The importance of parents' involvement in their child's medical care has been extensively discussed in the literature, and studies have indicated the need to expand the active role of parents in decision-making processes regarding such care. However, parents' actual wish to be active and informed in this context remains underexplored. The aim of the current study was to explore this gap by investigating the association between parents’ shared decision-making (SDM) experience and their well-being during the course of their child’s medical care, with a focus on parents' clinical decision-making style as a possible moderator.
Method
A total of 150 parents of children under the age of 18, who utilized various medical care services, participated in the study.
Results
Shared decision-making was found to be associated with parents’ anxiety levels during their child’s medical treatment, as well as with their post-traumatic growth (PTG). A moderating effect of clinical decision-making style was also found; namely, the relations between SDM, anxiety during the child’s treatment, and PTG were different among parents with a passive style than among parents with a shared-active style.
Conclusions
The findings emphasize the personalized nature of SDM, suggesting that its benefits are associated with parental preferences and attitudes. Healthcare professionals should assess parents’ actual desire to be involved in SDM in order to tailor services effectively.
{"title":"Shared decision-making, anxiety, and post-traumatic growth among parents in the context of their child's medical care: The moderating role of parental style","authors":"Ofir Negri-Schwartz , Tal Shilton , Mariela Mosheva , Doron Gothelf , Ilanit Hasson-Ohayon","doi":"10.1016/j.pec.2024.108620","DOIUrl":"10.1016/j.pec.2024.108620","url":null,"abstract":"<div><h3>Aim</h3><div>The importance of parents' involvement in their child's medical care has been extensively discussed in the literature, and studies have indicated the need to expand the active role of parents in decision-making processes regarding such care. However, parents' <em>actual</em> wish to be active and informed in this context remains underexplored. The aim of the current study was to explore this gap by investigating the association between parents’ shared decision-making (SDM) experience and their well-being during the course of their child’s medical care, with a focus on parents' clinical decision-making style as a possible moderator.</div></div><div><h3>Method</h3><div>A total of 150 parents of children under the age of 18, who utilized various medical care services, participated in the study.</div></div><div><h3>Results</h3><div>Shared decision-making was found to be associated with parents’ anxiety levels during their child’s medical treatment, as well as with their post-traumatic growth (PTG). A moderating effect of clinical decision-making style was also found; namely, the relations between SDM, anxiety during the child’s treatment, and PTG were different among parents with a passive style than among parents with a shared-active style.</div></div><div><h3>Conclusions</h3><div>The findings emphasize the personalized nature of SDM, suggesting that its benefits are associated with parental preferences and attitudes. Healthcare professionals should assess parents’ actual desire to be involved in SDM in order to tailor services effectively.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108620"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899704","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}
Pub Date : 2024-12-19DOI: 10.1016/j.pec.2024.108628
Brooke Nickel , Claire Hudson , Jennifer Isautier , Kirsten McCaffery , Allan Ben Smith , Paula Legerton , Tong Li , Shu Wang , Nehmat Houssami
Objectives
Previous research suggests a one-size-fits-all approach to breast density notification may disadvantage culturally and linguistically diverse (CALD) women. This study aimed to qualitatively explore CALD women’s understanding and views of breast density, attitudes towards health services access, acceptability of notification and preferences for breast density communication ahead of population-based notification in Australia.
Methods
Online focus groups were conducted with CALD women of breast screening age (40–74 years) who spoke one of the five languages with the lowest English proficiency in Australia (Korean, Mandarin, Cantonese, Vietnamese and Arabic). Focus group sessions were in-language and incorporated an evidence-based presentation interspersed with group discussions which were audio-recorded, transcribed and analysed thematically.
Results
Thematic analysis revealed four themes indicating participants had overall strong desires to be informed of breast density, despite some associated worry. CALD women may also face significant barriers to understanding and accessing breast density information and seeking supplemental screening.
Conclusions
Although CALD women have a strong desire to be notified of their breast density, increased anxiety and confusion may exacerbate health inequalities and barriers women from these communities already face.
