Patient Education and Counseling最新文献_第2页

Coping with checkpoint inhibitor adverse events: Assisting cancer patients in skills development - insights from the Immuno’Act© pre-experimental pilot study 应对检查点抑制剂不良事件：协助癌症患者的技能发展-来自Immuno 'Act的见解©预实验试点研究

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-10 DOI: 10.1016/j.pec.2026.109537

Sylvie STREEL , Delphine KIRKOVE , Rémi GAGNAYRE , Andrée RORIVE , Pierre FRERES , Christine GENNIGENS , Sabrina UCCELLO , Vanina EVRARD , Véronica GRECO , Irène CAMPOS CORRAL , Laurence SEIDEL , Anne SIBILLE , Astrid PAULUS , Benoit PETRE , Guy JERUSALEM

Objectives

Immune checkpoint inhibitors (ICIs) can lead to immune-related adverse events (irAEs), which can be severe if not promptly identified and managed. The therapeutic education tool Immuno’Act© has been created to teach cancer patients how to handle irAEs. This study aimed to assess: (1) the preliminary effects of the therapeutic patient education (TPE) session using Immuno’Act© on perceived self-efficacy (PSE), (2) the association between PSE and patients’ decision-making to cope with health events, and (3) patients’ acceptance of the tool.

Methods

This pre-experimental study included cancer patients treated with ICIs at the CHU of Liège, recruited by convenience. PSE was measured using an adapted self-administered questionnaire at least three weeks before the TPE session (T0), immediately afterwards (T1) and at least three weeks after T1 (T2). Decision-making was evaluated through patients’ action choices in real-life scenarios presented in Immuno’Act©. Acceptance was assessed with brief scales covering perceived utility, ease of use, aesthetic aspects and overall judgment. Sociodemographic and clinical data were collected. Adjusted general linear mixed model evaluated PSE over time; adjusted linear and logistic regression models assessed associations with PSE changes and decision-making. Descriptive statistics summarised acceptance.

Results

Eighty patients participated. The PSE total score remained high throughout the study, with no effect from a single use of Immuno’Act© (p = 0.91). Up to 25 % of patients never chose the recommended action in coping with urgent and non-urgent irAEs. No association was observed between global PSE level and decision-making. Acceptance was rated positively by over 95 % of participants, with an overall judgment of 8.61 ± 0.96/10.

Conclusion

The positive acceptance of Immuno’Act©, combined with concerning findings, underscores the need to integrate such tools into clinical practice to support patients in managing irAEs.

Practice implications

Healthcare professionals should integrate tools like Immuno’Act© in routine care, with optimal implementation strategy to be determined.

免疫检查点抑制剂（ICIs）可导致免疫相关不良事件（irAEs），如果不及时识别和管理，可能会很严重。治疗教育工具Immuno 'Act©的创建是为了教癌症患者如何处理irae。本研究旨在评估：(1)使用Immuno ' act©的治疗性患者教育（TPE）课程对感知自我效能感（PSE）的初步影响，(2)PSE与患者应对健康事件的决策之间的关系，以及(3)患者对该工具的接受程度。方法本实验前研究纳入我院接受ICIs治疗的癌症患者。PSE在TPE治疗前至少三周（T0）、治疗后立即（T1）和治疗后至少三周（T2）使用适应性自我管理问卷进行测量。通过患者在Immuno ' act©中展示的现实场景中的行动选择来评估决策。接受度是用简短的量表来评估的，包括感知效用、易用性、美学方面和整体判断。收集社会人口学和临床数据。调整后的一般线性混合模型评估PSE随时间的变化；调整后的线性和逻辑回归模型评估PSE变化与决策的关系。描述性统计总结了接受情况。结果80例患者参与。PSE总分在整个研究过程中保持较高，单次使用Immuno 'Act©没有影响（p = 0.91）。高达25% %的患者在处理紧急和非紧急irae时从未选择建议的行动。总体PSE水平与决策之间没有关联。超过95% %的参与者评价接受度为积极，总体评价为8.61 ± 0.96/10。结论对Immuno 'Act©的积极接受，结合相关研究结果，强调需要将这些工具整合到临床实践中，以支持患者管理irae。实践意义卫生保健专业人员应在日常护理中整合免疫法案©等工具，并确定最佳实施策略。

{"title":"Coping with checkpoint inhibitor adverse events: Assisting cancer patients in skills development - insights from the Immuno’Act© pre-experimental pilot study","authors":"Sylvie STREEL , Delphine KIRKOVE , Rémi GAGNAYRE , Andrée RORIVE , Pierre FRERES , Christine GENNIGENS , Sabrina UCCELLO , Vanina EVRARD , Véronica GRECO , Irène CAMPOS CORRAL , Laurence SEIDEL , Anne SIBILLE , Astrid PAULUS , Benoit PETRE , Guy JERUSALEM","doi":"10.1016/j.pec.2026.109537","DOIUrl":"10.1016/j.pec.2026.109537","url":null,"abstract":"<div><h3>Objectives</h3><div>Immune checkpoint inhibitors (ICIs) can lead to immune-related adverse events (irAEs), which can be severe if not promptly identified and managed. The therapeutic education tool Immuno’Act© has been created to teach cancer patients how to handle irAEs. This study aimed to assess: (1) the preliminary effects of the therapeutic patient education (TPE) session using Immuno’Act© on perceived self-efficacy (PSE), (2) the association between PSE and patients’ decision-making to cope with health events, and (3) patients’ acceptance of the tool.</div></div><div><h3>Methods</h3><div>This pre-experimental study included cancer patients treated with ICIs at the CHU of Liège, recruited by convenience. PSE was measured using an adapted self-administered questionnaire at least three weeks before the TPE session (T0), immediately afterwards (T1) and at least three weeks after T1 (T2). Decision-making was evaluated through patients’ action choices in real-life scenarios presented in Immuno’Act©. Acceptance was assessed with brief scales covering perceived utility, ease of use, aesthetic aspects and overall judgment. Sociodemographic and clinical data were collected. Adjusted general linear mixed model evaluated PSE over time; adjusted linear and logistic regression models assessed associations with PSE changes and decision-making. Descriptive statistics summarised acceptance.</div></div><div><h3>Results</h3><div>Eighty patients participated. The PSE total score remained high throughout the study, with no effect from a single use of Immuno’Act© (p = 0.91). Up to 25 % of patients never chose the recommended action in coping with urgent and non-urgent irAEs. No association was observed between global PSE level and decision-making. Acceptance was rated positively by over 95 % of participants, with an overall judgment of 8.61 ± 0.96/10.</div></div><div><h3>Conclusion</h3><div>The positive acceptance of Immuno’Act©, combined with concerning findings, underscores the need to integrate such tools into clinical practice to support patients in managing irAEs.</div></div><div><h3>Practice implications</h3><div>Healthcare professionals should integrate tools like Immuno’Act© in routine care, with optimal implementation strategy to be determined.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109537"},"PeriodicalIF":3.1,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Shared decision making with ethnic minorities in oncology: An interview study. 肿瘤学中少数民族共同决策：一项访谈研究。

