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Hurley R, Jury F, van Staa TP, Palin V, Armitage CJ. Clinician acceptability of an antibiotic prescribing knowledge support system for primary care: a mixed-method evaluation of features and context. BMC Health Serv Res 2023; 23:367. [PMID: 37060063 PMCID: PMC10103677 DOI: 10.1186/s12913-023-09239-4] [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: 07/08/2022] [Accepted: 03/02/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Overprescribing of antibiotics is a major concern as it contributes to antimicrobial resistance. Research has found highly variable antibiotic prescribing in (UK) primary care, and to support more effective stewardship, the BRIT Project (Building Rapid Interventions to optimise prescribing) is implementing an eHealth Knowledge Support System. This will provide unique individualised analytics information to clinicians and patients at the point of care. The objective of the current study was to gauge the acceptability of the system to prescribing healthcare professionals and highlight factors to maximise intervention uptake. METHODS Two mixed-method co-design workshops were held online with primary care prescribing healthcare professionals (n = 16). Usefulness ratings of example features were collected using online polls and online whiteboards. Verbal discussion and textual comments were analysed thematically using inductive (participant-centred) and deductive perspectives (using the Theoretical Framework of Acceptability). RESULTS Hierarchical thematic coding generated three overarching themes relevant to intervention use and development. Clinician concerns (focal issues) were safe prescribing, accessible information, autonomy, avoiding duplication, technical issues and time. Requirements were ease and efficiency of use, integration of systems, patient-centeredness, personalisation, and training. Important features of the system included extraction of pertinent information from patient records (such as antibiotic prescribing history), recommended actions, personalised treatment, risk indicators and electronic patient communication leaflets. Anticipated acceptability and intention to use the knowledge support system was moderate to high. Time was identified as a focal cost/ burden, but this would be outweighed if the system improved patient outcomes and increased prescribing confidence. CONCLUSION Clinicians anticipate that an eHealth knowledge support system will be a useful and acceptable way to optimise antibiotic prescribing at the point of care. The mixed method workshop highlighted issues to assist person-centred eHealth intervention development, such as the value of communicating patient outcomes. Important features were identified including the ability to efficiently extract and summarise pertinent information from the patient records, provide explainable and transparent risk information, and personalised information to support patient communication. The Theoretical Framework of Acceptability enabled structured, theoretically sound feedback and creation of a profile to benchmark future evaluations. This may encourage a consistent user-focused approach to guide future eHealth intervention development.
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Affiliation(s)
- Ruth Hurley
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
| | - Francine Jury
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Tjeerd P van Staa
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Victoria Palin
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK
- Academic Health Science Centre, Manchester University NHS Foundation Trust (MFT), NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
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Connell L, Finn Y, Sixsmith J. Health literacy education programmes developed for qualified health professionals: a scoping review. BMJ Open 2023; 13:e070734. [PMID: 36997248 PMCID: PMC10069593 DOI: 10.1136/bmjopen-2022-070734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES Both literature and policy have identified the need for health literacy education for qualified health professionals. This study aimed to identify and map health literacy competencies and health literacy related communication skills educational interventions for qualified health professionals. The research questions included: Of the qualified health professional education interventions identified, which are focused on diabetes care? What health literacy competencies and health literacy related communication skills are integrated into each programme? What are the characteristics of each education programme? What were the barriers and facilitators to implementation? What methods are used to evaluate intervention effectiveness, if any? DESIGN Scoping review, informed by the Joanna Briggs Institute guidelines. DATA SOURCES The following databases: OVID; CINAHL; Cochrane; EMBASE; ERIC: PsycInfo; RIAN; Pro-Quest; UpToDate were searched. ELIGIBILITY CRITERIA Articles were included if the education programme focused on qualified health professionals, in all clinical settings, treating adult patient populations, of all study types. DATA EXTRACTION AND SYNTHESIS Two authors independently screened titles, abstracts and full text articles that met the inclusion criteria. The third author mediated any discrepancies. The data were extracted and charted in table format. RESULTS In total, 53 articles were identified. One article referred to diabetes care. Twenty-six addressed health literacy education, and 27 addressed health literacy related communication. Thirty-five reported using didactic and experiential methods. The majority of studies did not report barriers (N=45) or facilitators (N=52) to implementation of knowledge and skills into practice. Forty-nine studies evaluated the reported education programmes using outcome measures. CONCLUSIONS This review mapped existing education programmes regarding health literacy and health literacy related communication skills, where programme characteristics were identified to inform future intervention development. An evident gap was identified regarding qualified health professional education in health literacy, specifically in diabetes care.
