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Pask EB, Wu QL. Let's (not) talk about sexual health: How sexual communication apprehension with healthcare providers and peer communication influence intentions to protect sexual health. PATIENT EDUCATION AND COUNSELING 2024; 126:108318. [PMID: 38743964 DOI: 10.1016/j.pec.2024.108318] [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: 01/25/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE This study examined how patients' clinical and peer interactions may affect their communication apprehension with healthcare providers, a major communication barrier to sexual health protective behaviors (SHPB). METHODS Between January 2022 and February 2023, we conducted an online survey with 310 participants recruited through snowball sampling. Using structural equation modeling (SEM), we explored relationships among patient-provider interactions, peer communication about sex, communication apprehension with providers, and SHPB intentions. RESULTS Significant predictors of SHPB intentions included lower communication apprehension and more peer communication. Communication apprehension was a significant mediator in paths from peer communication and three types of patient-provider communication to SHPB intentions. CONCLUSIONS Our study indicates the need to address communication barriers to increase patients' SHPB intentions. Active patient involvement and patient-centered communication may open up discussions about sex in the clinical setting. Peer interactions, informed by scientific guidance, may reduce patients' apprehension, leading to better health outcomes. PRACTICE IMPLICATIONS Communication interventions are needed to promote collaborative patient-provider environments and peer sexual communication. Active involvement and evidence-based discussions can help patients navigate difficult conversations (e.g., like sex), improving SHPB.
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Affiliation(s)
| | - Qiwei Luna Wu
- School of Communication, Cleveland State University, Cleveland, OH, USA
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Dixon L, Berger C, Smalley B. The Sacred Space: Using Stages of Change Model With Motivational Interviewing to Promote Patient-Centered Healing. J Am Psychiatr Nurses Assoc 2024; 30:697-700. [PMID: 36840356 DOI: 10.1177/10783903231154607] [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] [Indexed: 02/26/2023]
Abstract
OBJECTIVE Help patients make necessary life changes to reach desired health outcomes. METHODS By combining the transtheoretical stages of the change model with motivational interviewing, nurse practitioners can hone powerful skills to enable patients to make their desired life changes. RESULTS Nurses and nurse practitioners can make a difference in patients' lives by connecting and partnering with them to create positive change for improved health outcomes. CONCLUSIONS Nurse educators should provide opportunities for nurses at all levels to learn and incorporate these skills into their practice.
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Affiliation(s)
- Lynette Dixon
- Lynette Dixon, PhD, LPC, NCC, CRAADC, Independent Scholar, MO, USA
| | - Carol Berger
- Carol Berger, DNP, APRN, FNP-C, BA, Maryville University, St. Louis, MO, USA
| | - Brandie Smalley
- Brandie Smalley, PhD, PMHNP-BC, Maryville University, St. Louis, MO, USA
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Chen X, Yuan J, Zhao W, Qin W, Gao J, Zhang Y. Which aspects of patient experience are the 'moment of truth' in the healthcare context: a multicentre cross-sectional study in China. BMJ Open 2024; 14:e077363. [PMID: 38326249 PMCID: PMC10860089 DOI: 10.1136/bmjopen-2023-077363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/19/2023] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE This study aimed to examine the differential magnitude of associations between specific dimensions of patient experience and overall patient satisfaction. DESIGN A descriptive, cross-sectional design was used to collect patient experience and overall satisfaction data. SETTING Participants were recruited at one tertiary general hospital, one tertiary specialised hospital, and one secondary hospital in Shanghai, China. These three institutes represent the main kinds of hospitals in the Chinese healthcare system. PARTICIPANTS 1532 inpatients were recruited, and 1469 were included. The inclusion criteria were as follows: (1) having received inpatient service for at least 2 days; (2) able to understand the questions in the questionnaires; and (3) aged>18 years old. Patients who had impaired cognitive function and completed the questionnaires with missing information were excluded. PRIMARY AND SECONDARY OUTCOME MEASURE Patient experience was measured using the Inpatient Experience with Nursing Care Scale, which is widely used in the China. The overall patient satisfaction was measured with 10-point response option. RESULTS The LASSO (least absolute shrinkage and selection operator) regression results showed that as the penalty factor (λ) = 0.0162, age, marriage status, financial status, length of hospital stay and numbers of previous of hospitalisation and six dimensions of nursing care remained in the model. As λ increases to 0.1862, only four patient experience variables, potentially the most influential on patient satisfaction, remained in the model. Patient experience with emotional support was the most significant dimension explaining patient satisfaction (β=0.1564), the second most significant dimension was admission and discharge management (β=0.1562), and the third was monitoring and coping with the progress of diseases (β=0.0613). CONCLUSION Patient experience with emotional support, admission and discharge management, monitoring and coping with the progress of diseases, and information and education are the most significant dimensions explaining patient satisfaction.
