Patient Education and Counseling最新文献_第2页

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

How words discredit: A taxonomy of stigmatizing language in the electronic health record 单词如何诋毁：电子健康记录中污名化语言的分类

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.2026.109520

Amanda McArthur , Alya Ahmad , Anne R. Links , Kathleen R. Warner , Paul Drew , Mary Catherine Beach , Somnath Saha

Objective

Language in electronic health records (EHRs) can transmit stigma, discrediting patients in ways that undermine the clinician-patient relationship and compromise future care. We sought to develop a taxonomy of stigmatizing language in EHRs to understand what patients are being stigmatized for, how that stigma is conveyed linguistically, and why.

Methods

We conducted a two-stage qualitative analysis of EHR notes from multiple clinical contexts in a large U.S. academic health system. For both stages, we drew enriched samples using natural language processing (NLP) to identify notes with at least one stigmatizing keyword from prior studies. First, we open coded 296 notes to generate categories of stigmatizing language and linguistic mechanisms, and to develop a preliminary taxonomy. We then applied and refined this framework by coding 400 additional notes.

Results

We identified six categories of stigmatizing sentiments characterizing patients as: (1) Socially Undesirable, (2) Difficult to Interact With, (3) Incompetent, (4) Manipulative, (5) Noncompliant, and (6) Not Credible. These were implied through negative descriptions of patient behavior portraying them as, e.g., Demanding, Adversarial, Deceptive, etc. Linguistic mechanisms extended beyond keywords, including practices for emphasizing the intensity of patient behavior (e.g., intensifiers), marking distance or divergence from the patient’s perspective (e.g., skeptical evidentials), and casting the clinician as the neutral or rational party (e.g., euphemisms).

Conclusion

Stigmatizing language in EHRs is not limited to discrete terms but is embedded in broader linguistic practices that shape how patients are represented and understood, particularly those describing how they fail to align with clinical expectations. This language may serve to document professional challenges, but it nonetheless reinforces paternalistic norms and compromises care. Understanding these dynamics is critical for moving toward patient-centered documentation and reducing harm in the EHR.

目的电子健康记录（EHRs）中的语言可以传递污名，以破坏医患关系和损害未来护理的方式诋毁患者。我们试图在电子病历中建立一种侮辱性语言的分类，以了解患者被侮辱性的原因，这种侮辱性是如何在语言上传达的，以及为什么。方法我们对美国一个大型学术卫生系统中多个临床背景下的电子病历记录进行了两阶段定性分析。在这两个阶段，我们使用自然语言处理（NLP）绘制了丰富的样本，以识别至少一个来自先前研究的污名关键词的音符。首先，我们对296个注释进行了编码，生成了污名化语言的分类和语言机制，并建立了初步的分类体系。然后，我们通过编码400个额外的注释来应用和完善这个框架。结果我们确定了患者的六类污名化情绪特征：(1)社会不受欢迎，(2)难以互动，(3)无能，(4)操纵，(5)不服从，(6)不可信。这些都是通过对患者行为的负面描述来暗示的，例如，苛求，对抗，欺骗等。语言机制延伸到关键词之外，包括强调患者行为强度的实践（例如，强化词），标记与患者观点的距离或分歧（例如，怀疑证据），以及将临床医生塑造为中立或理性的一方（例如，委婉语）。结论电子病历中的污名化语言并不局限于离散的术语，而是嵌入到更广泛的语言实践中，这些实践塑造了如何代表和理解患者，特别是那些描述他们如何未能与临床期望保持一致的语言实践。这种语言可能有助于记录专业挑战，但它仍然强化了家长式的规范，损害了护理。了解这些动态对于实现以患者为中心的记录和减少电子病历中的危害至关重要。

