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Bylund CL, Taylor G, Vasquez TS, Alpert J, Johnson SB, Le T, Paige SR, Close J, Markham MJ. Talking with clinicians about online cancer information: a survey of cancer patients and surrogate information seekers. Support Care Cancer 2024; 32:362. [PMID: 38755329 DOI: 10.1007/s00520-024-08578-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 05/14/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES To describe patients' and surrogate information seekers' experiences talking to clinicians about online cancer information. To assess the impact of clinicians telling patients or surrogate seekers not to search for information online. DESIGN Cross-sectional survey. SAMPLE A total of 282 participants, including 185 individuals with cancer and 97 surrogate seekers. METHODS Individuals were recruited through a broad consent registry and completed a 20-min survey. FINDINGS Cancer patients and surrogate seekers did not differ significantly in their experiences talking with clinicians about online cancer information. Nearly all patients and surrogate seekers who were told by a clinician not to go online for cancer information did so anyway. IMPLICATIONS Interventions for improving cancer information seeking and communication with clinicians should target both patients and surrogate seekers. Clinicians should be educated about effective ways to communicate with patients and surrogate seekers about online cancer information.
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Affiliation(s)
- Carma L Bylund
- College of Medicine, University of Florida, Gainesville, FL, 32611, USA.
| | - Greenberry Taylor
- School of Creative Arts and Letters Flagler College, St. Augustine, FL, 32084, USA
| | - Taylor S Vasquez
- College of Journalism and Communications, University of Florida, Gainesville, FL, 32611, USA
| | - Jordan Alpert
- Department of Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Skyler B Johnson
- University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA
| | - Tien Le
- College of Journalism and Communications, University of Florida, Gainesville, FL, 32611, USA
| | - Samantha R Paige
- College of Journalism and Communications, University of Florida, Gainesville, FL, 32611, USA
| | - Julia Close
- College of Medicine, University of Florida, Gainesville, FL, 32611, USA
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Elkefi S, Asan O. Validating the Effectiveness of the Patient-Centered Cancer Care Framework by Assessing the Impact of Work System Factors on Patient-Centered Care and Quality of Care: Interview Study With Newly Diagnosed Cancer Patients. JMIR Hum Factors 2024; 11:e53053. [PMID: 38656776 PMCID: PMC11079762 DOI: 10.2196/53053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Patients with cancer who have recently been diagnosed have distinct requirements compared to cancer survivors. It is crucial to take into account their unique needs to ensure that they make informed decisions and are receptive to the care provided. OBJECTIVE This study suggested a framework titled Effectiveness of Patient-Centered Cancer Care that considers the needs of newly diagnosed patients with cancer and related work system factors. This study investigated how work system factors influence the perceptions of patient-centered care, quality of care, and associated outcomes among newly diagnosed patients with cancer. Patient-centered care is defined in terms of workload and communication considerations, whereas the quality of care is assessed through indicators such as trust in physicians, satisfaction with care, and perceptions of technology. METHODS This study used qualitative data collected through interviews with newly diagnosed patients with cancer (N=20) right after their first visits with their physicians. Thematic analysis was conducted to validate the 5 hypotheses of the framework, mapping the interactions among quality of care, patient-centered care, and work system factors. RESULTS We found that workload and patient-centered communication impact the quality of care and that the work system elements impact the patient-centeredness (workload and communication) and the quality of care (trust in physicians, satisfaction with care, and perception of technology use). CONCLUSIONS Qualitatively validating the proposed Effectiveness of Patient-Centered Cancer Care framework, this study demonstrated its efficacy in elucidating the interplay of various factors. The framework holds promise for informing interventions geared toward enhancing patients' experiences during their initial visits after diagnosis. There is a pressing need for heightened attention to the organizational design, patient processes, and collaborative efforts among diverse stakeholders and providers to optimize the overall patient experience.
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Affiliation(s)
- Safa Elkefi
- School of Nursing, Columbia University, New York, NY, United States
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
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Fahmer N, Faller H, Engehausen D, Hass HG, Reuss-Borst M, Duelli K, Wöckel A, Heuschmann PU, Meng K. Patients' challenges, competencies, and perceived support in dealing with information needs - A qualitative analysis in patients with breast and gynecological cancer. PATIENT EDUCATION AND COUNSELING 2022; 105:2382-2390. [PMID: 34930628 DOI: 10.1016/j.pec.2021.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to investigate challenges, competencies, and support in breast and gynecological cancer patients when dealing with information needs and how health literacy as an interplay of these factors might be improved. METHODS Semi-structured interviews were conducted with patients in acute care (n = 19), undergoing rehabilitation (n = 20) or attending self-help groups (n = 16). Interviews were analyzed using content analysis. RESULTS Challenges: gain information according to own needs, internet as information source, information evaluation and decisions, doctor-patient communication, situationally limited information processing, difficult access to information. Competencies: self-regulation of information needs, media and social competencies, communication skills in the doctor-patient conversation, internet competencies, self-directed decisions according to own needs, interest/self-efficacy, previous knowledge, trust in the doctor. SUPPORT by professionals (e.g., patient-centered communication), relatives (e.g., support during consultations), peers (e.g., exchange), facilities (e.g., clinics). CONCLUSIONS Our findings provide insight into challenges and competencies relevant to patients' health literacy and the influence of support. The individuality of the interplay highlights the relevance of an active patient role and patient-centered care. PRACTICE IMPLICATIONS Patients' health literacy should be improved in (psycho)oncological work by both reducing challenges (e.g., by communication skills training, involving relatives) and promoting competencies (e.g., by needs- and competence-oriented information offers).
