PEC innovation最新文献_第8页

Developing a digital video to support lung cancer screening in diverse populations 开发数字视频以支持不同人群的肺癌筛查

PEC innovation

Pub Date : 2025-03-17 DOI: 10.1016/j.pecinn.2025.100388

Meghan Lindsay , Iyanuoluwa P. Odole , Olivia Belliveau , Fuad Abujarad , Cary P. Gross , Ilana B. Richman

Objective

Lung cancer screening (LCS) with low dose computed tomography can reduce lung cancer mortality. However, awareness and knowledge of LCS are low. We developed and tested a video to support informed decision-making about LCS for use in diverse populations, including adults with low educational attainment.

Methods

We conducted a prospective pre-post pilot study of adults eligible for LCS at three primary care clinics in the USA from 08/2022–07/2023. We developed a brief digital video, incorporating iterative modifications using participant feedback. We assessed knowledge of LCS before and after viewing the video and solicited open-ended feedback on video format and content.

Results

The study included 29 adults (median [range] age, 62 [50–77] years; 52 % male). In interviews, participants commented on informational content, effect of the video on screening behaviors and intent, video style and appearance, and video features. After viewing the video, participant knowledge scores increased from baseline of 43 % correct to 59 %, p < 0.001. Knowledge scores increased across all levels of educational attainment.

Conclusions

A brief digital video about LCS, developed with feedback from end users, was motivating, clear, and effective in increasing knowledge across levels of educational attainment.

Innovation

Using a patient-engaged, theoretically grounded development process, we developed a digital tool specifically to support lung cancer screening in diverse populations, including those with varied educational attainment.

目的低剂量ct肺癌筛查可降低肺癌死亡率。然而，人们对LCS的认识和认识很低。我们开发并测试了一个视频，以支持在不同人群中使用LCS的知情决策，包括受教育程度较低的成年人。方法：我们于2022年8月至2023年7月在美国三家初级保健诊所对符合LCS条件的成年人进行了一项前瞻性前期-后期试点研究。我们制作了一个简短的数字视频，结合了参与者反馈的迭代修改。我们在观看视频之前和之后评估了LCS知识，并就视频格式和内容征求开放式反馈。结果该研究纳入29名成人(年龄中位数[范围]为62岁[50-77]岁；52%男性)。在访谈中，参与者对信息内容、视频对筛选行为和意图的影响、视频风格和外观以及视频特征进行了评论。观看视频后，参与者的知识得分从43%的基线正确率提高到59%。0.001. 所有受教育程度的学生的知识得分都有所提高。结论根据最终用户的反馈制作的关于LCS的简短数字视频，在提高不同教育程度的知识方面具有激励、清晰和有效的作用。创新采用以患者为中心的理论开发过程，我们开发了一个数字工具，专门用于支持不同人群的肺癌筛查，包括那些受教育程度不同的人群。

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引用次数: 0

Perceived acceptability of a prototype toolkit to support patients and informal caregivers to express their perspectives in palliative care conversations 支持患者和非正式照护者在姑息关怀对话中表达观点的原型工具包的可接受性

PEC innovation

Pub Date : 2025-03-17 DOI: 10.1016/j.pecinn.2025.100387

Annet Olde Wolsink-van Harlingen (AS) , Jan Jukema (JS) , Kris Vissers (KCP) , Madeleen Uitdehaag (MJ) , Jeroen Hasselaar (J) , Leontine Groen-van de Ven (L)

Background

Patients and informal caregivers experience challenges to express their personal perspectives in conversations with healthcare professionals (HCPs). A prototype toolkit, which consists of a hardcopy version and a website, was developed to address their challenges. The aim of this study is to gain insight into the perceived acceptability of this prototype toolkit.

Method

Patients and informal caregivers end users and HCPs participated in semi-structured individual or group interviews. This resulted in two databases of qualitative data which were thematically analysed.