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Affiliation(s)
- Lauren Connell
- Health Promotion Research Centre (HPRC), University of Galway, Galway, Ireland
- Alliance for Research and Innvoation in Wounds (ARIW), University of Galway, Galway, Ireland
- CDA Diabetic Foot Disease: from PRevention to Improved Patient Outcomes (CDA DFD PRIMO) programme, University of Galway, Galway, Ireland
| | - Yvonne Finn
- CDA Diabetic Foot Disease: from PRevention to Improved Patient Outcomes (CDA DFD PRIMO) programme, University of Galway, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Jane Sixsmith
- Health Promotion Research Centre (HPRC), University of Galway, Galway, Ireland
- CDA Diabetic Foot Disease: from PRevention to Improved Patient Outcomes (CDA DFD PRIMO) programme, University of Galway, Galway, Ireland
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Wolderslund M, Waidtløw K, Kofoed PE, Ammentorp J. Facilitators and Barriers to a Hospital-Based Communication Skills Training Programme: An Interview Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4834. [PMID: 36981743 PMCID: PMC10048912 DOI: 10.3390/ijerph20064834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to investigate the facilitators and barriers experienced by the department management (DMs) and communication skills trainers (trainers) during the implementation of a 3-day communication skills training (CST) programme for healthcare professionals (HCPs). Thus, we conducted semi-structured interviews with 23 DMs and 10 trainers from 11 departments concurrently implementing the CST programme. Thematic analysis was undertaken to elucidate the themes across the interviews. Five themes were developed: resource consumption; obstacles; management support; efforts and outcomes; and a lack of systematic follow-up. Although the DMs and trainers were largely in agreement, the theme of a lack of systematic follow-up was derived exclusively from the trainers, as were two of the subthemes within obstacles: (b) seniority, profession, and cultural differences, and (c) the trainers' competencies. The greatest perceived barrier was resource consumption. In addition, DMs found planning and staff resistance to be a challenge. However, the HCPs' resistance diminished or even changed to satisfaction after participating. The mandatory approach served as both a facilitator and a barrier; DMs' support was an essential facilitator. Explicit communication related to resource demands, planning, and participation is crucial, as is management support and the allocation of resources.
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Affiliation(s)
- Maiken Wolderslund
- Centre for Research in Patient Communication, Odense University Hospital, 5000 Odense, Denmark (J.A.)
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Karin Waidtløw
- Centre for Research in Patient Communication, Odense University Hospital, 5000 Odense, Denmark (J.A.)
| | - Poul-Erik Kofoed
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, 6000 Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, 5000 Odense, Denmark (J.A.)
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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Iversen ED, Wolderslund M, Kofoed PE, Gulbrandsen P, Poulsen H, Cold S, Ammentorp J. Communication Skills Training: A Means to Promote Time-Efficient Patient-Centered Communication in Clinical Practice. J Patient Cent Res Rev 2021; 8:307-314. [PMID: 34722798 DOI: 10.17294/2330-0698.1782] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose We hypothesized that health care providers would behave in a more patient-centered manner after the implementation of communication skills training, without causing the consultation to last longer. Methods This study was part of the large-scale implementation of a communication skills training program called "Clear-Cut Communication With Patients" at Lillebaelt Hospital in Denmark. Audio recordings from real-life consultations were collected in a pre-post design, with health care providers' participation in communication skills training as the intervention. The training was based on the Calgary-Cambridge Guide, and audio recordings were rated using the Observation Scheme-12. Results Health care providers improved their communication behavior in favor of being more patient-centered. Results were tested using a mixed-effect model and showed significant differences between pre- and postintervention assessments, with a coefficient of 1.3 (95% Cl: 0.35-2.3; P=0.01) for the overall score. The consultations did not last longer after the training. Conclusions Health care providers improved their communication in patient consultations after the implementation of a large-scale patient-centered communication skills training program based on the Calgary-Cambridge Guide. This did not affect the length of the consultations.
