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Mirzaee M, Mirzaee F. Medical ethics in childbirth: a structural equation modeling approach in south of Iran. BMC Med Ethics 2024; 25:76. [PMID: 38926698 PMCID: PMC11202324 DOI: 10.1186/s12910-024-01072-6] [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: 05/31/2023] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The existence of a valid instrument to evaluate the attitude of mothers towards compliance with medical ethics during childbirth can lead to appropriate interventions to create a positive attitude. The purpose of this study is to determine the construct validity of the MEAVDQ (Medical Ethics Attitude in Vaginal Delivery Questionnaire). METHODS The study was carried out with 350 women. The main research instrument was MEAVDQ. This 59-item questionnaire comprises three parts A, B, J. Part A is concerned with the first principles. Part B deals with the second and third principles and part J addresses the fourth principle of medical ethics. Structural Equations Modeling (SEM) was used to determine the construct validity of MEAVDQ. RESULTS The results of SEM revealed that there was a positive correlation between structures A and B. The relationship between structures B and J was also positive and significant. On the other hand, there was a direct and indirect relationship between structures A and J. One-unit increase in structure A led to 0.16 (95% CI: 0.01, 0.33) direct increase in structure J. Also, one-unit increase score increases in structure A caused 0.39 indirect rise (95% CI: 0.26, 0.53) in structure J with the mediating role of the structure B. CONCLUSIONS It can be suggested to midwifery policy maker and midwives that respect for the first principle of medical ethics and autonomy is the most important principle of medical ethics in childbirth. By respecting the autonomy of mothers, a positive birth experience can be created for them.
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Affiliation(s)
- Moghaddameh Mirzaee
- Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Firoozeh Mirzaee
- Reproductive and family health research center,, Kerman university of medical sciences, Kerman, Iran.
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Morsa M, Perrin A, David V, Rault G, Le Roux E, Alberti C, Gagnayre R, Pougheon Bertrand D. Experiences Among Patients With Cystic Fibrosis in the MucoExocet Study of Using Connected Devices for the Management of Pulmonary Exacerbations: Grounded Theory Qualitative Research. JMIR Form Res 2024; 8:e38064. [PMID: 38261372 PMCID: PMC10848132 DOI: 10.2196/38064] [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: 03/17/2022] [Revised: 10/01/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Early detection of pulmonary exacerbations (PEx) in patients with cystic fibrosis is important to quickly trigger treatment and reduce respiratory damage. An intervention was designed in the frame of the MucoExocet research study providing patients with cystic fibrosis with connected devices and educating them to detect and react to their early signs of PEx. OBJECTIVE This study aims to identify the contributions and conditions of home monitoring in relation to their care teams from the users' point of view to detect PEx early and treat it. This study focused on the patients' experiences as the first and main users of home monitoring. METHODS A qualitative study was conducted to explore patients' and professionals' experiences with the intervention. We interviewed patients who completed the 2-year study using semistructured guides and conducted focus groups with the care teams. All the interviews were recorded and transcribed verbatim. Their educational material was collected. A grounded analysis was conducted by 2 researchers. RESULTS A total of 20 patients completed the study. Three main categories emerged from the patients' verbatim transcripts and were also found in those of the professionals: (1) task technology fit, reflecting reliability, ease of use, accuracy of data, and support of the technology; (2) patient empowerment through technology, grouping patients' learnings, validation of their perception of exacerbation, assessment of treatment efficacy, awareness of healthy behaviors, and ability to react to PEx signs in relation to their care team; (3) use, reflecting a continuous or intermittent use, the perceived usefulness balanced with cumbersome measurements, routinization and personalization of the measurement process, and the way data are shared with the care team. Furthermore, 3 relationships were highlighted between the categories that reflect the necessary conditions for patient empowerment through the use of technology. CONCLUSIONS We discuss a theorization of the process of patient empowerment through the use of connected devices and call for further research to verify or amend it in the context of other technologies, illnesses, and care organizations. TRIAL REGISTRATION ClinicalTrials.gov NCT03304028; https://clinicaltrials.gov/ct2/show/results/NCT03304028.