Results

Twenty-two end users and twelve HCPs participated in this study. There is appreciation for the content and use of the prototype toolkit, with the hardcopy version of the toolkit being valued more than the website. Moreover, the use of the toolkit may strengthen end users' power and control and may support HCPs in tailoring communication and care. End users and HCPs recommendations for implementation are to further develop the prototype toolkit, provide HCPs with information, instruction and support and create facilitating conditions in healthcare.

Conclusion

High appreciation of the hardcopy version and the practical value are positive indicators of end users'and HCPS perceived acceptability of the prototype toolkit. However, the content of the toolkit is experienced as being too extensive, with the hardcopy version experienced as being incomplete without the website and the website is experienced as being too complicated to use. Further development and testing of the prototype toolkit is required to increase its acceptability by end users and HCPs.

Innovation

In this study a Design Thinking approach was used to test study the acceptability of a prototype toolkit by endusers and HCPs. This approach can contribute to a succesfull implementation of the toolkit and its effectiveness.

患者和非正式护理人员在与医疗保健专业人员（HCPs）的对话中表达他们的个人观点时遇到了挑战。开发了一个原型工具包，其中包括一个硬拷贝版本和一个网站，以解决他们的挑战。本研究的目的是深入了解这个原型工具包的可接受性。方法患者、非正式照护者、最终使用者和医护人员参与半结构化的个人或团体访谈。这就产生了两个定性数据数据库，并对其进行了专题分析。结果22名终端用户和12名HCPs参与了本研究。人们对原型工具包的内容和使用表示赞赏，工具包的硬拷贝版本比网站更有价值。此外，该工具包的使用可以加强最终用户的权力和控制，并可能支持hcp定制沟通和护理。最终用户和hcp建议进一步开发原型工具包，为hcp提供信息、指导和支持，并在医疗保健领域创造便利条件。结论精印本的高赞赏度和实用价值是最终用户和HCPS对原型工具包感知接受度的积极指标。然而，该工具包的内容被认为过于广泛，没有网站的硬拷贝版本被认为是不完整的，网站被认为太复杂而无法使用。需要进一步开发和测试原型工具包，以提高最终用户和hcp对其的接受程度。创新在这项研究中，设计思维方法被用于测试研究原型工具包的可接受性，最终用户和HCPs。这种方法有助于工具包的成功实现及其有效性。

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引用次数: 0

Editorial – Advancing family integrated care through health promotion, education, and communication 社论-通过健康促进、教育和交流推进家庭综合护理

PEC innovation

Pub Date : 2025-03-02 DOI: 10.1016/j.pecinn.2025.100384

Anne van Kempen, Nicole van Veenendaal, Nanon Labrie

引用次数: 0

Dissemination, adaptation, and uptake of patient-facing materials to improve care coordination in primary care 传播、改编和吸收面向患者的材料，以改善初级保健的护理协调

PEC innovation

Pub Date : 2025-03-02 DOI: 10.1016/j.pecinn.2025.100386

Claire E. O'Hanlon , Jenny M. Barnard , Danielle E. Rose , Susan E. Stockdale , Evelyn T. Chang , Elizabeth M. Yano , David A. Ganz

Objective

We sought to improve patients' experience of care coordination by promoting the uptake of patient-facing tools with evidence of sustained use in Veterans Affairs (VA) primary care clinics. We disseminated tools, adapted and improved tools in response to feedback, and tracked real-world uptake.

Methods

We conducted outreach to leadership and frontline providers at local, regional, and national levels. We collaborated with frontline providers and veteran patients using human-centered design approaches to guide tool adaptation. We assessed dissemination and real-world uptake through website analytics and QR code tracking.

Results

Tools included paper pamphlets that explained care processes, provided contact information, and answered frequently asked questions. Feedback resulted in use of larger fonts; pictures and colors; less dense text; and QR codes. Discussions led to development of new tools addressing current challenges coordinating care with VA-paid community providers. We observed substantial uptake (>2000 tool page views, >3000 QR code accesses).

Conclusion

Simple patient-facing tools are valuable to patients and frontline providers as evidenced by voluntary uptake despite competing demands.

