Patient Education and Counseling最新文献_第7页

Patients’ attitudes towards deprescribing disease modifying anti-rheumatic drugs in rheumatoid arthritis 类风湿关节炎患者对减病抗风湿药物的态度。

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

Patient Education and Counseling

Pub Date : 2025-11-22 DOI: 10.1016/j.pec.2025.109432

Lauren Fraser , Michael D. Wiese , Nagham Ailabouni , Lisa Kalisch Ellett , Caroline Sirois , William Berthelot , Susanna M. Proudman , Leah McWilliams , Emily Reeve

Objectives

People living with rheumatoid arthritis (RA) may be taking one or more medications that they no longer need. The objective of this study was to determine the attitudes and beliefs regarding Disease Modifying Anti-Rheumatic Drug (DMARD) use and RA patients’ willingness to have their medications deprescribed.

Methods

This cross-sectional study included adults aged ≥ 18 years with a diagnosis of RA and were currently taking methotrexate and/or hydroxychloroquine. Participants completed a self-administered survey, adapted from the validated revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire, tailored to patients living with RA. Additional sociodemographic and clinical data were collected to explore factors associated with participants’ willingness to deprescribe their DMARDs.

Results

A total of 87 participants were recruited with median age of 66 years (IQR 57.5–73), and 57 (65.5 %) were female. The majority of RA patients (84 %) agreed they would be willing to stop one of their RA medicines if their rheumatologist said it was possible. Participants expressed greater concerns with ceasing their DMARDs compared to their other medications. No factors were found to be significantly associated with willingness to deprescribe DMARDs.

Conclusion

Whilst people with RA are satisfied with their current therapy, most would be willing to have one or more of their DMARDs deprescribed if their rheumatologist supports it.

Practice implications

Clinicians should be encouraged to initiate deprescribing discussions, especially in stable rheumatoid arthritis, however, shared decision-making should involve identifying and addressing concerns patients have about deprescribing their DMARDs.

目的：类风湿性关节炎（RA）患者可能正在服用一种或多种他们不再需要的药物。本研究的目的是确定对疾病调节抗风湿药物（DMARD）使用的态度和信念，以及RA患者对药物开处方的意愿。方法：这项横断研究纳入年龄≥ 18岁的成人，诊断为RA，目前正在服用甲氨蝶呤和/或羟氯喹。参与者完成了一项自我管理的调查，该调查改编自针对RA患者量身定制的经过验证的修订的患者对处方解除的态度（rPATD）问卷。收集了额外的社会人口学和临床数据，以探索与参与者愿意停用dmard相关的因素。结果：共招募了87名参与者，中位年龄为66岁（IQR 57.5-73），其中57名（65.5 %）为女性。大多数类风湿性关节炎患者（84% %）同意，如果他们的风湿病医生说可能的话，他们愿意停止使用一种类风湿性关节炎药物。与其他药物相比，参与者对停用dmard表达了更大的担忧。没有发现与停用dmard的意愿有显著关联的因素。结论：虽然RA患者对他们目前的治疗感到满意，但如果他们的风湿病医生支持，大多数人愿意开一种或多种dmard。实践意义：应该鼓励临床医生开始开处方的讨论，特别是在稳定的类风湿性关节炎中，然而，共同的决策应该包括识别和解决患者对其dmard开处方的担忧。

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引用次数: 0

Financial toxicity and related factors: A cross-sectional study among family caregivers of cancer patients 经济毒性及其相关因素：癌症患者家庭照顾者的横断面研究

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

Patient Education and Counseling

Pub Date : 2025-11-21 DOI: 10.1016/j.pec.2025.109426

Xiao Miao , Liang Ma , Na Lv , Fengqin Xu , Jia Sun , Susu Zhu

Aims

To examine the relationships among financial toxicity, social support, general self-efficacy, and patients’ socioeconomic status among family caregivers of cancer patients.

Methods

A cross-sectional study was conducted (July–September 2024) with 210 family caregivers from a Chinese hospital. Socio-demographics and disease characteristics questionnaires were completed by each participant, the financial toxicity scale for cancer family caregivers, the Social Support Rating Scale (SSRS), the General Self-Efficacy Scale, and the Socioeconomic Status. Correlation and multivariable linear regression analyses were performed using SPSS 26.0.

Results

Caregivers reported substantial financial toxicity, with a mean score of 60.02 ± 10.45, approaching the upper limit of the scale (80 points). Regression analysis identified four key predictors: lower self-efficacy (β = −0.417, P < 0.001), catastrophic health expenditures (β = −0.231, P < 0.001), lack of commercial insurance (β = 0.127, P = 0.024), and reduced household income (β = −0.172, P = 0.002). Financial toxicity showed significant negative correlations with social support (r = -0.226), self-efficacy (r = -0.567), and patient socioeconomic status (r = -0.215) (all P < 0.01).

