Patient Education and Counseling最新文献_第7页

Diversity, equity, and inclusion in patient engagement in healthcare interactions

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

Patient Education and Counseling

Pub Date : 2025-01-10 DOI: 10.1016/j.pec.2025.108647

Maria K. Venetis, Shawnika J. Hull

引用次数: 0

Promoting interactional health equity through (Complementary and Integrative Health) talk during clinical encounters

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

Patient Education and Counseling

Pub Date : 2025-01-10 DOI: 10.1016/j.pec.2025.108651

Evelyn Y. Ho , Christopher J. Koenig

Objectives

Complementary and Integrative Health (CIH) is recognized as a set of modalities to bolster health and well-being often outside of standard biomedical practice. How people discuss CIH with their biomedical providers is a microcosm for health communication more generally. In this Discussion, we propose a revision of the Street et al. (2009) conceptual framework to illustrate how CIH talk during a clinical encounter has the potential to contribute to (or detract from) interactional health equity.

Methods

We use discourse analytic techniques to re-analyze two digitally recorded biomedical encounters.

Results

Two case studies are re-analyzed to illustrate how clinician-client conversation about CIH during a clinical encounter might lead to interactional health equity.

Conclusions

Interactions with clinicians can be challenging due to differences in knowledge about biomedicine, administrative processes, and even navigating interpersonal relationships. How a clinician responds can either center a biomedical agenda in the Voice of Medicine or help ratify a patient’s agenda in the Voice of the Lifeworld. How clinicians and patients negotiate CIH talk is conceptually linked with immediate interactional outcomes.

Practice implications

In populations in which patients/caregivers or their extended communities may already have low trust in biomedicine, a mistrustful therapeutic alliance, or history of discrimination, disattention of the Lifeworld and avoiding talk about CIH has the possibility of exacerbating inequities. Every turn at talk during a clinical encounter has the potential to foster increased social participation which, in turn, may contribute to health outcomes and influence patient and community well-being at individual, community, and institutional levels. CIH talk can open space for patients to actively participate in healthcare by incorporating the patients’ Lifeworld into the clinical encounter and can contribute to interactional health equity within clinical encounters.

{"title":"Promoting interactional health equity through (Complementary and Integrative Health) talk during clinical encounters","authors":"Evelyn Y. Ho , Christopher J. Koenig","doi":"10.1016/j.pec.2025.108651","DOIUrl":"10.1016/j.pec.2025.108651","url":null,"abstract":"<div><h3>Objectives</h3><div>Complementary and Integrative Health (CIH) is recognized as a set of modalities to bolster health and well-being often outside of standard biomedical practice. How people discuss CIH with their biomedical providers is a microcosm for health communication more generally. In this Discussion, we propose a revision of the Street et al. (2009) conceptual framework to illustrate how CIH talk during a clinical encounter has the potential to contribute to (or detract from) interactional health equity.</div></div><div><h3>Methods</h3><div>We use discourse analytic techniques to re-analyze two digitally recorded biomedical encounters.</div></div><div><h3>Results</h3><div>Two case studies are re-analyzed to illustrate how clinician-client conversation about CIH during a clinical encounter might lead to interactional health equity.</div></div><div><h3>Conclusions</h3><div>Interactions with clinicians can be challenging due to differences in knowledge about biomedicine, administrative processes, and even navigating interpersonal relationships. How a clinician responds can either center a biomedical agenda in the Voice of Medicine or help ratify a patient’s agenda in the Voice of the Lifeworld. How clinicians and patients negotiate CIH talk is conceptually linked with immediate interactional outcomes.</div></div><div><h3>Practice implications</h3><div>In populations in which patients/caregivers or their extended communities may already have low trust in biomedicine, a mistrustful therapeutic alliance, or history of discrimination, disattention of the Lifeworld and avoiding talk about CIH has the possibility of exacerbating inequities. Every turn at talk during a clinical encounter has the potential to foster increased social participation which, in turn, may contribute to health outcomes and influence patient and community well-being at individual, community, and institutional levels. CIH talk can open space for patients to actively participate in healthcare by incorporating the patients’ Lifeworld into the clinical encounter and can contribute to <em>interactional health equity</em> within clinical encounters.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108651"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042937","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 ecological model of communication in medical encounters: A scoping review

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

Patient Education and Counseling

Pub Date : 2025-01-10 DOI: 10.1016/j.pec.2025.108646

Lillie D. Williamson , Lynne M. Cotter , Brook L. Couch , Grace K. Herndon

Objective

The ecological model of communication in medical encounters (EMCME) could provide a framework for examining issues related to health equity in healthcare interactions. This study seeks to understand how scholarship has engaged with the model and the extent of its use in health equity work.

