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Dang TH, Ludlow C, Borle H, Alexander M, Wickramasinghe N, Burbury K, Jayaraman PP, Schofield P. Co-designing a motivational interviewing training platform to enhance oncology healthcare professional communication. PEC INNOVATION 2024; 5:100335. [PMID: 39257627 PMCID: PMC11385463 DOI: 10.1016/j.pecinn.2024.100335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 08/13/2024] [Accepted: 08/18/2024] [Indexed: 09/12/2024]
Abstract
Background Oncology healthcare professionals (HCPs) using motivational interviewing may motivate and support patients with chronic illness to adhere to medications. Research of online motivational interviewing training focusing on medication adherence in cancer is limited. Objective Co-design, develop, and preliminarily evaluate a motivational interviewing training platform (MITP) for oncology HCPs focused on medication adherence. Methods We used co-design and design science research methodology to develop and test the MITP in two phases: 1) program co-design and development and 2) interactive platform design and development. Results HCPs expressed a high demand for a practical and tailored motivational interviewing training. MITP is an online three-hour training comprising education, roleplay videos, and formative assessments. MITP was reported to be acceptable, usable, and useful by users. Innovation This study used a novel approach combining co-design and design science research methodology, and digital media to develop a flexible and acceptable online motivational interviewing training focused on medication adherence in cancer. Discussion and conclusion Applied rigorous methodology ensured the MITP was developed to address knowledge gaps and the needs of oncology HCPs for supporting patient adherence, and to be usable and useful. Study findings may inform future research on online motivational interviewing training and its potential impact on medication adherence.
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Affiliation(s)
- Thu Ha Dang
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Health Services Research and Implementation Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Digital Health Cooperative Research Centre, Sydney, Australia
| | - Chris Ludlow
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | | | - Marliese Alexander
- Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Nilmini Wickramasinghe
- Optus Digital Health, La Trobe University, Melbourne, Victoria, Australia
- Department Health and Bio-Statistics, School of Health Sciences and Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
- Epworth Healthcare, Victoria, Australia
| | - Kate Burbury
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
- Digital and Healthcare Innovation, Peter McCallum Cancer Centre, Melbourne, Victoria, Australia
- Tasmanian Health Services, Department of Health, Hobart, Tasmania, Australia
| | - Prem Prakash Jayaraman
- Factory of the Future and Digital Innovation Lab, Department of Computer Science and Software Engineering, School Software and Electrical Engineering, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Penelope Schofield
- Optus Digital Health, La Trobe University, Melbourne, Victoria, Australia
- Department of Psychological Sciences, and Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Brodsky CN, Sitto HM, Wittmann D, Wallner LP, Streur C, DeJonckheere M, Stoffel JS, Cameron AP, Sarma A, Clemens JQ, Ippolito GM. "There is a lot of shame that comes with this": A qualitative study of patient experiences of isolation, embarrassment, and stigma associated with overactive bladder. Neurourol Urodyn 2024. [PMID: 39039801 DOI: 10.1002/nau.25557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/30/2024] [Accepted: 07/06/2024] [Indexed: 07/24/2024]
Abstract
AIMS Beyond causing physical discomfort, overactive bladder (OAB) is distressing to patients across a variety of psychosocial domains. In this qualitative component of a larger mixed methods study, we explore patients' lived experience with OAB to understand how this condition impacts individuals on a personal and social level, as well as their experiences interacting with the health care system. METHODS A total of 20 patients and 12 physicians completed a questionnaire and semi-structured interview. The interview guide, developed in an iterative fashion by the authors, included questions about treatment decision making as well as experiences living with or treating OAB; this manuscript focuses on the questions probing lived experiences and interactions between patients and physicians. The interviews were recorded, transcribed and inductively coded and analyzed according to the principles of interpretive description to develop themes. RESULTS Analysis of patient and physician interviews yielded five key themes: isolation due to OAB diagnosis, social stigma associated with noticeable OAB symptoms, embarrassment from interactions with the health care system, feeling invalidated and dismissed by physicians, and OAB patients as a "vulnerable" population with "desperation" for cure. CONCLUSIONS OAB causes patients marked distress beyond their physical symptoms; it causes feelings of isolation from friends and family and makes them feel embarrassed to discuss their condition with loved ones and physicians alike. Efforts to destigmatize OAB, validate patient experiences, and improve access to OAB care may help diminish the psychosocial burden of OAB.
