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Lee H, Kim J. Core contents for a menopausal health literacy intervention for South Korean middle-aged women: an e-Delphi study. BMC Nurs 2024; 23:509. [PMID: 39075452 PMCID: PMC11287886 DOI: 10.1186/s12912-024-02179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/15/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND The attention on improving health literacy (HL) for self-management at the population level in many countries has been increasing. Although self-management among middle-aged women in the menopausal transition are important public health issues, few studies have developed the menopausal HL intervention reflecting the multidimensional aspects of HL. We aimed to generate consensus from an expert panel on the core contents of the menopausal HL intervention for middle-aged women based on the HL conceptual framework of the European Health Literacy Survey. METHODS The panel comprised 20 experts from multiple disciplines (nursing, medicine, public health, and food and nutrition). We conducted the e-Delphi process in three rounds, asking the panel to evaluate and prioritize the appropriateness of the core contents and provide open-ended responses to additional comments about the menopausal HL intervention. The e-Delphi questionnaire was developed based on the HL framework, integrating health and HL domains. RESULTS The experts reached a consensus on 38 components of the intervention. Among the 19 components of the four health domains, health topics in healthcare and disease prevention were more appropriate than those in health promotion. For the 19 HL competency components, strengthening the ability to access, appraise, and apply health information was more important than strengthening the ability to understand information. Finally, a consensus was achieved on the 12 priorities for intervention content by HL domains integrated with health domains. For example, contents included proper access to reliable information resources, understanding the definition and process of menopause, judging abnormal health symptoms, and performing the health checkups necessary for menopausal women. CONCLUSIONS Our findings provide evidence for HL skills that nurses and other health professionals can consider when developing interventions to improve self-management among middle-aged women. Future research should focus on incorporating the core contents of multidimensional HL skills into menopausal HL interventions to improve self-management among middle-aged women.
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Affiliation(s)
- Haein Lee
- College of Nursing, Daegu Catholic University, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu, 42472, Republic of Korea
| | - Junghee Kim
- Department of Nursing, Hallym Polytechnic University, 48 Janghak-gil, Dong-myeon, Chuncheon, Gangwon State, 24210, Republic of Korea.
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Murtaza F, Shirreff L, Huang LN, Jacobson M, Jarcevic R, Christakis MK. Quality and readability of online health information on menopausal hormone therapy in Canada: what are our patients reading? Menopause 2021; 29:54-62. [PMID: 34905747 DOI: 10.1097/gme.0000000000001881] [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: 11/26/2022]
Abstract
OBJECTIVE To assess the quality and readability of 24 of the most accessed menopause hormone therapy (MHT) websites by Canadian women. METHODS The top 24 websites from Google, Bing, and Yahoo were identified using the search term "hormone replacement therapy." Five menopause specialists assessed website content quality using the DISCERN Instrument, Journal of the American Medical Association (JAMA) benchmarks, and Abbott's Scale. Two reviewers assessed website credibility using the Health on the Net Foundation Code of Conduct certification, and website readability using the Simple Measure of Gobbledygook, Flesch-Kincaid Grade Level, and Flesch-Kincaid Read Ease formulae. RESULTS Scores for quality of information varied. The mean JAMA score was low at 2.3 ± 1.1 (out of 4). Only one website met all benchmarks. Fourteen websites (58%) had a good/excellent DISCERN score, while four (17%) had a poor/very poor score. For Abbott's Scale, both the mean authorship score at 2.2 ± 1.0 (out of 4) and mean content score at 45.9 ± 9.8 (out of 100) were low. Inter-rater reliability was high for all tools. Fifteen websites (63%) were Health on the Net Foundation Code of Conduct certified. The mean Flesch-Kincaid Read Ease was 42.7 ± 10.3, mean Flesch-Kincaid Grade Level was 12.3 ± 1.9, and mean Simple Measure of Gobbledygook grade level was 11.3 ± 1.5. Only one website presented content at a reading level recommended for the public. Websites meeting more JAMA benchmarks were significantly less readable (P < 0.05). CONCLUSION Although good quality MHT information exists online, several resources are inaccurate or incomplete. Overall, these resources are not considered comprehensible by the public. There is a need to disseminate accurate, comprehensive, and understandable MHT information online.