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Affiliation(s)
- Natascha Fahmer
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-University of Würzburg, 97080 Würzburg, Germany.
| | - Hermann Faller
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-University of Würzburg, 97080 Würzburg, Germany
| | | | - Holger G Hass
- Paracelsus Clinic Scheidegg, 88175 Scheidegg, Germany
| | - Monika Reuss-Borst
- Center for Rehabilitation and Prevention Bad Bocklet, 97708 Bad Bocklet, Germany
| | - Kristin Duelli
- Department of Gynecology and Obstetrics, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Achim Wöckel
- Department of Gynecology and Obstetrics, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-University of Würzburg, 97080 Würzburg, Germany; Clinical Trial Center Würzburg, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Karin Meng
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-University of Würzburg, 97080 Würzburg, Germany
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Schulte-Vieting T, Siegle A, Jung C, Villalobos M, Thomas M. Developing a question prompt list for the oncology setting: A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:1689-1702. [PMID: 34686381 DOI: 10.1016/j.pec.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 09/23/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The purpose of this study was to provide an overview of existing methods used to develop a Question Prompt List (QPL) for an oncology setting. METHODS We conducted a search of the literature published between 1999 and 2019 in five online databases followed by a hand search, and extracted data on the methods used to develop a QPL. RESULTS A total of 21 studies were included. The review shows differences in the development of older QPLs (1999-2009) and current QPLs (2010-2019). However, most QPLs were developed using interviews or focus groups with patients and an expert session to review or adapt the QPL. Health professionals, patients, and researchers were included in nearly all the studies. CONCLUSION To develop a QPL, it is important to combine several information sources and at least to involve health professionals, patients, and researchers in the development process. Review or evaluation steps can improve the appropriateness and acceptance of a QPL. PRACTICE IMPLICATIONS Further research is needed to define the type of target population for new QPLs and to develop a framework for their development.
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Affiliation(s)
- Tamara Schulte-Vieting
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
| | - Anja Siegle
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg, University Hospital, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Corinna Jung
- Medical School Berlin, Rüdesheimer Str. 50, 14197 Berlin, Germany
| | - Matthias Villalobos
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany.
| | - Michael Thomas
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Röntgenstraße 1, 69126 Heidelberg, Germany
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Lee LE, Greene K, Venetis MK, Bontempo AC, Catona D, Buckley de Meritens A, Devine KA. Aligned and Divergent Perceptions of Support Persons' Role in Triadic Gynecologic Cancer Communication. QUALITATIVE HEALTH RESEARCH 2022; 32:710-724. [PMID: 35000506 DOI: 10.1177/10497323211066868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Health care providers routinely advise cancer patients to involve support persons in oncology care to fulfill critical support roles. This qualitative descriptive study explored alignment of triadic perceptions of support person involvement in oncology treatment visits and cancer-related care from the perspectives of patients with gynecologic cancer (n = 18), regular visit-attending support people (n = 16), and health care providers (n = 10), including oncologists, nurses, and medical assistants. Semi-structured interviews (N = 44) captured perceptions of facilitation and interference of support persons' roles within and outside appointments with oncology providers. Thematic analyses revealed alignment and divergence regarding support persons' instrumental, informational, and emotional support behaviors. Perspectives aligned regarding what support functions companions provide. However, patients and support persons emphasized the significance of instrumental followed by informational and emotional support, whereas oncology providers highlighted informational, followed by emotional and instrumental support. Discussion provides insight into each role's perspective in the triad.
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Affiliation(s)
- Lauren E Lee
- Department of Communication, 242612Rutgers University, New Brunswick, NJ, USA
| | - Kathryn Greene
- Department of Communication, 242612Rutgers University, New Brunswick, NJ, USA
| | - Maria K Venetis
- Department of Communication, 242612Rutgers University, New Brunswick, NJ, USA
| | - Allyson C Bontempo
- Department of Communication, 242612Rutgers University, New Brunswick, NJ, USA
| | - Danielle Catona
- Department of Global and Community Health, 3298George Mason University, Fairfax, VA, USA
| | - Alexandre Buckley de Meritens
- 145249Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- 43982Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Katie A Devine
- 145249Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Street RL. Information giving, managing, and understanding in clinical encounters. PATIENT EDUCATION AND COUNSELING 2021; 104:1831-1833. [PMID: 34148629 DOI: 10.1016/j.pec.2021.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Richard L Street
- Department of Communication, Texas A&M University, College Station, TX, USA; Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Houston VA Center for Innovations in Quality, Effectiveness and Safety, USA.