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Affiliation(s)
- Else Dalsgaard Iversen
- Health Services Research Unit, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark'.,Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Maiken Wolderslund
- Health Services Research Unit, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark'
| | - Poul-Erik Kofoed
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Pål Gulbrandsen
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Helle Poulsen
- Department of Gastrointestinal Surgery, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Søren Cold
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Jette Ammentorp
- Health Services Research Unit, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark'
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Gabrani J, Schindler C, Wyss K. Factors associated with the utilisation of primary care services: a cross-sectional study in public and private facilities in Albania. BMJ Open 2020; 10:e040398. [PMID: 33262191 PMCID: PMC7709502 DOI: 10.1136/bmjopen-2020-040398] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/21/2020] [Accepted: 10/20/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To identify key factors influencing the utilisation of governmental and private primary healthcare services in Albania. DESIGN A cross-sectional health facility survey using a 4-point Likert scale questionnaire to rank the importance of factors driving services utilisation. SETTING Exit interviews with patients who consulted one of 23 primary care providers (18 public and 5 private) in Fier district of Albania from the period of July-August 2018. PARTICIPANTS Representative sample of 629 adults ≥18 years of age. MAIN OUTCOMES MEASURES (1) Factors influencing the decision to visit a governmental or private primary care provider and (2) the association of sociodemographic characteristics and patients' decision to attend a given provider. Data were analysed using mixed logistic regression models. RESULTS Nearly half of the participants in this study were older than 60 years (45%). The majority (63%) reported to suffer from a chronic condition. Prevailing determinants for choosing a provider were 'quality of care' and 'healthcare professionals' attitudes. Solely looking at patients using a public provider, 'geographical proximity' was the most important factor guiding the decision (85% vs 11%, p<0.001). For private provider's patients, the 'availability of diagnostic devices' was the most important factor (69% vs 9%, p<0.001). The odds of using public facilities were significantly higher among the patients who perceived their health as poor (OR 5.59; 95% CI 2.62 to 11.92), suffered from chronic conditions (OR 3.13; 95% CI 1.36 to 7.24) or were benefiting from a socioeconomic aid scheme (OR 3.52; 95% CI 1.64 to 7.56). CONCLUSION The use of primary healthcare is strongly influenced by geographical and financial access for public facility users and availability of equipment for private users. This study found that aspects of acceptability and adequacy of services are equally valued. Additional commitment to further develop primary care through engagement of local decision-makers and professional associations is needed.
