Journal of Communication in Healthcare最新文献

The Cures Rule permits patients to unfettered, immediate access of their documented health information unless medical providers 'block' this information. While the transparency of open notes has perceived benefits for clinic-based progress notes, the extension of the Cures Rule in its current form to include pathology reports could lead to unintended harms. Several consequences for both patient and provider are identified by examining hypothetical cases, inspired by patient and provider experiences, of misunderstood diagnoses and unexpectedly discovered cancers in seemingly benign tissue. Identified consequences include patient confusion, increased distress, harm to the patient-provider relationship, and moral injury to providers. These unintended consequences may be mitigated through several harm-reducing strategies: informed release, individualized delay, and the 'pop-up' warning. While each presented harm-reducing measure has pros and cons, they all have the potential to improve patient care from where it currently stands.

By addressing communication gaps, the integration of AI tools in healthcare has a greater ability to improve decision-making and to empower patients with more control over their health. Current systems for navigating healthcare - such as finding providers or understanding costs - are fragmented and cumbersome, often leaving patients frustrated and uninformed. An AI Healthcare Assistant App, leveraging advances in health IT interoperability, price transparency, and user-centred design, could simplify these processes. By integrating medical records, provider directories, cost data, and user preferences, the app could deliver tailored recommendations, schedule appointments, and even suggest alternatives based on patient feedback. However, widespread adoption of such tools faces challenges, particularly around data privacy and inclusivity. Effective communication strategies - emphasizing transparency, data ownership, and cultural tailoring - are crucial to building trust. Equitable design principles, such as low-literacy interfaces and device compatibility, ensure broader access. While the AI Healthcare Assistant App remains hypothetical, recent technological advances make it much more possible and its potential to revolutionize patient empowerment and healthcare communication is undeniable.

Background: Being inherently service oriented, healthcare organizations emphasize patient-centered care and service quality. However, unwarranted disruptions during patient-doctor interactions can negatively impact perceptions of service quality. Integrating digital technologies such as smartphones into patient-doctor interactions might affect perceived (as well as actual) service quality. Given the ubiquity of smartphones in daily life, it is vital to assess their impact on medical consultations.

Method: To address this lacuna, we examined patients' perceptions of their physicians' smartphone use during medical encounters. We investigated how these perceptions, either interruptive or constructive, affect the perceived service quality and patient satisfaction. Data from an online survey of 356 participants provided insights into patient comfort levels, perceived justifications, service quality perceptions, and overall satisfaction when physicians used smartphones during consultations in the past year.

Results: Patients view physicians' smartphone use during consultations as interruptive, which affects perceived service quality and satisfaction. They were more accepting when smartphone use was related to professional tasks or urgent personal matters rather than routine use. Notably, there was no correlation between patients' smartphone habits and their perceptions of disruptive smartphone use by their physicians.

Conclusion: This study expands our understanding of the implications of physician smartphone use in healthcare and highlights ways to boost patient satisfaction and perceived service quality. The findings suggest that healthcare organizations should develop policies and physician training to minimize disruptive smartphone use and encourage clear communication regarding essential work-related use during patient consultations.

Background: Public health professionals (PHPs) are seeing an increased impact of climate change on the physical and mental health of their communities. Diverse climate change strategies and interventions are needed to equitably protect people's health. Yet, limited information exists on U.S. health professionals' willingness to communicate with the public about climate change and act on the issue.

Methods: We used a pre-existing survey to assess the willingness of 173 PHPs to participate in climate change advocacy. Variables included beliefs, attitudes and risk perceptions of climate change, perceptions of the local impact of climate change on health, communication barriers and resources for communicating about climate change and health, and the perceived role of PHPs in mitigating climate change.

Results: Key findings included: (1) Belief in climate change is not unanimous among PHPs; (2) PHPs are worried about climate change (93.3%) and agree the issue of climate change is of personal importance (97.1%); (3) Participants are seeking resources/trainings (57.8%) on climate change (4)The main barriers of advocating for climate change are lack of time (54.3%) and knowledge (46.3%); (5)) Respondents acknowledge health impacts due to weather-related events are caused by human activities (83.2%) and (6) views of climate change are determined by willingness to advocate and take action to mitigate climate change (R² = .251; p = < .001).