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Affiliation(s)
- Maxime Morsa
- Adaptation, Resilience and Change Research Unit, University of Liège, Liège, Belgium
- Laboratory Health Promotion and Education (UR3412), Sorbonne Paris North University, Bobigny, France
| | - Amélie Perrin
- Paediatrics CF Centre, Nantes University Hospital, Nantes, France
| | - Valérie David
- Paediatrics CF Centre, Nantes University Hospital, Nantes, France
| | - Gilles Rault
- Laboratoire Educations et Pormotion de la santé, Université Sorbonne Paris Nord, Bobigny, France
| | - Enora Le Roux
- Institut National de la Santé et de la Recherche Médicale (UMR 1123 ECEVE), Université de Paris, Paris, France
- Unit of Clinical Epidemiology (CIC-EC 1426), Hôpital Universitaire Robert Debré, Assistance Publique des Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Corinne Alberti
- Institut National de la Santé et de la Recherche Médicale (UMR 1123 ECEVE), Université de Paris, Paris, France
- Unit of Clinical Epidemiology (CIC-EC 1426), Hôpital Universitaire Robert Debré, Assistance Publique des Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Rémi Gagnayre
- Laboratory Health Promotion and Education (UR3412), Sorbonne Paris North University, Bobigny, France
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Leena T, Jenna P, Carme C, Leeni L, Helena LK, Sònia M, Minna S, Virpi S, Heli V. Digital skills of health care professionals in cancer care: A systematic review. Digit Health 2024; 10:20552076241240907. [PMID: 38528966 PMCID: PMC10962045 DOI: 10.1177/20552076241240907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/05/2024] [Indexed: 03/27/2024] Open
Abstract
Background The digital transformation of healthcare enables new ways of working in cancer care directing attention on the digital skills of healthcare professionals. This systematic review aims to identify existing evidence about digital skills among health care professionals in cancer care to identify the needs for future education and research. Methods Database searches were conducted in PubMed, CINAHL, Web of Science, Scopus, Cochrane and ERIC to identify studies until March 2023. The inclusion criteria were digital skills of health care professionals in cancer care as described by themselves, other health care professionals, patients or significant others. The CASP tool was used for quality assessment of the studies. Data was analysed following inductive content analysis. Results The search produced 4563 records, of which 24 studies were included (12 qualitative, 10 quantitative, 1 mixed methods design and 1 strategy paper). Four main categories were identified describing HCPs' required skills, existing skills and development areas of digital skills in cancer care: Skills for information technology, Skills for ethical practice, Skills for creating a human-oriented relationship and Skills for digital education and support. In development areas, one more main category, Skills for implementing digital health, was identified. Conclusion The digital skills of health care professionals in cancer care are multifaceted and fundamental for quality cancer care. The skills need to be assessed to provide education based on actual learning needs. The review findings can be used for education and research in this field.
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Affiliation(s)
- Tuominen Leena
- Department of Nursing Science, University of Turku, Turku, Finland
- Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Poraharju Jenna
- Department of Nursing Science, University of Turku, Turku, Finland
- Intensive Care Unit, Helsinki University Hospital, Helsinki, Finland
| | - Carrion Carme
- Research of Faculty of Health Sciences Studies, Open University of Catalonia (Universitat Oberta de Catalunya, UOC), Barcelona, Spain
| | - Lehtiö Leeni
- Turku University Library, University of Turku, Turku, Finland
| | - Leino-Kilpi Helena
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Moretó Sònia
- Open University of Catalonia (Universitat Oberta de Catalunya, UOC), Barcelona, Spain
| | - Stolt Minna
- Department of Nursing Science, University of Turku, Turku, Finland
- Satakunta Wellbeing Services Country, Pori, Finland
| | - Sulosaari Virpi
- Turku University of Applied Sciences, Health and Well-being, Master School, Advancing Supportive Cancer and Palliative Care (CARE)—Research Group, European Oncology Nursing Society, Turku, Finland
| | - Virtanen Heli
- Department of Nursing Science, University of Turku, Turku, Finland
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Schwalbe D, Timmermann C, Gregersen TA, Steffensen SV, Ammentorp J. Communication, Cognition and Competency Development in Healthcare: A Model for Integrating Cognitive Ethnography and Communication Skills Training in Clinical Interventions. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205231223319. [PMID: 38204973 PMCID: PMC10777782 DOI: 10.1177/23821205231223319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The aim of this study was to conduct and evaluate the Blended Learning communication skills training program. The key objective was to investigate (i) how clinical intervention studies can be designed to include cognitive, organizational, and interactive processes, and (ii) how researchers and practitioners could work with integrated methods to support the desired change. METHODS The method combined design and implementation of a 12-week Blended Learning communication skills training program based on the Calgary-Cambridge Guide. The training was implemented in a patient clinic at a Danish university hospital and targeted all healthcare professionals at the clinic. Cognitive ethnography was used to document and evaluate healthcare professionals' implementation and individual competency development, and support the design of in-situ simulation training scenarios. RESULTS Thirteen participants completed the program. The synergy within the teams, as well as the opportunities for participants to coordinate, share, discuss, and reflect on the received knowledge with a colleague or on-site researcher, affected learning positively. The knowledge transfer process was affected by negative feedback loops, such as time shortages, issues with concept development and transfer, disjuncture between the expectations of participants and instructors of the overall course structure, as well as participant insecurity and a gradual loss of motivation and compliance. CONCLUSION We propose a novel 3-step model for clinical interventions based on our findings and literature review. This model will effectively support the implementation of educational interventions in health care by narrowing the theory-practice gap. It will also stimulate desired change in individual behavior and organizational culture over time. Furthermore, it will work for the benefit of the clinic and may be more suitable for the implementation of communication projects than, for example, randomized setups.
