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Harrison R, Iqbal MP, Chitkara U, Adams C, Chauhan A, Mitchell R, Manias E, Alston M, Hadley AM. Approaches for enhancing patient-reported experience measurement with ethnically diverse communities: a rapid evidence synthesis. Int J Equity Health 2024; 23:26. [PMID: 38342909 PMCID: PMC10860321 DOI: 10.1186/s12939-024-02107-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 01/13/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Patient-reported experience measures (PREMs) are used to drive and evaluate unit and organisational-level healthcare improvement, but also at a population level, these measures can be key indicators of healthcare quality. Current evidence indicates that ethnically diverse communities frequently experience poorer care quality and outcomes, with PREMs data required from this population to direct service improvement efforts. This review synthesises evidence of the methods and approaches used to promote participation in PREMs among ethnically diverse populations. METHODS A rapid evidence appraisal (REA) methodology was utilised to identify the disparate literature on this topic. A search strategy was developed and applied to three major electronic databases in July 2022 (Medline; PsycINFO and CINAHL), in addition to websites of health agencies in Organisation for Economic Co-operation and Development countries via grey literature searches. A narrative evidence synthesis was undertaken to address the review question. RESULTS The review resulted in 97 included studies, comprised 86 articles from electronic database searches and 11 articles from the grey literature. Data extraction and synthesis identified five strategies used in PREM instruments and processes to enhance participation among ethnically diverse communities. Strategies applied sought to better inform communities about PREMs, to create accessible PREMs instruments, to support PREMs completion and to include culturally relevant topics. Several methods were used, predominantly drawing upon bicultural workers, translation, and community outreach to access and support communities at one or more stages of design or administration of PREMs. Limited evidence was available of the effectiveness of the identified methods and strategies. PREMs topics of trust, cultural responsiveness, care navigation and coordination were identified as pertinent to and frequently explored with this population. CONCLUSIONS The findings provide a basis for a maturity model that may guide change to increase participation of ethnically diverse communities in PREMs. In the short-medium term, health systems and services must be able to recognise and respond to cultural and linguistic diversity in the population when applying existing PREMs. In the longer-term, by working in collaboration with ethnically diverse communities, systems and services may co-create adapted or novel PREMs that tackle the factors that currently inhibit uptake and completion among ethnically diverse communities.
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Affiliation(s)
- Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia.
| | - Maha Pervaz Iqbal
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Upma Chitkara
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Corey Adams
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Ashfaq Chauhan
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Rebecca Mitchell
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Monash University, Melbourne, VIC, 3800, Australia
| | - Megan Alston
- Elevating the Human Experience Program, NSW Ministry of Health, Sydney, NSW, 2065, Australia
| | - Anne Marie Hadley
- Elevating the Human Experience Program, NSW Ministry of Health, Sydney, NSW, 2065, Australia
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Arnold RM, Levoy K, Hickman SE, Jawahri AE, Jackson V, Tulsky JA. JPSM Controversies in Palliative Care: "What is the Most Important, Measurable Goal of Serious Illness Conversations in the Ambulatory Setting?". J Pain Symptom Manage 2024; 67:e105-e110. [PMID: 37591321 DOI: 10.1016/j.jpainsymman.2023.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023]
Abstract
There is widespread agreement that clinicians should talk to seriously ill patients and their families about their illnesses. However, advance directives as a quality metric have been called into question because of the lack of data that these conversations lead to goal-concordant care. The controversy has led many to reexamine the purpose of conversations with seriously ill patients and what should be discussed in ambulatory visits. In this Controversies in Palliative care, experts in palliative care review the literature and suggest both how it influences their clinical practice and what research needs to be done to clarify the controversy. While there is not a single outcome that the experts agree on, they posit a variety of different ways to assess these conversations.
