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Sweileh WM. Analysis and mapping the research landscape on patient-centred care in the context of chronic disease management. J Eval Clin Pract 2024; 30:638-650. [PMID: 38567707 DOI: 10.1111/jep.13988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 02/07/2024] [Accepted: 03/18/2024] [Indexed: 05/25/2024]
Abstract
RATIONALE Patient-centred care has emerged as a transformative approach in managing chronic diseases, aiming to actively involve patients in their healthcare decisions. AIMS AND OBJECTIVES This study was conducted to analyse and map the research landscape on patient-centred care in the context of chronic disease management. METHODS This study used Scopus to retrieve the relevant articles. The analysis focused on the growth pattern, highly cited articles, randomised clinical trials, patients and providers perspectives, facilitators and barriers, frequent author keywords, emerging topics, and prolific countries and journals in the field. RESULTS In total, 926 research articles met the inclusion criteria. There was a notable increase in the number of publications over time. Cancer had the highest number of articles (n = 379, 40.9%), followed by diabetes mellitus, and mental health and psychiatric conditions. Studies on patient-centred care in diabetic patients received the highest number of citations. The results identified 52 randomised controlled trials that covered four major themes: patient-centred care for diabetes management, shared decision-making in mental health and primary care, shared decision-making in cancer care, and economic evaluation and cost-effectiveness. The study identified 51 studies that examined the impact of tools such as computer-based systems, decision aids, smartphone apps, and online tools to improve patient-centred outcomes. A map of author keywords showed that renal dialysis, HIV, and atrial fibrillation were the most recent topics in the field. Researchers from the United States contributed to more than half of the retrieved publications. The top active journals included "Patient Education and Counselling" and "Health Expectations". CONCLUSION This study provides valuable insights into the research landscape of patient-centred care within the context of chronic diseases. The current study provided a comprehensive overview of the research landscape on patient-centred care, which can empower patients by raising their awareness about clinical experiences and outcomes.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology and Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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2
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Huertas-Zurriaga A, Alonso-Fernández S, Leyva-Moral JM. Reproductive Decision Making of Spanish Women Living With HIV: A Constructivist Grounded Theory Study. J Assoc Nurses AIDS Care 2024; 35:201-209. [PMID: 38417079 DOI: 10.1097/jnc.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
ABSTRACT The process of reproductive decision making among women living with HIV is intricate and multifaceted, influenced by health considerations, societal factors, and personal values. In this study, we employed Charmaz's Constructivist Grounded Theory to understand how Spanish women living with HIV make decisions regarding reproduction. We conducted 26 face-to-face interviews until data saturation was achieved. Findings suggested that social constructs such as femininity and motherhood play a significant role in the reproductive decision-making process for women living with HIV. The women's beliefs about HIV, doubts, marginalizing situations, and health barriers create challenges to making reproductive decisions. These findings provide valuable implications for designing care plans that meet the unique sexual and reproductive health needs of women with HIV. An integrated and comprehensive multidisciplinary counseling approach is necessary to improve the quality of care.
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Affiliation(s)
- Ariadna Huertas-Zurriaga
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Sergio Alonso-Fernández
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Juan M Leyva-Moral
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
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3
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Zagt AC, Bos N, Bakker M, de Boer D, Friele RD, de Jong JD. A scoping review into the explanations for differences in the degrees of shared decision making experienced by patients. PATIENT EDUCATION AND COUNSELING 2024; 118:108030. [PMID: 37897867 DOI: 10.1016/j.pec.2023.108030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVES In order to improve the degree of shared decision making (SDM) experienced by patients, it is necessary to gain insight into the explanations for the differences in these degrees. METHODS A scoping review of the literature on the explanations for differences in the degree of SDM experienced by patients was conducted. We assessed 21,329 references. Ultimately, 308 studies were included. The explanations were divided into micro, meso, and macro levels. RESULTS The explanations are mainly related to the micro level. They include explanations related to the patient and healthcare professionals, the relationship between the patient and the physician, and the involvement of the patient's relatives. On the macro level, explanations are related to restrictions within the healthcare system such as time constraints, and adequate information about treatment options. On the meso level, explanations are related to the continuity of care and the involvement of other healthcare professionals. CONCLUSIONS SDM is not an isolated process between the physician and patient. Explanations are connected to the macro, meso, and micro levels. PRACTICE IMPLICATIONS This scoping review suggests that there could be more focus on explanations related to the macro and meso levels, and on how explanations at different levels are interrelated.
