51
|
Lunde P, Bye A, Bergland A, Grimsmo J, Jarstad E, Nilsson BB. Long-term follow-up with a smartphone application improves exercise capacity post cardiac rehabilitation: A randomized controlled trial. Eur J Prev Cardiol 2020; 27:1782-1792. [PMID: 32106713 PMCID: PMC7564298 DOI: 10.1177/2047487320905717] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/21/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Mobile health interventions, especially smartphone applications (apps), have been proposed as promising interventions for supporting adherence to healthy behaviour in patients post cardiac rehabilitation (CR). The overall aim of the study was to examine the effect of individualized follow-up with an app for one year on peak oxygen uptake (VO2peak) in patients completing CR. DESIGN The study was designed as a single-blinded multicentre randomized controlled trial. METHODS The intervention group (IG) received individualized follow-up enabled with an app for one year, while the control group (CG) received usual care. The primary outcome was difference in VO2peak. Secondary outcomes included exercise performance (time to exhaustion, peak incline (%) and peak velocity (km/h)), bodyweight, resting blood pressure, lipid profile, triglycerides, exercise habits, health-related quality of life, health status and self-perceived goal achievement. RESULTS In total, 113 patients completing CR (73.4% with coronary artery disease, 16.8% after valve surgery and 9.8% with other heart diseases) were randomly allocated to the IG or CG. Intention to treat analyses showed a statistically significant difference in VO2peak between the groups at follow-up of 2.2 ml/kg/min, 95% confidence interval 0.9-3.5 (p < 0.001). Statistically significant differences were also observed in exercise performance, exercise habits and in self-perceived goal achievement. CONCLUSIONS Individualized follow-up for one year with an app significantly improved VO2peak, exercise performance and exercise habits, as well as self-perceived goal achievement, compared with a CG in patients post-CR. There were no statistically significant differences between the groups at follow-up in the other outcome measures evaluated.
Collapse
Affiliation(s)
- Pernille Lunde
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Norway
| | - Asta Bye
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Norway
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Norway
| | - Astrid Bergland
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Norway
| | - Jostein Grimsmo
- Norwegian Heart and Lung Patient Organization, LHL-Hospital Gardermoen, Norway
| | - Even Jarstad
- Norwegian Sport Medicine Clinic (NIMI), Department of Cardiology and Exercise Physiology, Norway
| | - Birgitta Blakstad Nilsson
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Norway
- Section for Physiotherapy, Division of Medicine, Oslo University Hospital, Norway
| |
Collapse
|
52
|
Having a Usual Source of Care Is Associated with Longer Telomere Length in a National Sample of Older Adults. J Am Board Fam Med 2020; 33:832-841. [PMID: 33219062 PMCID: PMC7758079 DOI: 10.3122/jabfm.2020.06.200008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To provide a potential biological, mechanistic link for the well-established association between primary care access and reduced mortality, this study sought to measure the impact of having a usual source of health care on leukocyte telomere length (LTL). DATA SOURCES Our study population included 3202 participants aged 50 to 84 years from National Health and Nutrition Examination Survey 1999 to 2001. STUDY DESIGN Cross-sectional Study. LTLs between people with and without a usual source of care were compared using unadjusted and adjusted linear regression models. Fully adjusted models accounted for demographic characteristics, health conditions, and health behaviors. PRINCIPAL FINDINGS After controlling for individual factors, health conditions, and health behaviors, people who had a usual source of health care had significantly longer LTL (β = 89.8 base pairs, P-value = .005) compared with those without a usual source of care; corresponding to approximately 7 years of life. CONCLUSIONS Having a usual source of health care is associated with longer LTL among older adults. This study provides a potential biologic link for the noted association between primary care access and reduced mortality that has been observed at the individual and population level.
Collapse
|
53
|
Dahne J, Player M, Carpenter MJ, Ford DW, Diaz VA. Evaluation of a Proactive Smoking Cessation Electronic Visit to Extend the Reach of Evidence-Based Cessation Treatment via Primary Care. Telemed J E Health 2020; 27:347-354. [PMID: 33085578 DOI: 10.1089/tmj.2020.0167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Best practice guidelines for smoking cessation treatment through primary care advise the 5As model. However, compliance with these guidelines is poor, leaving many smokers untreated. The purpose of this study was to develop and preliminarily evaluate an asynchronous smoking cessation electronic visit (e-visit) that could be delivered proactively through the electronic health record (EHR) to adult smokers treated within primary care. The goal of the e-visit is to automate 5As delivery to ensure that all smokers receive evidence-based cessation treatment. As such, the aims of this study were twofold: (1) to examine acceptability, feasibility, and treatment metrics associated with e-visit utilization and (2) to preliminarily examine efficacy relative to treatment as usual (TAU) within primary care. Methods: Participants (n = 51) were recruited from primary care practices between November 2018 and October 2019 and randomized 2:1 to receive either the smoking cessation e-visit or TAU. Participants completed assessments of cessation outcomes 1-month and 3-months postenrollment and e-visit analytics data were gathered from the EHR. Results: Self-report feedback from e-visit participants indicated satisfaction with the intervention and interest in using e-visits again in the future. Nearly all e-visits resulted in prescription of a U.S. Food and Drug Administration (FDA)-approved smoking cessation medication. In general, smoking cessation outcomes favored the e-visit condition at both 1 (odds ratios [ORs]: 2.10-5.39) and 3 months (ORs: 1.31-4.67). Conclusions: These results preliminarily indicate the feasibility, acceptability, and efficacy of this smoking cessation e-visit within primary care. Future studies should focus on larger scale examination of effectiveness and implementation across settings. The clinicaltrials.gov registration number for this trial is NCT04316260.
Collapse
Affiliation(s)
- Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.,Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Marty Player
- Department of Family Medicine,Medical University of South Carolina, Charleston, South Carolina, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.,Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Public Health Sciences, and Medical University of South Carolina, Charleston, South Carolina, USA
| | - Dee W Ford
- Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Vanessa A Diaz
- Department of Family Medicine,Medical University of South Carolina, Charleston, South Carolina, USA
| |
Collapse
|
54
|
Zhang Z, Yang H, He J, Lu X, Zhang R. The Impact of Treatment-Related Internet Health Information Seeking on Patient Compliance. Telemed J E Health 2020; 27:513-524. [PMID: 32907505 DOI: 10.1089/tmj.2020.0081] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Patients are increasingly using technology to seek health information, particularly on treatments. Treatment-related internet health information-seeking behavior may have impact on patients' trust in their physicians and the patient-physician relationship. Therefore, understanding the impacts of treatment-related internet health information-seeking behavior on patient-physician relationship, especially patient compliance, from the perspective of trust is important. Methods: The established research model has two independent variables (emerging and mature treatment-related internet health information seeking), two mediators (cognition- and affect-based trust), and one dependent variable (patient compliance). All variables were measured using previously validated multiple-item scales. We collected data through a web-based questionnaire survey in China and obtained 336 valid responses. The questionnaire validity rate was 89.6% (336/375), and reliability and validity were acceptable. Finally, we used confirmatory factor analysis and structural equation modeling to test the hypotheses and develop the research model. Results: Cognition- and affect-based trust had a direct positive impact on patient compliance. Cognition-based trust had a direct positive impact on affect-based trust. Mature treatment-related internet health information seeking had a significant positive impact on patient compliance through patients' cognition- and affect-based trust in their physicians. However, the emerging treatment-related internet health information seeking indicated a nonsignificant impact on patients' cognition- and affect-based trust in their physicians. Conclusions: Providing patients with access to treatment-related internet health information will not have a negative impact on the patient-physician relationship. Instead, encouraging patients to seek treatment-related health information online can improve patient compliance. Physicians can also learn much about health information related to emerging treatments to enhance their professionalism and reliability.
Collapse
Affiliation(s)
- Zhiwei Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, China.,Big Data Application on Improving Government Governance Capabilities National Engineering Laboratory, Guiyang, China.,CETC Big Data Research Institute Co., Ltd., Guiyang, China
| | - Hui Yang
- Big Data Application on Improving Government Governance Capabilities National Engineering Laboratory, Guiyang, China.,CETC Big Data Research Institute Co., Ltd., Guiyang, China
| | - Jie He
- Big Data Application on Improving Government Governance Capabilities National Engineering Laboratory, Guiyang, China.,CETC Big Data Research Institute Co., Ltd., Guiyang, China
| | - Xinyi Lu
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Runtong Zhang
- Department of Information Management, School of Economics and Management, Beijing Jiaotong University, Beijing, China
| |
Collapse
|
55
|
Zhang W, Huang Y, Zhou H, Lin G, Lu M, Xi Lecturer X. Associations between social capital and trust in general practitioners among the elderly people: Empirical evidence from China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1590-1602. [PMID: 32207223 DOI: 10.1111/hsc.12983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 02/16/2020] [Accepted: 03/04/2020] [Indexed: 05/27/2023]
Abstract
Elderly individuals' trust in general practitioners (GPs) is conducive to enhancing their health outcomes and promote healthy ageing. However, this trust has been declining in recent decades. Social capital is associated with patients' trust in healthcare providers in several countries, which make it a potential path for improving the trust of the elderly people in GPs in China, but it is not yet validated. The objective of this study was to explore how social capital influences elderly individuals' trust in GPs in China. The data were collected through a survey conducted with 2,754 people aged 60 and over in China, 2018. Multilevel regression models were employed to analyse the impact of social capital on the trust of the elderly people in GP in China. The results revealed that individual social capital (ISC) and community social capital (CSC) had significant positive correlations with the trust of the elderly people in GPs in China. In addition, CSC has more impact than ISC on the trust of the elderly people in GP. Additionally, older people, women and patients whose highest level of education was junior high school and who had participated in the New Cooperative Medical Scheme tended to have higher trust in GPs. In conclusion, more social capital, especially CSC, contributed more trust of the elderly people in GPs in China.
Collapse
Affiliation(s)
- Weiwei Zhang
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing City, China
| | - Yuankai Huang
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing City, China
| | - Hongjie Zhou
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing City, China
| | - Guohua Lin
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing City, China
| | - Mengqing Lu
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing City, China
| | - Xiaoyu Xi Lecturer
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing City, China
| |
Collapse
|
56
|
Comparcini D, Simonetti V, Tomietto M, Radwin LE, Cicolini G. Trust in Nurses Scale: validation of the core elements. Scand J Caring Sci 2020; 35:636-641. [PMID: 32666521 DOI: 10.1111/scs.12885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Trust in Nurses Scale (TNS) was developed and psychometrically assessed so that patients' trust could be accurately and reliably measured. The TNS has been translated, assessed and administered to patients in Europe, Asia and North America. AIM This descriptive, cross-sectional, correlational study aimed to assess the psychometric characteristics of the Italian version of the Trust in Nurses Scale. METHODS An Italian version of the TNS was developed. We used a forward-backward translation methodology to establish semantic and conceptual equivalence within the Italian context. The scale was then administered to a convenience sample of 200 hospitalised patients in medical, surgical or oncology units. Internal consistency and construct validity were assessed performing Cronbach's alpha and confirmatory factor analysis (CFA). Both a 4-item and a 5-item TNS were assessed. RESULTS The 4-item TNS demonstrated better construct validity than the 5-item version. Similarly, the internal consistency reliability was better with 4 items than 5 (0.83 and 0.79, respectively). CONCLUSION The Italian version of the scale has acceptable reliability and validity and may be used to assess this aspect of the nurse-patient relationship. Being tested in different settings, it may be used with all patients admitted to hospital. Trust in nurses is critically important to patient outcomes; however, it is rarely measured quantitatively on a wide scale. The use of the Italian validated scale could be useful to increase evidences on this important topic, as it represents a core component of nursing care.