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Fatigante M, Zucchermaglio C, Alby F. Being in Place: A Multimodal Analysis of the Contribution of the Patient's Companion to "First Time" Oncological Visits. Front Psychol 2021; 12:664747. [PMID: 34149558 PMCID: PMC8209470 DOI: 10.3389/fpsyg.2021.664747] [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: 02/05/2021] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
Companions to medical visits have been alternatively viewed as members who “support” or “inhibit” and “interfere” with the doctor-patient interaction. One way of looking at the companions' contribution to medical visits is by coding roles or functions of their communicative behavior. Our paper aims at reconsidering these findings and analyzing how the companion participation is a local and sequential accomplishment, changing from time to time in the consultation. The paper relies upon an overall collection of 58 videorecordings of first oncological visits. Visits were conducted in two different hospitals, one of which a University hospital, and by different oncologists, including both senior professionals and (in the second setting) medical students in oncology. Visits were fully transcribed according to the Jeffersonian conventions and authors examined the transcripts and video according to the methodology of Conversation Analysis. The aim of the paper focused on how patient's companions orient and contribute to the accomplishment of the different aims and activities at different stages of the visit as an institutional speech event. The multimodal analysis of turns and actions (such as, gaze shifts, prosodic modulation, bodily arrangements), and the close examination of the sequential and temporal arrangements of companions' and their co-participants' turns revealed that companions finely attune to the multiparty framework of the encounter and the institutional constraints that govern the oncological first visit. Overall, results show two relevant features: that companions act as to preserve the doctor-patient interaction and to maintain the patient as the most responsible and legitimate agent in the interaction; that companions' contributions are relevant to the activities that sequentially unfold at different stages in the consultation (e.g., history taking, problem presentation, treatment recommendation etc.). The study complements earlier findings on the companion's roles, showing how these are highly mobile, multimodal and multiparty accomplishments, and they are tied to the specific contingencies of the visit. The results solicit to consider the value of multimodal analysis in understanding the complexity of multiparty communication in medical setting, and make it usable also in medical education.
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Affiliation(s)
- Marilena Fatigante
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Cristina Zucchermaglio
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Francesca Alby
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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ElKefi S, Asan O. How technology impacts communication between cancer patients and their health care providers: A systematic literature review. Int J Med Inform 2021; 149:104430. [PMID: 33684711 DOI: 10.1016/j.ijmedinf.2021.104430] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To ensure the well-being of their patients, health care providers (HCPs) are putting more effort into the quality of the communication they provide in oncology clinics. With the emergence of Health Information Technology (HIT), the dynamics between doctors and patients in oncology settings have changed. The purpose of this literature review is to explore and demonstrate how various health information technologies impact doctor-patient communication in oncology settings. METHOD A systematic literature review was conducted in 4 databases (PubMed, Cochrane, Web of Science, IEEE Xplore) to select publications that are in English, published between January 2009 and September 2020. This review reports outcomes related to the impacts of using health information technologies on doctor-patient communication according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Reviews and Meta-Analysis guidelines (PRISMA). RESULTS We identified 31 studies which satisfied the selection and eligibility criteria. The review revealed a diverse range of HIT used to support communication between cancer patients and their HCPs in oncology settings. Outcomes related to communication were examined to demonstrate how technology can improve access to care in clinical settings and online. When technology is used effectively to support patient knowledge and shared understanding, this increases the patient's satisfaction and ability to manage emotions, make decisions, and progress in their treatment, in addition to increasing social support and building a stronger therapeutic alliance based on shared knowledge and transparency between clinicians and patients. CONCLUSION Technology-based solutions can help strengthen the relationship and communication between patients and their doctors. They can empower the patient's well-being, help doctors make better decisions and enhance the therapeutic alliance between them. Thus, using technology to enhance communication in healthcare settings remains beneficial if its use is structured and target oriented. Future studies should focus on comparing in-depth the difference between outpatient and inpatient settings in terms of the efforts required and the extent of the impacts from both clinicians' and cancer patients' perspectives.
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Affiliation(s)
- Safa ElKefi
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, 07047, USA
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, 07047, USA.
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Addressing cancer patient and caregiver role transitions during home hospice nursing care. Palliat Support Care 2020; 17:523-530. [PMID: 29761752 DOI: 10.1017/s1478951518000214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Many family caregivers and hospice patients experience role changes resulting from advancing illness and the need for increased caregiver responsibility. Successful navigation of conflicts that arise because of these role transitions has been linked to higher quality of patient care and improved caregiver bereavement adjustment. Nursing communication with patients and their caregivers plays an important role in facilitating these transitions. Our objective is to describe patient-caregiver-nurse communication during transitions at end of life. METHOD A secondary, qualitative analysis was conducted on transcripts. Using an iterative process of constant comparison, coders inductively categorized nurse, caregiver, and patient communication behavior into overarching themes. Participants were home hospice nurses and cancer patient/spouse caregiver dyads; participants were >45 years of age, English speaking, and cognitively able to participate. Research took place in the home during nurse visits. RESULT Nineteen unique home hospice visits were analyzed. Patient-caregiver conflict occurred in two major content themes (1) negotiating transitions in patient independence and (2) navigating caregiver/patient emotions (e.g., frustration, sadness). Nurse responses to transition conflict included problem-solving, mediating, or facilitating discussions about conflicts. Nurse responses to emotional conflict included validation and reassurance. SIGNIFICANCE OF RESULTS Our findings provide insight into the topics and processes involved in patient and caregiver transitions in home hospice and the role hospice nursing communication plays in mediating potential conflict. Nurses are often asked to take on the role of mediator, often with little conflict resolution communication education; results can be used for nursing education.
