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DeRosa AP, Grell Y, Razon D, Komsany A, Pinheiro LC, Martinez J, Phillips E. Decision-making support among racial and ethnic minorities diagnosed with breast or prostate cancer: A systematic review of the literature. PATIENT EDUCATION AND COUNSELING 2022; 105:1057-1065. [PMID: 34538465 DOI: 10.1016/j.pec.2021.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/01/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To describe the types of decision-making support interventions offered to racial and ethnic minority adults diagnosed with breast or prostate cancer and to draw any associations between these interventions and patient-reported quality of life (QoL) outcomes. METHODS We conducted literature searches in five bibliographic databases. Studies were screened through independent review and assessed for quality. Results were analyzed using inductive qualitative methods to determine thematic commonalities and synthesized in narrative form. RESULTS Searches across five databases yielded 2496 records, which were screened by title/abstract and full-text to identify 10 studies meeting inclusion criteria. The use of decision aids (DAs), trained personnel, delivery models and frameworks, and educational materials were notable decision-making support interventions. Analysis revealed six thematic areas: 1) Personalized reports; 2) Effective communication; 3) Involvement in decision-making; 4) Health literacy; 5) Social support; and 6) Feasibility in clinical setting. CONCLUSION Evidence suggests decision-making support interventions are associated with positive outcomes of racial and ethnic minorities with patient-reported factors like improved patient engagement, less decisional regret, higher satisfaction, improved communication, awareness of health literacy and cultural competence. PRACTICE IMPLICATIONS Future decision-making interventions for racial and ethnic minority cancer patients should focus on social determinants of health, social support systems, and clinical outcomes like QoL and survival.
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Affiliation(s)
- Antonio P DeRosa
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, USA.
| | | | - Dominic Razon
- Division of General Internal Medicine, Weill Cornell Medicine, New York, USA
| | - Alia Komsany
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, USA
| | - Laura C Pinheiro
- Division of General Internal Medicine, Weill Cornell Medicine, New York, USA
| | - Juana Martinez
- Division of General Internal Medicine, Weill Cornell Medicine, New York, USA
| | - Erica Phillips
- Division of General Internal Medicine, Weill Cornell Medicine, New York, USA
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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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Sandén U, Harrysson L, Thulesius H, Nilsson F. Breaking the patientification process - through co-creation of care, using old arctic survival knowledge. Int J Qual Stud Health Well-being 2021; 16:1926052. [PMID: 33974518 PMCID: PMC8118398 DOI: 10.1080/17482631.2021.1926052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Purpose: Cancer research and connected innovation processes often lack a major component; patient participation. We revisit three studies (a-c) in order to explore how Momentary contentment theory may be used to improve patient participation and psychosocial health. Method: We revisited data from the initial (a) classic grounded theory study on Momentary contentment, based on four years of observation and 14 interviews. It explains a way of dealing with life close to death and morbidity. In the imminence of danger the studied culture resembles the context of cancer patients. The two following studies used focus group interviews with (b) 19 cancer patients and (c) 17 relatives of cancer patients in southern Sweden. Results: We suggest a process where cancer patients are taught to be submissive and that the support they receive from health providers may be counterproductive to contentment; a patientification process. We present alternative ways for people to handle issues such as hope, waiting, knowledge gaps and healthcare navigation while living with cancer. We introduce an alternative to patientification and passive patients where active patients create their own safety and truly participates in their care.Conclusions: We propose clinical studies to introduce such a shift from patentification to co-creation of care.
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Affiliation(s)
- Ulrika Sandén
- Department of Design Sciences, Lund University, Lund, Sweden
| | | | - Hans Thulesius
- Department of Medicine and Optometry, Linnaeus University, Växjö, Sweden
| | - Fredrik Nilsson
- Department of Design Sciences, Lund University, Lund, Sweden
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Commentary on Patient Preferences for the Treatment of Basal Cell Carcinoma and Squamous Cell Carcinoma: A Mapping Review of Discrete Choice Experiments. Dermatol Surg 2018; 44:1050-1051. [PMID: 29994948 DOI: 10.1097/dss.0000000000001623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kloeppel EM, Hanaya H, Seilacher E, Schroth S, Liebl P, Keinki C, Koester MJ, Huebner J. Utility of a Referral Letter to Improve Comprehensibility of Cancer Patients in Palliative Care: a Single-Center Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:487-492. [PMID: 27325274 DOI: 10.1007/s13187-016-1062-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In spite of a referral letter as an important document for communicating between physicians, whether it could also be useful as a source of information for patients has not yet established. We included cancer patients in palliative care setting, all of whom completed a standardized questionnaire regarding their opinion concerning the utility of a referral letter as a source of information and its requirements to achieve a better understanding. Completed questionnaires were received from 50 cancer patients. Ninety-four percent of participants agreed that a referral letter could be of great importance for procuring medical information to them. There was only minor divergence among the participants respecting age, gender, or education. Particular requirements were diagnosis, treatment plan, prognosis, list of drugs, and contact data of involved physicians. Additional important topics were laboratory values, alternatives to current therapy, side effects and supportive therapy, and advices regarding lifestyle and naturopathy. The majority of patients also concluded to accept technical terms in doctor's letters if a glossary supported their comprehension. The majority of patients prefer a concise description of medical information in a referral letter. This form of a letter would boost patients' involvement and help them transfer medical information to other therapists or relatives.