Practice implications
This study highlights the need for careful consideration of breast density and supplemental screening communications for CALD women.
{"title":"Equity in breast density notification in Australia: A focus group study exploring the impact and needs amongst culturally and linguistically diverse (CALD) women","authors":"Brooke Nickel , Claire Hudson , Jennifer Isautier , Kirsten McCaffery , Allan Ben Smith , Paula Legerton , Tong Li , Shu Wang , Nehmat Houssami","doi":"10.1016/j.pec.2024.108628","DOIUrl":"10.1016/j.pec.2024.108628","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous research suggests a one-size-fits-all approach to breast density notification may disadvantage culturally and linguistically diverse (CALD) women. This study aimed to qualitatively explore CALD women’s understanding and views of breast density, attitudes towards health services access, acceptability of notification and preferences for breast density communication ahead of population-based notification in Australia.</div></div><div><h3>Methods</h3><div>Online focus groups were conducted with CALD women of breast screening age (40–74 years) who spoke one of the five languages with the lowest English proficiency in Australia (Korean, Mandarin, Cantonese, Vietnamese and Arabic). Focus group sessions were in-language and incorporated an evidence-based presentation interspersed with group discussions which were audio-recorded, transcribed and analysed thematically.</div></div><div><h3>Results</h3><div>Thematic analysis revealed four themes indicating participants had overall strong desires to be informed of breast density, despite some associated worry. CALD women may also face significant barriers to understanding and accessing breast density information and seeking supplemental screening.</div></div><div><h3>Conclusions</h3><div>Although CALD women have a strong desire to be notified of their breast density, increased anxiety and confusion may exacerbate health inequalities and barriers women from these communities already face.</div></div><div><h3>Practice implications</h3><div>This study highlights the need for careful consideration of breast density and supplemental screening communications for CALD women.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108628"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899730","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}
Pub Date : 2024-12-18DOI: 10.1016/j.pec.2024.108625
Nanon H.M. Labrie , Anne A.M.W. van Kempen , Marleen Kunneman , Sylvia A. Obermann-Borst , Liesbeth M. van Vliet , Nicole R. van Veenendaal , the IMPACT-Group
Objective
To examine the effects of clinicians’ provision of (un)reasonable arguments on parent-related outcomes in neonatal (intensive) care (NICU), starting from the NICU Communication Framework.
Methods
A video-vignette experiment, in which we systematically varied clinicians’ use of (reasonable, unreasonable, no) argumentation across two non-acute and two acute decision-making scenarios (3×4 design). Reasonable arguments were medically appropriate and constructive reasons to support the treatment plan, as defined by an expert panel. Based on argumentation theory, unreasonable arguments included hindering appeals to authority or the self-evident nature of the treatment plan. Parents of preterm infants completed an online survey, viewing 1 of 12 video-vignettes and answering questions pertaining to their communication stress, understanding, agreement, participation in communication, empowerment, trust and satisfaction with communication.
Results
N = 163 parents completed the full survey. We found statistically significant (p < 0.001) and large (η2: 0.13–0.38) effects of clinicians’ use of argumentation across all parent-related outcomes. Reasonable argumentation led to lower communication stress and higher understanding, agreement, participation in communication, empowerment, trust, and satisfaction with communication than no argumentation. In turn, no argumentation led to improved outcomes compared to unreasonable argumentation. This pattern was similar across non-acute and acute scenarios.
Conclusion
Clinicians’ use of reasonable argumentation has a consistently strong and positive impact on parent-related outcomes in neonatal care.
Practice implications
We argue that reasoned decision-making should be considered a good clinical practice, core to patient-centered communication. Our findings provide a starting point for (1) determining good argumentative practices and (2) designing evidence-based clinical argumentation trainings.