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Brütting J, Bergmann M, Garzarolli M, Rauschenberg R, Weber C, Berking C, Tilgen W, Schadendorf D, Meier F. Informationssuche und Nutzung von Informationsquellen durch Melanompatienten deutscher Hautkrebszentren. J Dtsch Dermatol Ges 2019; 16:1093-1102. [PMID: 30179323 DOI: 10.1111/ddg.13630_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Julia Brütting
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
| | - Maike Bergmann
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
| | - Marlene Garzarolli
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
| | - Ricarda Rauschenberg
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
| | - Christiane Weber
- Arbeitsgemeinschaft Dermatologische Onkologie (ADO), Saarbrücken, Deutschland
| | - Carola Berking
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, München, Deutschland
| | - Wolfgang Tilgen
- Nationale Versorgungskonferenz Hautkrebs (NVKH), Neckargemünd, Deutschland
| | - Dirk Schadendorf
- Klinik für Dermatologie, Universitätsklinikum Essen, Essen, Deutschland
| | - Friedegund Meier
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
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Brütting J, Reinhardt L, Bergmann M, Schadendorf D, Weber C, Tilgen W, Berking C, Meier F. Quality, Readability, and Understandability of German Booklets Addressing Melanoma Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:760-767. [PMID: 29736794 DOI: 10.1007/s13187-018-1369-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Booklets are the preferably used form among patient education materials and are often handed out during medical consultations in dermatological oncology settings. However, little is known about how beneficial they are and whether they correspond to essential quality characteristics. To assess the quality, readability, and understandability of currently freely available booklets written in German addressing melanoma patients (MP). Melanoma booklets in accordance with predefined criteria were searched and analyzed. Three reviewers independently assessed their quality and understandability by applying the DISCERN tool and PEMAT-P. The Flesch Reading Ease Score (FRES) was calculated to determine readability. Nine booklets addressing MP were analyzed. The overall median DISCERN score was 3.6 (interquartile range (IQR) 2.9-4.1), median PEMAT-P score was 91% (IQR 83-94.5), and median FRES was 43 (IQR 33.5-47.5), indicating a medium quality, a high application of understandability elements, but low readability in at least half of the booklets. Incomplete reporting on treatments and insufficient meta-information caused the main quality deficits. There is a need of content and didactic revision of German booklets for MP to raise their quality and to make them beneficial and understandable for more patients. An adaption in accordance with evidence-based criteria and an even stronger involvement of MP in assessment and development of patient education material are considered to be the best approaches.
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Affiliation(s)
- Julia Brütting
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Lydia Reinhardt
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany
| | - Maike Bergmann
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - Christiane Weber
- Dermatological Cooperative Oncology Group (DeCOG), Saarbrücken, Germany
| | - Wolfgang Tilgen
- Steering Group, Skin Cancer Counsil Germany, Neckargemünd, Germany
| | - Carola Berking
- Department of Dermatology and Allergy, University Hospital Munich, Munich, Germany
| | - Friedegund Meier
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany
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Pinto E, Cavallin F, Scarpa M. Psychological support of esophageal cancer patient? J Thorac Dis 2019; 11:S654-S662. [PMID: 31080642 PMCID: PMC6503274 DOI: 10.21037/jtd.2019.02.34] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/04/2019] [Indexed: 12/22/2022]
Abstract
Important questions are still open about psychological aspects in esophageal cancer (EC) and about the related psychological support. How to cope with the cancer diagnosis and poor prognosis: a psychological counselling may be a valid option to personalize the communication to patients with a poor prognosis. How to cope with long chemoradiotherapy: after neoadjuvant therapy, patients know that curative process is not completed, and they perceive the severity of the neoadjuvant side effects, considering themselves "fragile" and far from a healthy condition before the major surgery they are going to undergo. Therefore, this is a particularly crucial point when psychological support may be useful. How to cope with change of nutritional habits: esophagectomy for cancer strongly impairs nutritional function in the early postoperative period and feeding Jejunostomy impairs emotional function. How to cope with sleep disturbances: most cancer patients report disturbed sleep after cancer diagnosis and/or following cancer treatment. Psychological intervention aims to identify underlying concerns worsening sleep quality. How to cope with postoperative complications: the occurrence of such complications reduces patient's satisfaction and has a negative effect on doctor-patient relationship. How to cope with long-term functions impairment: EC patients need a plan for the future.
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Affiliation(s)
- Eleonora Pinto
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy
| | | | - Marco Scarpa
- General Surgery Unit, Azienda Ospedaliera di Padova, Padova, Italy
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Reblin M, Stanley NB, Galligan A, Reed D, Quinn GP. Family dynamics in young adult cancer caregiving: “It should be teamwork”. J Psychosoc Oncol 2019; 37:526-540. [DOI: 10.1080/07347332.2018.1563582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
| | - Nathanael B. Stanley
- Moffitt Cancer Center, Tampa, Florida, USA
- University of South Florida, Tampa, Florida, USA
| | | | - Damon Reed
- Moffitt Cancer Center, Tampa, Florida, USA
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Monga V, Maliske SM, Kaleem H, Mott SL, K D Zamba G, Milhem M. Discrepancy between treatment goals documentation by oncologists and their understanding among cancer patients under active treatment with chemotherapy. Eur J Cancer Care (Engl) 2018; 28:e12973. [PMID: 30511450 DOI: 10.1111/ecc.12973] [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: 01/21/2018] [Revised: 08/09/2018] [Accepted: 10/27/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE/BACKGROUND Discussion of treatment goals between oncologists and patients is challenging. Patients frequently misunderstand goals of therapy. There are several methods to document goals of chemotherapy, however, and are frequently not incorporated into patient charts. METHODS/DESIGN Cancer patients receiving their first cycle of chemotherapy were interviewed. Patients' recall of discussions with their oncologist regarding therapy intent was assessed and compared to documentation. An adjusted McNemar's test was utilised. A one-sample proportion test was used to evaluate whether the overall observed rate of discordance was significantly different from the proposed 33% rate; a rate posited as a threshold too high in the clinical sense. RESULTS Two hundred and seven eligible patients were interviewed. Oncologist identified treatment goals were not documented in 24.6% of cases and had to be excluded. There was not a significant difference in the directionality of discordance present. Inter-rater agreement between patient and oncologist was found to be adequate (κ = 0.64). The overall rate of discordance (17.29%) was found to be significantly less than the proposed acceptable level of 33% (p < 0.01). Upon univariable analysis, age, gender, marital and employment status were not found to be associated with discordance. CONCLUSIONS Discordance between treatment goals documentation and their understanding exists, indicating continued miscommunication between the patient and oncologist.
