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Armas A, Meyer SB, Corbett KK, Pearce AR. Face-to-face communication between patients and family physicians in Canada: A scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:789-803. [PMID: 29173960 DOI: 10.1016/j.pec.2017.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/07/2017] [Accepted: 11/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Patient-provider communication is critical in primary care. Canada's unique health system, population distribution, and cultural context suggest there is value in addressing the topic in the Canadian context. We conducted a scoping review to synthesize recent Canadian literature to inform practice in primary care settings and identify research agendas for patient-provider communication in Canada. METHODS Using Arksey and O'Malley's framework we searched four literature databases: Medline, Web of Science, CINAHL and EMBASE. We extracted 21,932 articles published between 2010 and 2017. A total of 108 articles met the inclusion criteria. The articles were analyzed qualitatively using thematic analysis to identify major themes. RESULTS Four major themes were identified: information sharing, relationships, health system challenges, and development and use of communication tools. CONCLUSION Our review identified a need for Canadian research regarding: communication in primary care with Aboriginal, immigrant, and rural populations; the impact of medical tourism on primary care; and how to improve communication to facilitate continuity of care. PRACTICE IMPLICATIONS Challenges providers face in primary care in Canada include: communicating with linguistically and culturally diverse populations; addressing issues that emerge with the rise of medical tourism; a need for decision aids to improve communication with patients.
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Affiliation(s)
- Alana Armas
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
| | - Samantha B Meyer
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Kitty K Corbett
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Alex R Pearce
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Gärtner FR, Bomhof-Roordink H, Smith IP, Scholl I, Stiggelbout AM, Pieterse AH. The quality of instruments to assess the process of shared decision making: A systematic review. PLoS One 2018; 13:e0191747. [PMID: 29447193 PMCID: PMC5813932 DOI: 10.1371/journal.pone.0191747] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 01/10/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. METHODS In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. RESULTS We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. CONCLUSIONS Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument's content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations.
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Affiliation(s)
- Fania R. Gärtner
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Hanna Bomhof-Roordink
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Ian P. Smith
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Isabelle Scholl
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, United States of America
| | - Anne M. Stiggelbout
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - Arwen H. Pieterse
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
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Rubashkin N, Szebik I, Baji P, Szántó Z, Susánszky É, Vedam S. Assessing quality of maternity care in Hungary: expert validation and testing of the mother-centered prenatal care (MCPC) survey instrument. Reprod Health 2017; 14:152. [PMID: 29145863 PMCID: PMC5689156 DOI: 10.1186/s12978-017-0413-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 11/10/2017] [Indexed: 11/19/2022] Open
Abstract
Background Instruments to assess quality of maternity care in Central and Eastern European (CEE) region are scarce, despite reports of poor doctor-patient communication, non-evidence-based care, and informal cash payments. We validated and tested an online questionnaire to study maternity care experiences among Hungarian women. Methods Following literature review, we collated validated items and scales from two previous English-language surveys and adapted them to the Hungarian context. An expert panel assessed items for clarity and relevance on a 4-point ordinal scale. We calculated item-level Content Validation Index (CVI) scores. We designed 9 new items concerning informal cash payments, as well as 7 new “model of care” categories based on mode of payment. The final questionnaire (N = 111 items) was tested in two samples of Hungarian women, representative (N = 600) and convenience (N = 657). We conducted bivariate analysis and thematic analysis of open-ended responses. Results Experts rated pre-existing English-language items as clear and relevant to Hungarian women’s maternity care experiences with an average CVI for included questions of 0.97. Significant differences emerged across the model of care categories in terms of informal payments, informed consent practices, and women’s perceptions of autonomy. Thematic analysis (N = 1015) of women’s responses identified 13 priority areas of the maternity care experience, 9 of which were addressed by the questionnaire. Conclusions We developed and validated a comprehensive questionnaire that can be used to evaluate respectful maternity care, evidence-based practice, and informal cash payments in CEE region and beyond.
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Affiliation(s)
- Nicholas Rubashkin
- Departments of Global Health Sciences and Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, Mission Hall, Box 1224, 550 16th Street, Third Floor, San Francisco, California, 94158, USA.