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Affiliation(s)
- Robert M Arnold
- Department of Medicine, Section of Palliative Care and Medical Ethics, Palliative Research Center (R.M.A.), UPMC Health System, Palliative and Supportive Care Institute, Pittsburgh, PA, USA.
| | - Kristin Levoy
- Department of Community and Health Systems (K.L., S.E.H.), Indiana University School of Nursing, Indianapolis, IN, USA; Indiana University Center for Aging Research (K.L., S.E.H.), Regenstrief Institute, Inc., Indianapolis, IN, USA; Indiana University Melvin and Bren Simon Comprehensive Cancer Center (K.L.), Indianapolis, IN, USA
| | - Susan E Hickman
- Department of Community and Health Systems (K.L., S.E.H.), Indiana University School of Nursing, Indianapolis, IN, USA; Indiana University Center for Aging Research (K.L., S.E.H.), Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - Areej El Jawahri
- Cancer Center (A.E.J.), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Vicki Jackson
- Division of Palliative Care and Geriatric Medicine, Department of Medicine (V.J.), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care (J.A.T.), Dana-Farber Cancer Institute, Boston, MA; Division of Palliative Medicine, Department of Medicine (J.A.T.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Dhanani S, Ramlakhan JU, Berta WB, Gagliardi AR. Optimizing the design and implementation of question prompt lists to support person-centred care: A scoping review. Health Expect 2023; 26:1404-1417. [PMID: 37227115 PMCID: PMC10349246 DOI: 10.1111/hex.13783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/13/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Question prompt lists (QPLs) are lists of questions that patients may want to discuss with clinicians. QPLs support person-centred care and have been associated with many beneficial outcomes including improved patient question-asking, and the amount and quality of the information provided by clinicians. The purpose of this study was to review published research on QPLs to explore how QPL design and implementation can be optimized. METHODS We performed a scoping review by searching MEDLINE, EMBASE, Scopus, CINAHL, Cochrane Library and Joanna Briggs Database from inception to 8 May 2022, for English language studies of any design that evaluated QPLs. We used summary statistics and text to report study characteristics, and QPL design and implementation. RESULTS We included 57 studies published from 1988 to 2022 by authors in 12 countries on a range of clinical topics. Of those, 56% provided the QPL, but few described how QPLs were developed. The number of questions varied widely (range 9-191). Most QPLs were single-page handouts (44%) but others ranged from 2 to 33 pages. Most studies implemented a QPL alone with no other accompanying strategy; most often in a print format before consultations by mail (18%) or in the waiting room (66%). Both patients and clinicians identified numerous benefits to patients of QPLs (e.g., increased patient confidence to ask questions, and patient satisfaction with communication or care received; and reduced anxiety about health status or treatment). To support use, patients desired access to QPLs in advance of clinician visits, and clinicians desired information/training on how to use the QPL and answer questions. Most (88%) studies reported at least one beneficial impact of QPLs. This was true even for single-page QPLs with few questions unaccompanied by other implementation strategies. Despite favourable views of QPLs, few studies assessed outcomes amongst clinicians. CONCLUSION This review identified QPL characteristics and implementation strategies that may be associated with beneficial outcomes. Future research should confirm these findings via systematic review and explore the benefits of QPLs from the clinician's perspective. PATIENT/PUBLIC CONTRIBUTION Following this review, we used the findings to develop a QPL on hypertensive disorders of pregnancy and interviewed women and clinicians about QPL design including content, format, enablers and barriers of use, and potential outcomes including beneficial impacts and possible harms (will be published elsewhere).
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Affiliation(s)
- Shazia Dhanani
- Toronto General Hospital Research InstituteUniversity Health NetworkTorontoCanada
| | - Jessica U. Ramlakhan
- Toronto General Hospital Research InstituteUniversity Health NetworkTorontoCanada
| | - Whitney B. Berta
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
| | - Anna R. Gagliardi
- Toronto General Hospital Research InstituteUniversity Health NetworkTorontoCanada
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Cvetanovska N, Jessup RL, Wong Shee A, Rogers S, Beauchamp A. Patients' perspectives of factors influencing active participation in healthcare interactions: A qualitative study. PATIENT EDUCATION AND COUNSELING 2023; 114:107808. [PMID: 37263050 DOI: 10.1016/j.pec.2023.107808] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/08/2023] [Accepted: 05/19/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To understand patients' perspectives of factors influencing their active participation in healthcare interactions. METHODS A descriptive qualitative approach informed by naturalistic inquiry was used to secondarily analyse interview and focus group data from a study that co-designed a communication-skills learning resource for patients. The COM-B Behaviour Model was used to explore factors that influenced patient participation in healthcare communication. Thirty-nine participants took part in either individual interviews (n = 25) or a focus group (n = 14). RESULTS From the COM-B domains nine factors emerged: capability (personal characteristics, patient language and culture, emotion or stress arising from the interaction), opportunity (time constraints, empowering actions, patient-clinician relationship, having a support person present) and motivation (preparation prior to the interaction, perception of patient-provider power imbalance). CONCLUSION Many of the factors influencing active patient participation are modifiable, suggesting barriers to effective communication are not insurmountable. Clinicians and patients both play a role in improving communication; effective strategies include agenda setting, cultural and communication skills training for staff, and teach-back. PRACTICE IMPLICATIONS Clinicians must be aware of the factors influencing patient active participation in healthcare interactions. Healthcare organisations should consider providing communication-skills training for clinicians so they can implement strategies to overcome communication barriers with patients.