Conclusion

Self-efficacy is a key modifiable factor in mitigating financial toxicity among cancer caregivers.

Practice Implications

Interventions should incorporate self-efficacy enhancement, insurance guidance, and income-protection strategies to reduce caregiver burden.

目的探讨癌症患者家庭照顾者的经济毒性、社会支持、一般自我效能感与患者社会经济地位的关系。方法对某医院210名家庭护理人员进行横断面研究（2024年7月- 9月）。每个参与者完成社会人口统计和疾病特征问卷，癌症家庭照顾者经济毒性量表，社会支持评定量表（SSRS），一般自我效能量表和社会经济地位。采用SPSS 26.0进行相关和多变量线性回归分析。结果评分者报告了大量的财务毒性，平均得分为60.02 ± 10.45，接近评分上限（80分）。回归分析确定了四个关键预测因子：较低的自我效率（β = - 0.417, P <； 0.001）、灾难性医疗支出（β = - 0.231, P <； 0.001）、缺乏商业保险（β = 0.127, P = 0.024）和家庭收入减少（β = - 0.172, P = 0.002）。财务毒性与社会支持（r = -0.226）、自我效能（r = -0.567）和患者社会经济地位（r = -0.215）呈显著负相关（P均为 <； 0.01）。结论自我效能感是减轻癌症照护者财务毒性的关键可调节因素。实践意义干预措施应结合自我效能增强、保险指导和收入保护策略，以减轻照顾者负担。

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引用次数: 0

Key factors in shared decision making between people with osteoarthritis and physiotherapists: A narrative study using storytelling 骨关节炎患者和理疗师共同决策的关键因素：一项使用讲故事的叙事研究

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

Patient Education and Counseling

Pub Date : 2025-11-21 DOI: 10.1016/j.pec.2025.109421

J. Jager , I. Rosbergen , G. van der Sluis , N.L.U. van Meeteren , P.C. Siemonsma

Objectives

To improve the quality of shared decision-making (SDM), this study examined factors perceived by people with osteoarthritis (PwOA) and physiotherapists to influence shared decision making (SDM), and how these perceptions align with a widely used SDM model.

Methods

Using a qualitative storytelling approach, we collected narratives from 10 PwOA and 7 physiotherapists in the Netherlands. Participants shared personal narratives of lived experiences ("stories") related to SDM in physiotherapy practice, resulting in 144 unique stories, of which 118 were related to decision-making and included for further analysis. These stories were analyzed through a seven-phase thematic analysis by a multidisciplinary research team (n = 12). Themes were plotted onto the SDM model of Moore and Kaplan.

Results

Analysis revealed six main themes: Decision-making as a reciprocal process (four aspects, 51 stories); Influence of patient expectations on decisions (four aspects, 48 stories); Communication and information provision (two aspects, 39 stories); Patients' voice and identity (three aspects, 33 stories); Relationship between patient and healthcare provider (two aspects, 26 stories); External factors influencing decisions (two aspects, 23 stories). Twelve aspects were shared by both PwOA and physiotherapists, one was exclusive to PwOA, and four were unique to physiotherapists. All aspects fit within Moore and Kaplan's SDM model; 12 aligned with specific stages, while five spanned multiple stages.

Conclusions

The study unravels the complex nature of SDM in physiotherapy. Storytelling revealed that factors like (power) dynamics as well as the physical environment seem to influence decision-making. Explicitly addressing these dynamics might provide opportunities for strengthening theoretical SDM models, clinical training, and SDM in real-world practice.

Practice implications

Greater attention to relational dynamics, patient expectations, and context have the potential to enhance the quality of SDM between PwOA and physiotherapists.

为了提高共同决策（SDM）的质量，本研究考察了骨关节炎患者（PwOA）和物理治疗师感知到的影响共同决策（SDM）的因素，以及这些感知如何与广泛使用的SDM模型相一致。方法采用定性讲故事的方法，收集荷兰10名PwOA和7名物理治疗师的叙述。参与者分享了在物理治疗实践中与SDM相关的个人生活经历（“故事”），共有144个独特的故事，其中118个与决策有关，并被纳入进一步分析。这些故事由一个多学科研究小组通过七阶段专题分析进行分析（n = 12）。主题被绘制到摩尔和卡普兰的SDM模型上。结果分析揭示了六个主题：决策是一个相互作用的过程（四个方面，51个故事）；患者期望对决策的影响（四个方面，48个故事）；传播与信息提供（两个方面，39个故事）；患者的声音和身份（三个方面，33个故事）；患者与医疗服务提供者之间的关系（两个方面，26个故事）；影响决策的外部因素（两个方面，23个故事）。PwOA和物理治疗师共有12个方面，1个是PwOA独有的，4个是物理治疗师独有的。所有方面都符合摩尔和卡普兰的SDM模型；12个项目与特定阶段相关，5个项目跨越多个阶段。结论本研究揭示了SDM在物理治疗中的复杂性。讲故事揭示了（权力）动力和物理环境等因素似乎会影响决策。明确地处理这些动态可能为加强理论SDM模型、临床培训和现实世界实践中的SDM提供机会。对关系动态、患者期望和环境的更多关注有可能提高PwOA和物理治疗师之间SDM的质量。