{"title":"How words discredit: A taxonomy of stigmatizing language in the electronic health record","authors":"Amanda McArthur , Alya Ahmad , Anne R. Links , Kathleen R. Warner , Paul Drew , Mary Catherine Beach , Somnath Saha","doi":"10.1016/j.pec.2026.109520","DOIUrl":"10.1016/j.pec.2026.109520","url":null,"abstract":"<div><h3>Objective</h3><div>Language in electronic health records (EHRs) can transmit stigma, discrediting patients in ways that undermine the clinician-patient relationship and compromise future care. We sought to develop a taxonomy of stigmatizing language in EHRs to understand <em>what</em> patients are being stigmatized for, <em>how</em> that stigma is conveyed linguistically, and <em>why</em>.</div></div><div><h3>Methods</h3><div>We conducted a two-stage qualitative analysis of EHR notes from multiple clinical contexts in a large U.S. academic health system. For both stages, we drew enriched samples using natural language processing (NLP) to identify notes with at least one stigmatizing keyword from prior studies. First, we open coded 296 notes to generate categories of stigmatizing language and linguistic mechanisms, and to develop a preliminary taxonomy. We then applied and refined this framework by coding 400 additional notes.</div></div><div><h3>Results</h3><div>We identified six categories of stigmatizing sentiments characterizing patients as: (1) Socially Undesirable, (2) Difficult to Interact With, (3) Incompetent, (4) Manipulative, (5) Noncompliant, and (6) Not Credible. These were implied through negative descriptions of patient behavior portraying them as, e.g., Demanding, Adversarial, Deceptive, etc. Linguistic mechanisms extended beyond keywords, including practices for emphasizing the intensity of patient behavior (e.g., intensifiers), marking distance or divergence from the patient’s perspective (e.g., skeptical evidentials), and casting the clinician as the neutral or rational party (e.g., euphemisms).</div></div><div><h3>Conclusion</h3><div>Stigmatizing language in EHRs is not limited to discrete terms but is embedded in broader linguistic practices that shape how patients are represented and understood, particularly those describing how they fail to align with clinical expectations. This language may serve to document professional challenges, but it nonetheless reinforces paternalistic norms and compromises care. Understanding these dynamics is critical for moving toward patient-centered documentation and reducing harm in the EHR.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109520"},"PeriodicalIF":3.1,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175188","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

Towards an interaction physiology: Unpacking the inferential property of language use 走向互动生理学：揭示语言使用的推理性质

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.2026.109517

Jennifer Gerwing , Julia Menichetti , Anne Marie Landmark

Objective

Dialogues between clinicians and patients constitute complex, dynamic systems comparable to human physiology. While human physiology focuses on the internal regulation of the body, interaction physiology focuses on the observable regulation between participants who are talking with each other. We draw attention to just one fundamental property of interaction physiology, namely that interaction is a continuous process of participants inferring meaning from what each other says and does. We unpack several sequences from authentic clinical dialogues to exemplify such inferential processes.

Discussion

Each contribution in a dialogue serves a function and meaning beyond its literal sense, indeed it has meaning potential, in that its meaning is dependent on the sense that interlocutors make of it, based on its immediate context (i.e., what has happened so far in the conversation and the broader context of time, purpose, and setting). Concrete, practical implications for clinicians are the following: to appreciate what is gained by paying close attention to what the patient says and does; to notice possible misalignments in understanding; to use opportunities that dialogue offers to bring the topic of understanding to the fore. For researchers, particularly ones who are not working within established analytical traditions, awareness of inferential processes entails developing the discipline (and humility) of differentiating between one’s own inferences as an observer and the participants’ displayed inferences while they respond to each other in real time.

Conclusions

We suggest that clinicians need communication recommendations to help them make sense of their interactions with patients in situ, supporting their ability to pay attention to what each patient is saying and doing in the moment. Such advice depends on distilling and promoting practice from a solid foundation of basic research on language use.

临床医生和患者之间的对话构成了与人体生理学相当的复杂、动态的系统。人体生理学关注的是身体内部的调节，而互动生理学关注的是相互交谈的参与者之间可观察到的调节。我们只关注互动生理学的一个基本属性，即互动是参与者从彼此的言行中推断意义的连续过程。我们从真实的临床对话中解包了几个序列，以举例说明这种推理过程。讨论对话中的每一个贡献都有其字面意义之外的功能和意义，实际上它有潜在的意义，因为它的意义取决于对话者对它的理解，基于它的直接背景（即，到目前为止在对话中发生了什么，以及时间、目的和背景等更广泛的背景）。对临床医生具体的、实际的影响如下：通过密切关注病人的言行来理解所获得的东西；注意到理解上可能的不一致；利用对话提供的机会，将理解的话题放在首位。对于研究人员，特别是那些没有在既定分析传统中工作的研究人员来说，对推理过程的认识需要培养一种纪律（和谦逊），即区分作为观察者的自己的推理和参与者在实时相互反应时所展示的推理。我们建议临床医生需要沟通建议，以帮助他们理解与患者的现场互动，支持他们关注每个患者当下的言行的能力。这些建议依赖于从语言使用的基础研究中提炼和促进实践。