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Affiliation(s)
- Natali Cvetanovska
- Monash Rural Health, Monash University, Warragul, Australia; Staying Well Program, Northern Health, Epping, Australia.
| | - Rebecca L Jessup
- Monash Rural Health, Monash University, Warragul, Australia; Staying Well Program, Northern Health, Epping, Australia
| | - Anna Wong Shee
- Deakin Rural Health, Deakin University, Melbourne, Australia; Grampians Health, Ballarat, Australia
| | | | - Alison Beauchamp
- Monash Rural Health, Monash University, Warragul, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Australia
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5
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Singer S, Riccetti N, Hempler I, Fried M, Knorrenschild JR, Kalie L, Merbach M, Reiser M, Mosthaf F, Heidt V, Hermes-Moll K. Awareness and use of psychosocial care among cancer patients and their relatives-a comparison of people with and without a migration background in Germany. J Cancer Res Clin Oncol 2022; 149:1733-1745. [PMID: 35689688 PMCID: PMC9188276 DOI: 10.1007/s00432-022-04091-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022]
Abstract
Purpose We examined how migration background is associated with awareness and usage of psycho-oncology services. Methods Oncologists in community-based practices and outpatient clinics asked their patients and their relatives to complete a questionnaire. Migrants were purposely over-sampled. The questionnaire was provided in Arabic, English, Farsi, French, German, Hindi, Kurdish, Pashto, Russian, Somali, Turkish, Urdu, and Vietnamese. Results From 9 collaborators, 177 participants were enrolled (130 with and 47 without migration background). The existence of outpatient cancer counselling centres was known to 38% of the participants without and 32% with migration background, self-help groups to 32 vs. 12%, and psychotherapy to 43 vs. 25%. Respondents from the Near and Middle East were less likely to know about psychotherapy (odds ratio (OR) 0.1, p = 0.01); those from the Commonwealth of the Independent States or former Yugoslavia were less often informed about self-help groups (OR 0.1, p = 0.06). Migrants retrieved information less frequently from the internet than non-migrants (10 vs. 25%). At least one service had been used by 27% of migrants and 42% of non-migrants (OR 0.5, p = 0.06). After adjusting for gender, age, education, and patient-relative status, there was no evidence for an association between migration background and service use. Conclusions Migrants should be better informed about psychotherapy and self-help groups, in particular the ones coming from the Near or Middle East and the Commonwealth of the Independent States or former Yugoslavia. The under-use of psychosocial services can largely be explained by confounding factors. Therefore, these factors must always be taken into account when analysing the use of psychosocial services in the aforementioned populations. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04091-1.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Nicola Riccetti
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany
- University Cancer Centre, Mainz, Germany
| | - Isabelle Hempler
- Scientific Institute of Office-Based Haematologists and Oncologists (WINHO), Cologne, Germany
| | | | | | - Louma Kalie
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, Albert-Ludwigs-University, Freiburg, Germany
| | - Martin Merbach
- Central Institute for Family Counselling, Berlin, Germany
- Association of Binational Families and Couples, Berlin, Germany
| | - Marcel Reiser
- Community-Based Practice for Medical Oncology, Cologne, Germany
| | - Franz Mosthaf
- Gemeinschaftspraxis für Hämatologie, Onkologie und Infektiologie, Zentrum für Ambulante Onkologie, Karlsruhe, Germany
| | - Vitali Heidt
- Scientific Institute of Office-Based Haematologists and Oncologists (WINHO), Cologne, Germany
| | - Kerstin Hermes-Moll
- Scientific Institute of Office-Based Haematologists and Oncologists (WINHO), Cologne, Germany
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6
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Aloudah NM. Qualitative research in the Arabic language. When should translations to English occur? A literature review. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 6:100153. [PMID: 35800471 PMCID: PMC9254492 DOI: 10.1016/j.rcsop.2022.100153] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/12/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022] Open
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7