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Affiliation(s)
- Jonila Gabrani
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Christian Schindler
- Epidemiology and Public Health EPH, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Kaspar Wyss
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
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Akseer R, Connolly M, Cosby J, Frost G, Kanagarajah RR, Lim SHE. Clinician–patient relationships after two decades of a paradigm of patient-centered care. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2020.1713535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Riaz Akseer
- Health Sciences Division, Abu Dhabi Women’s College, Higher Colleges of Technology Abu Dhabi, United Arab Emirates
| | - Maureen Connolly
- Department of Kinesiology at Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| | - Jarold Cosby
- Department of Kinesiology at Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| | - Gail Frost
- Department of Kinesiology at Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| | - Rajwin Raja Kanagarajah
- Perdana University-Royal College of Surgeons in Ireland, Perdana University, Selangor, Malaysia
| | - Swee-Hua Erin Lim
- Health Sciences Division, Abu Dhabi Women’s College, Higher Colleges of Technology Abu Dhabi, United Arab Emirates
- Perdana University-Royal College of Surgeons in Ireland, Perdana University, Selangor, Malaysia
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Bastemeijer CM, Boosman H, van Ewijk H, Verweij LM, Voogt L, Hazelzet JA. Patient experiences: a systematic review of quality improvement interventions in a hospital setting. Patient Relat Outcome Meas 2019; 10:157-169. [PMID: 31191062 PMCID: PMC6535098 DOI: 10.2147/prom.s201737] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/09/2019] [Indexed: 01/17/2023] Open
Abstract
Purpose: In the era of value-based healthcare, one strives for the most optimal outcomes and experiences from the perspective of the patient. So, patient experiences have become a key quality indicator for healthcare. While these are supposed to drive quality improvement (QI), their use and effectiveness for this purpose has been questioned. The aim of this systematic review was to provide insight into QI interventions used in a hospital setting and their effects on improving patient experiences, and possible barriers and promoters for QI work. Methods: Prisma guidelines were used to design this review. International academic literature was searched in Embase, Medline OvidSP, Web of Science, Cochrane Central, PubMed Publisher, Scopus, PsycInfo, and Google Scholar. In total, 3,289 studies were retrieved and independently screened by the first two authors for eligibility and methodological quality. Data was extracted on the study purpose, setting, design, targeted patient experience domains, QI strategies, results of QI, barriers, and promotors for QI. Results: Twenty-one pre-post intervention studies were included for review. The methodological quality of the included studies was assessed using a Critical Appraisal Skills Program (CASP) Tool. QI strategies used were staff education, patient education, audit and feedback, clinician reminders, organizational change, and policy change. Twenty studies reported improvement in patient experience, 14 studies of the 21 included studies reported statistical significance. Most studies (n=17) reported data-related barriers (eg, questionnaire quality), professional, and/or organizational barriers (eg, skepticism among staff), and 14 studies mentioned specific promoters (eg, engaging staff and patients) for QI. Conclusions: Several patient experience domains are targeted for QI using diverse strategies and methodological approaches. Most studies reported at least one improvement and also barriers and promoters that may influence QI work. Future research should address these barriers and promoters in order to enhance methodological quality and improve patient experiences.
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Affiliation(s)
- Carla M Bastemeijer
- MMT, Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hileen Boosman
- Department of Quality & Patient Safety, Leiden University Medical Center, Leiden, the Netherlands
| | - Hans van Ewijk
- Department of Normative Professionalization, University of Humanistic Studies, Utrecht, the Netherlands
| | - Lisanne M Verweij
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Lennard Voogt
- Department of Physical Therapy Studies, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Jan A Hazelzet
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
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Abstract
BACKGROUND It is seldom questioned, if information delivered (to a patient) actually produces knowledge. There is a lack of understanding of how patients in general, surgical patients in particular, perceive, process, and translate clinical information in their everyday lives. The objective of this study was to elucidate how patients undergoing spinal fusion surgery manage and assimilate information provided by clinicians and how they adapt and embrace this information pre- and postsurgery. METHODS The study employed qualitative methods of ethnographic observation and semistructured interview with a total of 14 individuals, that is, spinal fusion patients (n = 6) and clinicians (n = 8) over a 4-month period in 2014. RESULTS The results highlight that in the course of treatment, patients embrace or reject information on the basis of their previous experience, expectations, and confidence in their own ability. Overall, patients adjusting to everyday life after spinal fusion surgery used 4 strategies of information processing about their individual life situation. Patients do not use just one of these strategies but may use a number of strategies depending on the situation. Such production of knowledge is pivotal to the behavior of patients through their treatment trajectory. CONCLUSIONS This study points to the challenges of supporting patients to assimilate information and affect health-related behaviors, recognizing that knowledge and behavior change are emergent processes in patients and not a linear outcome of information.