{"title":"Towards an interaction physiology: Unpacking the inferential property of language use","authors":"Jennifer Gerwing , Julia Menichetti , Anne Marie Landmark","doi":"10.1016/j.pec.2026.109517","DOIUrl":"10.1016/j.pec.2026.109517","url":null,"abstract":"<div><h3>Objective</h3><div>Dialogues between clinicians and patients constitute complex, dynamic systems comparable to human physiology. While human physiology focuses on the internal regulation of the body, <em>interaction physiology</em> focuses on the observable regulation between participants who are talking with each other. We draw attention to just one fundamental property of interaction physiology, namely that interaction is a continuous process of participants <em>inferring meaning</em> from what each other says and does. We unpack several sequences from authentic clinical dialogues to exemplify such inferential processes.</div></div><div><h3>Discussion</h3><div>Each contribution in a dialogue serves a function and meaning beyond its literal sense, indeed it has <em>meaning potential</em>, in that its meaning is dependent on the sense that interlocutors make of it, based on its immediate context (i.e., what has happened so far in the conversation and the broader context of time, purpose, and setting). Concrete, practical implications for clinicians are the following: to appreciate what is gained by paying close attention to what the patient says and does; to notice possible misalignments in understanding; to use opportunities that dialogue offers to bring the topic of understanding to the fore. For researchers, particularly ones who are not working within established analytical traditions, awareness of inferential processes entails developing the discipline (and humility) of differentiating between one’s own inferences as an observer and the participants’ displayed inferences while they respond to each other in real time.</div></div><div><h3>Conclusions</h3><div>We suggest that clinicians need communication recommendations to help them make sense of their interactions with patients in situ, supporting their ability to pay attention to what each patient is saying and doing in the moment. Such advice depends on distilling and promoting practice from a solid foundation of basic research on language use.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109517"},"PeriodicalIF":3.1,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175192","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

Expectation management and patient-surgeon communication in aesthetic surgery: A narrative review of current challenges and communication strategies 期望管理和患者-外科医生沟通在美容手术：当前的挑战和沟通策略的叙述回顾。

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

Patient Education and Counseling

Pub Date : 2026-02-04 DOI: 10.1016/j.pec.2026.109511

Or Friedman

Objective

To examine patient-surgeon communication challenges in aesthetic surgery and identify effective strategies for expectation management and informed consent through narrative review of current literature.

Methods

A comprehensive narrative review was conducted using PubMed, PsycINFO, and communication databases (2010–2024). Search terms included "aesthetic surgery," "patient communication," "expectations," "informed consent," and "social media." Literature was analyzed thematically to identify key communication challenges, digital media influences, and evidence-based intervention strategies.

Results

This review identifies three primary themes and proposes an integrated framework combining traditional communication barriers with digital-era influences: (1) Communication barriers arise from the subjective nature of aesthetic goals and patients' difficulty articulating desires in clinical terms; (2) Social media significantly influences patient expectations, with recent surveys indicating that a substantial majority of facial plastic surgeons encounter patients requesting procedures to improve social media appearance—representing a significant increase from earlier years; (3) Evidence-based visual communication tools and structured decision aids demonstrate effectiveness in aligning expectations and improving satisfaction. Studies consistently show that unmet expectations account for 14.4 % of malpractice claims in plastic surgery versus 3.8 % in other medical specialties.

Conclusion

This review presents a comprehensive integrated communication framework specifically designed for the digital era of aesthetic surgery practice. Effective patient-surgeon communication now requires specialized approaches that address both traditional expectation management and unprecedented social media influences on patient goals.

Practice Implications

Surgeons should implement structured communication protocols including visual outcome ranges, psychological expectation assessment, and explicit discussion of social media influences. Professional development programs must emphasize communication skills specific to aesthetic consultation, with particular attention to cultural competence and digital literacy.