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Hyatt A, Lipson-Smith R, Gough K, Butow P, Jefford M, Hack TF, Hale S, Zucchi E, White S, Ozolins U, Schofield P. Including migrant oncology patients in research: A multisite pilot randomised controlled trial testing consultation audio-recordings and question prompt lists. Contemp Clin Trials Commun 2022; 28:100932. [PMID: 35677588 PMCID: PMC9167883 DOI: 10.1016/j.conctc.2022.100932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/21/2022] [Accepted: 05/24/2022] [Indexed: 01/06/2023] Open
Abstract
Background Oncology patients who are migrants or refugees face worse outcomes due to language and communication barriers impacting care. Interventions such as consultation audio-recordings and question prompt lists may prove beneficial in mediating communication challenges. However, designing robust research inclusive of patients who do not speak English is challenging. This study therefore aimed to: a) pilot test and assess the appropriateness of the proposed research design and methods for engaging migrant populations, and b) determine whether a multi-site RCT efficacy assessment of the communication intervention utilising these methods is feasible. Methods This study is a mixed-methods parallel-group, randomised controlled feasibility pilot trial. Feasibility outcomes comprised assessment of: i) screening and recruitment processes, ii) design and procedures, and iii) research time and costing. The communication intervention comprised audio-recordings of a key medical consultation with an interpreter, and question prompt lists and cancer information translated into Arabic, Greek, Traditional, and Simplified Chinese. Results Assessment of feasibility parameters revealed that despite barriers, methods utilised in this study supported the inclusion of migrant oncology patients in research. A future multi-site RCT efficacy assessment of the INFORM communication intervention using these methods is feasible if recommendations to strengthen screening and recruitment are adopted. Importantly, hiring of bilingual research assistants, and engagement with community and consumer advocates is essential. Early involvement of clinical and interpreting staff as key stakeholders is likewise recommended. Conclusion Results from this feasibility RCT help us better understand and overcome the challenges and misconceptions about including migrant patients in clinical research. Migrant oncology patients face worse health outcomes due to language barriers. Consultation recording and question prompt lists are effective communication interventions. Designing robust research methods which overcome language barriers is important and achievable. Engaging with community advocates and hiring of bilingual staff are research design strategies.
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Bavelaar L, Nicula M, Morris S, Kaasalainen S, Achterberg WP, Loucka M, Vlckova K, Thompson G, Cornally N, Hartigan I, Harding A, Preston N, Walshe C, Cousins E, Dening KH, De Vries K, Brazil K, van der Steen JT. Developing country-specific questions about end-of-life care for nursing home residents with advanced dementia using the nominal group technique with family caregivers. PATIENT EDUCATION AND COUNSELING 2022; 105:965-973. [PMID: 34376304 DOI: 10.1016/j.pec.2021.07.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE We aimed to develop question prompt lists (QPLs) for family caregivers of nursing home residents with advanced dementia in the context of a study involving Canada, the Czech Republic, Italy, the Netherlands, the United Kingdom and Ireland, and to explore cross-national differences. QPLs can encourage family caregivers to ask questions about their relative's end-of-life care. METHODS We used nominal group methods to create country-specific QPLs. Family caregivers read an information booklet about end-of-life care for people with dementia, and generated questions to ask healthcare professionals. They also selected questions from a shortlist. We analyzed and compared the QPLs using content analysis. RESULTS Four to 20 family caregivers per country were involved. QPLs ranged from 15 to 24 questions. A quarter (24%) of the questions appeared in more than one country's QPL. One question was included in all QPLs: "Can you tell me more about palliative care in dementia?". CONCLUSION Family caregivers have many questions about dementia palliative care, but the local context may influence which questions specifically. Local end-user input is thus important to customize QPLs. PRACTICE IMPLICATIONS Prompts for family caregivers should attend to the unique information preferences among different countries. Further research is needed to evaluate the QPLs' use.
