Patient Education and Counseling最新文献_第2页

The need for personalization when sharing results of amyloid imaging for Alzheimer’s disease: Insights from a randomized experimental study 分享阿尔茨海默病淀粉样蛋白成像结果时需要个性化：来自随机实验研究的见解。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108587

Agnetha D. Fruijtier , Wiesje M. van der Flier , Ingrid van Maurik , Jetske van der Schaar , Yolande A.L. Pijnenburg , Ellen M.A. Smets , Leonie N.C. Visser

Objective

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

Methods

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

Results

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

Conclusion

Most people wanted more information on varying topics, and gender and coping style influenced how communication strategies impacted information recall.

PRACTICE IMPLICATIONS

The importance of personalized information provision was emphasized, both in terms of what information is provided and how physicians share information, by paying attention to individuals’ needs and characteristics.

目的：研究接受异常淀粉样蛋白pet结果后的信息需求，以及个体特征如何调节不同沟通策略对信息回忆的影响。方法：在一个在线视频小插曲实验中，七个小插曲分别描述了医生与轻度认知障碍（MCI）患者分享异常淀粉样蛋白pet结果的咨询，使用不同的沟通策略。健康个体(N = 1017；年龄（64±8,808）（79%）女性)，被要求想象自己是视频患者，观看随机分配的小短片并完成问卷调查，以评估信息需求并测试性别、年龄、护理伙伴经历、健康素养和应对的调节作用。结果：63%的参与者（645/1017）希望获得更多的信息，例如，关于预后，额外的信息来源，生活方式建议和/或治疗。情感支持对女性的信息回忆有帮助，但对男性没有。与大多数其他策略相比，情感支持和视觉上呈现pet扫描对回避应对方式较强的个体的益处较小。结论：大多数人想要更多关于不同话题的信息，性别和应对方式影响沟通策略对信息回忆的影响。实践意义强调了个性化信息提供的重要性，无论是提供什么信息，还是医生如何共享信息，都要关注个人的需求和特征。

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引用次数: 0

A scoping review of parents’ disclosure of BRCA1/2 genetic alteration test results to underage children 父母向未成年子女披露BRCA1/2基因改变检测结果的范围审查。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108561

Celia Diez de los Rios de la Serna , Maura Dowling , Nichola McNamara , John D. Ivory , Yvonne Hanhauser , Meghan Murphy , Marleah Dean

Background

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

Objective

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

Methods

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

Results

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

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

Practice implications

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

背景：BRCA1/2突变个体在成年后患癌症的风险明显高于平均水平。一些BRCA1/2突变的父母希望与他们的孩子分享这些信息，但他们不知道如何、何时以及分享什么信息。目的：本综述的目的是确定父母向未成年子女传达BRCA1/2状况的沟通策略/干预措施，以及医疗保健专业人员使用哪些沟通干预措施来支持父母的披露过程。方法：对六个数据库检索的父母和/或卫生保健专业人员干预支持父母与子女沟通的研究进行范围审查。审查与PRISMA的范围审查指南保持一致，并使用PAGER的建议来指导图表和报告。结果：纳入2001 ~ 2020年发表的22篇文献。多重披露的促进/激励因素，父母如何和在哪里披露，对披露的反应被确定。此外，在披露过程中没有发现医疗保健专业人员的干预。结论：本综述总结了父母向未成年子女披露BRCA1/2基因状况的研究，发现缺乏沟通干预来指导父母这一艰难的过程。父母在向孩子传达结果时遇到了许多障碍。实践意义：这些发现使医疗保健专业人员能够努力开发和测试支持遗传风险信息交流的干预措施。此外，显然有必要进行更多的研究，以了解披露过程是如何在家庭中发生的。

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引用次数: 0

The influencing factors in intention making-decision of Human papillomavirus vaccine in Chinese college students: A qualitative study 中国大学生人乳头瘤病毒疫苗意向决策的影响因素：一项定性研究。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108594

