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Yaldo M, Pai AL, McGrady ME, Wallens E, Allen JM, Spraker-Perlman H, Ast A, Reeves T, Tillery Webster R. Factors influencing caregiver decisions to use complementary and integrative therapies in pediatric oncology settings: Findings from a qualitative analysis. Eur J Oncol Nurs 2024; 70:102588. [PMID: 38669955 DOI: 10.1016/j.ejon.2024.102588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
PURPOSE Complementary and integrative medicine (CIM) therapies (i.e., non-conventional Western medicine interventions) may reduce side-effects associated with pediatric oncology treatment. CIM therapies may also improve caregiver psychological and physical health that is exacerbated during pediatric cancer treatment. Despite known benefits, these therapies are not widely used within pediatric oncology populations in the United States. To guide and promote CIM use among this population, the aim of this project was to qualitatively explore factors that contribute to caregivers' decision to include CIM use in their own and child's care. METHODS Twenty caregivers of children (ages 0.5-14 years) being treated for cancer participated in this study. Each completed a demographic form and the CIM use questionnaire. Qualitative interviews followed by a card sort task were used to assess barriers and facilitators of uptake for caregivers and their child with cancer. RESULTS A number of predisposing (e.g., child age, beliefs) and needs factors (e.g., potential to treatment-related side-effects) provide insight into caregivers' decisions to use CIM for their child. Analyses also revealed the importance of enabling factors (e.g., resources) for caregiver use. Caregivers also reported benefiting from additional information about risk/benefit analysis of these therapies, and current research for CIM use in caregivers and children being treated for cancer. CONCLUSION Children may benefit from individually tailored complementary and integrative medicine consultations that explore patient history and specific needs factors to improve preference concordant care and uptake. Caregivers may benefit from support that improves enabling factors associated with care (e.g., improved accessibility).
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Affiliation(s)
- Marissa Yaldo
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ahna Lh Pai
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emma Wallens
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jennifer M Allen
- Department of Psychology, St. Louis Children's Hospital, St. Louis, MO, USA
| | - Holly Spraker-Perlman
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Allison Ast
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Tegan Reeves
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, USA
| | - Rachel Tillery Webster
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA; Comprehensive Cancer Center, St. Jude Children's Research Hospital, Memphis, TN, USA.
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2
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Wahlen S, Breuing J, Becker M, Bühn S, Hauprich J, Könsgen N, Meyer N, Blödt S, Carl G, Follmann M, Frenz S, Langer T, Nothacker M, Schaefer C, Pieper D. Use, applicability, and dissemination of patient versions of clinical practice guidelines in oncology in Germany: a qualitative interview study with healthcare providers. BMC Health Serv Res 2024; 24:272. [PMID: 38439061 PMCID: PMC10913627 DOI: 10.1186/s12913-024-10626-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND People with cancer have high information needs; however, they are often inadequately met. Patient versions of clinical practice guidelines (PVGs), a special form of evidence-based information, translate patient-relevant recommendations from clinical practice guidelines into lay language. To date, little is known about the experience of PVGs from healthcare providers' perspective in healthcare. This study aims to investigate the use, applicability, and dissemination of PVGs in oncology from the healthcare providers' perspective in Germany. METHODS Twenty semi-structured telephone interviews were conducted with oncological healthcare providers in Germany between October and December 2021. Interviews were recorded and transcribed verbatim. Mayring's qualitative content analysis with MAXQDA software was utilised to analyse the data. RESULTS A total of 20 healthcare providers (14 female, 6 male), mainly working as psychotherapists/psycho-oncologists and physicians, participated. Most participants (75%) were aware of the existence of PVGs. The content was predominantly perceived as comprehensible and relevant, whereas opinions on the design and format were mixed. The perceived lack of up-to-date information limited participants' trust in the content. Most felt that PVGs positively impact healthcare owing to the fact that they improve patients' knowledge about their disease. Additionally, PVGs served as a guide and helped healthcare providers structure physician-patient talks. Healthcare provider's unawareness of the existence of PVGs was cited as an obstructive factor to its dissemination to patients. CONCLUSION Limited knowledge of the existence of PVGs among healthcare providers, coupled with alternative patient information, hinders the use and dissemination of PVGs in healthcare. However, the applicability of PVGs seemed to be acceptable owing to their content and good comprehensibility, especially with respect to physician-patient communication.
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Affiliation(s)
- Sarah Wahlen
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.
| | - Jessica Breuing
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Monika Becker
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Stefanie Bühn
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Julia Hauprich
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Nadja Könsgen
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Nora Meyer
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Susanne Blödt
- Institute for Medical Knowledge Management c/o Philipps University Marburg, Association of the Scientific Medical Societies in Germany, Marburg/Berlin, Germany
| | - Günther Carl
- German Prostate Cancer Support Group, Bonn, Germany
| | - Markus Follmann
- Office of the German Guideline Program in Oncology (GGPO), c/o German Cancer Society, Berlin, Germany
| | - Stefanie Frenz
- Frauenselbsthilfe Krebs-Bundesverband e.V., Bonn, Germany
| | - Thomas Langer
- Office of the German Guideline Program in Oncology (GGPO), c/o German Cancer Society, Berlin, Germany
| | - Monika Nothacker
- Institute for Medical Knowledge Management c/o Philipps University Marburg, Association of the Scientific Medical Societies in Germany, Marburg/Berlin, Germany
| | | | - Dawid Pieper
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health System Research, Rüdersdorf, Germany
- Centre for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf, Germany
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3
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Damiaens A, Maes E, Van Roosbroek H, Van Hecke A, Foulon V. Methods to elicit and evaluate the attainment of patient goals in older adults: A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:3051-3061. [PMID: 35691792 DOI: 10.1016/j.pec.2022.06.002] [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: 12/21/2021] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This scoping review aimed to identify patient goal elicitation and evaluation methods for older adults, and to investigate which methods can be used in medication optimization interventions for nursing home residents (NHRs). METHODS The Arksey and O'Malley framework guided the review. A search was launched in PubMed, Embase, CINAHL, and Web of Science. Reference selection and data extraction were performed by three independent reviewers, followed by team discussions to solve discrepancies. Inductive thematic analysis was applied to synthesize the data. Included papers were reconsidered to identify methods for medication optimization interventions for NHRs. RESULTS Ninety-six references, encompassing 38 elicitation and 12 evaluation methods, were included. Elicitation methods differed in structure, content, and patient involvement levels. Qualitative and quantitative methods were found to assess goal attainment. Five elicitation and three evaluation methods were developed for NHRs, but none of these contained a medication-related assessment. CONCLUSION A variety of goal elicitation and evaluation methods for older adults was found, but none for medication optimization interventions in NHRs. PRACTICE IMPLICATIONS A holistic approach seems important to integrate patient goals into medication optimization interventions, not limiting goal elicitation to a medication-related assessment. Also, the choice of assessor seems important to obtain patient goals.
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Affiliation(s)
- Amber Damiaens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
| | - Evelien Maes
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Hanne Van Roosbroek
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, UGent, Department of Nursing Director, Ghent University Hospital Ghent, Belgium.