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Affiliation(s)
- Laura Bavelaar
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Nicula
- School of Nursing, McMaster University, Ontario, Canada
| | - Sophie Morris
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| | | | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | | | - Nicola Cornally
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Irene Hartigan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Andrew Harding
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Nancy Preston
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Catherine Walshe
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Emily Cousins
- School of Nursing and Midwifery, De Montfort University, Leicester, UK
| | - Karen Harrison Dening
- School of Nursing and Midwifery, De Montfort University, Leicester, UK; Dementia UK , London, UK
| | - Kay De Vries
- School of Nursing and Midwifery, De Montfort University, Leicester, UK
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; Department of Primary and Community Care, Radboud uNiversity Medical Center, Nijmegen, The Netherlands.
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Kwon DH, Karthikeyan S, Chang A, Borno HT, Koshkin VS, Desai A, Bose R, Friedlander T, Rodvelt T, Li P, Small EJ, Aggarwal RR, Belkora J. Mobile Audio Recording Technology to Promote Informed Decision Making in Advanced Prostate Cancer. JCO Oncol Pract 2021; 18:e648-e658. [PMID: 34932386 DOI: 10.1200/op.21.00480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Men with metastatic castration-resistant prostate cancer increasingly encounter complex treatment decisions. Consultation audio recordings and summaries promote patient informed decision making but are underutilized. Mobile recording software applications may increase access. Little is known regarding the feasibility of implementation in clinical encounters. METHODS We conducted a mixed-methods pilot study in men with progressive metastatic castration-resistant prostate cancer. We instructed patients to use a mobile software application to record an oncology visit. Patients could share the recording with our patient scribing program to receive a written summary. We assessed feasibility and acceptability with postvisit surveys. We measured patient-reported helpfulness of the intervention in decision making and change in Decisional Conflict Scale-informed subscale. We conducted semistructured interviews to explore implementation and analyzed transcripts using thematic analysis. RESULTS Across 20 patients, 18 (90%) recorded their visits. Thirteen of 18 (72%) listened to the recording, and 14 of 18 (78%) received a summary. Eighteen of 20 (90%) visits were telehealth. Fourteen patients (70% of all 20; 78% of 18 question respondents) found the application easy to use. Nine patients (50% of 18 recording patients; 90% of 10 question respondents) reported that the recording helped treatment decision making. Decisional conflict decreased from baseline to 1-week postvisit (47.4-28.5, P < .001). Interviews revealed benefits, facilitators, contextual factors, and technology and patient-related barriers to recordings and summaries. CONCLUSION In this single-institution academic setting, a mobile application for patients to record consultations was a feasible, acceptable, and potentially valued intervention that improved decision making in the telehealth setting. Studies in larger, diverse populations are needed.
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Affiliation(s)
- Daniel H Kwon
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Sneha Karthikeyan
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Alison Chang
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Hala T Borno
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Vadim S Koshkin
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Arpita Desai
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Rohit Bose
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Terence Friedlander
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Tammy Rodvelt
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Patricia Li
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Eric J Small
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Rahul R Aggarwal
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Jeffrey Belkora
- Department of Surgery, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA.,Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
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Scanlon B, Brough M, Wyld D, Durham J. Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping review. Global Health 2021; 17:87. [PMID: 34321015 PMCID: PMC8318324 DOI: 10.1186/s12992-021-00737-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023] Open
Abstract
International evidence suggests migrants experience inequitable access, outcomes and treatment quality across the cancer care continuum. There is currently limited research assessing equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia. A detailed protocol and search strategy were developed and used to identify all relevant literature, utilising the Joanna Briggs Institute Reviewer’s Manual. Systematic searching was conducted via multiple databases and identified studies were screened against pre-identified inclusion and exclusion criteria. 71 studies met the inclusion criteria for analysis. Most studies examined cancer detection via screening. Very few studies examined cancer prevention, diagnosis, treatment or palliative care. Most studies focused on patient-sided barriers to care and there was a paucity of information regarding institutional barriers to health. Cancer-related outcomes were seldom examined, and most studies were qualitative or behavioral analysis. Results highlighted significant communication issues spanning the cancer care continuum and a context of inadequate support for both patients and clinicians. There is a demonstrable need to examine equity in access and outcomes for culturally and linguistically diverse cancer populations. This requires the identification of cancer-related disparities and an examination of institutional barriers to care. Through addressing this dearth of information, future research and health policy can support the operationalisation of health equity.