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Affiliation(s)
- Casey N Brodsky
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Hannah M Sitto
- Central Michigan University, Mount Pleasant, Michigan, USA
| | - Daniela Wittmann
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lauren P Wallner
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Courtney Streur
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - John S Stoffel
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Anne P Cameron
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Aruna Sarma
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - James Q Clemens
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Giulia M Ippolito
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
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Jouanny C, Abhyankar P, Maxwell M. A mixed methods systematic literature review of barriers and facilitators to help-seeking among women with stigmatised pelvic health symptoms. BMC Womens Health 2024; 24:217. [PMID: 38570870 PMCID: PMC10993589 DOI: 10.1186/s12905-024-03063-6] [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: 10/24/2023] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Women's pelvic health is a globally important subject, included in international and United Kingdom health policies, emphasising the importance of improving information and access to pelvic health services. Consequences of pelvic symptoms are intimate, personal, and varied, often causing embarrassment and shame, affecting women's quality of life and wellbeing. AIM To understand the experience of seeking healthcare for stigmatised pelvic health symptoms by synthesising all types of published primary research and mapping the results to behavioural theory, to identify potential targets for intervention. METHODS Systematic search of MEDLINE, CINAHL, PsycINFO, SocINDEX, PubMED databases, CDSR and CENTRAL registers, from inception to May 2023 for all types of research capturing women's views and experiences of seeking help with stigmatised urogenital and bowel symptoms. Studies only reporting prevalence, predictors of help-seeking, non-health related help-seeking, or written in languages other than English, German, French, Spanish and Swedish were excluded. Reference checking and forward citation searching for all included studies was performed. A results-based synthesis approach was used to integrate quantitative and qualitative data. Themes were mapped to the Common-Sense model and Candidacy framework. The Mixed Methods Appraisal Tool was used for critical appraisal. Grading of Recommendations Assessment, Development and Evaluation - Confidence in Evidence from Reviews of Qualitative research for assessing certainty of review findings. RESULTS 86 studies representing over 20,000 women from 24 high income countries were included. Confidence was high that barriers to help-seeking were similar across all study types and pelvic symptoms: stigma, lack of knowledge, women's perception that clinicians dismissed their symptoms, and associated normalising and deprioritising of low bother symptoms. Supportive clinicians and increased knowledge were key facilitators. CONCLUSIONS Using the Common-Sense Model to explore women's help-seeking behaviour with stigmatised pelvic symptoms reveals problems with cognitive representation of symptom identity, emotional representations of embarrassment and shame, and a subjective norm that women believe their symptoms will be trivialised by clinicians. Together these barriers frustrate women's identification of their candidacy for healthcare. Addressing these issues through behavioural change interventions for women and clinicians, will help to achieve universal access to pelvic healthcare services (United Nations Sustainable Development Goal 3.7). SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021256956.
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Affiliation(s)
- Clare Jouanny
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland.