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引用次数: 0

Components of empathy: A Delphi study 共情的组成：德尔菲研究

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

Patient Education and Counseling

Pub Date : 2025-11-21 DOI: 10.1016/j.pec.2025.109430

Monika Byrne, Svetlana Daly, Clare M. McCann, Anna Miles

Objectives

The aim of this study was to define the components of empathy in the helping professions through group discussion between experts who rely on empathy in their work.

Methods

In round 1 of the three round online Delphi study, we developed the draft definition based on healthcare education, affective neuroscience and psychology literature on empathy. Professionals practising in New Zealand and Australia in the fields of medicine, nursing, allied health, psychology, counselling, social work and education were invited to participate. In round 2, participants indicated their agreement with empathy components and suggested improvements. In round 3, experts received a summary of the group responses and rated the modified empathy components. Threshold for inclusion of components in the final definition was 70 % agreement.

Results

Forty-three experts participated in round 2 and 25 in round 3. In round 2, 8 out of 12 components achieved 70 % agreement. Having considered participant feedback, multiple versions of some components were included in round 3 to improve their phrasing. Four components below the agreement threshold were updated and included in round 3, together with 3 new components.

Conclusions

The resulting definition of empathy focuses on sustainable ways empathy can be shown and the skills this capacity relies on. The components and sub-skills of empathy are self-reflection, which helps process empathic encounters and learn from them for the future; emotional intelligence, including self-regulation of emotions; self-awareness, specifically of own biases; avoiding judgement; active listening; and helpful action, understood as knowing what to do or say that another person may find helpful in a particular situation, especially when it is not possible to confirm their needs. The resulting empathy definition, highlighting its underlying skills, can guide the development of empathy fostering educational programs and the creation of measures that accurately reflect students’ proficiency in these skills.

目的本研究的目的是通过在工作中依赖共情的专家之间的小组讨论来定义帮助者职业中共情的组成部分。方法在三轮在线德尔菲研究的第一轮中，我们基于医疗保健教育、情感神经科学和心理学文献制定了关于共情的定义草案。邀请了在新西兰和澳大利亚从事医学、护理、联合保健、心理学、咨询、社会工作和教育等领域的专业人员参加。在第二轮中，参与者表示他们同意共情成分并提出改进建议。在第三轮中，专家们收到了小组反应的总结，并对修改后的移情成分进行了评分。最终定义中包含成分的阈值为70% %一致性。结果第2轮共有43名专家参与，第3轮共有25名专家参与。在第2轮中，12个组成部分中有8个达到了70% %的一致性。考虑到参与者的反馈，在第三轮中加入了一些组件的多个版本，以改进它们的措辞。低于协议阈值的四个组成部分被更新并纳入第3轮，以及3个新组成部分。结论共情的定义侧重于持续的共情表现方式和这种能力所依赖的技能。共情的组成部分和子技能是自我反思，它有助于处理共情遭遇并从中吸取教训；情商，包括情绪的自我调节；自我意识，特别是对自己偏见的意识；避免判断;积极倾听;以及有益的行动，被理解为知道在特定情况下做什么或说什么可能对另一个人有帮助，特别是当不可能确认他们的需求时。由此产生的共情定义，突出了其潜在的技能，可以指导共情培养教育项目的发展，并创建准确反映学生对这些技能熟练程度的措施。

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引用次数: 0

The role of perceived stress in the relationship between sexual communication, health literacy, and quality of life in women diagnosed with cervical cancer 感知到的压力在诊断为宫颈癌的妇女的性交流、卫生知识和生活质量之间的关系中的作用

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

Patient Education and Counseling

Pub Date : 2025-11-20 DOI: 10.1016/j.pec.2025.109428

Magdalena Liberacka-Dwojak , Monika Wiłkość-Dębczyńska , Roman Makarewicz

Objectives

This study aimed to examine the relationships between sexual communication self-efficacy, health literacy, perceived stress, and QoL in women with CC before the initiation of the proper treatment.

Methods

The study was conducted at the Oncology Center involving 60 women aged 40–65 with stage II-III CC undergoing radiotherapy or brachytherapy. Participants completed the 36-item Short Form Survey (SF-36) for QoL, the Female Sexual Function Index (FSFI), the Sexual Communication Self-Efficacy Scale (SCSES), the European Health Literacy Survey Questionnaire (HLS-EU-Q16), and the Perceived Stress Scale (PSS-10).