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-10 DOI: 10.1016/j.pec.2026.109539

Roukayya Oueslati, Asiye Gedik, Ria Reis, Yvonne van Zaalen, Joke C Korevaar, Meralda T Slager, Barbara C Schouten, Anne M Stiggelbout, Dorothea P Touwen

Objective: This study aims to 1) explore experiences of ethnic minority patients and their relatives regarding shared decision making (SDM) in oncological hospital care, alongside healthcare professionals' (HCPs) experiences of engaging in SDM with ethnic minority patients; 2) identify opportunities to improve SDM for ethnic minorities in oncology, if needed, by linking the findings to a previously developed value structure.

Methods: For this purpose, we interviewed ethnic minority patients (n = 22), relatives (n = 11), and HCPs (n = 14). Using reflexive thematic analysis, we applied Schwartz's value theory, adapted to the context of SDM, to code and analyze the interviews.

Results: From the data, we developed three themes: 1) Factors that empower(ed) and disempower(ed) patients in SDM. Knowledge, skills, and competences of both HCP and patient [i.e. Achievement], support [i.e. Benevolence], and a good HCP-patient relationship [i.e. Security] empower patients. A lack of these three disempowers them; 2) Individualizing treatment decisions. Participants individualized treatment decisions through deliberation, negotiation, and choosing; 3) HCPs' limited insight into patients' context. HCPs experienced this due to a lack of cultural competences and perceived cultural differences.

Conclusion: SDM for ethnic minorities can be enhanced by strengthening HCPs' cultural competencies, increasing the availability of culturally and linguistically tailored information and support, and fostering ongoing relationship-building efforts. These strategies empower patients, enhance HCPs' insight into ethnic minority patients' context, and contribute to more individualized treatment decisions.

Practice implications: We recommend educational programs to increase HCPs' cultural sensitivity in SDM, developing campaigns to focus more on the needs of ethnic minority populations, and incorporating culturally and linguistically tailored support within hospital systems. Importantly, efforts should avoid overemphasizing cultural differences, as many empowering and disempowering factors also apply to the general population, but should be responsive to cultural aspects where relevant.

目的：本研究旨在探讨少数民族患者及其家属在肿瘤医院护理中共同决策（SDM）的经验，以及医护人员（HCPs）参与少数民族患者共同决策（SDM）的经验；2)如果需要，通过将研究结果与先前开发的价值结构联系起来，确定改善肿瘤学中少数民族SDM的机会。方法：为此，我们采访了少数民族患者（n = 22）、亲属（n = 11）和HCPs （n = 14）。通过反身性主题分析，我们将Schwartz的价值理论应用到SDM的语境中，对访谈进行编码和分析。结果：从数据中，我们发展了三个主题：1)在SDM中赋予（ed）和剥夺（ed）患者的因素。医患双方的知识、技能和能力（即成就）、支持（即仁爱）和良好的医患关系（即安全）赋予患者权力。缺乏这三者会削弱他们的权力；2)个性化治疗决策。参与者通过商议、协商和选择做出个性化的治疗决定；3) HCPs对患者情况的了解有限。由于缺乏文化能力和感知到的文化差异，医护人员经历了这种情况。结论：少数民族可持续发展管理可以通过加强医务人员的文化能力，增加文化和语言定制信息和支持的可用性，以及促进持续的关系建立努力来加强。这些策略增强了患者的权能，增强了HCPs对少数民族患者情况的洞察力，并有助于做出更个性化的治疗决策。实践意义：我们建议开展教育项目，以提高HCPs在SDM中的文化敏感性，开展活动，更多地关注少数民族人群的需求，并在医院系统中纳入文化和语言定制的支持。重要的是，努力应避免过分强调文化差异，因为许多赋予权力和剥夺权力的因素也适用于一般人口，但应在有关情况下对文化方面作出反应。

{"title":"Shared decision making with ethnic minorities in oncology: An interview study.","authors":"Roukayya Oueslati, Asiye Gedik, Ria Reis, Yvonne van Zaalen, Joke C Korevaar, Meralda T Slager, Barbara C Schouten, Anne M Stiggelbout, Dorothea P Touwen","doi":"10.1016/j.pec.2026.109539","DOIUrl":"https://doi.org/10.1016/j.pec.2026.109539","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to 1) explore experiences of ethnic minority patients and their relatives regarding shared decision making (SDM) in oncological hospital care, alongside healthcare professionals' (HCPs) experiences of engaging in SDM with ethnic minority patients; 2) identify opportunities to improve SDM for ethnic minorities in oncology, if needed, by linking the findings to a previously developed value structure.</p><p><strong>Methods: </strong>For this purpose, we interviewed ethnic minority patients (n = 22), relatives (n = 11), and HCPs (n = 14). Using reflexive thematic analysis, we applied Schwartz's value theory, adapted to the context of SDM, to code and analyze the interviews.</p><p><strong>Results: </strong>From the data, we developed three themes: 1) Factors that empower(ed) and disempower(ed) patients in SDM. Knowledge, skills, and competences of both HCP and patient [i.e. Achievement], support [i.e. Benevolence], and a good HCP-patient relationship [i.e. Security] empower patients. A lack of these three disempowers them; 2) Individualizing treatment decisions. Participants individualized treatment decisions through deliberation, negotiation, and choosing; 3) HCPs' limited insight into patients' context. HCPs experienced this due to a lack of cultural competences and perceived cultural differences.</p><p><strong>Conclusion: </strong>SDM for ethnic minorities can be enhanced by strengthening HCPs' cultural competencies, increasing the availability of culturally and linguistically tailored information and support, and fostering ongoing relationship-building efforts. These strategies empower patients, enhance HCPs' insight into ethnic minority patients' context, and contribute to more individualized treatment decisions.</p><p><strong>Practice implications: </strong>We recommend educational programs to increase HCPs' cultural sensitivity in SDM, developing campaigns to focus more on the needs of ethnic minority populations, and incorporating culturally and linguistically tailored support within hospital systems. Importantly, efforts should avoid overemphasizing cultural differences, as many empowering and disempowering factors also apply to the general population, but should be responsive to cultural aspects where relevant.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"109539"},"PeriodicalIF":3.1,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pål Gulbrandsen: Researcher, educator, activist and team-builder And a man of solid wood 帕尔帕尔·古尔布兰森：研究员、教育家、活动家和团队建设者，也是一个脚踏实地的人