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
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Tyler A, Dempsey A, Spencer S, Freeman J, McGwire G, Marsh R, Morris MA. Do the Guidelines Apply?-A Multisite, Combined Stakeholder Qualitative Case Study to Understand Care Decisions in Bronchiolitis. Acad Pediatr 2022; 22:806-817. [PMID: 34375754 PMCID: PMC8904084 DOI: 10.1016/j.acap.2021.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Clinical practice guidelines for bronchiolitis recommend against tests and treatments that do not improve outcomes, yet most children admitted with bronchiolitis continue to receive them. An improved understanding of factors that influence care decisions across multiple stakeholders and diverse settings is needed to develop effective strategies to de-implement (or reduce) unnecessary testing and treatment. METHODS We explored health care provider, care team, and parent perspectives on testing and treatment in bronchiolitis to develop a combined stakeholder account of care decisions. We conducted a qualitative case study across 2 geographically distinct university affiliated children's hospitals representing a generally low and high test/treatment utilizing hospital respectively from March 2019 to May 2020. We conducted 46 semistructured interviews and 3 focus groups with a total of 74 participants. Data were analyzed using applied thematic analysis and findings were triangulated across participant group and data collection method. RESULTS Three themes emerged around care decisions: 1) awareness and perceptions of the guidelines or evidence; 2) perceptions of expected tests or treatments, and 3) organizational culture and existing care processes. Provider and care team participants commonly described parent expectations as drivers of utilization. Conversely, parents generally reported a lack of expectations for tests/treatments and that tests/treatments did not improve their experience of care. CONCLUSIONS This study illuminated factors associated with the differential adoption of evidence and targets for future de-implementation strategies. Importantly, incongruent with provider and care team perceptions, parents reported that they desire an evidence-based, less-is-more approach to bronchiolitis care.
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Affiliation(s)
- Amy Tyler
- Section of Pediatric Hospital Medicine, Children's Hospital Colorado (A Tyler), Aurora, Colo; Department of Pediatrics, University of Colorado School of Medicine (A Tyler, A Dempsey, and J Freeman), Aurora, Colo; Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado (A Tyler, A Dempsey, R Marsh, and MA Morris), Aurora, Colo.
| | - Amanda Dempsey
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado,Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO
| | - Sandra Spencer
- Division of Pediatric Emergency Medicine, Nationwide Children’s Hospital Columbus, Ohio,Section of Pediatric Emergency Medicine, Children’s Hospital Colorado, Aurora, Colorado
| | - Julia Freeman
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado,Section of Pediatric Emergency Medicine, Children’s Hospital Colorado, Aurora, Colorado
| | - Gerd McGwire
- Division of Pediatric Hospital Medicine, Nationwide Children’s Hospital Columbus, Ohio
| | - Rebekah Marsh
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO
| | - Megan A. Morris
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO
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Pryor TAM, Reynolds KA, Kirby PL, Bernstein MT. An examination of the quality of late-life depression websites on the Internet (Preprint). JMIR Form Res 2022; 6:e36177. [PMID: 36094802 PMCID: PMC9513688 DOI: 10.2196/36177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/12/2022] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background The internet can increase the accessibility of mental health information and improve the mental health literacy of older adults. The quality of mental health information on the internet can be inaccurate or biased, leading to misinformation. Objective This study aims to evaluate the quality, usability, and readability of websites providing information concerning depression in later life. Methods Websites were identified through a Google search and evaluated by assessing quality (DISCERN), usability (Patient Education Materials Assessment Tool), and readability (Simple Measure of Gobbledygook). Results The overall quality of late-life depression websites (N=19) was adequate, and the usability and readability were poor. No significant relationship was found between the quality and readability of the websites. Conclusions The websites can be improved by enhancing information quality, usability, and readability related to late-life depression. The use of high-quality websites may improve mental health literacy and shared treatment decision-making for older adults.
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Affiliation(s)
- Teaghan A M Pryor
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Kristin A Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Paige L Kirby
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
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Baumann LA, Brütt AL. Participation preferences of health service users in health care decision-making regarding rehabilitative care in Germany-A cross-sectional study. Health Expect 2021; 25:125-137. [PMID: 34519382 PMCID: PMC8849223 DOI: 10.1111/hex.13356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/12/2021] [Accepted: 08/19/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Involving patients and citizens in health care decision-making is considered increasingly important in Germany. Participatory structures have been implemented, especially in rehabilitative care. However, it is unknown whether and to what extent German patients and citizens want to participate in decisions that exceed their own medical treatment. OBJECTIVE This study aimed to survey participation preferences and associated factors of health service users in decisions regarding rehabilitative care at micro, meso and macro levels. METHODS A questionnaire was sent to 3872 former rehabilitants. We collected participation preferences using the Control Preference Scale or an adapted form. Possible influencing factors were examined using logistic regression models. RESULTS The response rate was 5.7% (n = 217). At all decision-making levels, joint decision-making was preferred. At the macro level, preferences for actively participating were the highest. Preferences were significantly interrelated between decision-making levels. At the micro level, an orthopaedic indication significantly decreased the desire for participation compared to psychosomatic indications (odds ratio = 0.44, p = .019). DISCUSSION Participants wanted to be equally involved in decision-making as experts. Higher preferences for active participation at the macro level might be due to dissatisfaction with the current health care organisation and lack of trust in politicians. Compared to the general public, our study sample was older (73.3% between 50 and 69 years) and more often chronically ill-factors associated with increased participation preferences in the literature. CONCLUSION Contrary to the identified preferences, participation opportunities in the German health care system are rare. Further research on participation preferences and structures that enable meaningful involvement are needed.
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Affiliation(s)
- Lisa A Baumann
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Anna L Brütt
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
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7
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Paukkonen L, Oikarinen A, Kähkönen O, Kyngäs H. Patient participation during primary health-care encounters among adult patients with multimorbidity: A cross-sectional study. Health Expect 2021; 24:1660-1676. [PMID: 34247439 PMCID: PMC8483210 DOI: 10.1111/hex.13306] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/11/2021] [Accepted: 06/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background Patient participation is essential for achieving high‐quality care and positive outcomes, especially among patients with multimorbidity, which is a major challenge for health care due to high prevalence, care complexity and impact on patients' lives. Objective To explore the patient participation related to their own care among patients with multimorbidity in primary health‐care settings. Methods A cross‐sectional survey was conducted among adult multimorbid patients who visited primary health‐care facilities. The key instrument used was the Participation in Rehabilitation Questionnaire. Data representing 125 patients were analysed using various statistical methods. Results The respondents generally felt patient participation to be important, yet provided highly varying accounts regarding the extent to which it was realized by professionals. Information and knowledge and Respect and encouragement were considered the most important and best implemented subcategories of participation. Several patient‐related factors had a statistically significant effect on patient perceptions of participation for all subcategories and as explanatory factors for perceptions of total participation in univariate models. Most patients reported active participation in health‐care communication, positively associated with patient activation and adherence. Gender, perceived health, patient activation and active participation were explanatory factors for total importance of participation in multivariate models, while patient activation was retained for realization of participation. Conclusions Multimorbid patients require individualized care that promotes participation and active communication; this approach may further improve patient activation and adherence. Poor perceived health and functional ability seemed to be related to worse perceptions of participation. Patient and public involvement The study topic importance was based on the patients' experiences in author's previous research and the need to develop patient‐centred care.
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Affiliation(s)
- Leila Paukkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Medical Research Centre, Oulu, Finland
| | - Anne Oikarinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Medical Research Centre, Oulu, Finland
| | - Outi Kähkönen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Medical Research Centre, Oulu, Finland
| | - Helvi Kyngäs
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Medical Research Centre, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
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8
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Burns L, da Silva AL, John A. Shared decision-making preferences in mental health: does age matter? A systematic review. J Ment Health 2020; 30:634-645. [PMID: 32662713 DOI: 10.1080/09638237.2020.1793124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Research to date suggests older adults prefer a passive involvement in the clinical decision-making process; however, the empirical evidence underlying this claim in the mental health context is yet to be reviewed systematically. AIMS To understand whether older adults desire involvement in mental health-related clinical decisions. METHOD A systematic review was conducted to identify primary research that explored mental-health decision-making preferences of people with a mean age of over 55 from January 1990 through to December 2018. RESULTS Three independent studies of varying design and quality were included. Study settings were in the USA, Germany, and the UK. A preference for shared decision-making was seen in two studies, while a preference for active decision-making was identified in one. CONCLUSIONS In contrast to other reviews on clinical decision-making, this review focused on mental health-related decisions of older adults. The evidence suggests older adults desire involvement in mental health-related clinical decisions. Given the political drive to empower patients and the need to ensure evidence-based clinical practice, more high-quality research regarding the shared decision-making preferences and outcomes of older adults with mental ill-health is needed. Systematic Review Registration PROSPERO: CRD42018102009.