目的：通过对当前文献的叙述性回顾，研究美容手术中患者与外科医生沟通的挑战，并确定有效的期望管理和知情同意策略。方法：采用PubMed、PsycINFO和communication数据库（2010-2024）进行综合叙述性综述。搜索词包括“美容手术”、“患者沟通”、“期望”、“知情同意”和“社交媒体”。对文献进行主题分析，以确定关键的传播挑战、数字媒体影响和基于证据的干预策略。结果：本综述确定了三个主要主题，并提出了一个结合传统沟通障碍和数字时代影响的综合框架：(1)沟通障碍源于审美目标的主观性和患者在临床术语中表达愿望的困难；(2)社交媒体显著影响患者的期望，最近的调查表明，绝大多数面部整形外科医生遇到患者要求进行手术以改善社交媒体外观-与早些年相比显着增加；(3)基于证据的视觉沟通工具和结构化决策辅助工具在调整期望和提高满意度方面表现出有效性。研究一致表明，在整形外科的医疗事故索赔中，未达到预期的占14.4% %，而在其他医学专业中，这一比例为3.8% %。结论：本综述提出了一个专门为数字时代美容外科实践设计的全面集成通信框架。有效的医患沟通现在需要专门的方法来解决传统的期望管理和前所未有的社会媒体对患者目标的影响。实践意义：外科医生应实施结构化的沟通协议，包括视觉结果范围、心理期望评估和明确讨论社交媒体的影响。专业发展计划必须强调美学咨询的沟通技巧，特别注意文化能力和数字素养。

{"title":"Expectation management and patient-surgeon communication in aesthetic surgery: A narrative review of current challenges and communication strategies","authors":"Or Friedman","doi":"10.1016/j.pec.2026.109511","DOIUrl":"10.1016/j.pec.2026.109511","url":null,"abstract":"<div><h3>Objective</h3><div>To examine patient-surgeon communication challenges in aesthetic surgery and identify effective strategies for expectation management and informed consent through narrative review of current literature.</div></div><div><h3>Methods</h3><div>A comprehensive narrative review was conducted using PubMed, PsycINFO, and communication databases (2010–2024). Search terms included \"aesthetic surgery,\" \"patient communication,\" \"expectations,\" \"informed consent,\" and \"social media.\" Literature was analyzed thematically to identify key communication challenges, digital media influences, and evidence-based intervention strategies.</div></div><div><h3>Results</h3><div>This review identifies three primary themes and proposes <strong>an</strong> integrated framework combining traditional communication barriers with digital-era influences: (1) Communication barriers arise from the subjective nature of aesthetic goals and patients' difficulty articulating desires in clinical terms; (2) Social media significantly influences patient expectations, with recent surveys indicating that a substantial majority of facial plastic surgeons encounter patients requesting procedures to improve social media appearance—representing a significant increase from earlier years; (3) Evidence-based visual communication tools and structured decision aids demonstrate effectiveness in aligning expectations and improving satisfaction. Studies consistently show that unmet expectations account for 14.4 % of malpractice claims in plastic surgery versus 3.8 % in other medical specialties.</div></div><div><h3>Conclusion</h3><div>This review presents a comprehensive integrated communication framework specifically designed for the digital era of aesthetic surgery practice. Effective patient-surgeon communication now requires specialized approaches that address both traditional expectation management and unprecedented social media influences on patient goals.</div></div><div><h3>Practice Implications</h3><div>Surgeons should implement structured communication protocols including visual outcome ranges, psychological expectation assessment, and explicit discussion of social media influences. Professional development programs must emphasize communication skills specific to aesthetic consultation, with particular attention to cultural competence and digital literacy.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"146 ","pages":"Article 109511"},"PeriodicalIF":3.1,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138128","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

Measuring the use of spoken plain language by clinicians in healthcare encounters: A scoping review 测量临床医生在医疗保健接触中使用口语：范围审查

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

Patient Education and Counseling

Pub Date : 2026-02-04 DOI: 10.1016/j.pec.2026.109531

Renata W. Yen , Aditya Singh , Diane Chen , Paul J. Barr , Daniel Kang , Glyn Elwyn

Objective

Poor communication in clinical encounters impacts both clinical and patient outcomes. We aimed to summarize the available data on the measurement and use of clinician-spoken plain language, as well as the associations between elements of plain language use and patient outcomes.