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-09 DOI: 10.1016/j.pec.2026.109522

Arnstein Finset

引用次数: 0

Genetic cancer risk knowledge among Mexican pathogenic variant carriers 墨西哥致病变异携带者的遗传癌症风险知识

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-09 DOI: 10.1016/j.pec.2026.109536

Alejandro Aranda-Gutierrez , Cynthia Villarreal-Garza , Dione Aguilar-y-Mendez , Salvador Gonzalez-Santiesteban , José Luis Rodríguez-Olivares , Fernanda Mesa-Chavez , Andrea Becerril-Gaitan , Bryan F. Vaca-Cartagena , Alex Lagunas-Medina , Laura Kay Lagarde-Santillán , Andrés Rodríguez-Faure , Daniela Obregon-Leal , Araceli Carrillo-Bedoya , Gregorio Quintero-Beuló , Maria Fernanda Ochoa-Chavez , Melina Miaja , Jeffrey N. Weitzel , Yanin Chavarri-Guerra

Objective

To assess knowledge of genetic cancer risk among Mexican carriers of cancer-associated pathogenic variants (PVs) using the Spanish version of the KnowGene Cancer Genetics Questionnaire, and to examine whether knowledge is associated with uptake of risk-reducing surgery (RRS) or cascade testing (CT).

Methods

We conducted a cross-sectional study of adult PV carriers who had received post-test genetic cancer risk assessment (GCRA) at two referral centers in Mexico. Participants completed the 16-item KnowGene Cancer Genetics Questionnaire assessing inheritance, result interpretation, clinical implications, and screening/risk reduction. Sociodemographic and clinical data were collected. Associations between knowledge scores and participant characteristics were evaluated using univariate analyses and multivariable linear regression. Associations between knowledge and uptake of RRS and CT were explored descriptively.

Results

Among 384 eligible carriers, 261 (68.0 %) completed the questionnaire. Median age was 44 years (range 20–77); 87.0 % were female, and 63.2 % were probands. The most frequent PVs were BRCA1 (36.8 %) and BRCA2 (25.7 %). The mean knowledge score was 9.42 out of 16 (SD 3.0), with item-level gaps most pronounced in inheritance and interpretation of variants of uncertain significance. Higher educational attainment was independently associated with higher knowledge scores in multivariable analysis (β = 1.92, p < 0.001). Knowledge scores were not significantly associated with uptake of RRS or CT.

Conclusion

Mexican carriers of cancer-associated PVs demonstrated moderate genetic knowledge after GCRA, with persistent gaps in clinically relevant concepts. Educational attainment was the primary determinant of knowledge, but greater knowledge alone did not translate into higher uptake of preventive interventions.

Practice implications

GCRA programs should incorporate tailored, patient-centered communication strategies and address structural and psychosocial barriers to improve informed decision-making and engagement with recommended preventive actions.

目的利用西班牙语版的KnowGene癌症遗传学问卷，评估墨西哥癌症相关致病变异（PVs）携带者对遗传癌症风险的了解程度，并研究这些知识是否与接受降低风险手术（RRS）或级联检测（CT）有关。方法：我们对墨西哥两家转诊中心接受检测后遗传癌症风险评估（GCRA）的成年PV携带者进行了横断面研究。参与者完成了16项KnowGene癌症遗传学问卷，评估遗传、结果解释、临床意义和筛查/风险降低。收集社会人口学和临床数据。使用单变量分析和多变量线性回归评估知识得分与参与者特征之间的关系。描述性地探讨了知识与RRS和CT摄取之间的关系。结果384例符合条件的携带者中，完成问卷调查的261例（68.0 %）。中位年龄44岁（范围20-77岁）；87.0 %为女性，63.2 %为先证者。最常见的pv是BRCA1（36.8 %）和BRCA2（25.7 %）。平均知识得分为9.42分（SD 3.0），项目水平差距在遗传和解释不确定意义的变异方面最为明显。在多变量分析中，较高的教育程度与较高的知识得分独立相关（β = 1.92, p <； 0.001）。知识得分与RRS或CT的摄取无显著相关。结论墨西哥癌症相关pv携带者在GCRA后表现出中等程度的遗传知识，但在临床相关概念上存在持续差距。受教育程度是知识的主要决定因素，但知识的提高本身并不能转化为预防性干预措施的提高。实践意义：cra项目应结合量身定制的、以患者为中心的沟通策略，解决结构和社会心理障碍，以改善知情决策和参与推荐的预防措施。

