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Salazar-Méndez J, Cuyul-Vásquez I, Ponce-Fuentes F, Guzmán-Muñoz E, Núñez-Cortés R, Huysmans E, Lluch-Girbés E, Viscay-Sanhueza N, Fuentes J. Pain neuroscience education for patients with chronic pain: A scoping review from teaching-learning strategies, educational level, and cultural perspective. PATIENT EDUCATION AND COUNSELING 2024; 123:108201. [PMID: 38387389 DOI: 10.1016/j.pec.2024.108201] [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: 12/08/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE (1) To identify the characteristics of PNE programs in terms of teaching-learning strategies, session modality, content delivery format, number of sessions, total minutes and instructional support material used in patients with chronic musculoskeletal pain, (2) to describe PNE adaptations for patients with different educational levels or cultural backgrounds, and (3) to describe the influence of the patient's educational level or cultural background on the effects of PNE. METHODS The PRISMA guideline for scoping reviews was followed. Nine databases were systematically searched up to July 8, 2023. Articles that examined clinical or psychosocial variables in adults with chronic musculoskeletal pain who received PNE were included. RESULTS Seventy-one articles were included. Studies found benefits of PNE through passive/active teaching-learning strategies with group/individual sessions. However, PNE programs presented great heterogeneity and adaptations to PNE were poorly reported. Most studies did not consider educational level and culture in the effects of PNE. CONCLUSIONS Despite the large number of studies on PNE and increased interest in this intervention, the educational level and culture are poorly reported in the studies. PRACTICAL IMPLICATIONS It is recommended to use passive and/or active teaching-learning strategies provided in individual and/or group formats considering the patient's educational level and culture.
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Affiliation(s)
| | - Iván Cuyul-Vásquez
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Chile; Facultad de las Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
| | - Felipe Ponce-Fuentes
- Escuela de Kinesiología, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Temuco, Chile
| | - Eduardo Guzmán-Muñoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Chile; Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Rodrigo Núñez-Cortés
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Departament of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy,Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels 1090, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels 1090, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium
| | - Enrique Lluch-Girbés
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy,Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels 1090, Belgium
| | | | - Jorge Fuentes
- Clinical Research Lab, Department of Physical Therapy, Catholic University of Maule, Chile; Faculty of Rehab Medicine, University of Alberta, Edmonton, Canada.
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Caroline D, Marie-France M. Get this thing out of my body! Factors determining consent for translational oncology research: a qualitative research. J Transl Med 2023; 21:336. [PMID: 37211597 DOI: 10.1186/s12967-023-04039-0] [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: 12/15/2022] [Accepted: 03/05/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Depending on the needs of scientific research at a given time, biobanks make biological samples and data available to researchers. In this article, we aim to describe the reasons and underlying logic that determine the decision to grant or deny consent to the conservation of tumour samples in a biological resource platform for research purposes. We make use of the CARPEM biological resource platform model, where broad consent is required. METHODS The results are based on semi-structured interviews, conducted between 2019 and 2021, with 25 individuals having various profiles. RESULTS All the people interviewed readily accepted the principle of conserving a tumour sample for research purposes. They explained their decision by citing the desire to participate in research dedicated to improving therapeutic medicine. Their trust in research institutions or in doctors was an important factor in their consent. The tumorous nature of the samples also played an important role, as did the absence of constraints. Finally, the high level of consent was also based on the difficulty they had in conceiving what the future risks might be once the sample had been taken, whereas the fact that they did not know the nature or purpose of the research to be carried out when they signed the consent form posed some problems. These results stem from a lack of a culture of ethics among the people interviewed. CONCLUSION The information provided in the context of consent at the CARPEM tumour bank seems inadequate for consent to be considered 'informed', given the low level of knowledge that people have of the risks and issues. Information is missing even though we feel it would not change consent or only marginally. This raises questions, since part of the act of granting consent is based on the implicit trust French people have in the hospital that collects the data and in research practices in general. In the minds of those who participate, transparency is the ground on which trust rests. Lack of transparency could be deleterious for future research practices. However, it is not by striving to improve information leaflets that the consent-related information will improve but, rather, by more effectively helping future patients to assimilate that information.
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Affiliation(s)
- Desprès Caroline
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Laboratoire Êtres, Unité Fonctionnelle d'Éthique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France.
| | - Mamzer Marie-France
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Laboratoire Êtres, Unité Fonctionnelle d'Éthique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France
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Brown A, Tan A, Anable L, Callander E, De Abreu Lourenco R, Pain T. Perceptions and recall of treatment for prostate cancer: A survey of two populations. Tech Innov Patient Support Radiat Oncol 2022; 24:78-85. [PMID: 36304425 PMCID: PMC9594631 DOI: 10.1016/j.tipsro.2022.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/22/2022] [Accepted: 10/03/2022] [Indexed: 11/14/2022] Open
Abstract
Background The complexity of prostate cancer care can impact on patient understanding and participation in shared decision-making. This study used a survey-based approach to investigate patients' recall of their prostate cancer treatment, and more broadly, to understand the perceptions of patients and the general population of prostate cancer treatment. Method The survey was completed by 236 patients with prostate cancer (PCa cohort) and 240 participants from the general population of Australia (GenPop cohort). Free-text comments from both cohorts were analysed using content analysis. The PCa cohort reported which treatments and image-guidance related procedures they had received. These patient-reports were compared to medical records and analysed using proportion agreement, kappa statistics and regression analysis. Results 135 (57%) PCa and 99 (41%) GenPop respondents provided at least one comment. Five major themes were identified by both cohorts: sharing experiences of treatment; preferences insights and reflections; mindsets; general commentary on the survey; and factors missing from the survey. There was overall good treatment recall amongst the PCa cohort, with proportions of correct recall ranging from 97.3% for chemotherapy to 66.8% for hormone therapy. There was a tendency for younger patients (<70 years old) to recall their hormone treatment more correctly. Conclusion Participant comments suggest the complexity of prostate cancer diagnosis and treatment, and the varying perceptions and experiences of participants with prostate cancer. Patients' recall overall was good for both treatment and image-guidance related procedures/approaches, however the poorer recall of hormone therapy requires further investigation.
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Affiliation(s)
- Amy Brown
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University - Bebegu Yumba Campus, Townsville, QLD, Australia
- Corresponding author at: PO Box 670, Townsville Hospital and Health Service, Queensland 4815, Australia.
| | - Alex Tan
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University - Bebegu Yumba Campus, Townsville, QLD, Australia
| | - Lux Anable
- Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - Emily Callander
- James Cook University - Bebegu Yumba Campus, Townsville, QLD, Australia
- Monash University, Melbourne, VIC, Australia
| | | | - Tilley Pain
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University - Bebegu Yumba Campus, Townsville, QLD, Australia
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Schnitman G, Gomes D, Deckelbaum D, Utiyama EM. Feasibility of multimedia animations as preoperative guides for urgent abdominal surgeries in a public hospital in Brazil. HEALTH EDUCATION RESEARCH 2022; 37:333-354. [PMID: 36125090 DOI: 10.1093/her/cyac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Health literacy, culture and language play vital roles in patients' understanding of health issues. Obstacles are more evident in low- and middle-income countries (LMICs), where inadequate patient education levels are higher and hospital resources are lower. This is a prospective pilot study assessing the feasibility of digital preoperative animations as guides for surgical patients. Patients admitted to a public hospital in Brazil for acute cholecystitis or appendicitis were included. Feasibility was represented by acceptability rate and ease of integration with department protocols. Thirty-four patients were included, and 26 patients concluded the intervention (76.5% acceptability rate). Demographic factors seemed to affect the results, indicated by higher acceptability from those with lower education levels, from younger patients and from women. Few studies have evaluated the use of multimedia resources for surgical patients, and no studies assessed the use of animations as digital patient education resources in an LMIC. This study demonstrated that the use of animations for patient education in LMICs is feasible. A step-based approach is proposed to aid the implementation of patient education digital interventions. The use of digital multimedia animations as preoperative guides in LMICs is feasible. It may help improve patient education and promote clinical benefits.
