PEC innovation最新文献_第4页

Patients' and health professionals' perspectives regarding shared decision making in the psychiatric inpatient setting – A multiple qualitative case study 病人和医护人员对精神病住院患者共同决策的看法--一项多重定性案例研究

PEC innovation

Pub Date : 2024-10-21 DOI: 10.1016/j.pecinn.2024.100352

Caroline Gurtner , Jos M.G.A. Schols , Christa Lohrmann , Sabine Hahn

Objective

Shared decision-making is one promising approach to promoting recovery and person-centred care but seems challenging for implementation in clinical practice. This study aimed to explore how patients and health professionals experience shared decision-making and its facilitators and barriers.

Methods

A multiple qualitative case study design was chosen, using a constant comparative method. Multiple data sources were used, including individual interviews, observation, document analysis and a focus group.

Results

Through first a within-case analysis and then second a cross-case analysis, four patient profiles and their potential for shared decision-making were constructed. The results indicate that in the daily routine of the psychiatric inpatient setting different forms of decision making are used, even though health professionals advocate shared decision-making as the favored approach. Patients also have varying expectations and perceptions regarding shared decision-making, which is reflected in the degree of their involvement.

Conclusion

Shared decision-making could be enhanced in the future by a more proactive communication style and the proactive provision of information on the part of health professionals, in order to enhance patient participation in decision-making.

Innovation

The study identified different forms of decision-making within the acute psychiatric inpatient setting, highlighting the gap between the advocated SDM approach and its practical implementation. This divergence is a key aspect, as it underlines the complexity of implementing SDM in real clinical settings.

目的共同决策是促进康复和以人为本的护理的一种有前途的方法，但在临床实践中实施起来似乎具有挑战性。本研究旨在探讨患者和医护人员如何体验共同决策，以及其促进因素和障碍。研究方法：本研究选择了多重定性案例研究设计，并采用了恒定比较法。研究使用了多种数据来源，包括个人访谈、观察、文件分析和焦点小组。结果通过首先进行病例内部分析，然后进行交叉分析，构建了四种病人特征及其共同决策的可能性。结果表明，在精神科住院病人的日常生活中，尽管医护人员主张共同决策是最受欢迎的方法，但他们还是采用了不同的决策形式。患者对共同决策的期望和看法也各不相同，这反映在他们的参与程度上。创新该研究发现了急诊精神病住院环境中的不同决策形式，凸显了所倡导的 SDM 方法与其实际执行之间的差距。这种差异是一个关键方面，因为它强调了在实际临床环境中实施 SDM 的复杂性。

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引用次数: 0

Uneasiness in interdisciplinary research and the importance of metaphors: A case story on building an interdisciplinary chronic pain research team 跨学科研究的不确定性和隐喻的重要性：建立跨学科慢性疼痛研究团队的案例故事

PEC innovation

Pub Date : 2024-10-20 DOI: 10.1016/j.pecinn.2024.100350

T.C. Van Charldorp , M.A. Strick , J.C. de Grauw , S. Brugman , Y. Van de Burgt , L.H.H. Winkens , F.J. Meye , M. Rijsdijk , H.L.D.M. Willemen

Interdisciplinary research is increasingly recognized as a key method to tackle complex societal challenges and stimulate creativity to find innovative solutions. Our key goal when starting our collaboration was to come to innovative ways of treating chronic pain. An ambitious goal that requires out-of-the-box and high-risk-high-gain research. However, interdisciplinary research in practice can be uneasy and will not always be successful. This paper describes a case story focussing on the challenges we faced building an interdisciplinary team. One of the most important lessons is that researchers from different disciplines may think they speak a universal ‘language of science’, but a thorough understanding of each other's ways of working, research paradigms, methods, and concepts is necessary before they can start working together on solving scientific questions. In fact, if researchers cannot understand each other's language, they cannot expect patients to understand scientific language either. Lastly, for academics to engage with a non-scientific audience and vice-versa, we need to find and create places to meet and find ways to interact effectively. Language is the medium through which all these interactions take place. It is therefore essential that language takes a central place in the process of collaboration across disciplines, interdisciplinary research, patient participation and public engagement. In this case story, we share our experiences in creating a common language, summarized in five steps (1: creating the team; 2: metaphor-forced introduction to disciplines; 3: creating common ground; 4: outreach; 5: integration). Metaphors play an important role in this process. We will demonstrate how we reflectively progressed through these steps while enhancing interdisciplinarity, (scientific) innovation and public engagement. This five-step journey can be used as a process-tool for any other high-risk-high-gain research team seeking to innovate through interdisciplinarity – with the risk of becoming a brilliant failure.

