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Zhao T, Cai X, Zhang S, Wang M, Chen L, Wang J, Yu Y, Tao L, Xu X, Luo J, Wang C, Du J, Liu Y, Lu Q, Cui F. Differences in Vaccination Consultation Preferred by Primary Health Care Workers and Residents in Community Settings. Vaccines (Basel) 2024; 12:534. [PMID: 38793785 PMCID: PMC11126119 DOI: 10.3390/vaccines12050534] [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: 04/01/2024] [Revised: 04/24/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVE To evaluate the preference of primary HCWs and residents on vaccination consultation in community health services to provide evidence for vaccine hesitancy intervention strategies. METHODS A discrete choice model (DCM) was constructed to evaluate the preference difference between primary HCWs and residents on vaccination consultation in community health services in China during May-July 2022. RESULTS A total of 282 residents and 204 HCWs were enrolled in this study. The residents preferred consulting with an HCW-led approach (β = 2.168), with specialized content (β = 0.954), and accompanied by telephone follow-up (β = 1.552). In contrast, the HCWs preferred face-to-face consultation (β = 0.540) with an HCW-led approach (β = 0.458) and specialized content (β = 0.409), accompanied by telephone follow-up (β = 0.831). College residents and residents with underlying self-reported disease may be near-critically inclined to choose traditional consultation (an offline, face-to-face consultation with standardized content and more prolonged duration) rather than a new-media consulting group (an online consultation with specialized content within 5 min). Urban HCWs preferred long-term consultation groups (the resident-led offline consultation with follow-up lasting more than 5 min). In contrast, rural HCWs preferred efficient consultation (the HCW-led, short-duration, standardized offline consultation mode). CONCLUSION The selection preference for vaccine consultation reveals a gap between providers and demanders, with different groups exhibiting distinct preferences. Identifying these targeted gaps can help design more acceptable and efficient interventions, increasing their likelihood of success and leading to better resource allocation for policymakers to develop targeted vaccination policies.
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Affiliation(s)
- Tianshuo Zhao
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Xianming Cai
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Sihui Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Mingting Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Linyi Chen
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Juan Wang
- Jiuzhaigou Center for Disease Control and Prevention, Ngawa 623099, China;
| | - Yajie Yu
- Yilan Center for Disease Control and Prevention, Harbin 154899, China
| | - Liandi Tao
- Longxi Center for Disease Control and Prevention, Longxi 748199, China
| | - Xiaoxia Xu
- Chengguan Center for Disease Control and Prevention, Lanzhou 730030, China;
| | - Jing Luo
- Suzhou Center for Disease Control and Prevention, Suzhou 234099, China
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Yaqiong Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
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Groenewegen PP, Spreeuwenberg P, Leyland AH, de Boer D, Boerma W. Case-mix adjustments for patient reported experience and outcome measures in primary care: an empirical approach to identify patient characteristics as case-mix adjusters based on a secondary analysis of an international survey among patients and their general practitioners in 34 countries. J Patient Rep Outcomes 2023; 7:127. [PMID: 38048040 PMCID: PMC10695892 DOI: 10.1186/s41687-023-00667-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/26/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Case-mix adjustment of patient reported experiences (PREMs) and outcomes (PROMs) of care are meant to enable fair comparison between units (e.g. care providers or countries) and to show where improvement is possible. It is important to distinguish between fair comparison and improvement potential, as case-mix adjustment may mask improvement potential. Case-mix adjustment takes into account the effect of patient characteristics that are related to the PREMs and PROMs studied, but are outside the sphere of influence of the units being compared. We developed an approach to assess which patient characteristics would qualify as case-mix adjusters, using data from an international primary care study. RESULTS We used multilevel analysis, with patients nested in general practices nested in countries. Case-mix adjustment is indicated under the following conditions: there is a main effect of the potential case-mix adjuster on the PREM/PROM; this effect does not vary between units; and the distribution of the potential case-mix adjuster differs between units. Random slope models were used to assess whether the impact of a potential case-mix adjuster varied between units. To assess whether a slope variance is big enough to decide that case-mix adjustment is not indicated, we compared the variances in the categories of a potential case-mix adjuster. Significance of the slope variance is not enough, because small variances may be significantly different from zero when numbers are large. We therefore need an additional criterion to consider a slope variance as important. Borrowing from the idea of a minimum clinically important difference (MCID) we proposed a difference between the variances of 0.25*variance (equivalent to a medium effect size). We applied this approach to data from the QUALICOPC (Quality and costs of primary care in Europe) study. CONCLUSIONS Our approach provides guidance to decide whether or not patient characteristics should be considered as case-mix adjusters. The criterion of a difference between variances of 0.25*variance works well for continuous PREMs and PROMs, but seems to be too strict for binary PREMs and PROMs. Without additional information, it is not possible to decide whether important slope variation is the result of either differences in performance between general practices or countries, or cultural differences.