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Affiliation(s)
- Anne C Zagt
- Nivel, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, the Netherlands.
| | - Nanne Bos
- Nivel, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, the Netherlands
| | - Max Bakker
- Nivel, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, the Netherlands
| | - Dolf de Boer
- Nivel, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, the Netherlands
| | - Roland D Friele
- Nivel, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, the Netherlands; Tranzo Scientifc Center for Care and Wellbeing, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands
| | - Judith D de Jong
- Nivel, the Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, the Netherlands; CAPHRI, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
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Rodriguez Gonzalez H, Volcan AI, Castonguay BJU, Carda-Auten J, Ruiz C, Peretti M, Suarez A, Kerrigan D, Wohl DA, Barrington C. "What Is the Benefit?": Perceptions and Preferences for Long-Acting Injectable Antiretroviral Therapy Among People Living With HIV. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:467-483. [PMID: 38096455 PMCID: PMC10785827 DOI: 10.1521/aeap.2023.35.6.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Long-acting injectable antiretroviral therapy (LA-ART) expands treatment options for people living with HIV (PLWH). This qualitative study characterizes LA-ART awareness, perceptions, and preferences among PLWH engaged in HIV care. From 2019 through 2021, we conducted semistructured in-depth interviews with 71 PLWH sampled from three clinics in three U.S. settings (North Carolina, Washington, DC, Massachusetts). Transcripts were analyzed using narrative and thematic techniques. Participant mean age was 46 years (range 24-72); most were cisgender men (55%) and virally suppressed (73%). Most participants had not heard of LA-ART and reacted with a mix of excitement and cautiousness. Potential LA-ART benefits included easier adherence, privacy, and effectiveness; concerns included effectiveness, side effects, costs, and increased clinic visits. Participants appreciated that LA-ART could support achieving and sustaining viral suppression. To inform their decision, participants wanted more information and convenient access and administration. Findings indicated that a shared decision-making approach and economic and logistical support for PLWH could facilitate LA-ART uptake.
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Affiliation(s)
- Humberto Rodriguez Gonzalez
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina
| | - Andrea Isabel Volcan
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, North Carolina
| | - Breana Jae Uhrig Castonguay
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, North Carolina
| | - Jessica Carda-Auten
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, North Carolina
| | - Carolina Ruiz
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina
| | - Matteo Peretti
- Fenway Institute at Fenway Health, Boston, Massachusetts
| | - Angela Suarez
- Program Integration and Evaluation, La Clinica Del Pueblo, Washington, D.C
| | - Deanna Kerrigan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, D.C
| | - David Alain Wohl
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, North Carolina
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina
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Beichler H, Kutalek R, Dorner TE. People Living with HIV and AIDS: Experiences towards Antiretroviral Therapy, Paradigm Changes, Coping, Stigma, and Discrimination-A Grounded Theory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3000. [PMID: 36833695 PMCID: PMC9962544 DOI: 10.3390/ijerph20043000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The experiences in coping with HIV/AIDS from people living with HIV (PLWH) in Austria, Munich, and Berlin regarding adherence, antiretroviral therapy (ART), stigmatization, and discrimination were the main focus of this study. Therapy adherence is the cornerstone for PLWH to reduce disease progression and increase life expectancy combined with a high quality of life. The experience of stigmatization and discrimination in different life situations and settings is still experienced today. AIMS We aimed to examine the subjective perspective of PLWH concerning living with, coping with, and managing HIV/AIDS in daily life. METHODS Grounded Theory Methodology (GTM) was used. Data collection was conducted with semi-structured face-to-face interviews with 25 participants. Data analysis was performed in three steps, open, axial, and selective coding. RESULTS Five categories emerged, which included the following: (1) fast coping with diagnosis, (2) psychosocial burden due to HIV, (3) ART as a necessity, (4) building trust in HIV disclosure, (5) stigmatization and discrimination are still existing. CONCLUSION In conclusion, it can be said that it is not the disease itself that causes the greatest stress, but the process of coping with the diagnosis. Therapy, as well as lifelong adherence, is hardly worth mentioning today. Much more significant is currently still the burden of discrimination and stigmatization.