Results

Sexual communication self-efficacy was positively related to all QoL components (r = {0.458; 0.713}; p < 0.001). Health literacy significantly impacted sexual functioning (F(2) = 6.003; p = 0.004), but not physical or psychological functioning. Perceived stress negatively influenced all QoL components (r = {-0.402; −0.662}; p < 0.001) and mediated the relationships between sexual communication self-efficacy, health literacy, and QoL. SEM confirmed the model fit (CMIN/df = 1.558; TLI = 0.964; IFI = 0.978; CFI = 0.997; RMSEA = 0.097).

Conclusions

These findings emphasize the significance of holistic care approaches that integrate psychological, social, and biological factors to enhance the QoL for women undergoing cancer treatment.

Practical implication

Early psychological interventions that focus on stress reduction, communication skills, and improving health literacy could be integrated into prehabilitation programs for women with cervical cancer. Such interventions may strengthen patients’ coping resources, improve sexual health, and promote better quality of life throughout the treatment trajectory.

目的探讨CC女性在接受适当治疗前的性沟通自我效能感、健康素养、压力感知和生活质量之间的关系。该研究在肿瘤中心进行，涉及60名年龄40-65岁的II-III期CC患者，接受放疗或近距离治疗。参与者完成了36项生活质量短表调查（SF-36）、女性性功能指数（FSFI）、性交流自我效能感量表（SCSES）、欧洲健康素养调查问卷（HLS-EU-Q16）和压力感知量表（PSS-10）。结果性交流自我效能感与生活质量各成分呈正相关（r = {0.458;0.713};p <； 0.001）。健康素养显著影响性功能(F(2) = 6.003；P = 0.004)，而不是身体或心理功能。感知压力负向影响所有生活质量成分（r = {-0.402;−0.662};p <； 0.001），并介导性沟通自我效能感、健康素养和生活质量之间的关系。SEM证实模型拟合（CMIN/df = 1.558; TLI = 0.964; IFI = 0.978; CFI = 0.997; RMSEA = 0.097）。结论综合心理、社会和生物学因素的整体护理方法对提高女性癌症患者的生活质量具有重要意义。实际意义侧重于减轻压力、沟通技巧和提高健康素养的早期心理干预措施可以纳入宫颈癌妇女的康复计划。这些干预措施可以加强患者的应对资源，改善性健康，并在整个治疗过程中提高生活质量。

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引用次数: 0

Development of a complex intervention to support patients managing cystic fibrosis diabetes 开发一种支持囊性纤维化糖尿病患者管理的复杂干预措施

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

Patient Education and Counseling

Pub Date : 2025-11-19 DOI: 10.1016/j.pec.2025.109407

Sarah Collins , Andrew Jones , Rita Forde , Sue Woodward

Objectives

Cystic fibrosis diabetes (CFD) is the most common co-morbidity affecting nearly half of adults with cystic fibrosis over 30 years. Contrary to UK clinical guidelines there are currently no self-management education programmes for people with CFD. The aim of this paper is to describe the development of a self-management education programme for people with CFD.

Methods

this study was guided by the Medical Research Council framework for developing and evaluating complex interventions. Programme development took part in three phases: identifying the evidence base, identifying/developing theory, and modelling process and outcomes. A stakeholder development group, consisting of expert healthcare professionals and people with CFD, were actively involved in the development of this intervention.

Results

Together with the stakeholder development group, we developed a self-management education programme for people with CFD. The MAGIC (managing abnormal glucose in CF) programme consists of four web-based modules: CF beginner, CF improver, CF advancer and CF wizard and is designed as a patient focussed, staged approach to learning. The MAGIC programme was highly regarded by the participants who reviewed it and all identified technological problems, omissions, errors and comprehension difficulties were addressed before face validity was established.

Conclusions

The MRC framework was successfully applied to develop the MAGIC programme, a unique web-based self-management education programme for people with CFD. It is grounded in evidence generated from a qualitative systematic review, qualitative interviews and shared experiences of people with CFD and healthcare professional expert in the management of CFD.

Practice implications

With improvements in survival observed in the CF population it is imperatives that resources are available to support the effective management of CFD effective. The MAGIC programme was well received by individuals with CFD. It requires further adaptations prior to further studies to demonstrate its efficacy for use in clinical practice.

囊性纤维化糖尿病（CFD）是最常见的合并症，在30岁以上的囊性纤维化成年人中有近一半的患者。与英国临床指南相反，目前没有针对CFD患者的自我管理教育计划。本文的目的是描述CFD患者自我管理教育计划的发展。方法本研究以医学研究委员会制定和评估复杂干预措施的框架为指导。项目发展分三个阶段进行：确定证据基础、确定/发展理论、模拟过程和结果。由医疗保健专家和CFD患者组成的利益相关者开发小组积极参与了该干预措施的开发。结果与利益相关者发展小组一起，我们为CFD患者开发了一个自我管理教育计划。MAGIC（管理CF中的异常葡萄糖）程序由四个基于网络的模块组成：CF初学者，CF改善者，CF高级和CF向导，并被设计为以患者为中心，分阶段学习的方法。MAGIC方案得到了审查它的参与者的高度评价，所有确定的技术问题、遗漏、错误和理解困难都在面孔有效性建立之前得到解决。MRC框架成功地应用于开发MAGIC计划，这是一个独特的基于网络的CFD患者自我管理教育计划。它基于定性系统回顾、定性访谈以及CFD患者和CFD管理方面的医疗保健专业专家的共享经验所产生的证据。实践意义随着观察到的CF患者生存率的提高，有必要提供资源来支持对CFD的有效管理。MAGIC计划受到患有CFD的个人的欢迎。在进一步的研究证明其在临床实践中的有效性之前，它需要进一步的适应。