Methods

Using Arksey and O’Malley’s framework, we conducted a scoping review of the published literature through November 2024 including any analysis of clinician use of plain language in English-based clinical encounters. We assessed study quality using the Joanna Briggs Institute cross-sectional assessment tool. We summarized our findings qualitatively.

Results

From 4398 unique citations, we found 36 papers (utilizing 34 distinct datasets) meeting our criteria. Studies were published from 2007 to 2023 and included 1225 clinicians total (range: 2–214) across many clinical settings. Study quality was mixed, although most (28/36, 77.8 %) measured plain language outcomes using reliable methods. Use of medical terminology was measured in 21/36 (58.3 %) studies, where all used manual methods to count terms, and some supplemented (5/21, 23.8 %) with automation. Median medical terms per encounter was 19.5 (range: 2.4–72.3), but interpretation was limited since encounter length varied substantially. Language complexity was measured in 15/36 (41.7 %), primarily using methods designed for written text. The average transcript grade level was 6.3 (range: 2.7–9.8; sixth grade). Only 4/36 (11.1 %) reported findings back to clinicians.

Conclusion

This review offers insight into an emerging area of research in measuring clinician-spoken plain language. Significant heterogeneity exists in the elements that are measured, methods used, and findings. Future research should account for variation in encounter length. The use of automated analysis methods is growing, but limited, in this field.

Practice implications

Measuring clinician-spoken plain language is an emerging area with potential applications in medical and continuing education. Real-world implementation may be supported through standardization of measurement methods and delivering results back to clinicians.

目的临床接触中沟通不良影响临床和患者预后。我们的目的是总结关于临床医师口语的测量和使用的现有数据，以及口语使用元素与患者预后之间的关联。使用Arksey和O 'Malley的框架，我们对截至2024年11月已发表的文献进行了范围审查，包括临床医生在以英语为基础的临床接触中使用普通语言的任何分析。我们使用乔安娜布里格斯研究所的横断面评估工具来评估研究质量。我们定性地总结了我们的发现。结果从4398个独立引用中，我们发现36篇论文（使用34个不同的数据集）符合我们的标准。研究发表于2007年至2023年，包括许多临床环境中的1225名临床医生（范围：2-214）。研究质量参差不齐，尽管大多数（28/36,77.8 %）使用可靠的方法测量了简单语言的结果。在21/36（58.3 %）的研究中测量了医学术语的使用情况，其中所有研究都使用人工方法计算术语，有些研究补充了自动化方法（5/21,23.8 %）。每次接触的医学术语中位数为19.5（范围：2.4-72.3），但由于接触的长度差异很大，因此解释有限。语言复杂性的测量为15/36(41.7 %)，主要使用为书面文本设计的方法。成绩单平均成绩为6.3分（范围：2.7-9.8分；六年级）。只有4/36（11.1 %）向临床医生报告了结果。结论：本综述提供了一个新兴的研究领域的见解，即测量临床医生说的普通语言。在测量的要素、使用的方法和发现中存在显著的异质性。未来的研究应该考虑到接触长度的变化。自动化分析方法的使用正在增长，但在这个领域是有限的。实践意义测量临床医生说的普通语言是一个新兴的领域，在医学和继续教育中具有潜在的应用。现实世界的实施可以通过标准化的测量方法和将结果反馈给临床医生来支持。