Collapse
Affiliation(s)
- Dania Comparcini
- Azienda Ospedaliero Universitaria "Ospedali Riuniti" di Ancona, Ancona, Italy
| | - Valentina Simonetti
- "Politecnica delle Marche" University, Ancona, Italy.,ASUR Marche, Ascoli Piceno, Italy
| | - Marco Tomietto
- Direzione Centrale Salute, Politiche Sociali e Disabilità; Regione Friuli Venezia Giulia., Italy
| | - Laurel E Radwin
- Center for Health Care Organizational and Implementation Research (CHOIR), VA Bonston Healthcare System Boston, West Roxbury, MA, USA
| | - Giancarlo Cicolini
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| |
Collapse
|
57
|
Abstract
Demands for more patient-centred care necessitate that leadership creates the conditions for more compassionate care that is sustainable even in periods of acute crisis. We draw on a growing body of empirical research in health services, management and medicine to highlight how the combination of interpersonal acts, leadership style and organisational structures underpins leading with compassion. We further detail how this benefits care provider well-being and patient outcomes through fostering integrative thinking and prosocial motivation. We conclude with implications for practice.
Collapse
|
58
|
Schatman ME, Patterson E, Shapiro H. Patient Interviewing Strategies to Recognize Substance Use, Misuse, and Abuse in the Dental Setting. Dent Clin North Am 2020; 64:503-512. [PMID: 32448454 DOI: 10.1016/j.cden.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Brief and effective clinical interviewing is critical for identifying patient risk factors, including those associated with substance use. Dental practitioners may perceive identifying patient substance misuse and abuse as a complex undertaking or may consider this clinical assessment beyond the scope of their training and practice. This article describes interviewing strategies that will help dental providers communicate effectively and empathically with their patients to collect relevant clinical information related to substance use, misuse, and abuse and provide better care for their patients.
Collapse
Affiliation(s)
- Michael E Schatman
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA; Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
| | - Ellen Patterson
- Department of Comprehensive Care, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA
| | - Hannah Shapiro
- Department of Biopsychology, Tufts University, Robinson Hall, 200 College Avenue, Medford, MA 02155, USA
| |
Collapse
|
59
|
The Impact of Joining a Team on the Initial Trust in Online Physicians. Healthcare (Basel) 2020; 8:healthcare8010033. [PMID: 32041333 PMCID: PMC7151224 DOI: 10.3390/healthcare8010033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/24/2020] [Accepted: 02/05/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction: Trust is a major challenge for the online market and this is especially the case for e-consultation platforms. Research that promotes online physician trust is highly desirable. In this study, we focus on whether joining a team led by a well-known physician will increase physician trust and what team characteristics will affect this trust. Materials and Methods: Brand extension theory is applied to the healthcare context to explain the impact of joining a team on physician trust. Specifically, both team strength and team similarity are hypothesized to have the main effects. In addition, team size is hypothesized to have a moderating effect. A 2 × 2 × 2 experiment was conducted to test the proposed research model. Results: The results indicated that joining a team would significantly increase physician trust (p < 0.001). Both team strength (p < 0.001) and team similarity (p < 0.001) had positive impacts on physician trust. In addition, a larger team size resulted in a reduced positive effect of team strength on physician trust (p < 0.001). Conclusions: Joining a physician team is an effective and low-cost method to address the initial trust problem of unknown online physicians.
Collapse
|
60
|
Ee C, de Courten B, Avard N, de Manincor M, Al-Dabbas MA, Hao J, McBride K, Dubois S, White RL, Fleming C, Egger G, Blair A, Stevens J, MacMillan F, Deed G, Grant S, Templeman K, Chang D. Shared Medical Appointments and Mindfulness for Type 2 Diabetes-A Mixed-Methods Feasibility Study. Front Endocrinol (Lausanne) 2020; 11:570777. [PMID: 33123089 PMCID: PMC7573307 DOI: 10.3389/fendo.2020.570777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/10/2020] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Type 2 diabetes (T2DM) is a major health concern with significant personal and healthcare system costs. There is growing interest in using shared medical appointments (SMAs) for management of T2DM. We hypothesize that adding mindfulness to SMAs may be beneficial. This study aimed to assess the feasibility and acceptability of SMAs with mindfulness for T2DM within primary care in Australia. MATERIALS AND METHODS We conducted a single-blind randomized controlled feasibility study of SMAs within primary care for people with T2DM living in Western Sydney, Australia. People with T2DM, age 21 years and over, with HbA1c > 6.5% or fasting glucose >7.00 mmol/L within the past 3 months were eligible to enroll. The intervention group attended six 2-h programmed SMAs (pSMAs) which were held fortnightly. pSMAs included a structured education program and mindfulness component. The control group received usual care from their healthcare providers. We collected quantitative and qualitative data on acceptability as well as glycemic control (glycated hemoglobin and continuous glucose monitoring), lipids, anthropometric measures, blood pressure, self-reported psychological outcomes, quality of life, diet, and physical activity using an ActiGraph accelerometer. RESULTS Over a 2-month period, we enrolled 18 participants (10 females, 8 males) with a mean age of 58 years (standard deviation 9.8). We had 94.4% retention. All participants in the intervention group completed at least four pSMAs. Participants reported that attending pSMAs had been a positive experience that allowed them to accept their diagnosis and empowered them to make changes, which led to beneficial effects including weight loss and better glycemic control. Four pSMA participants found the mindfulness component helpful while two did not. All of the seven participants who contributed to qualitative evaluation reported improved psychosocial wellbeing and found the group setting beneficial. There was a significant difference in total cholesterol levels at 12 weeks between groups (3.86 mmol/L in intervention group vs. 4.15 mmol/L in the control group; p = 0.025) as well as pain intensity levels as measured by the PROMIS-29 (2.11 vs. 2.38; p = 0.034). CONCLUSION pSMAs are feasible and acceptable to people with T2DM and may result in clinical improvement. A follow-up fully-powered randomized controlled trial is warranted. CLINICAL TRIAL REGISTRATION Australia and New Zealand Clinical Trial Registry, identifier ACTRN12619000892112.
Collapse
Affiliation(s)
- Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- *Correspondence: Carolyn Ee, ; Dennis Chang,
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Nicole Avard
- Next Practice Health, Erina, Sydney, NSW, Australia
| | - Michael de Manincor
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Mahmoud A. Al-Dabbas
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Jie Hao
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Kate McBride
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Shamieka Dubois
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Rhiannon Lee White
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Catharine Fleming
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Garry Egger
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
| | | | - John Stevens
- School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
| | - Freya MacMillan
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Gary Deed
- Mediwell Clinic, Brisbane, QLD, Australia
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Kate Templeman
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- *Correspondence: Carolyn Ee, ; Dennis Chang,
| |
Collapse
|
61
|
Scherer M, Weiss L, Kamler A, George MC, Navis A, Gebhardt Y, Robinson-Papp J. Patient recommendations for opioid prescribing in the context of HIV care: findings from a set of public deliberations. AIDS Care 2019; 32:1471-1478. [PMID: 31870170 DOI: 10.1080/09540121.2019.1705962] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
It is widely acknowledged that the growing opioid epidemic and associated increase in overdose deaths necessitates a reexamination of processes and procedures related to an opioid prescription for the treatment of chronic pain. However, the perspectives of patients, including those at the highest risk for opioid-related harms, are largely missing from this reexamination. To partially address the gap, we conducted a pair of one-day public deliberations on opioid prescribing in the context of HIV care. Results included recommendations and perspectives from people living with HIV that detail how providers can best assess patient needs, communicate regarding opioids, and reduce the risk of misuse. Participants emphasized the importance of building trust with patients and taking an extensive patient history prior to making decisions about whether to initiate or end an opioid prescription. This trust - together with an understanding of the origin of a patient's pain, history of drug use and other therapies tried - was perceived as essential to effective monitoring and pain management, as well as promotion of positive health outcomes. Ensuring that such patient perspectives are incorporated into the operationalization of guidelines for safe opioid prescribing may help to improve outcomes and quality of care for people living with HIV.
Collapse
Affiliation(s)
- Maya Scherer
- Center for Evaluation and Applied Research, The New York Academy of Medicine, New York, NY, USA
| | - Linda Weiss
- Center for Evaluation and Applied Research, The New York Academy of Medicine, New York, NY, USA
| | - Alexandra Kamler
- Center for Evaluation and Applied Research, The New York Academy of Medicine, New York, NY, USA
| | | | - Allison Navis
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yves Gebhardt
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | |
Collapse
|
62
|
Fatollahi JJ, Colbert JA, Agarwal P, Lee JL, Lehmann EY, Yuan N, Lehmann LS, Chretien KC. The Impact of Physician Social Media Behavior on Patient Trust. AJOB Empir Bioeth 2019; 11:77-82. [PMID: 31663810 DOI: 10.1080/23294515.2019.1678533] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Institutions have developed professionalism policies to help guide physician social media behavior in light of professionalism lapses that have resulted in serious consequences. Prior research has gathered perspectives on online professionalism; however, the public's views remain poorly understood. Importantly, the impact of physician social media behavior on patient trust is unknown. Methods: To determine whether patients' trust might change based on their physicians' social media behavior, we conducted a cross-sectional survey across three U.S. cities (n = 491). The survey assessed patient trust using hypothetical scenarios. Results: Most respondents reported they would have less trust if their physician posted racist comments online, wrote a disrespectful patient narrative, appeared intoxicated in a photograph, or wrote profanity. Respondent age and education impacted change in trust. Conclusions: We conclude that physicians' social media behavior may affect patient trust. Better understanding of how physicians' online presence impacts their relationships with patients can help guide policy and inform educational efforts.
Collapse
Affiliation(s)
| | - James A Colbert
- Harvard Medical School.,Blue Cross Blue Shield of Massachusetts
| | | | - Joy L Lee
- Indiana University School of Medicine.,Regenstrief Institute, Inc
| | | | - Neal Yuan
- University of California at San Francisco School of Medicine
| | | | - Katherine C Chretien
- George Washington University School of Medicine.,Washington DC Veterans Affairs Medical Center
| |
Collapse
|
63
|
Gabay G, Bokek-Cohen Y. Infringement of the right to surgical informed consent: negligent disclosure and its impact on patient trust in surgeons at public general hospitals - the voice of the patient. BMC Med Ethics 2019; 20:77. [PMID: 31660956 PMCID: PMC6819415 DOI: 10.1186/s12910-019-0407-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 09/06/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is little dispute that the ideal moral standard for surgical informed consent calls for surgeons to carry out a disclosure dialogue with patients before they sign the informed consent form. This narrative study is the first to link patient experiences regarding the disclosure dialogue with patient-surgeon trust, central to effective recuperation and higher adherence. METHODS Informants were 12 Israelis (6 men and 6 women), aged 29-81, who underwent life-saving surgeries. A snowball sampling was used to locate participants in their initial recovery process upon discharge. RESULTS Our empirical evidence indicates an infringement of patients' right to receive an adequate disclosure dialogue that respects their autonomy. More than half of the participants signed the informed consent form with no disclosure dialogue, and thus felt anxious, deceived and lost their trust in surgeons. Surgeons nullified the meaning of informed consent rather than promoted participants' moral agency and dignity. DISCUSSION Similarity among jarring experiences of participants led us to contend that the conduct of nullifying surgical informed consent does not stem solely from constraints of time and resources, but may reflect an underlying paradox preserving this conduct and leading to objectification of patients and persisting in paternalism. We propose a multi-phase data-driven model for informed consent that attends to patients needs and facilitates patient trust in surgeons. CONCLUSIONS Patient experiences attest to the infringement of a patient's right to respect for autonomy. In order to meet the prima facie right of respect for autonomy, moral agency and dignity, physicians ought to respect patient's needs. It is now time to renew efforts to avoid negligent disclosure and implement a patient-centered model of informed consent.