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Affiliation(s)
- Varun Monga
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Seth M Maliske
- Aspirus Wausau Hospital Regional Cancer Center, Wausau, Wisconsin
| | - Hassan Kaleem
- Division of Hematology and Oncology, Texas Tech University, Lubbock, Texas
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
| | - Gideon K D Zamba
- Department of Biostatistics, University of Iowa, Iowa City, Iowa
| | - Mohammed Milhem
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa Carver College of Medicine, Iowa City, Iowa
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15
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Troy E, Doltani D, Harmon D. The role of a companion attending consultations with the patient. A systematic review. Ir J Med Sci 2018; 188:743-750. [DOI: 10.1007/s11845-018-1920-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022]
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16
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Brütting J, Bergmann M, Garzarolli M, Rauschenberg R, Weber C, Berking C, Tilgen W, Schadendorf D, Meier F. Information-seeking and use of information resources among melanoma patients of German skin cancer centers. J Dtsch Dermatol Ges 2018; 16:1093-1101. [PMID: 30091517 DOI: 10.1111/ddg.13630] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/06/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study aimed to explore the information-seeking behavior (ISB) of melanoma patients (MPs) and MP subgroups, in order to provide data for needs-based adaptation of information provision. METHODS In a cross-sectional survey in 27 German skin cancer centers, we explored characteristics of the ISB of MPs with the aid of a standardized questionnaire. Sub-group differences were determined with the chi-squared test and predictors of media preferences with logistic regression. RESULTS 67 % of the 529 participating MPs had clinical stage III or IV melanoma. Most of the participants (81 %) reported medical consultations as their regularly or frequently used information resource (IR). 58 % wished to have more advice about IRs from their physician. Only 8 % of MPs used the services of self-help groups and 12 % of MPs took advantage of the services of cancer counseling centers. The internet (63 %) and booklets (58 %) were reported to be the preferred media. Age, educational level, general need for information and lack of awareness of their own condition proved to be predictors for media preferences. CONCLUSIONS Most MPs expected their physician to advise them about IRs they could use in addition to medical consultations. Peer support services were quite underused by MPs. The various preferences of media by MPs should be considered when deve-loping and providing IRs.
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Affiliation(s)
- Julia Brütting
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Dresden, Germany
| | - Maike Bergmann
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Dresden, Germany
| | - Marlene Garzarolli
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Dresden, Germany
| | - Ricarda Rauschenberg
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Dresden, Germany
| | - Christiane Weber
- Arbeitsgemeinschaft Dermatologische Onkologie (ADO), Saarbrücken, Germany
| | - Carola Berking
- Department of Dermatology and Allergy, University Hospital Munich, Munich, Germany
| | - Wolfgang Tilgen
- Nationale Versorgungskonferenz Hautkrebs (NVKH), Neckargemünd, Germany
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - Friedegund Meier
- Department of Dermatology, Dresden University Hospital Carl Gustav Carus, Dresden, Germany
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Vick JB, Amjad H, Smith KC, Boyd CM, Gitlin LN, Roth DL, Roter DL, Wolff JL. "Let him speak:" a descriptive qualitative study of the roles and behaviors of family companions in primary care visits among older adults with cognitive impairment. Int J Geriatr Psychiatry 2018; 33:e103-e112. [PMID: 28585721 PMCID: PMC5862540 DOI: 10.1002/gps.4732] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/04/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Cognitive impairment poses communication challenges in primary care. Although family "companions" commonly attend primary care visits of older adults with cognitive impairment, little is known about how their involvement affects communication. Therefore, we sought to understand how companion involvement affects the quality of primary care visit communication for older adults with cognitive impairment. METHODS Cross-sectional, descriptive qualitative study participants were as follows: (1) English-speaking adults age 65 or older with mild, moderate, or severe cognitive impairment; (2) family members or other unpaid companions who accompany older adults to primary care visits; and (3) primary care clinicians. Twenty semi-structured and in-depth qualitative interviews of older adults and their companions (N = 20 dyads) and two focus groups (N = 10 primary care clinicians) were conducted. Interviews and focus groups were transcribed and analyzed thematically. RESULTS Family companions commonly facilitate communication by advocating for patients, ensuring the accuracy of information exchange and understanding, and preserving rapport. Significant communication challenges were also identified, including patient and companion role ambiguity, competing visit agendas, and primary care clinician confusion regarding the most accurate source of information. Patients, companions, and clinicians each identified strategies to improve communication, chief among them being to identify, differentiate, and respect both patient and companion priorities and perspectives. CONCLUSIONS Family companions actively participate in primary care visits of older adults with cognitive impairment in ways that promote and inhibit effective communication. Findings suggest the need for strategies that more effectively and purposefully involve family in the care of primary care patients with cognitive impairment. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | | | - Cynthia M. Boyd