{"title":"Measuring the use of spoken plain language by clinicians in healthcare encounters: A scoping review","authors":"Renata W. Yen , Aditya Singh , Diane Chen , Paul J. Barr , Daniel Kang , Glyn Elwyn","doi":"10.1016/j.pec.2026.109531","DOIUrl":"10.1016/j.pec.2026.109531","url":null,"abstract":"<div><h3>Objective</h3><div>Poor communication in clinical encounters impacts both clinical and patient outcomes. We aimed to summarize the available data on the measurement and use of clinician-spoken plain language, as well as the associations between elements of plain language use and patient outcomes.</div></div><div><h3>Methods</h3><div>Using Arksey and O’Malley’s framework, we conducted a scoping review of the published literature through November 2024 including any analysis of clinician use of plain language in English-based clinical encounters. We assessed study quality using the Joanna Briggs Institute cross-sectional assessment tool. We summarized our findings qualitatively.</div></div><div><h3>Results</h3><div>From 4398 unique citations, we found 36 papers (utilizing 34 distinct datasets) meeting our criteria. Studies were published from 2007 to 2023 and included 1225 clinicians total (range: 2–214) across many clinical settings. Study quality was mixed, although most (28/36, 77.8 %) measured plain language outcomes using reliable methods. Use of medical terminology was measured in 21/36 (58.3 %) studies, where all used manual methods to count terms, and some supplemented (5/21, 23.8 %) with automation. Median medical terms per encounter was 19.5 (range: 2.4–72.3), but interpretation was limited since encounter length varied substantially. Language complexity was measured in 15/36 (41.7 %), primarily using methods designed for written text. The average transcript grade level was 6.3 (range: 2.7–9.8; sixth grade). Only 4/36 (11.1 %) reported findings back to clinicians.</div></div><div><h3>Conclusion</h3><div>This review offers insight into an emerging area of research in measuring clinician-spoken plain language. Significant heterogeneity exists in the elements that are measured, methods used, and findings. Future research should account for variation in encounter length. The use of automated analysis methods is growing, but limited, in this field.</div></div><div><h3>Practice implications</h3><div>Measuring clinician-spoken plain language is an emerging area with potential applications in medical and continuing education. Real-world implementation may be supported through standardization of measurement methods and delivering results back to clinicians.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"147 ","pages":"Article 109531"},"PeriodicalIF":3.1,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175109","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

Corrigendum to “Co-designing peer-to-peer support in oncology: A participatory study on the development of the PaRole OncO France model” [Patient Educ. Couns. 143 (2026) 109415] “共同设计肿瘤学中的点对点支持：一项关于假释OncO法国模式发展的参与性研究”的勘误表[患者教育]。第143（2026）条[109415]。

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

Patient Education and Counseling

Pub Date : 2026-02-03 DOI: 10.1016/j.pec.2026.109510

Yaël Busnel , Ibtissem Ben Dridi , Mathilde Lochmann , Laurie Panse , Stéphane Cognon , Claude Ganter , Sarah Prudhomme , Anne Termoz , Pascale Sontag , Pauline Maisani , Aurélien Troisoeufs , Emmanuelle Jouet , Véronique Christophe , Marie Preau , Marie-Pascale Pomey , Julie Haesebaert

引用次数: 0

Information needs of adult childhood, adolescent, and young adult cancer survivors (CAYACS): A systematic review 成人、儿童、青少年和青年癌症幸存者（CAYACS）的信息需求：一项系统综述。

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

Patient Education and Counseling

Pub Date : 2026-02-03 DOI: 10.1016/j.pec.2026.109506

Anne Maas , Elena Bertolini , Kathleen Ostheim , Hanne C. Lie , Charlotte Demoor-Goldschmidt , Miklós Garami , Gisela Michel , Anica Ilic

Objective

Childhood, adolescent, and young adult cancer survivors (CAYACS) often report cancer-related knowledge gaps. Addressing their information needs is associated with better quality of life. We aimed to explore and synthesize evidence on CAYACS’ cancer-related information needs and identify associated characteristics.

Methods

Peer-reviewed articles on information needs in adult CAYACS ≥ 5 years post-diagnosis were systematically searched in PubMed, PsycINFO, and Scopus. The quality of included publications was assessed using the Mixed Methods Appraisal Tool, and results were narratively synthesized.

Results

Twenty-one studies (n = 10 quantitative, n = 8 qualitative, n = 3 mixed-methods) with a total of 5624 participants (range: 14–1386 per study) were included. Between 51 % and 77 % of CAYACS had at least one information need. Needs were reported across 11 domains, including cancer-related health information (2 %-86 %), follow-up care and prevention (2 %-91 %), healthcare system interactions (9 %-36 %), living a healthy lifestyle (4 %-60 %), psychosocial well-being and support (12 %-40 %), sexual health (<1 %-32 %), finances (2 %-50 %), relationships (2 %-20 %), education and employment (<1 %-18 %), insurances (28 %-47 %), and peer support (7 %-35 %). The highest prevalences were observed in follow-up discussions on current health (92 %) and late effects (19 %-86 %). Female sex, older age at study, lower educational attainment, poorer mental and physical health, longer time since diagnosis/treatment, central nervous system tumor diagnosis, and lack of written information were associated with more information needs.