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Affiliation(s)
- Peter P Groenewegen
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568, 3500BN, Utrecht, The Netherlands.
| | - Peter Spreeuwenberg
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568, 3500BN, Utrecht, The Netherlands
| | - Alastair H Leyland
- MRC/CSO Social and Public Health Sciences Unit, Clarice Pears Building 90 Byres Road, Glasgow, G12 8TB, UK
| | - Dolf de Boer
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568, 3500BN, Utrecht, The Netherlands
| | - Wienke Boerma
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568, 3500BN, Utrecht, The Netherlands
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Koopman WJ, LaDonna KA, Kinsella EA, Venance SL, Watling CJ. Archetypes of incomplete stories in chronic illness medical encounters. PATIENT EDUCATION AND COUNSELING 2023; 117:107973. [PMID: 37734249 DOI: 10.1016/j.pec.2023.107973] [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: 04/14/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE During encounters, patients and practitioners engage in conversations to address health concerns. Because these interactions are time-pressured events, it may be inevitable that any story exchanged during these encounters will be incomplete in some way, potentially jeopardizing how quality and safety of care is delivered. In this study, we explored how and why incomplete stories might arise in health interactions. METHODS Constructivist grounded theory methodology was used to explore how patients and practitioners approach their interactions during encounters. In this two-phase study, we interviewed patients (n = 21) then practitioners (n = 12). RESULTS We identified three distinct archetypes of incomplete storytelling - the hidden story, the interpreted story, and the tailored story. Measured information sharing, triadic encounters and pre-planned agendas influenced these storylines, respectively. CONCLUSION Both patient and practitioner participants focused on what each considered important, appropriate, and useful for productive encounters. While incomplete stories may be a reality, educating practitioners about how incomplete stories come about from both sides of the conversation creates new opportunities to optimize interactions at medical encounters for in-depth patient practitioner storytelling.
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Affiliation(s)
- Wilma J Koopman
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada; London Health Sciences Centre, London, Ontario N6A 3K7, Canada; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 3K7, Canada; Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 3K7, Canada.
| | - K A LaDonna
- Department of Innovation in Medical Education and Department of Medicine, University of Ottawa, Ottawa, Ontario K1G 5Z3, Canada
| | - E A Kinsella
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada; Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A 1A3, Canada
| | - S L Venance
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 3K7, Canada
| | - C J Watling
- Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 3K7, Canada
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Six S, Bilsen J, Deschepper R. Dealing with cultural diversity in palliative care. BMJ Support Palliat Care 2023; 13:65-69. [PMID: 32826261 DOI: 10.1136/bmjspcare-2020-002511] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 01/29/2023]
Abstract
Palliative care is increasingly confronted with cultural diversity. This can lead to various problems in practice. In this perspective article, the authors discuss in more detail which issues play a role in culture-sensitive palliative care, why naive culturalism will not solve such problems and in which direction research into this aspect of care can be further elaborated.