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Affiliation(s)
- Xiao Chen
- Nursing Department, Zhongshan Hospital Fudan University, Shanghai, China
| | - Jie Yuan
- Nursing Department, Shanghai Fengxian District Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Wenjuan Zhao
- Nursing Department, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wei Qin
- Nursing Department, Zhongshan Hospital Fudan University, Shanghai, China
| | - Jian Gao
- Biostatistics Department, Zhongshan Hospital Fudan University, Shanghai, China
| | - Yuxia Zhang
- Nursing Department, Zhongshan Hospital Fudan University, Shanghai, China
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Khaleghzadegan S, Rosen M, Links A, Ahmad A, Kilcullen M, Boss E, Beach MC, Saha S. Validating computer-generated measures of linguistic style matching and accommodation in patient-clinician communication. PATIENT EDUCATION AND COUNSELING 2024; 119:108074. [PMID: 38070297 DOI: 10.1016/j.pec.2023.108074] [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: 07/06/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE To explore the validity of computer-analyzed linguistic style matching (LSM) in patient-clinician communication. METHODS Using 330 transcribed HIV patient encounters, we quantified word use with Linguistic Inquiry and Word Count (LIWC), a dictionary-based text analysis software. We measured LSM by calculating the degree to which clinicians matched patients in the use of LIWC "function words" (e.g., articles, pronouns). We tested associations of different LSM metrics with patients' perceptions that their clinicians spoke similiarly to them. RESULTS We developed 3 measures of LSM: 1) at the whole-visit level; (2) at the turn-by-turn level; and (3) using a "rolling-window" approach, measuring matching between clusters of 8 turns per conversant. None of these measures was associated with patient-rated speech similarity. However, we found that increasing trajectories of LSM, from beginning to end of the visit, were associated with higher patient-rated speech similarity (β 0.35, CI 0.06, 0.64), compared to unchanging trajectories. CONCLUSIONS Our findings point to the potential value of clinicians' adapting their communication style to match their patients, over the course of the visit. PRACTICE IMPLICATIONS With further validation, computer-based linguistic analyses may prove an efficient tool for generating data on communication patterns and providing feedback to clinicians in real time.
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Affiliation(s)
- Salar Khaleghzadegan
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA.
| | - Michael Rosen
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anne Links
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alya Ahmad
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Molly Kilcullen
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Emily Boss
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary Catherine Beach
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Somnath Saha
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA; Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, USA
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Wu QL, Brannon GE. What's after COVID-19?: Communication pathways influencing future use of telehealth. PATIENT EDUCATION AND COUNSELING 2024; 118:108025. [PMID: 37852153 DOI: 10.1016/j.pec.2023.108025] [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: 07/29/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE Telehealth usage for healthcare encounters has increased dramatically due to the coronavirus disease (COVID-19) precautions. As the pandemic health threat subsides, it is important to understand how telehealth encounters are perceived by users. In this study, we explore how patient-centered communication (PCC), and media and organizational factors, influence patients' intentions to use telehealth in the future. METHODS An online survey was conducted among 326 adult patients who reported visiting a healthcare provider using telehealth within the past 12 months. Structural equation modeling explored how contextual factors influenced patients' adoption of telehealth. RESULTS PCC and ease of use indirectly predicted telehealth adoption through enhanced patient satisfaction and sense of care continuity. Sense of security indirectly predicted telehealth adoption via its association with enhanced rating of care quality. CONCLUSION The functionality of telehealth technology does not solely determine patients' telehealth adoption. Instead, positive healthcare experiences, facilitated by organizational support, quality media designs, as well as patient-centered communication, are associated with telehealth adoption. PRACTICE IMPLICATIONS Healthcare providers should strategically improve telehealth-related communication processes that can lead to better patient health outcomes.