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Affiliation(s)
| | | | - Ann John
- Swansea University Medical School, Swansea, UK
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Wu VS, Smith AB, Girgis A. The unmet supportive care needs of Chinese patients and caregivers affected by cancer: A systematic review. Eur J Cancer Care (Engl) 2020; 31:e13269. [PMID: 32495473 DOI: 10.1111/ecc.13269] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/04/2019] [Accepted: 04/16/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Cancer patients and caregivers have myriad unmet needs which can have detrimental consequences on their psychosocial wellbeing. This systematic review aims to identify the unmet supportive care needs of immigrant and native Chinese cancer patients and caregivers. METHODS We systematically searched various electronic databases (e.g. Scopus, CINAHL, PsycInfo, etc.) from the earliest date available until January 2018. Additional studies were identified through reference lists and citation tracking. Eligibility criteria included: (a) qualitative, quantitative and/or mixed methods studies published in English; (b) immigrant and native Chinese cancer patients and/or caregivers (age ≥18 years); (c) unmet needs and/or their correlates. Studies were assessed for their risk of bias, and a narrative synthesis of findings was performed. RESULTS Forty-seven papers from 45 studies met eligibility criteria. The most prevalent area of unmet needs was health system and information. Patients most commonly desired one member of the hospital to talk to about all aspects of their care. Caregivers preferred information about the patient's prognosis and likely outcome. Anxiety was most commonly associated with higher levels of health system and information needs. CONCLUSION Chinese patients and caregivers experience a range of unmet health system and information needs, which differ depending on their stage along the cancer trajectory.
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Affiliation(s)
- Verena Shuwen Wu
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
| | - Allan Ben Smith
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
| | - Afaf Girgis
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
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10
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Andersson M, Wilde‐Larsson B, Persenius M. Oral care quality-Do humanity aspects matter? Nursing staff's and older people's perceptions. Nurs Open 2020; 7:857-868. [PMID: 33331694 PMCID: PMC7938398 DOI: 10.1002/nop2.461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/30/2019] [Accepted: 02/03/2020] [Indexed: 12/11/2022] Open
Abstract
AIM (a) To describe and compare perceptions of humanity aspects of oral care quality in relation to nursing staff in short-term care units and intensive care units and older people in short-term care units and their person-related conditions; and (b) to compare humanity aspects of oral care quality perceptions between nursing staff and older people in short-term care units. DESIGN Cross-sectional study. Self-reported questionnaire and clinical assessments. METHODS Nursing staff (N = 417) and older people (N = 74) completed the modified Quality of Care from a Patient Perspective instrument and person-related items. Older people's oral health status was clinically assessed using the Revised Oral Assessment Guide. Data were analysed using descriptive and analytic statistics. The data were collected from 2013-2016. RESULTS Nursing staff's perceptions of humanity aspects of oral care quality were related to gender, work role and care environment. Older people's perceptions of humanity aspects of oral care quality were related to self-reported physical health. Nursing staff in short-term care units perceived the subjective importance of humanity aspects of oral care quality higher compared with older people in short-term care units.
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Affiliation(s)
- Maria Andersson
- Department of Health ScienceFaculty of Health, Science and TechnologyKarlstad UniversityKarlstadSweden
| | - Bodil Wilde‐Larsson
- Department of Health ScienceFaculty of Health, Science and TechnologyKarlstad UniversityKarlstadSweden
- Faculty of Public Health StudiesInland Norway University of Applied SciencesElverumNorway
| | - Mona Persenius
- Department of Health ScienceFaculty of Health, Science and TechnologyKarlstad UniversityKarlstadSweden
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11
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Grobe JE, Goggin K, Harris KJ, Richter KP, Resnicow K, Catley D. Race moderates the effects of Motivational Interviewing on smoking cessation induction. PATIENT EDUCATION AND COUNSELING 2020; 103:350-358. [PMID: 31466882 PMCID: PMC7012686 DOI: 10.1016/j.pec.2019.08.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/31/2019] [Accepted: 08/17/2019] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Health disparities necessitate exploration of how race moderates response to smoking cessation treatment. Data from a randomized clinical trial of Motivational Interviewing (MI) for smoking cessation induction were used to explore differential treatment response between African American (AA) vs Non-Black (NB) smokers. METHODS Adult tobacco smokers (138 AA vs 66 NB) with low desire to quit were randomly assigned to four sessions of MI or health education (HE). Outcomes (e.g., quit attempts) were assessed 3- and 6-months. RESULTS There was evidence of a Race by Treatment interaction such that MI was less effective than HE in AA smokers. Mean Cohen's d for the interaction effect was -0.32 (95% CI [-0.44, -0.20]). However, the race interaction could be accounted for by controlling for baseline relationship status and communication preference (wants directive approach). CONCLUSIONS MI may be less effective for smoking cessation induction in AA vs NB smokers when compared to another active and more directive therapy. The differential response between races may be explained by psychosocial variables. PRACTICE IMPLICATIONS MI may not be an ideal choice for all African American smokers. Patients' relationship status and preference for a directive counseling approach might explain disparities in response to MI treatment.
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Affiliation(s)
- James E Grobe
- JEGrobe Consulting, 9209 Heatherdale Drive, Dallas, Texas, 75243, United States.
| | - Kathy Goggin
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City Hospitals and Clinics, and Schools of Medicine and Pharmacy, University of Missouri - Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, United States.
| | - Kari Jo Harris
- School of Public and Community Health Sciences, 32 Campus Drive Skaggs Building Room 352, The University of Montana, Missoula, Montana, 406-243-4685, United States.
| | - Kimber P Richter
- Department of Preventive Medicine & Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1008, 4004 Robinson, Kansas City, KS, 66160, United States.
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, United States.
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, United States.
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12
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Shang L, Zuo M, Ma D, Yu Q. The Antecedents and Consequences of Health Care Professional-Patient Online Interactions: Systematic Review. J Med Internet Res 2019; 21:e13940. [PMID: 31573908 PMCID: PMC6785718 DOI: 10.2196/13940] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/05/2019] [Accepted: 07/31/2019] [Indexed: 01/26/2023] Open
Abstract
Background Online health care services effectively supplement traditional medical treatment. The development of online health care services depends on sustained interactions between health care professionals (HCPs) and patients. Therefore, it is necessary to understand the demands and gains of health care stakeholders in HCP-patient online interactions and determine an agenda for future work. Objective This study aims to present a systematic review of the antecedents and consequences of HCP-patient online interactions. It seeks to reach a better understanding of why HCPs and patients are willing to interact with each other online and what the consequences of HCP-patient online interactions are for health care stakeholders. Based on this, we intend to identify the gaps in existing studies and make recommendations for future research. Methods In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic retrieval was carried out from the Web of Science, PubMed, and Scopus electronic databases. The search results were confined to those papers published in English between January 1, 2000 and June 30, 2018. Selected studies were then evaluated for quality; studies that did not meet quality criteria were excluded from further analysis. Findings of the reviewed studies related to our research questions were extracted and synthesized through inductive thematic analysis. Results A total of 8440 records were found after the initial search, 28 papers of which were selected for analysis. Accessibility to HCPs, self-management, and unmet needs were the main triggers for patients to participate in online interaction. For HCPs, patient education, career needs, and self-promotion were the major reasons why they took the online approach. There were several aspects of the consequences of HCP-patient online interactions on health care stakeholders. Consequences for patients included patient empowerment, health promotion, and acquisition of uncertain answers. Consequences for HCPs included social and economic returns, lack of control over their role, and gaining more appointments. HCP-patient online interactions also improved communication efficiency in offline settings and helped managers of online health care settings get a better understanding of patients’ needs. Health care stakeholders have also encountered ethical and legal issues during online interaction. Conclusions Through a systematic review, we sought out the antecedents and consequences of HCP-patient online interactions to understand the triggers for HCPs and patients to participate and the consequences of participating. Potential future research topics are the influences on the chain of online interaction, specifications and principles of privacy design within online health care settings, and roles that sociodemographic and psychological characteristics play. Longitudinal studies and the adoption of text-mining method are worth encouraging. This paper is expected to contribute to the sustained progress of online health care settings.