{"title":"Effects of reasoned treatment decision-making on parent-related outcomes: Results from a video-vignette experiment in neonatal care","authors":"Nanon H.M. Labrie , Anne A.M.W. van Kempen , Marleen Kunneman , Sylvia A. Obermann-Borst , Liesbeth M. van Vliet , Nicole R. van Veenendaal , the IMPACT-Group","doi":"10.1016/j.pec.2024.108625","DOIUrl":"10.1016/j.pec.2024.108625","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the effects of clinicians’ provision of (un)reasonable arguments on parent-related outcomes in neonatal (intensive) care (NICU), starting from the NICU Communication Framework.</div></div><div><h3>Methods</h3><div>A video-vignette experiment, in which we systematically varied clinicians’ use of (<em>reasonable, unreasonable, no</em>) argumentation across two non-acute and two acute decision-making scenarios (3×4 design). Reasonable arguments were medically appropriate and constructive reasons to support the treatment plan, as defined by an expert panel. Based on argumentation theory, unreasonable arguments included hindering appeals to authority or the self-evident nature of the treatment plan. Parents of preterm infants completed an online survey, viewing 1 of 12 video-vignettes and answering questions pertaining to their <em>communication stress, understanding, agreement</em>, <em>participation</em> in communication<em>, empowerment</em>, <em>trust</em> and <em>satisfaction</em> with communication.</div></div><div><h3>Results</h3><div>N = 163 parents completed the full survey. We found statistically significant (p < 0.001) and large (η<sup>2</sup>: 0.13–0.38) effects of clinicians’ use of argumentation across all parent-related outcomes. <em>Reasonable</em> argumentation led to lower <em>communication stress</em> and higher <em>understanding, agreement, participation</em> in communication<em>, empowerment, trust</em>, and <em>satisfaction</em> with communication than <em>no</em> argumentation. In turn, <em>no argumentation</em> led to improved outcomes compared to <em>unreasonable</em> argumentation. This pattern was similar across non-acute and acute scenarios.</div></div><div><h3>Conclusion</h3><div>Clinicians’ use of <em>reasonable</em> argumentation has a consistently strong and positive impact on parent-related outcomes in neonatal care.</div></div><div><h3>Practice implications</h3><div>We argue that <em>reasoned decision-making</em> should be considered a good clinical practice, core to patient-centered communication. Our findings provide a starting point for (1) determining good argumentative practices and (2) designing evidence-based clinical argumentation trainings.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108625"},"PeriodicalIF":2.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886373","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}
This study aimed to assess community clinics in enhancing health literacy among underserved patients. We focus on patient-provider communication at these clinics to understand how this communication may foster or hinder health literacy and how the organizational health literacy of clinics may be improved.
Methods
We surveyed 303 patients at three community clinics to evaluate providers' communication behaviors related to health literacy. The city health department entered surveys into SurveyMonkey™ and analyzed them using Stata/SE™. The analysis included frequencies of all variables for all participants and by clinic. Qualitative methods were also used.
Results
Community clinics are trusted care sources; however, around 13 % of patients reported rarely or never being encouraged to ask questions, 20 % reported providers spoke too fast, and 17 % reported that medical staff were not always informative. Patients needing an interpreter reported more communication problems than those not requiring one, making these results more salient.
Conclusions
Community clinics serving low-income patients can enhance personal and organizational health literacy by improving patient-provider communication such as active listening, encouraging patients to ask questions, and addressing language barriers.
Practice implications
Advancing health literacy impacts community and public health initiatives, improves health disparities, builds patient-provider trust, and improves health systems.
