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Tang YT, Chooi WT. A systematic review of the effects of positive versus negative framing on cancer treatment decision making. Psychol Health 2023; 38:1148-1173. [PMID: 34856837 DOI: 10.1080/08870446.2021.2006197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/21/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Presenting treatment outcomes positively or negatively may differently influence treatment preferences and lead to sub-optimal decision in a medical context. This review systematically organised how positive versus negative framing of treatment outcomes influenced cancer treatment decisions of cancer patients and individuals without a cancer diagnosis. DESIGN Three databases (PubMed, PsycInfo and Scopus) were searched for studies reporting the effects of positive versus negative framing on cancer treatment decision-making from 1981 to December 2020. MAIN OUTCOME MEASURE The effects of positive versus negative framing on cancer treatment preferences and the elimination of framing effect were evaluated. RESULTS A total of 12 studies that met inclusion criteria were reviewed. Framing effect was consistently observed in individuals without a cancer diagnosis. There was not enough evidence to suggest a robust framing effect in cancer patients. Surgery was preferred in positive framing, whereas adjuvant therapy was preferred in negative framing. Justification intervention significantly eliminated framing effect. Mixed framing failed to eliminate framing effect. CONCLUSION Current recommendations for presenting treatment options are based on research in cancer-screening decision-making. Knowledge of how positive versus negative framing affect cancer patients' treatment decisions is still limited. Our review highlighted the need for continued research in this area.
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Affiliation(s)
- Yi-Ting Tang
- School of Social Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Weng-Tink Chooi
- School of Social Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
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2
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Patel C, Snyder J. Using Whiteboard Animation and Patient Narratives for Learning Clinical Ophthalmology: Student Perspectives. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:585-593. [PMID: 37325129 PMCID: PMC10263155 DOI: 10.2147/amep.s408254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/27/2023] [Indexed: 06/17/2023]
Abstract
Purpose In ophthalmology, an area that lacks teaching time in university, whiteboard animation and patient narratives may be untapped resources for learning. This research will seek student perspectives on both formats. The authors hypothesise that these formats would be a useful learning tool for clinical ophthalmology in the medical curriculum. Patients and Methods The principal aims were to report the prevalence of using whiteboard animation and patient narratives to learn clinical ophthalmology and determine medical students' perspectives on their satisfaction and value as a learning tool. A whiteboard animation and patient narrative video on an ophthalmological condition were provided to students attending two medical schools in South Australia. Following this, they were asked to provide feedback via an online questionnaire. Results A total of 121 wholly answered surveys were obtained. 70% of students use whiteboard animation for medicine, but only 28% use it for ophthalmology. There was a significant association between the qualities of the whiteboard animation and satisfaction (P<0.001). 25% of students use patient narratives for medicine, but only 10% use it for ophthalmology. Nonetheless, most of the students reported that patient narratives are engaging and improve memory. Conclusion The consensus is that these learning methods would be welcome in ophthalmology if more content like this were available. According to medical students, whiteboard animation and patient narratives are helpful methods of learning ophthalmology, and a continued effort should be made for their use.
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Affiliation(s)
- Chirag Patel
- College of Medicine and Public Health, Flinders University, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Joseph Snyder
- College of Medicine and Public Health, Flinders University, Flinders Medical Centre, Bedford Park, SA, Australia
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3
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Grocott B, Reynolds K, Logan G, Hebbard P, El-Gabalawy R. Breast cancer patient experiences of perioperative distress and anxiety: A qualitative study. Eur J Oncol Nurs 2023; 63:102299. [PMID: 36893576 DOI: 10.1016/j.ejon.2023.102299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/01/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
PURPOSE Distress, often manifesting as anxiety, is common in breast cancer patients and becomes particularly elevated before surgery. This study investigated perspectives of those undergoing breast cancer surgery concerning what enhances and reduces distress and anxiety across the perioperative period (i.e., from diagnostic evaluation to recovery). METHODS The present study conducted qualitative semi-structured individual interviews with 15 adult breast cancer surgery patients within three months post-operation. Quantitative surveys provided background information (e.g., sociodemographics). Individual interviews were analyzed using thematic analysis. Quantitative data were analyzed descriptively. RESULTS Four main themes emerged from qualitative interviews: 1) "fighting an unknown" (sub-themes: uncertainty, health-related knowledge and experience); 2) "the cancer takes away the control" (sub-themes: "living at the whim of others", trusting care providers); 3) person at the centre of the patient (sub-themes: "managing life:" caregiving and work-related stressors, "everybody jumped in to help:" emotional and instrumental support); and 4) physical and emotional impacts of treatment (sub-themes: pain and impacted mobility, "losing a part of yourself"). Breast cancer patients' experiences of surgery-related distress and anxiety were contextualized by broader experiences of care. CONCLUSIONS Our findings illustrate the illness-specific experience of perioperative anxiety and distress in breast cancer patients and inform patient-centered care and intervention.