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10
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Tatla SK, Howard D, Antunes Silvestre A, Burnes S, Husson M, Jarus T. Implementing a collaborative coaching intervention for professionals providing care to children and their families: An exploratory study. J Interprof Care 2017; 31:604-612. [PMID: 28922022 DOI: 10.1080/13561820.2017.1336990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The growing complexity of healthcare requires family and interprofessional partnerships to deliver effective care. Interprofessional coaching can enhance family-centred practice and collaboration. The purpose of this study was to explore the acceptability and feasibility of collaborative coaching training to improve family centredness within acute paediatric rehabilitation. Using a participatory action design, service providers (SPs; n = 36) underwent a 6-month coaching programme involving coaching workshops, learning triads, and tailored sessions with a licensed coach. The feasibility and acceptability of coaching on SPs' family interactions and care was explored. Measure of Processes of Care (MPOC) and MPOC-SP, a coaching skills questionnaire, and focus groups were used to evaluate the acceptability of coaching training. We found that structured coaching training was feasible and SPs reported significant improvements in their coaching skills; however, MPOC and MPOC-SP scores did not reveal significant differences. Qualitative themes indicated that clinicians are developing coaching competencies and applying these skills in clinical practice. Participants perceived that the coaching approach strengthened relationships amongst colleagues, and they valued the opportunity for interprofessional learning. Findings suggest that coaching offers promise as an approach to facilitate successful patient outcomes and improve processes of care. Preliminary findings indicate that interprofessional coaching training is acceptable, feasible, and can significantly improve SP coaching skills and improve team cohesion. Further research to study the effects of coaching on interprofessional care using validated outcome measures and to assess the impact on service delivery is recommended.
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Affiliation(s)
- Sandy K Tatla
- a BC Children's and Women's Health Centre , BC Children's Hospital Research Institute , Vancouver , British Columbia , Canada.,b Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , British Columbia , Canada
| | - Dori Howard
- a BC Children's and Women's Health Centre , BC Children's Hospital Research Institute , Vancouver , British Columbia , Canada
| | - Alda Antunes Silvestre
- a BC Children's and Women's Health Centre , BC Children's Hospital Research Institute , Vancouver , British Columbia , Canada
| | - Stacey Burnes
- b Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , British Columbia , Canada
| | - Meghan Husson
- b Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , British Columbia , Canada
| | - Tal Jarus
- b Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , British Columbia , Canada
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Karlsen MMW, Gabrielsen AK, Falch AL, Stubberud DG. Intensive care nursing students' perceptions of simulation for learning confirming communication skills: A descriptive qualitative study. Intensive Crit Care Nurs 2017; 42:97-104. [PMID: 28549743 DOI: 10.1016/j.iccn.2017.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 04/16/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
Abstract
AIM The aim of this study was to explore intensive care nursing students experiences with confirming communication skills training in a simulation-based environment. RESEARCH METHODOLOGY The study has a qualitative, exploratory and descriptive design. The participants were students in a post-graduate program in intensive care nursing, that had attended a one day confirming communication course. Three focus group interviews lasting between 60 and 80min were conducted with 14 participants. The interviews were transcribed verbatim. Thematic analysis was performed, using Braun & Clark's seven steps. FINDINGS The analysis resulted in three main themes: "awareness", "ice-breaker" and "challenging learning environment". The participants felt that it was a challenge to see themselves on the video-recordings afterwards, however receiving feedback resulted in better self-confidence in mastering complex communication. CONCLUSION The main finding of the study is that the students reported improved communication skills after the confirming communication course. However; it is uncertain how these skills can be transferred to clinical practice improving patient outcomes.