{"title":"Patient at community clinics: Recommendations for advancing health literacy","authors":"Michelle Palmborg , Carolina Fernandez-Branson , Luisa Pessoa-Brandao","doi":"10.1016/j.pec.2024.108618","DOIUrl":"10.1016/j.pec.2024.108618","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess community clinics in enhancing health literacy among underserved patients. We focus on patient-provider communication at these clinics to understand how this communication may foster or hinder health literacy and how the organizational health literacy of clinics may be improved.</div></div><div><h3>Methods</h3><div>We surveyed 303 patients at three community clinics to evaluate providers' communication behaviors related to health literacy. The city health department entered surveys into SurveyMonkey™ and analyzed them using Stata/SE™. The analysis included frequencies of all variables for all participants and by clinic. Qualitative methods were also used.</div></div><div><h3>Results</h3><div>Community clinics are trusted care sources; however, around 13 % of patients reported rarely or never being encouraged to ask questions, 20 % reported providers spoke too fast, and 17 % reported that medical staff were not always informative. Patients needing an interpreter reported more communication problems than those not requiring one, making these results more salient.</div></div><div><h3>Conclusions</h3><div>Community clinics serving low-income patients can enhance personal and organizational health literacy by improving patient-provider communication such as active listening, encouraging patients to ask questions, and addressing language barriers.</div></div><div><h3>Practice implications</h3><div>Advancing health literacy impacts community and public health initiatives, improves health disparities, builds patient-provider trust, and improves health systems.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"132 ","pages":"Article 108618"},"PeriodicalIF":2.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873271","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}
Pub Date : 2024-12-17DOI: 10.1016/j.pec.2024.108608
Hanne Irene Jensen , Sarah Leeth Hansen Farmer , Lillian Oxholm Skaarup , Anders Løkke , Anette Hygum , Mette Jo Ipsen , Lisbeth Høilund Gamst , Maybritt Brunsgård Klausen
Objectives
The objective of this study was to develop and test a patient decision aid for end-of-life care to be used when some or all life-sustaining treatments have been withheld or withdrawn.
Methods
A multi-professional, multi-sectorial group together with patients and relatives used a systematic process to develop and test the patient decision aid, including alpha and beta testing.
Results
Healthcare professionals, patients and relatives were involved in the development and testing. The final Decision Helper included three areas with nine options: follow-up (outpatient clinic and general practitioner), palliative care (primary care, specialised palliative care team, hospital admission and hospice) and treatment level (intensive care, resuscitation attempt and nutrition via feeding tube). Most participants agreed that the amount of information in the Decision Helper was appropriate, that it clearly presented benefits and disadvantages and that it was useful in the value clarification process, helping to verbalise preferences and what is most important for patients.
Conclusions
Most patients and healthcare professionals found that the decision aid would be helpful in facilitating shared decision-making in an end-of-life conversation.
Practice implications
The decision aid will be usable in different healthcare setting ensuring that end-of-life care is in accordance with patients’ wishes.
{"title":"Development and testing of a generic patient decision aid for end-of-life care","authors":"Hanne Irene Jensen , Sarah Leeth Hansen Farmer , Lillian Oxholm Skaarup , Anders Løkke , Anette Hygum , Mette Jo Ipsen , Lisbeth Høilund Gamst , Maybritt Brunsgård Klausen","doi":"10.1016/j.pec.2024.108608","DOIUrl":"10.1016/j.pec.2024.108608","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to develop and test a patient decision aid for end-of-life care to be used when some or all life-sustaining treatments have been withheld or withdrawn.</div></div><div><h3>Methods</h3><div>A multi-professional, multi-sectorial group together with patients and relatives used a systematic process to develop and test the patient decision aid, including alpha and beta testing.</div></div><div><h3>Results</h3><div>Healthcare professionals, patients and relatives were involved in the development and testing. The final Decision Helper included three areas with nine options: follow-up (outpatient clinic and general practitioner), palliative care (primary care, specialised palliative care team, hospital admission and hospice) and treatment level (intensive care, resuscitation attempt and nutrition via feeding tube). Most participants agreed that the amount of information in the Decision Helper was appropriate, that it clearly presented benefits and disadvantages and that it was useful in the value clarification process, helping to verbalise preferences and what is most important for patients.</div></div><div><h3>Conclusions</h3><div>Most patients and healthcare professionals found that the decision aid would be helpful in facilitating shared decision-making in an end-of-life conversation.</div></div><div><h3>Practice implications</h3><div>The decision aid will be usable in different healthcare setting ensuring that end-of-life care is in accordance with patients’ wishes.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"132 ","pages":"Article 108608"},"PeriodicalIF":2.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873269","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}
Pub Date : 2024-12-16DOI: 10.1016/j.pec.2024.108606
Lu Liu, Wen Ma
Objectives
This study examines the design and delivery of surgical and non-surgical treatment recommendations in China.