{"title":"Genetic cancer risk knowledge among Mexican pathogenic variant carriers","authors":"Alejandro Aranda-Gutierrez , Cynthia Villarreal-Garza , Dione Aguilar-y-Mendez , Salvador Gonzalez-Santiesteban , José Luis Rodríguez-Olivares , Fernanda Mesa-Chavez , Andrea Becerril-Gaitan , Bryan F. Vaca-Cartagena , Alex Lagunas-Medina , Laura Kay Lagarde-Santillán , Andrés Rodríguez-Faure , Daniela Obregon-Leal , Araceli Carrillo-Bedoya , Gregorio Quintero-Beuló , Maria Fernanda Ochoa-Chavez , Melina Miaja , Jeffrey N. Weitzel , Yanin Chavarri-Guerra","doi":"10.1016/j.pec.2026.109536","DOIUrl":"10.1016/j.pec.2026.109536","url":null,"abstract":"<div><h3>Objective</h3><div>To assess knowledge of genetic cancer risk among Mexican carriers of cancer-associated pathogenic variants (PVs) using the Spanish version of the KnowGene Cancer Genetics Questionnaire, and to examine whether knowledge is associated with uptake of risk-reducing surgery (RRS) or cascade testing (CT).</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study of adult PV carriers who had received post-test genetic cancer risk assessment (GCRA) at two referral centers in Mexico. Participants completed the 16-item KnowGene Cancer Genetics Questionnaire assessing inheritance, result interpretation, clinical implications, and screening/risk reduction. Sociodemographic and clinical data were collected. Associations between knowledge scores and participant characteristics were evaluated using univariate analyses and multivariable linear regression. Associations between knowledge and uptake of RRS and CT were explored descriptively.</div></div><div><h3>Results</h3><div>Among 384 eligible carriers, 261 (68.0 %) completed the questionnaire. Median age was 44 years (range 20–77); 87.0 % were female, and 63.2 % were probands. The most frequent PVs were <em>BRCA1</em> (36.8 %) and <em>BRCA2</em> (25.7 %). The mean knowledge score was 9.42 out of 16 (SD 3.0), with item-level gaps most pronounced in inheritance and interpretation of variants of uncertain significance. Higher educational attainment was independently associated with higher knowledge scores in multivariable analysis (β = 1.92, p < 0.001). Knowledge scores were not significantly associated with uptake of RRS or CT.</div></div><div><h3>Conclusion</h3><div>Mexican carriers of cancer-associated PVs demonstrated moderate genetic knowledge after GCRA, with persistent gaps in clinically relevant concepts. Educational attainment was the primary determinant of knowledge, but greater knowledge alone did not translate into higher uptake of preventive interventions.</div></div><div><h3>Practice implications</h3><div>GCRA programs should incorporate tailored, patient-centered communication strategies and address structural and psychosocial barriers to improve informed decision-making and engagement with recommended preventive actions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109536"},"PeriodicalIF":3.1,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perspectives of patients with endometrial cancer on use of a personalized risk model for lymph node metastases in counselling. 子宫内膜癌患者在咨询中使用淋巴结转移的个性化风险模型的观点。

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-09 DOI: 10.1016/j.pec.2026.109535

Marike S Lombaers, Stephanie W Vrede, Anna Groeneveld, Nelleke Ottevanger, Dorry Boll, Nicole P M Ezendam, Johanna M A Pijnenborg, Rosella P M G Hermens

Objectives: A Bayesian network, ENDORISK, estimates a personalized risk of lymph node metastases (LNM) in patients with endometrial cancer (EC). A qualitative study was conducted to assess the perspectives of patients with EC on the use of ENDORISK in preoperative counselling.

Methods: Content analysis of transcribed semi-structured interviews with 19 patients treated for EC, purposively sampled between 2020 and 2023 from two regional oncology networks in the Netherlands RESULTS: Patients appreciated the potential use of ENDORISK in preoperative counselling to provide information on factors influencing their disease, risk of LNM, and treatment. Use of the model could increase their involvement in decision making on treatment. Emphasizing on the personalized nature of the risk estimation and the potential role of ENDORISK in the decision-making process on treatment could improve explanation of the model.

Conclusions: Using ENDORISK in preoperative counselling could potentially increase patient involvement in shared decision making for EC care. A simple explanation of this model is needed and the professional opinion of clinicians remains important in the treatment process.

Practice implications: In the development and implementation of clinical risk models it is important to include the perspective of the envisioned patient population to ensure clinical relevancy and explainability. This study provides an explorative groundwork for further investigations in the development and implementation of personalized risk estimation models such as ENDORISK.

目的：一个贝叶斯网络，ENDORISK，估计子宫内膜癌（EC）患者淋巴结转移（LNM）的个性化风险。进行了一项定性研究，以评估EC患者在术前咨询中使用ENDORISK的观点。方法：对19名接受EC治疗的患者进行转录半结构化访谈的内容分析，目的是在2020年至2023年期间从荷兰的两个区域肿瘤网络中取样。结果：患者欣赏在术前咨询中使用ENDORISK的潜在用途，以提供影响其疾病、LNM风险和治疗的因素的信息。使用该模型可以增加他们对治疗决策的参与。强调风险估计的个性化性质和ENDORISK在治疗决策过程中的潜在作用可以改善对模型的解释。结论：在术前咨询中使用ENDORISK可以潜在地增加患者参与EC护理的共同决策。这个模型需要一个简单的解释，临床医生的专业意见在治疗过程中仍然很重要。实践意义：在临床风险模型的开发和实施中，重要的是要包括预期患者群体的观点，以确保临床相关性和可解释性。本研究为进一步研究个性化风险评估模型（如ENDORISK）的开发和实施提供了探索性基础。

{"title":"Perspectives of patients with endometrial cancer on use of a personalized risk model for lymph node metastases in counselling.","authors":"Marike S Lombaers, Stephanie W Vrede, Anna Groeneveld, Nelleke Ottevanger, Dorry Boll, Nicole P M Ezendam, Johanna M A Pijnenborg, Rosella P M G Hermens","doi":"10.1016/j.pec.2026.109535","DOIUrl":"https://doi.org/10.1016/j.pec.2026.109535","url":null,"abstract":"<p><strong>Objectives: </strong>A Bayesian network, ENDORISK, estimates a personalized risk of lymph node metastases (LNM) in patients with endometrial cancer (EC). A qualitative study was conducted to assess the perspectives of patients with EC on the use of ENDORISK in preoperative counselling.</p><p><strong>Methods: </strong>Content analysis of transcribed semi-structured interviews with 19 patients treated for EC, purposively sampled between 2020 and 2023 from two regional oncology networks in the Netherlands RESULTS: Patients appreciated the potential use of ENDORISK in preoperative counselling to provide information on factors influencing their disease, risk of LNM, and treatment. Use of the model could increase their involvement in decision making on treatment. Emphasizing on the personalized nature of the risk estimation and the potential role of ENDORISK in the decision-making process on treatment could improve explanation of the model.</p><p><strong>Conclusions: </strong>Using ENDORISK in preoperative counselling could potentially increase patient involvement in shared decision making for EC care. A simple explanation of this model is needed and the professional opinion of clinicians remains important in the treatment process.</p><p><strong>Practice implications: </strong>In the development and implementation of clinical risk models it is important to include the perspective of the envisioned patient population to ensure clinical relevancy and explainability. This study provides an explorative groundwork for further investigations in the development and implementation of personalized risk estimation models such as ENDORISK.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"109535"},"PeriodicalIF":3.1,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Curious on curiosity – a qualitative study on curiosity in healthcare communication 好奇上的好奇——医疗保健传播中好奇心的定性研究