跨学科研究越来越被认为是应对复杂社会挑战和激发创造力以找到创新解决方案的重要方法。我们开始合作时的主要目标是找到治疗慢性疼痛的创新方法。这是一个雄心勃勃的目标，需要打破常规、高风险高收益的研究。然而，跨学科研究在实践中可能会遇到困难，也不一定总能取得成功。本文介绍了一个案例，重点阐述了我们在组建跨学科团队时面临的挑战。其中最重要的一条经验是，来自不同学科的研究人员可能会认为他们说的是一种通用的 "科学语言"，但在开始合作解决科学问题之前，他们必须对彼此的工作方式、研究范式、方法和概念有透彻的了解。事实上，如果研究人员不能理解对方的语言，就不能指望患者也能理解科学语言。最后，学术界要与非科学界的受众接触，反之亦然，我们需要找到并创造会面的场所，找到有效互动的方式。语言是进行所有这些互动的媒介。因此，在跨学科合作、跨学科研究、患者参与和公众参与的过程中，语言必须占据中心位置。在本案例故事中，我们分享了创建共同语言的经验，并将其总结为五个步骤（1：创建团队；2：以隐喻为基础的学科介绍；3：创建共同点；4：外联；5：整合）。隐喻在这一过程中发挥了重要作用。我们将展示如何通过这些步骤取得反思性进展，同时加强跨学科性、（科学）创新和公众参与。这五步旅程可作为任何其他高风险、高收益研究团队寻求通过跨学科进行创新的过程工具--冒着成为辉煌失败者的风险。

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引用次数: 0

Helping children cope with a mother's breast cancer diagnosis: ‘The telling box’ – A pilot study 帮助儿童应对母亲的乳腺癌诊断："倾诉箱"--一项试点研究

PEC innovation

Pub Date : 2024-10-18 DOI: 10.1016/j.pecinn.2024.100351

Joyce M.J. de Vos-Houben , Femke Bruls , Christel Heiyerjans , Rianne Roijen , Trijntje Völlink , Esther C. Bakker

Objective

Discussing cancer with children presents challenges. Evidence underscores the importance of transparent communication in aiding children's coping mechanisms amidst a parent's diagnosis. ‘The telling box’ intervention was developed to assist mothers in discussing cancer with their children. This study aimed to explore nurses' and mothers' perspectives on the ‘telling box’.

Methods

Semi-structured interviews were conducted with six oncology nurses and five mothers diagnosed with breast cancer to assess their experiences and opinions regarding ‘the telling box’.

Results and conclusion

Both nurses and mothers emphasize the significance of open communication with children. Nurses identified ‘the telling box’ as a valuable resource for starting discussions about cancer with children, but lack of time and knowledge were factors preventing them from distributing the boxes. The current design of the box did not meet the mothers' needs, and the timing of its distribution was suboptimal. We recommend education of nurses on the use of ‘the telling box’ and customizing its content based on the child's age and treatment stage of the mother.

Innovation

This study offers important insights from both patients and healthcare professionals. ‘The telling box’ was developed through collaborative efforts involving healthcare professionals and patients.