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Affiliation(s)
- Brighid Scanlon
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia. .,Royal Brisbane and Women's Hospital, Butterfield Street, QLD, 4029, Herston, Australia.
| | - Mark Brough
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia
| | - David Wyld
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia.,Royal Brisbane and Women's Hospital, Butterfield Street, QLD, 4029, Herston, Australia.,University of Queensland, 20 Weightman Street, QLD, 4006, Herston, Australia
| | - Jo Durham
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia
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Chawak S, Chittem M, Maya S, Dhillon HM, Butow PN. The Question-prompt list (QPL): Why it is needed in the Indian oncology setting? Cancer Rep (Hoboken) 2021; 4:e1316. [PMID: 33295152 PMCID: PMC8451377 DOI: 10.1002/cnr2.1316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In India, caregivers are an integral part of the illness experience, especially in cancer, to the extent that they can become proxy decision-makers for the patient. Further, owing to acute resource constraints in the Indian healthcare system, it may be difficult for oncologists to assess and elicit questions from each patient/caregiver. Consequently, there is a need to address these unique aspects of oncology care in India to improve patient outcomes and understanding of their illness and treatment. This can be achieved through a Question Prompt List (QPL), a checklist used by care recipients during medical consultations. RECENT FINDINGS This narrative review will first introduce research on the development and effectiveness of the QPL, and then it will highlight current gaps in oncology care in India and explore how the QPL may aid in closing these gaps. A literature search of the empirical research focused on the development, feasibility and acceptability of the QPL in oncology settings was conducted. The final review included 40 articles pertaining to QPL research. Additionally, psycho-oncology research in India centered on information needs and experiences was reviewed. Current Indian psycho-oncology research reports patients' want to be actively involved in their cancer care and a need for more illness information. However, a high demand on physicians' resources and the family caregivers' interference can be barriers to meeting patients' information/communication needs. International research demonstrates that a QPL helps structure and decrease consultation time, improves patient satisfaction with care, and improves the quality of communication during medical encounters. CONCLUSION QPLs for Indian patients and caregivers may focus on the scope of medical consultations to address patient needs while influencing the course and content of the patient-caregiver-physician interactions. Further, it can address the resource constraints in Indian oncology care settings, thus reducing the physician's burden.
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Affiliation(s)
- Shweta Chawak
- Department of Liberal ArtsIndian Institute of Technology HyderabadHyderabadIndia
| | - Mahati Chittem
- Department of Liberal ArtsIndian Institute of Technology HyderabadHyderabadIndia
| | - Sravannthi Maya
- Department of Liberal ArtsIndian Institute of Technology HyderabadHyderabadIndia
| | - Haryana M. Dhillon
- Centre for Medical Psychology & Evidence‐based Decision‐making, School of PsychologyThe University of SydneySydneyNew South WalesAustralia
| | - Phyllis N. Butow
- Centre for Medical Psychology & Evidence‐based Decision‐making, School of PsychologyThe University of SydneySydneyNew South WalesAustralia
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12
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Housten AJ, Gunn CM, Paasche-Orlow MK, Basen-Engquist KM. Health Literacy Interventions in Cancer: a Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:240-252. [PMID: 33155097 PMCID: PMC8005416 DOI: 10.1007/s13187-020-01915-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 05/05/2023]
Abstract
Approximately one-third of adults in the United States (U.S.) have limited health literacy. Those with limited health literacy often have difficultly navigating the health care environment, including navigating care across the cancer continuum (e.g., prevention, screening, diagnosis, treatment). Evidence-based interventions to assist adults with limited health literacy improve health outcomes; however, little is known about health literacy interventions in the context of cancer and their impact on cancer-specific health outcomes. The purpose of this review was to identify and characterize the literature on health literacy interventions across the cancer care continuum. Specifically, our aim was to review the strength of evidence, outcomes assessed, and intervention modalities within the existing literature reporting health literacy interventions in cancer. Our search yielded 1036 records (prevention/screening n = 174; diagnosis/treatment n = 862). Following deduplication and review for inclusion criteria, we analyzed 87 records of intervention studies reporting health literacy outcomes, including 45 pilot studies (prevention/screening n = 24; diagnosis/treatment n = 21) and 42 randomized controlled trials or quasi-experimental trials (prevention/screening n = 31; diagnosis/treatment n = 11). This literature included 36 unique interventions (prevention/screening n = 28; diagnosis/treatment n = 8), mostly in the formative stages of intervention development, with few assessments of evidence-based interventions. These gaps in the literature necessitate further research in the development and implementation of evidence-based health literacy interventions to improve cancer outcomes.