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-07 DOI: 10.1016/j.pec.2026.109513

Connie Timmermann , Christina Prinds , Terese Stenfors , Jette Ammentorp

Objective

Curiosity is increasingly recognized as a core element of person-centered healthcare communication, yet empirical evidence about how curiosity is recognized, valued, and constrained in clinical encounters remains limited. This study aimed to explore how curiosity manifests in healthcare communication and to identify its perceived value and barriers from the perspectives of patients, relatives, healthcare professionals, and communication experts.

Methods

A qualitative participatory design was used, comprising three sequential workshops: a World Café workshop with patients and relatives, a participatory theater workshop involving clinicians, patients, and researchers, and an international expert workshop with healthcare communication specialists. Data included written reflections, observational field notes, and video recordings. Analysis followed a reflective sense-making approach, integrating insights across workshop phases.

Results

Curiosity was identified as both a professional quality and a communicative skill, expressed through attentive listening, acknowledgment, openness, responsiveness, and the use of exploratory questions. Participants associated curiosity with enhanced trust, deeper dialogue, and more individualized care. Meaningful curiosity, perceived as relevant to patients’ lives and treatment decisions, was distinguished from curiosity experienced as intrusive. Barriers included time pressure, emotional stress, preconceived notions, cognitive overload, and clinician burnout.

Discussion

Curiosity emerged as both a professional quality and a communicative skill, expressed through attentive listening, acknowledgment, nonverbal presence, and explorative questioning. The findings highlight a reciprocal relationship between curiosity and trust, supporting deeper dialogue, patient empowerment, and partnership in care. Curiosity also creates reflective pauses that enhance understanding and meaning in clinical encounters.

Conclusion

Curiosity is a critical yet underdeveloped component of person-centered healthcare communication. Explicitly integrating curiosity into communication education and training may strengthen patient engagement, support shared decision-making, and enhance the quality of clinical encounters. Organizational efforts to address time pressure, workload, and clinician well-being are essential to fostering curiosity in everyday practice.

好奇心越来越被认为是以人为本的医疗保健沟通的核心要素，然而，关于在临床接触中如何识别、重视和约束好奇心的经验证据仍然有限。本研究旨在探讨好奇心如何在医疗保健沟通中表现出来，并从患者、亲属、医疗保健专业人员和沟通专家的角度确定其感知价值和障碍。方法采用定性参与性设计，包括三个连续的研讨会：一个由患者和家属组成的世界咖啡研讨会，一个由临床医生、患者和研究人员组成的参与性戏剧研讨会，以及一个由医疗保健沟通专家组成的国际专家研讨会。资料包括书面反思、实地观察笔记和录像。分析遵循了一种反思性的意义构建方法，集成了研讨会各个阶段的见解。结果好奇心被认为是一种专业素质和沟通技巧，通过认真倾听、承认、开放、回应和使用探索性问题来表达。参与者将好奇心与增强的信任、更深入的对话和更个性化的护理联系起来。有意义的好奇心，被认为与患者的生活和治疗决定相关，与被认为是侵入性的好奇心不同。障碍包括时间压力、情绪压力、先入为主的观念、认知超载和临床医生的倦怠。好奇心既是一种专业素质，也是一种沟通技巧，可以通过认真倾听、承认、非语言表现和探索性提问来表达。研究结果强调了好奇心和信任之间的相互关系，支持更深层次的对话、患者赋权和护理伙伴关系。好奇心也会产生反思性的停顿，在临床遭遇中增强理解和意义。结论好奇心是以人为本的医疗保健传播的重要组成部分。明确地将好奇心整合到沟通教育和培训中可以加强患者的参与，支持共同决策，并提高临床接触的质量。组织努力解决时间压力、工作量和临床医生的健康是在日常实践中培养好奇心的必要条件。

{"title":"Curious on curiosity – a qualitative study on curiosity in healthcare communication","authors":"Connie Timmermann , Christina Prinds , Terese Stenfors , Jette Ammentorp","doi":"10.1016/j.pec.2026.109513","DOIUrl":"10.1016/j.pec.2026.109513","url":null,"abstract":"<div><h3>Objective</h3><div>Curiosity is increasingly recognized as a core element of person-centered healthcare communication, yet empirical evidence about how curiosity is recognized, valued, and constrained in clinical encounters remains limited. This study aimed to explore how curiosity manifests in healthcare communication and to identify its perceived value and barriers from the perspectives of patients, relatives, healthcare professionals, and communication experts.</div></div><div><h3>Methods</h3><div>A qualitative participatory design was used, comprising three sequential workshops: a World Café workshop with patients and relatives, a participatory theater workshop involving clinicians, patients, and researchers, and an international expert workshop with healthcare communication specialists. Data included written reflections, observational field notes, and video recordings. Analysis followed a reflective sense-making approach, integrating insights across workshop phases.</div></div><div><h3>Results</h3><div>Curiosity was identified as both a professional quality and a communicative skill, expressed through attentive listening, acknowledgment, openness, responsiveness, and the use of exploratory questions. Participants associated curiosity with enhanced trust, deeper dialogue, and more individualized care. Meaningful curiosity, perceived as relevant to patients’ lives and treatment decisions, was distinguished from curiosity experienced as intrusive. Barriers included time pressure, emotional stress, preconceived notions, cognitive overload, and clinician burnout.</div></div><div><h3>Discussion</h3><div>Curiosity emerged as both a professional quality and a communicative skill, expressed through attentive listening, acknowledgment, nonverbal presence, and explorative questioning. The findings highlight a reciprocal relationship between curiosity and trust, supporting deeper dialogue, patient empowerment, and partnership in care. Curiosity also creates reflective pauses that enhance understanding and meaning in clinical encounters.</div></div><div><h3>Conclusion</h3><div>Curiosity is a critical yet underdeveloped component of person-centered healthcare communication. Explicitly integrating curiosity into communication education and training may strengthen patient engagement, support shared decision-making, and enhance the quality of clinical encounters. Organizational efforts to address time pressure, workload, and clinician well-being are essential to fostering curiosity in everyday practice.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109513"},"PeriodicalIF":3.1,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From talk to text: Extending the arc of doctor patient communication research to real-time visit documentation 从谈话到文字：将医患沟通研究的弧线扩展到实时访问记录