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Affiliation(s)
- Stefaan Six
- Mental Health and Wellbeing Research Group, Dpt. of Public Health, Vrije Universiteit Brussel-Brussels Health Campus, Brussel, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Dpt. of Public Health, Vrije Universiteit Brussel-Brussels Health Campus, Brussel, Belgium
| | - Reginald Deschepper
- Mental Health and Wellbeing Research Group, Dpt. of Public Health, Vrije Universiteit Brussel-Brussels Health Campus, Brussel, Belgium
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Tolotti A, Barello S, Vignaduzzo C, Liptrott SJ, Valcarenghi D, Nania T, Sari D, Bonetti L. Patient Engagement in Oncology Practice: A Qualitative Study on Patients' and Nurses' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11644. [PMID: 36141919 PMCID: PMC9517681 DOI: 10.3390/ijerph191811644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Patient engagement has gained increasing attention in cancer care as it is widely acknowledged as an essential element of high-quality care. There are limited data on how oncology nurses might apply techniques that encourage patient engagement. Therefore, this study aims to understand which nursing strategies can favour patient engagement in oncological care from patients' and nurses' perspectives. We conducted a qualitative study involving oncology patients and oncology nurses. Patients were interviewed, while nurses were involved in focus groups (FGs). Both interviews and FGs were analysed by the means of thematic analysis. We interviewed six patients and conducted two FGs, involving 17 nurses. Five themes were identified from patients' interviews: effective information, having the opportunity to choose, being considered a person, trusted relationship with nurses, and receiving support and advice. Additionally, five themes were identified from the FGs: the nurse-patient relationship, personalisation of care, information style, engagement strategies, and the team. The participants highlighted the importance of comprehensive information in order for patients to feel more involved. Great importance was given to the nurse-patient relationship, which must be based on trust and mutual respect. Both nurses and patients emphasised the importance of person-centred care. A more systematic implementation of suggestions from the participants in this study is desirable for the future.
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Affiliation(s)
- Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Serena Barello
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Camilla Vignaduzzo
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Sarah Jayne Liptrott
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
- Nursing Development and Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale (EOC), Via Ospedale 12, 6500 Bellinzona, Switzerland
| | - Dario Valcarenghi
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Tiziana Nania
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato Milanese, 20097 Milan, Italy
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Loris Bonetti
- Nursing Research Competence Centre, Department of Nursing, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland or
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Via Violino, 11, 6928 Manno, Switzerland
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Thomas TH, Hadley ML, Nilsen ML. "I pretty much followed the law, and there weren't any decisions to make": A qualitative study of self-advocacy experiences of men with cancer. Nurs Health Sci 2022; 24:34-43. [PMID: 34850513 PMCID: PMC9169248 DOI: 10.1111/nhs.12909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022]
Abstract
Current conceptualizations of patient self-advocacy focus on women with cancer, leaving knowledge of male self-advocacy deficient. The purpose of this study is to describe the key components of self-advocacy among men with cancer. Adult (≥18 years old) men with a history of invasive cancer were recruited from cancer clinics and registries. Trained researchers led individual semi-structured interviews regarding participants' challenges, how they overcame those challenges, and barriers and facilitators to their self-advocacy. All interviews were analyzed using descriptive content analysis methods and synthesized into major themes. These themes were refined after receiving feedback from key stakeholders. Participants (N = 28) reported three major self-advocacy themes: (i) managing through information and planning; (ii) finding the best team and falling in line; and (iii) strategic social connections. These themes are richly described with representative quotations for each theme and subtheme. Based on these findings, existing models of patient self-advocacy should be adjusted to encompass how men self-advocate. Clinicians should consider how gender may impact how and why patients with cancer self-advocate so that they can best support their patients in achieving patient-centered care.