| | - Purva Abhyankar
- Department of Psychology, University of Stirling, Stirling, Scotland
| | - Margaret Maxwell
- The Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, Scotland
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Anderson JN, Paladino AJ, Blue R, Dangerfield DT, Eggly S, Martin MY, Schwartzberg LS, Vidal GA, Graetz I. Silent suffering: the impact of sexual health challenges on patient-clinician communication and adherence to adjuvant endocrine therapy among Black women with early-stage breast cancer. J Cancer Surviv 2023:10.1007/s11764-023-01511-0. [PMID: 38114711 PMCID: PMC11216545 DOI: 10.1007/s11764-023-01511-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Adjuvant endocrine therapy (AET) increases sexual health challenges for women with early-stage breast cancer. Black women are more likely than women of other racial/ethnic groups to report adverse symptoms and least likely to initiate and maintain AET. Little is known about how sexual health challenges influence patient-clinician communication and treatment adherence. This study explores facilitators of and barriers to patient-clinician communication about sexual health and how those factors might affect AET adherence among Black women with early-stage breast cancer. METHODS We conducted 32 semi-structured, in-depth interviews among Black women with early-stage breast cancer in the U.S. Mid-South region. Participants completed an online questionnaire prior to interviews. Data were analyzed using thematic analysis. RESULTS Participants' median age was 59 (range 40-78 years, SD = 9.0). Adverse sexual symptoms hindered participants' AET adherence. Facilitators of patient-clinician communication about sexual health included female clinicians and peer support. Barriers included perceptions of male oncologists' disinterest in Black women's sexual health, perceptions of male oncologists' biased beliefs about sexual activity among older Black women, cultural norms of sexual silence among Southern Black women, and medical mistrust. CONCLUSIONS Adverse sexual symptoms and poor patient-clinician communication about sexual health contribute to lower AET adherence among Black women with early-stage breast cancer. New interventions using peer support models and female clinicians trained to discuss sexual health could ameliorate communication barriers and improve treatment adherence. IMPLICATIONS FOR CANCER SURVIVORS Black women with early-stage breast cancer in the U.S. Mid-South may require additional resources to address sociocultural and psychosocial implications of cancer survivorship to enable candid discussions with oncologists.
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Affiliation(s)
- Janeane N Anderson
- College of Nursing, University of Tennessee Health Science Center, 874 Union Avenue, Memphis, TN, 38163, USA.
| | - Andrew J Paladino
- College of Medicine, University of Tennessee Health Science Center, 910 Madison Avenue, Memphis, TN, 38103, USA
| | - Ryan Blue
- College of Nursing, University of Tennessee Health Science Center, 874 Union Avenue, Memphis, TN, 38163, USA
| | - Derek T Dangerfield
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave. NW #308, Washington, D.C, 20037, USA
| | - Susan Eggly
- Department of Oncology, School of Medicine, Wayne State University, 87 E. Canfield, Detroit, MI, 48201, USA
| | - Michelle Y Martin
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN, 38163, USA
| | | | - Gregory A Vidal
- West Cancer Center Research Institute, 7945 Wolf River Blvd, Germantown, TN, 38138, USA
| | - Ilana Graetz
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
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Kouchi Y, Ozaki A, Kaneda Y, Bhandari D, Saito K, Shimmura H. An examination of the relationship between satisfaction with overactive bladder (OAB) treatment and the doctor-patient gender: A questionnaire-based single-institution study. BJUI COMPASS 2023; 4:417-419. [PMID: 37334029 PMCID: PMC10268576 DOI: 10.1002/bco2.236] [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: 10/24/2022] [Revised: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 03/29/2023] Open
Abstract
Overactive bladder (OAB) significantly reduces quality of life. The primary goal of this study was to determine whether the gender combination of patient and physician may be associated with satisfaction with OAB treatment. This questionnaire survey was conducted at Jyoban Hospital. We considered the adult patients aged 18 years or older who attended the outpatient office of the urology department of the hospital, were diagnosed with OAB and had been taking anticholinergics or β3-receptor stimulants, or both, for at least 3 months. In addition to the OAB treatment satisfaction, the questionnaire covered OABSS, IPSS, oral medications, effectiveness of OAB treatment, response to OAB symptoms, and the medium and extent of information collection. A total of 147 patients participated in the study. In summary, 91 (61.9%) were male, and the mean age was 73.5 years. Compared to when the gender of doctor and patient was not the same, female patients tended to be significantly more satisfied when they were treated by female doctors (OR 10.79, 95% CI 1.27-92.05). On the other hand, no similar trend was observed when male patients were treated by male doctors (OR 1.26, 95% CI 0.25-6.34). In the present study, which examined doctor-patient gender combinations in satisfaction with OAB treatment, as hypothesized, satisfaction was higher for female doctor-female patient combinations compared to different doctor-patient genders. A notable fact was that similar associations were not observed among the male doctor-patient combination. This means that an embarrassment of female patients could be stronger than male patients particularly in disclosing urinary symptoms to healthcare providers. The percentage of female urologists in Japan is only 8.2%, and it will be necessary to further promote the recruitment of female doctors in urology fields in order to encourage female patients with OAB to more actively visit doctors.