Juanjuan Ma , Wenting Lu , Shuyan Sun , Yuxin Zhan , Jin Zhang , Hui Zhang

Objective

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

Methods

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

Results

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

Conclusion

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

Practice Implications

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

目的：大学生是HPV感染的高危人群。经证实，人乳头瘤病毒疫苗在预防男性和女性宫颈癌及相关癌症方面发挥了重要作用。本研究旨在探讨影响我国大学生人乳头瘤病毒疫苗意向决策的因素。方法：采用描述性质的研究方法，于2022年10 - 11月在黑龙江省大庆市进行自然主义调查。对中国大学生的半结构化访谈。我们使用NVivo 12.0软件进行专题框架分析，对访谈录音进行转录和分析。结果：我们进行了20次深度访谈。确定了四个主题和14个子主题：(a) HPV感染的潜在风险；(b) HPV感染的易感因素；(c)人乳头瘤病毒疫苗接种困难；(d) HPV疫苗接种决策支持。结论：大多数大学生对接种HPV疫苗表现出犹豫。政府应加强宣传疫苗的好处，以提高HPV疫苗接种率。实践启示：医疗保健提供者和政府应采取一些策略，促进促进因素，以提高HPV疫苗接种率。

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引用次数: 0

Examining healthcare workers’ engagement with social media-based health education: Influencing factors, challenges, and future directions 检查医疗工作者参与基于社交媒体的健康教育：影响因素、挑战和未来方向。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108577

Wei Zhang , Fuxiang Guo , Weihan Cheng , Richard Evans , Magdalena Kludacz-Alessandri , Chengyan Zhu

Background

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

Objective

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

Methods

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

Results

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

Conclusion

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

Practical value

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

背景：基于社交媒体的健康教育（SMHE）是解决健康差异和提高公众健康素养的有效途径。尽管具有固有的优势，但中国的卫生保健工作者（HCWs）对参与SMHE计划的兴趣有限且短暂。目的：本研究旨在了解医护人员对SMHE的认知，识别当前的影响因素、挑战，并提出未来的发展方向。方法：从2021年10月至2022年1月进行描述性定性研究，涉及从事SMHE的医护人员（即医生、护士和医院管理人员）。对30名卫生保健工作者进行了半结构化的深入访谈，随后对其进行了主题分析。结果：专题分析产生了165个初始代码，分为12个子类别，涵盖三个主要主题：(1)卫生保健工作者对SMHE的看法；(2)卫生保健工作者参与SMHE的驱动因素和障碍；(3)克服当前挑战的策略。结论：本研究得出了三个主要结论。首先，中国的卫生保健工作者对SMHE表现出明显的乐观态度，但大多数人仍有一定的担忧。其次，卫生保健工作者参与SMHE是受其组织的激励或要求，而不是他们自己的倡议。卫生保健工作者参与SMHE的主要障碍包括：缺乏时间、声誉损失风险、利益冲突、患者福利以及对法律问题的担忧。第三，医疗机构、社交媒体平台和政府机构必须合作解决这些问题，以确保参与SMHE的卫生工作者得到保护。实用价值：本研究发现，中国医护人员愿意从事中小企业医疗服务，只要他们得到适度的奖励和安全的环境。

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引用次数: 0

Exploring communication challenges in dementia care: Insights from home healthcare nurses 探索痴呆症护理中的沟通挑战：来自家庭保健护士的见解。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108590

Elaine Wittenberg , Catherine Mann , Suzanne S. Sullivan

Objectives

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

Methods

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

Results

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

Conclusions

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

Practice implications

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

目的：对痴呆症患者的护理主要在家中进行，并且在漫长的疾病发展过程中往往需要多次住院治疗。从医院的护理过渡通常涉及家庭保健。本研究的目的是探讨家庭保健护士所遇到的沟通挑战，以了解家庭痴呆症护理的沟通培训需求。方法：对某大型城乡家庭护理机构的家庭保健护士（31名）进行7次录音焦点小组讨论。对焦点小组记录进行主题分析。结果：我们确定了以下主题，突出了家庭保健护士面临的沟通挑战：解决潜在的伤害或伤害风险，患者脆弱性，护理伙伴需求，将决策转向代理，以及家庭健康目标和家庭需求的差异。这些主题确定了特定的护理过渡对话主题和交流内容，对于痴呆症特定的工作人员培训至关重要。结论：确定了沟通技巧培训的主题，以改善以人为本的痴呆症护理。这些发现为痴呆护理家庭卫生人员交流课程的未来发展提供了信息。先进的沟通技巧是必要的，以确保这些对话的进行和参与敏感。实践意义：我们的研究为沟通培训的发展提供了信息，这些沟通培训是针对护士提供的和家庭保健干预的关键沟通主题，旨在改善痴呆症护理。