Methods

A scoping review of the EMCME was conducted using three major databases: Scopus, Web of Science, and Google Scholar in September 2023. Databases were searched for works citing the article explicating the model.

Results

The search returned 336 unique documents. After inclusion and exclusion criteria were applied, 85 documents remained and were analyzed. Many pieces described the model or used the model to frame their work; far fewer pieces used the model to test empirical relationships. Most works, however, focused on a single context: interpersonal. Twenty-five works directly used the model in relation to health equity.

Conclusion

There are several contexts of the model that remain underexplored. More attention to these contexts may not only help to better the clinical encounter but advance health equity.

Practice implications

Increased use of the full EMCME in all facets – research, practice, and teaching – could provide a framework for framing and organizing work around health equity.

{"title":"The ecological model of communication in medical encounters: A scoping review","authors":"Lillie D. Williamson , Lynne M. Cotter , Brook L. Couch , Grace K. Herndon","doi":"10.1016/j.pec.2025.108646","DOIUrl":"10.1016/j.pec.2025.108646","url":null,"abstract":"<div><h3>Objective</h3><div>The ecological model of communication in medical encounters (EMCME) could provide a framework for examining issues related to health equity in healthcare interactions. This study seeks to understand how scholarship has engaged with the model and the extent of its use in health equity work.</div></div><div><h3>Methods</h3><div>A scoping review of the EMCME was conducted using three major databases: Scopus, Web of Science, and Google Scholar in September 2023. Databases were searched for works citing the article explicating the model.</div></div><div><h3>Results</h3><div>The search returned 336 unique documents. After inclusion and exclusion criteria were applied, 85 documents remained and were analyzed. Many pieces described the model or used the model to frame their work; far fewer pieces used the model to test empirical relationships. Most works, however, focused on a single context: interpersonal. Twenty-five works directly used the model in relation to health equity.</div></div><div><h3>Conclusion</h3><div>There are several contexts of the model that remain underexplored. More attention to these contexts may not only help to better the clinical encounter but advance health equity.</div></div><div><h3>Practice implications</h3><div>Increased use of the full EMCME in all facets – research, practice, and teaching – could provide a framework for framing and organizing work around health equity.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108646"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075676","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

Effects of warning information at medication initiation on deprescribing intentions in older adults: A hypothetical vignette 开始用药时警告信息对老年人处方意图的影响：一个假设的小插曲。

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

Patient Education and Counseling

Pub Date : 2025-01-10 DOI: 10.1016/j.pec.2025.108654

Sarah E. Vordenberg , Kari Ostaszewski , Vincent D. Marshall , Brian J. Zikmund-Fisher , Kristie Rebecca Weir

Objectives

To explore to what degree providing patients warning information about the long-term risks of a medication would affect their subsequent desire to discontinue it.

Methods

We conducted a vignette-based online experiment in which participants aged ≥ 65 years from the United States were asked to imagine starting and subsequently stopping omeprazole. Participants were randomized to one of four vignettes about starting omeprazole (potential long-term harms or no harm information; OTC vs. prescription). Participants reported interest in stopping omeprazole on a 6-point Likert scale. We calculated descriptive statistics and used logistic regression to compare participants with high (scores 4–6) versus low agreement (scores 1–3) with stopping.

Results

Participants (n = 1245) had a median age of 70 years. After adjusting for demographic characteristics, older adults who received warning information when starting the medication were more likely to agree to stop omeprazole (OR 1.21, 95 % C.I. 1.02, 1.43). Willingness to stop omeprazole was higher among women (vs. men), among respondents with higher literacy, and among those who had never or previously used PPIs (vs current use).

Conclusion

Warning information about potential long-term risks when initiating a medication may increase the likelihood of subsequently stopping a medication when recommended by a PCP.

目的：探讨向患者提供药物长期风险的警告信息在多大程度上影响他们随后的停药意愿。方法：我们进行了一项基于小视频的在线实验，要求年龄≥ 65岁的美国参与者想象开始和随后停止奥美拉唑。参与者被随机分配到四个关于开始服用奥美拉唑的小插曲中的一个(潜在的长期危害或没有危害信息；OTC vs.处方)。参与者报告对停止奥美拉唑的兴趣为6分李克特量表。我们计算了描述性统计数据，并使用逻辑回归来比较高（4-6分）和低（1-3分）的参与者是否停止。结果：参与者（n = 1245）的中位年龄为70岁。在调整人口统计学特征后，在开始用药时收到警告信息的老年人更有可能同意停用奥美拉唑（OR 1.21, 95 % C.I. 1.02, 1.43）。女性（与男性相比）、文化程度较高的受访者以及从未或以前使用过PPIs的受访者（与目前使用的受访者相比）停用奥美拉唑的意愿更高。结论：在开始用药时关于潜在长期风险的警告信息可能会增加随后在PCP推荐下停药的可能性。