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Affiliation(s)
- Yukiko Kouchi
- Department of UrologyJyoban Hospital of Tokiwa FoundationIwakiJapan
| | - Akihiko Ozaki
- Department of Breast and Thyroid SurgeryJyoban Hospital of Tokiwa FoundationIwakiJapan
| | - Yudai Kaneda
- School of MedicineHokkaido UniversitySapporoJapan
| | - Divya Bhandari
- Department of Breast and Thyroid SurgeryJyoban Hospital of Tokiwa FoundationIwakiJapan
| | - Kazuma Saito
- School of Political Science and EconomicsWaseda UniversityTokyoJapan
| | - Hiroaki Shimmura
- Department of UrologyJyoban Hospital of Tokiwa FoundationIwakiJapan
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Razdan S, Ho P, Bieber C, Sljivich M, Anastos H, Busby D, Simma‐Chiang V. Factors that influence preference for male or female urologist among underserved patients in New York City. BJUI COMPASS 2023; 4:167-172. [PMID: 36816153 PMCID: PMC9931541 DOI: 10.1002/bco2.196] [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: 07/14/2022] [Revised: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 02/17/2023] Open
Abstract
Objective To examine the prevalence of patient preference for male or female urologic provider and explore which patient characteristics influence this preference. Materials and Methods After obtaining hospital Institutional Review Board approval, a 14-question survey in English and Spanish was administered across four general urology clinic sites in a single hospital system in New York City. The survey asked demographic questions and preference for a male or a female urologist. The survey included questions pertaining to the nature of the clinic visit and subsequent provider preference as well. Statistics were performed using Stata 16 (StataCorp, College Station, TX). Results A total of 540 patients completed the 14-question survey. The vast majority of survey respondents identified as male (90%). The largest proportion demographic groups were those aged 41-60 (47%), Hispanic or Latino (43%), Catholic (47%), unemployed (40%) and those with a high school level of education (34%). Most patients (60%) did not have a preference for a specific gender provider, whereas 37% preferred a male provider, and 3% preferred a female provider. On univariate analysis, patient age 25-40, less than high school education level and lack of employment were significant predictors of provider gender preference (p < 0.05), with most patients indicating a male provider preference. On multivariate analysis of gender, age, education level and employment status, gender and education level were not significant predictors of preference, whereas age 25-40 and being unemployed were significant predictors (p < 0.05). Conclusion Patient gender, race and religion do not appear to influence their preference to be seen by a male or a female urologist in the clinic setting. However, patient age, unemployment and potentially educational attainment were significantly associated with a provider gender preference.