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Affiliation(s)
- Fahmeeda Murtaza
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Shirreff
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Lina N Huang
- Obstetrics & Gynaecology, Lakeshore General Hospital, Montreal, Quebec, Canada
- Department of Obstetrics and Gynaecology, McGill University, Montreal, Quebec, Canada
| | - Michelle Jacobson
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Radomir Jarcevic
- Obstetrics and Gynaecology, CIUSSS-de-l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Obstetrics and Gynaecology, Université de Montréal, Montreal, Quebec, Canada
| | - Marie K Christakis
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics & Gynaecology, St. Michael's Hospital, Toronto, Ontario, Canada
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Mao B, Morgan SE, Peng W, McFarlane SJ, Occa A, Grinfeder G, Byrne MM. What Motivates You to Share? The Effect of Interactive Tailored Information Aids on Information Sharing about Clinical Trials. HEALTH COMMUNICATION 2021; 36:1388-1396. [PMID: 32345059 PMCID: PMC9680906 DOI: 10.1080/10410236.2020.1754588] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Cancer patients learn about research studies outside of the clinical environment, including websites, print and online advertisements, and interpersonal interactions. When cancer patients share credible information about clinical trials, they also frequently help clarify misunderstandings that may exist in their social networks. The present study investigated how an interactive tailored information aid on clinical trial participation motivated patients' information sharing behaviors. In this study of 312 cancer patients and survivors, an interactive tailored information aid improved patients' likelihood of sharing online and offline information more than a non-interactive tool. Information sharing was directly predicted by cognitive absorption and perceived visual informativeness. In addition, perceived utility and ease of use indirectly impact information sharing positively through the antecedent factors of user engagement and design esthetics. Education level further moderated this effect; information sharing was higher among patients with more education. The implications of these findings are discussed and recommendations for future research are provided.
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Affiliation(s)
| | | | - Wei Peng
- School of Communication, University of Miami
| | | | - Aurora Occa
- Department of Communication, University of Kentucky
| | | | - Margaret M Byrne
- Department of Health Outcomes and Behavior, Moffitt Cancer Center
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Dayaratna S, Sifri R, Jackson R, Powell R, Sherif K, DiCarlo M, Hegarty SE, Petrich A, Lambert E, Quinn A, Myers R. Preparing women experiencing symptoms of menopause for shared decision making about treatment. Menopause 2021; 28:1060-1066. [PMID: 34260477 DOI: 10.1097/gme.0000000000001807] [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: 11/25/2022]
Abstract
OBJECTIVE To develop a decision support intervention that can be used with women experiencing menopausal symptoms to facilitate treatment shared decision making. METHODS Our research team contacted patients with reported menopausal symptoms by telephone to obtain consent and administer a baseline survey. Subsequently, we sent participants a booklet on the treatment of menopausal symptoms. A nurse educator then contacted participants by telephone to review the booklet and guide them through a structured decision counseling exercise designed to help clarify treatment preference. A 60-day endpoint telephone survey was completed. RESULTS Forty-eight consenting participants completed the baseline survey and 37 (77%) also completed a decision counseling session. At baseline, 19 of the women who had decision counseling were not being treated for menopausal symptoms and 18 were being treated. After decision counseling, 13 (68%) participants who were not being treated and 14 (78%) who were being treated identified a preferred treatment. Comparison of baseline and endpoint survey data showed that participant treatment knowledge increased (P = 0.007) and treatment decisional conflict decreased (P < 0.001). Furthermore, 71% of participants reported that they had received new information about treatment and 94% said they believed better prepared to discuss treatment with their healthcare provider. CONCLUSIONS Nurse-led decision counseling increased participant treatment knowledge, reduced treatment decisional conflict, and helped to clarify treatment preference. Implementation of this strategy could help to facilitate provider-patient shared decision making about the treatment of menopausal symptoms.