{"title":"Effects of warning information at medication initiation on deprescribing intentions in older adults: A hypothetical vignette","authors":"Sarah E. Vordenberg , Kari Ostaszewski , Vincent D. Marshall , Brian J. Zikmund-Fisher , Kristie Rebecca Weir","doi":"10.1016/j.pec.2025.108654","DOIUrl":"10.1016/j.pec.2025.108654","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore to what degree providing patients warning information about the long-term risks of a medication would affect their subsequent desire to discontinue it.</div></div><div><h3>Methods</h3><div>We conducted a vignette-based online experiment in which participants aged ≥ 65 years from the United States were asked to imagine starting and subsequently stopping omeprazole. Participants were randomized to one of four vignettes about starting omeprazole (potential long-term harms or no harm information; OTC vs. prescription). Participants reported interest in stopping omeprazole on a 6-point Likert scale. We calculated descriptive statistics and used logistic regression to compare participants with high (scores 4–6) versus low agreement (scores 1–3) with stopping.</div></div><div><h3>Results</h3><div>Participants (n = 1245) had a median age of 70 years. After adjusting for demographic characteristics, older adults who received warning information when starting the medication were more likely to agree to stop omeprazole (OR 1.21, 95 % C.I. 1.02, 1.43). Willingness to stop omeprazole was higher among women (vs. men), among respondents with higher literacy, and among those who had never or previously used PPIs (vs current use).</div></div><div><h3>Conclusion</h3><div>Warning information about potential long-term risks when initiating a medication may increase the likelihood of subsequently stopping a medication when recommended by a PCP.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108654"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014976","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 doctor will see you now… but not for long”: Linking physicians’ racial attitudes and patients’ discrimination experiences to racial disparities in the duration of medical consultations “医生现在会来看你……但不会太久”：将医生的种族态度和患者的歧视经历与医疗咨询期间的种族差异联系起来。

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

Patient Education and Counseling

Pub Date : 2025-01-10 DOI: 10.1016/j.pec.2025.108653

Emerson Do Bú , Susan Eggly , Louis Penner , Nao Hagiwara

Objective

To investigate the relationship between non-Black physicians’ racial attitudes, Black patients’ discrimination experiences, and consultation duration in diverse clinical settings.

Methods

Secondary analyses were conducted on data from three prior studies involving non-Black primary care physicians (Study 1: n = 14, Study 2: n = 5) and their Black patients (Study 1: n = 118, Study 2: n = 31), as well as 15 non-Black oncologists and their 72 Black patients (Study 3). Data included physician and patient surveys, along with video-recorded consultations.

Results

Study 1 revealed that, relative to other physicians, physicians whose racial attitudes fit an aversive racist profile (i.e., low explicit racial bias, high implicit bias) had longer consultations with Black patients who reported more (vs. fewer) discrimination experiences. Study 2 and 3 found that physicians’ implicit racial bias is negatively associated with consultation duration. Finally, a meta-analysis supported the effects of aversive racism and patients’ discrimination experiences on consultation duration.

Discussion

These findings demonstrate how physicians’ racial attitudes and patients’ discrimination experiences can affect medical consultation duration—an important aspect of patient-provider communication quality.

Practical value

These results provide initial evidence for the importance of helping physicians manage the negative consequences of their implicit bias within the current structural constraints of limited medical consultation time and empowering Black patients to advocate for their healthcare needs.

目的：探讨不同临床环境下非黑人医生的种族态度、黑人患者的歧视经历与会诊时间的关系。方法：对先前三项研究的数据进行二次分析，这些研究涉及非黑人初级保健医生（研究1:n = 14，研究2:n = 5）及其黑人患者（研究1:n = 118，研究2:n = 31），以及15名非黑人肿瘤学家及其72名黑人患者（研究3）。数据包括医生和患者调查以及视频记录的咨询。结果：研究1显示，相对于其他医生，那些种族态度符合厌恶种族主义形象（即低显性种族偏见，高隐性偏见）的医生与报告更多（相对较少）歧视经历的黑人患者进行更长时间的咨询。研究2和3发现医生的隐性种族偏见与会诊时间呈负相关。最后，荟萃分析支持厌恶种族主义和患者歧视经历对咨询时间的影响。讨论：这些发现证明了医生的种族态度和患者的歧视经历如何影响医疗咨询的持续时间——这是医患沟通质量的一个重要方面。实用价值：这些结果为帮助医生在有限的医疗咨询时间的当前结构约束下管理其隐性偏见的负面后果的重要性提供了初步证据，并赋予黑人患者倡导其医疗保健需求的权力。