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Affiliation(s)
- Shirin Razdan
- Department of UrologyIcahn School of Medicine at Mount Sinai HospitalNew YorkNew YorkUSA
| | - Patrick Ho
- Department of UrologyIcahn School of Medicine at Mount Sinai HospitalNew YorkNew YorkUSA
| | | | - Michaela Sljivich
- Department of UrologyIcahn School of Medicine at Mount Sinai HospitalNew YorkNew YorkUSA
| | - Harry Anastos
- Department of UrologyIcahn School of Medicine at Mount Sinai HospitalNew YorkNew YorkUSA
| | - Dallin Busby
- Department of UrologyIcahn School of Medicine at Mount Sinai HospitalNew YorkNew YorkUSA
| | - Vannita Simma‐Chiang
- Department of UrologyIcahn School of Medicine at Mount Sinai HospitalNew YorkNew YorkUSA
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Postpartum Urinary Incontinence: A Qualitative Study on Sexuality and Life Experiences of Muslim Turkish Women. Female Pelvic Med Reconstr Surg 2021; 27:514-520. [PMID: 34074935 DOI: 10.1097/spv.0000000000001072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The study was planned to identify the sexuality and life experiences of Muslim Turkish women with urinary incontinence (UI) within 12 months postpartum. METHODS A qualitative study was conducted using a semistructured interview. Data were collected between July and December 2019 via an in-depth, face-to-face interview technique using an interview form. The qualitative data obtained in this study were analyzed with the content analysis technique. RESULTS The main themes related to sexuality and life experiences of the women with UI in the postpartum period were identified as "problems in daily life," "emotional effects," "baby-related effects," and "spouse's and family's attitudes." CONCLUSIONS As a result, it was found that women in the postpartum period were affected by UI in terms of behavioral, emotional, and social aspects.
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Wynn J, Johns Putra L. Patient preference for urologist gender. Int J Urol 2020; 28:170-175. [PMID: 33150602 DOI: 10.1111/iju.14418] [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] [Received: 06/20/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the factors associated with patients preferring the gender of their treating urologist in various clinical settings. METHODS A total of 400 urology outpatients participated in a structured interview on the nature of their presenting complaint, perception of their complaint and the preference for the gender of their urologist in four specific scenarios of consultation, physical examination, office-based procedure and surgery. Patients who expressed a gender preference received follow-up telephone calls. RESULTS A gender preference was expressed by 63 (15.8%), 108 (27.0%), 89 (22.3%) and 29 (7.3%) patients for the scenarios of consultation, physical examination, office-based procedure and surgery, respectively. Patients were more likely to have a preference if they were female or had a condition they considered embarrassing, with most preferences being for a gender-concordant urologist. Reasons included a previous negative experience and perceived gender-specific treatment styles. Patients who subsequently saw a doctor of the opposite gender to their preference were more likely to change their mind if their clinical interaction was positive. CONCLUSIONS Female patients, those with a perceived embarrassing condition and patients undergoing examination or office-based procedures are more likely to have a gender preference for their urologist, with a subsequent positive experience leading to patients discarding pre-existing preferences. With improved understanding of how patient characteristics, perception of their condition and previous experiences can affect their choices in various clinical situations, urologists can better meet patient expectations and address barriers to healthcare in urology.
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Affiliation(s)
- Jessica Wynn
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lydia Johns Putra
- Department of Urology, Ballarat Health Services, Ballarat, Victoria, Australia.,Ballarat Urology, Ballarat, Victoria, Australia
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Gamé X, Doumerc N, Capronnier O, Gougeon A, Pignier C, Brierre T. [Knowledge, practices and expectations in the management of overactive bladder in general practice and gynecology in France]. Prog Urol 2020; 30:675-683. [PMID: 32684496 DOI: 10.1016/j.purol.2020.04.014] [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: 12/25/2019] [Revised: 04/10/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Overactive bladder (OAB) is a clinical syndrome characterized by urgency to urinate, with or without urinary incontinence, often associated with nycturia and pollakiuria. The aim of this practice survey is to identify diagnostic modalities and treatment circuits according to the patient's clinical profile and to practitioner's specialty. MATERIAL AND METHODS A cross-sectional survey was conducted among 262 physicians practicing in France: 181 general practitioners (GPs) and 81 gynecologists. RESULTS Urinary disorders were more easily addressed with patients by gynecologists than GPs. Behavioral therapy was the most widely used therapeutic measure, however half of the patients abandoned it. In oldest women and men of all ages, drugs were commonly prescribed, nevertheless only 4 out of 10 patients continued the treatment beyond 6months, according to the physicians. Incontinence was the symptom for which patients were in most need of relief. GPs and gynecologists expressed a need for training, practical tools and recommendations related to OAB. CONCLUSION Patients and doctors are reluctant to talk about urinary disorders. Non-urologist physicians such as GPs and gynecologists, as health professionals best placed to detect and diagnose OAB, are in demand for training, practical tools and recommendations. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, TSA 50032, 31059 Toulouse, France.