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Affiliation(s)
- Lili Shang
- Research Institute of Smart Senior Care, School of Information, Renmin University of China, Beijing, China
| | - Meiyun Zuo
- Research Institute of Smart Senior Care, School of Information, Renmin University of China, Beijing, China
| | - Dan Ma
- Research Institute of Smart Senior Care, School of Information, Renmin University of China, Beijing, China
| | - Qinjun Yu
- School of Basic Medicine, Peking University Health Science Center, Beijing, China
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13
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Marrie RA, Walker JR, Graff LA, Patten SB, Bolton JM, Marriott JJ, Fisk JD, Hitchon C, Peschken C, Bernstein CN. Gender differences in information needs and preferences regarding depression among individuals with multiple sclerosis, inflammatory bowel disease and rheumatoid arthritis. PATIENT EDUCATION AND COUNSELING 2019; 102:1722-1729. [PMID: 30982700 DOI: 10.1016/j.pec.2019.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/07/2019] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE We assessed the information needs of persons with any of three immune-mediated inflammatory diseases (multiple sclerosis [MS], inflammatory bowel disease [IBD] and rheumatoid arthritis [RA]) regarding depression, as a first step toward developing patient-relevant information resources, ultimately to facilitate self-management and appropriate care. We also compared information needs across genders. METHODS We surveyed participants with MS, IBD and RA regarding depression-related information needs including types of treatments, effectiveness, risks, benefits, and perceived helpfulness of treatments. We compared responses between groups using multivariate regression. RESULTS 328 participants provided complete responses (MS: 141, IBD: 114, RA: 73). Most of the topics queried were perceived as very important, and similarly important for all groups. Women placed higher importance than men on most topics. The most popular formats for receiving information were discussion with a counselor (very preferred: 67.4%) and written information (very preferred: 65.5%); this did not differ between groups. CONCLUSIONS Persons affected by MS, IBD and RA are interested in receiving information about multiple topics related to depression treatment, from multiple sources. Women desire more information than men. PRACTICE IMPLICATIONS These findings can be used to design information resources to meet information needs regarding depression in MS, IBD and RA.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - John R Walker
- Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lesley A Graff
- Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Scott B Patten
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James M Bolton
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Psychiatry, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - James J Marriott
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - John D Fisk
- Nova Scotia Health Authority, Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Canada
| | - Carol Hitchon
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Christine Peschken
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Charles N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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14
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Ebola-Related Health Information Wanted and Obtained by Nurses and Public Health Department Employees: Effects of Formal and Informal Communication Channels. Disaster Med Public Health Prep 2019; 14:312-321. [PMID: 31359854 DOI: 10.1017/dmp.2019.45] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of this study was to (1) understand types and amounts of Ebola-related information that health organization employees wanted and obtained through formal, informal, internal, and external organizational communication channels; (2) determine potential discrepancies between information wanted and obtained; and (3) investigate how organizational structure might affect information wanted and obtained through these communication channels. METHODS Primary data were collected from 526 health workers in 9 hospitals and 13 public health departments in Texas from June to November 2015. Survey data were collected for 7 types of Ebola-related information health organization employees wanted and obtained through various types of organizational communication channels. Descriptive statistical analyses, mixed design analysis of variance, regression analyses, and multilevel analyses were used to analyze the data. RESULTS Hospital employees (mostly nurses in our sample) received more self-care information than they wanted from every communication channel. However, they received less about all other types of information than they wanted from every communication channel separately and combined. Public health department employees wanted more information than they received from every communication channel separately and combined for all 7 types of information. CONCLUSIONS Discrepancies existed between the types of Ebola-related information wanted and obtained by employees of hospitals and public health departments.
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15
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Gheondea-Eladi A. Patient decision aids: a content analysis based on a decision tree structure. BMC Med Inform Decis Mak 2019; 19:137. [PMID: 31324237 PMCID: PMC6642566 DOI: 10.1186/s12911-019-0840-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 06/14/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION This paper presents the preliminary results of a decision-tree analysis of Patient Decision Aids (PDA). PDAs are online or offline tools used to structure health information, elicit relevant values and emphasize the decision as a process, in ways that help patients make more informed health decisions individually or with relevant others. METHOD Twenty PDAs are randomly selected from the International Patient Decision Aids Standards (IPDAS) ( https://decisionaid.ohri.ca/AZlist.html ) approved list. An evaluation tool is built bottom-up and top-down and results are described in terms of communicating uncertainty, completeness of the decision tree, ambiguous or misleading phrasing, overall strategies suggested within personal stories. RESULTS Twelve of the analyzed PDAs had branches of the decision tree which were not discussed in the tool and 6 had logically ambiguous phrasing. Many tools included dichotomous options, when the option range was wider. Several options were clustered within the "Do not take/Do not do" option and thus the PDA failed to provide all comparisons necessary to make a decision. Some tools employ expressions that do not differentiate between lack of information and known negative effects. Other tools provide unequal amounts or non-comparable bits of information about the options. CONCLUSION These results indicate a very loose range of interpretations of what constitutes an option, a treatment, and a treatment option. It thus emphasizes a gap between theory and practice in the evaluation of PDAs. Future developments of PDA evaluation tools should keep track of missing decision tree branches, accurate communication of uncertainty, ambiguity, and lack of knowledge and consider using measures for evaluating the completeness of the option spectrum at an agreed period in time.
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Affiliation(s)
- Alexandra Gheondea-Eladi
- Research Institute for Quality of Life, Romanian Academy, Calea 13 Septembrie, nr 13, Bucharest, Romania.
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16
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Ohana S, Barnoy S. Israeli E-patients' Informational Needs. Nurs Outlook 2019; 67:190-198. [PMID: 30558901 DOI: 10.1016/j.outlook.2018.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/06/2018] [Accepted: 11/16/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Online medical information has transformed the way patients obtain information. PURPOSE The present study examined patients' informational needs and the patient- Healthcare Provider (HCP) relationship from the perceptions of both patients and HCP. METHODS The study was a cross-sectional study; data were collected in Israel from100 HCPs (nurses and physicians) and 184 e-patients. FINDINGS E-patients were comfortable sharing e-information with their HCP and expected them to consider the e-information in treatment decision-making. Physicians thought they provided more information than the patients considered that they received from them, while both nurses and patients were in agreement about their interactions. Patients thought that there was a higher concordance between the e-information and the information they received from the physician/nurse as compared to what physicians and nurses reported. DISCUSSION AND CONCLUSIONS E-health information does not disrupt the patient-nurse/physician relationship. To promote compliance to treatment, it is important that HCPs consider information presented by patients when preparing the treatment plan.