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-07 DOI: 10.1016/j.pec.2026.109519

Richard M. Frankel

Objective

The scientific study of doctor-patient communication got its start with a textbook published almost nine decades ago. Based on 16 years of conversations between psychiatry residents and patients, it featured audio recordings as a method for studying the subtleties of verbal interaction in the clinical context. Hundreds of studies based on audio and video technology have been published since. The purpose of this paper is threefold. First, I provide a brief history of a line of inquiry based on direct observation and coding of recorded encounters. Second, I describe the development of the Four Habits of Highly Effective Clinicians, one of several evidence-based frameworks for studying and teaching about the medical interview. Third, I describe the phenomenon of documenting in the electronic health record (EHR) while simultaneously providing care. Documenting while doctoring (DWD) is both a resource and a constraint on clinicians’ time and attention. Notwithstanding, its effects on processes and outcomes of care have not typically been accounted for in doctor patient communication frameworks. To that end I describe a mnemonic POISED, to facilitate EHR use in the exam room.

Discussion

In 2004 only 1 of 10 US physicians’ offices used an EHR; in 2023, it was 9 out of 10. Pressures to increase efficiency and billing have resulted in a migration of the EHR from the back room into the exam room. A gap currently exists in research on the effects of DWD on doctor patient communication and outcomes of care. Accumulating evidence suggests that DWD has resulted in increased distraction, inaccurate data recording, and in some cases poorer outcomes of care.

Highlights

Larger studies across multiple medical specialties and a range of patient populations will be necessary to better understand the costs and benefits of the intersection of talk, text, and technology in doctor-patient communication and relationships.

医患沟通的科学研究始于近90年前出版的一本教科书。基于精神科住院医生和病人之间16年的对话，它将录音作为一种研究临床环境中语言互动微妙之处的方法。此后，数百项基于音频和视频技术的研究已经发表。本文的目的有三个。首先，我提供了一个基于直接观察和记录相遇的编码的调查线的简史。其次，我描述了“高效临床医生的四个习惯”的发展，这是研究和教学医学访谈的几个基于证据的框架之一。第三，我描述了在提供护理的同时记录电子健康记录（EHR）的现象。边看病边记录（DWD）既是一种资源，也是对临床医生时间和注意力的限制。尽管如此，在医患沟通框架中，其对护理过程和结果的影响通常没有得到考虑。为此，我描述了一个助记器，以方便在检查室使用电子病历。2004年，美国只有十分之一的医生办公室使用电子病历；2023年，这一比例为9 / 10。提高效率和计费的压力导致电子病历从后台转移到检查室。目前关于DWD对医患沟通和护理结果影响的研究存在空白。越来越多的证据表明，DWD导致注意力分散增加，数据记录不准确，在某些情况下，护理结果较差。为了更好地理解谈话、文本和技术在医患沟通和关系中的成本和收益，有必要对多个医学专业和一系列患者群体进行更大规模的研究。

{"title":"From talk to text: Extending the arc of doctor patient communication research to real-time visit documentation","authors":"Richard M. Frankel","doi":"10.1016/j.pec.2026.109519","DOIUrl":"10.1016/j.pec.2026.109519","url":null,"abstract":"<div><h3>Objective</h3><div>The scientific study of doctor-patient communication got its start with a textbook published almost nine decades ago. Based on 16 years of conversations between psychiatry residents and patients, it featured audio recordings as a method for studying the subtleties of verbal interaction in the clinical context. Hundreds of studies based on audio and video technology have been published since. The purpose of this paper is threefold. First, I provide a brief history of a line of inquiry based on direct observation and coding of recorded encounters. Second, I describe the development of the Four Habits of Highly Effective Clinicians, one of several evidence-based frameworks for studying and teaching about the medical interview. Third, I describe the phenomenon of documenting in the electronic health record (EHR) while simultaneously providing care. Documenting while doctoring (DWD) is both a resource and a constraint on clinicians’ time and attention. Notwithstanding, its effects on processes and outcomes of care have not typically been accounted for in doctor patient communication frameworks. To that end I describe a mnemonic POISED, to facilitate EHR use in the exam room.</div></div><div><h3>Discussion</h3><div>In 2004 only 1 of 10 US physicians’ offices used an EHR; in 2023, it was 9 out of 10. Pressures to increase efficiency and billing have resulted in a migration of the EHR from the back room into the exam room. A gap currently exists in research on the effects of DWD on doctor patient communication and outcomes of care. Accumulating evidence suggests that DWD has resulted in increased distraction, inaccurate data recording, and in some cases poorer outcomes of care.</div></div><div><h3>Highlights</h3><div>Larger studies across multiple medical specialties and a range of patient populations will be necessary to better understand the costs and benefits of the intersection of talk, text, and technology in doctor-patient communication and relationships.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109519"},"PeriodicalIF":3.1,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Shame among medical learners: An uncertainty-focused conception 医学学习者的羞耻感：一个以不确定性为中心的概念。

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-05 DOI: 10.1016/j.pec.2026.109516

Paul K.J. Han , Margrethe Schaufel , Edvin Schei

Objective

To analyze the nature and etiology of shame, a common problem that diminishes the well-being of learners and clinicians in medical education and practice, and to explore the relationship between shame and medical uncertainty.

Discussion

We draw upon various theoretical insights on both shame and uncertainty, and argue that shame is ultimately a product of uncertainty and its transformation by medical learners. We argue that this transformation involves two key processes. The first is a personalization of uncertainty—i.e., a transformation of medical uncertainties focused on clinical care into personal uncertainties focused on one’s self-worth. The second is a resolution of personal uncertainty—i.e., a transformation of personal uncertainties about one’s self-worth into personal certainties about one’s lack of self-worth. These key processes linking medical uncertainty to shame suggest that shame might be prevented or mitigated by targeted interventions aimed at 1) depersonalizing medical uncertainties, 2) helping learners maintain their personal uncertainties, rather than resolving them in self-destructive ways, and 3) making uncertainty and its management a more central, explicit focus of medical training.