目标与儿童讨论癌症是一项挑战。有证据表明，在父母被诊断出患有癌症时，透明的沟通对于帮助儿童建立应对机制非常重要。我们开发了 "倾诉箱 "干预措施，以帮助母亲与子女讨论癌症问题。本研究旨在探讨护士和母亲对 "倾诉箱 "的看法。方法对六名肿瘤科护士和五名确诊为乳腺癌的母亲进行了半结构式访谈，以评估她们对 "倾诉箱 "的经验和看法。护士们认为 "倾诉箱 "是与儿童开始讨论癌症问题的宝贵资源，但缺乏时间和知识是阻碍她们分发 "倾诉箱 "的因素。目前的 "倾诉箱 "设计不能满足母亲们的需求，而且分发的时机也不理想。我们建议对护士进行有关使用'倾诉箱'的教育，并根据儿童的年龄和母亲的治疗阶段定制其内容。倾诉箱 "是在医护人员和患者的共同努力下开发出来的。

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引用次数: 0

Understanding public response: Government communication during the COVID-19 crisis through the eyes of the Swiss public 了解公众反应：从瑞士公众的视角看 COVID-19 危机期间的政府沟通

PEC innovation

Pub Date : 2024-10-09 DOI: 10.1016/j.pecinn.2024.100349

Nicola Diviani , Maddalena Fiordelli , Sara Rubinelli

Objective

To analyze the Swiss public perception of COVID-19 communication by the government and its impact on behavior and trust.

Methods

A cross-sectional representative online survey was conducted in January 2022 in a sample of 2587 Swiss residents.

Results

Overall the survey showed moderate satisfaction with communication, with relevance rated highly. Perceptions of communication varied across demographics. Also, differences were noted in trust in institutions, risk perception, and attitudes towards public health measures based on perceived communication quality.

Conclusion

This study highlights the dynamic nature of public health communication and underscores the significance of continuous adaptation and evaluation of strategies to effectively reach and influence diverse audiences. As misinformation persists, the study underscores the need for informative, empathetic, and honest communication, as well as tailored approaches to build public trust—an essential asset for managing health crises successfully.

Innovation

This study provides innovative concrete insights into how governmental communication could be designed more strategically to effectively communicate with the public in contexts characterized by disinformation, emphasizing the role of quality, honest, and empathetic communication in public health messaging.

方法 2022 年 1 月，对 2587 名瑞士居民进行了一项横断面代表性在线调查。不同人群对沟通的看法各不相同。结论这项研究突出了公共卫生传播的动态性，强调了不断调整和评估策略以有效接触和影响不同受众的重要性。由于虚假信息持续存在，本研究强调了信息丰富、富有同情心和诚实的沟通以及量身定制的方法的必要性，以建立公众信任--这是成功管理健康危机的重要资产。创新本研究提供了创新性的具体见解，帮助我们了解如何更具战略性地设计政府沟通，以便在以虚假信息为特征的背景下有效地与公众沟通，同时强调了高质量、诚实和富有同情心的沟通在公共卫生信息传播中的作用。

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引用次数: 0

Comparing three methods to assess learning outcomes for a suicide prevention training program for pharmacy staff 比较三种评估药房员工自杀预防培训项目学习成果的方法

PEC innovation

Pub Date : 2024-10-04 DOI: 10.1016/j.pecinn.2024.100348

Grace Marley , Jill E. Lavigne , Wendi Cross , Abigail Gamble , Zhuying Zhang , Delesha M. Carpenter

Objective

To examine whether pharmacists and pharmacy staff who complete a suicide prevention gatekeeper training program (Pharm-SAVES) react similarly to a written patient case, a live simulated patient (SP), and a prerecorded SP case.

Methods

After completing the 30-min Pharm-SAVES training, participants completed a written patient case via survey and then, 1 month later, completed a prerecorded SP and live SP interaction via Zoom. For each assessment type, we documented whether the participant asked about suicide and referred the patient to the Suicide and Crisis Lifeline (988).

Results

Participants (n = 12) asked about suicide in 8 (67 %) written patient cases, 9 (75 %) prerecorded SP cases, and 8 (67 %) live SP cases. Participants referred patients to 988 in 8 (67 %) written patient cases, 5 (42 %) prerecorded SP cases, and 10 (83 %) live SP cases.

Conclusion

The number of participants who asked about suicide was similar regardless of assessment type; however, referrals to the Suicide & Crisis Lifeline happened less often with the prerecorded SP cases.

Innovation

This is the first study to compare key learning outcomes of pharmacy suicide prevention gatekeeper training across written, live, and prerecorded SP encounters.