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Affiliation(s)
- Helmut Beichler
- Nursing School, General Hospital, Medical University Vienna, 1090 Vienna, Austria
| | - Ruth Kutalek
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Thomas E. Dorner
- Academy for Ageing Research, Haus der Barmherzigkeit, 1160 Vienna, Austria
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria
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Homerova I, Patel A, Macallan DC. ‘We want it all’:
ART
preferences assessed by
D
esirability of
O
utcome
R
anking. HIV Med 2022; 24:588-595. [PMID: 36457194 DOI: 10.1111/hiv.13447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES Understanding how people living with HIV (PLWH) view antiretroviral therapy (ART) prescribing choices is fundamental to patient-centred care. We used the Desirability of Outcome Ranking (DOOR) approach to explore patient ART preferences. METHODS Seventy-four PLWH entered the study, 20 into the 'pilot study', and 54 in the 'comparative study'. Participants ranked five different hypothetical patient stories by desirability. Each story comprised five narrative lines, each line addressing one treatment characteristic drawn from one of five pre-selected domains (treatment failure, treatment difficulty, adverse effects, long-term complications, life events). Narrative lines could be favourable or adverse. In the pilot study the number of adverse domains varied from one to five. Comparative study stories were fixed at two adverse versus three favourable domains, to test the relative ranking of different domains. RESULTS The pilot study identified a relationship between the number of adverse domains and rank (R2 = 0.54; p < 0.0001, Friedman test), however pairwise differences in ranking were not significant beyond three adverse domains. In the comparative study, all domains were ranked equally across the cohort (p = 0.88; Friedman test). In pre-defined demographic subgroup analyses, women ranked the 'treatment failure' domain significantly less desirable than men (p = 0.0014, Mann-Whitney test). CONCLUSIONS People living with HIV appear to care equally about all aspects of ART. The observation that male and female PLWH have different treatment priorities merits further investigation in larger studies. Interindividual differences highlight the importance of individualized shared decision-making and treatment personalization. DOOR may have a role as a pre-treatment assessment tool as well as a research technique.
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Affiliation(s)
- Ivana Homerova
- Institute for Infection & Immunity, St George's, University of London London UK
| | - Avani Patel
- Institute for Infection & Immunity, St George's, University of London London UK
| | - Derek C. Macallan
- Institute for Infection & Immunity, St George's, University of London London UK
- Infection Clinical Academic Group, St George's University Hospitals NHS Foundation Trust London UK
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7
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Beichler H, Grabovac I, Leichsenring B, Dorner TE. Involvement, Perception, and Understanding as Determinants for Patient-Physician Relationship and Their Association with Adherence: A Questionnaire Survey among People Living with HIV and Antiretroviral Therapy in Austria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10314. [PMID: 36011949 PMCID: PMC9408219 DOI: 10.3390/ijerph191610314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The relationship between patients and healthcare professionals (physicians) is the cornerstone of successful long-term antiretroviral therapy for people living with human immunodeficiency virus (HIV). PURPOSE This study aimed to investigate the connection between involvement, perception, and understanding as the basis for the patient-physician relationship and drug adherence, measured as the probability of non-adherence. METHODS In an online survey, people with HIV were asked about their relationship with their physicians and the extent to which they felt involved in treatment-related decisions. A statistical analysis was conducted to determine whether a better patient-physician relationship was associated with higher adherence to therapy. This was performed by univariate group comparison (Mann-Whitney-U, Fishers Exact Test) and logistic regression. RESULTS A total of 303 persons living with HIV participated in the survey, and 257 patients were included in the analysis. Overall, 27.6% were classified as non-adherent and self-reporting based on whether an antiretroviral therapy (ART) was taken in the past or how often the ART was interrupted. This proportion was significantly higher among patients aged 50-74 years (39.7%) and those with a longer therapy duration (9-15 years: 46.6%; from 15 years on: 55.8%). Therapy-non-adherent patients showed significantly lower scores in the relationship aspects understanding (2.68 vs. 3.03), participation (2.63 vs. 3.07), and perception (3.00 vs. 3.24) compared to adherent patients. Logistic regression analysis confirms that higher scores for understanding, involvement, and perception are strongly associated with a reduction in the risk of becoming non-adherent. This was true for all examined regression models, regardless of whether they were adjusted for the length of therapy and socio-demographic characteristics. CONCLUSION The results reinforce the need for awareness among health care professionals (HCP) regarding understanding, involvement, and perception as important aspects to improve the quality of the patient-physician relationship for high adherence levels with maximized non-adherence in ART management by PLWH.