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Affiliation(s)
- Gabriel Schnitman
- Centre for Global Surgery, Department of Experimental Surgery, McGill University, 1650 Cedar Avenue, Room L9-505, Montreal, QC H3G 1A4, Canada
| | - Danila Gomes
- Hospital das Clínicas, Universidade de São Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira César, São Paulo, SP 05403-000, Brazil
| | - Dan Deckelbaum
- Centre for Global Surgery, Department of Experimental Surgery, McGill University, 1650 Cedar Avenue, Room L9-505, Montreal, QC H3G 1A4, Canada
| | - Edivaldo Massazo Utiyama
- Hospital das Clínicas, Universidade de São Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira César, São Paulo, SP 05403-000, Brazil
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Desprès C, Mamzer MF. Le consentement éclairé en question dans le cadre de collections en biobanque. Bull Cancer 2022; 109:948-959. [DOI: 10.1016/j.bulcan.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
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Vilela SR, Leão-Cordeiro JAB, Moraes KL, Suzuki K, Brasil VV, Silva AMTC. Cardiopulmonary resuscitation for lay people: Evaluation of videos from the perspective of digital health literacy. Rev Lat Am Enfermagem 2022; 30:e3601. [PMID: 35858005 DOI: 10.1590/1518-8345.5623.3601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/02/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze the quality indicators and technical content of the videos for lay people posted on the YouTube platform, on cardiopulmonary resuscitation in adults and their audiovisual production regarding the principles of digital health literacy. METHOD a descriptive and exploratory study, which selected videos recorded between December 2015 and April 2021. They were analyzed by indicators of the production of audiovisual material, considering the American Heart Association guidelines and the principles of digital health literacy. Descriptive and inferential statistics were performed. RESULTS of the 121 videos analyzed, 26 did not comply with any indicator on cardiopulmonary resuscitation, four reached 81% compliance, eight videos reached 79%, nine reached 69% and 74 videos, from 6% to 63%. According to the principles of digital health literacy, one video met 85% of the indicators, 81 met from 50% to 80% and 39, from 10% to 49%. A positive correlation was identified between literacy and cardiopulmonary resuscitation. CONCLUSION no video presented 100% compliance with the American Heart Association guidelines. The absence of mechanisms for supervision and control over health-related contents allows for the posting of mistaken videos, which have been used as a learning method by people and can thus miss their greatest goal: save lives.
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Affiliation(s)
- Sara Rodrigues Vilela
- Universidade Federal de Goiás, Faculdade de Enfermagem, Goiânia, GO, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | | | | | - Karina Suzuki
- Universidade Federal de Goiás, Faculdade de Enfermagem, Goiânia, GO, Brasil
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Vilela SR, Leão-Cordeiro JAB, Moraes KL, Suzuki K, Brasil VV, Silva AMTC. Reanimación cardiopulmonar para legos: evaluación de videos desde la perspectiva de la alfabetización digital en salud. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5623.3600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumen Objetivo: analizar los indicadores de calidad y contenido técnico de los videos publicados en la plataforma YouTube, para legos, sobre reanimación cardiopulmonar en adultos y su producción audiovisual según los principios de la alfabetización digital en salud. Método: estudio descriptivo, exploratorio, que seleccionó videos grabados entre diciembre de 2015 y abril de 2021. Fueron analizados en función de los indicadores de producción de material audiovisual, considerando las directrices de la American Heart Association y los principios de la alfabetización digital en salud. Se realizó estadística descriptiva e inferencial. Resultados: de los 121 videos analizados, 26 no cumplieron con ninguno de los indicadores de reanimación cardiopulmonar; cuatro lograron un 81% de conformidad; ocho videos, 79%; nueve videos, 69% y 74 videos de seis a 63%. De acuerdo con los principios de la alfabetización digital en salud, un video cumplió con el 85% de los indicadores; 81 videos cumplieron del 50 al 80% y 39 videos del 10 al 49%. Se identificó una correlación positiva entre la alfabetización y la reanimación cardiopulmonar. Conclusión: ningún video cumplió el 100% de las directrices de la American Heart Association. La falta de mecanismos de supervisión y control sobre los contenidos relacionados con la salud permite la publicación de videos erróneos, que han sido utilizados como experiencia de aprendizaje por las personas y es probable que no cumplan con el principal objetivo, que es salvar vidas.
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Affiliation(s)
- Sara Rodrigues Vilela
- Universidade Federal de Goiás, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Vilela SR, Leão-Cordeiro JAB, Moraes KL, Suzuki K, Brasil VV, Silva AMTC. Cardiopulmonary resuscitation for lay people: Evaluation of videos from the perspective of digital health literacy. Rev Lat Am Enfermagem 2022. [PMID: 35858005 PMCID: PMC9285196 DOI: 10.1590/1518-8345.5623.3542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: to analyze the quality indicators and technical content of the videos for lay people posted on the YouTube platform, on cardiopulmonary resuscitation in adults and their audiovisual production regarding the principles of digital health literacy. Method: a descriptive and exploratory study, which selected videos recorded between December 2015 and April 2021. They were analyzed by indicators of the production of audiovisual material, considering the American Heart Association guidelines and the principles of digital health literacy. Descriptive and inferential statistics were performed. Results: of the 121 videos analyzed, 26 did not comply with any indicator on cardiopulmonary resuscitation, four reached 81% compliance, eight videos reached 79%, nine reached 69% and 74 videos, from 6% to 63%. According to the principles of digital health literacy, one video met 85% of the indicators, 81 met from 50% to 80% and 39, from 10% to 49%. A positive correlation was identified between literacy and cardiopulmonary resuscitation. Conclusion: no video presented 100% compliance with the American Heart Association guidelines. The absence of mechanisms for supervision and control over health-related contents allows for the posting of mistaken videos, which have been used as a learning method by people and can thus miss their greatest goal: save lives.
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Affiliation(s)
- Sara Rodrigues Vilela
- Universidade Federal de Goiás, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Turkdogan S, Schnitman G, Wang T, Gotlieb R, How J, Gotlieb WH. Development of a Digital Patient Education Tool for Patients With Cancer During the COVID-19 Pandemic. JMIR Cancer 2021; 7:e23637. [PMID: 34101611 PMCID: PMC8218900 DOI: 10.2196/23637] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/24/2021] [Accepted: 06/02/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Due to the COVID-19 pandemic, a large portion of oncology consultations have been conducted remotely. The maladaptation or compromise of care could negatively impact oncology patients and their disease management. OBJECTIVE We aimed to describe the development and implementation process of a web-based, animated patient education tool that supports oncology patients remotely in the context of fewer in-person interactions with health care providers. METHODS The platform created presents multilingual oncology care instructions. Animations concerning cancer care and mental health during the COVID-19 pandemic as well as immunotherapy and chemotherapy guides were the major areas of focus and represented 6 final produced video guides. RESULTS The videos were watched 1244 times in a period of 6 months. The most watched animation was the COVID-19 & Oncology guide (viewed 565 times), followed by the video concerning general treatment orientations (viewed 249 times) and the video titled "Chemotherapy" (viewed 205 times). Although viewers were equally distributed among the age groups, most were aged 25 to 34 years (342/1244, 27.5%) and were females (745/1244, 59.9%). CONCLUSIONS The implementation of a patient education platform can be designed to prepare patients and their caregivers for their treatment and thus improve outcomes and satisfaction by using a methodical and collaborative approach. Multimedia tools allow a portion of a patient's care to occur in a home setting, thereby freeing them from the need for hospital resources.
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Affiliation(s)
- Sena Turkdogan
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - Gabriel Schnitman
- Department of Experimental Surgery, McGill University, Montreal, QC, Canada
| | - Tianci Wang
- Department of Physiology, McGill University, Montreal, QC, Canada
| | | | - Jeffrey How
- Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, TX, United States
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Jacquier E, Laurent-Puig P, Badoual C, Burgun A, Mamzer MF. Facing new challenges to informed consent processes in the context of translational research: the case in CARPEM consortium. BMC Med Ethics 2021; 22:21. [PMID: 33653311 PMCID: PMC7927247 DOI: 10.1186/s12910-021-00592-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the context of translational research, researchers have increasingly been using biological samples and data in fundamental research phases. To explore informed consent practices, we conducted a retrospective study on informed consent documents that were used for CARPEM's translational research programs. This review focused on detailing their form, their informational content, and the adequacy of these documents with the international ethical principles and participants' rights. METHODS Informed consent forms (ICFs) were collected from CARPEM investigators. A content analysis focused on information related to biological samples and data treatment (context of sampling and collect, aims, reuse, consent renewal), including the type of consent. An automatic assessment of the readability of the ICFs were performed with the IT program "Flesch Score". RESULTS 29 ICFs from 25 of 49 studies were analyzed after selection criteria were applied. Three types of consent were identified: 11 broad consents, six specific consents, and two opt-out consents. The Flesch Scores showed that most of the documents were too complex to be fully understood by most of the potential research participants. Most of the biological samples were collected during the healthcare routine, but the information content about secondary use of biological samples varied between ICFs. All documents mentioned personal data treatment but information about their reuse was not standardized in the ICFs. CONCLUSIONS Our review of current IC procedures of CARPEM showed that practices could be improved considering new translational research methods. "Old fashion written ICFs" should be adapted to the translational research approach, to better respect individual rights and international research ethics principles. In this context, theoretically, a digital tool allowing dynamic information and consent of participants, through an electronic interactive platform may be a good way to promote more active participation in research. Nevertheless, its feasibility in the complex environment of biological samples and data research remains to prove. The way of a combination of a broad consent followed by dynamic information may be alternatively tested.
