Journal of Communication in Healthcare最新文献

Background: The impact of health technology systems (HTS), including telehealth and patient portals, on patient-provider communication, especially among women with a high-risk pregnancy who need more in-depth medical assessments, is not fully understood. Hence, this study explored the experiences of women experiencing high-risk pregnancies and perinatal healthcare providers with telehealth and patient portals using the patient-provider communication framework.

Methods: This qualitative study used a phenomenological approach. Purposeful sampling was used to recruit fifteen women experiencing high-risk pregnancies and eight providers from two obstetric practices, predominantly serving women on Medicaid. Semi-structured interviews were conducted, transcribed, and then analyzed using inductive thematic analysis.

Results: The themes and subthemes were developed iteratively. The main themes were consistent across both groups while the subthemes varied. The main themes included benefits of and barriers to HTS, patient-provider interaction, system-level actions, and future recommendations. The analysis revealed that while HTS improved access to care and empowered patients, both groups faced significant challenges. Providers noted that HTS do not address the complex needs of high-risk pregnancies and the issue of workflow disruption. Patients appreciated the convenience of HTS, but reported delays in communication and limited interaction with healthcare teams.

Conclusions: HTS are emerging safety net tools that can improve access to prenatal care and increase shared-decision making and patient empowerment. High-risk pregnancy needs require multifactorial solutions to ensure comprehensive care leveraging HTS, with patient-provider communication at the core of managing these challenges. Healthcare systems need to invest in improving HTS to meet the needs of vulnerable populations.

Plain language abstract: This study explored the experiences of women experiencing high-risk pregnancies and perinatal healthcare providers with health technology systems (HTS), specifically telehealth and patient portals. Interviews were conducted with fifteen women with high-risk pregnancies and eight healthcare providers from two obstetric practices, predominantly serving women on Medicaid. The analysis revealed that while HTS improved access to care and empowered patients, both groups faced significant challenges. Providers noted that HTS do not address the complex needs of high-risk pregnancies and the issue of workflow disruption. Patients appreciated the convenience of HTS, but reported delays in communication and limited interaction with healthcare teams.

Background: Recent research has confirmed the media's impact on shaping public opinion and influencing the acceptance of new therapies and health-related technologies. However, despite significant changes in recent years, media representations of healthcare digitalization remain underexplored. This study is the first to describe how Spanish media addressed digital healthcare before, during, and after the COVID-19 pandemic.

Method: To this end, all related articles published in five of the most widely read newspapers in Spain over a 10-year period (2014-2023) were retrieved from the MyNews database. A qualitative analysis of written and visual content was conducted on 285 articles, including the identification of their general valence and the critical topics discussed.

Results: The findings reveal that articles on the topic have become longer and more complex, shifting toward a greater focus on healthcare and social concerns, along with a strong economic and business component. However, there is a persistent absence of debate throughout the period, as most articles (69.12%) state solely the benefits of digital healthcare, while only 10.53% exhibits drawbacks and barriers.

Conclusions: This dominant positive media discourse contrasts with the ongoing discussions in academic and clinical contexts where real limitations and challenges are acknowledged and remain important areas for further work. The current findings contribute to a deeper understanding of public perceptions on digital healthcare and help address media biases. A balanced narrative is crucial to ensure accurate representations of health-related issues given its significant influence on public trust, health resources prioritization, clinical practice and policymaking.

Background: Suicide accounts for 1 in every 100 deaths, which sets it as a global public health concern per the World Health Organization. COVID-19 increased concerns about mental health, particularly among youth, with suicide ranking as the fourth leading cause of death. This study investigates the relationship of age and the quality of family communication on suicidal ideation among Colombian university students, thus addressing a pertinent issue as Colombia reports an average of 8 daily suicide deaths.

Methods: A cross-sectional correlational design was employed, involving a representative sample of 660 Colombian university students aged between 18 and 26 years old. The study employed the Positive and Negative Suicide Ideation Inventory and the Parent-Adolescent Communication Scale. Participants were categorized into two groups: those surveyed before and during the COVID-19 pandemic.

Results: During the pandemic family communication, particularly of an offensive nature, had a significant relationship on suicidal ideation among young Colombian university students. A positive association was found between the pandemic context and suicidal ideation, moderated by age. Open family communication was observed to potentially mitigate suicidal thoughts, particularly among older students.

Conclusion: This research highlights the role of family communication in supporting students' mental health during crises like the COVID-19. Future studies should explore the preventive potential of close interpersonal communication to reduce youth suicide risk. Implementing proactive measures and robust support systems within universities are essential for approaching this issue and protecting vulnerable youth. Additionally, considering individual developmental trajectories is relevant for understanding age-related influences on student mental health.