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Affiliation(s)
- Helmut Beichler
- General Hospital, Nursing School, Medical University Vienna, 1090 Wien, Austria
| | - Igor Grabovac
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, 1090 Wien, Austria
| | | | - Thomas Ernst Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Unite Lifestyle and Prevention, Medical University of Vienna, 1090 Wien, Austria
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8
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Poor Self-efficacy for Healthcare Provider Interactions Among Individuals with HIV-Associated Neurocognitive Disorders. J Clin Psychol Med Settings 2020; 26:13-24. [PMID: 29557544 DOI: 10.1007/s10880-018-9560-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Two factors that influence HIV health behaviors and therefore may contribute to gaps in the HIV treatment continuum are poor health-related self-efficacy and HIV-associated neurocognitive disorders (HAND). However, the relationship between HAND and self-efficacy has not been assessed. In an HIV sample, 91 individuals with intact cognition (HAND-) and 40 individuals with HAND (HAND+) were administered a measure of self-efficacy for healthcare interactions with providers. Participants with HAND had significantly lower scores on this measure, which were correlated with poorer episodic and semantic memory performance, as well as self-reported memory symptoms in daily life. Findings suggest that neurocognitive impairment, and particularly memory dysfunction, may play an important role in self-efficacy for healthcare interactions in HIV. Further examination of the interplay between HAND and self-efficacy is warranted as these two factors may be important for the public health goal of identifying targets for improving access, delivery, and maintenance of HIV care.
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Huang RC, Song XT, Zhang DF, Xu JY, Boehmer KR, Leppin AA, Gionfriddo MR, Ting HH, Montori VM. Preferences and attitudes of young Chinese clinicians about using a shared decision making tools for communicating cardiovascular risk. Chronic Dis Transl Med 2019; 5:105-112. [PMID: 31367699 PMCID: PMC6656904 DOI: 10.1016/j.cdtm.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study assesses the attitudes and preferences of Chinese clinicians toward their involvement in shared decision making (SDM). METHODS From May 2014 to May 2015, 200 Chinese clinicians from two hospitals were enrolled to complete a survey on their attitude towards SDM. We conducted the survey via face-to-face interviews before and after an educational intervention on SDM among young Chinese clinicians. The clinicians were asked to give the extent of agreement to SDM. They also gave the extent of difficulty in using decision aids (DAs) during the SDM process. The variation in the range of responses to each question before and after the SDM intervention was recorded. The frequency of changed responses was analyzed by using JMP 6.0 software. Data were statistically analyzed using Chi-square and Mann-Whitney U tests, as appropriate to the data type. Multiple logistic regressions were used to test for those factors significantly and independently associated with preference for an approach for each scenario. RESULTS Of the 200 young Chinese clinicians sampled, 59.0% indicated a preference for SDM and a desire to participate in SDM before receiving education or seeing the DA, and this number increased to 69.0% after seeing the DA with the sample video of the SDM process on Statin Choice. However, 28.5% of the respondents still reported that, in their current practice, they make clinical decisions on behalf of their patients. The clinicians who denied a desire to use the DA stated that the main barriers to implement SDM or DA use in China are lack of time and knowledge of SDM. CONCLUSIONS Most young Chinese clinicians want to participate in SDM. However, they state the main barriers to perform SDM are lack of experience and time. The educational intervention about SDM that exposes clinicians to DAs was found to increase their receptivity.
