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McMillan D, Brown D, Rieger K, Duncan G, Plouffe J, Amadi C, Jafri S. Patient and family perceptions of a discharge bedside board. PEC INNOVATION 2023; 3:100214. [PMID: 37743957 PMCID: PMC10514555 DOI: 10.1016/j.pecinn.2023.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/14/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
Objective To explore patient and family perspectives of a discharge bedside board for supporting engagement in patient care and discharge planning to inform tool revision. Methods This qualitative descriptive study included 45 semi-structured interviews with a purposeful sample of English-speaking patients (n = 44; mean age 58.5 years) and their family members (n = 5) across seven adult inpatient units at a tertiary acute care hospital in mid-western Canada. Thematic (interviews), content (board, organization procedure document), and framework-guided integrated (all data) analyses were performed. Results Four themes were generated from interview data: understanding the board, included essential information to guide care, balancing information on the board, and maintaining a sense of connection. Despite application inconsistencies, documented standard procedures aligned with recommended board (re)orientation, timely patient-friendly content, attention to privacy, and patient-provider engagement strategies. Conclusion Findings indicate the tool supported consultation and some involvement level engagement in patient care and discharge. Board information was usually valued, however, perceived procedural gaps in tool education, privacy, and the quality of tool-related communication offer opportunities to strengthen patients' and families' tool experience. Innovation Novel application of a continuum engagement framework in the exploration of multiple data sources generated significant insights to guide tool revision.
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Affiliation(s)
- D.E. McMillan
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg R3T 2N2, Canada
- Health Sciences Centre, Winnipeg R3A 1R9, Canada
| | - D.B. Brown
- Health Sciences Centre, Winnipeg R3A 1R9, Canada
| | - K.L. Rieger
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg R3T 2N2, Canada
| | - G. Duncan
- Health Sciences Centre, Winnipeg R3A 1R9, Canada
| | - J. Plouffe
- Health Sciences Centre, Winnipeg R3A 1R9, Canada
| | - C.C. Amadi
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg R3T 2N2, Canada
| | - S. Jafri
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg R3T 2N2, Canada
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Kimminau KS, Jernigan C, Krebill H, Douglas S, Peltzer J, Hamilton-Reeves J, Chen RC, Jensen R. Roadmap to engagement: Bringing patient partners into cancer research and beyond. J Clin Transl Sci 2023; 7:e178. [PMID: 37654779 PMCID: PMC10465315 DOI: 10.1017/cts.2023.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 09/02/2023] Open
Abstract
The University of Kansas Cancer Center (KU Cancer Center) initiated an engagement program to leverage the lived experience of individuals and families with cancer. KU Cancer Center faculty, staff, and patient partners built an infrastructure to achieve a patient-designed, patient-led, and research-informed engagement program called Patient and Investigator Voices Organizing Together (PIVOT). This special communication offers an engagement roadmap that can be replicated, scaled, and adopted at other cancer centers and academic health systems. PIVOT demonstrates that collaboration among academic leaders, investigators, and people with a lived experience yields a patient-centered, vibrant environment that enriches the research enterprise.
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Affiliation(s)
- Kim S. Kimminau
- Department of Family and Community Medicine, University of Missouri-Columbia, Columbia, MO, USA
| | - Cheryl Jernigan
- University of Kansas Cancer Center, University of Kansas School of Medicine, Kansas City, KS, USA
| | | | - Sara Douglas
- Patient Advocacy and Engagement Talaris Therapeutics, Louisville, KY, USA
| | - Jill Peltzer
- University of Kansas School of Nursing, Kansas City, KS, USA
| | - Jill Hamilton-Reeves
- KU Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ronald C. Chen
- Department of Radiation Oncology, University of Kansas Cancer Center, Kansas City, KS, USA
| | - Roy Jensen
- University of Kansas Cancer Center, University of Kansas School of Medicine, Kansas City, KS, USA
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Büdenbender B, Köther AK, Grüne B, Michel MS, Kriegmair MC, Alpers GW. When attitudes and beliefs get in the way of shared decision-making: A mediation analysis of participation preference. Health Expect 2023; 26:740-751. [PMID: 36639880 PMCID: PMC10010103 DOI: 10.1111/hex.13699] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/26/2022] [Accepted: 12/22/2022] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Certain sociodemographic characteristics (e.g., older age) have previously been identified as barriers to patients' participation preference in shared decision-making (SDM). We aim to demonstrate that this relationship is mediated by the perceived power imbalance that manifests itself in patients' negative attitudes and beliefs about their role in decision-making. METHODS We recruited a large sample (N = 434) of outpatients with a range of urological diagnoses (42.2% urooncological). Before the medical consultation at a university hospital, patients completed the Patients' Attitudes and Beliefs Scale and the Autonomy Preference Index. We evaluated attitudes as a mediator between sociodemographic factors and participation preference in a path model. RESULTS We replicated associations between relevant sociodemographic factors and participation preference. Importantly, attitudes and beliefs about one's own role as a patient mediated this relationship. The mediation path model explained a substantial proportion of the variance in participation preference (27.8%). Participation preferences and attitudes did not differ for oncological and nononcological patients. CONCLUSION Patients' attitudes and beliefs about their role determine whether they are willing to participate in medical decision-making. Thus, inviting patients to participate in SDM should encompass an assessment of their attitudes and beliefs. Importantly, negative attitudes may be accessible to change. Unlike stable sociodemographic characteristics, such values are promising targets for interventions to foster more active participation in SDM. PATIENT OR PUBLIC CONTRIBUTION This study was part of a larger project on implementing SDM in urological practice. Several stakeholders were involved in the design, planning and conduction of this study, for example, three authors are practising urologists, and three are psychologists with experience in patient care. In addition, the survey was piloted with patients, and their feedback was integrated into the questionnaire. The data presented in this study is based on patients' responses. Results may help to empower our patients.