Background: Antimicrobial resistance (AMR) and vaccine hesitancy (VH) are significant public health threats in Nigeria/Africa, due to limited healthcare infrastructure and health literacy, thus encouraging misinformation, which further exacerbates these issues.

Methods: This review examines recent literature to explore how Infodemiology and Infodemics management can be integrated into strategies addressing AMR and VH in Nigeria and Africa. A narrative review methodology was employed, sourcing studies mostly from 2020 onwards to ensure contemporary relevance.

Results: Infodemiology offers tools for addressing the dual public health threats of AMR and VH in Nigeria/Africa. Evidence reveals AMR behaviors are strongly influenced by misconceptions about antibiotics, such as their efficacy against viral infections, perpetuated by social media and word-of-mouth misinformation. Similarly, VH is fueled by cultural beliefs and mistrust in health systems, amplified during the COVID-19 pandemic, where myths about infertility and harmful ingredients led to skepticism. Infodemiology enables real-time tracking of misinformation trends through digital tools, allowing health authorities to identify hotspots and intervene with targeted campaigns.

Conclusion: Integrating infodemiology into AMR and VH management strategies enhances public health outcomes by addressing misinformation at its roots and promoting evidence-based practices. By leveraging digital tools and engaging trusted local figures, health systems can foster trust and literacy among communities. African governments must invest in digital health infrastructure, establish supportive policies, and foster partnerships with social media platforms to sustainably manage infodemics. These strategies are ivotal for reducing AMR and increasing vaccine acceptance, ultimately safeguarding health across human, animal, and environmental domains.

Background: In the bilingual Canadian context, the use of a preferred official language with healthcare providers is linked to optimized communication, respectful patient-centered care, improved safety and quality of services. This study aimed to develop and test a questionnaire that measures patients' experience of how language was considered during an outpatient health encounter.

Methods: French and English questions were drafted based on a literature review. Questionnaire content and flow were validated through focus groups with experts and service users. Question understanding and clarity was verified with cognitive interviews and pre-tests with diverse service users. The final questionnaire was pilot tested in three health organizations and temporal stability, and construct validity was verified.

Results: Participants were nine anglophone and eleven francophone experts and service users for the focus groups, six anglophone and six francophone service users for the cognitive interviews, eleven anglophone and ten francophone service users for the pre-test. The resulting questionnaire has 31 experience-related questions organized under six themes: arrival/greeting, interpretation and translation services, language of health services, relationship with healthcare providers, visibility of official languages and follow-up. The questionnaire is completed online in French or English. The questionnaire was pilot tested with 199 participants in three sites. Temporal stability was moderate to good. Initial evidence of construct validity was demonstrated, suggesting that the questionnaire is adequate to evaluate patient experience.

Conclusion: This questionnaire is the first known bilingual patient-experience tool, focused on the active offer of services in official languages during outpatient healthcare encounters, with preliminary validation.

Background: Together with the global increase in actual and estimated cancer incidents and survival rates, the relevance of efficient follow-up care is rising. The digitalization of healthcare entails new expectations in oncological follow-up care for primary and speciality care physicians, but there is often a lack of clarity in care coordination, knowledge, and communication between them. This article aims to analyse the challenges and opportunities of oncological care that support or hinder effective communication in follow-up care.

Method: Data was collected using a qualitative approach, namely in-depth semi-structured interviews. A sample of 17 healthcare professionals, including speciality and primary care physicians, was formed. Inductive and deductive thematic analysis were used for data analysis. All relevant ethical approvals were obtained.

Results: Findings showed that digital communication between primary and speciality care physicians facilitates faster communication and more optimal patient referrals between care levels. However, a lack of interoperability, delays in discharge summaries, and the absence of unified guidelines and a systemic approach to digital communication may hinder the efficiency of follow-up care. These challenges represent key areas for improvement.

Conclusions: With the support of primary care physicians, there is potential to improve oncological follow-up care. Yet, unified understandings, guidelines and further improvements in the collaboration of two healthcare levels, especially regarding digital communication and systemic approaches in the implementation, are crucial.

Background: Effective communication is vital in healthcare. It improves the quality of care, treatment adherence, and follow-up. However, the extent to which communication gaps impact healthcare utilization, such as hospital inpatient and ED use within the pediatric population, is less understood. This study aims to bridge the gap in the literature.

Methods: The study used the 2019-2023 National Survey of Children's Health (NSCH) data to examine the relationship between perceived communication quality and healthcare utilization within the pediatric population. The primary independent variable, perceived patient-provider communication quality, was a composite score derived from five items evaluating the quality of provider-patient communication. We conducted two survey-weighted multivariable logistic regressions to evaluate the relationship between perceived patient-provider communication quality and two outcome variables of interest - emergency department utilization and hospital stay - while controlling for potential confounding variables.

