to (positively) affect a broad range of outcomes. Nevertheless, some preferred attentive silence or no emotion-oriented talk at all. Oncologists and patients had similar views on factors that may hinder oncologists to address emotions. Generally, oncologists mentioned that their response to emotions could be improved; for this, various (educational) strategies were suggested.Conclusion
Patients and oncologists generally agree that patients’ emotions can best be addressed by empathic, explorative, acknowledging, and supportive statements. Still, differences in preferences exist, thus oncologists need to attune their communication to the individual patient.Practice implications
The findings can inform medical communication training and encourage oncologists to improve their communication. The regular videotaping of consultations might be a promising method to provide feedback and reflect, thereby improving oncologists’ response to patients’ emotions. 相似文献19.
Kristie B. Hadden Latrina Y. Prince Marty K. Bushmiaer Jamie C. Watson C. Lowry Barnes 《Patient education and counseling》2018,101(10):1823-1827
Objectives
This study assessed patients’ health literacy and expectations for total hip (THA) and total knee (TKA) replacement surgery, and compared health literacy levels of patients and their caregivers.Methods
A convenience sample of 200 THA/TKA participants, patients and their caregivers, participated in this study.Results
Results demonstrated no statistical difference in health literacy between patients and their caregivers. However, patients with lower health literacy had significantly lower expectations for walking after surgery.Conclusions
Practices should be aware that caregivers may not be any better equipped to consume and use complicated patient education materials than the patient they are assisting. Additionally, lower health literacy, rather than or in addition to race or social factors, may contribute to disparities in opting for THA/TKA because of lower expectations for walking after surgery.Practice implications
Healthcare practices should develop patient educational materials that are easy for all patients and caregivers to understand, especially those with low health literacy. Additional patient education and counseling may help patients with low health literacy realistically align their expectations and mitigate barriers to consenting to surgery due to low expectations. 相似文献20.
Ikuko Noro Debra L. Roter Satoko Kurosawa Yasuhiko Miura Masato Ishizaki 《Patient education and counseling》2018,101(2):227-232