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1.
Demian Glujovsky Carlos E. Sueldo Andrea Coscia Paula De Carvalho Stella Lancuba Gustavo Martinez Agustín Ciapponi 《Patient education and counseling》2018,101(5):945-950
Objectives
To evaluate motivations to perform an elective single embryo transfer (e-SET).Methods
Cross-sectional surveys to reproductive medicine specialists and to infertile patients undergoing assisted reproductive treatments.Results
In the physician’s survey (n?=?278), we found that the main reasons for not offering e-SET were the physicians’ belief that patients prefer optimizing the pregnancy rates regardless of the potential complications (57.1%). Regarding the decision making process, 76.7% of physicians thought that patients and doctors should make these decisions together and 93.3% would like to have a more formal decision-aid to help with counseling. In the patients’ survey (n?=?100), 21.3% chose e-SET, while 33% mentioned that complications associated to multiple pregnancies were insufficiently discussed. Among those patients, none chose to have e-SET, while 30% of those who had a full discussion selected e-SET (p?=?0.05).Conclusions
Most physicians did not offer e-SET based on potential patients’ negative feelings. Also, almost 30% take important decisions without the patient’s participation. Patients that discussed more thoroughly this topic, more frequently selected e-SET. Almost all the physicians surveyed agreed that decision-aids could help in this important shared-decision process.Practice implications
Decision aids about e-SET vs DET are needed to help patients in the decision making process. 相似文献2.
Christy J.W. Ledford Kerry P. Sadler Jeremy T. Jackson Jasmyne J. Womack Heather A. Rider Angela B. Seehusen 《Patient education and counseling》2018,101(9):1620-1623
Objective
To demonstrate how the chronic care model can be applied in prenatal care.Methods
This study was conducted through analysis of data generated in the women’s health and family medicine departments of one community hospital and two medical centers across three states (Georgia, Nevada, and Virginia). 159 low-risk obstetric patients were monitored throughout their pregnancy for patient activation and biometric measures including: blood pressure at each appointment, baby’s gestational age at birth, and mode of delivery. Patient activation was assessed with the validated, licensed patient activation measure.Results
Patient activation was strongly associated with the Prenatal Interpersonal Processes of Care metric (F (2, 155)?=?3.41, p?<?.05). Also, increased age, decreased Prenatal Interpersonal Processes of Care, fewer pregnancies, and increased diastolic blood pressure were associated with an increased likelihood of cesarean delivery and the model correctly predicted 81% of cases.Conclusion
Women who identified as feeling more activated reported more positive pregnancy experiences, and women who reported more positive pregnancy experiences were more likely to experience a vaginal delivery.Practice implications
Activated patients, more positive prenatal experience, and improved delivery outcomes can be achieved through applying the chronic care model. 相似文献3.
José Pérez-Revuelta José María Villagrán-Moreno Luisa Moreno-Sánchez Juan Manuel Pascual-Paño Francisco González-Saiz 《Patient education and counseling》2018,101(8):1477-1482
Objective
The aim of this paper is to provide evidence of the validity and reliability of the COMRADE scale (Combined Outcome Measure for Risk communication And treatment Decision making Effectiveness) in patients suffering from schizophrenia spectrum disorders.Method
150 patients recruited at five mental health centers were assessed using a cross-sectional study design. The COMRADE, WAIS-S (therapeutic alliance) and TSQM (satisfaction with medication) scales were used.Results
Exploratory Factor Analysis identified three factors from the COMRADE (F1: “Risk communication”; F2: “Confidence in decision” and F3: “Knowledge of decisional balance”) which explain 45.2, 8.5 and 6% of the variance, respectively. Statistically significant correlations were observed between the scores of the COMRADE subscales with the subscales of the WAI-S and the TSQM. The internal consistency observed for each of the factorial scores of the COMRADE were (Cronbach’s alpha values) 0.90, 0.89 and 0.74, respectively.Conclusion
The COMRADE scale offers appropriate psychometric properties for its use as a measure of perceived patient involvement in the shared decision making process in antipsychotic treatment.Practice implications
The use of the COMRADE measure in psychiatric clinical practice and in research studies provides an outcome measure of interventions from the shared decision making model. 相似文献4.
