PEC innovation最新文献

Patient counselling on opioids by pharmacy technicians: A mixed-method study to explore facilitators and barriers

PEC innovation

Pub Date : 2025-02-17 DOI: 10.1016/j.pecinn.2025.100382

Elsemiek A.W. Jansen-Groot Koerkamp , Irem Simsek , Eman Badawy , Mette Heringa , Marcel L. Bouvy

Objectives

This study investigates community pharmacy technicians' (PTs) counselling practices for patients prescribed opioids and identifies facilitators and barriers influencing their counselling behaviour.

Methods

A sequential exploratory mixed-method study involving interviews and a questionnaire was conducted among PTs, working in Dutch community pharmacies. PTs were recruited via professional networks, panels and social media. Inductive thematic analysis was performed for interviews. Descriptive statistics of questionnaires was performed and associations between behaviour of discussing dependency and background characteristics (1), barriers (2) and beliefs (3) were tested.

Results

Nineteen topics emerged from 18 interviews. Out of 252 questionnaire-respondents, most PTs consistently discussed dosage and common side effects during the first opioid dispense. Although 92 % considered discussing opioid dependency important, only 62 % frequently performed it. Barriers included a lack of information about the indication (p = 0.012), lack of work agreements (p = 0.017), time (p = 0.022), feeling insecure (p = 0.041), less work experience (p = 0.025) and the belief that prescribers are responsible for discussing opioid dependency with patients (p = 0.018).

Conclusion

The high importance that PTs place on counselling patients on opioid dependency does not match their behaviour. To close this gap and optimize the role of PTs in promoting safe opioid use, organizational and competency-related barriers must be addressed. This includes clear work protocols, communication training and including the indication on opioid prescriptions.

Innovation

This research focuses on an underexplored group involved in patients' opioid management, crucial for designing effective interventions, as PTs frequently have direct patient contact.

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引用次数: 0

Enhancing perinatal health patient information through ChatGPT – An accuracy study

PEC innovation

Pub Date : 2025-02-10 DOI: 10.1016/j.pecinn.2025.100381

P.L.M. de Vries , D. Baud , S. Baggio , M. Ceulemans , G. Favre , E. Gerbier , H. Legardeur , E. Maisonneuve , C. Pena-Reyes , L. Pomar , U. Winterfeld , A. Panchaud

Objectives

To evaluate ChatGPT's accuracy as information source for women and maternity-care workers on “nutrition” and “red flags” in pregnancy.

Methods

Accuracy of ChatGPT-generated recommendations was assessed by a 5-point Likert scale by eight raters for ten indicators per topic in four languages (French, English, German and Dutch). Accuracy and interrater agreement were calculated per topic and language.

Results

For both topics, median accuracy scores of ChatGPT-generated recommendations were excellent (5.0; IQR 4–5) independently of language. Median accuracy scores varied with a maximum of 1 on a 5-point Likert-scare according to question's framing. Overall accuracy scores were 83–89 % for ‘nutrition in pregnancy’ versus 96–98 % for ‘red flags in pregnancy’. Inter-rater agreement was good to excellent for both topics.

Conclusion

Although ChatGPT generated accurate recommendations regarding the tested indicators for nutrition and red flags during pregnancy, women should be aware of ChatGPT's limitations such as inconsistencies according to formulation, language and the woman's personal context.

Innovation

Despite a growing interest in the potential use of artificial intelligence in healthcare, this is, to the best of our knowledge, the first study assessing potential limitations that may impact accuracy of ChatGPT-generated recommendations such as language and question-framing in key domains of perinatal health.

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引用次数: 0

Changes in community pharmacy communication – Towards emotional awareness at the pharmacy counter

PEC innovation

Pub Date : 2025-02-06 DOI: 10.1016/j.pecinn.2025.100380

Nanna Broch Mottelson , Gitte Reventlov Husted , Susanne Kaae , Charlotte Verner Rossing , Christina Fogtmann Fosgerau

Objective

To explore whether and how community pharmacy staff display an alteration in emotional awareness through interactional behavior during desk meetings after participating in a mentalizing education programme, and thereby to investigate if theoretical learnings, or offline social cognition, can be translated into actual communicative practice, or online social cognition.