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Affiliation(s)
- Rong-Chong Huang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China
| | - Xian-Tao Song
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Dong-Feng Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jia-Ying Xu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China
| | - Kasey R. Boehmer
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55902, USA
| | - Aaron A. Leppin
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55902, USA
| | - Michael R. Gionfriddo
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55902, USA
- Mayo Graduate School, Mayo Clinic, Rochester, MN 55902, USA
| | - Henry H. Ting
- Division of Cardiology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Victor M. Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55902, USA
- Division of Endocrinology, Mayo Clinic, Rochester, MN 55902, USA
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Yan H, Cao W, Mo P, Huan X, Wang Z, Lin X, Wang X, Gu L, Wang P, Agudile E, Lau J. Prevalence and associated factors of HIV serostatus disclosure to regular female sex partners among HIV-positive men who have sex with both men and women in China. AIDS Care 2019; 31:1026-1034. [PMID: 31046414 DOI: 10.1080/09540121.2019.1612002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
HIV-positive men who have sex with men and women (MSMW) may transmit HIV to regular female sexual partners (FSPs, including girlfriend and wife) through unprotected sex. FSPs' awareness of the HIV serostatus of the MSMW promotes them to access services. However, the prevalence of HIV disclosure among MSMW was low, and factors associated with this disclosure are largely unknown. This study aimed to examine factors associated with HIV disclosure to regular FSPs among HIV-positive MSMW. We recruited 432 HIV-positive MSMW from three provinces of China and collected information on participants' individual characteristics and interpersonal relationships with their FSPs using individualized structured questionnaire. Univariate and multivariate logistic regression were used for data analysis. The prevalence of HIV disclosure to their most recent FSPs was 49.8%. Facilitators of HIV disclosure included the presence of HIV/AIDS symptoms, perceiving this partner's HIV status as positive, exposure to counseling favoring disclosure, inconsistent condom use, and this partner's acknowledgment of MSM identity. Barriers against HIV disclosure included unknown HIV serostatus of this partner and an instrumental relationship to hide MSM identity. HIV disclosure to regular FSPs was low. Programs should target priority subgroups. Services in counseling favoring disclosure and partner HIV testing should be enhanced.
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Affiliation(s)
- Hongjing Yan
- a Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , People's Republic of China
| | - Wangnan Cao
- b Division of Behavioral Health and Health Promotion , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong , People's Republic of China
| | - Phoenix Mo
- b Division of Behavioral Health and Health Promotion , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong , People's Republic of China
| | - Xiping Huan
- a Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , People's Republic of China
| | - Zixin Wang
- b Division of Behavioral Health and Health Promotion , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong , People's Republic of China
| | - Xiaojie Lin
- c Chengdu Community Gay Care Organization , Chengdu , People's Republic of China
| | - Xiaodong Wang
- c Chengdu Community Gay Care Organization , Chengdu , People's Republic of China
| | - Li Gu
- d Hebei Light of Love Group Caring for People Living with HIV , Baoding , People's Republic of China
| | - Peng Wang
- d Hebei Light of Love Group Caring for People Living with HIV , Baoding , People's Republic of China
| | - Emeka Agudile
- e Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Harvard University , Boston , MA , US
| | - Joseph Lau
- b Division of Behavioral Health and Health Promotion , JC School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong , People's Republic of China.,f Shenzhen Research Institute , The Chinese University of Hong Kong , Shenzhen , People's Republic of China.,g School of Public Health , Zhejiang University School of Medicine , Hangzhou , People's Republic of China
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11
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Fuller SM, Koester KA, Erguera XA, Wilde Botta E, von Beetzen F, Steward WT, Avery A. The collaborative care model for HIV and depression: Patient perspectives and experiences from a safety-net clinic in the United States. SAGE Open Med 2019; 7:2050312119842249. [PMID: 31044076 PMCID: PMC6446432 DOI: 10.1177/2050312119842249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 03/14/2019] [Indexed: 12/22/2022] Open
Abstract
Objectives: Collaborative care models may improve outcomes for both HIV and depression. The model includes routine screening and re-assessment of depressive symptoms as well as care coordination services delivered by an ancillary provider focused on mental health. We sought to explore patient experiences and attitudes about the services received through the collaborative care model, including measurement-based care using the Patient Health Questionnaire-9. Methods: We conducted 17 qualitative interviews with patients in a collaborative care model implemented at an HIV primary care clinic in a safety-net hospital in the United States. Interviews were analyzed using Framework Analysis. Results: Our findings illustrate the ways in which the collaborative care model for depression may be meaningful to patients in HIV care settings. Participants appreciated the support offered through the collaborative care model. Most participants perceived measurement-based care as useful to their providers, and an additional subset used the Patient Health Questionnaire-9 for their own self-management and awareness of depression. Over time, the collaborative care model appeared to motivate some patients to address depressive symptoms. Conclusion: The collaborative care model may be particularly helpful to patients in the way that it reinforces how depressive symptoms can be measured and managed. Furthermore, routine screening and re-measurement for depressive symptoms using the Patient Health Questionnaire-9 hold promise as an additional self-management tool to complement other clinical and supportive services.