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Affiliation(s)
- Teresa Hagan Thomas
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA,Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Makenna L. Hadley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marci Lee Nilsen
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA,Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Expectations and behaviour of older adults with neurological disorders regarding general practitioner consultations: an observational study. BMC Geriatr 2021; 21:512. [PMID: 34563125 PMCID: PMC8466933 DOI: 10.1186/s12877-021-02469-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/10/2021] [Indexed: 12/30/2022] Open
Abstract
Background Patients’ relationship with their GPs is linked to adherence, patient behaviour and satisfaction with healthcare. Several factors pertaining to this relationship have already been identified, however expectations and preferences vary depending on age and diagnosis. Chronically ill elderly patients constitute a group of patients with specific needs that are not yet understood. Methods For this observational study, 100 (44 female, mean age 72.72 + − 8.28 years) patients were interviewed. Multiple linear or binary logistic regression as well as analysis of variance was used to understand the link between factors pertaining to GP relationship and patient behaviour, and principal component analysis was performed to understand the underlying structure of patients’ needs. Results Patients attribute high importance to their GP’s opinion of them. On average, what the GP thinks about the patients is almost as important as what their partners think. Patients primarily want to be perceived as engaged, friendly and respected individuals, and it is important for patients to be liked by their GP. This importance is linked to active preparation; 65% of the patients prepared actively for GP consultations. Expectations regarding GP consultations can be split into two components: a medical aspect with a subfactor concerning emotional support, and a social component. Prominent factors influencing the relationship are the possibility to talk about emotions and mental well-being, trust, and GP competency. Satisfaction and trust were mainly linked to medical competency. Being able to show emotions or talk about mental well-being enhances perceived GP competence, satisfaction, and active patient preparation. However, a focus on the social component such as frequent talking about private topics reduces both perceived GP competency as well as active patient preparation. Conclusion Older patients take GP consultations seriously, and their expectations regarding GP consultations focus on medical competence and care as well as empathetic listening and understanding. Older persons seek a deeper connection to their GPs and are willing to be active and cooperative. As the patient–GP relationship influences health outcomes, treatment of older patients should be adjusted to enable this active participation. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02469-3.
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Balanescu AR, Bojinca VC, Schweitzer AM, Joca B, Mardale DA, Badea D, Bojinca M. Translation and cultural adaptation of a romanian version of the communication assessment tool (CAT_Ro). BMC Health Serv Res 2021; 21:184. [PMID: 33639947 PMCID: PMC7913309 DOI: 10.1186/s12913-021-06186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The communication between health providers and patients influences the quality of medical care. The Communication Skills Assessment (CAT) is a reliable, validated tool, which was developed to assess interpersonal communication skills between physicians and patients. The purpose of this study was to obtain a Romanian version of the CAT (CAT_Ro), using a controlled and systematic process to translate and cross-culturally adapt the original questionnaire, since there are no validated instruments to assess healthcare professionals' communication capability in Romania. METHODS The study was conducted in two Departments of Internal Medicine and Rheumatology from Bucharest, Romania, using a rigorous scientific methodology for the translation process, according to literature recommendations, implicating conceptual evaluation, semantics, and cultural adaptation, which involved several steps. The updated version was pre-tested in a pilot study, which included 89 outpatients. RESULTS The results showed a narrow range of variability in item interpretation, without differences in patients' responses according to variables such as age, gender, education, disease type, number of previous visits with the same doctor. CONCLUSION CAT-Ro is the result of a comprehensive process study. It represents the first translation and cultural adaptation in Romanian of an instrument able to assess the health providers' communication skills, which was validated in a pilot study and is to be used in more extensive studies with patients from several specialties.
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Affiliation(s)
- Andra Rodica Balanescu
- University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu street, sector 2, 020021, Bucharest, Romania
- Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital, 37-39 Ion Mihalache Bl. Sector 1, 011172, Bucharest, Romania
| | - Violeta Claudia Bojinca
- University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu street, sector 2, 020021, Bucharest, Romania.
- Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital, 37-39 Ion Mihalache Bl. Sector 1, 011172, Bucharest, Romania.