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Affiliation(s)
- Qiwei Luna Wu
- School of Communication, Cleveland State University, USA.
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Lampart P, Häusler F, Langewitz W, Rubinelli S, Sigrist-Nix D, Scheel-Sailer A. Patients' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury: A pilot qualitative interview study. J Spinal Cord Med 2023; 46:837-847. [PMID: 35867389 PMCID: PMC10446827 DOI: 10.1080/10790268.2022.2095496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To explore patients' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury/disorder (SCI/D). DESIGN Qualitative design with semi-structured interviews and purposively sampled participants. Interviews were transcribed verbatim. Transcripts were analyzed for qualitative content analysis using the Mayring method. SETTING Specialized acute care and rehabilitation center for SCI/D-patients. PARTICIPANTS Patients in initial rehabilitation after a newly acquired SCI/D. INTERVENTIONS n.a. OUTCOME MEASURES n.a. RESULTS Ten participants were interviewed in the post-acute phase after a newly acquired SCI/D. Participants described individual patient characteristics as well as organizational elements influencing their experience with goal setting. Organizational elements comprised structural elements (e.g. ward rounds, rehabilitation meetings, etc.) and interaction with and among the interprofessional teams. Perspectives from various health care professionals (HCPs) were perceived as increasing adequate goal setting and motivation. Furthermore, the participants described their own involvement and motivation as crucial for goal achievement. The main point of the critique was the standardization of the goal setting process. Interviewees would have preferred individualized goal setting embedded in a clearly foreseeable rehabilitation plan. CONCLUSION Organization and collaboration with and among the HCPs should be geared towards identifying specific patient needs during the course of rehabilitation and deriving individually tailored goals from them. Communication plays an important role in the individual goal setting.
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Affiliation(s)
- Patricia Lampart
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Florin Häusler
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Sara Rubinelli
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Adebayo AL, Rowan KE, Sanchorawala V, Boedicker MN, Boedicker DD. Evaluating the Amyloidosis Speakers Bureau: the influence of amyloidosis patients' narratives on medical students' knowledge, attitudes, and behavioral intent. MEDEDPUBLISH 2023; 13:32. [PMID: 37753389 PMCID: PMC10518845 DOI: 10.12688/mep.19631.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Background: Amyloidosis is a complex multi-systemic disease. Lack of knowledge about amyloidosis and subsequent mis- or under-diagnosis are major obstacles to treatment, which result in life-threatening organ damage, morbidity, and mortality. Hence, the purpose of this study is to explore the effectiveness of amyloidosis patients' narratives on medical students. Methods: The Amyloidosis Speakers Bureau (ASB) arranges for amyloidosis patients to speak about their diagnostic and treatment experiences with medical students. Using a randomized post-test only experiment, we compared the effectiveness of patients' narratives between two groups (treatment and control). Outcome measures included medical students' intent to actively communicate with patients, acquire knowledge about amyloidosis, and reconsider diagnoses when warranted. Results: The treatment group (those who listened to an ASB patient speaker) had higher mean differences on all measures, including the desire to improve communication with patients, acquire and apply knowledge of amyloidosis, and willingness to reconsider diagnoses when symptoms are puzzling. Conclusions: ASB patient educators widened awareness of an under-diagnosed disease. Listening to a patient's narrative was associated with positive attitudes toward communication with patients, interest in acquiring and applying knowledge of amyloidosis, and humility about diagnosis. Narrative and persuasion theory are used to explain this quantitative evidence of the power of patient narratives.
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Affiliation(s)
- Adebanke L. Adebayo
- Department of Communication Studies, Washburn University, Topeka, Kansas, 66621, USA
| | - Katherine E. Rowan
- Department of Communication, George Mason University, Fairfix, Virginia, 22030, USA
| | - Vaishali Sanchorawala
- Amyloidosis Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts, 02115, USA
| | - Mackenzie N. Boedicker
- Amyloidosis Speakers Bureau / Mackenzie's Mission, Great Falls, Virginia, 22066, USA
- Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, 02115, USA
| | - Deborah D. Boedicker
- Amyloidosis Speakers Bureau / Mackenzie's Mission, Great Falls, Virginia, 22066, USA
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