Collapse
Affiliation(s)
- Gillie Gabay
- Behavioral Sciences and Psychology, College of Management Academci studies, 7 Rabin Blvd, 97150 Rishon Letzion, Israel
| | - Yaarit Bokek-Cohen
- Nursing Sciences, Tal-Aviv Jaffa Academic College, 7 Rabin Blvd, 97150 Rishon Letzion, Israel
| |
Collapse
|
64
|
Bientzle M, Minje J, Cress U, Kimmerle J. Therapeutic Touch in Exercise Videos: A Randomized Experiment of the Impact on the Evaluation of Therapists' Competence and Viewers' Self-Reliance. Front Sports Act Living 2019; 1:35. [PMID: 33344958 PMCID: PMC7739565 DOI: 10.3389/fspor.2019.00035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/10/2019] [Indexed: 01/21/2023] Open
Abstract
From a psychological health perspective, being physically touched is highly relevant throughout people's lives. Touch plays an important role in many contexts, such as in instructing movement exercises. Exercise videos have become a well-accepted format to support therapists in instructing movement exercises. In the study presented here we examined the impact of the use of therapeutic touch in exercise videos on people's evaluation of physiotherapists' competence and on their own self-reliance. In a between-group randomized experiment, 125 participants watched one of three videos that showed a physiotherapist who instructed a movement exercise to a patient. The physiotherapist touched the patient during the treatment (therapist-touch, TT), instructed the patient to use self-touch (ST), or provided only exercise instruction without physical touch (no-touch, NT). In the TT condition, the participants' perception was that the physiotherapist exhibited more professional competence. However, participants considered the movement exercise in this TT condition to have less potential for fostering their autonomy. Finally, participants in the ST condition had the biggest increase in perceived self-efficacy. The way of touching a patient in an exercise video influences the perception of the treatment. We conclude that therapeutic touch should be applied in exercise videos in a goal-oriented way: It seems appropriate to use ST if the aim is to strengthen viewers' self-reliance and to use TT to arouse trust in the competence of the therapist.
Collapse
Affiliation(s)
- Martina Bientzle
- Leibniz-Institut fuer Wissensmedien, Knowledge Media Research Center, Tübingen, Germany.,PT Academy Tübingen, Tübingen, Germany
| | | | - Ulrike Cress
- Leibniz-Institut fuer Wissensmedien, Knowledge Media Research Center, Tübingen, Germany.,Department of Psychology, University of Tübingen, Tübingen, Germany
| | - Joachim Kimmerle
- Leibniz-Institut fuer Wissensmedien, Knowledge Media Research Center, Tübingen, Germany.,Department of Psychology, University of Tübingen, Tübingen, Germany
| |
Collapse
|
65
|
Aoki T, Urushibara‐Miyachi Y. A qualitative study of socially isolated patients' perceptions of primary care. J Gen Fam Med 2019; 20:185-189. [PMID: 31516804 PMCID: PMC6732495 DOI: 10.1002/jgf2.262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/21/2019] [Accepted: 05/09/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although the previous quantitative study revealed that social isolation was negatively associated with patient experience of primary care, the underlying reasons for this phenomenon remain unclear. In the present study, we aimed to explore the reasons underlying the influence of social isolation on patient experience in the primary care setting. METHODS This study was a qualitative study and part of a mixed methods research. Semistructured telephone interviews were performed. We recruited participants among eligible participants in the previous quantitative survey who were classified as being socially isolated. Data were transcribed verbatim and analyzed thematically by two independent researchers until saturation was reached. RESULTS Eight socially isolated patients in the research were interviewed. In the thematic analysis, three major themes emerged as reasons underlying the influence of social isolation on patient experience of primary care: restriction of information about local primary care physicians, finding a usual primary care physician haphazardly, and superficial relationship with a usual primary care physician. CONCLUSIONS This study identified three major themes, which are beneficial to expand our understanding of socially isolated patients' perceptions of primary care. These findings can be used to improve patient experience of primary care in socially isolated patients.
Collapse
Affiliation(s)
- Takuya Aoki
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto UniversityKyotoJapan
| | | |
Collapse
|
66
|
Bishop M, Kayes N, McPherson K. Understanding the therapeutic alliance in stroke rehabilitation. Disabil Rehabil 2019; 43:1074-1083. [PMID: 31433673 DOI: 10.1080/09638288.2019.1651909] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The quality of the therapeutic alliance between a client and their clinician is thought to play an important role in healthcare but there is limited research about this concept in stroke rehabilitation. This study explored the core components of a therapeutic alliance and the factors perceived to impact on its development in a stroke rehabilitation unit. METHODS Interpretive description methodology was used to gather and synthesise participants' experiences of their therapeutic relationships. Ten individual client interviews and one clinician focus group were conducted. Data was were analysed using conventional content analysis. RESULTS A therapeutic alliance appeared to consist of three overlapping core components: a personal connection, a professional collaboration, and family collaboration. Clients valued these components to different degrees and priorities could change over time. Alliance breakdowns were perceived to stem from a clinician's incorrect assumptions about their client's relationship preferences or lack of responsiveness to their needs. Recovery of the alliance seemed to depend on the strength of the pre-existing relationship and steps taken to repair it. CONCLUSIONS Establishing and maintaining a therapeutic alliance appears to be an individualised and complex process. A clinician's ability to use their personal attributes therapeutically, and professional skills flexibly, appeared integral to relationship quality.IMPLICATIONS FOR REHABILITATIONDeveloping therapeutic relationships requires a person-centred and sometimes family/whānau-centred approach.The judicious use of self-disclosure may achieve emotional proximity and yet maintain professional boundaries.Maintaining relationship health requires a proactive approach to detect and manage relationship disruptions.
Collapse
Affiliation(s)
- Megan Bishop
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand.,School of Physiotherapy, University of Otago, Wellington, New Zealand
| | - Nicola Kayes
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Kathryn McPherson
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand.,Health Research Council of New Zealand, Auckland, New Zealand
| |
Collapse
|
67
|
Haldane V, Tan YG, Teo KWQ, Koh JJK, Srivastava A, Cheng RX, Yap YC, Ong PS, van Dam RM, Foo JM, Müller-Riemenschneider F, Koh GCH, Perel P, Legido-Quigley H. Perspectives on Acceptance and Use of a Mobile Health Intervention for the Prevention of Atherosclerotic Cardiovascular Disease in Singapore: Mixed-Methods Study. JMIR Mhealth Uhealth 2019; 7:e11108. [PMID: 30869651 PMCID: PMC6437612 DOI: 10.2196/11108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Cardiovascular disease, including atherosclerotic cardiovascular disease (ASCVD), is a growing public health threat globally and many individuals remain undiagnosed, untreated, and uncontrolled. Simultaneously, mobile health (mHealth) interventions using short messaging service (SMS) have gained popularity globally. There is an opportunity for innovative approaches such as mHealth to encourage and enable adherence to medications for ASCVD and its risk factors. OBJECTIVE This study aimed to understand mobile technology acceptance, use, and facilitating conditions among the study population ahead of the design of an mHealth intervention. METHODS Using data from a mixed-methods study conducted in Singapore, we conducted a cross-sectional survey with 100 participants and in-depth, semistructured interviews with 20 patients. All participants were over the age of 40 years with ASCVD or its risk factors. Interviews were conducted in English and Mandarin and if needed translated to English. Nvivo 11 (QSR International) was used for analyses. RESULTS Participants reported their perspectives on technology use and preferences, including low or sporadic mobile phone use and usability concerns including small screen and text size, among others; the benefit of previous mHealth use in creating a favorable opinion of SMS for health information; trust in both the source of mHealth SMS, as well as in treatment; the formation of habits; and fear of sequelae or death for facilitating intention to use an mHealth intervention and adhere to medication. We also highlighted a case that underscored the importance of the period after diagnosis in habit forming as an opportunity for an mHealth intervention. CONCLUSIONS We explored both technology- and adherence-related factors that influence a patient's intention to use an mHealth intervention for adherence to ASCVD medication in Singapore. We highlighted the importance of identifying the right opportunity to engage with patients and promote an mHealth intervention for adherence, such as immediately following diagnosis when patients are establishing medication-taking habits.
Collapse
Affiliation(s)
- Victoria Haldane
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
| | - Yao Guo Tan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Joel Jun Kai Koh
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
| | - Aastha Srivastava
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
| | - Rui Xiang Cheng
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Yi Cheng Yap
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Pei-Shi Ong
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Rob M van Dam
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
| | - Jie Min Foo
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Gerald Choon-Huat Koh
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
| | - Pablo Perel
- London School of Hygiene and Tropical Medicine, London, United Kingdom.,World Heart Federation, Geneva, Switzerland
| | - Helena Legido-Quigley
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
68
|
Cockroft JD, Adams SM, Bonnet K, Matlock D, McMillan J, Schlundt D. “A scarlet letter”: Stigma and other factors affecting trust in the health care system for women seeking substance abuse treatment in a community setting. Subst Abus 2019; 40:170-177. [DOI: 10.1080/08897077.2018.1544184] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Susie M. Adams
- Vanderbilt University School of Nursing, Nashville, Tennessee, USA
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | | | - Jessica McMillan
- Vanderbilt University School of Nursing, Nashville, Tennessee, USA
| | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| |
Collapse
|
69
|
Fonte D, Colson S, Côté J, Lagouanelle-Simeoni MC, Apostolidis T. 'Adolescents are reckless': Representations at stake in the construction of the relationship of trust in paediatric diabetology. J Health Psychol 2018; 26:270-282. [PMID: 30426776 DOI: 10.1177/1359105318809861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A total of 10 focus groups were held with adolescents living with diabetes, their parents and health professionals in order to explore their needs in therapeutic education. The analysis showed that the relationship of trust was a central concern for a number of participants. Several adults were divided between a feeling of confidence inspired by the need to empower adolescents to cope with the chronic condition and a sense of distrust inspired by the idea of carelessness and irresponsibility thought to characterize adolescence. Adolescents, for their part, seemed relatively clear-sighted about how they can be perceived, and blamed adults for not trusting them. These findings emphasize the importance of considering the representations at stake in the dynamics of the therapeutic relationship in order to better understand the construction of the relational climate.