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Affiliation(s)
- Bronwen Grocott
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Gabrielle Logan
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Pamela Hebbard
- Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; CancerCare Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; CancerCare Manitoba, Canada.
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4
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León-Salas B, Álvarez-Pérez Y, Ramos-García V, Del Mar Trujillo-Martín M, de Pascual Y Medina AM, Esteva M, Brito-García N, González-Hernández N, Bohn-Sarmiento U, Biurrun-Martínez MC, Serrano-Aguilar P. Information needs and research priorities in long-term survivorship of breast cancer: Patients and health professionals' perspectives. Eur J Cancer Care (Engl) 2022; 31:e13730. [PMID: 36226900 DOI: 10.1111/ecc.13730] [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: 05/24/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The objective of this work is to identify unmet information needs of long-term-survivors of breast cancer (BC) and future research needs from the perspectives of patients and health care professionals. METHODS Two online Delphi surveys were conducted. Participants in Survey 1 were patients. Participants in Survey 2 were health care professionals from both primary and secondary care involved in BC care. Both surveys included three successive rounds. The first round aimed to identify research and information needs; the second round aimed to rank the relative importance of those needs; the third round aimed to find consensus. RESULTS The most important information needs were self-management recommendations of common health problems after treatment and complications of breast reconstruction after 5 years. The most important research priorities were related to interventions and tools to increase information provision by professionals about certain tests, diet, and coordinated action between primary and specialised care during follow-up, and indications and safety issues of pregnancy in survivors. CONCLUSIONS Two fundamental ideas were identified: (1) Patients request information about self-management common health problems after treatment and breast reconstruction complications. (2) Health care professionals emphasise the need for a standardised approach based on protocols, recommendations, and coordinated actions in the provision of information. IMPLICATIONS FOR CANCER SURVIVORS Given the increasing number of BC survivors, it is essential to identify information and research needs to improve their care and health outcomes.
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Affiliation(s)
- Beatriz León-Salas
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.,University of La Laguna (ULL), Santa Cruz de Tenerife, Spain
| | - Mª Del Mar Trujillo-Martín
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | | | - Magdalena Esteva
- Research Unit, Majorca Primary Care Department, Palma de Mallorca, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.,Red de Investigación de Actividades Preventivas y Promoción de la Salud (RedIAPP), Madrid, Spain
| | | | - Nerea González-Hernández
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.,Kronikgune Institute for Health Services Research, Bizkaia, Basque Country, Spain.,Research Unit, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - Uriel Bohn-Sarmiento
- Medical Oncology Service, University Hospital of Gran Canaria "Dr. Negrin", Las Palmas de Gran Canaria, Spain
| | | | - Pedro Serrano-Aguilar
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.,Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
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5
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Collet R, Major M, van Egmond M, van der Leeden M, Maccow R, Eskes A, Stuiver M. Experiences of interaction between people with cancer and their healthcare professionals: A systematic review and meta-synthesis of qualitative studies. Eur J Oncol Nurs 2022; 60:102198. [DOI: 10.1016/j.ejon.2022.102198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/16/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
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6
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Maes-Carballo M, Martín-Díaz M, Mignini L, Khan KS, Trigueros R, Bueno-Cavanillas A. Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2128. [PMID: 33671649 PMCID: PMC7926688 DOI: 10.3390/ijerph18042128] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/12/2021] [Accepted: 02/18/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. MATERIALS AND METHODS A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. RESULTS The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36-4.55)) and were in favour of its implementation (mean 4.58 (4.51-4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37-3.55)) and agreed on policies that improved its implementation (3.96 (3.88-4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients' paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). CONCLUSIONS New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.