目的研究完成自杀预防把关人培训项目（Pharm-SAVES）的药剂师和药房员工对书面患者案例、现场模拟患者（SP）和预先录制的 SP 案例的反应是否相似。方法在完成 30 分钟的 Pharm-SAVES 培训后，参与者通过调查完成书面患者案例，然后在 1 个月后通过 Zoom 完成预先录制的 SP 和现场 SP 互动。对于每种评估类型，我们都记录了参与者是否询问过自杀问题以及是否将患者转介至自杀与危机生命热线（988）。结果参与者（n = 12）在 8 个（67%）书面患者案例、9 个（75%）预录 SP 案例和 8 个（67%）现场 SP 案例中询问过自杀问题。在 8 个（67 %）书面患者案例、5 个（42 %）预先录制的 SP 案例和 10 个（83 %）现场 SP 案例中，参与者向 988 转介了患者。结论无论评估类型如何，询问自杀问题的参与者人数相似；但是，在预先录制的 SP 案例中，向自杀& 危机生命热线转介的情况较少。

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引用次数: 0

Development and pilot testing of the Population And ContExt adaption of decision aids (PACE) framework 开发和试点测试人口与扩展决策辅助工具（PACE）框架

PEC innovation

Pub Date : 2024-09-30 DOI: 10.1016/j.pecinn.2024.100347

Hankiz Dolan , Deborah Bateson , Mu Li , Rachel Thompson , Chun Wah Michael Tam , Carissa Bonner , Lyndal Trevena

Objective

This study aimed to develop and pilot test a new framework for the adaptation of patient decision aids (PtDAs) using a specific case example of contraceptive method PtDAs for Chinese-speaking migrant women.

Methods

We developed a novel approach for adaptation – the PACE (Population And ContExt adaption of decision aids) framework – that incorporated both existing models and frameworks and innovative elements. It involves six stages: selection and appraisal; review by content experts; content validity and usability pre-testing; translation; decisional needs assessment; and perceived acceptability, usability and feasibility testing. We then followed the framework to pilot and adapt a suite of PtDAs on contraceptive methods for Chinese-speaking migrant women in Australia. Twenty healthcare providers and 22 Chinese migrant women participated during the stages five and six.

Results

The pilot resulted in adapted PtDAs that were acceptable to end users. For future research, we proposed further recommendations and considerations based on lessons learnt, which include flexibility in applying the framework and considering an additional real-world evaluation step.

Conclusion

Adaptation of PtDAs required a multi-stage and multidisciplinary team-based and pragmatic approach as exemplified in the application of the PACE framework.

Innovation

The PACE framework developed and piloted in this study fills a crucial gap in knowledge about how to adapt PtDAs for new populations and contexts and provides an innovative and systemic approach to guide the adaptation process.

方法我们开发了一种新的改编方法--PACE（Population And ContExt adaption of decision aids）框架，其中既有现有的模型和框架，也有创新元素。该框架包括六个阶段：选择和评估；内容专家审查；内容有效性和可用性预先测试；翻译；决策需求评估；以及认知接受度、可用性和可行性测试。然后，我们按照该框架对一套针对澳大利亚讲中文的移民妇女的避孕方法 PtDA 进行了试点和改编。20 名医疗保健提供者和 22 名中国移民妇女参与了第五和第六阶段的工作。对于未来的研究，我们在吸取经验教训的基础上提出了进一步的建议和考虑，其中包括灵活应用该框架，并考虑额外的真实世界评估步骤。创新本研究中开发和试用的 PACE 框架填补了有关如何针对新人群和新环境调整 PtDA 的知识空白，并提供了一种创新的系统方法来指导调整过程。

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引用次数: 0

Black women and the preemie prep for parents (P3) program: Exploratory analysis of a clinical trial 黑人妇女与早产儿父母预备（P3）计划：临床试验的探索性分析

PEC innovation

Pub Date : 2024-09-28 DOI: 10.1016/j.pecinn.2024.100346

Siobhan M. McDonnell , Kathryn E. Flynn , Kris Barnekow , U. Olivia Kim , Ruta Brazauskas , S. Iqbal Ahamed , Jennifer J. McIntosh , Michael B. Pitt , Steven R. Leuthner , Abbey Kruper , Mir A. Basir