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Affiliation(s)
- Daria Schwalbe
- Center for Human Interactivity, Department of Culture and Communication, University of Southern Denmark, Odense, Denmark
- Centre for Human Interactivity, Department of Language, Culture, History and Communication, University of Southern Denmark, Odense, Denmark
- Centre for Culture and the Mind, Department of English, Germanic and Romance Studies, University of Copenhagen, Copenhagen, Denmark
| | - Connie Timmermann
- Center for Human Interactivity, Department of Culture and Communication, University of Southern Denmark, Odense, Denmark
| | - Trine A Gregersen
- Center for Human Interactivity, Department of Culture and Communication, University of Southern Denmark, Odense, Denmark
| | - Sune Vork Steffensen
- Centre for Human Interactivity, Department of Language, Culture, History and Communication, University of Southern Denmark, Odense, Denmark
- Danish Institute for Advanced Study, University of Southern Denmark, Odense, Denmark
- Center for Ecolinguistics, South China Agricultural University, Guangzhou, China
- College of International Studies, Southwest University, Chongqing, China
| | - Jette Ammentorp
- Center for Human Interactivity, Department of Culture and Communication, University of Southern Denmark, Odense, Denmark
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Fortini C, Daeppen JB. How do hospital providers perceive and experience the information-delivery process? A qualitative exploratory study. PEC INNOVATION 2023; 3:100222. [PMID: 37842173 PMCID: PMC10570693 DOI: 10.1016/j.pecinn.2023.100222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/21/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023]
Abstract
Objective To explore how professionals deal with informing their patients and how they experience the process per se, in order to deepen understanding of the issues involved and to identify areas of focus for improvement. Methods Semi-structured qualitative interviews were conducted with 13 hospital professionals at Lausanne University Hospital, Switzerland. Results Information includes feedback, practical information, patient condition, treatment/process of care, and educational material. Information-delivery is a process that involves informing the patient then checking patient reception of the information. The main expected outcome is patient action. Providers can feel trapped, guilty, inadequate, powerless, disenchanted when the process fails to achieve its expected purpose. Conclusions Informing and checking strategies are not implemented optimally, and providers could benefit from guidance in order to decrease discomfort and become more proficient at delivering information. Innovation Addressing the information-delivery process per se provides us with a novel insight into the complexity of the process and contributes to identifying essential ingredients of future innovative training programs for providers at large.