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Affiliation(s)
| | | | - Anne Lise Falch
- Department of Emergencies & Critical Care, Oslo University Hospital, Norway
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12
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Beaird G, Nye C, Thacker LR. The Use of Video Recording and Standardized Patient Feedback to Improve Communication Performance in Undergraduate Nursing Students. Clin Simul Nurs 2017. [DOI: 10.1016/j.ecns.2016.12.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Wolderslund M, Kofoed PE, Holst R, Axboe M, Ammentorp J. Digital audio recordings improve the outcomes of patient consultations: A randomised cluster trial. PATIENT EDUCATION AND COUNSELING 2017; 100:242-249. [PMID: 27593087 DOI: 10.1016/j.pec.2016.08.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 08/26/2016] [Accepted: 08/28/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To investigate the effects on patients' outcome of the consultations when provided with: a Digital Audio Recording (DAR) of the consultation and a Question Prompt List (QPL). METHODS This is a three-armed randomised controlled cluster trial. One group of patients received standard care, while the other two groups received either the QPL in combination with a recording of their consultation or only the recording. Patients from four outpatient clinics participated: Paediatric, Orthopaedic, Internal Medicine, and Urology. The effects were evaluated by patient-administered questionnaires. RESULTS A total of 4349 patients participated in the study. DAR significantly increased the probability of fulfilling the participants' self-perceived information needs by 4.1% to 6.3%, particularly with regard to test results (OR=1.41, 95%CI: 1.14-1.74, p=0.001) and treatment options (OR=1.39, 95%CI: 1.13-1.71, p=0.002). Additionally, the interventions positively influenced the participants' satisfaction with the treatment, their relationship with the health professional, and their experience of being involved in the decision-making. CONCLUSION Providing outpatients with a QPL and DAR of their consultation positively influences the patients' perception of having adequate information after the consultation. PRACTICE IMPLICATIONS The implementation of a QPL and audio recording of consultations should be considered in routine practice.
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Affiliation(s)
- Maiken Wolderslund
- Health Services Research Unit, Lillebaelt Hospital, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Poul-Erik Kofoed
- Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Paediatrics, Lillebaelt Hospital, Kolding, Denmark.
| | - René Holst
- Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Mette Axboe
- Health Services Research Unit, Lillebaelt Hospital, Vejle, Denmark.
| | - Jette Ammentorp
- Health Services Research Unit, Lillebaelt Hospital, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
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Brown CE, Back AL, Ford DW, Kross EK, Downey L, Shannon SE, Curtis JR, Engelberg RA. Self-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops. Am J Hosp Palliat Care 2016; 35:45-51. [PMID: 28273752 DOI: 10.1177/1049909116681972] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees' self-assessments. AIM To examine whether Codetalk resulted in improved self-assessed communication competence by trainees. DESIGN Trainees were recruited from the University of Washington and the Medical University of South Carolina. Internal medicine residents, medicine subspecialty fellows, nurse practitioner students, or community-based advanced practice nurses were randomized to Codetalk, a simulation-based workshop, or usual education. The outcome measure was self-assessed competence discussing palliative care needs with patients and was assessed at the start and end of the academic year. We used robust linear regression models to predict self-assessed competency, both as a latent construct and as individual indicators, including randomization status and baseline self-assessed competency. RESULTS We randomized 472 trainees to the intervention (n = 232) or usual education (n = 240). The intervention was associated with an improvement in trainee's overall self-assessment of competence in communication skills ( P < .001). The intervention was also associated with an improvement in trainee self-assessments of 3 of the 4 skill-specific indicators-expressing empathy, discussing spiritual issues, and eliciting goals of care. CONCLUSION Simulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.