| | | | | | - Denise Ani Mardale
- Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital, 37-39 Ion Mihalache Bl. Sector 1, 011172, Bucharest, Romania
| | - Denisa Badea
- Department of Internal Medicine and Rheumatology, "Dr. Ion Cantacuzino" Clinical Hospital, 5-7 Ion Movila Street, Bucharest, 030167, Romania
| | - Mihai Bojinca
- University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu street, sector 2, 020021, Bucharest, Romania
- Department of Internal Medicine and Rheumatology, "Dr. Ion Cantacuzino" Clinical Hospital, 5-7 Ion Movila Street, Bucharest, 030167, Romania
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Tam L, Burns K, Barnes K. Responsibilities and capabilities of health engagement professionals (HEPs): Perspectives from HEPs and health consumers in Australia. Health Expect 2020; 24:111-120. [PMID: 33174668 PMCID: PMC7879552 DOI: 10.1111/hex.13155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/06/2020] [Accepted: 10/22/2020] [Indexed: 01/30/2023] Open
Abstract
Background In Australia, the National Safety and Quality Health Service Standards (2012) stipulates that partnering with health consumers to improve health‐care experiences is one of the criteria health‐care organizations are assessed and accredited against. This standard has given rise to a role: health engagement professionals (HEPs). While there are no standard requirements for recruitment into this role, this study contributes to much needed research into understanding their responsibilities and capabilities, and their contributions to engagement outcomes. Methods Using a qualitative, interpretive approach, 16 HEPs and 15 health consumer representatives (who have experiences of interacting with HEPs) participated in an in‐depth phone interview in December 2019. We explored (a) the purposes of the role, (b) the responsibilities and work activities and (c) the capabilities required to carry out the responsibilities. Results Health engagement professionals are specialists in designing engagement mechanisms for health‐care organizations to co‐design health services with health consumers. They facilitate partnerships between health‐care organizations and health consumers. They play significant roles in listening to, facilitating understanding amongst different stakeholder groups (eg hospital management, health‐care workers and health consumers) and navigating the bureaucratic structures to influence outcomes. Four major responsibilities (advocacy, education, facilitation and administration) and four categories of capabilities (relational, communication, professional and personal) were identified. Conclusion A list of job responsibilities and desired capabilities of HEPs is provided to help health‐care organizations better understand the requirements for the role. This would help them decide how applicants to these roles would meet the requirements (eg experience of navigating bureaucratic systems).
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Affiliation(s)
- Lisa Tam
- School of Advertising, Marketing and Public Relations, Queensland University of Technology, Brisbane, Qld, Australia
| | - Kara Burns
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Logan, Qld, Australia
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Salmi L, Côté P, Cedraschi C. Covering patient's perspective in case-based critical review articles to improve shared decision making in complex cases. Health Expect 2020; 23:1037-1044. [PMID: 32700821 PMCID: PMC7696115 DOI: 10.1111/hex.13108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/03/2020] [Accepted: 06/30/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The patient has always been at the centre of the evidence-based medicine model. Case-based critical reviews, such as best-evidence topics, however, are incomplete reflections of the evidence-based medicine philosophy, because they fail to consider the patient's perspective. We propose a new framework, called the 'Shared Decision Evidence Summary' (ShaDES), where the patient's perspective on available treatment options is explicitly included. METHODS Our framework is grounded in the critical appraisal of a clinical scenario, and the development of a clinical question, including patient characteristics, compared options and outcomes to be improved. Answers to the clinical question are informed by the literature, the evaluation of its quality and its potential usefulness to the clinical scenario. Finally, the evidence synthesis is presented to the patient to facilitate the formulation of an evidence-informed decision about the treatment options. KEY RESULTS Using three similar but contrasted clinical scenarios of patients with low back pain, we illustrate how considering the patient's preferences on the proposed treatment options impact the bottom line, a synthetic formulation of the answer to the focused question. ShaDES includes clinical and psychosocial components, transformed in a searchable question, with a full search strategy. CONCLUSIONS ShaDES is a practical framework that may facilitate clinical decisions adapted to psychological, social and other relevant non-clinical characteristics of patients.