| | - N Doumerc
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, TSA 50032, 31059 Toulouse, France
| | | | - A Gougeon
- Euraxi Pharma, 37300 Joué-lès-Tours, France
| | - C Pignier
- Pierre Fabre médicament, direction médicale, 81106 Castres cedex, France
| | - T Brierre
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, TSA 50032, 31059 Toulouse, France
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10
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Toye F, Barker KL. A meta-ethnography to understand the experience of living with urinary incontinence: 'is it just part and parcel of life?'. BMC Urol 2020; 20:1. [PMID: 31941470 PMCID: PMC6964106 DOI: 10.1186/s12894-019-0555-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 11/08/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Urinary incontinence (UI) is highly prevalent and affects the lives of many men and women. We aimed to conduct a qualitative evidence synthesis (QES) to explore the experience of living with UI and to develop a conceptual model that can help us to understand this experience, and the potential barriers to appropriate healthcare. METHODS We used the methods of meta-ethnography developed by Noblit and Hare and recently refined for larger studies. Meta-ethnography involves identifying concepts from the studies and abstracting these concepts into a line of argument. We searched for studies that explored the experience of adults with UI. We used the GRADE-CERQual framework to assess confidence in review findings. RESULTS We screened 2307 titles, 429 abstracts, 107 full texts and included 41 studies (36 unique samples) in the synthesis. We organised the concepts into 26 conceptual categories, which we further abstracted into 6 themes: (1) Am I ill or is this normal? (2) It effects who I am and how I feel; (3) I feel stigmatised, ashamed and guilty; (4) talking can be difficult but it can help; (5) keeping incontinence under control; (6) have I got to the point that I need help? Our model conceptualises living with UI as navigating antagonists: Is UI normal or am I ill? Do I need help or am I managing? Do I keep UI to myself (and manage alone) or do I tell other people (and get the support that I need)? Do I use control strategies that focus on concealing (avoid risky situations, wear pads) versus, I use strategies that focus on improving the bodily function to improve continence. Our model highlights the experience of stigma, shame and guilt which exert a pull towards concealment. CONCLUSIONS The culture of secrecy and profound sense of shame is barrier to seeking help. An environment which reduces the shame and stigma of UI may help people to switch the focus to strategies that will improve continence, rather than conceal incontinence.
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Affiliation(s)
- Francine Toye
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Oxford, OX3 7HE UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Karen L. Barker
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Oxford, OX3 7HE UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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11
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Lim BT, Huang YJ, Shepherd HL, Shaw J, Costa D, Durcinoska I, Young JM, White K, Sze M, Butow P. Health literacy and cancer care coordination in Chinese migrant patients and their carers: A cross-sectional survey. Psychooncology 2019; 28:1048-1055. [PMID: 30828923 DOI: 10.1002/pon.5050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This study aimed to describe the levels of health literacy and experience of care coordination among Chinese migrant patients with cancer and their carers in Australia, and to examine factors associated with these. METHODS Patients' self-reported data were collected using the Health Literacy and Cancer Care Coordination questionnaires. We conducted multivariate linear regression analyses to investigate predictors of patients' health literacy and their care experience. Canonical correlation analysis was used to examine the relationship between patients' health literacy and their care experience. RESULTS A total of 68 patients and eight carers participated in the survey. Patients and carers reported similar levels of health literacy, with the lowest scores being in the "Having sufficient information to manage health" and "Navigating the health system" subscales. Gender (P = 0.026, partial η2 = 0.281) and educational attainment (P = 0.015, partial η2 = 0.250) had significant and large effects on patients' health literacy, after controlling for each other. Educational attainment showed a significant and medium association with patients' experience of cancer care coordination (P = 0.041, partial η2 = 0.101). A large and positive correlation was found between patients' health literacy and experience of cancer care coordination (canonical correlation = 0.81). CONCLUSIONS Our findings reveal the health literacy and care coordination needs of Chinese migrant patients with cancer in Australia, especially those with lower educational attainment. Future efforts are necessary to enhance Chinese migrants' health literacy and establish an accessible and easy-to-navigate care environment.