{"title":"Exploring communication challenges in dementia care: Insights from home healthcare nurses","authors":"Elaine Wittenberg , Catherine Mann , Suzanne S. Sullivan","doi":"10.1016/j.pec.2024.108590","DOIUrl":"10.1016/j.pec.2024.108590","url":null,"abstract":"<div><h3>Objectives</h3><div>Care for people living with dementia predominantly takes place at home and is often characterized by multiple hospitalizations throughout the lengthy disease trajectory. Care transitions from the hospital often involve home health care. The purpose of this study was to explore communication challenges experienced by home health nurses to inform communication training needs for home-based dementia care.</div></div><div><h3>Methods</h3><div>Seven audio-recorded focus group discussions were held with home health nurses (n = 31) from a large home care agency serving rural and urban counties. Focus group transcripts were thematically analyzed.</div></div><div><h3>Results</h3><div>We identified the following themes highlighting communication challenges for home health nurses: addressing potential risk for harm or injury, patient vulnerability, care partner needs, shifting decision-making to surrogate, and discrepancy in home health goals and family needs. These themes identified specific care transition conversation topics and communication content imperative for dementia-specific staff training.</div></div><div><h3>Conclusions</h3><div>Topics for communication skills training to improve person-centered dementia care were identified. These findings inform the future development of a home health staff communication curriculum for dementia care. Advanced communication skills are necessary to ensure these conversations take place and are engaged with sensitivity.</div></div><div><h3>Practice implications</h3><div>Our study informs the development of communication training on key communication topics in nurse-delivered and home healthcare interventions aimed at improving dementia care.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"131 ","pages":"Article 108590"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Addressing psychological well-being in adolescents and young adults (AYA) cancer care: recommendations for research, policy, and technological solutions 解决青少年和青壮年（AYA）癌症护理中的心理健康问题：研究、政策和技术解决方案建议。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108588

Riza Amalia , Nur Hidayah, M. Ramli, Rizky Andana Pohan, Stephanus Benedictus Bera Liwun, Ethel Joy V. Sebastian, Erma Pratiwi Nufi

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

患有癌症的青少年和年轻人（AYAs）面临着独特的挑战，这些挑战可能会破坏他们的身份发展和心理健康。这封信强调需要加强研究和政策改革，将社会心理支持纳入AYA肿瘤治疗。它提倡对医疗保健专业人员进行有针对性的沟通技巧培训，以促进以人为本的互动，解决AYA患者的身体和情感需求。此外，报告还探讨了远程医疗和移动应用等数字卫生技术在弥合护理差距方面的作用，特别是在服务不足或偏远地区。通过推进这些战略，我们可以在全球范围内促进更全面和公平的AYA癌症治疗方法。

引用次数: 0

Student pharmacist counseling performance after hands-on continuous glucose monitoring education: A multi-institutional pragmatic randomized study 学生药师在实际连续血糖监测教育后的咨询表现：一项多机构实用随机研究。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108578