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引用次数: 0

Genetic counseling and testing for dementia – A scoping review of patient and relatives experiences and outcomes 痴呆症的遗传咨询和测试-患者和亲属的经历和结果的范围审查。

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

Patient Education and Counseling

Pub Date : 2025-11-19 DOI: 10.1016/j.pec.2025.109424

Gary Chen , Adrienne Sexton

Objective

This scoping review aims to map the experiences and outcomes of patients and their families undergoing genetic testing and counseling regarding dementia to inform future research directions and clinical practice.

Methods

Rigorous scoping review methodology was followed. Ovid Medline, Embase, PsycINFO, and CINAHL were searched with keywords and MeSH terms related to “genetic testing”, “genetic counseling”, “dementia”, “decision making”, and “patient outcomes” for peer-reviewed studies with adult participants published over the last ten years.

Results

Thirty-six articles met inclusion criteria. Narrative synthesis organized findings into temporal categories including motivations for genetic testing, experiences during the testing/counseling process, and outcomes after testing. Common motivators included reducing uncertainty, reproductive planning, life planning, and the prospect of a treatment becoming available in the future. A lack of current treatments and fear that knowledge of genetic risk would be difficult to cope with were common barriers to testing. Patient-centered communication improved satisfaction. Genetic testing was generally psychologically well tolerated, and a wide range of practical responses were reported including changes to lifestyle, diet, advanced care and financial planning, and engaging in clinical trials.

Conclusion

This review maps the experiences and outcomes of genetic testing or counseling for people with or at potentially increased genetic risk of dementia. Genetic testing and counseling for directly causal dementia genes and APOE genotype appears well tolerated but long-term outcome data is lacking. Motivations, concerns and perceived benefits of knowing genetic results vary depending on personal, familial and cultural viewpoints. Genetic counseling can help patients and families prepare, reduce decisional regret, and adapt to results.

Practice implications

Motivations varied, and a patient-centered approach addressing both information and psychological aspects improves satisfaction. Future longitudinal research should ascertain ways to support individuals from a wide range of demographics with understanding and adjusting to genetic risk information regarding dementia.

目的：本综述旨在了解痴呆症患者及其家属接受基因检测和咨询的经验和结果，为未来的研究方向和临床实践提供信息。方法：采用严格的范围审查方法。在Ovid Medline、Embase、PsycINFO和CINAHL上检索了与“基因检测”、“遗传咨询”、“痴呆”、“决策”和“患者结果”相关的关键词和MeSH术语，以检索过去十年发表的同行评议的成人参与者研究。结果：36篇文章符合纳入标准。叙事综合将发现分为时间类别，包括基因测试的动机、测试/咨询过程中的经历和测试后的结果。常见的动机包括减少不确定性，生育计划，生活计划，以及未来治疗的前景。缺乏现有的治疗方法和对遗传风险知识难以应对的恐惧是检测的常见障碍。以患者为中心的沟通提高了满意度。一般来说，基因测试在心理上是可以接受的，并且广泛的实际反应被报道，包括改变生活方式、饮食、高级护理和财务规划，以及参与临床试验。结论：这篇综述描绘了对患有或有潜在增加的痴呆症遗传风险的人进行基因检测或咨询的经验和结果。对直接导致痴呆的基因和APOE基因型的基因检测和咨询似乎耐受良好，但缺乏长期结果数据。了解遗传结果的动机、关注点和感知到的好处因个人、家庭和文化观点而异。遗传咨询可以帮助患者和家属做好准备，减少决策后悔，并适应结果。实践启示：动机各不相同，以患者为中心的方法解决信息和心理方面提高满意度。未来的纵向研究应该确定如何从广泛的人口统计数据中支持个人了解和适应与痴呆有关的遗传风险信息。

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引用次数: 0

Structured pharmaceutical interviews enhance knowledge and medication adherence in DOAC therapy: Insights from the EDUC-AOD study 结构化的药学访谈提高了DOAC治疗的知识和药物依从性：来自educo - aod研究的见解

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

Patient Education and Counseling

Pub Date : 2025-11-19 DOI: 10.1016/j.pec.2025.109423

Samuel D. Cohen , François Bouvier , Claire-Marie Tissot , Alice Viallet , Caroline Leiterer , Frédéric Tacco , Jean-Marc Dauchot , François Kramp , Catherine Verret , Solenne Martin , Hubert Nielly , Albert Boccara

Objective

Direct oral anticoagulants (DOACs) are first-line therapies for atrial fibrillation and venous thromboembolism. Structured pharmaceutical interviews (SPIs) aim to enhance patient knowledge of DOAC therapy, thereby improving medication adherence and reducing both disease-related and treatment-related complications. The EDUC-AOD study was conducted to assess the impact of SPIs on patient knowledge, medication adherence, and clinical complications.