引用次数: 0

Human milk feeding for moderate and late preterm infants at age 2 months: Insights from a cluster randomized controlled trial 2-month follow-up 中度和晚期早产儿 2 个月时的母乳喂养：群组随机对照试验 2 个月随访的启示

PEC innovation

Pub Date : 2024-09-19 DOI: 10.1016/j.pecinn.2024.100345

Amanda M. Moe , Meredith L. Brockway , Deborah A. McNeil , Arfan R. Afzal , Karen M. Benzies

Objective

Human milk (HM) is the optimal nutrition for infants; preterm infants demonstrate shorter HM feeding duration. Care interventions may increase HM feeding among preterm infants after NICU discharge. We compared Alberta Family Integrated Care (FICare) versus Standard Care on HM feeding in preterm infants at age 2 months.

Methods

We conducted a follow-up of a cluster randomized controlled trial of 455 infants and their mothers with data linked to the infant's 2-month public health visit. We used partial proportional odds to model group differences and factors associated with feeding type: exclusive HM (EHM), Non-EHM, or no HM (NHM).

Results

Compared to Standard Care, mothers in Alberta FICare were less likely to provide EHM versus NHM. There was no group difference between EHM and Non-EHM. Mothers with higher education who were on maternity leave or employed were more likely to provide EHM. Infants who received EHM at discharge were more likely to continue at age 2 months. Higher maternal breastfeeding self-efficacy at discharge was associated with a greater likelihood of EHM.

Conclusion

Alberta FICare was not associated with EHM feeding at age 2 months.

Innovation

Different factors predicted the three HM feeding categories, suggesting the need to individualize feeding supports.

Trial Registration.

ClinicalTrials.gov Identifier NCT02879799, retrospectively registered August 26, 2016.

目的人乳（HM）是婴儿的最佳营养；早产儿的人乳喂养持续时间较短。护理干预措施可增加早产儿在新生儿重症监护室出院后的人奶喂养。我们比较了艾伯塔省家庭综合护理（FICare）与标准护理对 2 个月大早产儿 HM 喂养的影响。方法我们对 455 名婴儿及其母亲进行了分组随机对照试验的随访，数据与婴儿 2 个月的公共健康检查相关联。结果与标准护理相比，艾伯塔省家庭护理中心的母亲不太可能提供纯母乳喂养（EHM）或无母乳喂养（NHM）。EHM和Non-EHM之间没有群体差异。受过高等教育、正在休产假或有工作的母亲更有可能提供超急诊护理。出院时接受超母乳喂养的婴儿更有可能在 2 个月大时继续母乳喂养。出院时母亲母乳喂养自我效能较高，与EHM的可能性较大相关。结论阿尔伯塔省家庭医疗保健计划与2个月大时的EHM喂养无关。创新不同的因素预测了三种HM喂养类别，表明需要个性化的喂养支持。Trial Registration.ClinicalTrials.gov Identifier NCT02879799，2016年8月26日回顾性注册。

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引用次数: 0

Evaluating the feasibility and utility of telephonic motivational interviewing in older adults 评估对老年人进行电话动机访谈的可行性和实用性

PEC innovation

Pub Date : 2024-09-14 DOI: 10.1016/j.pecinn.2024.100344

Nicholas R. Lamoureux , L. Alison Phillips , Kathryn J. DeShaw , Trina Radske-Suchan , Gregory J. Welk

Older adults face unique barriers and challenges related to physical activity (PA) participation. Motivational interviewing (MI) is a commonly used health coaching strategy to support behavior change that holds potential for older adults. Previous research on MI strategies has focused primarily on face-to-face delivery, limiting insights regarding virtual programs.

Objectives

The purpose of this study was to determine if MI could be delivered telephonically with high fidelity and high acceptability in older adult participants. The study is designed to inform future trials evaluating its effectiveness in supporting virtual PA programs.

Methods

This study evaluated the feasibility and acceptability of telephonic MI among older adults that enrolled in an online version of the Walk with Ease program.