{"title":"“The doctor will see you now… but not for long”: Linking physicians’ racial attitudes and patients’ discrimination experiences to racial disparities in the duration of medical consultations","authors":"Emerson Do Bú , Susan Eggly , Louis Penner , Nao Hagiwara","doi":"10.1016/j.pec.2025.108653","DOIUrl":"10.1016/j.pec.2025.108653","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between non-Black physicians’ racial attitudes, Black patients’ discrimination experiences, and consultation duration in diverse clinical settings.</div></div><div><h3>Methods</h3><div>Secondary analyses were conducted on data from three prior studies involving non-Black primary care physicians (Study 1: <em>n</em> = 14, Study 2: <em>n</em> = 5) and their Black patients (Study 1: <em>n</em> = 118, Study 2: <em>n</em> = 31), as well as 15 non-Black oncologists and their 72 Black patients (Study 3). Data included physician and patient surveys, along with video-recorded consultations.</div></div><div><h3>Results</h3><div>Study 1 revealed that, relative to other physicians, physicians whose racial attitudes fit an aversive racist profile (i.e., low explicit racial bias, high implicit bias) had longer consultations with Black patients who reported more (vs<em>.</em> fewer) discrimination experiences. Study 2 and 3 found that physicians’ implicit racial bias is negatively associated with consultation duration. Finally, a meta-analysis supported the effects of aversive racism and patients’ discrimination experiences on consultation duration.</div></div><div><h3>Discussion</h3><div>These findings demonstrate how physicians’ racial attitudes and patients’ discrimination experiences can affect medical consultation duration—an important aspect of patient-provider communication quality.</div></div><div><h3>Practical value</h3><div>These results provide initial evidence for the importance of helping physicians manage the negative consequences of their implicit bias within the current structural constraints of limited medical consultation time and empowering Black patients to advocate for their healthcare needs.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108653"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014994","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

What do patients know about their newly prescribed medication: Application of a novel knowledge index 病人对他们新开的药物了解多少：一种新的知识索引的应用。

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

Patient Education and Counseling

Pub Date : 2025-01-09 DOI: 10.1016/j.pec.2025.108645

Christine Sieling , Cosima Hoetger , Anika Steger , Lena Langer , Eva Ausbüttel , Friederike Geiss , Sebastian Mindt , Nadine Simons , Tobias Esch

Objective

The present study aimed to evaluate patients’ knowledge about their newly prescribed medications, contributing factors, and preferred sources of medication-related information.

Methods

A cross-sectional study using an online survey was conducted among 931 customers of a mail-order pharmacy. Medication-related knowledge was examined using a novel knowledge index (KI) assessing medication dosage, indication, time of administration, and side effects. Patients’ preferred sources of information were assessed. Univariate and multivariate regression analyses were performed to investigate predictors of medication-related knowledge.

Results

The average KI score was 2.97 (SD = 0.73); most participants answered correctly when asked about indication (94.2 %), dosage (90.0 %), and time of administration (92.3 %); however, knowledge of medication-related side effects was limited (23.1 %). KI scores were predicted by greater perceived informedness, younger age, and having received a medication plan (all ps < 0.05). Preferred sources of medication-related information included physicians, written information, and information obtained via secure electronic patient records.

Conclusion

Knowledge gaps were found for medication-related side effects. Insufficient medication-related knowledge is linked to non-adherence and subsequent personal and economic costs. Electronically issued information could provide a cost-effective solution. Practical applications including “OpenNotes” are discussed.

Practice Implications

Issuing medication plans via platforms such as “OpenNotes” can increase patient understanding and participation, and decrease non-adherence.

目的：本研究旨在评估患者对新开药物的知识、影响因素和药物相关信息的首选来源。方法：采用横断面研究方法，对某邮购药房的931名顾客进行在线调查。使用一种新的知识指数（KI）评估药物剂量、适应症、给药时间和副作用，检查药物相关知识。评估患者首选的信息来源。采用单因素和多因素回归分析探讨药物相关知识的预测因素。结果：KI评分平均为2.97分（SD = 0.73）；当被问及适应症（94.2 %）、剂量（90.0 %）和给药时间（92.3 %）时，大多数参与者回答正确；然而，对药物相关副作用的了解有限（23.1% %）。KI评分的预测依据是认知程度较高、年龄较小和接受过药物治疗计划(所有ps 结论：发现了药物相关副作用的知识差距。与药物有关的知识不足与不坚持用药以及随后的个人和经济成本有关。电子发布的信息可以提供一种经济有效的解决办法。讨论了包括“OpenNotes”在内的实际应用。实践启示：通过“OpenNotes”等平台发布药物计划可以增加患者的理解和参与，并减少不遵守。