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Affiliation(s)
- Shulamit Ohana
- Coordinator of Quality and Risk Management, Risk Management and Patient Safety Unit, Nursing Management, Kaplan Medical Center, Rehovot, Israel
| | - Sivia Barnoy
- Nursing Department, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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17
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Paukkonen L, Kankkunen P, Kreuter M, Pietilä AM. Patients’ perceptions of participation: Pilot validation study of the FI-PPRQ questionnaire in Finnish primary healthcare settings. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/2057158518815992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Patient participation is is a highly valued goal within healthcare. The aim of this study was to assess the validity of a Finnish version of the Participation in Rehabilitation Questionnaire (FI-PPRQ) developed to measure patients’ perceptions of the importance and their experience of participation in care. The original PPRQ was translated from Swedish into Finnish, then subjected to psychometric pilot testing using data acquired in a cross-sectional survey with a sample of adult patients in eight primary healthcare units (n = 88). The importance and experience ratings were evaluated separately, by calculating distributions of item and scale scores, Cronbach’s alpha coefficients, and correlations between items and scales. In addition, experience ratings were subjected to exploratory factor and multi-trait scaling analyses. The results of this study support the validity and reliability of the instrument for use in clinical settings to provide information about patient participation. However, further studies are needed with more varied settings.
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Affiliation(s)
- Leila Paukkonen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Margareta Kreuter
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Anna-Maija Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Social and Healthcare Services, Kuopio, Finland
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Xie B, Champion JD, Kwak J, Fleischmann KR. Mobile Health, Information Preferences, and Surrogate Decision-Making Preferences of Family Caregivers of People With Dementia in Rural Hispanic Communities: Cross-Sectional Questionnaire Study. J Med Internet Res 2018; 20:e11682. [PMID: 30530450 PMCID: PMC6305885 DOI: 10.2196/11682] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) technology holds promise for promoting health education and reducing health disparities and inequalities in underserved populations. However, little research has been done to develop mHealth interventions for family caregivers of people with dementia, particularly those in rural Hispanic communities, who often serve as surrogate decision makers for their relatives with dementia. OBJECTIVE As part of a larger project to develop and test a novel, affordable, and easy-to-use mHealth intervention to deliver individually tailored materials in rural Hispanic communities, in this pilot study, we aimed to examine (1) characteristics of people with dementia and their family caregivers in rural Hispanic communities, (2) caregivers' preferences for types and amounts of health information and participation in surrogate decision making, and (3) caregivers' mobile device usage and their desire for receiving information via mobile devices. METHODS This was a cross-sectional survey. A convenience sample of 50 caregivers of people with dementia was recruited from rural health care facilities in Southwest Texas during 3 weeks of April 2017 to May 2017 via word-of-mouth and flyers posted at the facilities. RESULTS More women than men were in the patient group (χ21=17.2, P<.001) and in the caregiver group (χ21=22.2, P<.001). More patients were on Medicare and Medicaid; more caregivers had private insurance (P<.001 in all cases). Overall, 42% of patients did not have a power of attorney for their health care; 40% did not have a living will or advance directive. Caregivers were interested in receiving all types of information and participating in all types of decisions, although on subscales for diagnosis, treatment, laboratory tests, self-care, and complementary and alternative medicine, their levels of interest for decision-making participation were significantly lower than those for receiving information. On the psychosocial subscale, caregivers' desire was greater for surrogate decision-making participation than for information. Caregivers did not differ in their interests in information and participation in decision making on the health care provider subscale. All but 1 caregiver (98%) owned a mobile phone and 84% had a smartphone. Two-thirds wanted to receive at least a little dementia-related information via a smartphone or tablet. The amount of dementia-related information caregivers wanted to receive via a mobile device was significantly greater for women than for men (U=84.50, P=.029). Caregivers who owned a tablet were more likely to want to receive dementia-related information via a mobile device than those who did not own a tablet (U=152.0, P=.006). CONCLUSIONS Caregivers in rural Hispanic communities were interested in receiving a wide range of information as well as participating in making decisions for their relatives with dementia. There is much need for effective mHealth interventions that can provide information tailored to the needs and preferences of these caregivers.
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Affiliation(s)
- Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | | | - Jung Kwak
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
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Witt S, Englander E, Kumlien C, Axelsson M. Mismatch between risk factors and preventive interventions? A register study of fall prevention among older people in one Swedish county. Int J Older People Nurs 2018; 13:e12209. [PMID: 30187674 DOI: 10.1111/opn.12209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 07/06/2018] [Accepted: 07/22/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Falls are a common and often a devastating health hazard for older people, causing suffering, morbidity and mortality. Falls are costly for society in terms of both resources and direct medical costs. Although knowledge about falls and fall prevention is well known, falls among older people are still a major problem. AIM AND OBJECTIVES The aim was to estimate the prevalence of the risk of falls among older people receiving municipal health care. A further aim was to investigate the consistency between fall risk factors and preventive nursing interventions. DESIGN A cross-sectional register study. METHODS Data containing risk assessments based on the Downton Fall Risk Index (DFRI) and planned interventions by the municipal health care were collected from the Swedish national quality registry, Senior Alert. Data were analysed using descriptive and analytic statistics. RESULTS In the sample of 5,427 older people, the prevalence of the risk of falling was 79%. There was a difference in prevalence between the different types of municipal health care, sex and age. The most common preventive intervention was environment adjustments, and the least planned intervention was information/education about falls. Physical activity as an intervention was planned among 13.2% of the participants. Approximately 27% of the older people did not have any planned interventions despite being at risk of falling. Planned interventions did not always correspond with the risk factors; for instance, only 35.4% of those at risk of falling due to medication obtained pharmaceutical reviews as a preventive measure to decrease the risk. CONCLUSION The risk of falling is common among older people, and the preventive interventions do not sufficiently follow current evidence. This implies that systematic implementation of fall-prevention guidelines is needed in municipal care. IMPLICATION FOR PRACTICE A better match between identified risk factors and preventive interventions is warranted.
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Affiliation(s)
- Sofia Witt
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.,Health Center Fågelbacken, Malmö, Sweden
| | - Emma Englander
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Christine Kumlien
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.,Department of Cardio-Thoracic and Vascular Surgery, Skane University Hospital, Malmö, Sweden
| | - Malin Axelsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
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20
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King L, Harrington A, Linedale E, Tanner E. A mixed methods thematic review: Health-related decision-making by the older person. J Clin Nurs 2018; 27:e1327-e1343. [PMID: 29322576 DOI: 10.1111/jocn.14261] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To undertake a mixed methods thematic literature review that explored how elderly adults approached decision-making in regard to their health care following discharge. BACKGROUND A critical time for appropriate health decisions occurs during hospital discharge planning with nursing staff. However, little is known how the 89% of elderly living at home make decisions regarding their health care. Research into older adults' management of chronic conditions emerges as an important step to potentially encourage symptom monitoring, prevent missed care and detect deterioration. All should reduce the risk of hospital re-admission. DESIGN A mixed methods thematic literature review was undertaken. The structure followed the PRISMA reporting guidelines for systematic reviews recommended by the EQUATOR network. METHODS PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus online databases were searched using keywords, inclusion and exclusion criteria. References drawn from relevant publications, identified by experts and published between 1995 and 2017 were also considered. Twenty-five qualitative, quantitative and mixed methods studies and reviews were critically appraised (CASP 2013) before inclusion in the review. Analysis of each study's findings was undertaken using Braun and Clarke's (2006) steps to identify major themes and sub-themes. RESULTS Four main themes associated with health-related decision-making in the elderly were identified: "the importance of maintaining independence," "decision making style," "management of conditions at home" and "discharge planning." CONCLUSION Health care decision preferences in the elderly emerged as highly complex and influenced by multiple factors. Development of a tool to assess these components has been recommended. RELEVANCE TO CLINICAL PRACTICE Nurses play a vital role in exploring and understanding the influence that maintaining independence has with each patient. This understanding provides an initial step toward development of a tool to assist collaboration between patients and healthcare professionals involved in their care.