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Affiliation(s)
- Marta Maes-Carballo
- Unidad de Patología Mamaria del Servicio de Cirugía General, Complexo Universitario Hospitalario de Ourense, 32005 Ourense, Spain;
- Department of Preventive Medicine and Public Health, University of Granada, 18014 Granada, Spain; (K.S.K.); (A.B.-C.)
| | | | - Luciano Mignini
- Unidad de Mastología del Grupo Oroño, 2000 Rosario, Argentina;
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, University of Granada, 18014 Granada, Spain; (K.S.K.); (A.B.-C.)
- CIBER of Epidimiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Rubén Trigueros
- Department of Language and Education, University of Antonio de Nebrija, 28015 Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, 18014 Granada, Spain; (K.S.K.); (A.B.-C.)
- CIBER of Epidimiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (IBS), 18012 Granada, Spain
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Brown DW, Atwood TF, Juang T, Moore KL, MacAulay R, Bazzo D, Murphy JD, Mundt AJ, Pawlicki T. Evaluation of a Patient Communication Skills Training Program for Medical Physicists. Int J Radiat Oncol Biol Phys 2020; 108:1284-1291. [PMID: 32711038 DOI: 10.1016/j.ijrobp.2020.07.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/12/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the efficacy of a training program designed to teach medical physicists how to communicate with patients effectively in the clinical environment. METHODS AND MATERIALS The training program was offered 3 times between 2016 and 2019. Participants were asked to rank their level of confidence in 5 categories relevant to patient communication on a 5-point Likert scale at 3 separate time points over the course of the training program. Participants were also asked to provide written responses to 5 common questions from patients at 2 separate time points, and these responses were numerically scored using the Constant Comparative Method. Competency in patient communication was assessed during simulated patient consults using a 9-element clinical competency assessment form. Changes in participants' stated level of confidence over the course of the training program and differences between faculty and residents were analyzed using the Student t test, and participants' scored responses to common questions were analyzed using analysis of variance. RESULTS Fifteen medical physicists participated in the training program: 6 resident physicists (4 first year and 2 second year) and 9 faculty physicists. Mean participant-stated level of confidence increased significantly across all categories (P < .05) between the first and second training intervention and between the second and third training intervention. There was no significant difference in mean participant-stated level of confidence between faculty and resident medical physicists. We observed statistically significant improvements in scored responses to common patient questions between the 2 assessment time points (P < .05). Of the 15 participants, 14 met competency assessment goals during simulated patient consults. CONCLUSIONS The patient communication skills training program increases medical physicists' level of confidence across 5 patient communication categories and improves their responses to common questions from patients. In addition, the program can discern differences in communication competency between physicists.
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Affiliation(s)
- Derek W Brown
- Department of Radiation Medicine and Applied Sciences, UC San Diego, Moores Cancer Center, La Jolla, California.