{"title":"What do patients know about their newly prescribed medication: Application of a novel knowledge index","authors":"Christine Sieling , Cosima Hoetger , Anika Steger , Lena Langer , Eva Ausbüttel , Friederike Geiss , Sebastian Mindt , Nadine Simons , Tobias Esch","doi":"10.1016/j.pec.2025.108645","DOIUrl":"10.1016/j.pec.2025.108645","url":null,"abstract":"<div><h3>Objective</h3><div>The present study aimed to evaluate patients’ knowledge about their newly prescribed medications, contributing factors, and preferred sources of medication-related information.</div></div><div><h3>Methods</h3><div>A cross-sectional study using an online survey was conducted among 931 customers of a mail-order pharmacy. Medication-related knowledge was examined using a novel knowledge index (KI) assessing medication dosage, indication, time of administration, and side effects. Patients’ preferred sources of information were assessed. Univariate and multivariate regression analyses were performed to investigate predictors of medication-related knowledge.</div></div><div><h3>Results</h3><div>The average KI score was 2.97 (SD = 0.73); most participants answered correctly when asked about indication (94.2 %), dosage (90.0 %), and time of administration (92.3 %); however, knowledge of medication-related side effects was limited (23.1 %). KI scores were predicted by greater perceived informedness, younger age, and having received a medication plan (all <em>p</em>s < 0.05). Preferred sources of medication-related information included physicians, written information, and information obtained via secure electronic patient records.</div></div><div><h3>Conclusion</h3><div>Knowledge gaps were found for medication-related side effects. Insufficient medication-related knowledge is linked to non-adherence and subsequent personal and economic costs. Electronically issued information could provide a cost-effective solution. Practical applications including “OpenNotes” are discussed.</div></div><div><h3>Practice Implications</h3><div>Issuing medication plans via platforms such as “OpenNotes” can increase patient understanding and participation, and decrease non-adherence.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108645"},"PeriodicalIF":2.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014984","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

Content and quality of consumer websites providing information about human papillomavirus infection in patients with systemic lupus erythematosus: An environmental scan 提供系统性红斑狼疮患者人乳头瘤病毒感染信息的消费者网站的内容和质量：环境扫描。

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

Patient Education and Counseling

Pub Date : 2025-01-09 DOI: 10.1016/j.pec.2025.108644

Juan I. Ruiz , Contessa Radabaugh , Yimin Geng , Maria E. Suarez-Almazor

Objective

We aimed to evaluate the content and quality of websites for consumers providing information about human papillomavirus (HPV) risks in patients with systemic lupus erythematosus (SLE).

Methods

We conducted an environmental scan of websites for patients and the general public with information about HPV and SLE. We searched Google from inception to June 2023, using the terms “HPV” and “lupus”. We included websites with information about HPV and SLE. Two reviewers appraised the websites and collected website characteristics, and rated various attributes: completeness and comprehensiveness, accuracy, technical elements, design and aesthetics, usability, readability, and accessibility.

Results

We identified 16 websites for analysis. Ten (62.5 %) were commercial websites One website provided complete and comprehensive information about HPV risk, screening, and vaccination in patients with SLE; 7 (44 %) websites provided only information about the HPV vaccine. Eight websites included risk of HPV infection, cervical cancer screening, and cervical cancer risk in patients with SLE. Seventy-five percent provided information based on clinical guidelines, textbooks, peer-reviewed papers or scientific publications while the remaining were based on expert opinions. All websites were considered to have adequate design and aesthetics and were easy to navigate. Only 1 (6 %) website had a 6th-grade reading level and the other had reading levels higher than that (not appropriate for consumer websites). The overall quality scores ranged from 32 to 51 (maximum 69).

Conclusion

Our findings showed that most websites for patients and the general public with information about HPV and SLE did not provide complete and comprehensive information about HPV.

目的：我们旨在评估为消费者提供系统性红斑狼疮（SLE）患者人乳头瘤病毒（HPV）风险信息的网站的内容和质量。方法：我们对患者和公众网站进行了环境扫描，了解HPV和SLE的信息。我们搜索谷歌从成立到2023年6月，使用术语“HPV”和“狼疮”。我们纳入了有关HPV和SLE信息的网站。两名评审员对网站进行评价，收集网站特征，并对网站的完整性和全面性、准确性、技术元素、设计和美学、可用性、可读性和可访问性等属性进行评分。结果：我们确定了16个网站进行分析。10个（62.5 %）是商业网站，其中一个网站提供了完整和全面的关于SLE患者HPV风险、筛查和疫苗接种的信息；7个（44% %）网站只提供有关HPV疫苗的信息。8个网站包括了SLE患者的HPV感染风险、宫颈癌筛查和宫颈癌风险。75%的人根据临床指南、教科书、同行评议的论文或科学出版物提供信息，其余的人则基于专家意见。所有的网站都被认为具有足够的设计和美学，并且易于浏览。只有1个（6 %）网站的阅读水平为6年级，其他网站的阅读水平高于6年级（不适合消费者网站）。总体质量得分从32分到51分（最高69分）。结论：我们的研究结果表明，大多数为患者和公众提供HPV和SLE信息的网站并没有提供完整和全面的HPV信息。