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Affiliation(s)
- Shannon M Fuller
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Kimberly A Koester
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Xavier A Erguera
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Emma Wilde Botta
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Fredrik von Beetzen
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Wayne T Steward
- Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA
| | - Ann Avery
- MetroHealth Medical Center, Cleveland, OH, USA.,Case Western Reserve University, School of Medicine, Cleveland, OH, USA
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12
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Understanding of Key Obstetric Quality Terminology by Asian and Pacific Islander Subgroups: Implications for Patient Engagement and Health Equity. Matern Child Health J 2018; 22:1543-1549. [PMID: 30006728 DOI: 10.1007/s10995-018-2597-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction Comprehension of healthcare terminology across diverse populations is critical to patient education and engagement. Methods Women in Oahu, Hawai'i with a recent delivery were interviewed about their understanding of ten common obstetric terms. Health literacy was assessed by the rapid estimate of adult literacy in medicine (REALM). Multivariable models predicted total terms comprehended by demographic factors. Results Of 269 participants, self-reported primary race was 20.5% Japanese, 19.0% Native Hawaiian, 19.0% White, 16.7% Filipino, 11.5% other Asian, 9.7% other Pacific Islander, and 3.7% other race/ethnicity; 12.7% had low health literacy. On average, participants understood 6.0 (SD: 2.2) of ten common obstetric terms. Comprehension varied by term, ranging from 97.8% for "Breastfeeding" to 27.5% for "VBAC routinely available." Models showed (1) being Filipino, Japanese, Native Hawaiian, or other Pacific Islander (vs. white); (2) having low (vs. adequate) health literacy; (3) having a high school (vs. a college) degree; and (4) being under 25-years-old (vs. 35 +) were significantly associated with less comprehension. Discussion Participants were unfamiliar with common obstetrics terminology. Comprehension struggles were more common among populations with maternal health disparities, including Asian and Pacific Islander subgroups, and those with low health literacy.
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13
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Wachira J, Genberg B, Kafu C, Braitstein P, Laws MB, Wilson IB. Experiences and expectations of patients living with HIV on their engagement with care in Western Kenya. Patient Prefer Adherence 2018; 12:1393-1400. [PMID: 30122904 PMCID: PMC6078080 DOI: 10.2147/ppa.s168664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE In resource-limited HIV care settings, effective and innovative interventions that respond to the existing challenges along the HIV care continuum are urgently needed to realize the benefits of antiretroviral therapy (ART). Initiating effective ART adherence dialog in an environment that promotes patient engagement in care is key. It is therefore critical to enhance our understanding about how patients living with HIV in these regions conceptualize and experience patient engagement. This study explores HIV patients' perceptions, experiences and expectations of their engagement in care. MATERIALS AND METHODS We sampled 86 patients from three Academic Model for Providing Access to Healthcare (AMPATHplus) sites, one urban and two rural. We conducted 24 in-depth interviews and eight focus group discussions in either Swahili or English. Audio recordings of the interviews were transcribed, and then translated into English. We performed content analysis after thematic coding. RESULTS Patients living with HIV in Kenya desire active engagement with care. However, their engagement was inconsistent and varied depending on the provider. Patients had a sense of how provider's interpersonal behaviors influenced their level of engagement. These included various aspects of provider-patient communication and relationship dynamics. Patients also highlighted relational boundaries that influenced the level and kind of information they shared with their providers. Aspects of their psychological, social or economic wellbeing were often viewed as personal and not discussed with their clinicians. Patients identified factors that would promote or impede their engagement with care including those related to patients themselves, providers, and the healthcare system. CONCLUSION Patients living with HIV desired more active engagement in their care. In addition, they desired clinicians to engage in more social behaviors to promote patient engagement. To address existing patient engagement barriers, HIV care systems in the region should apply contextualized patient-centered interventions.