| | - Todd F Atwood
- Department of Radiation Medicine and Applied Sciences, UC San Diego, Moores Cancer Center, La Jolla, California
| | - Titania Juang
- Department of Radiation Medicine and Applied Sciences, UC San Diego, Moores Cancer Center, La Jolla, California
| | - Kevin L Moore
- Department of Radiation Medicine and Applied Sciences, UC San Diego, Moores Cancer Center, La Jolla, California
| | - Robert MacAulay
- Professional Development Center, School of Medicine, UC San Diego, La Jolla, California
| | - David Bazzo
- Family Medicine and Public Health, School of Medicine, UC San Diego, La Jolla, California
| | - James D Murphy
- Department of Radiation Medicine and Applied Sciences, UC San Diego, Moores Cancer Center, La Jolla, California
| | - Arno J Mundt
- Department of Radiation Medicine and Applied Sciences, UC San Diego, Moores Cancer Center, La Jolla, California
| | - Todd Pawlicki
- Department of Radiation Medicine and Applied Sciences, UC San Diego, Moores Cancer Center, La Jolla, California
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8
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Haste A, Lambert M, Sharp L, Thomson R, Sowden S. Patient experiences of the urgent cancer referral pathway-Can the NHS do better? Semi-structured interviews with patients with upper gastrointestinal cancer. Health Expect 2020; 23:1512-1522. [PMID: 32989907 PMCID: PMC7752202 DOI: 10.1111/hex.13136] [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: 03/12/2020] [Revised: 07/28/2020] [Accepted: 09/08/2020] [Indexed: 01/22/2023] Open
Abstract
Background Timeliness is viewed as a key feature of health‐care quality. Internationally, this is challenging. In England, cancer waiting time targets are currently not being met. For example, between 2015 and 2018 only 71% of patients with upper gastrointestinal (UGI) cancer started treatment within the recommended 62 days of referral. Objective We explored patients’ experiences to identify areas for service improvement. Design Semi‐structured interviews were conducted. Setting and participants Twenty patients who were referred through the urgent (two‐week) GP referral route and were within six months of receiving first treatment were recruited. Data analysis Data from the interviews were analysed thematically. Results Four themes were developed: organization of care; diagnosis; support; and views and expectations of the NHS. Patients described cross‐cutting issues such as complex and varied pathways and uncertainty about what would happen next. They felt daunted by the intensity and speed of investigations. They were presented with a recommended course of action rather than options and had little involvement in decision making. They were grateful for care, reluctant to complain and resigned to the status quo. Discussion and conclusions In order to meet patient needs, the NHS needs to improve communication and streamline pathways. Future cancer pathways also need to be designed to support shared decision making, be truly person‐centred and informed by patient experience.
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Affiliation(s)
- Anna Haste
- Department of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
| | - Mark Lambert
- Public Health England, North East Centre, Newcastle, UK
| | - Linda Sharp
- Newcastle University Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Richard Thomson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sarah Sowden
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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9
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Plage S. Cancer survivorship reimagined: A qualitative study on evolving interpretative repertoires of cancer and survivorship using participant-produced photography. Eur J Cancer Care (Engl) 2020; 29:e13320. [PMID: 32875657 DOI: 10.1111/ecc.13320] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/07/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE As more people live with cancer and for longer time periods, it is important to understand the growing diversity in lived experiences of survivorship. This study explored interpretative repertoires around cancer and their implications for survivorship from the perspectives of people with cancer to inform communication in cancer care. METHODS The sample included 11 participants (7 male, 4 female) with diverse cancer diagnoses and prognoses recruited through two public cancer care centres in Queensland, Australia. A narrative analysis of sequential interviews (n = 20) and photographs produced by the participants (n = 455) was conducted. RESULTS Four interrelated metaphors and narratives emerged in the interpretative repertoires of participants: cancer as a presence, survivorship as a struggle for meaning, survivorship as movement and survivorship as confluence. Continuities with "battle" and "journey" terminology were evident. However, these were subtly adapted and reimagined within participants' own lived experience. This was particularly pronounced among participants with incurable cancers, as they strived to make sense of contradictions within cancer survivorship. CONCLUSION The findings offer in-depth insights into the complexity and nuances of cancer survivorship. Such insights can contribute to facilitating successful and open-ended communication between cancer care providers, people with cancer and their families.