{"title":"Content and quality of consumer websites providing information about human papillomavirus infection in patients with systemic lupus erythematosus: An environmental scan","authors":"Juan I. Ruiz , Contessa Radabaugh , Yimin Geng , Maria E. Suarez-Almazor","doi":"10.1016/j.pec.2025.108644","DOIUrl":"10.1016/j.pec.2025.108644","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to evaluate the content and quality of websites for consumers providing information about human papillomavirus (HPV) risks in patients with systemic lupus erythematosus (SLE).</div></div><div><h3>Methods</h3><div>We conducted an environmental scan of websites for patients and the general public with information about HPV and SLE. We searched Google from inception to June 2023, using the terms “HPV” and “lupus”. We included websites with information about HPV and SLE. Two reviewers appraised the websites and collected website characteristics, and rated various attributes: completeness and comprehensiveness, accuracy, technical elements, design and aesthetics, usability, readability, and accessibility.</div></div><div><h3>Results</h3><div>We identified 16 websites for analysis. Ten (62.5 %) were commercial websites One website provided complete and comprehensive information about HPV risk, screening, and vaccination in patients with SLE; 7 (44 %) websites provided only information about the HPV vaccine. Eight websites included risk of HPV infection, cervical cancer screening, and cervical cancer risk in patients with SLE. Seventy-five percent provided information based on clinical guidelines, textbooks, peer-reviewed papers or scientific publications while the remaining were based on expert opinions. All websites were considered to have adequate design and aesthetics and were easy to navigate. Only 1 (6 %) website had a 6th-grade reading level and the other had reading levels higher than that (not appropriate for consumer websites). The overall quality scores ranged from 32 to 51 (maximum 69).</div></div><div><h3>Conclusion</h3><div>Our findings showed that most websites for patients and the general public with information about HPV and SLE did not provide complete and comprehensive information about HPV.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108644"},"PeriodicalIF":2.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972923","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

Stigma towards functional disability and anxiety among patients with cancer: The moderating role of physicians’ behaviors 癌症患者对功能障碍的耻感与焦虑：医生行为的调节作用。

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

Patient Education and Counseling

Pub Date : 2025-01-06 DOI: 10.1016/j.pec.2025.108643

Anat Katalan , Efrat Dagan , Anat Drach-Zahavy

Objective

To explore the moderating role of physicians' behaviors in medical encounters with cancer patients in the association between physicians’ public stigma towards functional disability and post-meeting patient anxiety.

Methods

A three time-point prospective nested study was conducted between November 2019 and July 2022 in two medical centres. Before the medical encounters, 32 physicians completed the Disability Attitudes in Health Care Scale, and 150 adult cancer patients completed the State-Trait Anxiety Inventory (STAI), pre and post medical encounters. During the medical encounters, structured ‘real-time’ observations of the physicians’ behaviors were recorded using the Four Habits Coding Scheme.

Results

The mixed linear analysis model revealed that the two-way interaction between stigma towards functional disability and physicians’ communication behaviors was significantly associated with post-meeting anxiety (b=.161, p < .05). When physicians’ behaviors were more negative, the association between physicians’ stigma and patients’ post-meeting anxiety was stronger. Additionally, pre-meeting anxiety was positively associated with post-meeting anxiety (b=.578, p < .01).

Conclusions

The findings highlight the positive effect of stigma and the importance of physicians' communication behaviors in alleviating patients’ anxiety associated stigma towards functional disability.

Practice implications

Healthcare training programs should address stigma and develop protocols encouraging healthcare professionals to request patients' to share their specific needs.

目的：探讨医生在会诊癌症患者时的行为在医生对功能障碍的公开污名与会诊后患者焦虑之间的调节作用。方法：2019年11月至2022年7月在两家医疗中心进行三时间点前瞻性巢式研究。在就诊前，32名医生完成了《医疗保健残疾态度量表》，150名成年癌症患者完成了“状态-特质焦虑量表”（STAI）。在就医过程中，对医生行为的结构化“实时”观察使用四种习惯编码方案进行记录。结果：混合线性分析模型显示，功能障碍耻感与医生沟通行为的双向交互作用与会后焦虑显著相关(b=。结论：研究结果强调了耻辱感的积极作用，以及医生沟通行为在缓解患者对功能障碍的耻辱感焦虑中的重要性。实践启示：医疗保健培训项目应解决耻辱感问题，并制定方案，鼓励医疗保健专业人员要求患者分享他们的具体需求。