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Affiliation(s)
- Elise Jacquier
- Centre de Recherche Des Cordeliers (UMRS 1138), INSERM, Sorbonne Université, Université de Paris, Team ETREs, 75006 Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche Des Cordeliers (UMRS 1138), Team Personalized Medicine, INSERM, Sorbonne Université, Université de Paris, Pharmacogenomics and Therapeutic Optimization, 75006 Paris, France
- Pharmacogénétique Et Oncologie Moléculaire, Hôpital Européen Georges Pompidou, Assistance publique – Hôpitaux de Paris, Paris, France
| | - Cécile Badoual
- Centre de Ressources Biologiques, Service d’anatomo-pathologie, Hôpital Européen Georges Pompidou, Assistance publique – Hôpitaux de Paris, Paris, France
| | - Anita Burgun
- Département D’informatique Médicale, de Biostatistique Et de Santé Publique, Hôpital Européen Georges Pompidou, Assistance publique – Hôpitaux de Paris, Paris, France
- UMR-S 1138, Centre de Recherche Des Cordeliers, Paris, France
- Faculté de Médecine, Université Paris Descartes, Sorbonne Universités, Paris, France
| | - Marie-France Mamzer
- Centre de Recherche Des Cordeliers (UMRS 1138), INSERM, Sorbonne Université, Université de Paris, Team ETREs, 75006 Paris, France
- Unité Fonctionnelle D’éthique Et Médecine Légale, Hôpital Necker-Enfants Maladies, Paris, France
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López-Entrambasaguas OM, Martínez-Linares JM, Sola-García M, García-Redecillas C, Díaz-Meco-Niño AM. Economic Problems and Loneliness as Factors Related to Subjective Unmet Health Needs in People with Chronic Diseases and Dependency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082924. [PMID: 32340277 PMCID: PMC7216074 DOI: 10.3390/ijerph17082924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/17/2022]
Abstract
Background: The continuous increase of people with chronic diseases is one of the greatest challenges for healthcare systems worldwide. Population growth and life expectancy means that an increasing number of people with chronic diseases and dependency need some kind of assistance to meet their needs. Determining these subjective unmet needs helps to understand the situation of these people. The aim of this study was to explore the perceptions of chronic patients over 65 years of age from the day-care center toward subjective health needs that are not being met by the socio-health system. Methods: Qualitative exploratory-descriptive study. Through convenience sampling, we selected people with chronic diseases and dependency who used day-care centers and met the inclusion criteria. Focus groups were performed. The data were transcribed and a thematic analysis was carried out using Atlas.ti software. Results: The topics resulting from the analysis were classified into dissatisfaction of biological/physiological needs, psychological needs, social needs, and other issues that arose in both groups of participants which referred to the types of needs previously indicated. The issues related to social and psycho-social needs stood out. Conclusions: People with chronic diseases and dependency have their physiological needs covered with the help they receive, but their situation of dependency generates additional costs that worsen their economic situation. However, their greatest need is due to the loneliness they feel and the feeling they have of “being a burden” on their families.
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Affiliation(s)
| | | | - Miguel Sola-García
- Complejo Hospitalario de Jaén, Servicio Andaluz de Salud, 23007 Jaén, Spain; (M.S.-G.); (C.G.-R.); (A.M.D.-M.-N.)
| | - Carmen García-Redecillas
- Complejo Hospitalario de Jaén, Servicio Andaluz de Salud, 23007 Jaén, Spain; (M.S.-G.); (C.G.-R.); (A.M.D.-M.-N.)
| | - Ana María Díaz-Meco-Niño
- Complejo Hospitalario de Jaén, Servicio Andaluz de Salud, 23007 Jaén, Spain; (M.S.-G.); (C.G.-R.); (A.M.D.-M.-N.)
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Readability of Patient Education Materials From RadiologyInfo.org: Has There Been Progress Over the Past 5 Years? AJR Am J Roentgenol 2019; 213:875-879. [PMID: 31386570 DOI: 10.2214/ajr.18.21047] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. As patients increasingly turn to the Internet for healthcare information, it is imperative that patient educational materials be written at an appropriate readability level. Although RadiologyInfo.org, a patient education library sponsored by the American College of Radiology (ACR) and Radiological Society of North America, was shown in 2012 to be written at levels too high for the average patient to adequately comprehend, it is unclear if there has been progress made in the past 5 years. The purpose of this study was to provide a 5-year update on the readability of patient education materials from RadiologyInfo.org. MATERIALS AND METHODS. All patient education articles available in 2017 from the ACR and RSNA-sponsored RadiologyInfo.org patient education library were reviewed. We assessed each article for readability using 6 quantitative readability scales: the Flesch-Kincaid (FK) grade level, Flesch Reading Ease, Gunnin-Fog Index, Coleman-Liau Index, Automated Readability Index, and the Simple Measure of Gobbledygook (SMOG). The number of articles with readability ≤ the 8th grade level (average reading ability of US adults) and the 6th-grade level (NIH-recommended level for patient materials) were determined. RESULTS. 131 patient education articles were reviewed. The mean readability grade level was greater than the 11th grade reading level for all readability scales. None of the articles were written at less than the 8th-grade or the 6th-grade levels. CONCLUSION. Although there has been an increasing awareness of the issue of readability of patient educational materials within the radiological community, the patient educational materials within the ACR and RSNA-sponsored RadiologyInfo.org website are still written at levels too high for the average patient. Future efforts should be made to improve the readability of those patient education materials.
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Bröder J, Chang P, Kickbusch I, Levin-Zamir D, McElhinney E, Nutbeam D, Okan O, Osborne R, Pelikan J, Rootman I, Rowlands G, Nunes-Saboga L, Simmons R, Sørensen K, Van den Broucke S, Velardo S, Wills J. IUHPE Position Statement on Health Literacy: a practical vision for a health literate world. Glob Health Promot 2018. [DOI: 10.1177/1757975918814421] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The International Union for Health Promotion and Education (IUHPE) Position Statement on Health Literacy provides an overview of existing evidence and continuing debate on health literacy. Developed by the IUHPE Global Working Group on Health Literacy, including experts from around the globe, the Statement provides a basis for discussion and advocacy, by and with IUHPE, both within the health promotion community, and among stakeholders and partners in health promotion. The Statement offers a detailed introduction to the concept of health literacy, calling for global action to improve health literacy in populations. It positions health literacy as an important and modifiable social determinant of health, that plays a significant role in broadly-based strategies for health promotion. The Statement emphasises the necessity of a systems approach to health literacy, underpinned by global, national, regional and local policies. It summarises key evidence to guide practice and policy development, recognising the importance of continued investment in intervention research, in professional and consumer capacity building, and in the transfer of research findings into frontline health promotion practice. In summary, health literacy is understood as an important cross-cutting issue in health promotion throughout the lifespan, which has practical application in guiding clinical practice, public health interventions and public policy for the advancement of global health.
