PEC innovation最新文献

Background

This study explores social media (SM) usage and trust in information among cancer patients and their caregivers. We compare socio-demographic characteristics to identify groups more likely to rely on social media for treatment decisions and those less inclined to validate social media information with their provider.

Methods

A national survey of people diagnosed with cancer and those who were caregivers to people diagnosed with cancer was conducted via online survey in November–December 2021. Socio-demographic factors associated with respondents' use of SM and comfort disclosing SM use were assessed using logistic regression.

Findings

Out of 262 respondents, 65% were likely to use SM to make decisions about lifestyle changes, cancer screening, vaccination, cancer treatment, medical testing, or choosing a provider. SM users were younger (OR_adj = 0.11, p < 0.01), identified as Black (OR_adj = 10.19, p < 0.01), and had less education (OR_adj = 0.86, p = 0.02). Those with less education reported not being comfortable discussing SM with their providers (OR_adj = 1.25, p_adj = 0.01).

Discussion

Results contribute new understanding of the digital divide, highlighting the need for not only improving access to digital information but also the need for a supportive environment that provides patients with dependable methods to verify the authenticity of the information they encounter.

Objective

This study applied the Family Systems Illness Model to examine how child disorder severity influences mental health in mothers and fathers of children with chronic (mainly developmental) disorders (CD).

Methods

We measured parental mental health and perceived child disorder severity among 204 mothers and 125 fathers of 220 children with CD and compared the mental health scores with norms. We analyzed how much of the variance in parental mental health was explained by child disorder severity, including discrepancy between maternally and paternally perceived severity.

Results

Compared to norms, we found elevated mental health problems in both mothers (d = 0.45) and fathers (d = 0.20) of children with CD. Mothers had higher scores than fathers on both mental health problems (d = 0.63) and severity (d = 0.43). Perceived disorder severity was similarly associated with mental health problems for mothers (β = 0.23) and fathers (β = 0.34). Discrepancy between maternal and paternal perceived disorder severity did not influence parental mental health.

Conclusion

Findings suggest gender-specific challenges in parenting children with CD. Subjective perception of disorder severity plays a substantial role for parental mental health.

Innovation

This comparative study of mothers and fathers contributes to a predominantly mother-focused field.

Objective

The purpose of this study was to characterize similarities and differences in HPV vaccine misinformation narratives present in the comment sections of top-performing initial creator posts across three social media platforms.

Methods

A qualitative multi-method design was used to analyze comments collected from social media posts. A sample of 2996 comments were used for thematic analysis (identifying similar themes) and content analysis (identifying differences in comment type, opinion, and misinformation status).

Results

Misinformation was pervasive in comment sections. Cross-cutting misinformation themes included adverse reactions, unnecessary vaccine, conspiracy theories, and mistrust of authority. The proportion of comments related to these themes varied by platform. Initial creator posts crafted to be perceived as educational or with an anti-vaccine opinion had a higher proportion of misinformation in the comment sections. Facebook had the highest proportion of misinformation comments.

Conclusion

Differences in the proportion of cross-cutting themes in the comment sections across platforms suggests the need for targeted communication strategies to counter misinformation narratives and support vaccine uptake.

Innovation

This study is innovative due to its characterization of misinformation themes across three social media platforms using multiple qualitative methods to assess similarities and differences and focusing on conversations occurring within the comment sections.

Objective

Improper use and poor understanding of asthma medications can lead to poorly controlled asthma, emergency department visits, and hospitalizations for children with asthma. Pharmacists play a critical role in improving asthma medication adherence through education on asthma self-management. The use of color-coded labels applied at pharmacies to help patients differentiate between rescue and maintenance inhalers has not been explored.

Methods

Pharmacies were recruited to join a community pharmacy asthma coalition. Pharmacists provided patient education and labeled inhalers with two types of color-coded stickers. A red sticker labeled “RESCUE” was used for short-acting β-2 agonist medication inhalers. A green sticker labeled “USE EVERY DAY” was used for inhaled corticosteroids (ICS) or combination ICS/long-acting β-2 agonist medication inhalers.