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Affiliation(s)
- Bee Teng Lim
- Faculty of Science, School of Psychology, Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia
| | - Yi-Jing Huang
- Faculty of Science, School of Psychology, Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia
| | - Heather L Shepherd
- Faculty of Science, School of Psychology, Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Faculty of Science, School of Psychology, Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia
| | - Daniel Costa
- Royal North Shore Hospital, Pain Management Research Institute, Sydney, NSW, Australia.,Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Ivana Durcinoska
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, Institute of Academic Surgery, Surgical Outcomes Research Centre, Sydney, NSW, Australia
| | - Kate White
- Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit, The University of Sydney, Sydney, NSW, Australia
| | - Minglo Sze
- Faculty of Science, School of Psychology, Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia
| | - Phyllis Butow
- Faculty of Science, School of Psychology, Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia
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Pun JKH, Chan EA, Wang S, Slade D. Health professional-patient communication practices in East Asia: An integrative review of an emerging field of research and practice in Hong Kong, South Korea, Japan, Taiwan, and Mainland China. PATIENT EDUCATION AND COUNSELING 2018; 101:1193-1206. [PMID: 29422231 DOI: 10.1016/j.pec.2018.01.018] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To provide an integrative review of literature on health communication in East Asia and detail culturally-specific influences. METHODS Using PRISMA model, search of PubMed, PsychInfo, Web of Knowledge, ERIC and CINAHL databases were conducted for studies between January 2000 and March 2017, using the terms 'clinician/health professional-patient', 'nurse/doctor-patient, 'communication' and 'Asia'. RESULTS 38 studies were included: Mainland China, Hong Kong, Japan, South Korea, and Taiwan. The existing body of research on clinician patient communication in East Asia can be classified: 1) understanding the roles and expectations of the nurse, clinician, patient, and family in clinician-patient consultations: a) nurse-patient communication; b) doctor-patient communication; c) the role of family member; and 2) factors affecting quality of care: d) cultural attitudes towards death and terminal illnesses; e) communication preferences affecting trust, decision-making and patient satisfaction; f) the extent to which patient centred care is being implemented in practice; and g) communication practices in multilingual/multi-disciplinary environments. CONCLUSION The review detailed the complexity and heterogeneity of clinician-patient communication across East Asia. The studies reviewed indicate that research in East Asia is starting to move beyond a preference for Western-based communication practices. PRACTICE IMPLICATIONS There is a need to consider local culture in understanding and interpreting medical encounters in East Asia. The paper highlights the need for a specific culturally-appropriate model of health communication in East Asia which may significantly improve relationships between clinicians and patients.
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Affiliation(s)
- Jack K H Pun
- Department of English, The City University of Hong Kong, 83, Tat Chee Avenue, Kowloon, Hong Kong, China; Department of Education, St Antony's College, University of Oxford, 15 Norham Gardens, Oxford, United Kingdom; The Institute for Communication in Health Care, School of Languages, Literature and Linguistics, The Australian National University, Canberra, Australia.