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Affiliation(s)
- Lindy King
- College of Nursing & Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Ann Harrington
- College of Nursing & Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Ecushla Linedale
- College of Nursing & Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Elizabeth Tanner
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Nursing and School of Medicine, Baltimore, MD, USA
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21
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Andersson M, Wilde-Larsson B, Carlsson E, Persenius M. Older people's perceptions of the quality of oral care in short-term care units: A cross-sectional study. Int J Older People Nurs 2018; 13:e12185. [PMID: 29363883 DOI: 10.1111/opn.12185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 12/22/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is a lack of knowledge about oral care among older people living in short-term care (STC) units and how the quality of oral care provided by nursing staff is perceived by the older people. AIM To (i) describe person-related conditions among older people in STC, (ii) describe and compare perceptions of the quality of oral care (including perceptions of care received and the subjective importance of such care), within and between older people who have the ability to perform oral self-care and those who are dependent on help with oral care and (iii) examine the relationship between person-related conditions and the quality of oral care. METHODS A cross-sectional study was conducted with 391 older people in STC units in Sweden based on self-reported questionnaire and clinical assessments. RESULTS The older people were assessed as having normal oral health (2%), moderate oral health problems (78%) or severe oral health problems (20%). When comparing older people's perceptions of quality of oral care in terms of perceived reality and subjective importance, significant differences appeared within and between groups. Psychological well-being had a significant relationship with perception of the quality of oral care (both perceived reality and subjective importance), and gender and oral health status had a significant relationship with subjective importance. CONCLUSIONS Older people's perceptions of areas for improvement regarding quality of oral care is a new and important knowledge for nursing staff in STC units. Older people want personalised information regarding oral health and oral care. Registered Nurses who take the responsibility in nursing care for older people's oral health may avoid unnecessary suffering by older people caused by oral health problems. IMPLICATIONS FOR PRACTICE Older people's perspective is an important component for quality work and might lead to improvements in the quality of oral care in STC.
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Affiliation(s)
- Maria Andersson
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Bodil Wilde-Larsson
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.,Faculty of Public Health Studies, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Eva Carlsson
- Faculty of Health and Medicine, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Mona Persenius
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
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22
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Baker DM, Lee MJ, Jones GL, Brown SR, Lobo AJ. The Informational Needs and Preferences of Patients Considering Surgery for Ulcerative Colitis: Results of a Qualitative Study. Inflamm Bowel Dis 2017; 24:179-190. [PMID: 29272489 DOI: 10.1093/ibd/izx026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patients considering surgery for ulcerative colitis (UC) face a difficult decision as surgery may or may not improve quality of life. National Institute for Health and Care Excellence guidelines for UC emphasize the importance of providing quality preoperative information to patients but note no quality studies for the desired content of this information. Our aim was to explore patient information preferences prior to undergoing surgery for ulcerative colitis. METHODS Semistructured interviews with patients who underwent an operation and patients who considered but declined an operation were conducted. Interviews explored informational preferences, with emphasis on preoperative information given, preoperative information desired but not received, and retrospective informational desires. Interviews were transcribed and coded using an inductive thematic analysis using NVivo software. Data saturation was assessed after 12 interviews, with interviews continuing until saturation was achieved. Ethical approval was gained prior to interviews commencing (16/NW/0639). RESULTS A total of 16 interviews were conducted before data saturation was achieved (male n = 7, female n = 9). Eight patients declined surgery, and 8 opted for subtotal colectomy with permanent end ileostomy (n = 5) or ileoanal pouch (n = 3). A total of 4 themes and 14 subthemes were identified. Three dominant subthemes of informational shortcomings emerged: "long-term effects of surgery," "practicalities of daily living," and "long-term support." Peer support was desired by patients but was infrequently supported by health care professionals. CONCLUSIONS Current preoperative information does not address patient informational needs. Surgical consultations should be adapted to suit patient preferences. Clinical practice may need to be altered to ensure that patients are better supported following surgery.
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Affiliation(s)
- Daniel Mark Baker
- University of Sheffield Medical School, Sheffield, UK.,Department of General Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | - Matthew James Lee
- University of Sheffield Medical School, Sheffield, UK.,Department of General Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | | | - Steven Ross Brown
- Department of General Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | - Alan Joseph Lobo
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
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23
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Xie B, Su Z, Zhang W, Cai R. Chinese Cardiovascular Disease Mobile Apps' Information Types, Information Quality, and Interactive Functions for Self-Management: Systematic Review. JMIR Mhealth Uhealth 2017; 5:e195. [PMID: 29242176 PMCID: PMC5746618 DOI: 10.2196/mhealth.8549] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/16/2017] [Accepted: 11/02/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND China has a large population with cardiovascular disease (CVD) that requires extensive self-management. Mobile health (mHealth) apps may be a useful tool for CVD self-management. Little is currently known about the types and quality of health information provided in Chinese CVD mobile apps and whether app functions are conducive to promoting CVD self-management. OBJECTIVE We undertook a systematic review to evaluate the types and quality of health information provided in Chinese CVD mobile apps and interactive app functions for promoting CVD self-management. METHODS Mobile apps targeting end users in China with CVD conditions were selected in February 2017 through a multi-stage process. Three frameworks were used to evaluate the selected apps: (1) types of health information offered were assessed using our Health Information Wants framework, which encompasses 7 types of information; (2) quality of information provided in the apps was assessed using the 11 guidelines recommended by the National Library of Medicine of the National Institutes of Health; and (3) types of interactive app functions for CVD self-management were assessed using a 15-item framework adapted from the literature, including our own prior work. RESULTS Of 578 apps identified, 82 were eligible for final review. Among these, information about self-care (67/82, 82%) and information specifically regarding CVD (63/82, 77%) were the most common types of information provided, while information about health care providers (22/82, 27%) and laboratory tests (5/82, 6%) were least common. The most common indicators of information quality were the revealing of apps' providers (82/82, 100%) and purpose (82/82, 100%), while the least common quality indicators were the revealing of how apps' information was selected (1/82, 1%) and app sponsorship (0/82, 0%). The most common interactive functions for CVD self-management were those that enabled user interaction with the app provider (57/82, 70%) and with health care providers (36/82, 44%), while the least common interactive functions were those that enabled lifestyle management (13/82, 16%) and psychological health management (6/82, 7%). None of the apps covered all 7 types of health information, all 11 indicators of information quality, or all 15 interactive functions for CVD self-management. CONCLUSIONS Chinese CVD apps are insufficient in providing comprehensive health information, high-quality information, and interactive functions to facilitate CVD self-management. End users should exercise caution when using existing apps. Health care professionals and app developers should collaborate to better understand end users' preferences and follow evidence-based guidelines to develop mHealth apps conducive to CVD self-management.