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Affiliation(s)
- Stefanie Plage
- Centre for Social Research in Health (CSRH), The University of New South Wales, Kensington, NSW, Australia
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10
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Hultstrand C, Coe AB, Lilja M, Hajdarevic S. Negotiating bodily sensations between patients and GPs in the context of standardized cancer patient pathways - an observational study in primary care. BMC Health Serv Res 2020; 20:46. [PMID: 31952534 PMCID: PMC6969453 DOI: 10.1186/s12913-020-4893-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 01/06/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND How interactions during patient-provider encounters in Swedish primary care construct access to further care is rarely explored. This is especially relevant nowadays since Standardized Cancer Patient Pathways have been implemented as an organizational tool for standardizing the diagnostic process and increase equity in access. Most patients with symptoms indicating serious illness as cancer initially start their diagnostic trajectory in primary care. Furthermore, cancer symptoms are diverse and puts high demands on general practitioners (GPs). Hence, we aim to explore how presentation of bodily sensations were constructed and legitimized in primary care encounters within the context of Standardized Cancer Patient Pathways (CPPs). METHODS Participant observations of patient-provider encounters (n = 18, on 18 unique patients and 13 GPs) were carried out at primary healthcare centres in one county in northern Sweden. Participants were consecutively sampled and inclusion criteria were i) patients (≥18 years) seeking care for sensations/symptoms that could indicate cancer, or had worries about cancer, Swedish speaking and with no cognitive disabilities, and ii) GPs who met with these patients during the encounter. A constructivist approach of grounded theory method guided the data collection and was used as a method for analysis, and the COREQ-checklist for qualitative studies (Equator guidelines) were employed. RESULTS One conceptual model emerged from the analysis, consisting of one core category Negotiating bodily sensations to legitimize access, and four categories i) Justifying care-seeking, ii) Transmitting credibility, iii) Seeking and giving recognition, and iv) Balancing expectations with needs. We interpret the four categories as social processes that the patient and GP constructed interactively using different strategies to negotiate. Combined, these four processes illuminate how access was legitimized by negotiating bodily sensations. CONCLUSIONS Patients and GPs seem to be mutually dependent on each other and both patients' expertise and GPs' medical expertise need to be reconciled during the encounter. The four social processes reported in this study acknowledge the challenging task which both patients and primary healthcare face. Namely, negotiating sensations signaling possible cancer and further identifying and matching them with the best pathway for investigations corresponding as well to patients' needs as to standardized routines as CPPs.
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Affiliation(s)
- Cecilia Hultstrand
- Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden.
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, SE-901 87, Umeå, Sweden.
| | - Anna-Britt Coe
- Department of Sociology, Umeå University, SE-901 87, Umeå, Sweden
| | - Mikael Lilja
- Department of Public Health and Clinical Medicine, Unit of Research, Education, and Development, Östersund Hospital, Umeå University, SE-901 87, Umeå, Sweden
| | - Senada Hajdarevic
- Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, SE-901 87, Umeå, Sweden
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11
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Villarejo-Rodríguez MG, Rodríguez-Martín B. Parents' and primary caregivers' conceptualizations of fever in children: A systematic review of qualitative studies. Nurs Health Sci 2019; 22:162-170. [PMID: 31452312 DOI: 10.1111/nhs.12639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/02/2019] [Accepted: 07/16/2019] [Indexed: 12/19/2022]
Abstract
This study was a systematic review and thematic synthesis of qualitative studies. The aim was to explore parents' and primary caregivers' knowledge and conceptualizations of fever in children aged between 0 and 12 years. A systematic literature search of the Medline, CINAHL, SCOPUS, Web of Science, Cochrane Library, BIREME, CUIDEN, ProQuest, and PsycINFO databases was undertaken for qualitative studies published in English or Spanish up to December 2018. Ten studies were included in the thematic synthesis. Parents' perceptions of their children's fever were classified according to three criteria: fever as a pathology, care for the febrile child, and the search for understandable and reliable information on this topic. Fever was perceived as being harmful to children's health and as a pathology that requires health care. Further studies are necessary to gather key information for improving health action plans and satisfaction with the care received. This information might help us to understand the management of fever and the related fears experienced by caregivers. These perceptions can be influenced by parents' knowledge, attitudes, and beliefs on fever and their previous experiences.