- Johns Hopkins University School of Medicine
- Johns Hopkins Bloomberg School of Public Health
| | - Laura N. Gitlin
- Johns Hopkins University School of Medicine
- Johns Hopkins University School of Nursing, Center for Innovative Care in Aging
| | - David L. Roth
- Johns Hopkins University School of Medicine
- Johns Hopkins Bloomberg School of Public Health
| | | | - Jennifer L. Wolff
- Johns Hopkins University School of Medicine
- Johns Hopkins Bloomberg School of Public Health
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18
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Pinto E, Cavallin F, Saadeh LM, Bellissimo MC, Alfieri R, Mantoan S, Cagol M, Castoro C, Scarpa M. Potential curability and perception of received information in esophageal cancer patients. Support Care Cancer 2017; 26:1807-1814. [PMID: 29260389 DOI: 10.1007/s00520-017-4005-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 12/05/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to evaluate patients' perceived receipt of information according to the possibility of cure in esophageal cancer. METHODS One hundred and twelve consecutive patients presenting at the multidisciplinary visit at the Veneto Institute of Oncology for esophageal cancer between 2014 and 2016 were included in the study. The Italian version of the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaires C30 (core questionnaire), OG25 (esophago-gastric cancer module), and INFO25 (information module) were used. RESULTS Candidates for palliative treatment were less informed about the disease (adjusted mean difference - 11.5, 95% CI - 23.0 to - 0.02) and less satisfied with information provided (adjusted mean difference - 18.3, 95% CI - 31.9 to - 4.7) than candidates for curative treatment. In addition, candidates for palliative treatment wanted to receive more information than candidates for curative treatment (adjusted mean difference 26.1, 95% CI 0.5 to 51.6). Better quality of life was associated with satisfaction of received information (β = 0.77, p < 0.0001) and of receiving information about things that the patient can do to help himself (β = 0.26, p = 0.04). More anxiety was associated to receiving more information about disease (β = 0.46, p = 0.02) but less information about things that the patient can do to help himself (β = - 0.38, p = 0.02). CONCLUSIONS Candidates for palliative treatment were less satisfied with information about the disease and wanted to receive more information. Additionally, some aspects of quality of life were found to be associated with perceived receipt of information. Appropriate training in communication of prognostic information may improve clinical management of incurable cancer patients.
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Affiliation(s)
- Eleonora Pinto
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Francesco Cavallin
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Luca Maria Saadeh
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Maria Cristina Bellissimo
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Rita Alfieri
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Silvia Mantoan
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Matteo Cagol
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Carlo Castoro
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Marco Scarpa
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy.
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19
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Reblin M, Clayton MF, Xu J, Hulett JM, Latimer S, Donaldson GW, Ellington L. Caregiver, patient, and nurse visit communication patterns in cancer home hospice. Psychooncology 2017; 26:2285-2293. [PMID: 28029712 PMCID: PMC5489378 DOI: 10.1002/pon.4361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/15/2016] [Accepted: 12/23/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Few studies have examined the triadic communication between patients, spouse caregivers, and nurses in the home hospice setting. Thus, little is known about the types of communication patterns that unfold. The goals of the study were to, first, identify common patterns of communication in nurse-patient-caregiver home hospice visits and, second, to identify nurse, caregiver-patient dyad, and visit characteristics that predict visit communication patterns. METHOD Nurses (N = 58) and hospice cancer patient and spouse caregiver dyads (N = 101; 202 individuals) were recruited from 10 hospice agencies. Nurses audio recorded visits to patient/caregiver homes from study enrollment until patient death. All patient, caregiver, and nurse utterances from the audio recordings were coded using an adapted Roter interaction analysis system. Using identified codes, cluster analysis was conducted to identify communication patterns within hospice visits. Logistic regression was used with demographic variables to predict visit communication patterns. RESULTS Six visit communication patterns were identified and were defined largely by 2 dimensions: (1) either the patient, the caregiver, or the patient and caregiver dyad interacting with the nurse and (2) the relatively high or low expression of distress during the visit. Time until death significantly predicted several clusters. CONCLUSION This study leads the way in outlining triadic communication patterns in cancer home hospice visits. Our findings have implications for nursing education, letting future nurses know what to expect, and lays the foundation for future research to determine effectiveness and interventions to improve health care communication.