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Affiliation(s)
- Janine Bröder
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Peter Chang
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Ilona Kickbusch
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Diane Levin-Zamir
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Evelyn McElhinney
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Don Nutbeam
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Orkan Okan
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Richard Osborne
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Jürgen Pelikan
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Irving Rootman
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Gillian Rowlands
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Luis Nunes-Saboga
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Robert Simmons
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Kristine Sørensen
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Stephan Van den Broucke
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Stefania Velardo
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
| | - Jane Wills
- Acknowledgement of supporting policy documents: Nutbeam (37); Sorensen (38); Kickbusch et al. (34)
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Huang YJ, Chen CT, Lin GH, Wu TY, Chen SS, Lin LF, Hou WH, Hsieh CL. Evaluating the European Health Literacy Survey Questionnaire in Patients with Stroke: A Latent Trait Analysis Using Rasch Modeling. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 11:83-96. [PMID: 28710681 DOI: 10.1007/s40271-017-0267-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The effective self-management and treatment of long-term disability after stroke depends greatly on the health literacy of patients. The European Health Literacy Survey Questionnaire (HLS-EU-Q) is a comprehensive and theory-based measure that captures multiple self-perceived competencies of health literacy and covers a diverse range of health contexts. However, there is no psychometric evidence on the HLS-EU-Q in the stroke population. OBJECTIVE The aim of this study was to examine the validity of the HLS-EU-Q in patients with stroke using Rasch analysis. METHODS We compared the model deviance among the one-domain, three-domain, four-domain, and 12-domain structures using likelihood ratio tests to determine the dimensionality of the HLS-EU-Q. Thereafter, we examined the unidimensionality of each domain, local independence, item fit, response categories, and differential item functioning (DIF) for the best fitting structure. RESULTS A total of 311 patients with stroke participated in this study. Rasch analysis revealed that the 12-domain HLS-EU-Q demonstrated the best data-model fit. The original 4-point scales showed disordering, which can be corrected by rescaling them as 3-point scales with the two middle categories collapsed. All 47 items in the rescaled HLS-EU-Q fit the 12-domain Rasch model, demonstrated local independence, assessed the 12 unidimensional domains respectively, and had invariant difficulties between different age or education groups of the patients with stroke. CONCLUSION We recommend using the 12-domain scores of the rescaled HLS-EU-Q to comprehensively and accurately capture the competencies to access, understand, appraise, and apply health information within the three health contexts of healthcare, disease prevention, and health promotion for patients with stroke.
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Affiliation(s)
- Yi-Jing Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Te Chen
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu, Taiwan
| | - Gong-Hong Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzu-Yi Wu
- Institute of Economics, Academia Sinica, Taipei, Taiwan
| | - Sheng-Shiung Chen
- Department of Physical Medicine and Rehabilitation, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Gerontology and Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Wen-Hsuan Hou
- School of Gerontology and Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan. .,Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei, 110, Taiwan. .,Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan.
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
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15
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Patients' experience of decision-making and receiving information during radiation therapy: A qualitative study. Eur J Oncol Nurs 2017; 30:97-106. [DOI: 10.1016/j.ejon.2017.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/09/2017] [Accepted: 08/19/2017] [Indexed: 02/03/2023]
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16
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Lee K, Hoti K, Hughes JD, Emmerton L. Dr Google Is Here to Stay but Health Care Professionals Are Still Valued: An Analysis of Health Care Consumers' Internet Navigation Support Preferences. J Med Internet Res 2017; 19:e210. [PMID: 28615156 PMCID: PMC5489708 DOI: 10.2196/jmir.7489] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/28/2017] [Accepted: 04/10/2017] [Indexed: 11/13/2022] Open
Abstract
Background The Internet offers great opportunities for consumers to be informed about their health. However, concerns have been raised regarding its impact on the traditional health consumer-health professional relationship. Our recent survey of 400 Australian adults identified that over half of consumers required some form of navigational support in locating appropriate Web-based health information. We propose that support provided by health professionals would be preferred by consumers; this preference is regardless of whether consumers have a need for navigational support. Secondary analysis of the survey dataset is presented here to quantify consumer-reported support preferences and barriers when navigating Web-based health information. Objective We aimed to quantitatively identify consumers’ support preferences for locating Web-based health information and their barriers when navigating Web-based health information. We also aimed to compare such preferences and barriers between consumers identified as needing and not needing support when locating Web-based health information. Methods Chi-square (χ2) tests identified whether each listed support preference differed between subgroups of consumers classified as needing (n=205, 51.3%) or not needing (n=195, 48.8%) navigational support; degree of association, via phi coefficient (φ) tests, were also considered to ascertain the likely practical significance of any differences. This was repeated for each listed barrier. Free-text responses regarding additional support preferences were descriptively analyzed and compared with the quantitative findings to provide a richer understanding of desired support for health information searches. Results Of the 400 respondents, the most preferred mode of navigational support was involvement of health professionals; this was reported by participants identified as needing and not needing navigational support. While there was a significant difference between groups, the degree of association was small (χ21 [N=400]=13.2; P<.001; φ=.18). Qualitative data from the free-text responses supported consumers’ desire for health professional involvement. The two most commonly reported barriers when navigating desired Web-based health information were (1) volume of available information and (2) inconsistency of information between sources; these were reported by participants with and without a need for navigational support. While participants identified with a need for navigational support were more likely to report volume (χ21 [N=387]= 4.40; P=.04; φ=.11) and inconsistency of information (χ21 [N=387]= 16.10, P<.001, φ=.20) as barriers, the degrees of association were small to moderate. Conclusions Despite concerns in the literature that the popularity of the Internet could compromise the health consumer-health professional relationship, our findings suggest the contrary. Our findings showed that health professionals were found to be the most commonly preferred mode of navigational support, even among consumers classified as not needing navigational support. Further research into how health professionals could assist consumers with Web-based health information seeking could strengthen the health consumer-health professional relationship amidst the growing use of “Dr Google.”
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Affiliation(s)
- Kenneth Lee
- Division of Pharmacy, School of Medicine, University of Tasmania, Hobart, Australia
| | - Kreshnik Hoti
- School of Pharmacy, Faculty of Health Sciences, Curtin University, Perth, Australia.,Division of Pharmacy, Faculty of Medicine, University of Prishtina, Prishtina, Albania
| | - Jeffery David Hughes
- School of Pharmacy, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Lynne Emmerton
- School of Pharmacy, Faculty of Health Sciences, Curtin University, Perth, Australia
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Lee K, Hoti K, Hughes JD, Emmerton LM. Consumer Use of "Dr Google": A Survey on Health Information-Seeking Behaviors and Navigational Needs. J Med Internet Res 2015; 17:e288. [PMID: 26715363 PMCID: PMC4710847 DOI: 10.2196/jmir.4345] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 09/15/2015] [Accepted: 11/09/2015] [Indexed: 12/12/2022] Open
Abstract
Background The Internet provides a platform to access health information and support self-management by consumers with chronic health conditions. Despite recognized barriers to accessing Web-based health information, there is a lack of research quantitatively exploring whether consumers report difficulty finding desired health information on the Internet and whether these consumers would like assistance (ie, navigational needs). Understanding navigational needs can provide a basis for interventions guiding consumers to quality Web-based health resources. Objective We aimed to (1) estimate the proportion of consumers with navigational needs among seekers of Web-based health information with chronic health conditions, (2) describe Web-based health information-seeking behaviors, level of patient activation, and level of eHealth literacy among consumers with navigational needs, and (3) explore variables predicting navigational needs. Methods A questionnaire was developed based on findings from a qualitative study on Web-based health information-seeking behaviors and navigational needs. This questionnaire also incorporated the eHealth Literacy Scale (eHEALS; a measure of self-perceived eHealth literacy) and PAM-13 (a measure of patient activation). The target population was consumers of Web-based health information with chronic health conditions. We surveyed a sample of 400 Australian adults, with recruitment coordinated by Qualtrics. This sample size was required to estimate the proportion of consumers identified with navigational needs with a precision of 4.9% either side of the true population value, with 95% confidence. A subsample was invited to retake the survey after 2 weeks to assess the test-retest reliability of the eHEALS and PAM-13. Results Of 514 individuals who met our eligibility criteria, 400 (77.8%) completed the questionnaire and 43 participants completed the retest. Approximately half (51.3%; 95% CI 46.4-56.2) of the population was identified with navigational needs. Participants with navigational needs appeared to look for more types of health information on the Internet and from a greater variety of information sources compared to participants without navigational needs. However, participants with navigational needs were significantly less likely to have high levels of eHealth literacy (adjusted odds ratio=0.83, 95% CI 0.78-0.89, P<.001). Age was also a significant predictor (P=.02). Conclusions Approximately half of the population of consumers of Web-based health information with chronic health conditions would benefit from support in finding health information on the Internet. Despite the popularity of the Internet as a source of health information, further work is recommended to maximize its potential as a tool to assist self-management in consumers with chronic health conditions.