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Affiliation(s)
- Louis‐Rachid Salmi
- Univ. Bordeaux, ISPEDCentre INSERM U1219 Bordeaux Population HealthBordeauxFrance
- INSERMISPEDCentre INSERM U1219 Bordeaux Population HealthBordeauxFrance
- CHU de BordeauxPole de Sante PubliqueService d’information MedicaleBordeauxFrance
| | - Pierre Côté
- Center for Disability Prevention and RehabilitationCanadian Memorial Chiropractic CollegeUniv. of Ontario Institute of TechnologyOshawaONCanada
- Ontario Technical UniversityOshawaONCanada
| | - Christine Cedraschi
- Division of General Medical RehabilitationGeneva Faculty of MedicineGenevaSwitzerland
- Division of Clinical Pharmacology & ToxicologyMultidisciplinary Pain CentreUniv. HospitalsGeneva UniversityGenevaSwitzerland
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von Glinski A, Ishak B, Elia CJ, Goodmanson R, Pierre C, Norvell DC, Ansari D, Brune P, Oskouian RJ, Chapman JR. Emerging Insight in the Use of an Active Post Discharge Surveillance Program in Spine Surgery: A Retrospective Pilot Study. World Neurosurg 2020; 139:e237-e244. [DOI: 10.1016/j.wneu.2020.03.185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/27/2022]
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Hasanpoor E, Bahadori M, Yaghoubi M, Haghgoshayie E, Mahboub-Ahari A. Evidence-based management as a basis for evidence-based medical consultation. BMJ Evid Based Med 2020; 25:83-84. [PMID: 30498086 DOI: 10.1136/bmjebm-2018-111104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Edris Hasanpoor
- Department of Healthcare Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Mohammadkarim Bahadori
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Maryam Yaghoubi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Elaheh Haghgoshayie
- Department of Healthcare Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Alireza Mahboub-Ahari
- Department of Health Economics, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Gans R. Missing the mark in marketing healthcare services to emergent populations: Why we go wrong and how we might do better. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2020.1763234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Roger Gans
- Department of Communication, University of Texas at Arlington, Arlington, TX, USA
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Mahoney B, Walklet E, Bradley E, O'Hickey S. Improving adrenaline autoinjector adherence: A psychologically informed training for healthcare professionals. Immun Inflamm Dis 2019; 7:214-228. [PMID: 31290265 PMCID: PMC6688075 DOI: 10.1002/iid3.264] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/05/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Clinicians draw on instructional approaches when training patients with anaphylaxis to use adrenaline autoinjectors, but patient use is poor. Psychological barriers to these behaviours exist but are not considered routinely when training patients to use autoinjectors. Health Psychology principles suggest exploring these factors with patients could improve their autoinjector use. OBJECTIVE To evaluate the impact of a 90-minute workshop training clinicians in strategies and techniques for exploring and responding to psychological barriers to autoinjector use with patients. Attendees' knowledge, confidence and likelihood of using the strategies were expected to improve. METHODS Impact was evaluated using a longitudinal mixed-method design. Twenty-nine clinicians (general and specialist nurses, general practitioners, and pharmacists) supporting patients with anaphylaxis in UK hospitals and general practice attended. Self-rated knowledge, confidence, and likelihood of using the strategies taught were evaluated online 1 week before, 1 to 3, and 6 to 8 weeks after the workshop. Clinicians were invited for telephone interview after attending to explore qualitatively the workshop impact. RESULTS χ2 analyses were significant in most cases (P < .05), with sustained (6-8 weeks) improvements in knowledge, confidence, and likelihood of using the strategies taught. Thematic analysis of interview data showed the workshop enhanced attendees' knowledge of the care pathway, understanding of patient's experience of anaphylaxis as psychological not purely physical, and altered their communication with this and other patient groups. However, interviewees perceived lack of time and organisational factors as barriers to using the strategies and techniques taught in clinical contexts. CONCLUSION Training clinicians in psychologically informed strategies produce sustained improvements in their confidence and knowledge around patient autoinjector education, and their likelihood of using strategies in clinical practice. CLINICAL RELEVANCE Exploring psychological barriers should be part of training patients with anaphylaxis in autoinjector use.
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Affiliation(s)
- Béré Mahoney
- School of PsychologyUniversity of WorcesterWorcesterUK
| | | | | | - Steve O'Hickey
- School of PsychologyUniversity of WorcesterWorcesterUK
- College of Health, Life and Environmental SciencesWorcestershire Acute Hospitals NHS TrustWorcesterUK
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