Innovation

Tools with evidence of sustained uptake were adapted to address current challenges with navigating care and care coordination among VA and non-VA providers. QR codes enabled tracking of real-world uptake.

目标我们试图通过促进退伍军人事务（VA）初级保健诊所对有持续使用证据的面向患者的工具的使用，来改善患者的护理协调体验。我们传播了工具，根据反馈意见调整和改进了工具，并跟踪了实际使用情况。方法我们在地方、地区和国家层面对领导层和一线医疗服务提供者进行了宣传。我们与一线医疗服务提供者和退伍军人患者合作，采用以人为本的设计方法来指导工具的改编。我们通过网站分析和 QR 码跟踪评估了传播情况和实际使用情况。结果工具包括纸质小册子，解释了护理流程、提供了联系信息并回答了常见问题。根据反馈意见，使用了较大的字体、图片和颜色、较少的文字密度以及 QR 码。通过讨论，我们开发了新的工具，以解决目前与退伍军人事务部付费的社区医疗服务提供者协调医疗服务所面临的挑战。我们观察到了大量的使用情况（2000 次工具页面浏览，3000 次 QR 代码访问）。结论面向患者的简单工具对患者和一线医疗服务提供者很有价值，尽管存在相互竞争的需求，但自愿使用这些工具的情况证明了这一点。通过 QR 码可以跟踪现实世界中的使用情况。

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引用次数: 0

Learning from brilliant failures 从辉煌的失败中学习

PEC innovation

Pub Date : 2025-03-02 DOI: 10.1016/j.pecinn.2025.100383

Annemiek J Linn, Nanon Labrie

引用次数: 0

Patient counselling on opioids by pharmacy technicians: A mixed-method study to explore facilitators and barriers 由药学技术人员对阿片类药物进行患者咨询：一项探索促进因素和障碍的混合方法研究

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.

目的调查社区药学技术人员（PTs）对阿片类药物处方患者的咨询实践，并确定影响其咨询行为的因素和障碍。方法采用顺序探索性混合方法，对在荷兰社区药房工作的PTs进行访谈和问卷调查。PTs是通过专业网络、小组和社交媒体招募的。对访谈进行归纳主题分析。对问卷进行描述性统计，并检验讨论依赖行为与背景特征(1)、障碍(2)和信念(3)之间的关系。结果18次访谈共产生19个主题。在252名问卷调查对象中，大多数PTs在第一次阿片类药物分配期间一致讨论剂量和常见副作用。虽然92%的人认为讨论阿片类药物依赖很重要，但只有62%的人经常这样做。障碍包括缺乏有关适应症的信息（p = 0.012）、缺乏工作协议（p = 0.017）、时间（p = 0.022）、缺乏安全感（p = 0.041）、工作经验不足（p = 0.025）以及认为开处方者有责任与患者讨论阿片类药物依赖（p = 0.018）。结论精神科医师对患者阿片类药物依赖咨询的重视程度与其行为不匹配。为了缩小这一差距并优化PTs在促进阿片类药物安全使用方面的作用，必须解决与组织和能力相关的障碍。这包括明确的工作规程、沟通培训以及包括阿片类药物处方的适应症。创新本研究的重点是参与患者阿片类药物管理的一个未被充分开发的群体，这对于设计有效的干预措施至关重要，因为PTs经常与患者直接接触。

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引用次数: 0

Enhancing perinatal health patient information through ChatGPT – An accuracy study 通过ChatGPT增强围产期健康患者信息-准确性研究

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.