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Affiliation(s)
| | - Beatriz Rodríguez-Martín
- Social and Health Care Center, University of Castilla-La Mancha, Cuenca, Spain.,Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
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12
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Women's stories of living with breast cancer: A systematic review and meta-synthesis of qualitative evidence. Soc Sci Med 2019; 222:231-245. [PMID: 30665063 DOI: 10.1016/j.socscimed.2019.01.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/07/2018] [Accepted: 01/13/2019] [Indexed: 02/08/2023]
Abstract
RATIONALE Globally, breast cancer is by far the most frequently occurring cancer amongst women. Whilst the physical consequences of the disease and associated treatments are well documented, a comprehensive picture of how breast cancer is experienced at all stages of disease progression is lacking. OBJECTIVE This systematic review aimed to synthesize qualitative studies documenting women's breast cancer narratives into an empirically based explanatory framework. METHODS Two investigators independently searched Academic Search Premiere, CINAHL, Health Source: Nursing/Academic Edition, MEDLINE, PsycARTICLES, PubMed, Science Direct, SCOPUS, Web of Science and three international dissertation repositories using a pre-specified search strategy to identify qualitative studies on women's breast cancer narratives across all geographic and income-level settings. Of the 7840 studies that were screened for eligibility, included in the review were 180 studies, which were assessed using the Critical Appraisal Skills Programme. Using a 'meta-study' approach, an explanatory model of the breast cancer experience was formulated. Finally, we assessed the confidence in the review findings using the 'Confidence in the Evidence from Reviews of Qualitative Research' (CERQual) guidelines. RESULTS Eight core themes were identified: the burden of breast cancer, existential ordeal, illness appraisal, sources of support, being in the healthcare system, the self in relation to others, changes in self-image, and survivor identity. Together, these form the proposed Trajectory of Breast Cancer (TBC) framework. CONCLUSION The Trajectory of Breast Cancer explanatory framework offers a theoretically defensible synthesis of women's experiences of breast cancer. This framework provides an empirical basis for future reviewers conducting qualitative and narrative breast cancer research.
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13
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Ko E, Zúñiga ML, Peacher D, Palomino H, Watson M. Efficacy of Cancer Care Communication Between Clinicians and Latino Patients in a Rural US-Mexico Border Region: a Qualitative Study of Barriers and Facilitators to Better Communication. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:116-127. [PMID: 27558475 DOI: 10.1007/s13187-016-1100-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Quality of clinician-patient cancer communication is vital to cancer care and survivorship. Racial/ethnic minority patients in rural regions may have unique characteristics including cultural beliefs, language barriers, and low health literacy which require effective cross-cultural cancer communication. Despite the growing US population of racial/ethnic minorities and widespread emphasis on culturally appropriate health communication, little is known about challenges and facilitators of cancer communication among underserved rural Latino cancer patients in the US-Mexico border region. This study conducted secondary data analysis of interview data collected from 22 individual cancer patients living on the US side of the US-Mexico border. Thematic analysis was conducted to explore a priori questions regarding patient experiences with cancer care communication with their providers. Emerging themes included lack of language concordance, patient perspectives on clarity and accuracy of information provided, patient perceptions on provider sensitivity in giving cancer diagnosis, and improving the clinical interpersonal relationship. Practice guidelines are suggested and discussed. These findings illuminate the importance of advancing improvement of cancer communication between clinicians and Spanish language-dominant Latinos.
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Affiliation(s)
- Eunjeong Ko
- School of Social Work, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4119, USA.
| | - María Luisa Zúñiga
- Center for Alcohol and Drug Studies, School of Social Work, San Diego State University, 6386 Alvarado Court Ste 224, San Diego, CA, 92120, USA
| | - Diana Peacher
- Cancer Resource Center of the Desert, 444 S. 8th Street, Suite B3, El Centro, CA, 92243, USA
| | - Helen Palomino
- Cancer Resource Center of the Desert, 444 S. 8th Street, Suite B3, El Centro, CA, 92243, USA
| | - Mercedes Watson
- Cancer Resource Center of the Desert, 444 S. 8th Street, Suite B3, El Centro, CA, 92243, USA
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14
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Weller D, Mackenzie J. The EU and cancer research. Eur J Cancer Care (Engl) 2016; 25:689-90. [PMID: 27546531 DOI: 10.1111/ecc.12565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D Weller
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - James Mackenzie
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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