Patient Education and Counseling最新文献

Introduction: Digital tools could assist obstetric providers by delivering information given increasing options for fetal aneuploidy screening.

Purpose: To determine the impact of a chatbot for pre-test education and counseling in low-risk pregnancies.

Methods: Two sites participated in this randomized controlled trial. Patients in the intervention group used a chatbot prior to the provider visit, while patients in the control group only received education by the provider. The primary outcome was change in patient knowledge scores after provider education. Analysis was by intention to treat.

Results: Overall, 258 women participated (n = 130; intervention and n = 128; control). Knowledge gain was significantly higher among patients using the chatbot (mean increase in correct answers [out of 20]: +4.1 vs +1.9, p < 0.001). Both groups reported high satisfaction, with no statistically significant difference between intervention and control groups (mean patient satisfaction [1-10]: 8.2 vs 8.5 respectively, p = 0.35). Providers also reported high satisfaction scores with no significant difference between intervention and control groups (mean provider satisfaction [1 - 10]: 8.7 vs 8.4 respectively, p = 0.13).

Conclusions: Pre-test education via a chatbot can increase patient knowledge of prenatal testing choices, with high patient and provider satisfaction.

Objective: To study information needs after receiving abnormal amyloid-PET results, and how individual characteristics moderate effects of different communication strategies on information recall.

Methods: In an online video-vignette experiment, seven vignettes each depicted a consultation of a physician sharing abnormal amyloid-PET results with a patient with Mild Cognitive Impairment(MCI), using different communication strategies. Healthy individuals (N = 1017; age 64 ± 8, 808(79 %) female), instructed to imagine themselves as the video-patient, viewed a randomly-assigned vignette and completed questionnaires to assess information needs and test moderation effects of gender, age, care-partner experience, health literacy, and coping.

Results: Sixty-three percent of participants (645/1017) would have liked to receive more information, e.g., on prognosis, additional information sources, lifestyle advice, and/or treatment. Emotional support benefited information recall in women, but not men. Emotional support and visually presenting the PET-scan were less beneficial for individuals with a stronger avoidant coping style, compared to most other strategies.

Conclusion: Most people wanted more information on varying topics, and gender and coping style influenced how communication strategies impacted information recall. PRACTICE IMPLICATIONS The importance of personalized information provision was emphasized, both in terms of what information is provided and how physicians share information, by paying attention to individuals' needs and characteristics.

Objective: Hurried encounters in clinical settings contribute to dissatisfaction among both patients and clinicians and may indicate and contribute to low-quality care. We sought to identify patient- or clinician-reported instruments concerning this experience of time in clinical encounters.

Methods: We searched multiple databases from inception through July 2023. Working in duplicate without restrictions by language or clinical context, we identified published instruments or single items measuring perceptions of time adequacy in clinical encounters. We characterized these by time domain (perceived duration or pace of the encounter), responder (patient or clinician), and reference (experience of care in general or of a particular encounter).

Results: Of the 96 instruments found, none focused exclusively on perception of time adequacy in clinical encounters. Nonetheless, these instruments contained 107 time-related items. Of these, 81 items (77 %) measured the perception of the encounter duration, assessing whether there was adequate consultation time overall or for specific tasks (e.g., listening to the patient, exploring psychosocial issues, formulating the care plan). Another 19 (18 %) assessed encounter pace, and 7 (7 %) assessed both duration and pace. Pace items captured actions perceived as rushed or hurried or the perception that patients and clinicians felt pressed for time or rushed. Patients were the respondents for 76 (71 %) and clinicians for 24 (22 %) items. Most patient-reported items (48 of 76) referred to the patient's general care experience.

Conclusion: There are existing items to capture patient and clinician perceptions of the duration and/or pace of clinical encounters. Further work should ascertain their ability to identify hurried consultations and to detect the effect of interventions to foster unhurried encounters.

Practice implications: The available items assessing patient and clinician perceptions of duration and pace can illuminate the experience of time adequacy in clinical encounters as a target for quality improvement interventions. These items may capture unintended consequences on perceived time for care of interventions to improve healthcare access and efficiency.