Conclusions and practice implications

Adult CAYACS report significant information needs years after treatment, particularly regarding cancer-related health information, follow-up care and prevention, and lifestyle. Addressing these needs with age-appropriate, individualized information may improve their quality of life. Electronic and mobile health tools are promising methods to provide such support.

目的：儿童、青少年和青年癌症幸存者（CAYACS）经常报告癌症相关知识的空白。满足他们的信息需求与提高生活质量有关。我们的目的是探索和综合有关CAYACS癌症相关信息需求的证据，并确定相关特征。方法：系统检索PubMed、PsycINFO和Scopus中关于成人CAYACS≥ 5年后信息需求的同行评议文章。使用混合方法评估工具评估纳入出版物的质量，并对结果进行叙述性综合。结果：共纳入21项研究（n = 10项定量方法，n = 8项定性方法，n = 3项混合方法），共5624名受试者（范围：每项研究14 ~ 1386人）。51% %至77% %的CAYACS至少有一种信息需求。需要被报道11个领域,包括癌症相关健康信息(-86  % %),后续护理和预防(-91  % %),医疗系统交互(9 -36  % %),一个健康的生活方式(-60  % %),心理社会健康和支持(-40  % %),性健康(结论和实践意义:成人CAYACS报告重大信息需求年治疗后,特别是关于癌症相关的健康信息,后续治疗和预防,和生活方式。通过与年龄相适应的个性化信息来解决这些需求可能会提高他们的生活质量。电子和移动保健工具是提供这种支持的有希望的方法。

{"title":"Information needs of adult childhood, adolescent, and young adult cancer survivors (CAYACS): A systematic review","authors":"Anne Maas , Elena Bertolini , Kathleen Ostheim , Hanne C. Lie , Charlotte Demoor-Goldschmidt , Miklós Garami , Gisela Michel , Anica Ilic","doi":"10.1016/j.pec.2026.109506","DOIUrl":"10.1016/j.pec.2026.109506","url":null,"abstract":"<div><h3>Objective</h3><div>Childhood, adolescent, and young adult cancer survivors (CAYACS) often report cancer-related knowledge gaps. Addressing their information needs is associated with better quality of life. We aimed to explore and synthesize evidence on CAYACS’ cancer-related information needs and identify associated characteristics.</div></div><div><h3>Methods</h3><div>Peer-reviewed articles on information needs in adult CAYACS ≥ 5 years post-diagnosis were systematically searched in PubMed, PsycINFO, and Scopus. The quality of included publications was assessed using the Mixed Methods Appraisal Tool, and results were narratively synthesized.</div></div><div><h3>Results</h3><div>Twenty-one studies (n = 10 quantitative, n = 8 qualitative, n = 3 mixed-methods) with a total of 5624 participants (range: 14–1386 per study) were included. Between 51 % and 77 % of CAYACS had at least one information need. Needs were reported across 11 domains, including cancer-related health information (2 %-86 %), follow-up care and prevention (2 %-91 %), healthcare system interactions (9 %-36 %), living a healthy lifestyle (4 %-60 %), psychosocial well-being and support (12 %-40 %), sexual health (<1 %-32 %), finances (2 %-50 %), relationships (2 %-20 %), education and employment (<1 %-18 %), insurances (28 %-47 %), and peer support (7 %-35 %). The highest prevalences were observed in follow-up discussions on current health (92 %) and late effects (19 %-86 %). Female sex, older age at study, lower educational attainment, poorer mental and physical health, longer time since diagnosis/treatment, central nervous system tumor diagnosis, and lack of written information were associated with more information needs.</div></div><div><h3>Conclusions and practice implications</h3><div>Adult CAYACS report significant information needs years after treatment, particularly regarding cancer-related health information, follow-up care and prevention, and lifestyle. Addressing these needs with age-appropriate, individualized information may improve their quality of life. Electronic and mobile health tools are promising methods to provide such support.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"146 ","pages":"Article 109506"},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144645","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