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Affiliation(s)
- Sandra Dayaratna
- Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA
| | - Randa Sifri
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Rebecca Jackson
- Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA
| | - Rhea Powell
- Division of Internal Medicine, Department of Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Katherine Sherif
- Division of Women's Health, Department of Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Melissa DiCarlo
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Sarah E Hegarty
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Anett Petrich
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Emily Lambert
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Anna Quinn
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Ronald Myers
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
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Occa A, Morgan SE, Peng W, Mao B, McFarlane SJ, Grinfeder K, Byrne M. Untangling interactivity's effects: The role of cognitive absorption, perceived visual informativeness, and cancer information overload. PATIENT EDUCATION AND COUNSELING 2021; 104:1059-1065. [PMID: 33969824 PMCID: PMC8110950 DOI: 10.1016/j.pec.2020.10.007] [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] [Received: 02/27/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Learning about clinical trials is as stressful and challenging for cancer patients as it is for the clinical staff who provide education to patients. Information aids (IAs) can support both discussions and patients' decision-making, especially when IAs offer interactive features that provide information based on individuals' needs and experiences. However, it is not clear which factors contribute to interactive IAs' effectiveness. METHODS An experiment with cancer patients and survivors (n = 313) compared the effects of two IAs about clinical trial participation: one with modality (i.e. website/technological) interactivity only and one with both modality and message interactivity (i.e. provides information contingent on individual users' information needs). RESULTS The IA with both modality and message interactivity features elicited the higher perceived visual informativeness (PVI) and cognitive absorption (CA) scores. The model supports the moderating role of PVI and cancer information overload (CIO), and the mediating role of CA. CONCLUSION The IA with both modality and message interactivity better supported individuals' decision-making and improved attitudes and knowledge scores. CIO was experienced more by participants using the modality interactivity-only IA. PRACTICE IMPLICATIONS Message interactivity may simplify individuals' cognitive processes. IAs about clinical trial participation should include both message and modality interactivity.
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Affiliation(s)
- Aurora Occa
- Department of Communication, University of Kentucky, United States.
| | - Susan E Morgan
- Department of Communication Studies, University of Miami, Coral Gables, FL, 33146, United States
| | - Wei Peng
- The Edward R. Murrow College of Communication, Washington State University, United States
| | - Bingjing Mao
- Department of Communication Studies, University of Miami, Coral Gables, FL, 33146, United States
| | - Soroya Julian McFarlane
- Department of Communication Studies, University of Georgia, Athens, GA, 30602, United States
| | - Kim Grinfeder
- Department of Interactive Media, University of Miami, Coral Gables, FL, 33146, United States
| | - Margaret Byrne
- Department of Health Outcomes and Behavior, Moffit Cancer Center, Tampa, FL, 33612, United States
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Siyam T, Shivji A, Ross S, Eurich DT, Lavasanifar A, Yuksel N. Developing and evaluating a patient decision aid for hormone therapy to manage symptoms of surgical menopause: the story behind the "SheEmpowers" patient decision aid. ACTA ACUST UNITED AC 2020; 28:157-166. [PMID: 33235034 DOI: 10.1097/gme.0000000000001685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To develop and evaluate an evidence-based patient decision aid (PDA) that can support women making decisions on hormone therapy (HT) for the management of early surgical menopause. METHODS The PDA development was guided by the Ottawa Decision Support Framework and the International Patient Decision Aid Standards and involved three phases: an exploratory phase to identify women's decisional needs; a development phase to identify evidence related to treatment options and draft initial prototype; and an evaluation phase to evaluate the prototype and elicit views on acceptability in women (N = 12). All phases were driven by a multidisciplinary group of researchers, clinicians, and patient stakeholders to ensure women's priorities were met. RESULTS A prototype PDA was drafted based on needs identified from the exploratory phase. The PDA has five domains: information on surgical menopause and HT; HT outcome probabilities; patient stories; values clarification; and guidance in deliberation. Participants in the evaluation phase perceived the tool as acceptable and offered suggestions for modifications. CONCLUSION Through our adopted, systematic approach the SheEmpowers PDA was developed to help women overcome deterrents to decision-making related to lack of knowledge, decision-making skills, and involvement in therapy decisions. The decisional effectiveness of the tool is to be assessed in future studies.