| | - E Angela Chan
- The Institute for Communication in Health Care, School of Languages, Literature and Linguistics, The Australian National University, Canberra, Australia; School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Sophie Wang
- Faculty of Arts and Social Science, The University of Technology Sydney, Sydney, Australia
| | - Diana Slade
- The Institute for Communication in Health Care, School of Languages, Literature and Linguistics, The Australian National University, Canberra, Australia; School of Literature, Language and Linguistics, ANU College of Arts & Social Sciences, The Australian National University, Canberra, Australia
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See, Do, Teach? A Review of Contemporary Literature and Call to Action for Communication Skills Teaching in Urology. Urology 2018; 114:33-40. [DOI: 10.1016/j.urology.2017.10.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 09/22/2017] [Accepted: 10/24/2017] [Indexed: 11/30/2022]
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Imprisoned in the Cultural Stereotypes of Overactive Bladder: Cultural Meanings of Disease and Sick Role Adaptation in Hong Kong. Nurs Res 2017; 65:352-61. [PMID: 27579503 DOI: 10.1097/nnr.0000000000000177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Diseases often carry cultural meanings and metaphors, and these meanings can influence illness experiences and behavioral responses. OBJECTIVES This research investigated how old cultural stereotypes and new social understandings of overactive bladder (OAB) intertwined to influence sick role adaptation and behavioral responses among those with OAB. METHODS A qualitative approach using in-depth individual, semistructured interviews was adopted. Thirty patients having OAB were purposively sampled from a patient self-help group for people with OAB. RESULTS The cultural stereotypes about OAB-as an "old people" disease, as a hopeless disease without cure, as a sexually related disease, and as a disease of substance use-had significant impact on the social and illness experiences of participants, leading to difficulty in adapting to their sick role, indicated by behavioral responses of denial, concealment, resignation, and self-seclusion. DISCUSSION Cultural stereotypes of OAB significantly influenced sick role adaptation, which affected illness experiences of persons with OAB. These cultural stereotypes were associated with behavioral responses that led to difficulties in coping with OAB.
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Patient Preference for Physician Gender in the Emergency Department. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2016; 89:131-42. [PMID: 27354840 PMCID: PMC4918861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Despite historical gender bias against female physicians, few studies have investigated patients' physician gender preference in the emergency department (ED) setting. We sought to determine if there is an association between ED patient demographics and physician gender preference. We surveyed patients presenting to an ED to determine association between patient demographics and patient physician gender preference for five ED situations: 1) 'routine' visit, 2) emergency visit, 3) 'sensitive' medical visit, 4) minor surgical/'procedural' visit, and 5) 'bad news' delivery. A total of 200 ED patients were surveyed. The majority of ED patients reported no physician gender preference for 'routine' visits (89.5 percent), 'emergent' visits (89 percent), 'sensitive' medical visits (59 percent), 'procedural' visits (89 percent) or when receiving 'bad news' (82 percent). In the setting of 'routine' visits and 'sensitive' medical visits, there was a propensity for same-sex physician preference.
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Mengesha ZB, Dune T, Perz J. Culturally and linguistically diverse women. Sex Health 2016; 13:SH15235. [PMID: 27209062 DOI: 10.1071/sh15235] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/08/2016] [Indexed: 02/28/2024]
Abstract
The proportion of women from culturally and linguistically diverse backgrounds is growing in Australia. Synthesising existing evidence concerning the views and experiences of these women in accessing sexual and reproductive health care is crucial to future policy and service development. A systematic review of scientific articles and grey literature published in English between 1990 and 2015 was conducted to identify the barriers and facilitators in accessing sexual and reproductive health care in Australia experienced by culturally and linguistically diverse women. The search strategy covered seven electronic databases (ProQuest, PubMed, EMBASE/Elsevier, SCOPUS, PsycINFO, CINAHL and Infomit) and websites. Thematic analysis methodology was used to analyse and interpret the data extracted from individual studies. From the 1401 potentially relevant articles identified, 22 articles that represent the views and experiences of 1943 culturally and linguistically diverse women in accessing sexual and reproductive health care in Australia were reviewed. The main barriers and facilitators identified were grouped into three major themes. These include personal level experiences of accessing health care, women's interaction with the healthcare system and women's experience with healthcare providers. Implications for clinical practice and future research are discussed based on the findings of the review.
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