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Affiliation(s)
- Kenneth Lee
- Curtin University, School of Pharmacy, Curtin University, Perth, Australia
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18
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Laybourne AH, Morgan M, Watkins SH, Lawton R, Ridsdale L, Goldstein LH. Self-management for people with poorly controlled epilepsy: Participants' views of the UK Self-Management in epILEpsy (SMILE) program. Epilepsy Behav 2015; 52:159-64. [PMID: 26426353 DOI: 10.1016/j.yebeh.2015.08.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 08/11/2015] [Accepted: 08/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Epilepsy is a long-term condition that requires self-management, but currently, there is no well-evaluated epilepsy self-education or self-management intervention in the United Kingdom (UK). AIM The aim of this study was to examine the views and experiences of the first participants of the Self-Management in epILEpsy UK (SMILE UK) program to assist the development of a full trial. METHOD In-depth semistructured interviews and group discussions were conducted with 10 people with poorly controlled epilepsy to explore their views and experiences of the self-management program. Interviews were audio-recorded, transcribed, and analyzed thematically. RESULTS All participants viewed the program positively. Three themes emerged: i) peer support was experienced through knowledge sharing, disclosure of experiences, and exchange of contact details; ii) participants felt better equipped to enter discussions with doctors and other health-care professionals about their condition; and iii) participants reported an improvement in their personal life through increased confidence to live with epilepsy and acceptance of their diagnosis. CONCLUSION A brief group self-management intervention increased knowledge and confidence in managing epilepsy.
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Affiliation(s)
- Anne H Laybourne
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Myfanwy Morgan
- King's College London, Division of Health & Social Care Research, Faculty of Life Sciences & Medicine, Addison House, Guy's campus, London SE1 1UL, United Kingdom.
| | - Sarah H Watkins
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Rebecca Lawton
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Leone Ridsdale
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Laura H Goldstein
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom.
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Simpson ML, Berryman K, Oetzel J, Iti T, Reddy R. A cultural analysis of New Zealand palliative care brochures. Health Promot Int 2015; 31:839-848. [PMID: 26163520 DOI: 10.1093/heapro/dav067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Low utilization of palliative care services by Māori remains despite increases in services designed to meet Māori needs. The purpose of this study is to explore palliative care information brochures in the context of Māori principles of well-being and communication protocols, and health literacy. We examined 99 brochures from palliative care services in New Zealand and held two focus groups with 12 Māori elders (kaumātua) and extended family (whanau) members. Taking a cultural-discursive approach incorporating Māori worldviews, we analysed textual and conceptual features of the brochures. The findings centred on cultural connection and disconnection within the brochures and serve as a critique of the prominent messages currently presented in these brochures. The findings raise questions about the capacity of agencies to convey culturally resonant messages to kaumātua and their whānau. We identify implications of palliative care brochures for health literacy of provider organizations as well as kaumātua and whanau.
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Affiliation(s)
- Mary Louisa Simpson
- Management Communication, University of Waikato, PB 3105, Hillcrest Rd, Hamilton 3240, New Zealand
| | - Kay Berryman
- Waikato-Tainui College for Research and Development, Hamilton, New Zealand
| | - John Oetzel
- Management Communication, University of Waikato, PB 3105, Hillcrest Rd, Hamilton 3240, New Zealand
| | - Tiwai Iti
- Rauawaawa Kaumātua Charitable Trust, Hamilton, New Zealand
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20
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Hart TL, Blacker S, Panjwani A, Torbit L, Evans M. Development of multimedia informational tools for breast cancer patients with low levels of health literacy. PATIENT EDUCATION AND COUNSELING 2015; 98:370-377. [PMID: 25481575 DOI: 10.1016/j.pec.2014.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 09/23/2014] [Accepted: 11/12/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To create informational tools for breast cancer patients with low levels of health literacy. METHODS Tools were developed through a three-stage process. (1) Focus groups were conducted with breast cancer survivors and interviews were held with health educators to determine content, source of information, format and medium of the tools. (2) Based on this feedback, a suite of tools was developed. (3) Focus groups were reconvened and health educators re-interviewed to obtain feedback and determine satisfaction. RESULTS We developed a suite of five informational tools using low health literacy principles, which focused on learning about breast cancer resources and learning about the members of one's healthcare team, understanding the "journey" or trajectory of care beginning at diagnosis, hearing from other breast cancer patients about their own journey, and becoming informed about what to expect pre-and post-surgery for breast cancer. The final products were rated highly by breast cancer survivors. CONCLUSION The developed materials, designed for patients who read below an 8th grade level, reflect the informational needs reported by breast cancer patients. PRACTICE IMPLICATIONS Healthcare providers must consider utilizing design principles and theories of adult learning appropriate for those with low health literacy.
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Affiliation(s)
- Tae L Hart
- Department of Psychology, Ryerson University, Toronto, Canada; Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
| | - Susan Blacker
- Cancer Services, Planning, and Performance, St. Michael's Hospital, Toronto, Canada
| | - Aliza Panjwani
- Department of Psychology, Ryerson University, Toronto, Canada
| | - Lindsey Torbit
- Department of Psychology, Ryerson University, Toronto, Canada
| | - Michael Evans
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Health Design Lab, St. Michael's Hospital, Toronto, Canada
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21
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Lee K, Hoti K, Hughes JD, Emmerton L. Dr Google and the consumer: a qualitative study exploring the navigational needs and online health information-seeking behaviors of consumers with chronic health conditions. J Med Internet Res 2014; 16:e262. [PMID: 25470306 PMCID: PMC4275480 DOI: 10.2196/jmir.3706] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/24/2014] [Accepted: 10/20/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The abundance of health information available online provides consumers with greater access to information pertinent to the management of health conditions. This is particularly important given an increasing drive for consumer-focused health care models globally, especially in the management of chronic health conditions, and in recognition of challenges faced by lay consumers with finding, understanding, and acting on health information sourced online. There is a paucity of literature exploring the navigational needs of consumers with regards to accessing online health information. Further, existing interventions appear to be didactic in nature, and it is unclear whether such interventions appeal to consumers' needs. OBJECTIVE Our goal was to explore the navigational needs of consumers with chronic health conditions in finding online health information within the broader context of consumers' online health information-seeking behaviors. Potential barriers to online navigation were also identified. METHODS Semistructured interviews were conducted with adult consumers who reported using the Internet for health information and had at least one chronic health condition. Participants were recruited from nine metropolitan community pharmacies within Western Australia, as well as through various media channels. Interviews were audio-recorded, transcribed verbatim, and then imported into QSR NVivo 10. Two established approaches to thematic analysis were adopted. First, a data-driven approach was used to minimize potential bias in analysis and improve construct and criterion validity. A theory-driven approach was subsequently used to confirm themes identified by the former approach and to ensure identified themes were relevant to the objectives. Two levels of analysis were conducted for both data-driven and theory-driven approaches: manifest-level analysis, whereby face-value themes were identified, and latent-level analysis, whereby underlying concepts were identified. RESULTS We conducted 17 interviews, with data saturation achieved by the 14th interview. While we identified a broad range of online health information-seeking behaviors, most related to information discussed during consumer-health professional consultations such as looking for information about medication side effects. The barriers we identified included intrinsic barriers, such as limited eHealth literacy, and extrinsic barriers, such as the inconsistency of information between different online sources. The navigational needs of our participants were extrinsic in nature and included health professionals directing consumers to appropriate online resources and better filtering of online health information. Our participants' online health information-seeking behaviors, reported barriers, and navigational needs were underpinned by the themes of trust, patient activation, and relevance. CONCLUSIONS This study suggests that existing interventions aimed to assist consumers with navigating online health information may not be what consumers want or perceive they need. eHealth literacy and patient activation appear to be prevalent concepts in the context of consumers' online health information-seeking behaviors. Furthermore, the role for health professionals in guiding consumers to quality online health information is highlighted.