{"title":"Stigma towards functional disability and anxiety among patients with cancer: The moderating role of physicians’ behaviors","authors":"Anat Katalan , Efrat Dagan , Anat Drach-Zahavy","doi":"10.1016/j.pec.2025.108643","DOIUrl":"10.1016/j.pec.2025.108643","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the moderating role of physicians' behaviors in medical encounters with cancer patients in the association between physicians’ public stigma towards functional disability and post-meeting patient anxiety.</div></div><div><h3>Methods</h3><div>A three time-point prospective nested study was conducted between November 2019 and July 2022 in two medical centres. Before the medical encounters, 32 physicians completed the Disability Attitudes in Health Care Scale, and 150 adult cancer patients completed the State-Trait Anxiety Inventory (STAI), pre and post medical encounters. During the medical encounters, structured ‘real-time’ observations of the physicians’ behaviors were recorded using the Four Habits Coding Scheme.</div></div><div><h3>Results</h3><div>The mixed linear analysis model revealed that the two-way interaction between stigma towards functional disability and physicians’ communication behaviors was significantly associated with post-meeting anxiety (b=.161, p < .05). When physicians’ behaviors were more negative, the association between physicians’ stigma and patients’ post-meeting anxiety was stronger. Additionally, pre-meeting anxiety was positively associated with post-meeting anxiety (b=.578, p < .01).</div></div><div><h3>Conclusions</h3><div>The findings highlight the positive effect of stigma and the importance of physicians' communication behaviors in alleviating patients’ anxiety associated stigma towards functional disability.</div></div><div><h3>Practice implications</h3><div>Healthcare training programs should address stigma and develop protocols encouraging healthcare professionals to request patients' to share their specific needs.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108643"},"PeriodicalIF":2.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015086","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

Effectiveness of a Calgary-Cambridge model-based communication skills training for paediatric trainees in Sri Lanka: A nationwide pre-post intervention study using observed practices 基于卡尔加里-剑桥模式的斯里兰卡儿科受训者沟通技巧培训的有效性：一项使用观察实践的全国性干预前-后研究。

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

Patient Education and Counseling

Pub Date : 2025-01-03 DOI: 10.1016/j.pec.2025.108635

Kavinda Dayasiri , Sinnarajah Krishnapradeep , Dihan Caldera , Hashini Wijayasinghe , Rasnayaka Mudiyanse

Objective

To evaluate the effectiveness of a Calgary-Cambridge model-based communication skills training program for postgraduate paediatric trainees in Sri Lanka.

Methods

A pre-post intervention study was conducted among 133 paediatric trainees across Sri Lanka. The training program focused on relationship-building, information gathering, and information giving. Communication skills were assessed using an OSCE with simulated patients and a 12-item checklist. Paired t-tests were used to analyze score differences.

Results

Significant improvements were observed across all domains. Relationship-building scores increased from 13.5 to 23, information gathering from 12.6 to 20.2, and information giving from 13.3 to 24.8 (p < 0.01 for all). Relationship-building correlated positively with information gathering (r = 0.626) and giving (r = 0.600, p < 0.01). Trainees with prior communication training scored higher post-intervention (mean difference = 10.5, p = 0.019). No gender differences were observed.

Conclusion

The Calgary-Cambridge model-based training program effectively enhanced communication skills among Sri Lankan paediatric trainees.

Practice implications

Incorporating structured communication skills training into postgraduate curricula is essential, particularly in culturally diverse medical settings.

目的：评价基于卡尔加里-剑桥模式的斯里兰卡儿科研究生沟通技巧培训项目的有效性。方法：对斯里兰卡133名儿科实习生进行干预前后研究。培训计划的重点是建立关系、收集信息和提供信息。沟通技巧采用OSCE与模拟患者和12项检查表进行评估。配对t检验分析得分差异。结果：在所有领域观察到显著的改善。关系建立得分从13.5分提高到23分，信息收集得分从12.6分提高到20.2分，信息提供得分从13.3分提高到24.8分（p ）。结论：基于卡尔加里-剑桥模式的培训项目有效地提高了斯里兰卡儿科学员的沟通技巧。实践影响：将结构化的沟通技巧培训纳入研究生课程至关重要，特别是在文化多样化的医疗环境中。