Results: From 2019 to 2023, over 26 million parents of children reported inadequacies in the quality of communication with their children's providers. Approximately 35% of them belonged to minority racial groupings. In adjusted models, children whose parents reported lower quality of communication with the child's providers were more likely to visit the emergency room (OR = 1.30, 95% CI = 1.23-1.37) and require hospitalization (OR =  1.27, 95% CI = 1.14-1.42). Being a Black /African American child, compared to Non-Hispanic White (OR =  1.27, 95% CI = 1.16-1.38), was significantly and positively associated with ER visits but not hospital stays.

Conclusions: Inadequate provider-patient communication may increase the likelihood of children using emergency department and inpatient services.

Background: Racism has a significant impact on health outcomes and racial health disparities, but little has been published on how to communicate effectively about racism, particularly in and around oncology. This project sought to gain insight from populations who experience structural racism in cancer treatment and to test draft messages about health equity in cancer treatment with audiences who have limited understanding of structural racism and its connection to cancer.

Methods: We conducted three phases of research: 12 virtual focus groups and 11 virtual in-depth interviews with cancer patients/caretakers; a nationwide online survey (n = 2500) with the general population (n = 2000) and an oversample (n = 500) of people of color; and seven virtual focus groups with individuals of varied races/ethnicities and cancer patients/caretakers.

Results: Prior to message exposure, some struggled to connect cancer treatment disparities to systemic racism or to assess combating inequity as actionable. Message content about structural racism in cancer treatment at times generated polarized reactions. A narrative style video testimonial portraying first-hand narratives of racism in cancer treatment, however, generated receptive responses across all audience subgroups.

Conclusion: Exposure to statements about racism in cancer treatment can strengthen the perception that race is related to receiving prompt, quality cancer treatment and to the importance of addressing equity. The 'what' and 'how' of communicating that information are important; well-intentioned messages on racism in cancer treatment can be alienating and have unintended consequences (e.g. counterarguing) if not brief, inclusive, direct, and framed for 'the all.'

Background: Research on the associations between medical communication competence (MCC) and physicians' psychological adjustment and therapeutic relationships is warranted. This study aimed to analyze the associations between MCC and both physicians' psychological adjustment outcomes (i.e. burnout and flourishing) and therapeutic relationships via barriers to compassion and expressive suppression.

Methods: A sample of 221 physicians completed an online survey, which assessed MCC, barriers to compassion, expressive suppression, burnout, flourishing and therapeutic relationships. Structural equation modeling was used to explore direct and indirect associations between variables. Multigroup analyses were performed to ascertain the invariance of the obtained model between groups of physicians with more (≥14) or fewer (<14) years of professional experience.

Results: Barriers to compassion and expressive suppression were indirectly associated with the relationship between MCC and both physician burnout (β = -.01, 95% CI [-.03, -.00] and β = -.01, 95% CI [-.02, -.00], respectively) and flourishing (β = .04, 95% CI [.01, .10] and β = .07, 95% CI [.03, .13], respectively). The association between MCC and therapeutic relationship was exclusively explained by barriers to compassion (β = .03, 95% CI [.01, .06]). The mediation model was invariant across groups of physicians with more or fewer years of professional experience.

Conclusions: Regardless of professional experience, MCC training should address physicians' barriers to compassion and emotion regulation skills to improve their psychological adjustment and the quality of their therapeutic relationships. Interventions at the physician level may impact the quality of health care at an organizational level.

Background: Zambia's Copperbelt Province maintains HIV prevalence of 11.9% among adults. PMC-Zambia conducted formative research in five districts (Ndola, Kitwe, Chingola, Kalulushi, Mpongwe) to inform a Radio Talk Show (RTS) addressing HIV prevention and pre-exposure prophylaxis (PrEP) uptake.

Methods: We employed focus group discussions (FGDs) and key informant interviews (KIIs) across the districts. Semi-structured guides explored HIV perceptions, stigma, and PrEP awareness. Thematic and narrative analyses identified patterns and stakeholder perspectives.

Results: Significant perception gaps emerged between healthcare workers reporting decreased stigma and community members describing persistent discrimination. PrEP awareness remained critically low with widespread misconceptions confusing prevention with lifelong treatment. Youth particularly feared partner suspicion and peer judgment, while older adults cited religious influences and relationship concerns as barriers.

Conclusions: Findings reveal urgent need for targeted health communication bridging provider-community perception gaps, addressing misconceptions through expert dialogue, and leveraging interactive formats to reduce stigma while promoting informed HIV prevention decision-making.