Background: Individuals with BRCA1/2 mutations have a notably higher than average lifetime risk of developing cancer as adults. Some parents with BRCA1/2 mutations wish to share this information with their children, yet they struggle to know how, when, and what information to share.

Objective: The objective of this review was to identify what communication strategies/interventions exist for parents communicating their BRCA1/2 status to their minor children, and what communication interventions do healthcare professionals use to support parents' disclosure process.

Methods: Scoping review on six databases search for studies with parents and/or healthcare professionals' interventions on supporting communication from parents to children. The review aligned PRISMA guidelines for scoping reviews and used the PAGER recommendations to guide charting and reporting.

Results: 22 articles published from 2001 to 2020 were included. Multiple facilitators/motivators of disclosure, how and where parents disclosed, reactions to disclosure were identified. Also, there were no healthcare professionals' interventions in the disclosure process found.

Conclusions: The review summarizes research on parents' disclosure of their BRCA1/2 status to their underage children and demonstrates a paucity of communication interventions for guiding parents in this difficult process. Parents experience many obstacles communicating the results to their children.

Practice implications: These findings equip healthcare professionals in their efforts to develop and test interventions which support the communication of genetic risk information. Furthermore, it is evident there is a need for more research to understand how the disclosure process occurs in the families.

Objective: College students are considered as a high-risk age group for contracting HPV. HPV vaccines are proved to play a major role in preventing Cervical cancer and related cancers among both men and women. This study aimed to explore influencing factors in intention making-decision of Human papillomavirus vaccine in Chinese college students.

Methods: A descriptive qualitative research based on naturalistic inquiry in Daqing City, Heilong Jiang Province from October to November 2022 was conducted. Semi-structured interviews with Chinese college students. We used thematic framework analysis with NVivo 12.0 software to transcribe and analyze the interview recordings.

Results: We conducted 20 in-depth interviews. Four main themes with 14 subthemes were identified: (a) potential risks of HPV infection; (b) susceptibility factors of HPV infection; (c) difficulties in HPV vaccination; (d) decision support for HPV vaccination.

Conclusion: Most college students expressed hesitancy toward receiving the HPV vaccine. The government should strengthen the advocacy of the benefits of the vaccine to increase the HPV vaccination rate.

Practice implications: Healthcare providers and the government should take some strategies to promote facilitate factors to increase HPV vaccination rates.

Adolescents and young adults (AYAs) with cancer face unique challenges that can disrupt their identity development and psychological well-being. This letter emphasizes the need for enhanced research and policy reforms to integrate psychosocial support into AYA oncology care. It advocates for targeted communication skills training for healthcare professionals to foster person-centered interactions that address both the physical and emotional needs of AYA patients. Additionally, it explores the role of digital health technologies, such as telemedicine and mobile applications, in bridging care gaps, particularly in underserved or remote areas. By advancing these strategies,we can promote a more holistic and equitable approach to AYA cancer care globally.

Objective: To assess the impact of wearing a continuous glucose monitoring (CGM) device on student pharmacist counseling ability (primary), knowledge, confidence, and empathy (secondary).

Methods: Students from two institutions were randomized to wear a CGM device (intervention) vs not (control). All received CGM education via lecture and live demonstration. Intervention group students were provided a CGM device. After two weeks, all students completed a standardized patient (SP) encounter regarding CGM prescription counseling. Pre-post CGM-related knowledge, confidence, and empathy were assessed. Analysis of variance was used to compare between-group counseling score difference, and analysis of covariance was used to compare changes in pre-post knowledge, confidence, and empathy scores. Analyses were performed using Stata/BE17.0.

Results: Of 86 students enrolled, 63 consented and completed surveys (32 intervention, 31 control). The intervention group demonstrated higher average SP counseling score vs control (82.4 % vs 77.7 %, p = .046). The intervention group had greater change in confidence vs control from pre to post survey (+ 2.3 vs + 1.7, p = 0.03, range 1-5). No between-group differences were observed in knowledge or empathy.