Collapse
Affiliation(s)
- David Fonte
- Aix Marseille Univ, LPS, Aix-en-Provence, France
| | - Sébastien Colson
- Aix Marseille Univ, UFR Sciences médicales et paramédicales, Ecole des Sciences Infirmières, CEReSS, Marseille, France
| | - José Côté
- Université de Montréal, Faculté des Sciences Infirmières, Montréal, Canada.,CRCHUM, Chaire de recherche sur les nouvelles pratiques de soins infirmiers, Montréal, Canada
| | - Marie-Claude Lagouanelle-Simeoni
- Aix Marseille Univ, LPS, Aix-en-Provence, France.,APHM, Hôpital Conception, Service d'évaluation médicale, 13385, Marseille, France
| | | |
Collapse
|
70
|
Gopalan A, Kellom K, McDonough K, Schapira MM. Exploring how patients understand and assess their diabetes control. BMC Endocr Disord 2018; 18:79. [PMID: 30400859 PMCID: PMC6219190 DOI: 10.1186/s12902-018-0309-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor understanding of diabetes management targets is associated with worse disease outcomes. Patients may use different information than providers to assess their diabetes control. In this study, we identify the information patients use to gauge their current level of diabetes control and explore patient-perceived barriers to understanding the hemoglobin A1c value (HbA1c). METHODS Adults who self-reported a diagnosis of diabetes were recruited from outpatient, academically-affiliated, Internal Medicine clinics. Semi-structured interviews were conducted with participants and collected data were analyzed using thematic analysis. RESULTS The mean age of the 25 participants was 56.8 years. HbA1c was one of several types of information participants used to assess diabetes control. Other information included perceived self-efficacy and adherence to self-care, the type and amount of medications taken, the presence or absence of symptoms attributed to diabetes, and feedback from self-monitoring of blood glucose. Most participants reported familiarity with the HbA1c (22 of 25), though understanding of the value's meaning varied significantly. Inadequate diabetes education and challenges with patient-provider communication were cited as common barriers to understanding the HbA1c. CONCLUSIONS In addition to the HbA1c, several categories of information influenced participants' assessments of their diabetes control. Increased provider awareness of the factors that influence patients' perceptions of diabetes control can inform effective, patient-centered approaches for communicating vital diabetes-related information, facilitating behavior change towards improved patient outcomes.
Collapse
Affiliation(s)
- Anjali Gopalan
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 USA
- Michael J. Crescenz VA Medical Center, 3900 Woodland Ave, Philadelphia, PA 19104 USA
| | - Katherine Kellom
- Policy Lab, The Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Kevin McDonough
- Division of General Internal Medicine, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Marilyn M. Schapira
- Michael J. Crescenz VA Medical Center, 3900 Woodland Ave, Philadelphia, PA 19104 USA
- Division of General Internal Medicine, The Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| |
Collapse
|
71
|
Hagiwara N, Mezuk B, Elston Lafata J, Vrana SR, Fetters MD. Study protocol for investigating physician communication behaviours that link physician implicit racial bias and patient outcomes in Black patients with type 2 diabetes using an exploratory sequential mixed methods design. BMJ Open 2018; 8:e022623. [PMID: 30341127 PMCID: PMC6196822 DOI: 10.1136/bmjopen-2018-022623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/12/2018] [Accepted: 08/17/2018] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Patient-physician racial discordance is associated with Black patient reports of dissatisfaction and mistrust, which in turn are associated with poor adherence to treatment recommendations and underutilisation of healthcare. Research further has shown that patient dissatisfaction and mistrust are magnified particularly when physicians hold high levels of implicit racial bias. This suggests that physician implicit racial bias manifests in their communication behaviours during medical interactions. The overall goal of this research is to identify physician communication behaviours that link physician implicit racial bias and Black patient immediate (patient-reported satisfaction and trust) and long-term outcomes (eg, medication adherence, self-management and healthcare utilisation) as well as clinical indicators of diabetes control (eg, blood pressure, HbA1c and history of diabetes complication). METHODS AND ANALYSIS Using an exploratory sequential mixed methods research design, we will collect data from approximately 30 family medicine physicians and 300 Black patients with type 2 diabetes mellitus. The data sources will include one physician survey, three patient surveys, medical interaction videos, video elicitation interviews and medical chart reviews. Physician implicit racial bias will be assessed with the physician survey, and patient outcomes will be assessed with the patient surveys and medical chart reviews. In video elicitation interviews, a subset of patients (approximately 20-40) will watch their own interactions while being monitored physiologically to identify evocative physician behaviours. Information from the interview will determine which physician communication behaviours will be coded from medical interactions videos. Coding will be done independently by two trained coders. A series of statistical analyses (zero-order correlations, partial correlations, regressions) will be conducted to identify physician behaviours that are associated significantly with both physician implicit racial bias and patient outcomes. ETHICS AND DISSEMINATION Ethics approval was obtained from the Virginia Commonwealth University IRB. Study results will be disseminated through publications in peer-reviewed journals and presentations at conferences. A novel Medical Interaction involving Black Patients Coding System from this project will be made publicly available.
Collapse
Affiliation(s)
- Nao Hagiwara
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Briana Mezuk
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer Elston Lafata
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Scott R Vrana
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michael D Fetters
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
72
|
Peterson M, Nowotny K, Dauria E, Arnold T, Brinkley-Rubinstein L. Institutional distrust among gay, bisexual, and other men who have sex with men as a barrier to accessing pre-exposure prophylaxis (PrEP). AIDS Care 2018; 31:364-369. [PMID: 30227719 DOI: 10.1080/09540121.2018.1524114] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Populations at highest risk for acquiring HIV are more likely to pass through criminal justice (CJ) settings, and CJ-involved individuals are often at the intersection of multiple overlapping risk factors. The present study explored interest in, knowledge of, and barriers to PrEP uptake among gay, bisexual, and other men who have sex with men involved in the criminal justice system. Using semi-structured interviews, 26 participants who identified as MSM were asked about PrEP knowledge and interest, HIV risk, and incarceration experience. One theme that emerged across interviews was how institutional distrust in CJ settings may instill lack of trust in medical care after perceived mistreatment. Participants explained how lack of privacy fostered feelings that medical care was not confidential, care received was tied to status as an incarcerated person, and feelings of dehumanization led to distrust. Findings explore how distrust may hinder PrEP uptake and other HIV prevention efforts in CJ settings as well as after release. They highlight the need for greater privacy efforts and cultural humility, and explore how medical settings may function as spaces for people who are incarcerated to disclose HIV risk status. Few studies to our knowledge have examined the role of institutional distrust on men who have sex with men (MSM) in the context of pre-exposure prophylaxis (PrEP) interventions. The present study has implications for creating best practices to structure HIV prevention interventions in CJ settings.
Collapse
Affiliation(s)
- Meghan Peterson
- a School of Public Health , Brown University , Providence , RI , USA.,b Center for Prisoner Health and Human Rights , Miriam Hospital , Providence , RI , USA
| | - Kathryn Nowotny
- c Department of Sociology , University of Miami , Miami , FL , USA
| | - Emily Dauria
- d Department of Psychiatry , University of California , San Francisco , CA , USA
| | - Trisha Arnold
- e Department of Psychology , Rhode Island Hospital , Providence , RI , USA
| | - Lauren Brinkley-Rubinstein
- f Department of Social Medicine , University of North Carolina , Chapel Hill , NC , USA.,g Center for Health Equity Research , University of North Carolina , Chapel Hill , NC , USA
| |
Collapse
|
73
|
Wiering B, de Boer D, Krol M, Wieberneit-Tolman H, Delnoij D. Entertaining accurate treatment expectations while suffering from chronic pain: an exploration of treatment expectations and the relationship with patient- provider communication. BMC Health Serv Res 2018; 18:706. [PMID: 30200955 PMCID: PMC6131883 DOI: 10.1186/s12913-018-3497-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate patient expectations are important to optimise treatment success, especially for complex conditions such as chronic pain. Communication may be the key to managing patient expectations. This study aimed to explore whether health care provider communication influences patient expectations and which communication aspects are most important. METHODS We conducted secondary analyses on data that had been collected between September and November 2012. 2603 patients suffering from chronic pain were invited to complete a survey. RESULTS Although 69.9% of patients achieved or surpassed their treatment goal, 30.2% of patients were unsatisfied. Even though overall health care provider communication and shared decision making were unrelated to patient expectations, several affective communication aspects were related. These aspects were attentive listening, taking enough time, building patient's trust in the physician's competence and giving patients the feeling that the physician is doing all he or she can (p's < 0.05). CONCLUSIONS Even though treatment goals are not always explicitly discussed, patients still form expectations regarding treatment outcomes. Affective communication may be more important for managing patient expectations than sharing information. Building a good therapeutic relationship by showing affective communication may be important to increase the accuracy of patient expectations.
Collapse
Affiliation(s)
- Bianca Wiering
- Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
| | - Dolf de Boer
- NIVEL (Netherlands institute for health services research), Utrecht, the Netherlands
| | - Maarten Krol
- NIVEL (Netherlands institute for health services research), Utrecht, the Netherlands
| | | | - Diana Delnoij
- Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
| |
Collapse
|
74
|
Aoki T, Yamamoto Y, Ikenoue T, Urushibara-Miyachi Y, Kise M, Fujinuma Y, Fukuhara S. Social Isolation and Patient Experience in Older Adults. Ann Fam Med 2018; 16:393-398. [PMID: 30201635 PMCID: PMC6130989 DOI: 10.1370/afm.2257] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 02/27/2018] [Accepted: 03/22/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Social isolation has been identified as a major health problem, particularly in the elderly. In the present study, we examine the association between social isolation and patient experience in elderly primary care patients. METHODS This cross-sectional study was conducted in a primary care practice-based research network (28 clinics) in Japan. We assessed social isolation using an abbreviated Lubben Social Network Scale and patient experience of primary care using a Japanese version of the Primary Care Assessment Tool (JPCAT), which comprises 6 domains: first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided), and community orientation. We used a linear mixed effects model to adjust clustering within clinics and individual covariates. RESULTS Data were analyzed for 465 elderly primary care patients aged ≥65 years. After adjustment for possible confounders and clustering within clinics, social isolation was negatively associated with the JPCAT total score, (mean difference = -3.67; 95% CI, -7.00 to -0.38). Among the JPCAT domain scores, social isolation was significantly associated with longitudinality, comprehensiveness (service provided), and community orientation scores. CONCLUSIONS Social isolation was associated with negative patient experience in elderly primary care patients. Raising awareness regarding patient social networks among primary care providers and targeted interventions for socially isolated elderly patients aimed at improving the experience of primary care, especially regarding longitudinality, comprehensiveness, and community orientation, may be warranted.
Collapse
Affiliation(s)
- Takuya Aoki
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tatsuyoshi Ikenoue
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Morito Kise
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Yasuki Fujinuma
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan .,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan.,Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Fukushima, Japan
| |
Collapse
|
75
|
McCabe E, Miciak M, Dennett L, Manns P, Guptill C, Hall J, Gross DP. Measuring therapeutic relationship in the care of patients with haemophilia: A scoping review. Health Expect 2018; 21:1208-1230. [PMID: 30160003 PMCID: PMC6250875 DOI: 10.1111/hex.12827] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE We conducted a scoping review of the tools used to measure therapeutic relationship in patients with haemophilia. BACKGROUND Haemophilia is an inherited bleeding disorder caused by a deficiency of a clotting factor in the blood. Therapeutic relationship is foundational to the management of patients with chronic diseases like haemophilia. A reliable and valid measurement tool for assessing therapeutic relationship is needed to evaluate the quality of care received by these patients, and to rigorously study the association between therapeutic relationship and the outcomes of treatment. METHODS We adopted the Arksey and O'Malley framework for scoping studies. The following electronic databases were searched for studies that measured a construct related to therapeutic relationships in haemophilia care: MEDLINE, EMBASE, CINAHL, PsycINFO and Scopus. We inventoried these studies, identified the measurement tools used, and described each tool by purpose, content, measurement properties and target population. We identified gaps in the current evidence and directions for future research. RESULTS There were 253 unique records retrieved in the search, and twenty studies were deemed relevant. Ten measurement tools were identified. None of the tools measured therapeutic relationship as a single entity; however, six tools measured constructs considered part of patient-provider relationship (eg trust, communication, working alliance). There has been little validation testing of these tools in haemophilia patient populations. CONCLUSIONS There is a need for a validated tool for measuring therapeutic relationship in the care of patients with haemophilia. This review provides a foundation for future research in this area.