Methods

As part of a larger feasibility study, we developed a methodological framework to categorize interactional contributions in relation to mentalizing communication and emotional awareness. The framework was applied to a total of 50 video recordings of community pharmacy desk interactions from 11 Danish community pharmacies who all participated in the mentalizing education programme. Through this, pharmacy staffs' interactional contributions from 25 video recordings before and 25 video recordings after participation were categorized and descriptively compared.

Results

Pharmacy staff appear to display an altered orientation towards patients post-education; they produce more questions when initiating interactions (first position talk-turns) and more responses to patients' utterances (third position talk-turns). Furthermore, the realizations of third position contributions in post-participation measures display heightened emotional awareness, rendering a greater orientation to patients' perspectives.

Conclusion

In post-participation measures pharmacy staff displayed an altered interactional approach to patients. This contributes to research concerning competency training of healthcare professionals and adds weight to the notion that online social cognitive skills can be affected through training of offline social cognitive skills.

Innovation

The methodological framework provides a novel and innovative approach to investigating changes in communicative practices. The framework is appropriate for all dialogical healthcare communication research.

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引用次数: 0

Corrigendum to “Factors contributing to implementation of a father-friendly neonatal intensive care unit in Denmark” [PEC Innovation 5 (2024) 100353]

PEC innovation

Pub Date : 2025-02-05 DOI: 10.1016/j.pecinn.2025.100379

Betty Noergaard , Karin Yde Waidtløw , Poul-Erik Kofoed , Signe Vahlkvist

引用次数: 0

“It's hard to talk to a computer, I get it”: An exploratory analysis of clinician connection-building communication practices in rural telepalliative care encounters

PEC innovation

Pub Date : 2025-01-25 DOI: 10.1016/j.pecinn.2025.100377

Elise C. Tarbi , Natalie Ambrose , Eric C. Anderson , Rebecca N. Hutchinson , Paul K.J. Han , Maija Reblin , Robert Gramling

Context/Objectives

Establishing human connection is critical during serious illness conversations, however the sensory and relational environment of telehealth may require innovative communication practices for clinicians, patients, and families to do so effectively. We sought to explore if and how recommended in-person best practices for establishing human connection are adapted to the telehealth palliative care (telePC) setting, to enable discovery and description of practice innovations in this new care environment.

Methods

We analyzed data from the Northern New England Palliative Care TeleConsult Research Study – a formative mixed-methods pilot study at two academic medical centers in rural US states with patients with serious illness (2019–2020). We used a qualitative descriptive approach paired with directed content analysis to analyze video-recorded telePC consultations.

Results

Nine video-recorded telePC consultations were analyzed including 9 patients and 6 palliative care clinicians. Patient-participants had a mean age of 68 years, 56 % were women, and 38 % did not complete high school. Mean consultation duration was 52 min (standard deviation 10, range 40–70 min). Our qualitative analysis of visits resulted in three key themes describing clinician communication: 1) Practices for fostering human connection; 2) Practices for overcoming technical problems/difficulties; and 3) Practices for engaging in multi-participant tele-conversations.

Conclusion

Our study findings help to provide proof-of-concept evidence that clinicians can use recommended in-person connection-building communication practices in telePC. As palliative care clinicians naturally adapt to telehealth environments, more empirical research is needed to understand which innovative approaches most effectively foster human connection.

Innovation

TelePC represents an expanding, yet understudied, mode of palliative care delivery. This study is among the first to describe how the telePC context is catalyzing naturally-occurring communication innovations.

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引用次数: 0

“In some ways it feels like a specialism”: Exploring the lived experience of multilingual maternity professionals – A qualitative interview study

PEC innovation

Pub Date : 2025-01-22 DOI: 10.1016/j.pecinn.2025.100378

Emma Brooks

Objective

This study aimed to investigate the experience of multilingual maternity staff working in UK NHS hospitals.

Methods

As part of an exploratory qualitative descriptive approach, semi-structured interviews were conducted with multilingual healthcare professionals, working in perinatal care in different NHS trusts across the United Kingdom. Interviews were audio-recorded, transcribed and subsequently analyzed using thematic analysis.