Conclusions

Medical uncertainty has a central, paradoxical relationship to shame among medical learners—representing both a source of the problem and a potential solution. Key processes that lead from uncertainty to shame represent potential targets for interventions to prevent and mitigate shame among medical learners, and fruitful directions for future research.

目的：分析羞耻感的性质和病因，探讨羞耻感与医学不确定性之间的关系。羞耻感是医学教育和实践中困扰学习者和临床医生幸福感的常见问题。讨论：我们借鉴了关于羞耻和不确定性的各种理论见解，并认为羞耻最终是医学学习者不确定性及其转化的产物。我们认为这种转变涉及两个关键过程。第一个是对不确定性的个性化。在美国，以临床护理为重点的医学不确定性转变为以自我价值为重点的个人不确定性。第二是解决个人的不确定性。即个人对自我价值的不确定转变为对缺乏自我价值的确定。这些将医疗不确定性与羞耻感联系起来的关键过程表明，羞耻感可以通过以下有针对性的干预措施来预防或减轻：1)将医疗不确定性去个人化；2)帮助学习者保持个人的不确定性，而不是以自我毁灭的方式解决这些不确定性；3)将不确定性及其管理作为医疗培训的一个更核心、更明确的重点。结论：医学上的不确定性与医学学习者的羞耻感有着核心的、矛盾的关系——既代表了问题的根源，也代表了潜在的解决方案。从不确定性到羞耻感的关键过程代表了预防和减轻医学学习者羞耻感的干预措施的潜在目标，也是未来研究的富有成效的方向。

{"title":"Shame among medical learners: An uncertainty-focused conception","authors":"Paul K.J. Han , Margrethe Schaufel , Edvin Schei","doi":"10.1016/j.pec.2026.109516","DOIUrl":"10.1016/j.pec.2026.109516","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the nature and etiology of shame, a common problem that diminishes the well-being of learners and clinicians in medical education and practice, and to explore the relationship between shame and medical uncertainty.</div></div><div><h3>Discussion</h3><div>We draw upon various theoretical insights on both shame and uncertainty, and argue that shame is ultimately a product of uncertainty and its transformation by medical learners. We argue that this transformation involves two key processes. The first is a personalization of uncertainty—i.e., a transformation of medical uncertainties focused on clinical care into personal uncertainties focused on one’s self-worth. The second is a resolution of personal uncertainty—i.e., a transformation of personal uncertainties about one’s self-worth into personal certainties about one’s lack of self-worth. These key processes linking medical uncertainty to shame suggest that shame might be prevented or mitigated by targeted interventions aimed at 1) depersonalizing medical uncertainties, 2) helping learners maintain their personal uncertainties, rather than resolving them in self-destructive ways, and 3) making uncertainty and its management a more central, explicit focus of medical training.</div></div><div><h3>Conclusions</h3><div>Medical uncertainty has a central, paradoxical relationship to shame among medical learners—representing both a source of the problem and a potential solution. Key processes that lead from uncertainty to shame represent potential targets for interventions to prevent and mitigate shame among medical learners, and fruitful directions for future research.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109516"},"PeriodicalIF":3.1,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Increasing contextualization of care rates through clinician prompting interventions 通过临床医生提示干预提高护理率的情境化

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-05 DOI: 10.1016/j.pec.2026.109518

Alan Schwartz , Saul J. Weiner

Objective

Contextualizing care results in better outcomes for patients. Several different prompts to clinicians to increase contextualization have been studied: audit & feedback (A&F), clinical decision support (CDS), or making recording of visits openly accessible to patients (OA). We measured the effects of prompting interventions on probing of contextual red flags and incorporation of contextual factors into care plans.

Methods

Individual participant data meta-analysis of data from three controlled studies of prompts. The first (A&F, 4160 visits to 667 physicians at 6 sites) employed reports to provider teams of missed and successful contextualization opportunities. The second (CDS, 450 visits to 39 physicians at 2 sites) employed a real-time CDS tool. The third (OA, 317 visits to 30 physicians at 2 sites) cued providers that visits were recorded and would be available to patients. In each, the audios were coded using the 4 C system to identify contextual red flags, clinician probes of red flags, contextual factors, and contextualization of care plans.

Results

Prompting interventions increased the odds of probing by 71 % (95 % CI 54 % - 79 %) on average, with the largest impact in the A&F study but the highest probing rate in the CDS study. Overall, they increased the odds of contextualizing care plans by 33 % (95 % CI 13 %-58 %), an effect partially mediated by probing of red flags, which increased the odds of contextualization by 337 % (95 % CI 287 % - 396 %). Contextual factors in the domains of Access to Care, Financial Situation, Emotional State, and Skills, Abilities, and Knowledge were most likely to be incorporated into plans and those in Competing Responsibilities least so.

Conclusion

Multiple strategies prompt clinicians to consider patient life context in care planning, with varying effectiveness according to the patient context.

Practical implications

Future efforts should consider combining prompting interventions and provide clinicians with additional domain-specific resources.