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Affiliation(s)
- Juddy Wachira
- Department of Behavioral Sciences, School of Medicine, Moi University, Eldoret, Kenya,
- Department of Epidemiology, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA,
| | - Becky Genberg
- Academic Model Providing Access to Healthcare (AMPATH) Partnership, Eldoret, Kenya
| | - Catherine Kafu
- Department of Epidemiology, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA,
| | - Paula Braitstein
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Michael Barton Laws
- Department of Health Services, Policy and Practice, Brown University, Providence, RI, USA
| | - Ira B Wilson
- Department of Health Services, Policy and Practice, Brown University, Providence, RI, USA
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14
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Lytvyn L, Siemieniuk RA, Dilmitis S, Ion A, Chang Y, Bala MM, Manja V, Mirza R, Rodriguez-Gutierrez R, Mir H, El Dib R, Banfield L, Vandvik PO, Bewley S. Values and preferences of women living with HIV who are pregnant, postpartum or considering pregnancy on choice of antiretroviral therapy during pregnancy. BMJ Open 2017; 7:e019023. [PMID: 28893759 PMCID: PMC5988094 DOI: 10.1136/bmjopen-2017-019023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/17/2017] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To investigate women's values and preferences regarding antiretroviral therapy (ART) during pregnancy to inform a BMJ Rapid Recommendation. SETTING Primary studies reporting patient-reported outcomes relevant to decision-making regarding ART in any clinical and geographical setting. PARTICIPANTS Women living with HIV who are pregnant, postpartum or considering pregnancy. OUTCOME MEASURES Quantitative measurements and qualitative descriptions of values and preferences in relation to ART during pregnancy. We also included studies on women's reported barriers and facilitators to adherence. We excluded studies correlating objective measures (eg, CD4 count) with adherence, or reporting only outcomes which are not expected to differ between ART alternatives (eg, access to services, knowledge about ART). RESULTS We included 15 qualitative studies reporting values and preferences about ART in the peripartum period; no study directly studied choice of ART therapy during pregnancy. Six themes emerged: a desire to reduce vertical transmission (nine studies), desire for child to be healthy (five studies), concern about side effects to the child (eight studies), desire for oneself to be healthy (five studies), distress about side effect to oneself (10 studies) and pill burden (two studies). None of the studies weighed the relative importance of these outcomes directly, but pill burden/medication complexity appears to be a lower priority for most women compared with other factors. Overall, the body of evidence was at low risk of bias, with minor limitations. CONCLUSIONS Women who are or may become pregnant and who are considering ART appear to place a high value on both their own and their children's health. Evidence on the relative importance between these values when choosing between ART regimens is uncertain. There is variability in individual values and preferences among women. This highlights the importance of an individualised women-centred approach, such as shared decision-making when choosing between ART alternatives. TRIAL REGISTRATION NUMBER International Prospective Register of Systematic Reviews:CRD42017057157.
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Affiliation(s)
- Lyubov Lytvyn
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Reed A Siemieniuk
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | | | - Allyson Ion
- School of Social Work, McMaster University, Hamilton, Canada
| | - Yaping Chang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Malgorzata M Bala
- Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Veena Manja
- Department of Medicine, Division of Cardiology, VA Western New York Health Care System, Buffalo, New York, USA
| | - Reza Mirza
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Rene Rodriguez-Gutierrez
- Internal Medicine, University Hospital 'Dr. José E. González', Monterrey, Mexico
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Hassan Mir
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Regina El Dib
- Institute of Science and Technology, UNESP—Universidade Estadual Paulista, São José dos Campos, São Paulo, Brazil
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Canada
| | - Per Olav Vandvik
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Medicine, Innlandet Hospital Trust-division, Gjøvik, Norway
| | - Susan Bewley
- Women's Health Academic Centre, King's College London, London, UK
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