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Affiliation(s)
- Björn Büdenbender
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Anja K Köther
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Britta Grüne
- Department of Urology and Urosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maurice S Michel
- Department of Urology and Urosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maximilian C Kriegmair
- Department of Urology and Urosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
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Garratt A, Sagen J, Børøsund E, Varsi C, Kjeken I, Dagfinrud H, Moe RH. The Public and Patient Engagement Evaluation Tool: forward-backwards translation and cultural adaption to Norwegian. BMC Musculoskelet Disord 2022; 23:556. [PMID: 35676674 PMCID: PMC9178893 DOI: 10.1186/s12891-022-05514-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background Patient engagement is recommended for improving health care services, and to evaluate its organisation and impact appropriate, and rigorously evaluated outcome measures are needed. Methods Interviews (N = 12) were conducted to assess relevance of the Canadian Public and Patient Engagement Evaluation Tool (PPEET) in a Norwegian setting were performed. The tool was translated, back translated, and assessed following cognitive interviews (N = 13), according to the COSMIN checklist. Data quality was assessed in a cross-sectional survey of patient advisory board members from different rehabilitation institutions (N = 47). Results Interviews with patient board representatives confirmed the relevance of the PPEET Organisational questionnaire in a Norwegian setting and contributed five additional items. Translation and back translation of the original PPEET showed no major content differences. Differences in vocabulary and sentence structure were solved by discussion among the translators. Comments from cognitive interviews mainly related to the use of different synonyms, layout, and minor differences in semantic structure. Results of the cross-sectional survey support the data quality and construct validity of PPEET items, including 95 score comparisons where 76 (80%) were as hypothesized. Conclusions The PPEET Organisational questionnaire has been thoroughly translated and tested, and the resulting Evalueringsverktøy for Brukermedvirkning (EBNOR) has adequate levels of comprehensibility and content validity. Further testing for measurement properties is recommended, but given these results, the EBNOR should be considered for assessing patient engagement in a Norwegian health care organisational context.
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Affiliation(s)
- Andrew Garratt
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Joachim Sagen
- Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway.,Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Cecilie Varsi
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Ingvild Kjeken
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Hanne Dagfinrud
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Rikke Helene Moe
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
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Tobiano G, Chaboyer W, Dornan G, Teasdale T, Manias E. Older patients' engagement in hospital medication safety behaviours. Aging Clin Exp Res 2021; 33:3353-3361. [PMID: 33945114 DOI: 10.1007/s40520-021-01866-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/16/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Increasing age is associated with more medication errors in hospitalised patients. Patient engagement is a strategy to reduce medication harm. AIMS To measure older patients' preferences for and reported medication safety behaviours, identify the relationship between preferred and reported medication safety behaviours and identify whether perceptions of medication safety behaviours differ between groups of young-old, middle-old and old-old patients (65-74 years, 75-84 years, and ≥ 85 years). METHODS A survey, which included the Inpatient Medication Safety Involvement Scale (IMSIS) was administered to 200 older patients from medical settings, at one hospital. Data were analysed using descriptive statistics, Spearman's rho and the Kruskal-Wallis test. RESULTS Patients reported a desire to ask questions (59.5% n = 119) and check with healthcare professionals if they perceived that a medication was wrong (86.5% n = 173) or forgotten (87.0% n = 174). Patients did not have particular preferences, which differed from their experiences in terms of viewing the medication administration chart and self-administering medications. Preferred and reported behaviours correlated positively (r = 0.46-0.58, n = 200, p ≤ 0.001). Young-old patients preferred notifying healthcare professionals of perceived medication errors more than middle-old and old-old patients (p ≤ 0.05). CONCLUSIONS Older patients may prefer verbal medication safety behaviours like asking questions and notifying healthcare professionals of medication errors, over viewing medication charts and self-administering medications. The young-old group wanted to identify perceived medication errors more than other age groups. Older patients are willing to engage in medication safety behaviours, and healthcare professionals and organisations need to embrace this engagement in an effort to reduce medication harm.