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Affiliation(s)
- Maija Reblin
- Department of Health Outcomes and Behavior, Moffitt Cancer Center,
Tampa, FL, USA
| | | | - Jiayun Xu
- College of Nursing, University of Utah, Salt Lake City, UT,
USA
| | | | - Seth Latimer
- College of Nursing, University of Utah, Salt Lake City, UT,
USA
| | - Gary W. Donaldson
- Pain Research Center, Department of Anesthesiology, University of
Utah, Salt Lake City, UT, USA
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT,
USA
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20
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Street RL, Mazor KM. Clinician-patient communication measures: drilling down into assumptions, approaches, and analyses. PATIENT EDUCATION AND COUNSELING 2017; 100:1612-1618. [PMID: 28359660 DOI: 10.1016/j.pec.2017.03.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/31/2017] [Accepted: 03/14/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To critically examine properties of clinician-patient communication measures and offer suggestions for selecting measures appropriate to the purposes of research or clinical practice assessment. METHODS We analyzed different types of communication measures by focusing on their ontological properties. We describe their relative advantages and disadvantages with respect to different types of research questions. RESULTS Communication measures vary along dimensions of reporter (observer vs. participant), focus of measurement (behavior, meaning, or quality), target, and timing. Observer coded measures of communication behavior function well as dependent variables (e.g., evaluating communication skill interventions, examining variability related to gender or race), but are less effective as predictors of perceptions and health outcomes. Measures of participants' judgments (e.g., what the communication means or how well it was done) capture patients' or clinicians' experiences (e.g., satisfaction) and can be useful for predicting outcomes, especially in longitudinal designs. CONCLUSION In the absence of a theoretically coherent set of measures that could be used across research programs and applied setting, users should take steps to select measures with properties that are optimally matched to specific questions. PRACTICE IMPLICATIONS Quality assessments of clinician-patient communication should take into account the timing of the assessment and use measures that drill down into specific aspects of patient experience to mitigate ceiling effects.
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Affiliation(s)
- Richard L Street
- Department of Communication, Texas A&M University, College Station, TX, USA; Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Houston VA Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA.
| | - Kathleen M Mazor
- Department of Medicine, Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA
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21
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Alden DL, Friend J, Lee PY, Lee YK, Trevena L, Ng CJ, Kiatpongsan S, Lim Abdullah K, Tanaka M, Limpongsanurak S. Who Decides: Me or We? Family Involvement in Medical Decision Making in Eastern and Western Countries. Med Decis Making 2017; 38:14-25. [DOI: 10.1177/0272989x17715628] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Research suggests that desired family involvement (FI) in medical decision making may depend on cultural values. Unfortunately, the field lacks cross-cultural studies that test this assumption. As a result, providers may be guided by incomplete information or cultural biases rather than patient preferences. Methods. Researchers developed 6 culturally relevant disease scenarios varying from low to high medical seriousness. Quota samples of approximately 290 middle-aged urban residents in Australia, China, Malaysia, India, South Korea, Thailand, and the USA completed an online survey that examined desired levels of FI and identified individual difference predictors in each country. All reliability coefficients were acceptable. Regression models met standard assumptions. Results. The strongest finding across all 7 countries was that those who desired higher self-involvement (SI) in medical decision making also wanted lower FI. On the other hand, respondents who valued relational-interdependence tended to want their families involved – a key finding in 5 of 7 countries. In addition, in 4 of 7 countries, respondents who valued social hierarchy desired higher FI. Other antecedents were less consistent. Conclusion. These results suggest that it is important for health providers to avoid East–West cultural stereotypes. There are meaningful numbers of patients in all 7 countries who want to be individually involved and those individuals tend to prefer lower FI. On the other hand, more interdependent patients are likely to want families involved in many of the countries studied. Thus, individual differences within culture appear to be important in predicting whether a patient desires FI. For this reason, avoiding culture-based assumptions about desired FI during medical decision making is central to providing more effective patient centered care.
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Affiliation(s)
- Dana L. Alden
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - John Friend
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - Ping Yein Lee
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - Yew Kong Lee
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - Lyndal Trevena
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - Chirk Jenn Ng
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - Sorapop Kiatpongsan
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - Khatijah Lim Abdullah
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - Miho Tanaka
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
| | - Supanida Limpongsanurak
- University of Hawaii, Honolulu, HI, USA (DLA)
- College of St. Benedict and St. John’s University, Collegeville, MN, USA (JF)
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia (PYL)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (YKL)
- School of Public Health, The University of Sydney, Sydney, NSW, Australia (LT)
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Bowen DJ, Albrecht T, Hay J, Eggly S, Harris-Wei J, Meischke H, Burke W. Communication Among Melanoma Family Members. JOURNAL OF HEALTH COMMUNICATION 2017; 22:198-204. [PMID: 28248624 PMCID: PMC5592097 DOI: 10.1080/10810730.2016.1259374] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Interventions to improve communication among family members may facilitate information flow about familial risk and preventive health behaviors. This is a secondary analysis of the effects of an interactive website intervention aimed at increasing communication frequency and agreement about health risk among melanoma families. Participants were family units, consisting of one family member with melanoma identified from a previous research study (the Case) and an additional first degree relative and a parent of a child 0-17. Family triads were randomized to receive access to the website intervention or to serve as control families. Family communication frequency and agreement about melanoma prevention behaviors and beliefs were measured at baseline and again at 1 year post randomization. Intervention participants of all three types significantly increased the frequency of communication to their first degree relatives (Parents, siblings, children; range = 14-18 percentage points; all p < .05). At baseline, approximately two-thirds of all three family members talked with at least some member of the family about cancer risk. Agreement between Cases and First Degree Relatives and between Cases and Parents increased from pre to post intervention in the intervention participants compared to the control participants (p < .05). These findings provide support for interventions to improve family communication about cancer risk.