目的评价ChatGPT作为妇女和妇幼保健工作者孕期“营养”和“危险信号”信息来源的准确性。方法chatgpt生成的推荐的准确性由8位评分者以4种语言（法语、英语、德语和荷兰语）对每个主题的10个指标进行5点李克特量表评估。准确度和译员一致性按主题和语言计算。结果对于这两个主题，chatgpt生成的推荐的中位数准确率得分都很好(5.0；IQR 4-5)独立于语言。根据问题的框架，5分Likert-scare的中位数准确度得分最高为1分。“孕期营养”的总体准确率为83 - 89%，而“孕期危险信号”的总体准确率为96 - 98%。评分者对这两个题目的一致意见都很好。结论：尽管ChatGPT对怀孕期间的营养和危险信号的测试指标给出了准确的建议，但女性应该意识到ChatGPT的局限性，例如根据配方、语言和女性的个人情况不一致。尽管人们对人工智能在医疗保健领域的潜在应用越来越感兴趣，但据我们所知，这是第一项评估可能影响chatgpt生成的建议准确性的潜在局限性的研究，例如围产期健康关键领域的语言和问题框架。

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引用次数: 0

Changes in community pharmacy communication – Towards emotional awareness at the pharmacy counter 社区药房沟通的变化——走向药房柜台的情感意识

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.

目的探讨社区药房员工在参加心理化教育项目后，在案头会议中是否通过互动行为表现出情绪意识的改变，以及如何表现出情绪意识的改变，从而探讨理论学习或线下社会认知能否转化为实际交际实践或线上社会认知。方法作为一个更大的可行性研究的一部分，我们开发了一个方法框架来分类与心智化沟通和情感意识相关的互动贡献。该框架被应用于11个丹麦社区药房的50个社区药房柜台互动录像，这些药店都参加了心理教育方案。通过对参与前和参与后的25段视频中药学人员的互动贡献进行分类和描述性比较。结果药房工作人员对患者的教育后取向有所改变；他们在开始互动时产生更多的问题（第一个位置谈话转向），并对患者的话语做出更多的反应（第三个位置谈话转向）。此外，在参与后的措施中，第三位贡献的实现显示出更高的情感意识，使患者的观点更有针对性。结论在参与后测量中，药学人员对患者的互动方式发生了改变。这有助于医疗保健专业人员能力培训的研究，并增加了在线社会认知技能可以通过线下社会认知技能培训受到影响的概念的权重。创新方法框架提供了一种新颖和创新的方法来调查交际实践的变化。该框架适用于所有对话式卫生保健传播研究。

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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] “促成丹麦实施父亲友好型新生儿重症监护病房的因素”的勘误[PEC创新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 “和电脑交谈很困难，我明白了”：对农村远程护理接触中临床医生建立联系的沟通实践的探索性分析

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.

背景/目的在重症对话中建立人际关系是至关重要的，然而远程医疗的感官和关系环境可能需要临床医生、患者和家属创新的沟通实践来有效地做到这一点。我们试图探索建立人际关系的推荐的面对面最佳实践是否以及如何适应远程医疗姑息治疗（telePC）环境，以便在这种新的护理环境中发现和描述实践创新。方法：我们分析了新英格兰北部姑息治疗远程咨询研究的数据，这是一项形成性的混合方法试点研究，在美国农村州的两个学术医疗中心进行，患者患有严重疾病（2019-2020）。我们使用定性描述方法与直接内容分析相结合来分析视频记录的电话咨询。结果分析了9例姑息治疗患者和6名姑息治疗临床医生的视频会诊。患者参与者的平均年龄为68岁，56%为女性，38%未完成高中学业。平均会诊时间为52分钟（标准差10，范围40-70分钟）。我们对就诊的定性分析得出了描述临床医生沟通的三个关键主题：1)培养人际关系的实践；2)克服技术问题/困难的实践；3)进行多参与者远程对话的练习。结论我们的研究结果有助于为临床医生在远程诊疗中使用推荐的面对面建立联系的沟通实践提供概念验证证据。由于姑息治疗临床医生自然适应远程医疗环境，需要更多的实证研究来了解哪些创新方法最有效地促进人际关系。InnovationTelePC代表了一种正在扩大但尚未得到充分研究的姑息治疗提供模式。这项研究是第一批描述电信环境如何催化自然发生的通信创新的研究之一。

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引用次数: 0