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Affiliation(s)
- Kenneth Lee
- School of Pharmacy, Curtin University, Perth, Australia
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22
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Morris RL, Brand CA, Hill KD, Ayton DR, Redfern J, Nyman SR, Lowthian JA, Hill AM, Etherton-Beer CD, Flicker L, Hunter PC, Barker AL. RESPOND: a patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall-protocol for a mixed methods programme evaluation. Inj Prev 2014; 22:153-60. [PMID: 25392367 DOI: 10.1136/injuryprev-2014-041453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 10/26/2014] [Indexed: 11/03/2022]
Abstract
BACKGROUND Programme evaluations conducted alongside randomised controlled trials (RCTs) have potential to enhance understanding of trial outcomes. This paper describes a multi-level programme evaluation to be conducted alongside an RCT of a falls prevention programme (RESPOND). OBJECTIVES (1) To conduct a process evaluation in order to identify the degree of implementation fidelity and associated barriers and facilitators. (2) To evaluate the primary intended impact of the programme: participation in fall prevention strategies and the factors influencing participation. (3) To identify the factors influencing RESPOND RCT outcomes: falls, fall injuries and emergency department (ED) re-presentations. METHODS/DESIGN 528 community-dwelling adults aged 60-90 years presenting to two EDs with a fall will be recruited and randomly assigned to the intervention or standard care group. All RESPOND participants and RESPOND clinicians will be included in the evaluation. A mixed methods design will be used and a programme logic model will frame the evaluation. Data will be sourced from interviews, focus groups, questionnaires, clinician case notes, recruitment records, participant-completed calendars, hospital administrative datasets and audio-recordings of intervention contacts. Quantitative data will be analysed via descriptive and inferential statistics and qualitative data will be interpreted using thematic analysis. DISCUSSION The RESPOND programme evaluation will provide information about contextual and influencing factors related to the RESPOND RCT outcomes. The results will assist researchers, clinicians and policy makers regarding decisions about future falls prevention interventions. Insights gained may be applicable to a range of chronic conditions where similar preventive intervention approaches are indicated. TRIAL REGISTRATION NUMBER This programme evaluation is linked to the RESPOND RCT which is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684).
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Affiliation(s)
- R L Morris
- Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - C A Brand
- Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - K D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - D R Ayton
- Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J Redfern
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | - S R Nyman
- Department of Psychology, Faculty of Science and Technology, Bournemouth University Dementia Institute, Bournemouth University, Poole, Dorset, UK
| | - J A Lowthian
- Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - A M Hill
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - C D Etherton-Beer
- University of Western Australia, Perth, Western Australia, Australia Department of Psychology Geriatric Medicine, Royal Perth Hospital, Perth, Western Australia, Australia Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
| | - L Flicker
- University of Western Australia, Perth, Western Australia, Australia Department of Psychology Geriatric Medicine, Royal Perth Hospital, Perth, Western Australia, Australia Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
| | - P C Hunter
- Alfred Health, Melbourne, Victoria, Australia Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - A L Barker
- Health Services Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Lee K, Hoti K, Hughes JD, Emmerton LM. Interventions to assist health consumers to find reliable online health information: a comprehensive review. PLoS One 2014; 9:e94186. [PMID: 24710348 PMCID: PMC3978031 DOI: 10.1371/journal.pone.0094186] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 03/10/2014] [Indexed: 02/07/2023] Open
Abstract
Background Health information on the Internet is ubiquitous, and its use by health consumers prevalent. Finding and understanding relevant online health information, and determining content reliability, pose real challenges for many health consumers. Purpose To identify the types of interventions that have been implemented to assist health consumers to find reliable online health information, and where possible, describe and compare the types of outcomes studied. Data Sources PubMed, PsycINFO, CINAHL Plus and Cochrane Library databases; WorldCat and Scirus ‘gray literature’ search engines; and manual review of reference lists of selected publications. Study Selection Publications were selected by firstly screening title, abstract, and then full text. Data Extraction Seven publications met the inclusion criteria, and were summarized in a data extraction form. The form incorporated the PICOS (Population Intervention Comparators Outcomes and Study Design) Model. Two eligible gray literature papers were also reported. Data Synthesis Relevant data from included studies were tabulated to enable descriptive comparison. A brief critique of each study was included in the tables. This review was unable to follow systematic review methods due to the paucity of research and humanistic interventions reported. Limitations While extensive, the gray literature search may have had limited reach in some countries. The paucity of research on this topic limits conclusions that may be drawn. Conclusions The few eligible studies predominantly adopted a didactic approach to assisting health consumers, whereby consumers were either taught how to find credible websites, or how to use the Internet. Common types of outcomes studied include knowledge and skills pertaining to Internet use and searching for reliable health information. These outcomes were predominantly self-assessed by participants. There is potential for further research to explore other avenues for assisting health consumers to find reliable online health information, and to assess outcomes via objective measures.
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Affiliation(s)
- Kenneth Lee
- School of Pharmacy, Curtin University, Perth, Western Australia, Australia
| | - Kreshnik Hoti
- School of Pharmacy, Curtin University, Perth, Western Australia, Australia
| | - Jeffery D. Hughes
- School of Pharmacy, Curtin University, Perth, Western Australia, Australia
| | - Lynne M. Emmerton
- School of Pharmacy, Curtin University, Perth, Western Australia, Australia
- * E-mail:
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Pham AK, Bauer MT, Balan S. Closing the patient-oncologist communication gap: a review of historic and current efforts. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:106-113. [PMID: 24092531 DOI: 10.1007/s13187-013-0555-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Effective communication is essential in developing any relationship--this is particularly true between oncologists and their patients. The patient-oncologist relationship is one of the most delicate in medicine, and given the strong emotions associated with cancer, successful communication plays a paramount role in the wellbeing of patients and oncologists. Significant advances to close the communication gap have occurred over the past several decades, largely by addressing deficiencies in the various stages of an oncologist's lengthy training: undergraduate medical education, residency and fellowship, and continuing medical education. Stemming from several milestones achieved by highly motivated groups of individuals, including the creation of consensus statements and guidelines by communication education experts, progress has been made to improve patient-oncologist communication. This progress is marked by the development of evidence-based communication skills training programs, such as Oncotalk and Comskil, in addition to the creation of distant-learning modalities, such as the Studying Communication in Oncologist-Patient Encounters trial. This review article outlines the history of communication education during medical education and training, and brings to light more recent efforts to promote competent, communication-minded physicians necessary for effective cancer care.
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Affiliation(s)
- A Khoa Pham
- Geisel School of Medicine at Dartmouth, Dartmouth College, Rubin Mail Box 75, Hanover, NH, 03755, USA,
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Hamrosi KK, Raynor DK, Aslani P. Pharmacist and general practitioner ambivalence about providing written medicine information to patients—A qualitative study. Res Social Adm Pharm 2013; 9:517-30. [DOI: 10.1016/j.sapharm.2013.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 01/18/2013] [Accepted: 02/28/2013] [Indexed: 10/27/2022]
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Smith S, Petrak LM, Dhillon H, Taylor J, Milross C. Are radiation oncologists aware of health literacy among people with cancer treated with radiotherapy? Eur J Cancer Care (Engl) 2013; 23:111-20. [DOI: 10.1111/ecc.12111] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- S.K. Smith
- Psychosocial Research Group; Prince of Wales Clinical School; Faculty of Medicine; University of New South Wales; Sydney NSW
| | - L.-M. Petrak
- Sydney Medical School; University of Sydney; Sydney NSW
| | - H.M. Dhillon
- Central Clinical School; Sydney Medical School; University of Sydney; Sydney NSW
- Psycho-Oncology Cooperative Research Group; School of Psychology; Faculty of Science; University of Sydney; Sydney NSW
| | - J. Taylor
- Sydney Medical School; University of Sydney; Sydney NSW
| | - C.G. Milross
- Central Clinical School; Sydney Medical School; University of Sydney; Sydney NSW
- Sydney Cancer Centre; Department of Radiation Oncology; Royal Prince Alfred Hospital; Sydney NSW Australia
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Persson K. The right perspective on responsibility for ill health. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2013; 16:429-441. [PMID: 22893116 DOI: 10.1007/s11019-012-9432-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There is a growing trend in policy making of holding people responsible for their lifestyle-based diseases. This has sparked a heated debate on whether people are responsible for these illnesses, which has now come to an impasse. In this paper, I present a psychological model that explains why different views on people's responsibility for their health exist and how we can reach a resolution of the disagreement. My conclusion is that policymakers should not perceive people as responsible while health care personnel should take the opposing view.