Collapse
Affiliation(s)
- Erin McCabe
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Maxi Miciak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Performance Management and Evaluation, Alberta Innovates, Edmonton, AB, Canada
| | - Liz Dennett
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Patricia Manns
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Christine Guptill
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jeremy Hall
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Douglas P Gross
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
76
|
Mature or Emerging? The Impact of Treatment-Related Internet Health Information Seeking on Patients' Trust in Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091855. [PMID: 30154309 PMCID: PMC6165357 DOI: 10.3390/ijerph15091855] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 11/26/2022]
Abstract
Years of clinical trials have proven the maturity and safety of certain treatments, however, some of these mature treatments may not be highly effective. Several treatments have emerged through technological innovations, but their long-term safety, efficacy, and adverse effects remain unknown. At present, many patients seek information related to their treatments on the Internet, which may impact their attitudes towards different treatments and their trust in physicians. In this study, a research model was developed to examine how patients’ trust in their physicians is influenced by related online information on mature or emerging treatments. The hypotheses were tested using confirmatory factor analysis (CFA) and structural equation modelling (SEM). A total of 336 valid responses were collected through an online survey. Mature treatments related health information was found to significantly improve patients’ trust. Thus, physicians should pay more attention to mature treatments, and encourage their patients to seek related information online. Moreover, the quality of online information should be developed further to increase patients’ satisfaction. Physicians should also consider their patients’ psychological safety in communication with patients to strengthen their trust.
Collapse
|
77
|
Lu X, Zhang R, Wu W, Shang X, Liu M. Relationship Between Internet Health Information and Patient Compliance Based on Trust: Empirical Study. J Med Internet Res 2018; 20:e253. [PMID: 30120087 PMCID: PMC6119214 DOI: 10.2196/jmir.9364] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 05/10/2018] [Accepted: 06/21/2018] [Indexed: 01/10/2023] Open
Abstract
Background The internet has become a major mean for acquiring health information; however, Web-based health information is of mixed quality and may markedly affect patients’ health-related behavior and decisions. According to the social information processing theory, patients’ trust in their physicians may potentially change due to patients’ health-information-seeking behavior. Therefore, it is important to identify the relationship between internet health information and patient compliance from the perspective of trust. Objective The objective of our study was to investigate the effects of the quality and source of internet health information on patient compliance using an empirical study based on the social information processing theory and social exchange theory. Methods A Web-based survey involving 336 valid participants was conducted in China. The study included independent variables (internet health information quality and source of information), 2 mediators (cognition-based trust [CBT] and affect-based trust [ABT]), 1 dependent variable (patient compliance), and 3 control variables (gender, age, and job). All variables were measured using multiple-item scales from previously validated instruments, and confirmative factor analysis as well as structural equation modeling was used to test hypotheses. Results The questionnaire response rate was 77.16% (375/486), validity rate was 89.6% (336/375), and reliability and validity were acceptable. We found that the quality and source of internet health information affect patient compliance through the mediation of CBT and ABT. In addition, internet health information quality has a stronger influence on patient compliance than the source of information. However, CBT does not have any direct effect on patient compliance, but it directly affects ABT and then indirectly impacts patient compliance. Therefore, the effect of ABT seems stronger than that of CBT. We found an unexpected, nonsignificant relationship between the source of internet health information and ABT. Conclusions From patients’ perspective, internet health information quality plays a stronger role than its source in impacting their trust in physicians and the consequent compliance with physicians. Therefore, patient compliance can be improved by strengthening the management of internet health information quality. The study findings also suggest that physicians should focus on obtaining health information from health websites, thereby expanding their understanding of patients’ Web-based health-information-seeking preferences, and enriching their knowledge structure to show their specialization and reliability in the communication with patients. In addition, the mutual demonstration of care and respect in the communication between physicians and patients is important in promoting patients’ ABT in their physicians.
Collapse
Affiliation(s)
- Xinyi Lu
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Runtong Zhang
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Wen Wu
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Xiaopu Shang
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Manlu Liu
- Saunders College of Business, Rochester Institute of Technology, Rochester, NY, United States
| |
Collapse
|
78
|
Pan W, Ge S, Xu Y, Toobert D. Cross-Validating a Structural Model of Factors Influencing Diabetes Self-Management in Chinese Americans with Type 2 Diabetes. J Transcult Nurs 2018; 30:163-172. [DOI: 10.1177/1043659618790085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction: The purpose of this study was to cross-validate a structural model depicting the effects of individual and environmental factors on diabetes self-management in Chinese Americans with type 2 diabetes. Methodology: A cross-sectional survey was administered to a convenience sample of 209 Chinese Americans with type 2 diabetes in the Midwest of the United States. Structural equation modeling was used to cross-validate the model fit. Results: Provider–patient communication indirectly influenced self-management via belief in treatment. Knowledge indirectly influenced self-management via belief in treatment and self-efficacy. Social support indirectly influenced self-management via belief in treatment and knowledge. Discussion: This study demonstrated that the structural model, previously tested with Chinese diabetes patients in China, also fits Chinese Americans in the United States with few modifications. The cross-validated model provides a theoretical basis for developing culturally relevant diabetes self-management interventions for Chinese Americans, which may lead to health improvements in this ethnic population.
Collapse
Affiliation(s)
- Wei Pan
- Duke University, Durham, NC, USA
| | | | - Yin Xu
- Innovative Spine and Orthopedic Clinic, San Antonio, TX, USA
| | | |
Collapse
|
79
|
Hong HC, Lee H, Collins EG, Park C, Quinn L, Ferrans CE. Factors affecting trust in healthcare among middle-aged to older Korean American women. BMC WOMENS HEALTH 2018; 18:109. [PMID: 29929508 PMCID: PMC6013887 DOI: 10.1186/s12905-018-0609-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/15/2018] [Indexed: 01/02/2023]
Abstract
Background Predictors of trust in healthcare providers and the healthcare system have never been studied in Korean Americans (KA) despite the fact that trust plays an important role in health behaviors. The purpose of this study is to examine factors influencing trust in the healthcare system and providers among KA women. Methods Data were collected in 196 KA women examining the effects of perceived discrimination and trust on breast cancer screening in the Chicago metropolitan area. Path analysis was used to identify factors influencing trust in the healthcare system and providers. Results Acculturation was positively related to trust in healthcare providers (β = .15, p =. 002), and discrimination in the healthcare system was inversely related to trust in healthcare providers (β = −.60, p <. 001). Length of stay in the US was inversely related to distrust in the healthcare system (β = −.14, p <. 001), and discrimination in healthcare was positively related to distrust in the healthcare system (β = .60, p <. 001). Trust in healthcare providers and distrust in the healthcare system were moderately correlated (r = .51, p < .001). Conclusion Higher levels of acculturation and lower levels of perceived discrimination were identified as predictors of higher levels of trust in healthcare providers. A shorter stay in the US and higher levels of discrimination were identified as predictors of higher levels of distrust in the healthcare system. Perceived discrimination is a target for interventions to enhance trust in the healthcare system, and therefore reduce healthcare disparities in KAs.
Collapse
Affiliation(s)
- Hye Chong Hong
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - Hyeonkyeong Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Eileen G Collins
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Chang Park
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Lauretta Quinn
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | | |
Collapse
|
80
|
Reach G, Pellan M, Crine A, Touboul C, Ciocca A, Djoudi Y. Holistic psychosocial determinants of adherence to medication in people with type 2 diabetes. DIABETES & METABOLISM 2018; 44:500-507. [PMID: 30031714 DOI: 10.1016/j.diabet.2018.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/02/2018] [Accepted: 06/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The aim of this study was to determine whether adherent and non-adherent patients with type 2 diabetes can be differentiated according to psychosocial characteristics. METHODS A total of 1214 patients were included in the analysis. Data were derived from a cross-sectional observational study of adults with diabetes of the Access Santé (Access Health) panel of Kantar Health France. Patients completed a questionnaire on adherence to medication, psychological determinants (trust in physicians, constancy of habits, patience, temporal horizon, health locus of control, obedience, psychological reactivity, prevention vs promotion, optimism vs pessimism) and social deprivation. RESULTS Of these 1214 subjects, 46.2% were considered strictly adherent to antidiabetic medication, as reflected by negative answers to all six questions suggesting a non-adherent behaviours, whereas 48.9% provided 1-2 positive answers and 4.9% provided 3-6 positive answers, and were considered non-adherent. In addition to the effect of younger age (P=0.03), multivariate logistic regression analysis demonstrated the following psychosocial determinants of non-adherence: chance locus of control (P=0.02); lack of trust in physicians (P=0.010); and pessimism (P=0.021). Multiple factor analysis identified adherence and social deprivation as dimensions separating three distinct patient populations: (i) non-adherent; (ii) adherent and socially deprived; and (iii) adherent and non-socially deprived. It also revealed that patience, obedience, cautious behaviour, optimism, trust in physicians and constancy of habits were associated with adherence. CONCLUSION Of the multiple determinants of adherence, trust in physicians and constancy of habits represent modifiable factors, and constitute targets to prevent non-adherence because they can be reinforced through patient education and improved physician - patient relationship. Also, psychosocial determinants of adherence differ widely between socially deprived and non-deprived patients.
Collapse
Affiliation(s)
- G Reach
- Endocrinology, diabetes and metabolic diseases department, Avicenne hospital, EA 3412, Paris 13 University, Paris Sorbonne Cité, AP-HP, 125, route de Stalingrad, 93000 Bobigny, France.
| | - M Pellan
- Kantar Health France, 75014 Paris, France
| | - A Crine
- Kantar Health France, 75014 Paris, France
| | - C Touboul
- Kantar Health France, 75014 Paris, France
| | - A Ciocca
- Sanofi-Aventis, 94250 Gentilly, France
| | - Y Djoudi
- Sanofi-Aventis, 94250 Gentilly, France
| |
Collapse
|
81
|
Perrault EK. Adding Multimedia Cues to Medical Providers' Online Biographies: Do Pictures, Video, and B-Roll Matter? JOURNAL OF HEALTH COMMUNICATION 2018; 23:462-469. [PMID: 29702033 DOI: 10.1080/10810730.2018.1465492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Developing engaging online healthcare provider biographies for prospective patients to consult is becoming a big business. Health-care systems are beginning to add more multichannel components-like videos-to these provider search tools at increasingly higher costs. Prior research finds that prospective patients desire videos offering additional footage (i.e., b-roll) displaying how a provider might interact with a patient during a consultation. Shooting and editing b-roll footage to add to providers' videos takes additional time and resources. Using predictions and questions generated from uncertainty reduction and cue summation theories, this study sought to determine whether the addition of multichannel media (e.g., a video with added b-roll) offers any greater effects in the form of reduced uncertainty, provider likability, patient satisfaction, or trust than biographies providing fewer multichannel cues. A between-subjects online experiment randomly exposed participants (n = 523) to one of four biographies with increasing levels of multichannel components (i.e., text only biography, text with picture, video, video with b-roll). Results revealed that the two video biographies generated more significant effects than text-only biographies. However, the biography with just the video of the provider (i.e., a-roll only) and the video including added b-roll were not significantly different from one another on any of the dependent variables measured. These findings indicate that there may be a limit to the number of multichannel components needed to be an effective biography to help patients select their next healthcare provider. Both theoretical and practical implications of these results are discussed, in addition to future directions for research.
