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Gasteiger C, Perera A, Yielder R, Scholz U, Dalbeth N, Petrie KJ. Using family-centered communication to optimize patient-provider-companion encounters about changing to biosimilars: A randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2023; 106:142-150. [PMID: 36400636 DOI: 10.1016/j.pec.2022.11.006] [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: 07/08/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To explore whether family-centered communication impacts decisions and optimizes patient-companion-provider consultations. METHODS A parallel, two-arm randomized controlled trial was conducted with 108 participants acting as patients with inflammatory arthritis or companions. Pairs attended a mock consultation where a physician explained the change from a bio-originator to a biosimilar using family-centered or patient-only communication. Participants reported their willingness to transition, risk perceptions, understanding and social support, and completed various scales including the Patient Perception Scale. Interviews helped understand perceptions towards the consultation. RESULTS Family-centered communication did not impact willingness to change or cognitive risk perceptions compared to patient-only communication. However, it improved emotional risk perceptions (p = 0.047, Cohen's d=.55) and satisfaction with communication (p = 0.015, Cohen's d=.71). Feeling the explanation was reassuring was associated with less worry (p = 0.004). Receiving emotional support (p = 0.014) and companions asking fewer questions (p = 0.046) were associated with higher recall. The intervention improved companion involvement (p < 0.001, Cohen's d= 1.23) and support (p = 0.002, Cohen's d=.86). Interviews showed that encouraging questions, inclusive body language, and acknowledging companions facilitated involvement. CONCLUSION Family-centered communication augments patient-companion-provider encounters but does not influence willingness to change treatment. PRACTICE IMPLICATIONS Practitioners can use family-centered communication when discussing biosimilars but should provide reassurance, encourage emotional support, and summarize key points to improve understanding.
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Affiliation(s)
- Chiara Gasteiger
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Anna Perera
- School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Rachael Yielder
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Urte Scholz
- University Research Priority Program "Dynamics of Healthy Aging," University of Zurich, Zurich, Switzerland; Department of Psychology - Applied Social and Health Psychology, University of Zurich, Zurich, Switzerland
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Rheumatology, Auckland District Health Board, Auckland, New Zealand
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Slightam C, Risbud R, Guetterman TC, Nevedal AL, Nelson KM, Piette JD, Trivedi RB. Patient, caregiving partner, and clinician recommendations for improving heart failure care in the Veterans Health Administration. Chronic Illn 2022; 18:330-342. [PMID: 33115281 DOI: 10.1177/1742395320966366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Heart Failure (HF) care requires substantial care coordination between patients, patients' informal caregivers, and clinicians, but few studies have examined recommendations from all three perspectives. The objective of this study was to understand and identify shared recommendations to improve HF self-care from the perspective of VA persons with HF, their caregiving partners, and clinicians. METHODS Secondary data analysis from a study of semi-structured interviews with 16 couples (persons with HF and their caregiving partners) and 13 clinicians (physicians, nurses, other specialists) from a large Veterans Affairs (VA) hospital. Interviews were double-coded, and analyzed for themes around commonly used or recommended self-care strategies. RESULTS Three themes emerged: (1) Couples and clinicians believe that improvements are still needed to existing HF education, especially the need to be tailored to learning style and culture, (2) Couples and clinicians believe that technology can facilitate better HF self-care, and (3) Couples and clinicians believe that caregiving partners are part of the self-care team, and should be involved in care management to support the person with HF. DISCUSSION Recommendations from couples and clinicians address barriers to HF self-care and encourage patient-centered care.
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Affiliation(s)
- Cindie Slightam
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Rashmi Risbud
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | | | - Andrea L Nevedal
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Karin M Nelson
- Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA
| | - John D Piette
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Medicine, School of Medicine, University of Washington, Seattle, WA
| | - Ranak B Trivedi
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA.,School of Public Health, University of Michigan, Ann Arbor, MI, USA
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English W, Gott M, Robinson J. The meaning of rapport for patients, families, and healthcare professionals: A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:2-14. [PMID: 34154861 DOI: 10.1016/j.pec.2021.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Rapport is considered fundamental to clinical relationships but is a concept which is rarely defined. This review explores how rapport is defined, characterised, and operationalised in healthcare. METHODS A scoping review methodology was used. Data were synthesised using thematic analysis. The review process adhered to the Preferred Reporting System for Meta-Analysis for Scoping reviews (PRISMA-ScR). RESULTS Medline, CINAHL, and psychINFO were searched with thirty-four studies meeting inclusion criteria. Results were presented in two themes: The meanings of rapport and the implications for building rapport. CONCLUSIONS This scoping review found rapport has no commonly shared definition or conceptualisation in the reviewed research. At the same time rapport is operationalised and characterised. Factors that facilitate, and hinder rapport-building were identified. Having a consistently used definition and conceptualisation will benefit the research that is needed into patient and family experiences and outcomes of rapport. PRACTICE IMPLICATIONS It is crucial for health professionals to incorporate simple kind gestures into practice to facilitate rapport. Equally it is necessary for health professionals to review their practice for dismissive, avoiding behaviours that impede rapport-building and consider how they spend their time with patients.
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Affiliation(s)
- Wendy English
- School of Nursing, University of Auckland, Auckland, New Zealand.
| | - Merryn Gott
- School of Nursing, University of Auckland, Auckland, New Zealand.
| | - Jackie Robinson
- School of Nursing, University of Auckland, Auckland, New Zealand.