Conclusions: Although the majority of PHPs believe climate change is happening, this belief is not unanimous and steadfast. Opportunities remain on how health professionals can better inform, educate, and empower others about climate change and health.

Background: During the Covid-19 pandemic, people with chronic conditions experienced delayed or missed care, while their carers endured social isolation, loneliness, and reduced support. Information communication technology (ICT) can be utilized to encourage continuity of care, address misinformation, and allocate support. This study aimed to identify factors associated with the ICT adaptation of South Asian carers of individuals with chronic conditions by comparing changes in ICT utilization and preferences before and during the pandemic.

Method: 416 South Asian carers reporting feelings of loneliness and isolation were identified from the Coping with Loneliness, Isolation and Covid-19 (CLIC) online survey. Descriptive statistics and multinomial regression models were utilized.

Result: The most commonly used ICT modality was auditory, followed by written and audio-visual. Four variables identified were: social network size and relationship proximity, Covid-19-induced distress, age, and living arrangements. We identified a negative correlation between social network size and ICT frequency/intensity, reductions in communication frequency/intensity associated with Covid-19-induced distress, working-age carer (18-60) preference adaptation toward written communication during the pandemic, written and auditory ICT fluency in carers spending time alone by choice, and aversion from auditory ICT in carers who lived and were often alone involuntarily.

Conclusion: The findings provide insights into South Asian carers' ICT usage, preferences, and adaptation in response to the pandemic. The findings aid in the development of health and social care pathways that fulfil local caregivers' unmet support and resource needs.

Background: To better understand informal coping strategies among adolescents and young adults (AYAs) with cancer, the current investigation asked AYA study participants to describe the 'advice' they would offer to hypothetical peers about coping following diagnosis. This study explores the utility of the single item 'advice' prompt for supportive oncology research and practice.

Methods: AYA cancer patients (n = 27) aged 12-25 years were recruited through electronic health record query at a single-institution health system. Participants completed semi-structured interviews. Inductive themes were described regarding advice about informal coping strategies following cancer diagnosis. The Institutional Review Board approved this study (HUM#00157267).

Results: Emergent advice themes included (1) attitude re/framing, (2) engage support network, and (3) self-advocacy. Participants advised cultivating a positive yet realistic attitude about the present and future. Reaching out to support network members and accepting help were advised, as was rebuffing unhelpful support. Participants also advocated for addressing medical information needs and building trusting relationships with clinicians.

Conclusions: Soliciting AYA advice serves to identify informal coping mechanisms in response to life-stage-specific concerns. Future research is called to substantiate the utility of 'advice' as a single item tool for research and clinical questionnaires. Practice implications call for creating opportunities for AYAs to impart their advice to others (e.g. anonymous community message board) as a means of personal catharsis, altruistic service, and legitimizing AYAs as 'embodied' experts of their own experiences.

Background: Technological advancement has added new dimensions to the communication between physicians and their patients in healthcare settings worldwide. This study aimed to measure patients' views about physicians' interpersonal communication during telemedicine consultations by cultural adaptation and validation of the communication assessment tool (CAT) in Bangladesh.

Methods: A cross-sectional phone survey was conducted among 400 patients who received healthcare services from a telemedicine centre in Bangladesh. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test the dimensionality of the CAT-Bangla scale. The goodness of fit of the CFA was assessed using the comparative fit index (CFI), Tucker-Lewis index (TLI), Chi-square values, root-mean-square error of approximation (RMSEA) and standardized root mean squared residual (SRMR). The internal consistency reliability of the CAT-Bangla scale was assessed using Cronbach's alpha.

Results: Factor analysis findings suggest that the CAT-Bangla scale is unidimensional with good internal consistency (Cronbach's α = 0.876). The individual item analysis findings suggest that most of the patients felt that the physicians treated them with respect (81% rated 'excellent') and allowed them to talk without interruption (73.5% rated 'excellent'). Overall, the level of satisfaction among patients regarding physicians' communication skills was high with a mean score of 4.36 (SD = 0.30) across all the 14 items. However, the patients were not satisfied with the amount of time that physicians spent with them as none of them reported 'excellent' in that domain.