Results

During the two years of the pilot program, 25 pharmacy locations participated. Pharmacies labeled over 6000 rescue and 9000 controller medications using color-coded labels. Over 1000 children and 7000 adults were served by the coalition.

Conclusion

Color-coded asthma medication labels can be successfully utilized by pharmacies. This low-cost tool provides vital information regarding the proper use of asthma medications.

Innovation

The color-coded labeling of asthma medications is a novel innovation that can be successfully used by pharmacists to improve asthma self-management education.

Background and objective

There is currently no self-management package designed to meet the needs of people with pulmonary fibrosis (PF). This study evaluated the feasibility and acceptability of a PF-specific self-management package.

Methods

Adults with PF were randomly allocated (1:1) to either receive the self-management package with healthcare professional (HCP) support or standardised PF information. Primary outcomes were feasibility and acceptability of the intervention. Secondary outcomes included health-related quality of life, self-efficacy, breathlessness, daily steps, use of PF-related treatments, and healthcare utilisation. Participants' experiences of using the package were explored using qualitative interviews.

Results

Thirty participants were included. Recruitment rate was 91% and 100% of those recruited were randomised. Eighty-seven percent of participants who received the package read ≥1 module and set a goal. Secondary outcomes were feasible to collect with high assessment completion rates (87%). Most participants reported the package was easy to use and enhanced knowledge, but suggested some improvements, while HCP support was highly valued.

Conclusion

A PF-specific self-management package was feasible to deliver and requires further testing in a trial powered to detect changes in clinical outcomes.

Innovation

This is the first self-management package designed specifically for people with PF, informed by patient experience and expert consensus.

Objective

The novel concept of Family-Integrated Care (FICare) requires nurses to be parents' partners in neonatal care. We combined analyses of real-life parent-nurse conversations and interviews to elucidate nurses' role in providing psychosocial support to parents. Findings inform the development of communication training on topicalizing parents' feelings.

Methods

Conversation analysis of 15 audio-recorded parent-nurse conversations, and thematic analysis of interviews with 2 nurses.

Results

In parent-nurse conversations, nurses showed a “balancing act” in formulating parents' feelings, revealing the complexities of addressing parents' feelings. Overall, parents confirmed nurses' formulations, but also expanded or modified them, or indicated restricted conversational space. In the interviews, nurses discussed four purposes of conversations with parents, emphasizing elaborating on parents' feelings, while discussing associated challenges.

Conclusion

Our conversation analysis revealed a continuum of nurses' formulations of parents' feelings, and nurses' reflections illuminated how and when the formulations were used to invite parents' “feelings talk”.

Innovation

This study is the first to use conversation analysis to analyze parent-nurse conversations. Additionally, it pioneers combining these analyses with interviews, inviting nurses to reflect on how to incorporate the findings into FICare. This combination strongly informs the development of tailored communication training, drawing from real-life conversations and nurses' articulated needs.

Objective

The purpose of this study was to investigate how parents of children with complex care needs conceptualize burnout from the perspective of parents themselves.

Methods

We conducted semi-structured interviews with 38 parents, selected for maximal variation in parental, child, and family characteristics. Inductive thematic analysis was employed.

Results

Burnout was conceptualized as encompassing three themes: having a reoccurring long-term nature, commencing with symptoms of stress progressing into exhaustion, and ending in a survival mode wherein parents worked hard to project an image of everything being well and under control (fighting) while distancing physically and emotionally from others and themselves (fleeing).

Conclusion

Burnout involves specific aspects of caregiving and parenting, such as long-term responsibility for the child, which cannot be relinquished. Furthermore, burnout may also be ‘hidden’: not always showing to the outside world, which requires extra attention and vigilance among parent's informal and formal networks. Awareness of the various interpretations of the term may foster constructive communication.