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Affiliation(s)
- Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Zhaohui Su
- School of Advertising and Public Relations, The University of Texas at Austin, Austin, TX, United States
| | - Wenhui Zhang
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- Department of Statistics and Data Science, The University of Texas at Austin, Austin, TX, United States
| | - Run Cai
- Chongqing Cancer Institute, Chongqing, China
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Bae JM. Shared decision making: relevant concepts and facilitating strategies. Epidemiol Health 2017; 39:e2017048. [PMID: 29092391 PMCID: PMC5733387 DOI: 10.4178/epih.e2017048] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 10/30/2017] [Indexed: 11/09/2022] Open
Abstract
As the paradigm in healthcare nowadays is the evidence-based, patient-centered decision making, the issue of shared decision making (SDM) is highlighted. The aims of this manuscript were to look at the relevant concepts and suggest the facilitating strategies for overcoming barriers of conducting SDM. While the definitions of SDM were discordant, several concepts such as good communication, individual autonomy, patient participants, and patient-centered decision-making were involved. Further, the facilitating strategies of SDM were to educate and train physician, to apply clinical practice guidelines and patient decision aids, to develop valid measurement tools for evaluation of SDM processes, and to investigate the impact of SDM.
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Affiliation(s)
- Jong-Myon Bae
- Department of Preventive Medicine, Jeju National University Scool of Medicine, Jeju, Korea
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The ability of older adults to use customized online medical databases to improve their health-related knowledge. Int J Med Inform 2017; 102:1-11. [PMID: 28495336 DOI: 10.1016/j.ijmedinf.2017.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 02/04/2017] [Accepted: 02/18/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Patient compliance with medical advice and recommended treatment depends on perception of health condition, medical knowledge, attitude, and self-efficacy. This study investigated how use of customized online medical databases, intended to improve knowledge in a variety of relevant medical topics, influenced senior adults' perceptions. METHOD Seventy-nine older adults in residence homes completed a computerized, tablet-based questionnaire, with medical scenarios and related questions. Following an intervention, control group participants answered questions without online help while an experimental group received internet links that directed them to customized, online medical databases. RESULTS Medical knowledge and test scores among the experimental group significantly improved from pre- to post-intervention (p<0.0001) and was higher in comparison with the control group (p<0.0001). No significant change occurred in the control group. CONCLUSION Older adults improved their knowledge in desired medical topic areas using customized online medical databases. The study demonstrated how such databases help solve health-related questions among older adult population members, and that older patients appear willing to consider technology usage in information acquisition.
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Lim BT, Butow P, Mills J, Miller A, Goldstein D. Information needs of the Chinese community affected by cancer: A systematic review. Psychooncology 2017; 26:1433-1443. [DOI: 10.1002/pon.4347] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 10/14/2016] [Accepted: 12/08/2016] [Indexed: 01/09/2023]
Affiliation(s)
- Bee Teng Lim
- Practical Support Unit; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - Phyllis Butow
- The Psycho-oncology Co-operative Research Group; the University of Sydney; Sydney New South Wales Australia
| | - Jill Mills
- Practical Support Unit; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - Annie Miller
- Practical Support Unit; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - David Goldstein
- Department of Medical Oncology; Prince of Wales Hospital; Randwick New South Wales Australia
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Xie B, Su Z, Liu Y, Wang M, Zhang M. Health information sources for different types of information used by Chinese patients with cancer and their family caregivers. Health Expect 2016; 20:665-674. [PMID: 27604843 PMCID: PMC5513017 DOI: 10.1111/hex.12498] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 12/15/2022] Open
Abstract
Context Little is known about the information sources of Chinese patients with cancer and their family caregivers, yet this knowledge is critical for providing patient‐centred care. Objective To assess and compare the information sources used by Chinese patients with cancer and their family caregivers. Design The validated Health Information Wants Questionnaire (HIWQ) was translated and administered in March 2014. Setting The oncology department of a general hospital in south‐west China. Participants A convenience sample of 198 individuals, including 79 patients with cancer (mean age=55.24, SD=13.80) and 119 family caregivers (mean age=46.83, SD=14.61). Main outcome measures Ratings on the HIWQ items assessing information sources for different types of information. Results The interaction between information source and group was significant (F3,576=6.32, P<.01). Caregivers obtained more information than patients from the Internet. Caregivers and patients did not differ in the amount of information they obtained from doctors/nurses, interpersonal contacts or mass media. The interaction between information type and information source was significant (F18,3456=6.38, P<.01). Participants obtained more information of all types from doctors/nurses than from the other three sources and obtained more information from interpersonal contacts than from mass media or the Internet. Conclusions The information sources of Chinese patients with cancer and their family caregivers were similar, with an important difference that caregivers obtained more online information than patients. These findings have important implications for patient care and education in China where the family typically plays a major role in the care and decision making.
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Affiliation(s)
- Bo Xie
- School of Nursing & School of Information, The University of Texas at Austin, Austin, TX, USA
| | - Zhaohui Su
- Department of Advertising and Public Relations, The University of Texas at Austin, Austin, TX, USA
| | - Yihao Liu
- Department of Management, Warrington College of Business Administration, University of Florida, College Park, MD, USA
| | - Mo Wang
- Department of Management, Warrington College of Business Administration, University of Florida, College Park, MD, USA
| | - Ming Zhang
- Department of Oncology, Sichuan Provincial People's Hospital, Sichuan, China
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Krok-Schoen JL, Palmer-Wackerly AL, Dailey PM, Wojno JC, Krieger JL. Age Differences in Cancer Treatment Decision Making and Social Support. J Aging Health 2016; 29:187-205. [PMID: 26850474 DOI: 10.1177/0898264316628488] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this study was to examine the decision-making (DM) styles of younger (18-39 years), middle-aged (40-59 years), and older (≥60 years) cancer survivors, the type and role of social support, and patient satisfaction with cancer treatment DM. METHOD Adult cancer survivors ( N = 604) were surveyed using Qualtrics online software. RESULTS Older adults reported significantly lower influence of support on DM than younger adults. The most common DM style for the age groups was collaborative DM with their doctors. Younger age was a significant predictor of independent ( p < .05), collaborative with family ( p < .001), delegated to doctor ( p < .01), delegated to family ( p < .001), and demanding ( p < .001) DM styles. DISCUSSION Despite having lower received social support in cancer treatment DM, older adults were more satisfied with their DM than younger and middle-aged adults. Health care workers should be aware of different DM styles and influence of social networks to help facilitate optimal patient DM and satisfaction.
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Nie L, Xie B, Yang Y, Shan YM. Characteristics of Chinese m-Health Applications for Diabetes Self-Management. Telemed J E Health 2016; 22:614-9. [PMID: 27171016 PMCID: PMC5824655 DOI: 10.1089/tmj.2015.0184] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 10/30/2015] [Accepted: 10/30/2015] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To examine the features and types of health information provided in Chinese diabetes mobile applications (apps) for patients' self-management. MATERIALS AND METHODS Through multiple rounds of screening, we identified a total of 95 relevant iOS (Apple, Cupertino, CA) and Android™ (Google, Mountain View, CA) apps and examined each app's features and health information types based on each app's description in the app stores. We used a 15-feature algorithm to evaluate the apps' abilities for supporting diabetic patients' self-management, based on U.S. national standards for diabetes self-management. We also adapted the health information wants framework to analyze the types of information that the apps provided for diabetic patients. RESULTS Diabetes education was the most common feature, provided by 75% of the apps. Blood glucose checking was enabled by 65% of the apps. Diet management, insulin checking, and physical activity monitoring were enabled by 53%, 49%, and 44% of the apps, respectively. Only a small percentage of the apps enabled psychosocial support (29%) or tracking of blood pressure (14%), cholesterol (14%), or body mass index (11%). None of the apps provided all seven types of information posited by the health information wants framework. Only a small percentage of the apps provided information about psychosocial support (29%), healthcare providers (24%), or healthcare facilities (24%). Information about complementary and alternative medicine was the least likely type of information provided in the apps, with only 7% of the apps providing this type of information. CONCLUSIONS Our findings have important implications for improving the quality of Chinese diabetes mobile apps to facilitate patients' self-management.