Heather N. Folz , Sun Lee , Christina H. Sherrill

Objective

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

Methods

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

Results

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

Conclusion

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

Practice implications

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

目的：评估佩戴连续血糖监测（CGM）设备对学生药师咨询能力（第一）、知识、信心和同理心（第二）的影响。方法：将两所院校的学生随机分为佩戴CGM装置（干预组）和不佩戴CGM装置（对照组）两组。通过讲座和现场演示，对所有学员进行了CGM教育。干预组学生提供CGM装置。两周后，所有学生都完成了关于CGM处方咨询的标准化患者（SP）会面。评估前后cgm相关知识、信心和同理心。采用方差分析比较组间辅导得分的差异，采用协方差分析比较前后知识、信心和共情得分的变化。采用Stata/BE17.0进行分析。结果：入选的86名学生中，63人同意并完成了调查（干预组32人，对照组31人）。干预组SP辅导平均得分高于对照组（82.4% vs 77.7%, p = 0.046）。干预组与对照组相比，调查前后的信心变化更大（+ 2.3 vs + 1.7, p = 0.03，范围1-5）。在知识和同理心方面，组间没有差异。结论：佩戴CGM装置的机会提高了CGM咨询的表现，并大大提高了CGM相关的信心。本研究支持利用资源提供实际操作的CGM培训。实践意义：关于新的糖尿病技术的实践教育可以帮助学生为照顾和咨询患者做好准备。

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引用次数: 0

A nurse-led approach to testing and adapting a telehealth guide for e-empathy in goals of care conversations for Black patients with chronic kidney disease 一种护士主导的方法来测试和调整远程医疗指南，以实现黑人慢性肾病患者护理对话的电子移情目标。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108593

Adriana Glenn , Payton J. Smith , Sherrie Flynt Wallington

Objective

This study aims to explore and enhance the expression of empathy in telehealth visits (e-empathy) with Black American Chronic Kidney Disease (CKD) patients, focusing on goals of care conversations. It seeks to address the intersection of CKD, telehealth advancements, palliative care discussions, and the impact of racism in healthcare for holistic understanding.

Methodology

A qualitative case study design was employed in Washington, DC, involving Black patients with CKD. Data collection included cognitive testing via semi-structured interviews and feedback from a Stakeholder Advisory Group (SAG). Thematic analysis was conducted using NVivo 20 software.

Results

Themes emerged regarding empathy definitions, telehealth understanding, factors influencing confidence, importance of patient stories, cultural awareness, handling upsetting conversations, prioritizing treatment preferences, end-of-life decisions, and definitions of mental health professionals.

Conclusion

The study highlights the significance of e-empathy in telehealth for Black CKD patients, emphasizing respect, trust, and effective communication. It underscores the need for culturally targeted guidance and acknowledges limitations such as self-selection bias and a small sample size. Future work should address healthcare disparities and improve palliative care discussions, including virtual advance directives.

Practice Implications

Providers should prioritize e-empathy in telehealth visits with Black CKD patients, fostering trust and communication to improve patient outcomes during goals of care discussions.

目的：探讨美国黑人慢性肾脏疾病（CKD）患者远程医疗访视中共情的表达（e-empathy），重点关注护理对话的目标。它旨在解决CKD，远程医疗进步，姑息治疗的讨论，以及种族主义在医疗保健的整体理解的影响的交集。方法：在华盛顿特区采用定性案例研究设计，涉及黑人慢性肾病患者。数据收集包括通过半结构化访谈进行认知测试和来自利益相关者咨询小组（SAG）的反馈。采用NVivo 20软件进行专题分析。结果：出现的主题包括移情定义、远程医疗理解、影响信心的因素、患者故事的重要性、文化意识、处理令人不安的谈话、优先考虑治疗偏好、临终决定和心理健康专业人员的定义。结论：本研究强调电子共情在黑人CKD患者远程医疗中的重要性，强调尊重、信任和有效沟通。它强调需要有文化针对性的指导，并承认自我选择偏见和小样本量等局限性。未来的工作应解决医疗保健差距和改善姑息治疗的讨论，包括虚拟预先指示。实践启示：在与黑人慢性肾病患者的远程医疗访问中，提供者应该优先考虑电子移情，在护理讨论的目标中培养信任和沟通，以改善患者的结果。

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引用次数: 0

Child–physician rapport at a neurodevelopmental clinic: In the eyes of the beholder 神经发育诊所的儿童-医生关系：在旁观者的眼中。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108586

Yael Karni-Visel , Shirie Gordon-Feliks , Menachem Lam , Michal Klein , Mitchell Schertz

Background

Building rapport with young patients is crucial for fostering a sense of comfort that enhances their cooperation during clinical encounters and improves clinical outcomes. The available data on children with neurodevelopmental disabilities in community-based settings, including data on child–physician rapport, is limited.