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Affiliation(s)
- Cristiana Fortini
- Addiction Medicine, Lausanne University Hospital CHUV, 23A rue du Bugnon, Lausanne 1011, Switzerland
| | - Jean-Bernard Daeppen
- Addiction Medicine, Lausanne University Hospital CHUV, 23A rue du Bugnon, Lausanne 1011, Switzerland
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Yeung AWK, Torkamani A, Butte AJ, Glicksberg BS, Schuller B, Rodriguez B, Ting DSW, Bates D, Schaden E, Peng H, Willschke H, van der Laak J, Car J, Rahimi K, Celi LA, Banach M, Kletecka-Pulker M, Kimberger O, Eils R, Islam SMS, Wong ST, Wong TY, Gao W, Brunak S, Atanasov AG. The promise of digital healthcare technologies. Front Public Health 2023; 11:1196596. [PMID: 37822534 PMCID: PMC10562722 DOI: 10.3389/fpubh.2023.1196596] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
Digital health technologies have been in use for many years in a wide spectrum of healthcare scenarios. This narrative review outlines the current use and the future strategies and significance of digital health technologies in modern healthcare applications. It covers the current state of the scientific field (delineating major strengths, limitations, and applications) and envisions the future impact of relevant emerging key technologies. Furthermore, we attempt to provide recommendations for innovative approaches that would accelerate and benefit the research, translation and utilization of digital health technologies.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Research Translational Institute, La Jolla, CA, United States
| | - Atul J. Butte
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, United States
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin S. Glicksberg
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Björn Schuller
- Department of Computing, Imperial College London, London, United Kingdom
- Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Augsburg, Germany
| | - Blanca Rodriguez
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Daniel S. W. Ting
- Singapore National Eye Center, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - David Bates
- Department of General Internal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Eva Schaden
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Hanchuan Peng
- Institute for Brain and Intelligence, Southeast University, Nanjing, China
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Jeroen van der Laak
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Josip Car
- Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Centre for Population Health Sciences, LKC Medicine, Nanyang Technological University, Singapore, Singapore
| | - Kazem Rahimi
- Deep Medicine Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Leo Anthony Celi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Lodz, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Oliver Kimberger
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Roland Eils
- Digital Health Center, Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Stephen T. Wong
- Department of Systems Medicine and Bioengineering, Houston Methodist Cancer Center, T. T. and W. F. Chao Center for BRAIN, Houston Methodist Academic Institute, Houston Methodist Hospital, Houston, TX, United States
- Departments of Radiology, Pathology and Laboratory Medicine and Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, United States
| | - Tien Yin Wong
- Singapore National Eye Center, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, United States
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Atanas G. Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
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Thomae AV, Rogge AA, Helmer SM, Icke K, Witt CM. Development, Implementation, and Evaluation of an e-Learning in Integrative Oncology for Physicians and Students Involving Experts and Learners: Experiences and Recommendations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:805-812. [PMID: 35776378 PMCID: PMC9247929 DOI: 10.1007/s13187-022-02189-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 06/02/2023]
Abstract
In this project, an e-Learning program for complementary and integrative medicine in oncology was systematically developed, implemented, and evaluated in a stepwise procedure. Learning objectives and content were defined within the KOKON project network, considering the educational competencies for integrative oncology. To design a valuable e-Learning, experts were involved in all relevant steps of the process, as well as stakeholders from various target groups (undergraduates: medicine students, postgraduates: oncology physicians). We used mixed methods including quantitative surveys, progress tests, and qualitative focus groups. The developed e-Learning program led to a significant measurable knowledge gain about complementary and integrative medicine. In parallel, physicians and students were subjectively satisfied with the training. For the majority of e-Learning elements, the needs of both target groups are comparable. Furthermore, both groups emphasized the value of formative assessment tools for gaining knowledge. From the various surveys and experiences collected in this project, we derive recommendations for others developing e-Learning programs.
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Affiliation(s)
- Anita V Thomae
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland.
| | - Alizé A Rogge
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Stefanie M Helmer
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353, Berlin, Germany
| | - Katja Icke
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
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Barbosa B, Bravo I, Oliveira C, Antunes L, Couto JG, McFadden S, Hughes C, McClure P, Dias AG. Digital skills of therapeutic radiographers/radiation therapists - Document analysis for a European educational curriculum. Radiography (Lond) 2022; 28:955-963. [PMID: 35842952 DOI: 10.1016/j.radi.2022.06.017] [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: 01/21/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION It is estimated that around 50% of cancer patients require Radiotherapy (RT) at some point during their treatment, hence Therapeutic Radiographers/Radiation Therapists (TR/RTTs) have a key role to play in patient management. It is essential for TR/RTTs to keep abreast with new technologies and continuously develop the digital skills necessary for safe RT practice. The RT profession and education is not regulated at European Union level, which leads to heterogeneity in the skills developed and practised among countries. This study aimed to explore the white and grey literature to collate data on the relevant digital skills required for TR/RTTs practice. METHODS An exhaustive systematic search was conducted to identify literature discussing digital skills of TR/RTTs; relevant grey literature was also identified. A thematic analysis was performed to identify and organise these skills into themes and sub-themes. RESULTS 195 digital skills were identified, organised in 35 sub-themes and grouped into six main themes: (i) Transversal Digital Skills, (ii) RT Planning Image, (iii) RT Treatment Planning, (iv) RT Treatment Administration, (v) Quality, Safety and Risk Management, and (vi) Management, Education and Research. CONCLUSION This list can be used as a reference to close current gaps in knowledge or skills of TR/RTTs while anticipating future needs regarding the rapid development of new technologies (such as Artificial Intelligence or Big Data). IMPLICATIONS FOR PRACTICE It is imperative to align education with current and future RT practice to ensure that all RT patients receive the best care. Filling the gaps in TR/RTTs skill sets will improve current practice and provide TR/RTTs with the support needed to develop more advanced skills.