Results

Where practitioners were able to draw on their linguistic skills, they felt that multilingualism was a specialism and appreciated by colleagues. Practitioners also felt that the utilisation of shared languages could boost the confidence of women and birthing people, as well as improving their understanding and sense of wellbeing. Conversely, several practitioners felt an obligation to offer linguistic support, noting that it added to a workload burden, and fear of litigation, that was not experienced by monolingual colleagues.

Conclusion

Strategic utilisation of linguistically skilled NHS practitioners may hold the potential for advancing equity of care for migrant populations, who are regularly and disproportionately represented in data recording adverse outcomes.

Innovation

Investing in institutional support and formal accreditation for multilingual health professionals would enable them to be able to operate with confidence, redress (invisibilized) workloads and contribute to advancing parity of care for migrant patients.

{"title":"“In some ways it feels like a specialism”: Exploring the lived experience of multilingual maternity professionals – A qualitative interview study","authors":"Emma Brooks","doi":"10.1016/j.pecinn.2025.100378","DOIUrl":"10.1016/j.pecinn.2025.100378","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the experience of multilingual maternity staff working in UK NHS hospitals.</div></div><div><h3>Methods</h3><div>As part of an exploratory qualitative descriptive approach, semi-structured interviews were conducted with multilingual healthcare professionals, working in perinatal care in different NHS trusts across the United Kingdom. Interviews were audio-recorded, transcribed and subsequently analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Where practitioners were able to draw on their linguistic skills, they felt that multilingualism was a specialism and appreciated by colleagues. Practitioners also felt that the utilisation of shared languages could boost the confidence of women and birthing people, as well as improving their understanding and sense of wellbeing. Conversely, several practitioners felt an obligation to offer linguistic support, noting that it added to a workload burden, and fear of litigation, that was not experienced by monolingual colleagues.</div></div><div><h3>Conclusion</h3><div>Strategic utilisation of linguistically skilled NHS practitioners may hold the potential for advancing equity of care for migrant populations, who are regularly and disproportionately represented in data recording adverse outcomes.</div></div><div><h3>Innovation</h3><div>Investing in institutional support and formal accreditation for multilingual health professionals would enable them to be able to operate with confidence, redress (invisibilized) workloads and contribute to advancing parity of care for migrant patients.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100378"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143219154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Visuals versus textual scales: Optimizing reliability and user experience in observational assessment of parent-child interaction

PEC innovation

Pub Date : 2025-01-20 DOI: 10.1016/j.pecinn.2025.100376

Mirte L. Forrer , Carlo Schuengel , Mirjam Oosterman

Objective

Assessment of parent-child interaction by practitioners is of great importance but hindered by a lack of instruments that withstand the constraints daily practice places on usage. Visuals may offer an alternative format. Visualizations were tested on reliability, accuracy, and feasibility in observational assessment of parent-child interaction, as alternatives for textual rating scales.

Methods

In Study 1, 95 students rated parent-child interactions with a video or text anchor scale, and in Study 2, 217 professionals rated the same interactions with a decision tree including visual components or a text anchor scale.

Results

Students using the video anchor scale were less reliable and accurate, slower, and had a less positive user experience than students using the text anchor scale. Professionals using the decision tree did not differ in reliability and were comparable in user experience with professionals using the text anchor scale. Rater accuracy showed similar dependency on quality of parental behavior for both scales: ratings were less accurate when the quality of the parent-child interaction was low, and more accurate when the quality was high. However, professionals were less accurate and slower in using the decision tree than the text anchor scale.

Conclusion

With a first iteration of a decision tree performing the same to or only slightly worse, efforts to further develop decision trees might be worthwhile.

Innovation

These nonintuitive findings underscore the value of experimental testing in assessment design in daily practice.