Laura B. Attanasio Katy B. Kozhimannil Kristen H. Kjerulff 《Patient education and counseling》2018,101(6):1130-1136
Objective
To examine correlates of shared decision making during labor and delivery.Methods
Data were from a cohort of women who gave birth to their first baby in Pennsylvania, 2009–2011 (N?=?3006). We used logistic regression models to examine the association between labor induction and mode of delivery in relation to women’s perceptions of shared decision making, and to investigate race/ethnicity and SES as potential moderators.Results
Women who were Black and who did not have a college degree or private insurance were less likely to report high shared decision making, as well as women who underwent labor induction, instrumental vaginal or cesarean delivery. Models with interaction terms showed that the reduction in odds of shared decision making associated with cesarean delivery was greater for Black women than for White women.Conclusions
Women in marginalized social groups were less likely to report shared decision making during birth and Black women who delivered by cesarean had particularly low odds of shared decision making.Practice implications
Strategies designed to improve the quality of patient-provider communication, information sharing, and shared decision making must be attentive to the needs of vulnerable groups to ensure that such interventions reduce rather than widen disparities. 相似文献5.
Ikuko Noro Debra L. Roter Satoko Kurosawa Yasuhiko Miura Masato Ishizaki 《Patient education and counseling》2018,101(2):227-232
Objective
This study was designed to address significant gaps in the predominantly western-centric research literature by examining the influence of gender concordance in medical communication and patient satisfaction within the Japanese context.Methods
New primary care patients (54 male and 49 female) were randomly assigned to study internists (6 males and 5 females). Recorded visits were coded with the Roter Interaction Analysis System (RIAS). Post-visit, patients completed a Japanese version of the Medical Interview Satisfaction Scale (MISS).Results
Female concordant visits showed higher levels of patient-centeredness than all other gender combinations. Female physicians substantially modified their communication based on patient gender while male physicians did not. Gender concordance was associated with higher female, but lower male patient satisfaction relative to gender discordant visits.Conclusion
Contrary to normative experience of medicine as a male dominated profession in Japan, and gender-based power differentials, male-gendered clinical communication is less likely to satisfy male than female patients, while female-gendered communication is positively associated with female patient satisfaction.Practice implications
Patient satisfaction ratings reflect greater gender flexibility in terms of acceptable physician behavior than Japanese norms would suggest. 相似文献6.
Sophie Veilleux Isabelle Noiseux Nathalie Lachapelle Rita Kohen Luc Vachon Brian White Guay Alain Bitton John D. Rioux 《Patient education and counseling》2018,101(2):331-339
Objectives
This study aims to characterize the relationships between the quality of the information given by the physician, the involvement of the patient in shared decision making (SDM), and outcomes in terms of satisfaction and anxiety pertaining to the treatment of inflammatory bowel disease (IBD).Methods
A Web survey was conducted among 200 Canadian patients affected with IBD. The theoretical model of SDM was adjusted using path analysis. SAS software was used for all statistical analyses.Results
The quality of the knowledge transfer between the physician and the patient is significantly associated with the components of SDM: information comprehension, patient involvement and decision certainty about the chosen treatment. In return, patient involvement in SDM is significantly associated with higher satisfaction and, as a result, lower anxiety as regards treatment selection.Conclusions
This study demonstrates the importance of involving patients in shared treatment decision making in the context of IBD.Practice implications
Understanding shared decision making may motivate patients to be more active in understanding the relevant information for treatment selection, as it is related to their level of satisfaction, anxiety and adherence to treatment. This relationship should encourage physicians to promote shared decision making. 相似文献7.