Collapse
Affiliation(s)
- Evan K Perrault
- a Purdue University - Brian Lamb School of Communication , West Lafayette , IN , USA
| |
Collapse
|
82
|
Brown-Johnson CG, Boeckman LM, White AH, Burbank AD, Paulson S, Beebe LA. Trust in Health Information Sources: Survey Analysis of Variation by Sociodemographic and Tobacco Use Status in Oklahoma. JMIR Public Health Surveill 2018; 4:e8. [PMID: 29434015 PMCID: PMC5826981 DOI: 10.2196/publichealth.6260] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 07/08/2017] [Accepted: 07/27/2017] [Indexed: 01/24/2023] Open
Abstract
Background Modern technology (ie, websites and social media) has significantly changed social mores in health information access and delivery. Although mass media campaigns for health intervention have proven effective and cost-effective in changing health behavior at a population scale, this is best studied in traditional media sources (ie, radio and television). Digital health interventions are options that use short message service/text messaging, social media, and internet technology. Although exposure to these products is becoming ubiquitous, electronic health information is novel, incompletely disseminated, and frequently inaccurate, which decreases public trust. Previous research has shown that audience trust in health care providers significantly moderates health outcomes, demographics significantly influence audience trust in electronic media, and preexisting health behaviors such as smoking status significantly moderate audience receptivity to traditional mass media. Therefore, modern health educators must assess audience trust in all sources, both media (traditional and digital) and interpersonal, to balance pros and cons before structuring multicomponent community health interventions. Objective We aimed to explore current trust and moderators of trust in health information sources given recent changes in digital health information access and delivery to inform design of future health interventions in Oklahoma. Methods We conducted phone surveys of a cross-sectional sample of 1001 Oklahoma adults (age 18-65 years) in spring 2015 to assess trust in seven media sources: traditional (television and radio), electronic (online and social media), and interpersonal (providers, insurers, and family/friends). We also gathered information on known moderators of trust (sociodemographics and tobacco use status). We modeled log odds of a participant rating a source as “trustworthy” (SAS PROC SURVEYLOGISTIC), with subanalysis for confounders (sociodemographics and tobacco use). Results Oklahomans showed the highest trust in interpersonal sources: 81% (808/994) reported providers were trustworthy, 55% (550/999) for friends and family, and 48% (485/998) for health insurers. For media sources, 24% of participants (232/989) rated the internet as trustworthy, followed by 21% of participants for television (225/998), 18% for radio (199/988), and only 11% for social media (110/991). Despite this low self-reported trust in social media, 40% (406/991) of participants reported using social media for tobacco-related health information. Trust in health providers did not vary by subpopulation, but sociodemographic variables (gender, income, and education) and tobacco use status significantly moderated trust in other sources. Women were on the whole more trusting than men, trust in media decreased with income, and trust in friends and family decreased with education. Conclusions Health education interventions should incorporate digital media, particularly when targeting low-income populations. Utilizing health care providers in social media settings could leverage high-trust and low-cost features of providers and social media, respectively.
Collapse
Affiliation(s)
- Cati G Brown-Johnson
- Evaluation Sciences Unit, Division of Primary Care and Population Health, Stanford School of Medicine, Stanford, CA, United States
| | - Lindsay M Boeckman
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ashley H White
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Andrea D Burbank
- Stanford Health for All Alumni, Stanford Prevention Research Center, Stanford School of Medicine, Stanford, CA, United States
| | - Sjonna Paulson
- Oklahoma Tobacco Settlement Endowment Trust, Oklahoma City, OK, United States
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| |
Collapse
|
83
|
The introduction of simple cardiorespiratory fitness testing in overweight/obese type 2 diabetics: a pilot study. Prim Health Care Res Dev 2018; 19:475-484. [PMID: 29331169 DOI: 10.1017/s1463423617000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Low level of cardiorespiratory fitness has been recognized as an important independent and modifiable risk factor of increased morbidity and mortality. However, in standard outpatient settings, patients are not routinely screened for fitness and advantages of such testing for the management of type 2 diabetes have not been defined.AimTo describe the toleration of a fast, simple and practicable fitness test (2-min step-in-place test) by overweight/obese type 2 diabetics and their performance indicated by 2-min step-in-place test score (STS). To study short-term anthropometric, functional and metabolic changes following the implementation of the test in the selected population. METHODS A total of 33 overweight/obese type 2 diabetics underwent, besides routine examination at the outpatient clinic, the fitness test (group A). Patients were asked to increase their regular physical activity with focus on walking without change in diet and chronic medication. Three to four months later, the subjects were tested again. An identical number of age- and sex-matched obese diabetics followed in our outpatient clinic (without fitness testing), was randomly selected from the Hospital Information System (control group B).FindingsAll patients subjected to fitness testing completed the protocol successfully. STS score was found to have a considerable range with differences between males and females at the borderline of statistical significance. The data are compliant with lower aerobic endurance of obese diabetics compared with healthy population. Within study period, the tested group presented with improvements in STS (referring especially to the males) as well as in several laboratory parameters of glucose and lipid homeostasis, glomerular function and subclinical inflammation with no reflection in anthropometry. Group B demonstrated no significant change. In conclusion, 2-min step-in-place test is fast, undemanding and well-tolerated by patients and personnel. Following its validation based on cardiopulmonary exercise testing, the test may prove recommendable for screening or self-monitoring purposes.
Collapse
|
84
|
Choy HH, Ismail A. Indicators for Medical Mistrust in Healthcare-A Review and Standpoint from Southeast Asia. Malays J Med Sci 2017; 24:5-20. [PMID: 29379382 PMCID: PMC5771511 DOI: 10.21315/mjms2017.24.6.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 05/30/2017] [Indexed: 10/18/2022] Open
Abstract
The relationship based on trust is exceptionally important in healthcare, where life or death and quality of health are major concerns. Relational crack jeopardises the provision of quality healthcare when trust is taken for granted. Trust is believed to be the vital key to minimise medical negligence, lawsuits and patient complaints towards healthcare providers while acting as an empowering agent to significant clinical outcomes. Trust is indispensable to healthcare. However, to identify its deterioration is not a simple feature. Moreover, lack of research and public dissemination complicate this topic further. Hence, understanding medical mistrust issues and their associated indicators is urgently needed to ensure the top-notch provision of healthcare. We employed narrative review methodology together with key terms matching for the selected electronic databases for this article. Our review concluded that an "Increasing number of medical litigations and complaints towards physicians", "Physicians' low mastery of interpersonal communication skill" and "Patients' demand, practice, and non-disclosure of alternative treatments" are the possible indicators to predict mistrust. Efforts to restore and strengthen trust can only be made when these indicators are well understood firsthand.
Collapse
Affiliation(s)
- Hew Hei Choy
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Aniza Ismail
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| |
Collapse
|
85
|
Understanding the Patient Experience of Peripherally Inserted Central Catheter-Related Deep Vein Thrombosis Using Interpretive Phenomenology. JOURNAL OF INFUSION NURSING 2017; 40:287-296. [PMID: 28885477 DOI: 10.1097/nan.0000000000000238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this interpretive phenomenological study was to determine what it means to patients to live with a peripherally inserted central catheter (PICC)-related deep vein thrombosis and to describe the influence of the experience on the individual's quality of life. The sample included 11 adult patients from an acute care setting who developed a PICC-related symptomatic thrombus between November 2014 and March 2016, using purposive sampling. Three distinct themes emerged from the data in this study: a loss of trust in health care providers, additional burdens to existing problems, and a yearning for understanding.
Collapse
|
86
|
[Family, socioeconomic status and health services: Clues to health care in diabetic patients with lower limb amputations in Andalusia. A qualitative study]. Aten Primaria 2017; 50:611-620. [PMID: 29150148 PMCID: PMC6837089 DOI: 10.1016/j.aprim.2017.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 06/18/2017] [Accepted: 06/23/2017] [Indexed: 11/27/2022] Open
Abstract
Objetivo Explorar la vivencia de los cuidados diabéticos en pacientes sometidos a amputación de miembros inferiores por pie diabético. Diseño Estudio cualitativo con perspectiva fenomenológica. Emplazamiento Área hospitalaria de Cádiz. Participantes Dieciséis participantes (11 hombres y 5 mujeres) con diabetes tipo 2 y amputación no traumática de miembros inferiores. Métodos Entrevistas semiestructuradas individuales y análisis de contenido de la información usando el método propuesto por Graneheim y Lundman. Resultados Se identificaron 4 categorías: 1. La familia es la piedra angular de los cuidados; 2. Los aspectos socioeconómicos y laborales determinan la calidad de los autocuidados; 3. La interacción paciente-personal de salud dinamiza los cuidados; y 4. Las limitaciones en la provisión de servicios sanitarios. Conclusión La familia, la situación económica y laboral y los factores del sistema sanitario constituyen los elementos más relevantes en los cuidados de pacientes con diabetes y amputación de miembros inferiores. Los determinantes sociales, económicos y laborales deben ser tomados en especial consideración y de manera más personalizada desde los servicios sanitarios para aumentar el impacto de los cuidados proporcionados en la prevención de las complicaciones de la diabetes mellitus.
Collapse
|
87
|
Karel Y, Thoomes-de Graaf M, Scholten-Peeters G, Ferreira P, Rizopoulos D, Koes BW, Verhagen AP. Validity of the Flemish working alliance inventory in a Dutch physiotherapy setting in patients with shoulder pain. Physiother Theory Pract 2017; 34:384-392. [PMID: 29120251 DOI: 10.1080/09593985.2017.1400141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Working alliance is the interaction between the patient and therapist. It is a crucial part of the physiotherapeutic process. One instrument to measure working alliance is available in Dutch/Flemish language and validated in psychotherapy setting. OBJECTIVE This study aims to validate the Working Alliance Inventory Short-Form in a Dutch physiotherapy setting. DESIGN A prospective cohort study in primary-care physiotherapy. METHOD To validate the Dutch/Flemish version of the working alliance inventory short-form (WAV-12) a RASCH analysis was used. RESULTS Sixty-six physiotherapists enrolled in total 389 patients with an average age of 50 years and a mean duration of shoulder pain of 33 weeks. A total of 274 patients filled in one or more items of the WAV-12. The WAV-12 showes good discriminative abilities and all items contributed to a one-dimensional construct. Due to the selective nature of the missing items, we believed rewording was necessary to make it more suitable to the physiotherapy setting. We performed a Delphi study and revised the WAV-12 into the PAS (Physio Alliance Scale). The validity of the revised version is unknown and is therefore not sufficiently strong to be implemented as a measurement tool. LIMITATIONS The response rate for three items especially was low and we found ceiling effects in ten items. CONCLUSION Although the measurement instrument shows good internal consistency and reliability, we made adjustments to the WAV-12 for Dutch physiotherapy setting.