| | - Imre Szebik
- Institute of Behavioral Sciences, Semmelweis University, VIII. Nagyvárad tér 4. XX. Em, Budapest, H-1089, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8. Main Building Room E113, Budapest, 1093, Hungary
| | - Zsuzsa Szántó
- Institute of Behavioral Sciences, Semmelweis University, VIII. Nagyvárad tér 4. XX. Em, Budapest, H-1089, Hungary
| | - Éva Susánszky
- Institute of Behavioral Sciences, Semmelweis University, VIII. Nagyvárad tér 4. XX. Em, Budapest, H-1089, Hungary
| | - Saraswathi Vedam
- The Birth Place Lab, Faculty of Medicine, The University of British Columbia, Vancouver, Canada.,Midwifery Program
- Department of Family Practice, Suite 320 - 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
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104
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Sando D, Abuya T, Asefa A, Banks KP, Freedman LP, Kujawski S, Markovitz A, Ndwiga C, Ramsey K, Ratcliffe H, Ugwu EO, Warren CE, Jolivet RR. Methods used in prevalence studies of disrespect and abuse during facility based childbirth: lessons learned. Reprod Health 2017; 14:127. [PMID: 29020966 PMCID: PMC5637332 DOI: 10.1186/s12978-017-0389-z] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 09/25/2017] [Indexed: 11/10/2022] Open
Abstract
Background Several recent studies have attempted to measure the prevalence of disrespect and abuse (D&A) of women during childbirth in health facilities. Variations in reported prevalence may be associated with differences in study instruments and data collection methods. This systematic review and comparative analysis of methods aims to aggregate and present lessons learned from published studies that quantified the prevalence of Disrespect and Abuse (D&A) during childbirth. Methods We conducted a systematic review of the literature in accordance with PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Five papers met criteria and were included for analysis. We developed an analytical framework depicting the basic elements of epidemiological methodology in prevalence studies and a table of common types of systematic error associated with each of them. We performed a head-to-head comparison of study methods for all five papers. Using these tools, an independent reviewer provided an analysis of the potential for systematic error in the reported prevalence estimates. Results Sampling techniques, eligibility criteria, categories of D&A selected for study, operational definitions of D&A, summary measures of D&A, and the mode, timing, and setting of data collection all varied in the five studies included in the review. These variations present opportunities for the introduction of biases – in particular selection, courtesy, and recall bias – and challenge the ability to draw comparisons across the studies’ results. Conclusion Our review underscores the need for caution in interpreting or comparing previously reported prevalence estimates of D&A during facility-based childbirth. The lack of standardized definitions, instruments, and study methods used to date in studies designed to quantify D&A in childbirth facilities introduced the potential for systematic error in reported prevalence estimates, and affected their generalizability and comparability. Chief among the lessons to emerge from comparing methods for measuring the prevalence of D&A is recognition of the tension between seeking prevalence measures that are reliable and generalizable, and attempting to avoid loss of validity in the context where the issue is being studied. Electronic supplementary material The online version of this article (10.1186/s12978-017-0389-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David Sando
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Timothy Abuya
- Population Council, Reproductive Health Program, 5 Rose Avenue, PO Box 17643-00500, Nairobi, Kenya
| | - Anteneh Asefa
- School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia
| | - Kathleen P Banks
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave, Crosstown Building, 3rd Floor, Boston, MA, 02118, USA
| | - Lynn P Freedman
- Averting Maternal Death and Disability Program (AMDD), Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, 60 Haven Avenue, B3, New York, NY, 10032, USA
| | - Stephanie Kujawski
- Department of Epidemiology, Columbia University Mailman School of Public Health, 60 Haven Avenue, B3, New York, NY, 10032, USA
| | - Amanda Markovitz
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115; 677 Huntington Ave, Boston, MA, 02115, USA
| | - Charity Ndwiga
- Population Council, Ralph Bunche Rd, Nairobi City, Nairobi, Kenya
| | - Kate Ramsey
- Management Sciences for Health, 45 Broadway #320, New York, NY, 10006, USA
| | - Hannah Ratcliffe
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA, 02215, USA
| | - Emmanuel O Ugwu
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria Enugu Campus, Enugu, Enugu State, Nigeria
| | - Charlotte E Warren
- Population Council, 4301 Connecticut Ave NW # 280, Washington, DC, 20008, USA
| | - R Rima Jolivet
- Maternal Health Task Force, Women & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 651 Huntington Avenue, Boston, MA, 02115, USA.
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105
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Informal cash payments for birth in Hungary: Are women paying to secure a known provider, respect, or quality of care? Soc Sci Med 2017; 189:86-95. [DOI: 10.1016/j.socscimed.2017.07.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 07/09/2017] [Accepted: 07/20/2017] [Indexed: 01/09/2023]
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106
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Saftner MA, Neerland C, Avery MD. Enhancing women's confidence for physiologic birth: Maternity care providers' perspectives. Midwifery 2017; 53:28-34. [PMID: 28743051 DOI: 10.1016/j.midw.2017.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 07/13/2017] [Accepted: 07/17/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this research study was to explore MCP's beliefs and attitudes about physiologic birth and to identify components of antenatal care that providers believe may impact a woman's confidence for physiologic labor and birth. METHODS This qualitative descriptive study included maternity care providers (N=31) in the Midwestern United States. Providers participated in semi-structured interviews to describe their beliefs about physiologic birth, their role in providing information to women and specific care practices to promote women's confidence for physiologic birth. FINDINGS Six themes emerged including: positive beliefs about physiologic birth, trusted relationship with provider, woman centered care, education and knowledge, barriers to confidence, and antenatal practices to enhance confidence. Variations in beliefs occurred amongst providers with different training (i.e., physicians and midwives). CONCLUSION Maternity care providers, including midwives, family physicians and obstetrician-gynecologists, overwhelmingly support a physiologic approach to labor and birth. These providers had a number of suggestions about how antenatal care could be enhanced in an effort to increase women's confidence during the antenatal period. Supporting physiologic birth is imperative for providers who wish to enhance outcomes for mothers and babies.
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Affiliation(s)
- Melissa A Saftner
- The University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Carrie Neerland
- The University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Melissa D Avery
- The University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
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