Sarina R. Isenberg Rebecca A. Aslakson James N. Dionne-Odom Katherine Clegg Smith Sarabdeep Singh Susan Larson John F.P. Bridges Thomas J. Smith Jennifer L. Wolff Debra L. Roter 《Patient education and counseling》2018,101(6):1066-1074
Objective
To examine the association between family companion presence during pre-surgical visits to discuss major cancer surgery and patient-provider communication and satisfaction.Methods
Secondary analysis of 61 pre-surgical visit recordings with eight surgical oncologists at an academic tertiary care hospital using the Roter Interaction Analysis System (RIAS). Surgeons, patients, and companions completed post-visit satisfaction questionnaires. Poisson and logistic regression models assessed differences in communication and satisfaction when companions were present vs. absent.Results
There were 46 visits (75%) in which companions were present, and 15 (25%) in which companions were absent. Companion communication was largely emotional and facilitative, as measured by RIAS. Companion presence was associated with more surgeon talk (IRR 1.29, p?=?0.006), and medical information-giving (IRR 1.41, p?=?0.001). Companion presence was associated with less disclosure of lifestyle/psychosocial topics by patients (IRR 0.55, p?=?0.037). In adjusted analyses, companions’ presence was associated with lower levels of patient-centeredness (IRR 0.77, p 0.004). There were no differences in patient or surgeon satisfaction based on companion presence.Conclusion
Companions’ presence during pre-surgical visits was associated with patient-surgeon communication but was not associated with patient or surgeon satisfaction.Practice implications
Future work is needed to develop interventions to enhance patient-companion-provider interactions in this setting. 相似文献8.
Objective
To examine whether illness perceptions among patients with fibromyalgia and negative responses from medical professionals correlate with their satisfaction with their physicians or with their number of hospital visits.Methods
Questionnaires were sent by post to members of the Japan Fibromyalgia Support Association. Measures collected included, as independent variables, the Brief Illness Perception Questionnaire and the Illness Invalidation Inventory; and as outcomes, the Patient Satisfaction Consultation Questionnaire and the number of hospital visits.Results
We analyzed data from 304 patients. Multiple logistic regressions showed that perception of poor treatment control and the experience of being discounted and misunderstood by medical professionals were strongly correlated with dissatisfaction with attending physicians. Patients who perceived poor treatment control visited the hospital fewer times, while patients who reported being discounted by medical professionals visited more times. Patients’ negative emotions correlated neither with patient satisfaction nor with the number of hospital visits.Conclusion
Treatment effectiveness and the respect accorded to patients were the key factors significantly correlated both with patient satisfaction and the number of hospital visits.Practice implications
Physicians should not emphasize only patients’ negative psychological status but also should convey a respectful attitude and help patients understand their current treatment is useful. 相似文献9.
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10.
Kimberly A. Fisher Andy S.L. Tan Daniel D. Matlock Barry Saver Kathleen M. Mazor Arwen H. Pieterse 《Patient education and counseling》2018,101(12):2195-2201
Objective
To examine situations where shared decision making (SDM) in practice does not achieve the goal of a patient-centered decision.Methods
We explore circumstances in which elements necessary to realize SDM – patient readiness to participate and understanding of the decision – are not present. We consider the influence of contextual factors on decision making.Results
Patients’ preference and readiness for participation in SDM are influenced by multiple interacting factors including the patient’s comprehension of the decision, their emotional state, the strength of their relationship with the clinician, and the nature of the decision. Uncertainty often inherent in information can lead to misconceptions and ill-formed opinions that impair patients’ understanding. In combination with cognitive biases, these factors may result in decisions that are incongruent with patients’ preferences. The impact of suboptimal understanding on decision making may be augmented by the context.Conclusions
There are circumstances in which basic elements required for SDM are not present and therefore the clinician may not achieve the goal of a patient-centered decision.Practice Implications
A flexible and tailored approach that draws on the full continuum of decision making models and communication strategies is required to achieve the goal of a patient-centered decision. 相似文献11.
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12.
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13.
Objectives
Pregnancy options counseling, or nondirective counseling of patients with unintended pregnancy, is a “necessary competency” for medical students according the Association of Professors of Gynecology and Obstetrics. Narrative Medicine (NM) utilizes stories of illness to inform clinical practice and promotes self-reflection in medical education. The authors analyzed the effect of a NM workshop on medical students’ ability to provide pregnancy options counseling.Methods
The authors randomized students in the major clinical year at Columbia University Medical Center (CUMC) to either a 2-hour NM workshop or to a control intervention. The NM group participated in reading and reflective writing exercises addressing varying perspectives on pregnancy. Students then completed a video-taped and numerically-scored OSCE (Objective Structured Clinical Examination) regarding pregnancy options counseling. The authors compared mean OSCE scores between the groups.Results
The study analyzed 103 participants. Overall mean OSCE scores were higher in the NM group (11.9?±?1.5, n?=?51) than the control group (11.3?±?1.6, n?=?52) (p?=?0.049).Conclusions
Students undergoing a NM workshop had higher scores on a pregnancy options counseling OSCE.Practice implications
This brief intervention may aid future physicians in providing nondirective pregnancy options. This novel approach to teaching is an easily shared learning tool. 相似文献14.