{"title":"Visuals versus textual scales: Optimizing reliability and user experience in observational assessment of parent-child interaction","authors":"Mirte L. Forrer , Carlo Schuengel , Mirjam Oosterman","doi":"10.1016/j.pecinn.2025.100376","DOIUrl":"10.1016/j.pecinn.2025.100376","url":null,"abstract":"<div><h3>Objective</h3><div>Assessment of parent-child interaction by practitioners is of great importance but hindered by a lack of instruments that withstand the constraints daily practice places on usage. Visuals may offer an alternative format. Visualizations were tested on reliability, accuracy, and feasibility in observational assessment of parent-child interaction, as alternatives for textual rating scales.</div></div><div><h3>Methods</h3><div>In Study 1, 95 students rated parent-child interactions with a video or text anchor scale, and in Study 2, 217 professionals rated the same interactions with a decision tree including visual components or a text anchor scale.</div></div><div><h3>Results</h3><div>Students using the video anchor scale were less reliable and accurate, slower, and had a less positive user experience than students using the text anchor scale. Professionals using the decision tree did not differ in reliability and were comparable in user experience with professionals using the text anchor scale. Rater accuracy showed similar dependency on quality of parental behavior for both scales: ratings were less accurate when the quality of the parent-child interaction was low, and more accurate when the quality was high. However, professionals were less accurate and slower in using the decision tree than the text anchor scale.</div></div><div><h3>Conclusion</h3><div>With a first iteration of a decision tree performing the same to or only slightly worse, efforts to further develop decision trees might be worthwhile.</div></div><div><h3>Innovation</h3><div>These nonintuitive findings underscore the value of experimental testing in assessment design in daily practice.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100376"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patients' emotional expressions and clinicians' responses in oncology – From recognition to exploration of concerns

PEC innovation

Pub Date : 2025-01-17 DOI: 10.1016/j.pecinn.2025.100374

Fernanda Bittencourt Romeiro , Vanessa Garrido Pais , Gerry Humphris , Margarida Figueiredo-Braga

Objectives

The objective of this study was to analyze patient's emotional expressions during the consultations and the responses of their oncologists to these expressions.

Methods

The study employed a mixed-method, observational, descriptive, and explanatory design. A total of 31 adult patients at different clinical stages, undergoing cancer treatment and 8 oncologists were included. Thirty-one routine outpatient oncology consultations were analyzed, after being transcribed and coded, using the Portuguese version of the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

Results

The oncologists elicited and recognized patients' emotional concerns but they did not explore them in a way that encouraged patients to continue verbalizing their feelings. Oncologists provided more directive and guidance-oriented responses, focusing on cues related to physical pain and symptoms. Multilevel logistic regression analysis modeled the probability of oncologists' responses showing reduction of space in relation to patients' emotional cues/concerns, controlling for clustering and patients' clinical and socio-demographic variables. The type of cue and treatment influenced the oncologists' responses.

Conclusions

Communication skills training focused on the ability to better explore patients' emotions may help oncologists to provide more explicit and empathetic responses that validate the emotional content expressed during consultations. Practice Implications: Oncologists do not use the same responses as a standard with patients, thus adjusting them individually.

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引用次数: 0

Are we offering palliative care and employing shared decision making in the neonatal intensive care unit? A 10-year retrospective chart review

PEC innovation

Pub Date : 2025-01-16 DOI: 10.1016/j.pecinn.2025.100375

Sawyer Karabelas-Pittman , Helen Coo , Hannah Lee , Christine C. Moon , Gillian MacLean

Objective

Perinatal palliative care (PPC) supports families with a fetal diagnosis of a life-limiting condition or who are facing preterm labour at the limits of viability. Shared decision making (SDM) is the gold standard approach in PPC. The objectives of this study were to describe the Neonatal Intensive Care Unit (NICU) team's involvement in PPC and the extent of SDM at an academic hospital in southeastern Ontario, and the frequency with which PPC was offered, accepted and received for live births.

Methods

We retrospectively reviewed charts for births from January 2010–January 2020 where a life-limiting condition (LLC) had been prenatally diagnosed or there was threatened preterm labour (TPTL) at the limits of viability. Frequency distributions were used to summarize the NICU team's involvement, extent of SDM, and data related to PPC provision.