Conclusion: The CAT-Bangla scale is feasible, valid, and internally consistent for measuring physicians' communication skills in the telemedicine environment. This study can contribute to policymakers regarding the integration of learning communication skills of future physicians to competently deliver healthcare in the telemedicine environment. It would also help to understand various aspects of doctor-patient communication in a telemedicine context.

Background: In times of a public health emergency such as COVID-19, a government-centric approach may not be sufficient to contain the epidemic and ensure citizens' compliance. This study proposes a theoretical model that integrates individual-oriented, social-oriented, and community-oriented factors to predict individuals' engagement in preventive behaviors and citizen health emergency communication (CHEC). Perceived shared responsibility, which results from the communal nature of the pandemic, is tested as a mediator in the relationships between different motivations and behaviors in the context of COVID-19.

Method: To test the model, an online survey with a quota sample of 1,301 adults reflecting the composition of the U.S. population was conducted via Qualtrics.

Results: Results show that perceived severity, self-efficacy, worry, and social support significantly increase the perception of shared responsibility, subsequently increasing individuals' adherence to preventive behaviors and their engagement in CHEC. In this process, shared responsibility serves as a mediator between some tested relationships between motivators and two types of behaviors (i.e. communication and prevention).

Conclusions: During a public health emergency, individuals' preventive behaviors and communication behaviors are determined by the individual-oriented (e.g. perceived severity), social-oriented (e.g. social support), and community-oriented (e.g. perception of shared responsibility) factors. In this mechanism, the perception of shared responsibility explains how some motivators influence individuals' communication and prevention behaviors.

Background: Prescriber-patient communication plays a crucial role in understanding patients' needs, while reducing risks for developing an opioid use disorder (OUD), yet research on this is sparse. As such, the need to understand healthcare providers' skills, comfort, and confidence when discussing opioids with patients and other providers is an important step in balancing patients' needs from a pain perspective and risks from an OUD perspective.

Method: We interviewed 32 Massachusetts providers (physicians, physician associates, nurse practitioners, and dental practitioners) to assess their communication strategies with patients and other providers. Interviews were conducted online (January - September 2021) and were transcribed verbatim, coded, and analyzed using deductive content analysis.

Results: Contextualized in the Health Education Theory, one major theme was how providers communicated with patients about opioids, including their tone, use of language, and the content they covered. Providers described frequently encountering patients who expressed fears and concerns about opioid addiction and did not want an opioid prescription. Another major theme, related to the ongoing process of preventing problems with opioids was a focus on provider engagement in follow-up, including checking if a prescription was filled, having the patient come back to the office, or calling another provider after a certain duration. Recommendations about communication with patients and other providers were also discussed.

Conclusions: Overall, open, supportive, tailored communication with patients and other providers was deemed essential when considering opioid prescriptions. Further research is recommended to learn about the status of opioid-prescription knowledge, beliefs, and practices within the fourth wave of the current opioid overdose epidemic.

Background: The demand for simplified languages such as Easy Language has grown, also in healthcare. Despite this, very few studies have examined how healthcare personnel perceive Easy Language, or its effects on healthcare.

Methods: This qualitative case study was conducted in a Finnish hospital. The data consisted of 14 interviews with hospital management and operational staff on their experiences of implementing and using Easy Language in patient communication.

Results: According to the hospital personnel, the experiences of Easy Language use were mainly positive. The staff felt that patient instructions in Easy Language improved communication with customers. They were proud that the values of the hospital's strategy, especially customer orientation, were realized in practical work. However, operational-level personnel also reported certain challenges, especially regarding the adequacy of resources and training.

Conclusions: Considering its modest financial investment, we conclude that the Easy Language project had a positive impact. The hospital staff were satisfied and perceived that health communication in the hospital had improved. Their positive reputation due to their use of Easy Language brought added value to their work. Further studies are needed to measure the direct customer experience and financial effects of using Easy Language.