Innovation

Focusing on parents’ individual experiences has illuminated new aspects of burnout. By purposively sampling a variety of parents of children with complex care needs, a broader understanding of the meaning of the term ‘burnout’ from the perspective of parents was achieved.

Objectives

1) Examine if participation in iSibWorks, a group-based virtual intervention for siblings of children with disabilities, impacted siblings' perception of quality of life (QoL) and social support; and 2) Explore siblings' feedback on iSibWorks.

Methods

Thirty-eight children participated in iSibWorks and completed questionnaires (Pediatric Quality of Life [PedsQL™], Social Support Scale for Children [SSSC]) one week pre- and post-intervention. Conventional content analysis was used to explore siblings' open-ended responses on a post-participation feedback form.

Results

No significant differences in PedsQL™ and SSSC scores were observed after participating in iSibWorks. Despite this, siblings had positive feedback about iSibWorks and discussed: 1) Engaging in group learning and activities, 2) Meeting other siblings, and 3) Applying iSibWorks content to their daily life.

Conclusion

Factors related to the COVID-19 pandemic such as family stress, school closures, virtual learning, and social distancing likely impacted study results. Although there were no significant changes in QoL and social support, siblings found iSibWorks to be fun, meaningful, and engaging.

Innovation

Siblings of children with disabilities can experience psychosocial challenges and there are few virtual interventions designed for this population. iSibWorks was adapted to address this gap and increase access and support for siblings of children with disabilities.

Objective

We sought to evaluate the potential reinforcement of misconceptions in websites discussing carpal tunnel syndrome (CTS).

Methods

After removing all cookies to limit personalization, we entered “carpal tunnel syndrome” into five search engines and collected the first 50 results displayed for each search. For each of the 105 unique websites, we recorded publication date, author background, and number of views. The prevalence of potential reinforcement and/or reorientation of misconceptions for each website was then scored using a rubric based on our interpretation of the best current evidence regarding CTS. The informational quality of websites was graded with the DISCERN instrument, a validated tool for assessing online health information.

Results

Every website contained at least one potentially misleading statement in our opinion. The most common misconceptions reference “excessive motion” and “inflammation.” Greater potential reinforcement of misinformation about CTS was associated with fewer page views and lower informational quality scores.

Conclusions

Keeping in mind that this analysis is based on our interpretation of current best evidence, potential misinformation on websites addressing CTS is common and has the potential to increase symptom intensity and magnitude of incapability via reinforcement of unhelpful thoughts regarding symptoms.

Innovation

The prevalence of patient-directed health information that can increase discomfort and incapability by reinforcing common unhelpful thoughts supports the need for innovations in how we develop, oversee, and evolve healthy online material.

Objective

The lack of descriptions for education programs in studies evaluating the efficacy of continuous glucose monitoring (CGM) compared to blood glucose monitoring (BGM) for individuals with T2DM makes it difficult to compare results across trials. This study aimed to develop and evaluate a new education program for adults with insulin-treated T2DM and HbA1c ≥58 mmol/mol (7.5 %) initiating CGM.

Methods

A 3-h education program was created to provide information on diabetes self-management and CGM or BGM based on international guidelines and a pre-evaluation based on user needs assessment. Questionnaires were used to post-evaluate participant-rated benefits from the program.

Results

Seven individuals attended a user needs assessment of the program and 96 participated in the final education program (61.5 % men, mean age 61 (59.5;63) years, mean diabetes duration 18.2 (16.9;19.5) years, and median HbA1c 69 (63–78)mmol/mol (8.5 (7.9–9.3)%). Benefit from this program was rated good/very good by 95.5 % with no statistically significant difference between glucose monitoring groups.

Conclusions

This study presents a new well-received education program for T2DM for both the CGM and BGM group.

Innovation

The description of the development process and the education provided for both glucose monitoring groups may be useful for CGM initiation in clinics and trials.