Christine M. Gunn Tracy A. Battaglia Michael K. Paasche-Orlow Amanda K. West Nancy R. Kressin 《Patient education and counseling》2018,101(6):1123-1129
Objective
Currently, 30 US states mandate that radiologists notify women when dense breast tissue is found on mammography. Little is understood about how notifications are perceived by recipients. This qualitative study sought to understand how dense breast notifications (DBNs) impact women’s perceptions and their participation in follow-up care.Methods
We assessed rates of DBN recall and conducted semi-structured telephone interviews with 30 English-speaking women ages 40 to 74 after receiving a DBN from a Massachusetts hospital. Content coding characterized women’s recall of the notification content, perceptions of breast density, and planned or actual participation in follow-up care.Results
Most women (81%) recalled receiving a DBN, but few could recall specific content. Women described struggling to understand the meaning of breast density and created their own explanatory models of dense breasts that differed from medical explanations. Many women planned to or did talk with their doctors about breast density as a result of receiving the notification.Conclusions
Women receiving DBNs have limited knowledge and many misperceptions about the implications of having dense breasts.Practice implications
Educational support is needed to promote informed decision- making about breast cancer screening that incorporates personal risk in the setting of dense breast legislation. 相似文献15.
Sarah Bauerle Bass Amy Jessop Muhamed Gashat Laurie Maurer Mohammed Alhajji Jon Forry 《Patient education and counseling》2018,101(11):1995-2004
Objective
This paper describes the development of a mobile health tool to facilitate Hepatitis C (HCV) treatment decision making in methadone patients.Methods
Using an iterative, formative evaluation framework, we used commercial marketing techniques to create 3D maps of survey data to develop culturally relevant messaging that was concept tested. The resulting tool was then user tested and results were used to modify the tool.Results
The “Take Charge, Get Cured” tool was developed with surveys (n?=?100), perceptual mapping analysis, concept testing (n?=?5), and user testing (n?=?10). “Think aloud” sessions were audio recorded and surveys given. Patients thought the goal of the tool was to encourage treatment and it was aimed to the needs of methadone patients. Means of 6.7–7 (on a 7 point scale) were observed for survey items related to ease of use, content, and satisfaction.Conclusion
The iterative development was essential to ensuring a culturally targeted tool, specific to the needs of HCV?+?methadone patients. There was a high level of acceptance for the tool.Practice Implications
Our study indicates that using a formative evaluation strategy is essential for development of highly targeted patient communication, especially in hard-to-reach populations. 相似文献16.
Aaron R. Scott Cody J. Sanderson Augustus J. Rush Elizabeth A. Alore Aanand D. Naik David H. Berger James W. Suliburk 《Patient education and counseling》2018,101(5):917-925
Objective
Patient education materials are a crucial part of physician-patient communication. We hypothesize that available discharge instructions are difficult to read and fail to address necessary topics. Our objective is to evaluate readability and content of surgical discharge instructions using thyroidectomy to develop standardized discharge materials.Methods
Thyroidectomy discharge materials were analyzed for readability and assessed for content. Fifteen endocrine surgeons participated in a modified Delphi consensus panel to select necessary topics. Using readability best practices, we created standardized discharge instructions which included all selected topics.Results
The panel evaluated 40 topics, selected 23, deemed 4 inappropriate, consolidated 5, and did not reach consensus on 8 topics after 4 rounds. The evaluated instructions’ reading levels ranged from grade 6.5 to 13.2; none contained all consensus topics.Conclusion
Current post surgical thyroidectomy discharge instructions are more difficult to read than recommended by literacy standards and omit consensus warning signs of major complications. Our easy-to-read discharge instructions cover pertinent topics and may enhance patient education. Delphi methodology is useful for developing post-surgical instructions.Practice implications
Patient education materials need appropriate readability levels and content. We recommend the Delphi method to select content using consensus expert opinion whenever higher level data is lacking. 相似文献17.
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18.
19.
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20.
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