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Affiliation(s)
- Karl Persson
- Department of Philosophy, Linguistics and Theory of Science, The Faculty of Arts, Olof Wijksgatan 6, Box 200, 405 30 Göteborg, Sweden.
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Smith SK, Zhu Y, Dhillon HM, Milross CG, Taylor J, Halkett G, Zilliacus E. Supporting patients with low health literacy: what role do radiation therapists play? Support Care Cancer 2013; 21:3051-61. [PMID: 23812495 DOI: 10.1007/s00520-013-1875-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 06/05/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Health literacy plays a key role in a patient's ability to use health information and services, and can affect health outcomes. This study aimed to explore radiation therapists' perspectives on how they support people with lower health literacy who are undergoing radiotherapy. METHODS Semi-structured interviews were conducted with 25 radiation therapists working in radiation oncology departments in New South Wales, Australia. RESULTS The four key themes were (1) the process of identifying a patient with low health literacy, (2) the perceived consequences of low health literacy, (3) managing and responding to the needs of different health literacy groups and (4) recommendations to address low health literacy in radiotherapy. Radiation therapists appeared to make an informal, intuitive judgment about a patient's health literacy, using a variety of verbal and non-verbal cues as well as impromptu conversations with the multi-disciplinary team. Patients perceived to have lower health literacy were described as having greater difficulties assimilating knowledge and engaging in self-care. Although participants reported communicating to patients at a basic level initially, they subsequently tailored their communication to match a patient's health literacy. Strategies reported to communicate to low health literacy groups ranged from using lay language with minimal medical terminology, using visual aids (photos), using analogies, reiterating information and asking family members with higher literacy to attend consultations. CONCLUSION A more structured approach to supporting patients with low health literacy and integrating health literacy training in radiation oncology departments may help to minimise the adverse outcomes typically experienced by this population.
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Affiliation(s)
- Sian K Smith
- Psychosocial Research Group Prince of Wales Clinical School Level 4, C25 Lowy Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia,
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Bostock S, Steptoe A. Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ 2012; 344:e1602. [PMID: 22422872 PMCID: PMC3307807 DOI: 10.1136/bmj.e1602] [Citation(s) in RCA: 338] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the association between low functional health literacy (ability to read and understand basic health related information) and mortality in older adults. DESIGN Population based longitudinal cohort study based on a stratified random sample of households. SETTING England. PARTICIPANTS 7857 adults aged 52 or more who participated in the second wave (2004-5) of the English Longitudinal Study of Ageing and survived more than 12 months after interview. Participants completed a brief four item test of functional health literacy, which assessed understanding of written instructions for taking an aspirin tablet. MAIN OUTCOME MEASURE Time to death, based on all cause mortality through October 2009. RESULTS Health literacy was categorised as high (maximum score, 67.2%), medium (one error, 20.3%), or low (more than one error, 12.5%). During follow-up (mean 5.3 years) 621 deaths occurred: 321 (6.1%) in the high health literacy category, 143 (9.0%) in the medium category, and 157 (16.0%) in the low category. After adjusting for personal characteristics, socioeconomic position, baseline health, and health behaviours, the hazard ratio for all cause mortality for participants with low health literacy was 1.40 (95% confidence interval 1.15 to 1.72) and with medium health literacy was 1.15 (0.94 to 1.41) compared with participants with high health literacy. Further adjustment for cognitive ability reduced the hazard ratio for low health literacy to 1.26 (1.02 to 1.55). CONCLUSIONS A third of older adults in England have difficulties reading and understanding basic health related written information. Poorer understanding is associated with higher mortality. The limited health literacy capabilities within this population have implications for the design and delivery of health related services for older adults in England.
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Affiliation(s)
- Sophie Bostock
- Department of Epidemiology and Public Health, University College London, UK.
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Edwards M, Wood F, Davies M, Edwards A. The development of health literacy in patients with a long-term health condition: the health literacy pathway model. BMC Public Health 2012; 12:130. [PMID: 22332990 PMCID: PMC3305618 DOI: 10.1186/1471-2458-12-130] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 02/14/2012] [Indexed: 11/10/2022] Open
Abstract
Background Inadequate health literacy has been associated with poor management of long-term health conditions and has been identified as a key social determinant of health outcomes. However, little is understood about how health literacy might develop over time or the processes by which people may become more health literate. Our objectives were to describe how patients with a long-term condition practice health literacy in the management of their health and communication with health professionals, how they become more health literate over time and their experience of using health services. We also sought to identify and describe the motivations, facilitators and barriers in the practice of health literacy in healthcare consultations. Methods We designed a longitudinal qualitative study using serial interviews with 18 participants to explore their experiences of learning to manage their condition and their experiences of health literacy when participating in healthcare processes. Participants were recruited from patient education programmes and were interviewed three times over a period of 9 months. A framework approach was used to analyse data. Results A model is presented that illustrates the development of health literacy along a trajectory that includes the development of knowledge, health literacy skills and practices, health literacy actions, abilities in seeking options and informed and shared decision making opportunities. Motivations and barriers to developing and practising health literacy skills partly reflected participants' characteristics but were also influenced by health professionals. Some participants developed their health literacy to a point where they became more involved in healthcare processes (including informed and shared decision-making). Conclusions Patients with a long-term condition can develop health literacy skills over time and put their skills into practice in becoming more active in healthcare consultations. Our findings have implications for developing health literacy interventions aimed at patient involvement in healthcare processes and improved self-management of long-term conditions.
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Affiliation(s)
- Michelle Edwards
- Department of Primary Care and Public Health, School of Medicine, Cardiff University, Heath Park, Heath, Cardiff CF14 4XN, UK.
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The Information Needs of New Radiotherapy Patients: How to Measure? Do They Want to Know Everything? And if Not, Why? Int J Radiat Oncol Biol Phys 2012; 82:418-24. [DOI: 10.1016/j.ijrobp.2010.09.032] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 09/02/2010] [Accepted: 09/21/2010] [Indexed: 11/19/2022]
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Cancer and chronic diseases in minority populations: the need for more educational materials in Spanish for healthcare providers. J Immigr Minor Health 2011; 13:1180-2. [PMID: 21559967 PMCID: PMC3204105 DOI: 10.1007/s10903-011-9475-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This short communication piece provides an overview of the Latin American Supercourse, a collection of public health lectures in Spanish targeting educators in Mexico, US, and Spanish speaking countries.
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Evaluation of a hospital-based cancer information and support centre. Support Care Cancer 2011; 20:287-300. [PMID: 21225290 DOI: 10.1007/s00520-010-1071-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 12/20/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although information seeking is encouraged by health care professionals as a positive coping strategy evidence suggests information needs of those affected by cancer are not always fully met. In response to the need for novel models of information provision and educational support for people affected by cancer, a hospital-based cancer information and support centre (CISC) was introduced into a tertiary cancer hospital. Professional support is provided by a cancer support nurse (CSN) with the clinical experience of working with cancer patients, whilst peer support is provided by volunteers. MATERIALS AND METHODS A survey was developed to ascertain the perceptions and experiences of consumers (users) of a hospital-based CISC. The aim was to understand what information and support patients and families consider important and helpful in order to develop the service to reflect the needs of its users. During a 12-month period 111 surveys were distributed to users of the centre. RESULTS Sixty-nine surveys were returned (62.1%). Nearly all visits were motivated by the need to access (58/84.0%) information, indicating an unmet or changing need. The CSN initiated referrals to support services, both internal and community based, for 21 (53.9%) participants with whom there was contact. Contact with the CISC volunteers also resulted in internal or community-based referrals for 15 (32.6%) of participants. Of note, half of the participants (35/50.7%) reported seeking additional information from the internet as a consequence of having visited the CISC and/or having contact with the CSN or volunteer, in contrast to the six (8.7%) who had reported internet use for information prior to their first visit. Participants indicated a desire for the service to provide additional support to enhance self-care capacity and to do so alongside other people affected by cancer. CONCLUSIONS Our study results support the capacity of a hospital-based CISC to provide a highly valued service that can broaden information options and meet changing information and support needs of people affected by cancer in an ongoing capacity. An experienced, qualified CSN in this setting is ideally positioned to screen for unmet information and support needs and deliver tailored education to support both inpatient and ambulatory care services. Information prescriptions have the potential to provide a 'directed information seeking approach' to those who visit a CISC. Through the use of information technology there is scope to develop information and support that expands beyond pamphlets and booklets.