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Relationship between Provider Communication Behaviors and the Quality of Life for Patients with Advanced Cancer in Saudi Arabia. Curr Oncol 2021; 28:2893-2901. [PMID: 34436019 PMCID: PMC8395490 DOI: 10.3390/curroncol28040253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/10/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
Context: Patients with advanced cancer from Saudi Arabia are often not well informed about diagnoses, prognoses, and treatment options. Poor communication can lead to health-care decisions that insufficiently meet patients’ preferences, concerns, and needs and that subsequently affect patients’ quality of life. Objectives: The purpose of this study is to examine the relationship between provider communication behaviors and the quality of life of patients with advanced cancer. Method: A cross-sectional, correlation design was used in the present study, in which 159 patients with confirmed diagnoses of stage III or IV solid cancer were surveyed. Results: The mean summary score of the patients’ quality of life was 57.31. We found a significant relationship between provider communication behaviors and patient quality of life (β = 0.18, b = 0.35, SE = 0.15, p = 0.021). In addition, R2 shows that only 3.4% of variance in patient quality of life is predicated on provider communication behaviors. Conclusions: The relationship between provider communication behaviors and patient quality of life was low (r = 0.18). A possible reason for this is that provider communication behaviors are not the only factor that affects patient quality of life; other variables, such as the patient’s age, cancer type, and level of awareness, can also have an effect. Another possible explanation is that communication behaviors between patients and providers may vary depending on the level of cultural contact.
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Otto AK, Reblin M, Harper FWK, Hamel LM, Moore TF, Ellington L, Eggly S. Impact of Patients' Companions on Clinical Encounters Between Black Patients and Their Non-Black Oncologists. JCO Oncol Pract 2021; 17:e676-e685. [PMID: 33411574 DOI: 10.1200/op.20.00820] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
PURPOSE The presence of caregivers or companions during clinical encounters influences the dynamics and outcomes of the encounters. Most prior studies of companions in clinical encounters focus on non-Hispanic White patients. However, there is generally lower-quality patient-physician communication during encounters with Black patients; these communication differences may contribute to racial health disparities. The purpose of the present study was to examine effects of the presence and active participation of companions on encounters between Black patients with cancer and non-Black oncologists. METHODS This was a secondary analysis of data collected during a larger intervention study. Participants were Black patients with breast, colon, or lung cancer who had a treatment-discussion encounter with a participating non-Black medical oncologist. Video recordings of encounters were coded for patient, companion, and oncologist communication. After the encounter, patients reported perceptions of the recommended treatment; patients and oncologists reported perceptions of each other. RESULTS Data from 114 patients and 19 oncologists were included in analyses. Only 47% of patients brought a companion to the encounter. Oncologists spent more time with accompanied Black patients, used more patient-centered communication with them, and perceived them as having more social support compared with unaccompanied Black patients. Oncologists reported that accompanied patients asked more questions. When companions participated more actively in the encounter, oncologists used more patient-centered communication. DISCUSSION Bringing a companion to oncology appointments may be beneficial to Black patients because oncologists spend more time with patients, use more patient-centered communication, and perceive patients more positively, all of which may ultimately improve patient health and well-being outcomes.
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Affiliation(s)
- Amy K Otto
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Public Health Sciences at the University of Miami, Miami, FL
| | - Maija Reblin
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Felicity W K Harper
- Department of Oncology, Wayne State University, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Lauren M Hamel
- Department of Oncology, Wayne State University, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Tanina F Moore
- Department of Oncology, Wayne State University, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT
| | - Susan Eggly
- Department of Oncology, Wayne State University, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
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Zhang A, Yocum RM, Repplinger MD, Broman AT, Kim MK. Factors Affecting Family Presence During Fracture Reduction in the Pediatric Emergency Department. West J Emerg Med 2018; 19:970-976. [PMID: 30429929 PMCID: PMC6225943 DOI: 10.5811/westjem.2018.9.38379] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/13/2018] [Accepted: 09/11/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Asking family members to leave during invasive procedures has historically been common practice; however, evidence-based recommendations have altered the trend of family presence during pediatric procedures. The aim of this study was to determine factors related to family members’ choice to be present or absent during fracture reductions in a pediatric emergency department (ED), and their satisfaction with that choice. Methods We administered role-specific, anonymous surveys to a convenience sample of patients’ family members in the ED of a Level I pediatric trauma center. All family members were given a choice of where to be during the procedure. Results Twenty-five family members of 18 patients completed surveys. Seventeen family members chose to stay in the room. Family member satisfaction with their decision to be inside or outside the room during the procedure (median = very satisfied) was almost uniformly high and not associated with any of the following variables: previous presence during a medical procedure; provider-reported procedure difficulty, or anxiety levels. Family member perception of procedure success (median = extremely well) was also high and not associated with other variables. Location during the procedure was associated with a desire to be in the same location in the future (Fisher’s exact test, p=0.001). Common themes found among family members’ reasons for their location decisions and satisfaction levels were a desire to support the patient, high staff competence, and their right as parents to choose their location. Conclusion Family members self-select their location during their child’s fracture reduction to high levels of satisfaction, and they considered the ability to choose their location as important.
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Affiliation(s)
- Albert Zhang
- University of Minnesota, Department of Pediatrics, Minneapolis, Minnesota
| | - Regina M Yocum
- American Family Children's Hospital, Department of Child Life Services, Madison, Wisconsin
| | - Michael D Repplinger
- University of Wisconsin, Madison, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.,University of Wisconsin, Madison, Department of Radiology, Madison, Wisconsin
| | - Aimee T Broman
- University of Wisconsin, Madison, Department of Biostatistics and Medical Informatics, Madison, Wisconsin
| | - Michael K Kim
- University of Wisconsin, Madison, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.,University of Wisconsin, Madison, Department of Pediatrics, Madison, Wisconsin
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Cené CW, Southwell BG. Introduction to the Special Section: Networks and Health Care Outcomes. Transl Behav Med 2018; 8:527-530. [PMID: 30016527 DOI: 10.1093/tbm/iby077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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