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Affiliation(s)
- B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain; Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - I Bravo
- Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - C Oliveira
- Radiotherapy Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Escola Internacional de Doutoramento, Universidad de Vigo, Circunvalación ao Campus Universitario, 36310 Vigo, Pontevedra, Spain.
| | - L Antunes
- School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal.
| | - J G Couto
- Radiography Department, Faculty of Health Sciences, University of Malta, Msida MSD2080, Malta.
| | - S McFadden
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - C Hughes
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - P McClure
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - A G Dias
- Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Porto Comprehensive Cancer Center (Porto.CCC) & Rise@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal; Medical Physics Department, Instituto Português de Oncologia do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
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Kip H, Keizer J, da Silva MC, Beerlage-de Jong N, Köhle N, Kelders SM. Methods for Human-Centered eHealth Development: Narrative Scoping Review. J Med Internet Res 2022; 24:e31858. [PMID: 35084359 PMCID: PMC8832261 DOI: 10.2196/31858] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/29/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022] Open
Abstract
Background Thorough holistic development of eHealth can contribute to a good fit among the technology, its users, and the context. However, despite the availability of frameworks, not much is known about specific research activities for different aims, phases, and settings. This results in researchers having to reinvent the wheel. Consequently, there is a need to synthesize existing knowledge on research activities for participatory eHealth development processes. Objective The 3 main goals of this review are to create an overview of the development strategies used in studies based on the CeHRes (Center for eHealth Research) Roadmap, create an overview of the goals for which these methods can be used, and provide insight into the lessons learned about these methods. Methods We included eHealth development studies that were based on the phases and/or principles of the CeHRes Roadmap. This framework was selected because of its focus on participatory, iterative eHealth design in context and to limit the scope of this review. Data were extracted about the type of strategy used, rationale for using the strategy, research questions, and reported information on lessons learned. The most frequently mentioned lessons learned were summarized using a narrative, inductive approach. Results In the included 160 papers, a distinction was made between overarching development methods (n=10) and products (n=7). Methods are used to gather new data, whereas products can be used to synthesize previously collected data and support the collection of new data. The identified methods were focus groups, interviews, questionnaires, usability tests, literature studies, desk research, log data analyses, card sorting, Delphi studies, and experience sampling. The identified products were prototypes, requirements, stakeholder maps, values, behavior change strategies, personas, and business models. Examples of how these methods and products were applied in the development process and information about lessons learned were provided. Conclusions This study shows that there is a plethora of methods and products that can be used at different points in the development process and in different settings. To do justice to the complexity of eHealth development, it seems that multiple strategies should be combined. In addition, we found no evidence for an optimal single step-by-step approach to develop eHealth. Rather, researchers need to select the most suitable research methods for their research objectives, the context in which data are collected, and the characteristics of the participants. This study serves as a first step toward creating a toolkit to support researchers in applying the CeHRes Roadmap to practice. In this way, they can shape the most suitable and efficient eHealth development process.