Methods
We examined 936-minute recordings of medical consultations using conversation analysis. Data were collected from two tertiary hospitals in China. They are authentic interactions from the departments of orthopedics and proctology.
Results
Non-surgical treatment recommendations are proposed after diagnoses delivery. They are delivered in straightforward and simple form, and as already determined. Surgical treatment recommendations are proposed early and sometimes occupy the diagnostic slot. They are delivered in straightforward, simple, but mitigated form. These recommendations are formulated as a matter that is not fully settled and requires further discussions.
Conclusions
Patients’ stances toward specific treatments are made manifest in the tailoring of doctors’ recommendations. The formulations of treatment recommendations exhibit doctors’ understanding of what patients are anticipating or resisting. Chinese patients’ preference for non-surgical treatments over surgery is reflected in how doctors present the recommendations for surgical and non-surgical treatments.
Practice implications
Patients’ concerns vary depending on the treatments recommended. Doctors should incorporate these concerns into their medical advice. In China, for non-surgical patients, the focus is on clearly explaining the treatment plan. For surgical patients, doctors should first assist them in making informed treatment decisions.
{"title":"Recommending surgical or non-surgical treatments in medical consultations: The case in Chinese contexts","authors":"Lu Liu, Wen Ma","doi":"10.1016/j.pec.2024.108606","DOIUrl":"10.1016/j.pec.2024.108606","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the design and delivery of surgical and non-surgical treatment recommendations in China.</div></div><div><h3>Methods</h3><div>We examined 936-minute recordings of medical consultations using conversation analysis. Data were collected from two tertiary hospitals in China. They are authentic interactions from the departments of orthopedics and proctology.</div></div><div><h3>Results</h3><div>Non-surgical treatment recommendations are proposed after diagnoses delivery. They are delivered in straightforward and simple form, and as already determined. Surgical treatment recommendations are proposed early and sometimes occupy the diagnostic slot. They are delivered in straightforward, simple, but mitigated form. These recommendations are formulated as a matter that is not fully settled and requires further discussions.</div></div><div><h3>Conclusions</h3><div>Patients’ stances toward specific treatments are made manifest in the tailoring of doctors’ recommendations. The formulations of treatment recommendations exhibit doctors’ understanding of what patients are anticipating or resisting. Chinese patients’ preference for non-surgical treatments over surgery is reflected in how doctors present the recommendations for surgical and non-surgical treatments.</div></div><div><h3>Practice implications</h3><div>Patients’ concerns vary depending on the treatments recommended. Doctors should incorporate these concerns into their medical advice. In China, for non-surgical patients, the focus is on clearly explaining the treatment plan. For surgical patients, doctors should first assist them in making informed treatment decisions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"132 ","pages":"Article 108606"},"PeriodicalIF":2.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866104","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}
Pub Date : 2024-12-12DOI: 10.1016/j.pec.2024.108607
Jared Raynor , Jennifer Stephens , Ijeoma Ezeofor Harris , Adam Carl Sukhija-Cohen , Lauren Jeanne Natoli , Susan Wolfson
Objectives
To learn how the COVID-19 pandemic response could shape public health messaging for sexually transmitted infections (STIs), researchers conducted qualitative interviews with young adults in demographic groups experiencing disparate rates of STIs and healthcare providers in California, Florida, Louisiana, and Missouri.
Methods
Between October 2020 and October 2021, researchers interviewed 55 young adults and 49 providers about COVID-19 and STI information sources, perceived risk, and messaging. Young adults included Black/African American gay, bisexual, or other men who have sex with men (Black MSM); Latinx MSM; Black/African American transgender women; Latinx transgender women; and Black/African American cisgender women. Providers were medical doctors, doctors of osteopathy, nurse practitioners, physician assistants, and registered nurses.