Conclusion: The opportunity to wear a CGM device resulted in higher performance on CGM counseling and greater rise in CGM-related confidence. This study supports the use of resources to provide hands-on CGM training.

Practice implications: Hands-on education about new diabetes technology can help students prepare to care for and counsel patients.

Background: Social Media-based Health Education (SMHE) provides an effective way to address health disparities and improve public health literacy. Despite its inherent advantages, Healthcare Workers (HCWs) in China have showed limited and transient interest in engaging with SMHE initiatives.

Objective: This study aims to examine healthcare workers' perceptions of SMHE, identifying current influencing factors, challenges, and proposing future directions for development.

Methods: A descriptive qualitative study was conducted from October 2021 to January 2022, involving healthcare workers (i.e., physicians, nurses, and hospital administrators) engaged in SMHE. Semi-structured in-depth interviews were undertaken with 30 HCWs, which were subsequently analyzed thematically.

Results: Thematic analysis yielded 165 initial codes, organized into 12 subcategories spanning three main themes: (1) HCWs' perceptions of SMHE, (2) drivers and barriers to HCWs' engagement with SMHE, and (3) strategies to overcome current challenges.

Conclusion: This study yielded three main conclusions. First, HCWs in China exhibit a noticeable optimism toward SMHE, but most of them still have certain concerns. Second, HCWs engagement with SMHE is motivated or requested by their organizations, rather than their own initiatives. The main barriers for HCWs engagement with SMHE include: lack of time, risk of reputational loss, conflicts of interest, patient welfare, and concerns about legal issues. Third, healthcare organizations, social media platforms, and governmental bodies, must collaboratively address these issues to ensure protection for health workers engaged with SMHE.

Practical value: This study finds that Chinese HCWs are willing to engage in SMHE provided they are moderately rewarded and assured of a secure environment.

Objectives: Care for people living with dementia predominantly takes place at home and is often characterized by multiple hospitalizations throughout the lengthy disease trajectory. Care transitions from the hospital often involve home health care. The purpose of this study was to explore communication challenges experienced by home health nurses to inform communication training needs for home-based dementia care.

Methods: Seven audio-recorded focus group discussions were held with home health nurses (n = 31) from a large home care agency serving rural and urban counties. Focus group transcripts were thematically analyzed.

Results: We identified the following themes highlighting communication challenges for home health nurses: addressing potential risk for harm or injury, patient vulnerability, care partner needs, shifting decision-making to surrogate, and discrepancy in home health goals and family needs. These themes identified specific care transition conversation topics and communication content imperative for dementia-specific staff training.

Conclusions: Topics for communication skills training to improve person-centered dementia care were identified. These findings inform the future development of a home health staff communication curriculum for dementia care. Advanced communication skills are necessary to ensure these conversations take place and are engaged with sensitivity.

Practice implications: Our study informs the development of communication training on key communication topics in nurse-delivered and home healthcare interventions aimed at improving dementia care.

Objectives: To identify the components of therapeutic empathy based on a review of existing definitions.

Methods: A search for therapeutic empathy definitions was conducted in two stages. First, a list of empathy definitions from within healthcare contexts was compiled using existing systematic reviews and a database of empathy definitions. The components of those definitions were identified through thematic analysis. Then, forward and backward citation searching (snowballing) of the papers from which those definitions were retrieved was conducted. These papers were randomly sampled and integrated into the analysis until saturation was reached.

Results: The searches yielded 3948 definitions of therapeutic empathy. Saturation was reached after analysing 39 individual definitions. Six interrelated components of therapeutic empathy were identified: exploring, understanding, shared understanding, feeling, therapeutic action, and maintaining boundaries.

Conclusions: This study identified six prevailing components of therapeutic empathy that distinguish it from empathy in general. The findings provide a conceptual starting point that can help the field better focus its understanding and use of activities that relate to empathy in practice.

Practice implications: Future practice, research, and education can use the components generated in this study to more consistently define therapeutic empathy, thereby offering potential to improve patient and practitioner outcomes.