Methods

Patients newly prescribed DOACs were enrolled from two centers, with only one center delivering SPIs. The primary objective was to evaluate the impact of SPIs on patients’ knowledge and medication adherence at 3 months, using standardized questionnaires. Secondary objectives included evaluating the impact of SPIs on clinical complications, as well as knowledge and medication adherence at 6 months. Multivariate logistic regression analysis, adjusted for propensity score, was used to identify predictors of improved knowledge and adherence.

Results

From January 2021 to June 2023, 145 patients were enrolled: 68 in the intervention group and 77 in the control group. At 3 months, the intervention group demonstrated significantly higher rates of satisfactory knowledge (74 % vs. 12 %, p < 0.001) and good medication adherence (86 % vs. 64 %, p = 0.008). SPIs were significant predictors of satisfactory knowledge (OR = 23.6, 95 % CI [8.3–81.1], p < 0.001) and good medication adherence (OR = 3.5, 95 % CI [1.4–10.0], p = 0.012). Treatment indication (OR = 4.9, 95 % CI [1.7–16.3], p = 0.005) and lower HAS-BLED score (OR = 0.4, 95 % CI [0.1–1.0], p = 0.039) were also associated with improved outcomes. At 6 months, the intervention group experienced significantly fewer clinical complications (0 vs. 9, p = 0.010).

Conclusion

SPIs substantially enhance patients’ knowledge and adherence to DOAC therapy and reduce clinical complications. Integrating SPIs into routine care may optimize anticoagulant management. Further randomized trials are needed to confirm these findings.

目的直接口服抗凝剂（DOACs）是房颤和静脉血栓栓塞的一线治疗方法。结构化药物访谈（SPIs）旨在提高患者对DOAC治疗的认识，从而提高药物依从性，减少与疾病和治疗相关的并发症。educo - aod研究旨在评估SPIs对患者知识、药物依从性和临床并发症的影响。方法从两个中心招募新开doac的患者，其中只有一个中心提供SPIs。主要目的是使用标准化问卷评估SPIs对患者3个月时的知识和药物依从性的影响。次要目标包括评估SPIs对临床并发症的影响，以及6个月时的知识和药物依从性。多变量逻辑回归分析，调整倾向评分，用于确定提高知识和依从性的预测因素。结果从2021年1月至2023年6月，共纳入145例患者：干预组68例，对照组77例。在3个月时，干预组表现出更高的满意知识率（74 %对12 %，p <； 0.001）和良好的药物依从性（86 %对64 %，p = 0.008）。spi是令人满意的知识（OR = 23.6, 95 % CI [8.3-81.1], p <； 0.001）和良好的药物依从性（OR = 3.5, 95 % CI [1.4-10.0], p = 0.012）的显著预测因子。治疗适应症（OR = 4.9, 95 % CI [1.7-16.3], p = 0.005）和较低的HAS-BLED评分（OR = 0.4, 95 % CI [0.1-1.0], p = 0.039）也与预后改善相关。6个月时，干预组的临床并发症明显减少（0比9，p = 0.010）。结论spi显著提高了患者对DOAC治疗的认知度和依从性，减少了临床并发症。将spi纳入常规护理可优化抗凝管理。需要进一步的随机试验来证实这些发现。