Collapse
Affiliation(s)
- Yasmaine Karel
- a Research Group Diagnostics , Avans University of Applied Sciences , Breda , The Netherlands.,b Department of General Practice , Erasmus Medical Center , Rotterdam , The Netherlands
| | - M Thoomes-de Graaf
- a Research Group Diagnostics , Avans University of Applied Sciences , Breda , The Netherlands.,b Department of General Practice , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Gwendolijne Scholten-Peeters
- a Research Group Diagnostics , Avans University of Applied Sciences , Breda , The Netherlands.,c Faculty of Behavioural and Movement Sciences, MOVE research Institute Amsterdam , VU University of Amsterdam , Amsterdam , The Netherlands
| | - Paulo Ferreira
- d Faculty of Health Sciences , University of Sydney , Sydney , Australia
| | - Dimitris Rizopoulos
- e Department of Biostatistics , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Bart W Koes
- b Department of General Practice , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Arianne P Verhagen
- a Research Group Diagnostics , Avans University of Applied Sciences , Breda , The Netherlands.,b Department of General Practice , Erasmus Medical Center , Rotterdam , The Netherlands
| |
Collapse
|
88
|
Cornet V, Voida S, Holden RJ. Activity Theory Analysis of Heart Failure Self-Care. MIND, CULTURE, AND ACTIVITY 2017; 25:22-39. [PMID: 31105419 PMCID: PMC6519742 DOI: 10.1080/10749039.2017.1372785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The management of chronic health conditions such as heart failure is a complex process emerging from the activity of a network of individuals and artifacts. This article presents an Activity Theory-based secondary analysis of data from a geriatric heart failure management study. Twenty-one patients' interviews and clinic visit observations were analyzed to uncover eight configurations of roles and activities involving patients, clinicians, and others in the sociotechnical network. For each configuration or activity pattern, we identify points of tension and propose guidelines for developing interventions for future computer-supported healthcare systems.
Collapse
Affiliation(s)
- Victor Cornet
- Indiana University–Purdue University, Indianapolis (IUPUI)
| | | | - Richard J. Holden
- Indiana University–Purdue University, Indianapolis (IUPUI)
- Indiana University Center for Aging Research, Regenstrief Institute, Inc
| |
Collapse
|
89
|
Thompson T, Mitchell JA, Johnson-Lawrence V, Watkins DC, Modlin CS. Self-Rated Health and Health Care Access Associated With African American Men's Health Self-Efficacy. Am J Mens Health 2017; 11:1385-1387. [PMID: 26231730 PMCID: PMC5675189 DOI: 10.1177/1557988315598555] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Health self-efficacy, a measure of one's self-assurance in taking care of their own health, is known to contribute to a range of health outcomes that has been under examined among African American men. The purpose of this investigation was to identify and contextualize predictors of general health self-efficacy in this population. A cross-sectional sample of surveys from 558 African American was examined. These men were older than 18 years, could read and write English, and attended a hospital-based community health fair targeting minority men in 2011. The outcome of interest was health self-efficacy, which was assessed by asking, "Overall, how confident are you in your ability to take good care of your health?" Responses ranged from 1 ( not confident at all) to 5 ( completely confident). Covariates included age, self-rated health, health insurance status, having a regular physician, and being a smoker. The mean age of participants was 54.4 years, and 61.3% of participants indicated confidence in their ability to take good care of their health. Older age and being a smoker were inversely associated with the outcome. Good self-rated health, having health insurance, and having a regular doctor were positively associated with reports of health self-efficacy. Findings suggest that multiple points of connection to the health care system increase the likelihood of health self-efficacy for this sample and interventions to support older African American men who may evaluate their own health status as poor and who may face barriers to health care access are implicated.
Collapse
|
90
|
Padela AI, Pruitt L, Mallick S. The Types of Trust Involved in American Muslim Healthcare Decisions: An Exploratory Qualitative Study. JOURNAL OF RELIGION AND HEALTH 2017; 56:1478-1488. [PMID: 28343283 DOI: 10.1007/s10943-017-0387-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Trust in physicians and the healthcare system underlies some disparities noted among minority populations, yet a descriptive typology of different types of trust informing healthcare decisions among minority populations is limited. Using data from 13 focus groups with 102 American Muslims, we identified the types and influence of trust in healthcare decision-making. Participants conveyed four types of trust implicating their health-seeking behaviors-(I) trust in allopathic medicine, (II) trust in God, (III) trust in personal relationships, and (IV) trust in self. Healthcare disparity research can benefit from assessing how these types of trust are associated with health outcomes among minority populations so as to inform intervention programs that seek to enhance trust as a means to improve community health.
Collapse
Affiliation(s)
- Aasim I Padela
- Initiative on Islam and Medicine, Program on Medicine and Religion, The University of Chicago, 5841 S. Maryland Ave, MC 5068, Chicago, IL, 60637, USA.
- Section of Emergency Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA.
- MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA.
| | - Liese Pruitt
- Initiative on Islam and Medicine, Program on Medicine and Religion, The University of Chicago, 5841 S. Maryland Ave, MC 5068, Chicago, IL, 60637, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Saleha Mallick
- Initiative on Islam and Medicine, Program on Medicine and Religion, The University of Chicago, 5841 S. Maryland Ave, MC 5068, Chicago, IL, 60637, USA
- College of Medicine, University of Illinois, Peoria, IL, USA
| |
Collapse
|
91
|
Imai H, Furukawa TA, Hayashi SU, Goto A, Izumi K, Hayashino Y, Noda M. Risk perception, self-efficacy, trust for physician, depression, and behavior modification in diabetic patients. J Health Psychol 2017; 25:350-360. [PMID: 28810485 DOI: 10.1177/1359105317718057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We evaluated the associations of risk perception, self-efficacy, and trust with two health promotion behaviors (food habits and exercise) and depressive mood. Diabetic patients aged between 40 and 64 (n = 1195) were included in the analyses. Risk perception worsened behavioral changes in terms of food habits and depression, whereas self-efficacy and trust improved food habits, exercise, and depression; trust improved exercise and depression. In conclusion, self-efficacy and trust appear to be more beneficial than risk perception for positive behavioral changes and for improving depression in diabetic patients. However, their influence on behavioral changes may be different according to the types of behaviors.
Collapse
Affiliation(s)
| | | | | | | | - Kazuo Izumi
- Japan Agency for Medical Research and Development, Japan
| | | | | | | |
Collapse
|
92
|
Medicalized addiction, self-medication, or nonmedical prescription drug use? How trust figures into incarcerated women's conceptualization of illicit prescription drug use. Soc Sci Med 2017; 183:106-115. [DOI: 10.1016/j.socscimed.2017.04.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 11/23/2022]
|
93
|
Linetzky B, Jiang D, Funnell MM, Curtis BH, Polonsky WH. Exploring the role of the patient-physician relationship on insulin adherence and clinical outcomes in type 2 diabetes: Insights from the MOSAIc study. J Diabetes 2017; 9:596-605. [PMID: 27368146 DOI: 10.1111/1753-0407.12443] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 06/21/2016] [Accepted: 06/27/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The 2-year prospective MOSAIc (Multinational Observational Study assessing Insulin use: understanding the challenges associated with progression of therapy) study is investigating whether patient-, physician-, and health system-related factors affect outcomes in patients with type 2 diabetes (T2D). This baseline subanalysis investigated how aspects of the patient-physician relationship are associated with diabetes-related distress, insulin adherence, and glycemic control. METHODS Patients with T2D taking insulin for ≥3 months were recruited at primary care and specialty practice sites in 18 countries. Physicians provided usual care. Clinical history and most recent HbA1c values were collected; patients were surveyed regarding their perception of physician interactions, diabetes-related distress level, and insulin adherence. RESULTS The analysis population comprised 4341 patients. Four (of six) domains showed a significant relationship with total diabetes-related distress (P < 0.01). Poor insulin adherence was associated with greater diabetes-related distress (adjusted odds ratio [aOR] 1.14; 95% confidence interval [CI] 1.06-1.22), higher Discrimination (aOR 1.13; 95% CI 1.02-1.27) and Hurried Communication (aOR 1.35; 95% CI 1.20-1.53) scores, and a lower Explained Results score (aOR 0.86; 95% CI 0.77-0.97). Poor insulin adherence was associated with a 0.43% increase in HbA1c, whereas a 1-unit increase in total diabetes-related distress and Hurried Communication scores was associated with a 0.171% and 0.145% increase in HbA1c, respectively. CONCLUSIONS Patients distressed about living with T2D, and dissatisfied with aspects of their interactions with physicians, exhibited poor insulin adherence. Perceived physician inattention and lack of engagement (and diabetes-related distress) directly affect insulin adherence and glycemic control.
Collapse
Affiliation(s)
| | | | | | | | - William H Polonsky
- Behavioral Diabetes Institute, San Diego, USA
- University of California, San Diego, USA
| |
Collapse
|
94
|
Koponen AM, Simonsen N, Suominen S. Quality of primary health care and autonomous motivation for effective diabetes self-management among patients with type 2 diabetes. Health Psychol Open 2017; 4:2055102917707181. [PMID: 28567300 PMCID: PMC5438041 DOI: 10.1177/2055102917707181] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
This study showed, in line with self-determination theory, that of the six central quality dimensions of primary health care (access to care, continuity of care, diabetes counseling, autonomy support from one’s physician, trust, patient-centered care), autonomy support from one’s physician was most strongly associated with autonomous motivation (self-regulation) for effective diabetes self-management among patients with type 2 diabetes (n = 2866). However, overall support for diabetes care received from friends, family members, other patients with diabetes, and health care professionals may even play a greater role.
Collapse
Affiliation(s)
- Anne M Koponen
- Folkhälsan Research Center, Finland.,University of Helsinki, Finland
| | - Nina Simonsen
- Folkhälsan Research Center, Finland.,University of Helsinki, Finland
| | - Sakari Suominen
- Folkhälsan Research Center, Finland.,University of Skövde, Sweden.,University of Turku, Finland
| |
Collapse
|
95
|
McKillip RP, Borden BA, Galecki P, Ham SA, Patrick-Miller L, Hall JP, Hussain S, Danahey K, Siegler M, Sorrentino MJ, Sacro Y, Davis AM, Rubin DT, Lipstreuer K, Polonsky TS, Nanda R, Harper WR, Koyner JL, Burnet DL, Stadler WM, Ratain MJ, Meltzer DO, O'Donnell PH. Patient Perceptions of Care as Influenced by a Large Institutional Pharmacogenomic Implementation Program. Clin Pharmacol Ther 2017; 102:106-114. [PMID: 27981566 DOI: 10.1002/cpt.586] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/14/2016] [Accepted: 11/18/2016] [Indexed: 12/21/2022]
Abstract
Despite growing clinical use of genomic information, patient perceptions of genomic-based care are poorly understood. We prospectively studied patient-physician pairs who participated in an institutional pharmacogenomic implementation program. Trust/privacy/empathy/medical decision-making (MDM)/personalized care dimensions were assessed through patient surveys after clinic visits at which physicians had access to preemptive pharmacogenomic results (Likert scale, 1 = minimum/5 = maximum; mean [SD]). From 2012-2015, 1,261 surveys were issued to 507 patients, with 792 (62.8%) returned. Privacy, empathy, MDM, and personalized care scores were significantly higher after visits when physicians considered pharmacogenomic results. Importantly, personalized care scores were significantly higher after physicians used pharmacogenomic information to guide medication changes (4.0 [1.4] vs. 3.0 [1.6]; P < 0.001) compared with prescribing visits without genomic guidance. Multivariable modeling controlling for clinical factors confirmed personalized care scores were more favorable after visits with genomic-influenced prescribing (odds ratio [OR] = 3.26; 95% confidence interval [CI] = (1.31-8.14); P < 0.05). Physicians seem to individualize care when utilizing pharmacogenomic results and this decision-making augmentation is perceived positively by patients.