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Affiliation(s)
- Hanneke Kip
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.,Department of Research, Transfore, Deventer, Netherlands
| | - Julia Keizer
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Marcia C da Silva
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Nienke Beerlage-de Jong
- Department of Health Technology & Services Research, University of Twente, Enschede, Netherlands
| | - Nadine Köhle
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Saskia M Kelders
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.,Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
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10
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Sztankay M, Wintner LM, Roggendorf S, Nordhausen T, Dirven L, Taphoorn MJB, Verdonck-de Leeuw IM, Velikova G, Bottomley A, Kulis D, Kachel T, Schmidt H. Developing an e-learning course on the use of PRO measures in oncological practice: health care professionals' preferences for learning content and methods. Support Care Cancer 2021; 30:2555-2567. [PMID: 34797424 PMCID: PMC8794964 DOI: 10.1007/s00520-021-06676-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/01/2021] [Indexed: 12/23/2022]
Abstract
Purpose Implementation of patient-reported outcome measures (PROMs) in clinical routine requires knowledge and competences regarding their use. In order to facilitate implementation, an e-learning course for health care professionals (HCPs) on the utilisation of European Organisation for Research and Treatment of Cancer (EORTC) PROMs in oncological clinical practice is being developed. This study aimed to explore future users’ educational needs regarding content and learning methods. Methods The sequential mixed methods approach was applied. A scoping literature review informed the guideline for qualitative interviews with HCPs with diverse professional backgrounds in oncology and cancer advocates recruited using a purposive sampling strategy. An international online survey was conducted to validate the qualitative findings. Results Between December 2019 and May 2020, 73 interviews were conducted in 9 countries resulting in 8 topic areas (Basic information on PROs in clinical routine, Benefits of PRO assessments in clinical practice, Implementation of PRO assessments in clinical routine, Setup of PRO assessments for clinical application, Interpretation of PRO data, Integration of PROs into the communication with patients, Use of PROs in clinical practice, Self-management recommendations for patients based on PROs) subsequently presented in the online survey. The online survey (open between 3 June and 19 July 2020) was completed by 233 HCPs from 33 countries. The highest preference was indicated for content on interpretation of PRO data (97%), clinical benefits of assessing PRO data (95.3%) and implementation of routine PRO data assessment (94.8%). Regarding learning methods, participants indicated a high preference for practical examples that use a mixed approach of presentation (written, audio, video and interactive). Conclusion Educational needs for an integration of PROs in communication in clinical care and coherent implementation strategies became evident. These results inform the development of an e-learning course to support HCPs in the clinical use of EORTC PRO measures. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06676-x.
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Affiliation(s)
- Monika Sztankay
- University Hospital of Psychiatry II, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria.
| | - Lisa M Wintner
- University Hospital of Psychiatry II, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria
| | - Sigrid Roggendorf
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Thomas Nordhausen
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam University Medical Centers (Location VUmc), Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Faculty of Behavioural and Movement Sciences, Section Clinical Psychology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Cancer Centre, St James's University Hospital, Leeds, UK
| | - Andrew Bottomley
- European Organisation for Research and Treatment of Cancer (EORTC), Quality of Life Department, Brussels, Belgium
| | - Dagmara Kulis
- European Organisation for Research and Treatment of Cancer (EORTC), Quality of Life Department, Brussels, Belgium
| | - Timo Kachel
- University Hospital of Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria
| | - Heike Schmidt
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany.,Department for Radiation Medicine, University Hospital Halle (Saale), Halle, Germany
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11
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van de Water LF, van den Boorn HG, Hoxha F, Henselmans I, Calff MM, Sprangers MAG, Abu-Hanna A, Smets EMA, van Laarhoven HWM. Informing Patients With Esophagogastric Cancer About Treatment Outcomes by Using a Web-Based Tool and Training: Development and Evaluation Study. J Med Internet Res 2021; 23:e27824. [PMID: 34448703 PMCID: PMC8433928 DOI: 10.2196/27824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/07/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background Due to the increasing use of shared decision-making, patients with esophagogastric cancer play an increasingly important role in the decision-making process. To be able to make well-informed decisions, patients need to be adequately informed about treatment options and their outcomes, namely survival, side effects or complications, and health-related quality of life. Web-based tools and training programs can aid physicians in this complex task. However, to date, none of these instruments are available for use in informing patients with esophagogastric cancer about treatment outcomes. Objective This study aims to develop and evaluate the feasibility of using a web-based prediction tool and supporting communication skills training to improve how physicians inform patients with esophagogastric cancer about treatment outcomes. By improving the provision of treatment outcome information, we aim to stimulate the use of information that is evidence-based, precise, and personalized to patient and tumor characteristics and is communicated in a way that is tailored to individual information needs. Methods We designed a web-based, physician-assisted prediction tool—Source—to be used during consultations by using an iterative, user-centered approach. The accompanying communication skills training was developed based on specific learning objectives, literature, and expert opinions. The Source tool was tested in several rounds—a face-to-face focus group with 6 patients and survivors, semistructured interviews with 5 patients, think-aloud sessions with 3 medical oncologists, and interviews with 6 field experts. In a final pilot study, the Source tool and training were tested as a combined intervention by 5 medical oncology fellows and 3 esophagogastric outpatients. Results The Source tool contains personalized prediction models and data from meta-analyses regarding survival, treatment side effects and complications, and health-related quality of life. The treatment outcomes were visualized in a patient-friendly manner by using pictographs and bar and line graphs. The communication skills training consisted of blended learning for clinicians comprising e-learning and 2 face-to-face sessions. Adjustments to improve both training and the Source tool were made according to feedback from all testing rounds. Conclusions The Source tool and training could play an important role in informing patients with esophagogastric cancer about treatment outcomes in an evidence-based, precise, personalized, and tailored manner. The preliminary evaluation results are promising and provide valuable input for the further development and testing of both elements. However, the remaining uncertainty about treatment outcomes in patients and established habits in doctors, in addition to the varying trust in the prediction models, might influence the effectiveness of the tool and training in daily practice. We are currently conducting a multicenter clinical trial to investigate the impact that the combined tool and training have on the provision of information in the context of treatment decision-making.