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Affiliation(s)
- Crystal E Brown
- 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA
| | - Anthony L Back
- 2 Division of Medical Oncology, Department of Medicine, Seattle Cancer Care Alliance, University of Washington and Fred Hutchinson Cancer Research Center, Seattle WA, USA
| | - Dee W Ford
- 3 Division of Pulmonary and Critical Care, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Erin K Kross
- 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA
| | - Lois Downey
- 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA
| | - Sarah E Shannon
- 4 School of Nursing, Oregon Health & Sciences University, Portland, OR, USA
| | - J Randall Curtis
- 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA
| | - Ruth A Engelberg
- 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA
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15
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Kornhaber R, Walsh K, Duff J, Walker K. Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review. J Multidiscip Healthc 2016; 9:537-546. [PMID: 27789958 PMCID: PMC5072574 DOI: 10.2147/jmdh.s116957] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Therapeutic interpersonal relationships are the primary component of all health care interactions that facilitate the development of positive clinician-patient experiences. Therapeutic interpersonal relationships have the capacity to transform and enrich the patients' experiences. Consequently, with an increasing necessity to focus on patient-centered care, it is imperative for health care professionals to therapeutically engage with patients to improve health-related outcomes. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO databases of peer-reviewed research, limited to the English language with search terms developed to reflect therapeutic interpersonal relationships between health care professionals and patients in the acute care setting. This study found that therapeutic listening, responding to patient emotions and unmet needs, and patient centeredness were key characteristics of strategies for improving therapeutic interpersonal relationships.
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Affiliation(s)
- Rachel Kornhaber
- School of Health Sciences, Faculty of Health, University of Tasmania, Alexandria, NSW
| | - Kenneth Walsh
- School of Health Sciences, Faculty of Health, University of Tasmania, Alexandria, NSW
- Tasmanian Health Services – Southern Region, Hobart, TAS
| | - Jed Duff
- School of Health Sciences, Faculty of Health, University of Tasmania, Alexandria, NSW
- St Vincent’s Private Hospital, Sydney, NSW, Australia
| | - Kim Walker
- School of Health Sciences, Faculty of Health, University of Tasmania, Alexandria, NSW
- St Vincent’s Private Hospital, Sydney, NSW, Australia
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16
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Orthopaedic patient education practice. Int J Orthop Trauma Nurs 2016; 21:39-48. [DOI: 10.1016/j.ijotn.2015.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 05/09/2015] [Accepted: 08/28/2015] [Indexed: 11/21/2022]
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17
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CORR Insights(®): do 360-degree feedback survey results relate to patient satisfaction measures? Clin Orthop Relat Res 2015; 473:1598-9. [PMID: 25421959 PMCID: PMC4385339 DOI: 10.1007/s11999-014-4063-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 11/13/2014] [Indexed: 01/31/2023]
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18
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Connolly M, Thomas JM, Orford JA, Schofield N, Whiteside S, Morris J, Heaven C. The impact of the SAGE & THYME foundation level workshop on factors influencing communication skills in health care professionals. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2014; 34:37-46. [PMID: 24648362 DOI: 10.1002/chp.21214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
INTRODUCTION The "SAGE & THYME Foundation Level Workshop" delivers evidence-based communication skills training to 30 health care workers in 3 hours. It teaches a structured approach (the SAGE & THYME model) to discuss patient/carer concerns. The aim of this study was to determine whether the workshop had a positive outcome on factors that influence communication skills. METHODS The study had a pragmatic, mixed methods design. Workshops were run in an acute hospital. One hundred seventy health care workers completed questionnaires pre- and post-workshop; 141 were sent follow-up questionnaires at 2 weeks and 2 months; and 9 were filmed talking to a simulated patient pre- and post-workshop. RESULTS From pre- to post-workshop, there was a significant increase in knowledge (p < 0.001), self-efficacy (p < 0.001), and outcome expectancy (p < 0.001). An expert's rating of behavior with the simulated patient also significantly increased after the training (p = 0.011). Motivation to use the training, and the perceived usefulness of the SAGE & THYME model, were high post-workshop. There was a poor response rate in the follow-up period; hence, the quantitative data are not reported. The qualitative data are described, however, as they give an insight into the impact of the training on staff and their patients. DISCUSSION The SAGE & THYME Foundation Level Workshop significantly increases communication skills knowledge, self-efficacy, and outcome expectancy of hospital health care workers who are predominantly white, female, nursing, or nonclinical staff. This suggests that the workshop may have a positive impact on some factors influencing communication skills in this group.