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Affiliation(s)
- Deborah J Bowen
- a Department of Bioethics and Humanities , University of Washington , Seattle , Washington , USA
| | - Terrance Albrecht
- b Department of Communication and Behavioral Oncology , Karamos Cancer Institute, Wayne State University , Detroit , Michigan , USA
| | - Jennifer Hay
- c Department of Psychiatry and Behavioral Sciences , Memorial Sloan Kettering Cancer Center , New York , New York , USA
| | - Susan Eggly
- b Department of Communication and Behavioral Oncology , Karamos Cancer Institute, Wayne State University , Detroit , Michigan , USA
| | - Julie Harris-Wei
- d Institute for Public Health Genetics, University of California San Francisco , San Francisco , California , USA
| | - Hendrika Meischke
- e Department of Health Services , University of Washington , Seattle , Washington , USA
| | - Wylie Burke
- a Department of Bioethics and Humanities , University of Washington , Seattle , Washington , USA
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Huebner J, Keinki C, Kleeberg J, Seilacher E. Communication before Cancer Surgery - the Perspective of Patients with Gastrointestinal Cancer. Oncol Res Treat 2016; 39:724-727. [PMID: 27855378 DOI: 10.1159/000450985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/05/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Jutta Huebner
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Frankfurt/M., Germany
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24
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Street RL. Measuring the quality of clinician-patient information exchange. PATIENT EDUCATION AND COUNSELING 2016; 99:ix-xi. [PMID: 27015985 DOI: 10.1016/j.pec.2016.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Richard L Street
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Houston VA Center for Innovations in Quality, Effectiveness and Safety, USA.
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25
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Satisfaction with information and unmet information needs in men and women with cancer. J Cancer Surviv 2015; 10:62-70. [DOI: 10.1007/s11764-015-0451-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/08/2015] [Indexed: 11/12/2022]
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Paschali AA, Hadjulis M, Papadimitriou A, Karademas EC. Patient and physician reports of the information provided about illness and treatment: what matters for patients' adaptation to cancer during treatment? Psychooncology 2015; 24:901-9. [PMID: 25640412 DOI: 10.1002/pon.3741] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/26/2014] [Accepted: 11/27/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to examine (a) whether illness representations mediate the relation of the amount of information provided by physicians to patients' adaptation to illness; (b) whether patient-physician agreement on the information provided impacts the aforementioned relationship. The study focused on information that, according to the Common Sense Self-Regulation Model, is essential for adaptation to illness. METHODS The sample consisted of 93 patients undergoing chemotherapy and their physicians. Indirect (mediation) effects and conditional (moderated) indirect effects were examined using bootstrapping. RESULTS The more illness and treatment-related information was provided by physicians, the more positive illness representations (specifically, illness consequences, emotional representations, and personal control) were reported by patients. In turn, these illness representations were related to better physical functioning and better adjustment to cancer. The degree of the patient-physician agreement on the information provided did not affect this relationship. CONCLUSIONS What seems to be more crucial for patients' adaptation to cancer during treatment is the amount of information provided by physicians rather than their agreement with patients on the information provided. Also, there is a need to thoroughly examine the pathways through which information provision impacts adaptation to illness.
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Affiliation(s)
- Antonia A Paschali
- Department of Mental Health and Behavioral Sciences, Faculty of Nursing, National & Kapodistrian University of Athens, Athens, Attica, Greece
| | - Michael Hadjulis
- Department of Mental Health and Behavioral Sciences, Faculty of Nursing, National & Kapodistrian University of Athens, Athens, Attica, Greece
| | - Angela Papadimitriou
- Department of Mental Health and Behavioral Sciences, Faculty of Nursing, National & Kapodistrian University of Athens, Athens, Attica, Greece
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Tsang DS, Alibhai SM. Bone health care for patients with prostate cancer receiving androgen deprivation therapy. Hosp Pract (1995) 2014; 42:89-102. [PMID: 24769788 DOI: 10.3810/hp.2014.04.1107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Patients with prostate cancer often receive androgen deprivation therapy (ADT) as part of their treatment regimen. However, treatment with ADT causes multiple side effects, including reduced bone mineral density (BMD), lower lean body mass, and a higher risk for fractures. Several organizations provide clinical practice guidelines for osteoporosis screening, prevention, and treatment in this population, but adherence to these guidelines remains low. Areas for improvement in provider adherence include baseline and follow-up BMD testing, as well as counseling regarding healthy bone behaviors such as calcium/vitamin D intake, lifestyle changes, and physical exercise. Comparison of osteoporosis care in breast cancer and non-oncology populations shows that suboptimal bone health care is not isolated to prostate cancer. A summary of the literature examining improvements in patient adherence and provider delivery of bone health care is included in this review, but high-quality studies are lacking. Patients may be the most receptive to written educational information delivered at or near the time of ADT initiation. Involvement of a primary care practitioner and oncologist in care delivery is associated with higher BMD test use. Institution-level programs that automatically initiate osteoporosis screening and management may be effective at reducing the incidence of hip fracture. Lastly, suggestions are provided for future approaches to knowledge translation and quality of care studies to improve bone health.
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Affiliation(s)
- Derek S Tsang
- Resident Physician, Department of Radiation Oncology, University of Toronto, Toronto, Canada
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