{"title":"Structured pharmaceutical interviews enhance knowledge and medication adherence in DOAC therapy: Insights from the EDUC-AOD study","authors":"Samuel D. Cohen , François Bouvier , Claire-Marie Tissot , Alice Viallet , Caroline Leiterer , Frédéric Tacco , Jean-Marc Dauchot , François Kramp , Catherine Verret , Solenne Martin , Hubert Nielly , Albert Boccara","doi":"10.1016/j.pec.2025.109423","DOIUrl":"10.1016/j.pec.2025.109423","url":null,"abstract":"<div><h3>Objective</h3><div>Direct oral anticoagulants (DOACs) are first-line therapies for atrial fibrillation and venous thromboembolism. Structured pharmaceutical interviews (SPIs) aim to enhance patient knowledge of DOAC therapy, thereby improving medication adherence and reducing both disease-related and treatment-related complications. The EDUC-AOD study was conducted to assess the impact of SPIs on patient knowledge, medication adherence, and clinical complications.</div></div><div><h3>Methods</h3><div>Patients newly prescribed DOACs were enrolled from two centers, with only one center delivering SPIs. The primary objective was to evaluate the impact of SPIs on patients’ knowledge and medication adherence at 3 months, using standardized questionnaires. Secondary objectives included evaluating the impact of SPIs on clinical complications, as well as knowledge and medication adherence at 6 months. Multivariate logistic regression analysis, adjusted for propensity score, was used to identify predictors of improved knowledge and adherence.</div></div><div><h3>Results</h3><div>From January 2021 to June 2023, 145 patients were enrolled: 68 in the intervention group and 77 in the control group. At 3 months, the intervention group demonstrated significantly higher rates of satisfactory knowledge (74 % vs. 12 %, p < 0.001) and good medication adherence (86 % vs. 64 %, p = 0.008). SPIs were significant predictors of satisfactory knowledge (OR = 23.6, 95 % CI [8.3–81.1], p < 0.001) and good medication adherence (OR = 3.5, 95 % CI [1.4–10.0], p = 0.012). Treatment indication (OR = 4.9, 95 % CI [1.7–16.3], p = 0.005) and lower HAS-BLED score (OR = 0.4, 95 % CI [0.1–1.0], p = 0.039) were also associated with improved outcomes. At 6 months, the intervention group experienced significantly fewer clinical complications (0 vs. 9, p = 0.010).</div></div><div><h3>Conclusion</h3><div>SPIs substantially enhance patients’ knowledge and adherence to DOAC therapy and reduce clinical complications. Integrating SPIs into routine care may optimize anticoagulant management. Further randomized trials are needed to confirm these findings.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109423"},"PeriodicalIF":3.1,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736651","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

Designing a lifestyle intervention to optimise cardiometabolic health in high-risk prenatal and postnatal women: A pre-implementation study 设计一种生活方式干预以优化高危产前和产后妇女的心脏代谢健康：一项实施前研究

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

Patient Education and Counseling

Pub Date : 2025-11-19 DOI: 10.1016/j.pec.2025.109422

Elaine K. Osei-Safo , Angela Melder , Frances Taylor , Kaylee Slater , Anjana Reddy , Lisa Moran , Sarah Lang

Objectives

To explore key stakeholder’s perspectives and co-design the design, content and delivery of a lifestyle intervention to optimise cardiometabolic health during and after pregnancy for women at risk or diagnosed with gestational diabetes mellitus (GDM) and/or hypertensive disorders of pregnancy (HDP).

Methods

Pre-implementation qualitative study using co-design workshops (n = 2) and semi-structured interviews (n = 6). Workshop discussions and interviews were audio recorded, transcribed and thematically analysed using template analysis.

Results

Women with prior cardiometabolic pregnancy complications (n = 11) and research partners (n = 13) participated. Participants reported liking that the intervention fills a healthcare gap and highlighted the importance of a holistic, user-friendly, patient-centred, culturally diverse approach to intervention design, content and delivery. Delivery by female healthcare professionals who utilise good risk communication skills, display empathy and understanding was recommended to empower and support women with the knowledge, resources and skills to take ownership of their health and reduce cardiometabolic risks.

Conclusion

This research supported the co-design of a lifestyle intervention to reduce cardiometabolic risks in women at risk or diagnosed with GDM and/or HDP.

Practice implications

The findings demonstrate the importance of stakeholder engagement in intervention design and the need for a patient-centred approach when developing lifestyle interventions for pregnant and postpartum women at risk of cardiometabolic conditions.

目的探讨关键利益相关者的观点，共同设计生活方式干预的设计、内容和交付，以优化妊娠期糖尿病（GDM）和/或妊娠期高血压疾病（HDP）风险或诊断为妊娠期糖尿病（GDM）和/或妊娠期高血压疾病（HDP）的妇女妊娠期间和妊娠后的心脏代谢健康。方法采用协同设计研讨会（n = 2）和半结构化访谈（n = 6）进行实施前定性研究。对讲习班讨论和访谈进行了录音、转录，并使用模板分析对主题进行了分析。结果既往有妊娠心脏代谢并发症的妇女（n = 11）和研究伙伴（n = 13）参与研究。与会者报告说，该干预措施填补了医疗保健方面的空白，并强调了在干预措施的设计、内容和实施方面采取全面、用户友好、以患者为中心、文化多样化的方法的重要性。建议利用良好的风险沟通技巧、表现出同理心和理解能力的女性保健专业人员提供服务，以增强和支持妇女的知识、资源和技能，使她们能够掌握自己的健康并减少心脏代谢风险。结论：本研究支持生活方式干预的共同设计，以降低有风险或诊断为GDM和/或HDP的妇女的心脏代谢风险。实践意义研究结果表明，利益相关者参与干预设计的重要性，以及在为有心脏代谢疾病风险的孕妇和产后妇女制定生活方式干预措施时，需要以患者为中心的方法。