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Affiliation(s)
| | - Alisha Shivji
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Sue Ross
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Afsaneh Lavasanifar
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Nesé Yuksel
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
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Effects of a Combination of Foeniculum vulgare, Melissa officinalis Extract, and Nigella saliva Powder on Healthy Menopausal Women with Sexual Dysfunction: A Randomized Clinical Trial. Jundishapur J Nat Pharm Prod 2020. [DOI: 10.5812/jjnpp.89925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Menopause is a critical period with frequent sexual disorders. Objectives: The current study assessed the therapeutic effect of a combination of the aerial part of Melissa officinalis, fennel fruit extract, and Nigella sativa seed powder on the sexual dysfunction of postmenopausal women. Methods: This randomized clinical trial was performed on 48 menopausal women from April 2015 to October 2017. The participants included the menopausal women referring to the clinic of Gorgan health centers aged between 41 and 54 years with natural menopause (amenorrhea for at least 12 months) and discomfort in sexual activity. They were randomized into two treatment groups. Group 1 (n = 27) received 1000 mg capsules (Melissa officinalis, fennel extract, and Nigella sativa powder), and group 2 (n = 21) received a placebo (1000 mg starch capsules (in an eight-week course of treatment (one capsule per day for each group). The variables in the female sexual function index (FSFI) questionnaire were compared in the two groups before and after the intervention. Results: The results showed that the mean scores of sexual dysfunction in the domains of arousal, lubrication, orgasm, satisfaction, and pain were not significantly different between the two groups (P > 0.05). Conclusions: Despite many studies on the effectiveness of Melissa, Foenculum, and Nigella, this study showed that a combination of Foeniculum vulgare, Melissa officinalis extract, and Nigella sativa seed powder does not improve the sexual function of postmenopausal women with sexual dysfunction, and it might be the synergism effect of this combination.
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Wickramasekera N, Taylor SK, Lumley E, Gray T, Wilson E, Radley S. Can electronic assessment tools improve the process of shared decision-making? A systematic review. HEALTH INF MANAG J 2020; 52:72-86. [PMID: 33016126 PMCID: PMC10170559 DOI: 10.1177/1833358320954385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Patient involvement in decision-making plays a prominent role in improving the quality of healthcare. Despite this, shared decision-making is not routinely implemented. However, electronic assessment tools that capture patients’ history, symptoms, opinions and values prior to their medical appointment are used by healthcare professionals during patient consultations to facilitate shared decision-making. Objective: To assess the effectiveness of electronic assessment tools to improve the shared decision-making process. Method: A systematic review was conducted following PRISMA guidelines. Published literature was searched on MEDLINE, EMBASE and PsycINFO to identify potentially relevant studies. Data were extracted and analysed narratively. Results: Seventeen articles, representing 4004 participants, were included in this review. The main findings were significant improvement in patient–provider communication and provider management of patient condition in the intervention group compared to the control group. In contrast, patient–provider satisfaction and time efficiency were assessed by relatively few included studies, and the effects of these outcomes were inconclusive. Conclusion: This review found that communication and healthcare professional’s management of a patient’s condition improves because of the use of electronic questionnaires. This is encouraging because the process of shared decision-making is reliant on high-quality communication between healthcare professionals and patients. Implications: We found that this intervention is especially important for people with chronic diseases, as they need to establish a long-term relationship with their healthcare provider and agree to a treatment plan that aligns with their values. More rigorous research with validated instruments is required.