目的情境化护理可提高患者的预后。已经研究了几种不同的提示临床医生增加情境化：审计和反馈（A&；F），临床决策支持（CDS），或使访问记录对患者开放（OA）。我们测量了提示干预对探查情境危险信号和将情境因素纳入护理计划的影响。方法对三项提示性对照研究的个体参与者数据进行meta分析。第一项研究（在6个地点对667名医生进行了4160次访问）向医疗团队报告了错过和成功的情境化机会。第二组（CDS，在2个地点对39名医生进行450次访问）采用实时CDS工具。第三份（OA，在2个地点对30名医生进行了317次就诊）提示医疗服务提供者，就诊记录已被记录下来，并可供患者使用。在每个音频中，使用4 C系统对音频进行编码，以识别上下文危险信号、临床医生对危险信号的探测、上下文因素和护理计划的上下文化。结果提示干预平均使探查的几率增加71 %(95 % CI 54 % - 79 %)，在A&；F研究中影响最大，但在CDS研究中探查率最高。总体而言，他们将情境化护理计划的几率增加了33 %(95 % CI 13 %-58 %)，这一效应部分由探测危险信号介导，它将情境化的几率增加了337 %（95 % CI 287 % - 396 %）。在获得护理、财务状况、情绪状态、技能、能力和知识等领域的背景因素最有可能被纳入计划，而在竞争责任方面的因素则最少。结论多种策略促使临床医生在护理计划中考虑患者的生活环境，根据患者的生活环境不同，其效果也不同。实际意义未来的努力应考虑结合提示干预措施，并为临床医生提供额外的领域特定资源。

{"title":"Increasing contextualization of care rates through clinician prompting interventions","authors":"Alan Schwartz , Saul J. Weiner","doi":"10.1016/j.pec.2026.109518","DOIUrl":"10.1016/j.pec.2026.109518","url":null,"abstract":"<div><h3>Objective</h3><div>Contextualizing care results in better outcomes for patients. Several different prompts to clinicians to increase contextualization have been studied: audit & feedback (A&F), clinical decision support (CDS), or making recording of visits openly accessible to patients (OA). We measured the effects of prompting interventions on probing of contextual red flags and incorporation of contextual factors into care plans.</div></div><div><h3>Methods</h3><div>Individual participant data meta-analysis of data from three controlled studies of prompts. The first (A&F, 4160 visits to 667 physicians at 6 sites) employed reports to provider teams of missed and successful contextualization opportunities. The second (CDS, 450 visits to 39 physicians at 2 sites) employed a real-time CDS tool. The third (OA, 317 visits to 30 physicians at 2 sites) cued providers that visits were recorded and would be available to patients. In each, the audios were coded using the 4 C system to identify contextual red flags, clinician probes of red flags, contextual factors, and contextualization of care plans.</div></div><div><h3>Results</h3><div>Prompting interventions increased the odds of probing by 71 % (95 % CI 54 % - 79 %) on average, with the largest impact in the A&F study but the highest probing rate in the CDS study. Overall, they increased the odds of contextualizing care plans by 33 % (95 % CI 13 %-58 %), an effect partially mediated by probing of red flags, which increased the odds of contextualization by 337 % (95 % CI 287 % - 396 %). Contextual factors in the domains of Access to Care, Financial Situation, Emotional State, and Skills, Abilities, and Knowledge were most likely to be incorporated into plans and those in Competing Responsibilities least so.</div></div><div><h3>Conclusion</h3><div>Multiple strategies prompt clinicians to consider patient life context in care planning, with varying effectiveness according to the patient context.</div></div><div><h3>Practical implications</h3><div>Future efforts should consider combining prompting interventions and provide clinicians with additional domain-specific resources.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109518"},"PeriodicalIF":3.1,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The art and science of providing patients with helpful information. 为病人提供有用信息的艺术和科学。

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2026-02-05 DOI: 10.1016/j.pec.2026.109514

Ellen M A Smets, Wolf A Langewitz, Sandra van Dulmen

Objective: Access to accurate and appropriate information is crucial for patients' wellbeing and participation in decision-making. Patients' information needs are subject to change; this concerns the content as well as the amount, timing and mode of information delivery. Moreover, patients differ in their information processing capacity. Consequently, healthcare professionals should preferably tailor their information to individual patients' preexisting knowledge, cognitive abilities, as well as their emerging information needs. Based on own research and experience in medical teaching, this discussion paper aims to critically reflect on what we know about person-centered communication practices that promote such tailoring of information, i.e. providing patients with information that can help them to manage and understand their symptoms or disease.

Discussion: For various reasons, tailoring can be challenging. Recommendations are provided for healthcare professionals who wish to identify their patients' specific information needs as regards certain topics and the amount of detail they desire. Additionally, communication practices are discussed that promote patients' understanding and recall of information.

Conclusion: Providing patients with information that can help them requires curiosity, creativity and the skillful use of various communication practices.

目的：获得准确和适当的信息是至关重要的病人的福祉和参与决策。患者的信息需求可能会发生变化；这涉及到信息传递的内容、数量、时间和方式。此外，患者的信息处理能力也存在差异。因此，医疗保健专业人员最好根据个别患者先前存在的知识、认知能力以及他们新出现的信息需求来定制他们的信息。根据自己的研究和医学教学经验，本讨论文件旨在批判性地反思我们对促进信息定制的以人为本的沟通实践的了解，即向患者提供可以帮助他们管理和了解其症状或疾病的信息。讨论：由于各种原因，裁剪可能具有挑战性。建议提供给医疗保健专业人员，他们希望确定患者在某些主题方面的具体信息需求和他们希望的详细程度。此外，讨论了沟通实践，以促进患者的理解和回忆的信息。结论：向患者提供对其有帮助的信息需要好奇心、创造力和各种沟通方式的熟练运用。

{"title":"The art and science of providing patients with helpful information.","authors":"Ellen M A Smets, Wolf A Langewitz, Sandra van Dulmen","doi":"10.1016/j.pec.2026.109514","DOIUrl":"https://doi.org/10.1016/j.pec.2026.109514","url":null,"abstract":"<p><strong>Objective: </strong>Access to accurate and appropriate information is crucial for patients' wellbeing and participation in decision-making. Patients' information needs are subject to change; this concerns the content as well as the amount, timing and mode of information delivery. Moreover, patients differ in their information processing capacity. Consequently, healthcare professionals should preferably tailor their information to individual patients' preexisting knowledge, cognitive abilities, as well as their emerging information needs. Based on own research and experience in medical teaching, this discussion paper aims to critically reflect on what we know about person-centered communication practices that promote such tailoring of information, i.e. providing patients with information that can help them to manage and understand their symptoms or disease.</p><p><strong>Discussion: </strong>For various reasons, tailoring can be challenging. Recommendations are provided for healthcare professionals who wish to identify their patients' specific information needs as regards certain topics and the amount of detail they desire. Additionally, communication practices are discussed that promote patients' understanding and recall of information.</p><p><strong>Conclusion: </strong>Providing patients with information that can help them requires curiosity, creativity and the skillful use of various communication practices.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"109514"},"PeriodicalIF":3.1,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0