Aims

To examine how children with neurodevelopmental disabilities perceive rapport with treating physicians compared to parents and treating physicians and to evaluate the relationship between the child-reported rapport and its impact on their cooperation.

Methods

One hundred two children with neurodevelopmental disabilities (M years = 9.63, SD = 2.42) completed the CHARM-C Questionnaire, which assessed their experience of rapport with their examining physicians following neurodevelopmental assessments. In parallel, their parents and physicians completed the CHARM-A Questionnaire, which assessed how they perceived the children’s experience of rapport (a total of 306 questionnaires). The physicians also rated children’s cooperation. The data were analyzed using correlation, regression, and mixed linear analyses.

Results

Children’s perceptions of rapport were significantly less positive than those of parents (d = −0.60) and physicians (d = −0.45). A moderate partial correlation (r = .37) was found between children’s and parents’ perceptions. Neither children’s nor parents’ perceptions were correlated with physicians’ perceptions. Children’s perceptions of rapport were positively associated with greater cooperation (β = .28).

Discussion

Children with neurodevelopmental disabilities rated their rapport with physicians lower than parents and doctors. Their evaluations offer valuable insights, complementing caregivers’ and professionals’ perspectives. Training physicians to improve their assessments of children’s needs during medical encounters is critically important.

背景：与年轻患者建立融洽的关系对于培养一种舒适感至关重要，这种舒适感可以增强他们在临床接触中的合作，并改善临床结果。关于社区环境中神经发育障碍儿童的现有数据，包括关于儿童-医生关系的数据，是有限的。目的：研究神经发育障碍儿童与主治医生、父母和主治医生之间的融洽关系，并评估儿童报告的融洽关系及其对合作的影响。方法：120例神经发育障碍儿童（M岁= 9.63,SD = 2.42）填写CHARM-C问卷，评估其在接受神经发育评估后与检查医师的关系体验。与此同时，他们的父母和医生完成了问卷调查（共306份问卷），以评估他们如何看待孩子们的融洽体验。医生们还对孩子们的合作程度进行了评分。采用相关分析、回归分析和混合线性分析对数据进行分析。结果：儿童对融洽关系的感知明显低于父母（d = -0.60）和医生（d = -0.45）。在孩子和父母的认知之间发现中度偏相关（r = .37）。孩子和父母的看法与医生的看法都不相关。儿童对融洽关系的感知与更大的合作呈正相关（β = .28）。讨论：患有神经发育障碍的儿童认为他们与医生的关系比父母和医生的关系要低。他们的评估提供了有价值的见解，补充了护理人员和专业人士的观点。对医生进行培训，以提高他们在就医时对儿童需求的评估，这一点至关重要。

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引用次数: 0

Uncovering the components of therapeutic empathy through thematic analysis of existing definitions 通过对现有定义的专题分析，揭示治疗性共情的组成部分。

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-02-01 DOI: 10.1016/j.pec.2024.108596

Jeremy Howick , Amber Bennett-Weston , Maya Dudko , Kevin Eva

Objectives

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

Methods

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

Results

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

Conclusions

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

Practice implications

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

目的：在回顾现有定义的基础上，确定治疗性共情的组成部分。方法：对治疗性共情定义的搜索分两个阶段进行。首先，利用现有的系统综述和共情定义数据库，编制了医疗保健背景下的共情定义列表。这些定义的组成部分是通过专题分析确定的。然后，对检索到这些定义的论文进行正向和反向引文检索（滚雪球）。这些论文被随机取样并整合到分析中，直到达到饱和。结果：共情治疗定义共3948个。在分析了39个单独的定义后达到饱和。研究确定了治疗性共情的六个相互关联的组成部分：探索、理解、共享理解、感觉、治疗行动和维持边界。结论：本研究确定了治疗性共情的六个主要组成部分，使其区别于一般的共情。研究结果提供了一个概念起点，可以帮助该领域更好地集中理解和使用与移情相关的活动在实践中。实践启示：未来的实践、研究和教育可以使用本研究中产生的成分来更一致地定义治疗共情，从而提供改善患者和医生结果的潜力。

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