Results
Half of young adults identified the Centers for Disease Control and Prevention and the news as primary trusted sources of COVID-19 information; for trusted STI information, they identified providers. Conversely, providers perceived that young adults receive sexual health information from the internet, peers, and social media. Nearly all young adults assessed their likelihood of contracting COVID-19 infection and STIs as low.
Conclusions
Communication efforts surrounding the novel coronavirus can help sexual healthcare providers improve messaging by aligning multiple, trusted sources of information to reduce message variability; increasing accountability for providers’ critical role in affirming sexual health discussions; and supporting patient-driven communications to address individualized STI information needs.
Practice Implications
STI information should be presented in a simple, consistent manner from multiple credible sources—in particular, providers. Second, providers should promote patient-driven conversations that address young people’s concerns and communicate with empathy in a non-judgmental fashion. Third, we can address young people’s low-risk perception by emphasizing factors both within and outside of young adults’ control that can facilitate an ongoing sexually healthy life.
{"title":"Lessons from COVID-19 for sexually transmitted infections: Listening and learning from young adults and healthcare providers on sexual health communications dynamics and decisions in four states","authors":"Jared Raynor , Jennifer Stephens , Ijeoma Ezeofor Harris , Adam Carl Sukhija-Cohen , Lauren Jeanne Natoli , Susan Wolfson","doi":"10.1016/j.pec.2024.108607","DOIUrl":"10.1016/j.pec.2024.108607","url":null,"abstract":"<div><h3>Objectives</h3><div>To learn how the COVID-19 pandemic response could shape public health messaging for sexually transmitted infections (STIs), researchers conducted qualitative interviews with young adults in demographic groups experiencing disparate rates of STIs and healthcare providers in California, Florida, Louisiana, and Missouri.</div></div><div><h3>Methods</h3><div>Between October 2020 and October 2021, researchers interviewed 55 young adults and 49 providers about COVID-19 and STI information sources, perceived risk, and messaging. Young adults included Black/African American gay, bisexual, or other men who have sex with men (Black MSM); Latinx MSM; Black/African American transgender women; Latinx transgender women; and Black/African American cisgender women. Providers were medical doctors, doctors of osteopathy, nurse practitioners, physician assistants, and registered nurses.</div></div><div><h3>Results</h3><div>Half of young adults identified the Centers for Disease Control and Prevention and the news as primary trusted sources of COVID-19 information; for trusted STI information, they identified providers. Conversely, providers perceived that young adults receive sexual health information from the internet, peers, and social media. Nearly all young adults assessed their likelihood of contracting COVID-19 infection and STIs as low.</div></div><div><h3>Conclusions</h3><div>Communication efforts surrounding the novel coronavirus can help sexual healthcare providers improve messaging by aligning multiple, trusted sources of information to reduce message variability; increasing accountability for providers’ critical role in affirming sexual health discussions; and supporting patient-driven communications to address individualized STI information needs.</div></div><div><h3>Practice Implications</h3><div>STI information should be presented in a simple, consistent manner from multiple credible sources—in particular, providers. Second, providers should promote patient-driven conversations that address young people’s concerns and communicate with empathy in a non-judgmental fashion. Third, we can address young people’s low-risk perception by emphasizing factors both within and outside of young adults’ control that can facilitate an ongoing sexually healthy life.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108607"},"PeriodicalIF":2.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191083","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}
Pub Date : 2024-12-12DOI: 10.1016/j.pec.2024.108604
Shengchao Sun , Ting Li , Anqi Zheng , Zexu Zhang , Qingyun Wang , Chao Chen , Zhirong Zeng
The United Nations Sustainable Development Goal (SDG 3) aims to strengthen healthcare systems, combat chronic and infectious diseases, and improve global health. However, chronic diseases pose significant public health challenges, straining healthcare resources and escalating economic burdens. In China, they affect 180 million people, account for over 90 % of the national disease burden, and are the leading cause of mortality. Community chronic disease management faces challenges such as limited capacity, uneven resource allocation, and weak information systems. Despite policies to improve primary healthcare, outcomes remain modest due to implementation gaps. Addressing these issues requires creating "multidimensional value" through collaboration among doctors, patients, families, and communities. This framework emphasizes functional value (efficiency), social value (community ties), emotional value (well-being), and health value (better outcomes). However, most research narrowly focuses on doctor-patient collaboration, overlooking broader dynamics involving families and community healthcare providers. By explicitly exploring the goals and collaborative roles of doctor-patient-family value co-creation in community chronic disease management, we aim to develop well informed strategies to enhance interaction and resource integration, offering insights for China and scalable solutions for global health.