Results

The LLC group included 73 patients. The NICU team was consulted for 26 (36 %). Among the 10 consults that involved decision making, SDM was documented in 9 instances (90 %). PPC was offered to 9 of 60 LLC families (15 %) with a live birth and was accepted by 8 (89 %). The TPTL Group included 112 patients. Seventy (62 %) received a consult with the NICU team. SDM was documented in 34 of 39 consults (87 %) that involved decision making. PPC was offered to 28 of 90 families (31 %) who experienced a live birth and was accepted by 16 (57 %).

Conclusion

Our results demonstrate the need for standardized consultation and palliative care referral protocols to advance access to and quality of neonatal end-of-life care.

{"title":"Are we offering palliative care and employing shared decision making in the neonatal intensive care unit? A 10-year retrospective chart review","authors":"Sawyer Karabelas-Pittman , Helen Coo , Hannah Lee , Christine C. Moon , Gillian MacLean","doi":"10.1016/j.pecinn.2025.100375","DOIUrl":"10.1016/j.pecinn.2025.100375","url":null,"abstract":"<div><h3>Objective</h3><div>Perinatal palliative care (PPC) supports families with a fetal diagnosis of a life-limiting condition or who are facing preterm labour at the limits of viability. Shared decision making (SDM) is the gold standard approach in PPC. The objectives of this study were to describe the Neonatal Intensive Care Unit (NICU) team's involvement in PPC and the extent of SDM at an academic hospital in southeastern Ontario, and the frequency with which PPC was offered, accepted and received for live births.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed charts for births from January 2010–January 2020 where a life-limiting condition (LLC) had been prenatally diagnosed or there was threatened preterm labour (TPTL) at the limits of viability. Frequency distributions were used to summarize the NICU team's involvement, extent of SDM, and data related to PPC provision.</div></div><div><h3>Results</h3><div>The LLC group included 73 patients. The NICU team was consulted for 26 (36 %). Among the 10 consults that involved decision making, SDM was documented in 9 instances (90 %). PPC was offered to 9 of 60 LLC families (15 %) with a live birth and was accepted by 8 (89 %). The TPTL Group included 112 patients. Seventy (62 %) received a consult with the NICU team. SDM was documented in 34 of 39 consults (87 %) that involved decision making. PPC was offered to 28 of 90 families (31 %) who experienced a live birth and was accepted by 16 (57 %).</div></div><div><h3>Conclusion</h3><div>Our results demonstrate the need for standardized consultation and palliative care referral protocols to advance access to and quality of neonatal end-of-life care.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100375"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of clinician-expressed empathy and nocebo-alleviating information on breast-cancer-patients' anxiety and side effects during active chemotherapy: A clinical feasibility study

PEC innovation

Pub Date : 2025-01-15 DOI: 10.1016/j.pecinn.2025.100373

Lara C. Gröschel , Fiona T. Brosig , Marcel Soesan , Katherina T. Vourtsis , Mirte van der Spek , Elise Sluiter , Liesbeth M. van Vliet

Objective

We set up a pilot-study to investigate main and interaction effects of nocebo-alleviating information and clinician-expressed empathy delivered via a standardized information-video on breast cancer patients' psychological and side effect outcomes during chemotherapy. Additionally, we aimed to reflect on the feasibility of the intervention (acceptability, practicality and integration) to inform future – follow-up – studies.

Methods

Using a clinical proof-of-principle randomized controlled trial, female breast cancer patients undergoing chemotherapy viewed one of four videos, varying in the level of nocebo-alleviating information(+/−) and clinician-expressed empathy(+/−). Due to the small sample size (n = 27), descriptive and recruitment data were utilized to evaluate effects and reflect on feasibility.

Results

The interventions appeared to yield limited effects on our small sample. Feasibility reflections mainly focused on the practical level, such as the use of more generalizable videos and optimizing the flow.

Conclusion

The study showed limited effects of the video intervention. It revealed recruitment challenges, while acceptability was high after inclusion. Moving forward, face-to-face clinician-patient interactions remain important, while cautiously exploring the potential benefits of modern technological advancements, ensuring thorough testing of their effects before implementation.

Innovation

This study marks an innovative approach in utilizing digital interventions to enhance cancer patient outcomes within clinical settings.

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引用次数: 0