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Wilson FL, Mood D, Nordstrom CK, Risk J. The effect of low literacy on the self-care behaviors of men receiving radiation therapy. Nurs Sci Q 2011; 23:326-33. [PMID: 20871005 DOI: 10.1177/0894318410380254] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using Orem's theory as the framework, two purposes guided the study: (a) to test the effectiveness of an audio-visual education program and behavioral contracting to promote self-care behaviors in managing radiation side effects and (b) to determine the extent to which low literacy affects self-care abilities. Seventy men diagnosed with prostate cancer participated in this experimental study. The nursing interventions of education and behavioral contracting significantly increased the self-care behaviors of men in managing radiation side effects. An increase in self-care behaviors was especially shown in men with low-literacy skills.
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Hoving C, Visser A, Mullen PD, van den Borne B. A history of patient education by health professionals in Europe and North America: from authority to shared decision making education. PATIENT EDUCATION AND COUNSELING 2010; 78:275-281. [PMID: 20189746 DOI: 10.1016/j.pec.2010.01.015] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Revised: 01/22/2010] [Accepted: 01/27/2010] [Indexed: 05/26/2023]
Abstract
OBJECTIVE This paper describes the development of patient education from the 1960s until now and identifies future challenges to improve patient education. RESULTS Patient education developed from the health care professional deciding what the patient needed to know to a shared decision making design where physician and patient are equally influential on the decision making process. The development of patient education is described for primary and secondary health care, as well as the impact of biomedical advances, an ageing population and cultural diversity on patient education. Some of the challenges for future patient education are identified: training health professionals as well as patients, involvement of the patient's social environment and application of e-Health techniques to patient education. CONCLUSION Patient education has made several developmental changes, has spread to different settings in health care and has now finally established itself as a valuable part of health care for patients. Nevertheless, both patients and health professionals still need to be provided with skills to optimize patient education. A good science-practice fit for future interventions to facilitate patient education is paramount. PRACTICE IMPLICATION Lessons from the past of patient education are important for the growth and future development of patient education.
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Affiliation(s)
- Ciska Hoving
- Maastricht University, Department of Health Promotion, Maastricht, The Netherlands.
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Vardavas CI, Kondilis BK, Patelarou E, Akrivos PD, Falagas ME. Health literacy and sources of health education among adolescents in Greece. Int J Adolesc Med Health 2009; 21:179-86. [PMID: 19702197 DOI: 10.1515/ijamh.2009.21.2.179] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED Knowledge on health and disease prevention and adolescent satisfaction from the health care system are factors that can affect the adolescent's health status. OBJECTIVE To assess the sources of health information of adolescents in a sample of teenagers from Athens and Crete, Greece. STUDY GROUP Data were obtained from a convenience sample of 369 adolescents aged 12-18 years from urban areas of Athens and Crete, Greece. METHODS Data on health care information sources and overall adolescent health literacy were collected with the use of a questionnaire exploring education on health topics over the past year, sources of health information, and interaction with their physician. RESULTS More than half the study participants indicated having received information within the past year on oral health, sexually transmitted diseases, physical activity, smoking, and nutrition. The family (71.8%) and the physician (51.5%; boys vs. girls: 44.2% vs. 57.9%, p = .009) are most usually consulted for health information. Girls were found to seek out more sources of health information than boys and to receive more information from their friends (26.9% vs. 11.0%, p < .001), magazines (23.4% vs. 15.1%, p = .046), other health professionals (boys vs. girls: 11.2% vs. 5.8%, p = .068), and pamphlets (boys vs. girls: 21.3% vs. 9.9%, p = .003). CONCLUSIONS A large percentage of adolescents, especially boys, are insufficiently informed on major health issues. Health education programming for youth in Greek schools is imperative to promote healthier lifestyles and to prevent chronic and infectious diseases.
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Smith SK, Trevena L, Barratt A, Dixon A, Nutbeam D, Simpson JM, McCaffery KJ. Development and preliminary evaluation of a bowel cancer screening decision aid for adults with lower literacy. PATIENT EDUCATION AND COUNSELING 2009; 75:358-367. [PMID: 19272747 DOI: 10.1016/j.pec.2009.01.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 01/22/2009] [Accepted: 01/23/2009] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Several countries have recently implemented national bowel cancer screening programs. To ensure equal access to screening, information is needed to suit adults ranging in literacy level. Decision aids are effective in providing balanced information and have been applied in screening. However, few have been designed for populations with lower education and literacy. This article describes the development and preliminary evaluation of a bowel cancer screening decision aid for this group. METHOD We conducted face-to-face interviews with adults of varying literacy ability, to develop the decision aid (Stage 1). We applied principles of plain language, created visual illustrations to support key textual messages, and used colour coding to direct the reader through the booklet. We then explored its acceptability and comprehension among consumers with higher and lower education (Stage 2). Participants were recruited from a community sample with lower education and a university alumni network. RESULTS A total of 75 participants were interviewed, 43 with lower educational attainment and 32 with university education. The decision aid was positively reviewed by both education groups. Results highlighted the need to clarify the purpose of the decision aid and the availability of choice in the context of screening, especially to those with lower education. CONCLUSION The 2 stage iterative development process identified important factors to consider in the development of decision tools for this target group, and is recommended. PRACTICE IMPLICATIONS Our findings have implications for how to support people with lower education and literacy make informed screening decisions.
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Affiliation(s)
- Sian K Smith
- Screening and Diagnostic Test Evaluation Program, Centre for Medical Psychology and Evidence Based Decision Making, School of Public Health, University of Sydney, New South Wales, NSW, Australia.
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Mackert M, Love B, Whitten P. Patient education on mobile devices: an e-health intervention for low health literate audiences. J Inf Sci 2008. [DOI: 10.1177/0165551508092258] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Providing health information to low health literate audiences remains a challenge. Beyond message design, realistic delivery models are needed for delivering information to a traditionally hard-to-reach audience. This study investigated two e-health interventions to provide health information on mobile devices — one providing diabetes information and one offering childcare information. Both were well-received, and most of the subjects' usability issues related to the translation of these interventions to the mobile device's smaller screen. The diabetes website was effective in providing information to study participants (as measured by pre- and post-tests of knowledge), while the childcare website was not. Continued work in this area could explore improved design strategies for mobile devices — a delivery model that could be used in doctors' offices, for example. Effective delivery of health information to low health literate audiences is an important issue, and this research highlights a critical element by targeting another potential delivery model.
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Affiliation(s)
- Michael Mackert
- Department of Advertising, The University of Texas at Austin, USA,
| | - Brad Love
- Department of Advertising, The University of Texas at Austin, USA
| | - Pamela Whitten
- College of Communication Arts & Sciences, Michigan State University, USA
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The decision-related psychosocial concerns of men with localised prostate cancer: targets for intervention and research. World J Urol 2008; 26:469-74. [PMID: 18548254 DOI: 10.1007/s00345-008-0279-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2008] [Accepted: 05/07/2008] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To describe decision-related psychosocial issues relevant for men with clinically localised prostate cancer. METHODS Searches were conducted across three electronic databases to search the health and psychological literature for articles examining decision-related psychosocial issues for men with localised prostate cancer and their partners. Medline, PsycINFO and CINAHL databases were examined for the period from 1990 to December 2007. RESULTS Most men with localised prostate cancer want active involvement in decision-making. Difficulty in making the decision is common and decision-related distress may persist over time. Cancer-specific psychological distress (such as fear of recurrence but not overall anxiety) appears to be related to changes in PSA levels; and this distress influences treatment pathways. Decision support interventions are acceptable to men, improve knowledge and might reduce decision and cancer-related distress. However, the quality of intervention studies to date is low. CONCLUSION Clinicians should seek to involve men and their partners in treatment decision making concurrent with decision and psychological support. There is a need for high quality randomised control trials to identify the optimal approach to decision support for men with clinically localised prostate cancer.
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Manning DL, Dickens C. Cancer Information and Support Centres: fixing parts cancer drugs cannot reach. Eur J Cancer Care (Engl) 2007; 16:33-8. [PMID: 17227351 DOI: 10.1111/j.1365-2354.2006.00699.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D L Manning
- Head of Communications, Cancer Institute NSW, Sydney, Australia.
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