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Affiliation(s)
- Loïs F van de Water
- Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Héctor G van den Boorn
- Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Florian Hoxha
- Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Inge Henselmans
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Mart M Calff
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Ameen Abu-Hanna
- Department of Medical Informatics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
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12
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Schooley B, Singh A, Hikmet N, Brookshire R, Patel N. Integrated Digital Patient Education at the Bedside for Patients with Chronic Conditions: Observational Study. JMIR Mhealth Uhealth 2020; 8:e22947. [PMID: 33350961 PMCID: PMC7785403 DOI: 10.2196/22947] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/13/2020] [Accepted: 11/30/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Patient education delivered by a health care provider increases patients' understanding and adherence to medical instructions, which helps to improve patient health. Multiple challenges exist to delivering effective patient education to patients with multiple chronic conditions, including giving the necessary time, range, and types of learning materials, and assessing the level of understanding. To help overcome these challenges, it is important to study new electronic means to assist in patient education, such as the use of mobile devices, interactive media, 3-dimensional images, and multimedia educational content at the bedside. OBJECTIVE The goal of this study was to address the need for blended learning strategies combining technical and workflow integration of digital patient education systems for patients with chronic conditions within and across the regular process of care. Studies are needed to evaluate the utility and benefits of these technologies for providers and patients alike. METHODS A mixed-methods approach was employed including survey administration to 178 patients after they received digital patient education in person with a health care provider, and qualitative interviews with 16 nurse educators who used the mobile digital health education technology to deliver instruction to patients. Patient survey data were analyzed using chi-square statistical tests. Qualitative interviews were analyzed for user acceptance and perceived value themes. RESULTS Patients who were counseled using a blended digital health education approach reported improved understanding of educational content (P=.034) and chronic health conditions (P<.001), were more motivated to care for themselves at home (P<.001), were more likely to say that they felt capable of making health care decisions with their doctors (P<.001) and on their own (P=.001), and were more likely to report their intention to follow their doctor's instructions (P<.001) than were patients whose education was not computer-based. Nurse educators felt that the digital education system and content enhanced their education efforts and could be easily integrated into the outpatient clinical workflow. CONCLUSIONS Patient education for individuals with chronic conditions may be more effective than traditional formats when provided in blended digital formats supervised by a health care provider.
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Affiliation(s)
- Benjamin Schooley
- Health Information Technology Program, College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
| | - Akanksha Singh
- Department of Computer Science and Engineering, College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
| | - Neşet Hikmet
- Health Information Technology Program, College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
| | - Robert Brookshire
- Health Information Technology Program, College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
| | - Nitin Patel
- Department of Medicine, School of Medicine, University of South Carolina, Columbia, SC, United States
- Digital Health, Prisma Health, Columbia, SC, United States
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13
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Stuij SM, Drossaert CHC, Labrie NHM, Hulsman RL, Kersten MJ, van Dulmen S, Smets EMA. Developing a digital training tool to support oncologists in the skill of information-provision: a user centred approach. BMC MEDICAL EDUCATION 2020; 20:135. [PMID: 32357886 PMCID: PMC7195777 DOI: 10.1186/s12909-020-1985-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 02/25/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND For patients with cancer, being well informed by their oncologist about treatment options and the implications thereof is highly relevant. Communication skills training (CST) programs have shown to be effective in improving clinicians' communication skills, yet CSTs are time-consuming, inconvenient to schedule, and costly. Online education enables new ways of accessible learning in a safe and personalised environment. AIM AND METHODS We describe the design of a digital CST-tool for information provision skills that meets oncologists' learning needs. We used the CeHRes Roadmap for user-centred design as a guiding framework. Phase 1 (Contextual Inquiry) involved consultation of the literature and a focus group interview study to uncover the learning needs and training preferences of clinicians' regarding a digital training for the skill of information-provision. In phase 2 (Value Specification), two multidisciplinary expert panels specified the learning content and format of a digital training. Phase 3 (Design) encompassed an iterative development process, including two user group assessment sessions and 5 individual user sessions in which prototypes were tested. All sessions were recorded and independently analyzed by two researchers. RESULTS Based on literature and consultation of the users in the inquiry phase of the development process, and on expert opinion in the value specification phase, relevant (sub) skills and user requirements were defined to consider for the digital training format. It was decided to develop a conventional e-learning and a chatbot. Personalization and interactivity were integrated in the prototypes by including features that allow for e.g., choosing text, video or animation; to upload video-recorded consultations to receive peer-feedback; and to consult a communication expert. Results revealed that, overall, participants expressed a willingness to use a digital training tool to acquire information-provision skills. Individual user testing (including junior clinicians), indicated a preference for the chatbot over the e-learning. CONCLUSION We offer a description of extensive development work which was conducted in collaboration with multiple health care professionals to iteratively develop two innovative prototypes of digital tools that would appropriately engage oncologists in learning effective information giving skills. The resulting prototypes were well appreciated and thus provide a solid basis for further development and testing.