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Affiliation(s)
- Eva-Marie Kloeppel
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Hani Hanaya
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Eckart Seilacher
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Sarah Schroth
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Patrick Liebl
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Christian Keinki
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Marie Jolin Koester
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Jutta Huebner
- Working Group Integrative Oncology, Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
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Sandén U, Harrysson L, Thulesius H, Nilsson F. Exploring health navigating design: momentary contentment in a cancer context. Int J Qual Stud Health Well-being 2017; 12:1374809. [PMID: 28911272 PMCID: PMC5654017 DOI: 10.1080/17482631.2017.1374809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2017] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The technocratic and medicalized model of healthcare is rarely optimal for patients. By connecting two different studies we explore the possibilities of increasing quality of life in cancer care. METHODS The first study captures survival strategies in a historically isolated Arctic village in Norway resulting in Momentary contentment theory, which emerged from analysing four years of participant observation and interview data. The second study conceptualizes everyday life of cancer patients based on in-depth interviews with 19 cancer patients; this was conceptualized as Navigating a new life situation. Both studies used classic grounded theory methodology. The connection between the studies is based on a health design approach. RESULTS We found a fit between cancer patients challenging life conditions and harsh everyday life in an Arctic village. Death, treatments and dependence have become natural parts of life where the importance of creating spaces-of-moments and a Sense of Safety is imminent to well-being. While the cancer patients are in a new life situation, the Arctic people show a natural ability to handle uncertainties. CONCLUSION By innovation theories connected to design thinking, Momentary contentment theory modified to fit cancer care would eventually be a way to improve cancer patients' quality of life.
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Affiliation(s)
- Ulrika Sandén
- Department of Design Sciences, Lund University, Lund, Sweden
| | | | - Hans Thulesius
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Fredrik Nilsson
- Department of Design Sciences, Lund University, Lund, Sweden
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Sawka AM, Straus S, Rodin G, Heus L, Brierley JD, Tsang RW, Rotstein L, Ezzat S, Segal P, Gafni A, Thorpe KE, Goldstein DP. Thyroid cancer patient perceptions of radioactive iodine treatment choice: Follow-up from a decision-aid randomized trial. Cancer 2015. [PMID: 26195199 PMCID: PMC4832354 DOI: 10.1002/cncr.29548] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Patient decision aids (P-DAs) inform medical decision making, but longer term effects are unknown. This article describes extended follow-up from a thyroid cancer treatment P-DA trial. METHODS In this single-center, parallel-design randomized controlled trial conducted at a Canadian tertiary/quaternary care center, early-stage thyroid cancer patients from a P-DA trial were contacted 15 to 23 months after randomization/radioactive iodine (RAI) decision making to evaluate longer term outcomes. It was previously reported that the use of the computerized P-DA in thyroid cancer patients considering postsurgical RAI treatment significantly improved medical knowledge in comparison with usual care alone. The P-DA and control groups were compared for the following outcomes: feeling informed about the RAI treatment choice, decision satisfaction, decision regret, cancer-related worry, and physician trust. In a subgroup of 20 participants, in-depth interviews were conducted for a qualitative analysis. RESULTS Ninety-five percent (70 of 74) of the original population enrolled in follow-up at a mean of 17.1 months after randomization. P-DA users perceived themselves to be significantly more 1) informed about the treatment choice (P = .008), 2) aware of options (P = .009), 3) knowledgeable about treatment benefits (P = .020), and 4) knowledgeable about treatment risks/side effects (P = .001) in comparison with controls. There were no significant group differences in decision satisfaction (P = .142), decision regret (P = .199), cancer-related worry (P = .645), mood (P = .211), or physician trust (P = .764). In the qualitative analysis, the P-DA was perceived to have increased patient knowledge and confidence in decision making. CONCLUSIONS The P-DA improved cancer survivors' actual and long-term perceived medical knowledge with no adverse effects. More research on the long-term outcomes of P-DA use is needed.
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Affiliation(s)
- Anna M Sawka
- Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada
| | - Sharon Straus
- Department of Medicine, St. Michael's Hospital/University of Toronto, Toronto, Canada
| | - Gary Rodin
- Department of Psychosocial Oncology, University Health Network/University of Toronto, Toronto, Canada
| | - Lineke Heus
- Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada
| | - James D Brierley
- Department of Radiation Oncology, University Health Network/University of Toronto, Toronto, Canada
| | - Richard W Tsang
- Department of Radiation Oncology, University Health Network/University of Toronto, Toronto, Canada
| | - Lorne Rotstein
- Department of Surgery, University Health Network/University of Toronto, Toronto, Canada
| | - Shereen Ezzat
- Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada
| | - Phillip Segal
- Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada
| | - Amiram Gafni
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - Kevin E Thorpe
- Dalla Lana School of Public Health, University of Toronto/Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada
| | - David P Goldstein
- Department of Otolaryngology and Head and Neck Surgery, University Health Network/University of Toronto, Toronto, Canada
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