{"title":"Doctor-patient-family collaboration in community-based chronic disease management to enhance multidimensional value","authors":"Shengchao Sun , Ting Li , Anqi Zheng , Zexu Zhang , Qingyun Wang , Chao Chen , Zhirong Zeng","doi":"10.1016/j.pec.2024.108604","DOIUrl":"10.1016/j.pec.2024.108604","url":null,"abstract":"<div><div>The United Nations Sustainable Development Goal (SDG 3) aims to strengthen healthcare systems, combat chronic and infectious diseases, and improve global health. However, chronic diseases pose significant public health challenges, straining healthcare resources and escalating economic burdens. In China, they affect 180 million people, account for over 90 % of the national disease burden, and are the leading cause of mortality. Community chronic disease management faces challenges such as limited capacity, uneven resource allocation, and weak information systems. Despite policies to improve primary healthcare, outcomes remain modest due to implementation gaps. Addressing these issues requires creating \"multidimensional value\" through collaboration among doctors, patients, families, and communities. This framework emphasizes functional value (efficiency), social value (community ties), emotional value (well-being), and health value (better outcomes). However, most research narrowly focuses on doctor-patient collaboration, overlooking broader dynamics involving families and community healthcare providers. By explicitly exploring the goals and collaborative roles of doctor-patient-family value co-creation in community chronic disease management, we aim to develop well informed strategies to enhance interaction and resource integration, offering insights for China and scalable solutions for global health.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"132 ","pages":"Article 108604"},"PeriodicalIF":2.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873270","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}
Pub Date : 2024-12-12DOI: 10.1016/j.pec.2024.108605
Erin O. Wissler Gerdes , Sarah H. Nash , Robin C. Vanderpool , Erin L. Van Blarigan , Angela L.W. Meisner , Nicole Senft Everson
Objectives
Clinical trial knowledge and discussions about clinical trials with healthcare providers contribute to clinical trial participation and clinical trial representation. This study explored 1) the association of patient-provider communication with clinical trial knowledge, 2) how patient-provider communication impacts the associations of demographic and clinical factors with clinical trial knowledge, and 3) motivations for clinical trial participation among people with a history of cancer.
Methods
Cross-sectional data from the 2021 Health Information National Trends Survey-Surveillance, Epidemiology, and End Results (HINTS-SEER) study included 1201 adult cancer survivors recruited from three SEER registries. Multivariable logistic regression models estimated adjusted associations of sociodemographic and clinical characteristics with clinical trial knowledge (none, a little bit/a lot) with and without the inclusion of clinical trial discussion with a healthcare provider (yes, no).
Results
Approximately three-quarters of cancer survivors reported having at least “a little” knowledge about clinical trials, though only 15 % reported having discussed clinical trials with their provider. Those who reported patient-provider communication about clinical trials had 8.71 times higher odds of having some clinical trial knowledge. In multivariable logistic regression, odds of knowing at least a little bit about clinical trials were lower among adults without a college degree and among Hispanic and Non-Hispanic Asian (versus Non-Hispanic White) adults. Associations of demographic factors with clinical trial knowledge were not impacted by the inclusion of patient-provider discussion in the model. Top motivations for clinical trial participation were helping other people, new treatment, and getting better.
Conclusion/practice implications
There is a need to ensure information about clinical trials is provided to all people with cancer and to facilitate high quality communication between patients and providers about clinical trials.
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Pub Date : 2024-12-12DOI: 10.1016/j.pec.2024.108581
Yanhui Ma, Junxiang Gao, Chongyang Zhang, Lihua Zhang, Ling Lu
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