Collapse
Affiliation(s)
- R P McKillip
- The University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - B A Borden
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA
| | - P Galecki
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA
| | - S A Ham
- The Center for Health and the Social Sciences, The University of Chicago, Chicago, Illinois, USA
| | - L Patrick-Miller
- Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - J P Hall
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA
| | - S Hussain
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA
| | - K Danahey
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Center for Research Informatics, The University of Chicago, Chicago, Illinois, USA
| | - M Siegler
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA.,MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Illinois, USA.,Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois, USA
| | - M J Sorrentino
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Y Sacro
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - A M Davis
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - D T Rubin
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - K Lipstreuer
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - T S Polonsky
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - R Nanda
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - W R Harper
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - J L Koyner
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - D L Burnet
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - W M Stadler
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - M J Ratain
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA.,Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois, USA
| | - D O Meltzer
- The Center for Health and the Social Sciences, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - P H O'Donnell
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois, USA.,Department of Medicine, The University of Chicago, Chicago, Illinois, USA.,Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois, USA
| |
Collapse
|
96
|
Schwei RJ, Johnson TP, Matthews AK, Jacobs EA. Perceptions of negative health-care experiences and self-reported health behavior change in three racial and ethnic groups. ETHNICITY & HEALTH 2017; 22:156-168. [PMID: 27748134 PMCID: PMC5548094 DOI: 10.1080/13557858.2016.1244621] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Our two study objectives were: (1) to understand the relationship between the perception of a previous negative health-care experience and race/ethnicity, and how socio-demographic, access-to-health-care, and self-reported health variables modified this relationship; and (2) to assess how many behaviors participants reported changing as a result of experiencing a perceived negative health-care experience, which behaviors they changed, and if there were differences in patterns of change across racial/ethnic groups. DESIGN We conducted a cross-sectional survey of a convenience sample of 600 African-American, Mexican-Hispanic, and white adults in socioeconomically diverse neighborhoods in Chicago, IL. We used multivariable logistic regression to analyze the relationship between a perceived negative health-care experience in the last 5 years and race/ethnicity. We summed and then calculated the percentage of people who changed each of the 10 behaviors and evaluated whether or not there were differences in behavior change across racial/ethnic groups. PRINCIPAL FINDINGS More than 32% of participants reported a perceived negative health-care experience in the past 5 years. Participants who had a bachelor's degree or above (OR: 2.95, 95%CI: 1.01-8.63), avoided needed care due to cost (OR: 1.84, 95%CI: 1.11-3.06), or who reported fair/poor health (OR: 3.58, 95%CI: 1.66-7.80) had significantly increased odds of reporting a negative health-care experience. Of these people, 88% reported 'sometimes/always' changing at least one health-seeking behavior. There were no racial/ethnic differences in reporting negative experiences or in patterns of behavior change. CONCLUSIONS Race/ethnicity was not related to reporting a perceived negative health-care experience or reported patterns of behavior change in response to that experience. However, those who avoided care due to cost were more highly educated, or who indicated poorer health status reported having a negative experience more often. Our findings suggest that the perception of a previous negative experience may influence subsequent health-care-seeking behaviors.
Collapse
Affiliation(s)
- Rebecca J Schwei
- a Department of Medicine , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Timothy P Johnson
- b Institute for Health Research and Policy, University of Illinois at Chicago , Chicago , IL , USA
| | - Alicia K Matthews
- b Institute for Health Research and Policy, University of Illinois at Chicago , Chicago , IL , USA
| | - Elizabeth A Jacobs
- c Departments of Medicine & Population Health Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| |
Collapse
|
97
|
Aoki T, Miyashita J, Yamamoto Y, Ikenoue T, Kise M, Fujinuma Y, Fukuma S, Kimachi M, Shimizu S, Fukuhara S. Patient experience of primary care and advance care planning: a multicentre cross-sectional study in Japan. Fam Pract 2017; 34:206-212. [PMID: 28334740 DOI: 10.1093/fampra/cmw126] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Advance care planning (ACP) is becoming increasingly important in the primary care setting because of its positive impact on the end-of-life care. OBJECTIVE We aimed to investigate the relationship between patient experience of primary care and ACP. METHODS This cross-sectional study was conducted in 28 primary care clinics in Japan. We assessed patient experience of primary care using a Japanese version of Primary Care Assessment Tool (JPCAT), which comprises six domains: first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided) and community orientation. The primary outcome measures were ACP discussion between patients and primary care providers and completion of advance directives (AD). We used a generalized linear mixed model to adjust clustering within clinics and individual covariates. RESULTS Data were analysed for 535 primary care patients. After adjustment for patients' sociodemographic and health characteristics, the JPCAT total score was found to be significantly associated with ACP discussion [odds ratio (OR) per 1 SD increase = 4.33; 95% confidence interval (CI), 2.53-7.47] but not with completion of AD (OR per 1 SD increase = 1.42; 95% CI, 0.94-2.12). All domains of JPCAT, which represent attributes of primary care, had positive associations with ACP discussion. First contact and comprehensiveness (services provided) domain scores were significantly associated with completion of AD. CONCLUSIONS We found that better patient experience of primary care was strongly associated with ACP discussion. Our findings reinforce the significance of patient experience in primary care as part of quality end-of-life care.
Collapse
Affiliation(s)
- Takuya Aoki
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jun Miyashita
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tatsuyoshi Ikenoue
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Morito Kise
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Yasuki Fujinuma
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Shingo Fukuma
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Miho Kimachi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sayaka Shimizu
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Fukushima, Japan.,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
| |
Collapse
|
98
|
Aoki T, Inoue M. Primary care patient experience and cancer screening uptake among women: an exploratory cross-sectional study in a Japanese population. ASIA PACIFIC FAMILY MEDICINE 2017; 16:3. [PMID: 28190971 PMCID: PMC5297167 DOI: 10.1186/s12930-017-0033-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 02/02/2017] [Indexed: 05/15/2023]
Abstract
BACKGROUND Patient experience and clinical quality, which are represented by preventive care measures such as cancer screening, are both widely used for the evaluation of primary care quality. The aim of this study was to examine the association between patient experience and cancer screening uptake among women in a Japanese population. METHODS We conducted a cross-sectional mail survey. The questionnaire was sent to 1000 adult female residents randomly selected from a basic resident register in Yugawara town, Kanagawa, Japan. We assessed patient experience of primary care using a Japanese version of Primary Care Assessment Tool (JPCAT) and uptake of breast and cervical cancer screening. RESULTS The overall response rate was 46.5%. Data were analyzed for 190 female participants aged 21-74 years who had a usual source of primary care. Multivariate logistic regression analyses revealed that the JPCAT total score was significantly associated with uptake of breast cancer screening [odds ratio (OR) per 1 standard deviation increase = 1.63; 95% CI 1.11-2.41], but not with uptake of cervical cancer screening (OR per 1 standard deviation increase = 1.47; 95% CI 0.97-2.24). CONCLUSIONS Patient experience of primary care was associated with uptake of breast cancer screening among Japanese women. The results of our study might support the argument that patient experience of primary care and the clinical process of preventive care, such as breast cancer screening, are linked.
Collapse
Affiliation(s)
- Takuya Aoki
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Kyoto Prefecture 606-8501 Japan
| | - Machiko Inoue
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215 USA
- Department of Family and Community Medicine, Hamamatsu University School of Medicine, Shizuoka, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka Prefecture 431-3192 Japan
| |
Collapse
|
99
|
Kalsingh MJ, Veliah G, Gopichandran V. Psychometric properties of the Trust in Physician Scale in Tamil Nadu, India. J Family Med Prim Care 2017; 6:34-38. [PMID: 29026745 PMCID: PMC5629896 DOI: 10.4103/2249-4863.214966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Trust in health care is of high intrinsic value. It also leads to positive outcomes such as better treatment adherence and disclosure of sensitive information. Therefore, there is a need to measure trust in health care objectively. AIMS To assess the psychometric properties of the Trust in Physician Scale in Tamil Nadu, India. SETTINGS AND DESIGN The study was conducted in a private tertiary hospital setting in Tamil Nadu by a cross-sectional survey design. METHODS The Trust in Physician Scale and General Trust Scale were administered to 288 participants in the waiting area of a tertiary care hospital in Tamil Nadu. STATISTICAL ANALYSIS Descriptive statistics, exploratory factor analysis, and Cronbach's alpha statistics were used to assess the validity and reliability of the scale. RESULTS The respondents were predominantly men from rural areas, older than 35 years of age, and with lesser than 8 years of schooling. The questionnaire had acceptable internal consistency with Cronbach's alpha of 0.707 (95% confidence interval 0.654-0.755). Exploratory factor analysis divided the questionnaire into four domains. Seven items loaded into factor 1 which explained dependability and competence of the physician, two items loaded on factor 2, and one each in factors 3 and 4. The latter four items had very low item to total correlations and hence did not contribute much to the questionnaire. CONCLUSIONS The Trust in Physician questionnaire needs to be modified to accurately measure the domains of trust in the context of the study area. More qualitative studies are required to understand the domains of trust in this cultural and social context.
Collapse
Affiliation(s)
- Maria Jusler Kalsingh
- Department of Biostatistics, National Institute of Malaria Research, Chennai, Tamil Nadu, India
| | - Geetha Veliah
- Division of Health Communication and Promotion, School of Public Health, SRM University, Chennai, Tamil Nadu, India
| | | |
Collapse
|
100
|
Orom H, Underwood W, Cheng Z, Homish DL, Scott I. Relationships as Medicine: Quality of the Physician-Patient Relationship Determines Physician Influence on Treatment Recommendation Adherence. Health Serv Res 2016; 53:580-596. [PMID: 27981559 DOI: 10.1111/1475-6773.12629] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine whether quality of physician-patient relationships influences uptake of physician treatment recommendations in men with clinically localized prostate cancer (PCa). STUDY SETTING Data were collected July 2010 to August 2014 at two cancer centers and three community facilities. STUDY DESIGN Analyses were prospective and cross-sectional. We modeled associations between quality of the patient-physician relationship and influence of physician recommendations on treatment choice using generalized estimating equations (GEE). DATA COLLECTION Data were collected via survey and medical record abstraction. PRINCIPAL FINDINGS Participants (N = 1166) were 14.7 percent minority; 37.1 percent had low-, 47.5 percent had intermediate-, and 15.4 percent had high-risk PCa. Those reporting a better physician-patient relationship perceived that their physician's treatment recommendation was more influential (RR = 1.05, 95 percent CI = 1.04-1.05, p < .001) and were more likely to choose the recommended treatment (OR = 2.92, 95 percent CI = 2.39, 3.58, p < .001). A pattern of interactions emerged indicating that quality of the physician-patient relationship was more strongly associated with influence of recommendations for more, versus less aggressive treatment in those with low-risk, but not intermediate-risk disease. CONCLUSIONS Prioritizing quality of the physician-patient relationship through training, practice change, and patient feedback may increase adherence. However, strategies need to align with efforts to reduce physician recommendations for inefficacious treatments to prevent overtreatment.
Collapse
Affiliation(s)
- Heather Orom
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY
| | - Willie Underwood
- Department of Urology, Roswell Park Cancer Institute, Buffalo, NY
| | - Zinan Cheng
- Touro College of Osteopathic Medicine, Middletown, NY
| | - D Lynn Homish
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY
| | - I'Yanna Scott
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY
| |
Collapse
|