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Affiliation(s)
- Georgia Tobiano
- National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
| | - Wendy Chaboyer
- National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia
| | - Gemma Dornan
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia
| | - Trudy Teasdale
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Deakin University and Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
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Mixed Methods Study of Nurse Assessment of Patient Preferences for Engagement During Hospitalization. Nurs Res 2021; 70:366-375. [PMID: 34116548 DOI: 10.1097/nnr.0000000000000526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Global health care initiatives emphasize the importance of engaging patients in their health care to improve the patient's experience and outcomes. Assessing patient preferences for engagement is critical, as there are many ways patients can engage in their care and preferences vary across individuals. OBJECTIVE The primary purpose of this study was to evaluate the effect of implementation of the Patient Preferences for Engagement Tool 13-Item Short Form (PPET13) during hospitalization on patient and nurse experience of engagement. Readmissions and emergency department (ED) usage within 30 days postdischarge was also examined. METHODS The mixed methods study was conducted within two medical units in the United States between December 2018 and May 2019. Pre-implementation group patients completed a demographic survey and the Patient Experience of Engagement Survey (PEES) on discharge. Implementation group patients completed the PPET13 within 24 hr of admission with their nurse and the demographic survey and PEES on discharge. A focus group with nurses who implemented the PPET13 was conducted following the implementation period. Data analysis included confirmatory factor analysis, multiple and logistic regression, and qualitative content analysis. RESULTS There was significant improvement in PEES during the implementation phase. The PEES score was a significant predictor of ED visits, but not 30-day readmissions. Nurses were not always certain how to best integrate patient preferences for engagement into their care delivery and suggested integrating the PPET13 into the electronic health record to assist with streamlining the assessment and communicating preferences across the care team. DISCUSSION Assessing patients' preferences for engagement using the PPET13 was associated with an improved experience of engagement, which was found to mediate the relationship between utilization of PPET13 and ED usage within 30 days postdischarge. Use of a PPET, such as the PPET13, can help inform the delivery of individualized engagement strategies to improve patient and family engagement and outcomes; however, nurses need formalized education on how to tailor their care to meet the individual engagement preferences of their patients.
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Tobiano G, Marshall AP, Chaboyer W. Comparing Perceptions of Patient Nonparticipation in Nursing Care: A Secondary Analysis. J Nurs Scholarsh 2021; 53:449-457. [PMID: 33713562 DOI: 10.1111/jnu.12643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Patient participation is characterized by dyadic patient-nurse interactions that enable patients to passively or actively participate in communicative and physical care activities. Less research has been conducted on nonparticipation. Examining this phenomenon may highlight issues to address and identify strategies that may ultimately promote patient participation and move the rhetoric of patient participation to a reality. The aim of this secondary analysis was to explore hospital patients' and nurses' perceptions of nonparticipation in nursing care specifically focused on communication and self-care. DESIGN Secondary supplementary analysis of qualitative data. We collated original transcripts from one dataset that included 20 patient and 20 nurse interviews conducted at two hospitals in Australia, in November 2013 to March 2014. METHODS Interviews were arranged into units of analysis dependent on group (patient/nurse) and setting (public/private hospital) and were reanalyzed using manifest, inductive content analysis. FINDINGS Two categories were found: (a) nurses impeding two-way clinical communication; and (b) patients and nurses disregarding patients' self-care efforts. These categories describe that nonparticipation occurred when nurses inhibited communication, and when patients were not involved in self-care while hospitalized or during discharge planning. CONCLUSIONS Perceptions of nonparticipation differ across settings, having implications for how patient participation recommendations are enacted in different contexts. CLINICAL RELEVANCE There is no one-size-fits-all approach; nurses need to identify common instances of nonparticipation within their setting and develop and implement strategies to promote patient participation that are suited to their context.
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Affiliation(s)
- Georgia Tobiano
- Phi Delta at Large, Senior Research Fellow (End User Engagement), National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University; and Gold Coast Health, Gold Coast, Australia
| | - Andrea P Marshall
- Phi Delta at Large, Professor of Acute and Complex Care in Nursing, Gold Coast Health and Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
| | - Wendy Chaboyer
- Phi Delta at Large, Director, National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
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Tobiano G, Jerofke‐Owen T, Marshall AP. Promoting patient engagement: a scoping review of actions that align with the interactive care model. Scand J Caring Sci 2020; 35:722-741. [DOI: 10.1111/scs.12914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/22/2020] [Accepted: 09/07/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Georgia Tobiano
- Nursing and Midwifery Education and Research Unit Gold Coast Health Southport Qld Australia
- Menzies Health Institute Queensland Griffith University Southport Qld Australia
| | | | - Andrea P. Marshall
- Nursing and Midwifery Education and Research Unit Gold Coast Health Southport Qld Australia
- Menzies Health Institute Queensland Griffith University Southport Qld Australia
- School of Nursing and Midwifery, Griffith University Southport Qld Australia
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