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Affiliation(s)
- A J Housten
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, 660 S. Euclid Ave. Campus Box 8100, St. Louis, MO, 63110, USA.
| | - C M Gunn
- Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - M K Paasche-Orlow
- Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - K M Basen-Engquist
- Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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13
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Dommershuijsen LJ, Dedding CWM, Van Bruchem-Visser RL. Consultation Recording: What Is the Added Value for Patients Aged 50 Years and Over? A Systematic Review. HEALTH COMMUNICATION 2021; 36:168-178. [PMID: 31556750 DOI: 10.1080/10410236.2019.1669270] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This systematic review aimed to provide medical professionals with insight into beneficial and harmful effects of consultation recording for patients aged 50 years and over. This insight could enable medical professionals to decide on whether or not to promote consultation recording in their practice. The systematic literature search was performed in six databases; additional relevant articles were sought using the snowball method. Studies were included that investigated the value of consultation recording for patients aged 50 years and over. The selected studies were analyzed on affective cognitive outcomes, behavioral outcomes, and health outcomes. Twenty-five studies of both qualitative and quantitative design were included. Consultation recordings mainly improved patient satisfaction, recall, fulfillment of information needs, and decision-making. Both positive and negative effects were reported on anxiety. The recordings did not distinctly affect functional outcomes or quality of life. In conclusion, consultation recording positively influenced patients' affective cognitive and behavioral outcomes, and the negative effects of consultation recording were minor. Because of the positive effects of consultation replay, we recommend that doctors promote consultation recording among their patients of 50 years and over. However, more studies are necessary among older patients because this patient population is underrepresented in the current literature.
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Prictor M, Johnston C, Hyatt A. Overt and covert recordings of health care consultations in Australia: some legal considerations. Med J Aust 2020; 214:119-123.e1. [PMID: 33131072 DOI: 10.5694/mja2.50838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Megan Prictor
- Melbourne Law School, University of Melbourne, Melbourne, VIC
| | | | - Amelia Hyatt
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC
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15
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Filler T, Foster AM, Grace SL, Stewart DE, Straus SE, Gagliardi AR. Patient-Centered Care for Women: Delphi Consensus on Evidence-Derived Recommendations. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:1012-1019. [PMID: 32828212 DOI: 10.1016/j.jval.2020.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/06/2020] [Accepted: 03/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Patient-centered care (PCC) could reduce gender inequities in quality of care. Little is known about how to implement patient-centered care for women (PCCW). We aimed to generate consensus recommendations for achieving PCCW. METHODS We used a 2-round Delphi technique. Panelists included 21 women of varied age, ethnicity, education, and urban/rural residence; and 21 health professionals with PCC or women's health expertise. Panelists rated recommendations, derived from prior research and organized by a 6-domain PCC framework, on a 7-point Likert scale in an online survey. We used summary statistics to report response frequencies and defined consensus as when ≥85% panelists chose 5 to 7. RESULTS The response rate was 100%. In round 1, women and professionals retained 46 (97.9%) and 42 (89.4%) of 47 initial recommendations, respectively. The round 2 survey included 6 recommendations for women and 5 recommendations for professionals (did not achieve consensus in round 1 or were newly suggested). In round 2, women retained 2 of 6 recommendations and professionals retained 3 of 5 recommendations. Overall, 49 recommendations were generated. Both groups agreed on 44 (94.0%) recommendations (13 retained by 100% of both women and clinicians): fostering patient-physician relationship (n = 11), exchanging information (n = 10), responding to emotions (n = 4), managing uncertainty (n = 5), making decisions (n = 8), and enabling patient self-management (n = 6). CONCLUSION The recommendations represent the range of PCC domains, are based on evidence from primary research, and reflect high concordance between women and professional panelists. They can inform the development of policies, guidelines, programs, and performance measures that foster PCCW.