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Peng W, Morgan SE, Mao B, McFarlane SJ, Occa A, Grinfeder G, Byrne MM. Ready to Make A Decision: A Model of Informational Aids to Improve Informed Participation in Clinical Trial Research. JOURNAL OF HEALTH COMMUNICATION 2019; 24:865-877. [PMID: 31663824 PMCID: PMC9617566 DOI: 10.1080/10810730.2019.1680773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Enrollment rates for cancer clinical trials remain low, affecting the generalizability of new treatments. Research shows that many patients face significant challenges in understanding basic clinical trial vocabulary and making informed decisions about participation. Informational aids (IA) are developed to address these challenges and support decision making of cancer clinical trial participation. The present study proposed and tested a structural path model to explain the efficacy of three (i.e., interactive, non-interactive, non-cancer control) IAs. The results revealed that clinical trial participation intention was associated with attitudes and social constructs (i.e., social norm, social sharing, and cues to action). Ease of use, rather than knowledge, was the primary communication feature of IA that influenced the outcome variables. The path relations linking messages features, mediators, and outcome variables were different across all three IAs. The results therefore provide theoretical and practical implications for the use and development of IAs to support clinical trial accrual.
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Affiliation(s)
- Wei Peng
- School of Communication, University of Miami, Coral Gables, Florida
| | - Susan E. Morgan
- School of Communication, University of Miami, Coral Gables, Florida
| | - Bingjing Mao
- School of Communication, University of Miami, Coral Gables, Florida
| | | | - Aurora Occa
- Department of Communication, University of Kentucky, Lexington, Kentucky
| | - Gilles Grinfeder
- School of Communication, University of Miami, Coral Gables, Florida
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Evaluating the content and development of decision aid tools for the management of menopause: A scoping review. Maturitas 2017; 106:80-86. [DOI: 10.1016/j.maturitas.2017.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/08/2017] [Accepted: 09/15/2017] [Indexed: 11/17/2022]
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Arroll N, Armstrong S, Aneke KU, Jordan V, Farquhar C. Decision aids for the management of menopausal symptoms. Hippokratia 2015. [DOI: 10.1002/14651858.cd011892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Nicola Arroll
- University of Auckland; Department of Obstetrics and Gynaecology; Private Bag 92019 Grafton Auckland New Zealand 1142
| | - Sarah Armstrong
- University of Auckland; Department of Obstetrics and Gynaecology; Private Bag 92019 Grafton Auckland New Zealand 1142
| | | | - Vanessa Jordan
- University of Auckland; Department of Obstetrics and Gynaecology; Private Bag 92019 Grafton Auckland New Zealand 1142
| | - Cindy Farquhar
- University of Auckland; Department of Obstetrics and Gynaecology; Private Bag 92019 Grafton Auckland New Zealand 1142
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Croden J, Ross S, Yuksel N, Sydora BC. A survey of the availability in Canadian pharmacy chains of over-the-counter natural health products for menopause symptoms. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:86. [PMID: 25887967 PMCID: PMC4414444 DOI: 10.1186/s12906-015-0608-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/12/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Menopause is a natural phase in a woman's aging process, characterized by the cessation of menstruation. Women who are going through the menopause transition can experience physiological symptoms that significantly impact their quality of life. Concern about adverse effects of traditional hormone therapy often leads women to purchase over-the-counter (OTC) natural health products (NHPs). The goal of this study was toinvestigate the range of OTC NHPs for menopause available to Canadian women, and the packaging information they can access to make self-management decisions. METHODS Edmonton stores belonging to each of nine Canadian pharmacy chains were visited to identify NHPs marketed for the relief of menopausal symptoms. Details were extracted from the packaging: a) product name and manufacturer, b) Health Canada license number, c) medically active ingredients, d) claims of efficacy, e) contra-indications and warnings, and f) daily cost. Data were entered and analyzed using Microsoft Excel. RESULTS We identified 20 OTC NHP menopausal products, 19 of which had Health Canada license numbers. Twenty-eight medically active ingredients were identified, with the most common being black cohosh (in 14 products) and soy isoflavones (n = 7), chaste tree (n = 5), and dong quai (n = 3). Most products claimed they would relieve vasomotor symptoms, including hot flashes (n = 14) and night sweats (n = 10). Each product had a labeled contraindication for at least one specific condition. Costs per recommended daily dose ranged from $0.07 to a maximum of $2.50 (CAD$). CONCLUSION Natural health products for menopausal symptoms are easily available to Canadian women. The lack of clear evidence of product efficacy makes the need for easily accessible, balanced information on this topic important for women to make well informed choices.