{"title":"Effectiveness of a Calgary-Cambridge model-based communication skills training for paediatric trainees in Sri Lanka: A nationwide pre-post intervention study using observed practices","authors":"Kavinda Dayasiri , Sinnarajah Krishnapradeep , Dihan Caldera , Hashini Wijayasinghe , Rasnayaka Mudiyanse","doi":"10.1016/j.pec.2025.108635","DOIUrl":"10.1016/j.pec.2025.108635","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of a Calgary-Cambridge model-based communication skills training program for postgraduate paediatric trainees in Sri Lanka.</div></div><div><h3>Methods</h3><div>A pre-post intervention study was conducted among 133 paediatric trainees across Sri Lanka. The training program focused on relationship-building, information gathering, and information giving. Communication skills were assessed using an OSCE with simulated patients and a 12-item checklist. Paired t-tests were used to analyze score differences.</div></div><div><h3>Results</h3><div>Significant improvements were observed across all domains. Relationship-building scores increased from 13.5 to 23, information gathering from 12.6 to 20.2, and information giving from 13.3 to 24.8 (p < 0.01 for all). Relationship-building correlated positively with information gathering (r = 0.626) and giving (r = 0.600, p < 0.01). Trainees with prior communication training scored higher post-intervention (mean difference = 10.5, p = 0.019). No gender differences were observed.</div></div><div><h3>Conclusion</h3><div>The Calgary-Cambridge model-based training program effectively enhanced communication skills among Sri Lankan paediatric trainees.</div></div><div><h3>Practice implications</h3><div>Incorporating structured communication skills training into postgraduate curricula is essential, particularly in culturally diverse medical settings.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108635"},"PeriodicalIF":2.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967134","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 children and adolescents with chronic pain describe their pain experiences: A qualitative systematic review

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

Patient Education and Counseling

Pub Date : 2025-01-03 DOI: 10.1016/j.pec.2025.108634

Jessica Coventry , Verity Pacey , Mitchell Smith , Cylie M Williams , Binh Ta , Elizabeth Sturgiss

Purpose

To explore how children and adolescents with chronic pain describe their pain experiences.

Method

A systematic search of OVID Medline, CINAHL Complete, OVID Embase and APA PsycINFO (database inception to 19th August 2024) was conducted for qualitative or mixed-method studies investigating children’s chronic pain experiences. Studies were excluded if focused on post-surgical or acute pain. Two independent reviewers screened studies, and disagreements resolved by a third reviewer. Methodological quality was assessed with the CASP checklist. Data from included studies were extracted and analysed using qualitative analysis.

Results

Forty studies were included, and 4 main themes were identified: 1. ‘I’m missing out because of my pain’; in which children described frustration and isolation due to missing activities. 2. ‘Things that help me to get by with my pain’; described a variety of children’s coping mechanisms. 3. ‘It hurts and no one else understands my pain’; where children felt frequently disbelieved about their pain severity, and 4. ‘I keep trying to make sense of my pain’; in which children identified ways they seek to understand the cause and possible outcomes of their pain, including accessing health care services.

Conclusions

This review highlights how children describe their pain challenges in managing their day to day while emphasising the necessity of understanding and incorporating children’s perspectives into research and practice.

Practice Implications

This review found that children were primarily concerned by how their pain affects their day-to-day activities and highlights the need to equip children with multiple strategies and promote autonomy in managing their pain. Additionally, further research is warranted into the ways that children understand their pain experience and seek information about their pain.

{"title":"How children and adolescents with chronic pain describe their pain experiences: A qualitative systematic review","authors":"Jessica Coventry , Verity Pacey , Mitchell Smith , Cylie M Williams , Binh Ta , Elizabeth Sturgiss","doi":"10.1016/j.pec.2025.108634","DOIUrl":"10.1016/j.pec.2025.108634","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore how children and adolescents with chronic pain describe their pain experiences.</div></div><div><h3>Method</h3><div>A systematic search of OVID Medline, CINAHL Complete, OVID Embase and APA PsycINFO (database inception to 19th August 2024) was conducted for qualitative or mixed-method studies investigating children’s chronic pain experiences. Studies were excluded if focused on post-surgical or acute pain. Two independent reviewers screened studies, and disagreements resolved by a third reviewer. Methodological quality was assessed with the CASP checklist. Data from included studies were extracted and analysed using qualitative analysis.</div></div><div><h3>Results</h3><div>Forty studies were included, and 4 main themes were identified: 1. ‘I’m missing out because of my pain’; in which children described frustration and isolation due to missing activities. 2. ‘Things that help me to get by with my pain’; described a variety of children’s coping mechanisms. 3. ‘It hurts and no one else understands my pain’; where children felt frequently disbelieved about their pain severity, and 4. ‘I keep trying to make sense of my pain’; in which children identified ways they seek to understand the cause and possible outcomes of their pain, including accessing health care services<strong>.</strong></div></div><div><h3>Conclusions</h3><div>This review highlights how children describe their pain challenges in managing their day to day while emphasising the necessity of understanding and incorporating children’s perspectives into research and practice.</div></div><div><h3>Practice Implications</h3><div>This review found that children were primarily concerned by how their pain affects their day-to-day activities and highlights the need to equip children with multiple strategies and promote autonomy in managing their pain. Additionally, further research is warranted into the ways that children understand their pain experience and seek information about their pain.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108634"},"PeriodicalIF":2.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042914","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