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Affiliation(s)
- Tali Filler
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Angel M Foster
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Donna E Stewart
- Centre for Mental Health, University Health Network, Toronto, Canada
| | - Sharon E Straus
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
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16
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Ozolins U, Hale S, Cheng X, Hyatt A, Schofield P. Translation and back-translation methodology in health research – a critique. Expert Rev Pharmacoecon Outcomes Res 2020; 20:69-77. [DOI: 10.1080/14737167.2020.1734453] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Uldis Ozolins
- School of Humanities and Languages, University of New South Wales, Sydney, Australia
| | - Sandra Hale
- School of Humanities and Languages, University of New South Wales, Sydney, Australia
| | - Xiang Cheng
- School of Humanities and Languages, University of New South Wales, Sydney, Australia
| | - Amelia Hyatt
- Behavioural Sciences Unit, Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Penelope Schofield
- Behavioural Sciences Unit, Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Psychology, And Iverson Health Innovation Research Institute, Swinburne University, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
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Hyatt A, Lipson-Smith R, Morkunas B, Krishnasamy M, Jefford M, Baxter K, Gough K, Murphy D, Drosdowsky A, Phipps-Nelson J, White F, White A, Serong L, McDonald G, Milne D. Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study. JMIR Mhealth Uhealth 2020; 8:e15593. [PMID: 31961333 PMCID: PMC7001044 DOI: 10.2196/15593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/30/2019] [Accepted: 10/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False.
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Affiliation(s)
- Amelia Hyatt
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ruby Lipson-Smith
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Bryce Morkunas
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Meinir Krishnasamy
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Nursing, University of Melbourne, Melbourne, Australia.,Victorian Comprehensive Cancer Centre, Melbourne, Australia.,Centre for Cancer Research, The University of Melbourne, Melbourne, Australia
| | - Michael Jefford
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Kathryn Baxter
- Health Information Management, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Karla Gough
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Declan Murphy
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Allison Drosdowsky
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Jo Phipps-Nelson
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Fiona White
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Alan White
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Lesley Serong
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Geraldine McDonald
- Prevention and Wellbeing, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Donna Milne
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
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18
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Lipson-Smith R, White F, White A, Serong L, Cooper G, Price-Bell G, Hyatt A. Co-Design of a Consultation Audio-Recording Mobile App for People With Cancer: The SecondEars App. JMIR Form Res 2019; 3:e11111. [PMID: 30860487 PMCID: PMC6434400 DOI: 10.2196/11111] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/10/2018] [Accepted: 10/15/2018] [Indexed: 11/14/2022] Open
Abstract
Background Many patients choose to audio-record their medical consultations so that they can relisten to them at home and share them with family. Consultation audio-recordings can improve patients’ recall and understanding of medical information and increase their involvement in decision making. A hospital-endorsed consultation audio-recording mobile app would provide patients with the permission and means to audio-record their consultations. The Theory of Planned Behavior provides a framework for understanding how patients can be encouraged to appropriately audio-record consultations. Objective The aim of this study was to use a co-design process to develop a consultation audio-recording mobile app called SecondEars. Methods App development began with stakeholder engagement, followed by a series of 6 co-design workshops and then user acceptance testing. Stakeholder engagement included advice from legal, information technology (IT), clinical and allied health leads; digital strategy; and medical records. he co-design workshops were attended by: patient consumers, members of the research team, IT staff, the app designers, clinicians, and staff from medical records. During workshops 1 to 4, the purpose and scope of the app were refined, possible pitfalls were addressed, and design features were discussed. The app designers then incorporated the results from these workshops to produce a wireframe mock-up of the proposed SecondEars app, which was presented for feedback at workshops 5 and 6. Results The stakeholders identified 6 requirements for the app, including that it be patient driven, secure, clear in terms of legal responsibilities, linked to the patient’s medical record, and that it should require minimal upfront and ongoing resources. These requirements informed the scope of the co-design workshops. The workshops were attended by between 4 and 13 people. The workshop attendees developed a list of required features and suggestions for user interface design. The app developers used these requirements and recommendations to develop a prototype of the SecondEars app in iOS, which was then refined through user acceptance testing. Conclusions The SecondEars app allows patients to have control and autonomy over audio-recording and sharing their consultations while maintaining privacy and safety for medical information and legal protection for clinicians. The app has been designed to have low upkeep and minimal impact on clinical processes. The SecondEars prototype is currently being tested with patients in a clinical setting.
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Affiliation(s)
- Ruby Lipson-Smith
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | | | | | - Guy Cooper
- Wave Digital, Melbourne, Victoria, Australia
| | | | - Amelia Hyatt
- Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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