Patient Education and Counseling最新文献

Objective: This study evaluated the cultural feasibility and impact of a decision coaching workshop for nurses in Japan, using the Ottawa Decision Support Framework (ODSF).

Methods: A pre-post study was conducted to evaluate a four-hour workshop based on the ODSF, integrating lectures, instructional videos, and role-play. Outcomes assessed include participants' perceptions of SDM-related concepts, decision-making skills, and confidence. Confidence was measured using a self-report Likert scale. Quantitative data were analyzed using paired t-tests, and qualitative feedback was thematically summarized.

Results: A total of 54 nurses participated in the workshop. Before the workshop, only 57.4% reported understanding SDM concepts, and many described challenges such as conflicting patient-family preferences and limited patient decision-making capacity. After the workshop, the understanding of ODSF increased by 87.0% , the ability to use decision-support tools by 72.2% , and self-assessment of SDM skills by 50.0% . Confidence in SDM involvement improved from 2.25 to 3.37 and confidence in self-assessment of SDM skills from 2.04 to 3.04 (both p < .001). Participants valued role-play and video demonstrations as particularly effective in enhancing cultural relevance, especially in family-centered decision-making contexts.

Conclusion: The workshop significantly improved SDM confidence among nurses. This decision coaching training is culturally feasible and may support patient- and family-centered care in Japanese healthcare settings.

Practice implications: Decision coaching adapted to family-centered decision-making may strengthen SDM training in collectivist cultures and contribute to more patient- and family-centered care internationally.

Objectives: To examine gynecological cancer patients' preferred role in decision making, their experienced involvement, and their advice to patients and clinicians on preparing for and supporting SDM in clinical consultations.

Methods: Two validated questionnaires, the Control Preference Scale (CPS) and CollaboRATE, were used to assess patients' preferred roles in SDM and their perceived level of involvement in medical decisions. Two open-ended questions were included to gather descriptive advice from patients, intended for both patients and clinicians. The sample for this survey was drawn from participants in a Danish patient advocacy group.

Results: In total, 117 patients completed the CPS, with 90% (n = 105) indicating a preference for an active role and 10% (n = 12) indicating a preference for a collaborative role in decision making. Mean item scores for CollaboRATE (n = 114) were 6.6 (SD = 2.1) for explanation, 5.2 (SD = 2.6) for preference elicitation, and 5.5 (SD = 2.5) for integration, with 7.9% of the respondents giving a top score. The most repeated theme of advice to patients was to ask questions. Empathic communication, including active listening and the provision of clear, easy-to-understand information, was the most frequently emphasized advice to clinicians.

Conclusions: Patients with gynecological cancer express a strong desire for involvement in SDM; however, many report that their experienced level of participation falls short of their preferences. They recommend an active role by asking targeted questions, thoroughly understanding benefits and risks of options, and remaining persistent in expressing needs. Patients emphasized the importance of empathetic communication, active listening, and the provision of clear, easy-to-understand information by clinicians.

Practical implications: Our findings offer actionable recommendations to bridge the gap between patients' preferred role in SDM and their actual experiences across the care journey. By incorporating these recommendations, both patients and clinicians can adopt practical strategies to facilitate more personalized, patient-centered decisions aligned with individual preferences and needs.

Objective: Lower extremity arterial disease (LEAD) is a significant health concern, often leading to adverse outcomes. This study aimed to investigate the association between self-management ability and adverse outcomes in patients with LEAD who underwent endovascular revascularization (EVR).

Methods: A prospective longitudinal observational study was conducted across three hospitals. Patients were recruited from February 2021 to November 2023 and were followed-up for 1 year. A self-Management questionnaire for lower extremity arterial disease patients who underwent endovascular revascularization (LESQ) was used to assess patients' self-management abilities. The adverse outcomes were death, restenosis, and major adverse limb events (MALE).

Results: This study included 665 participants, with a mean age of 75.4 ± 9.5 years. The average postoperative follow-up duration was 12.9 ± 5.3 months. 31.7 %, 47.1 %, and 21.2 % exhibited low, moderate, and high self-management capabilities, respectively. During the follow-up period, 17.0 % of patients died, 19.5 % of patients underwent restenosis, and 16.4 % experienced MALE. Compared with the low self-management group, patients in the moderate or high self-management groups demonstrated lower risks of death and restenosis. For death, the hazard ratios (HRs) were 0.344 (95 % CI: 0.220-0.536) and 0.233 (95 % CI: 0.126-0.434) in the moderate and high self-management groups, respectively. Regarding restenosis, the subdistribution hazard ratios (sHRs) were 0.582 (95 % CI: 0.389-0.871) and 0.479 (95 % CI: 0.294-0.780) in the moderate and high self-management group. Despite this protective association, self-management ability was not determined significant factor for MALE.

Conclusions: Inadequate self-management abilities among patients with LEAD who underwent EVR are associated with increased risks of death and restenosis.

Practice implications: Enhancing the self-management abilities of patients with LEAD who underwent EVR may aid to mitigate mortality and restenosis risks.