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19
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Bergh AL, Persson E, Karlsson J, Friberg F. Registered nurses' perceptions of conditions for patient education - focusing on aspects of competence. Scand J Caring Sci 2013; 28:523-36. [DOI: 10.1111/scs.12077] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 08/05/2013] [Indexed: 12/27/2022]
Affiliation(s)
| | - Eva Persson
- School of Health Sciences; University of Borås; Borås Sweden
- Faculty of Medicine; Department of Health Sciences; Lund University; Lund Sweden
| | - Jan Karlsson
- Institute of Health and Care Sciences; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Centre for Health Care Sciences; Örebro University Hospital; Örebro Sweden
| | - Febe Friberg
- Faculty of Social Sciences; Department of Health Studies; University of Stavanger; Stavanger Norway
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20
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Seys D, Deneckere S, Sermeus W, Van Gerven E, Panella M, Bruyneel L, Mutsvari T, Bejarano RC, Kul S, Vanhaecht K. The Care Process Self-Evaluation Tool: a valid and reliable instrument for measuring care process organization of health care teams. BMC Health Serv Res 2013; 13:325. [PMID: 23958206 PMCID: PMC3751913 DOI: 10.1186/1472-6963-13-325] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 08/15/2013] [Indexed: 11/10/2022] Open
Abstract
Background Patient safety can be increased by improving the organization of care. A tool that evaluates the actual organization of care, as perceived by multidisciplinary teams, is the Care Process Self-Evaluation Tool (CPSET). CPSET was developed in 2007 and includes 29 items in five subscales: (a) patient-focused organization, (b) coordination of the care process, (c) collaboration with primary care, (d) communication with patients and family, and (e) follow-up of the care process. The goal of the present study was to further evaluate the psychometric properties of the CPSET at the team and hospital levels and to compile a cutoff score table. Methods The psychometric properties of the CPSET were assessed in a multicenter study in Belgium and the Netherlands. In total, 3139 team members from 114 hospitals participated. Psychometric properties were evaluated by using confirmatory factor analysis (CFA), Cronbach’s alpha, interclass correlation coefficients (ICCs), Kruskall-Wallis test, and Mann–Whitney test. For the cutoff score table, percentiles were used. Demographic variables were also evaluated. Results CFA showed a good model fit: a normed fit index of 0.93, a comparative fit index of 0.94, an adjusted goodness-of-fit index of 0.87, and a root mean square error of approximation of 0.06. Cronbach’s alpha values were between 0.869 and 0.950. The team-level ICCs varied between 0.127 and 0.232 and were higher than those at the hospital level (0.071-0.151). Male team members scored significantly higher than females on 2 of the 5 subscales and on the overall CPSET. There were also significant differences among age groups. Medical doctors scored significantly higher on 4 of the 5 subscales and on the overall CPSET. Coordinators of care processes scored significantly lower on 2 of the 5 subscales and on the overall CPSET. Cutoff scores for all subscales and the overall CPSET were calculated. Conclusions The CPSET is a valid and reliable instrument for health care teams to measure the extent care processes are organized. The cutoff table permits teams to compare how they perceive the organization of their care process relative to other teams.
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Affiliation(s)
- Deborah Seys
- Department of Public Health, Center for Health Services and Nursing Research, University of Leuven, Kapucijnenvoer 35 4th Floor, Leuven B-3000, Belgium
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21
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Gill SD, Dunning T, McKinnon F, Cook D, Bourke J. Understanding the experience of inpatient rehabilitation: insights into patient-centred care from patients and family members. Scand J Caring Sci 2013; 28:264-72. [DOI: 10.1111/scs.12055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Stephen D. Gill
- Safety and Quality Unit; Barwon Health; Geelong Geelong, VIC Australia
| | - Trisha Dunning
- Centre for Nursing and Allied Health Research Deakin University and Barwon Health; Geelong VIC Australia
| | | | - Desma Cook
- Safety and Quality Unit; Barwon Health; Geelong Geelong, VIC Australia
| | - Jo Bourke
- Safety and Quality Unit; Barwon Health; Geelong Geelong, VIC Australia
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