Results

Of 39 participants referred, 29 enrolled and 27 provided feedback. Participants were highly accepting and adherent, with 74 % of patients attending at least five of six sessions, and 96 % of participants indicating satisfaction with the MI provided. Coaches improved program enjoyment by helping set effective goals and providing ongoing accountability.

Conclusions

Evaluations documented adequate fidelity and high acceptability of telephonic delivery, and motivation results revealed large, significant increases in autonomous regulation (quality of motivation).

Innovation

Telephonic MI using non-healthcare professional coaches is feasibly delivered with high fidelity, and is acceptable to older adult participants. The innovative delivery format offers novel opportunities supporting virtual and telehealth interventions to reduce chronic disease risk among older adults.

老年人在参加体育活动（PA）方面面临着独特的障碍和挑战。动机访谈法（MI）是一种常用的健康指导策略，用于支持行为改变，对老年人具有潜力。本研究的目的是确定激励访谈是否可以通过电话以高保真和高可接受性的方式提供给老年人参与者。本研究旨在为未来评估其在支持虚拟 PA 项目中有效性的试验提供信息。方法本研究评估了在参加在线版 "轻松行走 "项目的老年人中进行电话 MI 的可行性和可接受性。参与者的接受度和依从性都很高，74% 的患者至少参加了六节课中的五节，96% 的参与者对所提供的多元智能疗法表示满意。教练通过帮助设定有效目标和提供持续的责任感，提高了参与者对项目的满意度。创新使用非医疗保健专业教练进行的电话多元智能疗法具有高保真的可行性，并为老年人参与者所接受。创新的授课形式为支持虚拟和远程医疗干预提供了新的机会，以降低老年人患慢性病的风险。

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引用次数: 0

Provider preparedness to care for sexual and gender minority adolescent and young adult cancer patients: A scoping review 医疗服务提供者为性取向和性别少数的青少年和年轻成人癌症患者提供护理的准备情况：范围界定审查

PEC innovation

Pub Date : 2024-09-13 DOI: 10.1016/j.pecinn.2024.100343

Christabel K. Cheung , Haelim Lee , Nina Francis-Levin , Eunju Choi , Yimin Geng , Bria N. Thomas , Valentina A. Roman , Michael E. Roth

Objective

The purpose of the current scoping review is to explore knowledge and gaps in the literature on the preparedness of health care providers (HCPs) to deliver cancer care that addresses the needs of sexual and gender minority (SGM) adolescent and young adult (AYA) patients diagnosed with cancer between ages 15–39 years.

Methods

We conducted two comprehensive searches on OVID MEDLINE, PsycINFO, and CINAHL in February 2022 and June 2024; examined the empirical literature on HCPs who treat SGM AYA cancer patients; characterized existing research; and evaluated each contribution.

Results

A total of thirteen articles were included in the final review. The reviewed studies varied widely in sample sizes (n = 6 to n = 1253), reflecting different methodological approaches: quantitative cross-sectional (n = 3), qualitative (n = 4), and mixed methods (n = 6).

Innovation

The current scoping review piloted an innovative Quality Assessment (QA) Tool of Foundational Progress for SGM AYA Research to assess the quality of evidence, providing a new framework for evaluating and guiding future research.

Conclusion

The existing literature on provider preparedness to care for SGM AYA cancer patients is limited. Future studies are critically needed to improve providers' ability to holistically respond to the unique health care needs and concerns of this population.

目的本次范围界定综述旨在探讨医疗保健提供者（HCPs）在提供癌症护理以满足 15-39 岁之间被诊断患有癌症的性与性别少数群体（SGM）青少年和年轻成人（AYA）患者的需求方面的知识和文献差距。方法我们分别于 2022 年 2 月和 2024 年 6 月在 OVID MEDLINE、PsycINFO 和 CINAHL 上进行了两次全面检索；研究了有关治疗 SGM AYA 癌症患者的 HCP 的实证文献；描述了现有研究的特点；并对每项贡献进行了评估。创新本次范围界定综述试用了创新性的 "SGM AYA 研究基础进展质量评估 (QA) 工具 "来评估证据的质量，为评估和指导未来研究提供了新的框架。今后亟需开展研究，以提高医疗服务提供者全面应对这一人群独特的医疗保健需求和关切的能力。

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引用次数: 0