{"title":"Designing a lifestyle intervention to optimise cardiometabolic health in high-risk prenatal and postnatal women: A pre-implementation study","authors":"Elaine K. Osei-Safo , Angela Melder , Frances Taylor , Kaylee Slater , Anjana Reddy , Lisa Moran , Sarah Lang","doi":"10.1016/j.pec.2025.109422","DOIUrl":"10.1016/j.pec.2025.109422","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore key stakeholder’s perspectives and co-design the design, content and delivery of a lifestyle intervention to optimise cardiometabolic health during and after pregnancy for women at risk or diagnosed with gestational diabetes mellitus (GDM) and/or hypertensive disorders of pregnancy (HDP).</div></div><div><h3>Methods</h3><div>Pre-implementation qualitative study using co-design workshops (n = 2) and semi-structured interviews (n = 6). Workshop discussions and interviews were audio recorded, transcribed and thematically analysed using template analysis.</div></div><div><h3>Results</h3><div>Women with prior cardiometabolic pregnancy complications (n = 11) and research partners (n = 13) participated. Participants reported liking that the intervention fills a healthcare gap and highlighted the importance of a holistic, user-friendly, patient-centred, culturally diverse approach to intervention design, content and delivery. Delivery by female healthcare professionals who utilise good risk communication skills, display empathy and understanding was recommended to empower and support women with the knowledge, resources and skills to take ownership of their health and reduce cardiometabolic risks.</div></div><div><h3>Conclusion</h3><div>This research supported the co-design of a lifestyle intervention to reduce cardiometabolic risks in women at risk or diagnosed with GDM and/or HDP.</div></div><div><h3>Practice implications</h3><div>The findings demonstrate the importance of stakeholder engagement in intervention design and the need for a patient-centred approach when developing lifestyle interventions for pregnant and postpartum women at risk of cardiometabolic conditions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109422"},"PeriodicalIF":3.1,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579893","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

A scoping review of communication tools for risk-based breast cancer screening 基于风险的乳腺癌筛查沟通工具的范围审查

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

Patient Education and Counseling

Pub Date : 2025-11-19 DOI: 10.1016/j.pec.2025.109425

Claire Hudson , Jennifer Isauiter , Nehmat Houssami , M. Luke Marinovich , Jennifer Brooks , Naomi Noguchi , Brooke Nickel

Objectives

Risk-based breast cancer screening involves giving women tailored recommendations regarding breast screening initiation, frequency and imaging modalities based on their personal breast cancer risk. It is unclear what risk-based screening communication tools exist across the world for women between 50 and 74 years of age. Hence this scoping review aimed to investigate the breadth of communication tools available to inform women, without a previous breast cancer diagnosis nor those who are known carriers of cancer-susceptibility genes, of risk-based screening and to report an overview of the information the tools present.

Methods

Medline, CINAHL, Scopus and Cochrane Library databases and grey literature using Google advanced were searched. The readability, understandability and actionability of each tool was assessed.

Results

Four research articles and five additional communication tools were identified as relevant for the design and testing of risk-based screening communication. The discussed benefits and harms of risk-based screening and breast cancer risk factors varied between communication tools with some including outcomes not substantiated by robust evidence. Moreover, the readability and actionability of communication tools varied and were limited. The understandability of most tools was adequate.

Conclusions

There are few risk-based screening communication tools designed, tested and available for women without a previous breast cancer diagnosis nor those who are known carriers of cancer-susceptibility genes.

Practice implications

Addressing the balance of risks and benefits in future communication tools, and their readability and actionability is important for access to valuable decision support.

目的基于风险的乳腺癌筛查包括根据女性的个人乳腺癌风险，就乳腺癌筛查的开始、频率和成像方式向女性提供量身定制的建议。目前尚不清楚世界各地针对50岁至74岁女性存在哪些基于风险的筛查沟通工具。因此，本综述的目的是调查现有通信工具的广度，以告知没有乳腺癌诊断或已知癌症易感基因携带者的妇女进行基于风险的筛查，并报告现有工具的信息概述。方法检索medline、CINAHL、Scopus和Cochrane图书馆数据库及谷歌advanced灰色文献。评估各工具的可读性、可理解性和可操作性。结果四篇研究论文和五种额外的沟通工具被确定为与基于风险的筛查沟通的设计和测试相关。所讨论的基于风险的筛查和乳腺癌危险因素的利弊因交流工具而异，其中一些结果没有得到有力证据的证实。此外，通信工具的可读性和可操作性各不相同，而且受到限制。大多数工具的可理解性是足够的。结论很少有基于风险的筛查沟通工具被设计、测试并可用于没有乳腺癌诊断的女性或已知的癌症易感基因携带者。实践意义在未来的沟通工具中处理风险和利益的平衡，以及它们的可读性和可操作性对于获得有价值的决策支持是很重要的。

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引用次数: 0