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Affiliation(s)
- Jennifer Croden
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, 5S131 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3 V9, Canada.
| | - Sue Ross
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, 5S131 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3 V9, Canada.
| | - Nese Yuksel
- Faculty of Pharmacy and Pharmaceutical Sciences, 3-171 Edmonton Clinic Health Academy, 11405 - 87 Avenue NW, Edmonton, AB, T6G 1C9, Canada.
| | - Beate C Sydora
- Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, 5S131 Lois Hole Hospital for Women, Robbins Pavilion, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3 V9, Canada.
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Gionfriddo MR, Leppin AL, Brito JP, Leblanc A, Shah ND, Montori VM. Shared decision-making and comparative effectiveness research for patients with chronic conditions: an urgent synergy for better health. J Comp Eff Res 2014; 2:595-603. [PMID: 24236798 DOI: 10.2217/cer.13.69] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chronic conditions are the most important cause of morbidity, mortality and health expense in the USA. Comparative effectiveness research (CER) seeks to provide evidence supporting the relative value of alternative courses of action. This research often concludes with estimates of the likelihood of desirable and undesirable outcomes associated with each option. Patients with chronic conditions should engage with their clinicians in deciding which of these options best fits their goals and context. In practicing shared decision-making (SDM), clinicians and patients should make use of CER to inform their deliberations. In these ways, SDM and CER are interrelated. SDM translates CER into patient-centered practice, while CER provides the backbone evidence about options and outcomes in SDM interventions. In this review, we explore the potential for a SDM-CER synergy in improving healthcare for patients with chronic conditions.
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Affiliation(s)
- Michael R Gionfriddo
- Knowledge & Evaluation Research Unit, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Ahmed S, Gardner M, Sandberg D. Management of children with disorders of sex development: new care standards explained. PSYCHOLOGY & SEXUALITY 2013. [DOI: 10.1080/19419899.2013.831211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Crowe M, Burrell B, Whitehead L. Lifestyle risk management--a qualitative analysis of women's descriptions of taking hormone therapy following surgically induced menopause. J Adv Nurs 2011; 68:1814-23. [PMID: 22082259 DOI: 10.1111/j.1365-2648.2011.05873.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This article is a report of a study that examined how women describe their decisions in relation to the use of menopausal hormone therapy following surgical menopause. BACKGROUND Women who have had a surgically induced menopause generally experience more intense menopausal symptoms than natural menopause and are regularly prescribed menopausal hormone therapy. Since 2002 the risks associated with this therapy have been widely reported. METHOD This study is a qualitative analysis of semi-structured interviews between March and May 2009 with 30 participants who had experienced surgical menopause and were, or had in the past, taken menopausal hormone therapy. This was a community sample recruited in Christchurch, New Zealand. A risk management theoretical approach underpinned the analysis. FINDINGS The womens' descriptions of managing the risks associated with menopausal therapy fell into two main themes: Life has to go on and Waiting for someone to tell me. All these women had either made an active decision to continue on treatment because of the impact of menopausal symptoms or took their doctor's advice to continue. A less dominant theme but one that was also evident was Relying on my body to get me through in which the women had decided to discontinue treatment because they regarded it as unnatural. CONCLUSION The study provided insights into how women utilize an experiential reasoning process to manage the health and lifestyle risks associated with taking menopausal hormone therapy. Nurses need to be aware of how this process influences women's reasoning processes when working with women following surgical menopause.
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Affiliation(s)
- Marie Crowe
- Centre for Postgraduate Nursing, University of Otago, Christchurch, New Zealand.
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Carpenter JS, Byrne MM, Studts JL. Factors related to menopausal symptom management decisions. Maturitas 2011; 70:10-5. [DOI: 10.1016/j.maturitas.2011.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 06/02/2011] [Indexed: 12/28/2022]
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