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Affiliation(s)
- Sebastiaan M Stuij
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Constance H C Drossaert
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Nanon H M Labrie
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Robert L Hulsman
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Marie José Kersten
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Haematology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, The Netherlands
| | - Sandra van Dulmen
- NIVEL (Netherlands institute for health services research), Utrecht, the Netherlands
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Public Health research institute, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Amsterdam, The Netherlands.
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14
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Labrie N, van Dulmen S, Kersten MJ, de Haes HJ, Pieterse AH, van Weert JC, van Spronsen DJ, Smets EM. Effective Information Provision About the Side Effects of Treatment for Malignant Lymphoma: Protocol of a Randomized Controlled Trial Using Video Vignettes. JMIR Res Protoc 2019; 8:e12453. [PMID: 31045506 PMCID: PMC6521215 DOI: 10.2196/12453] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/30/2019] [Accepted: 02/24/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Informing patients with cancer about the possible implications of prospective treatment is a crucial yet challenging task. Unfortunately, patients' recall of medical information is generally poor and their information needs are not met. Effective information giving entails that oncologists help patients understand and recall the implications of their treatment, meanwhile fostering a trusting physician-patient relationship. Communication strategies that are often suggested to be effective are structuring and tailoring (cognition-oriented) but also are oncologists' expressions of caring or empathy (affect-oriented). OBJECTIVE The aim of this study is to provide evidence concerning the pathways linking physician communication to (improved) consultation outcomes for patients. More specifically, the aim is to determine the effects of information structuring and information tailoring, combined with physician caring, on information recall, satisfaction with information, and trust in the physician (primary objective) and on symptom distress (secondary objective). METHODS A randomized controlled trial, systematically testing the effects of information structuring and information tailoring, each combined with caring, in 2 video-vignette experiments (2×2 and 2×2×2 design). Using an online survey platform, participants will be randomly allocated (blinded) to 1 of 12 conditions in which they are asked to view a video vignette (intervention) in which an oncologist discusses a treatment plan for malignant lymphoma with a patient. The independent variables of interest are systematically varied across conditions. The outcome measures are assessed in a survey, using validated instruments. Study participants are (former) patients with cancer and their relatives recruited via online panels and patient organizations. This protocol discusses the trial design, including the video-vignette design, intervention pretesting, and a pilot study. RESULTS Data collection has now been completed, and preliminary analyses will be available in Spring 2019. A total of 470 participants completed the first part of the survey and were randomized to receive the intervention. CONCLUSIONS The results of the proposed trial will provide evidence concerning the pathways linking physician information, giving skills to (improved) consultation outcomes for patients. TRIAL REGISTRATION Netherlands Trial Register NTR6153; https://www.trialregister.nl/trial/6022 (Archived by Webcite at http://www.webcitation.org/76xVV9xC8). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/12453.
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Affiliation(s)
- Nanon Labrie
- Medical Psychology, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, Netherlands.,Athena Institute, Vrije Universiteit van Amsterdam, Amsterdam, Netherlands
| | - Sandra van Dulmen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands.,Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Marie José Kersten
- Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Hanneke Jcm de Haes
- Medical Psychology, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Arwen H Pieterse
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands
| | - Julia Cm van Weert
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | | | - Ellen Ma Smets
- Medical Psychology, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, Netherlands
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