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Affiliation(s)
- Lisa Nie
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, Texas
- School of Information, The University of Texas at Austin, Austin, Texas
| | - Yan Yang
- Department of Endocrinology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Yan Min Shan
- Department of Diabetes Education, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Kolovos P, Kaitelidou D, Lemonidou C, Sachlas A, Sourtzi P. Patients’ perceptions and preferences of participation in nursing care. J Res Nurs 2016. [DOI: 10.1177/1744987116633498] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to investigate patients’ perceptions and preferences of their participation in nursing care during hospitalisation in Greece. The sample consisted of medical and surgical patients ( n = 300). A questionnaire was developed to measure patients’ perception of participation, including an open question and the control preference scale. Descriptive and inferential statistics were used for quantitative data analysis and content analysis for qualitative data. Participation was described as ‘information receiving and responsibility’ and ‘ability to influence’. One-third of the respondents preferred a collaborative role with the nurses, while 77.2% rationalised patient participation with the themes ‘strengthening patient’s role’, ‘improve hospitalisation’ and ‘collaborative relationship’. The meaning of participation seems to support shared information, patient responsibility and motivation during nursing care. Patients were aware of the positive effects of their involvement in care and were willing to assume, at least to some extent, an active role in their own care. Changes in nursing care organisation, nurses’ communication skills and additional educational strategies need to be developed and implemented in clinical practice to optimise patient participation.
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Affiliation(s)
- Petros Kolovos
- Teaching Staff, Department of Nursing, University of Peloponnese, Greece
| | - Daphne Kaitelidou
- Assistant Professor, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
| | - Chrysoula Lemonidou
- Professor, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
| | | | - Panayota Sourtzi
- Professor, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
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Health information wanted and obtained from doctors/nurses: a comparison of Chinese cancer patients and family caregivers. Support Care Cancer 2015; 23:2873-80. [DOI: 10.1007/s00520-015-2651-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 02/08/2015] [Indexed: 01/16/2023]
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Malin Malmgren R, Eva Törnvall R, Inger Jansson R. Patients with hip fracture: Experiences of participation in care. Int J Orthop Trauma Nurs 2014. [DOI: 10.1016/j.ijotn.2013.08.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zhang Y. The effects of preference for information on consumers' online health information search behavior. J Med Internet Res 2013; 15:e234. [PMID: 24284061 PMCID: PMC3869058 DOI: 10.2196/jmir.2783] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 07/16/2013] [Accepted: 09/15/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Preference for information is a personality trait that affects people's tendency to seek information in health-related situations. Prior studies have focused primarily on investigating its impact on patient-provider communication and on the implications for designing information interventions that prepare patients for medical procedures. Few studies have examined its impact on general consumers' interactions with Web-based search engines for health information or the implications for designing more effective health information search systems. OBJECTIVE This study intends to fill this gap by investigating the impact of preference for information on the search behavior of general consumers seeking health information, their perceptions of search tasks (representing information needs), and user experience with search systems. METHODS Forty general consumers who had previously searched for health information online participated in the study in our usability lab. Preference for information was measured using Miller's Monitor-Blunter Style Scale (MBSS) and the Krantz Health Opinion Survey-Information Scale (KHOS-I). Each participant completed four simulated health information search tasks: two look-up (fact-finding) and two exploratory. Their behaviors while interacting with the search systems were automatically logged and ratings of their perceptions of tasks and user experience with the systems were collected using Likert-scale questionnaires. RESULTS The MBSS showed low reliability with the participants (Monitoring subscale: Cronbach alpha=.53; Blunting subscale: Cronbach alpha=.35). Thus, no further analyses were performed based on the scale. KHOS-I had sufficient reliability (Cronbach alpha=.77). Participants were classified into low- and high-preference groups based on their KHOS-I scores. The high-preference group submitted significantly shorter queries when completing the look-up tasks (P=.02). The high-preference group made a significantly higher percentage of parallel movements in query reformulation than did the low-preference group (P=.04), whereas the low-preference group made a significantly higher percentage of new concept movements than the high-preference group when completing the exploratory tasks (P=.01). The high-preference group found the exploratory tasks to be significantly more difficult (P=.05) and the systems to be less useful (P=.04) than did the low-preference group. CONCLUSIONS Preference for information has an impact on the search behavior of general consumers seeking health information. Those with a high preference were more likely to use more general queries when searching for specific factual information and to develop more complex mental representations of health concerns of an exploratory nature and try different combinations of concepts to explore these concerns. High-preference users were also more demanding on the system. Health information search systems should be tailored to fit individuals' information preferences.
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Affiliation(s)
- Yan Zhang
- University of Texas at Austin, Austin, TX, United States.
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Xie B, Wang M, Feldman R, Zhou L. Internet use frequency and patient-centered care: measuring patient preferences for participation using the health information wants questionnaire. J Med Internet Res 2013; 15:e132. [PMID: 23816979 PMCID: PMC3714005 DOI: 10.2196/jmir.2615] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/30/2013] [Accepted: 06/13/2013] [Indexed: 12/23/2022] Open
Abstract
Background The Internet is bringing fundamental changes to medical practice through improved access to health information and participation in decision making. However, patient preferences for participation in health care vary greatly. Promoting patient-centered health care requires an understanding of the relationship between Internet use and a broader range of preferences for participation than previously measured. Objective To explore (1) whether there is a significant relationship between Internet use frequency and patients’ overall preferences for obtaining health information and decision-making autonomy, and (2) whether the relationships between Internet use frequency and information and decision-making preferences differ with respect to different aspects of health conditions. Methods The Health Information Wants Questionnaire (HIWQ) was administered to gather data about patients’ preferences for the (1) amount of information desired about different aspects of a health condition, and (2) level of decision-making autonomy desired across those same aspects. Results The study sample included 438 individuals: 226 undergraduates (mean age 20; SD 2.15) and 212 community-dwelling older adults (mean age 72; SD 9.00). A significant difference was found between the younger and older age groups’ Internet use frequencies, with the younger age group having significantly more frequent Internet use than the older age group (younger age group mean 5.98, SD 0.33; older age group mean 3.50, SD 2.00; t436=17.42, P<.01). Internet use frequency was positively related to the overall preference rating (γ=.15, P<.05), suggesting that frequent Internet users preferred significantly more information and decision making than infrequent Internet users. The relationships between Internet use frequency and different types of preferences varied: compared with infrequent Internet users, frequent Internet users preferred more information but less decision making for diagnosis (γ=.57, P<.01); more information and more decision-making autonomy for laboratory test (γ=.15, P<.05), complementary and alternative medicine (γ=.32, P<.01), and self-care (γ=.15, P<.05); and less information but more decision-making autonomy for the psychosocial (γ=-.51, P<.01) and health care provider (γ=-.27, P<.05) aspects. No significant difference was found between frequent and infrequent Internet users in their preferences for treatment information and decision making. Conclusions Internet use frequency has a positive relationship with the overall preferences for obtaining health information and decision-making autonomy, but its relationship with different types of preferences varies. These findings have important implications for medical practice.
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Affiliation(s)
- Bo Xie
- School of Nursing & School of Information, University of Texas at Austin, Austin, TX, United States.
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Swenne CL, Skytt B. The ward round - patient experiences and barriers to participation. Scand J Caring Sci 2013; 28:297-304. [DOI: 10.1111/scs.12059] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/24/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Christine Leo Swenne
- Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | - Bernice Skytt
- Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
- Department of Health and Caring Sciences; Faculty of Health and Occupational Studies; University of Gävle; Gävle Sweden
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