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Tuominen L, Leino-Kilpi H, Poraharju J, Cabutto D, Carrion C, Lehtiö L, Moretó S, Stolt M, Sulosaari V, Virtanen H. Interactive digital tools to support empowerment of people with cancer: a systematic literature review. Support Care Cancer 2024; 32:396. [PMID: 38816629 PMCID: PMC11139693 DOI: 10.1007/s00520-024-08545-9] [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: 11/01/2023] [Accepted: 05/03/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE To identify and synthesise interactive digital tools used to support the empowerment of people with cancer and the outcomes of these tools. METHODS A systematic literature review was conducted using PubMed, CINAHL, Web of Science, Cochrane, Eric, Scopus, and PsycINFO databases in May 2023. Inclusion criteria were patient empowerment as an outcome supported by interactive digital tools expressed in study goal, methods or results, peer-reviewed studies published since 2010 in cancer care. Narrative synthesis was applied, and the quality of the studies was assessed following Joanna Briggs Institute checklists. RESULTS Out of 1571 records screened, 39 studies published in 2011-2022 with RCT (17), single-arm trial (15), quasi-experimental (1), and qualitative designs (6) were included. A total of 30 interactive digital tools were identified to support empowerment (4) and related aspects, such as self-management (2), coping (4), patient activation (9), and self-efficacy (19). Significant positive effects were found on empowerment (1), self-management (1), coping (1), patient activation (2), and self-efficacy (10). Patient experiences were positive. Interactivity occurred with the tool itself (22), peers (7), or nurses (7), physicians (2), psychologists, (2) or social workers (1). CONCLUSION Interactive digital tools have been developed extensively in recent years, varying in terms of content and methodology, favouring feasibility and pilot designs. In all of the tools, people with cancer are either active or recipients of information. The research evidence indicates positive outcomes for patient empowerment through interactive digital tools. Thus, even though promising, there still is need for further testing of the tools.
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Affiliation(s)
- Leena Tuominen
- Department of Nursing Science, University of Turku, Turku, Finland.
| | - Helena Leino-Kilpi
- University of Turku FI and Wellbeing Services County of Southwest Finland, University of Turku FI, Turku University Hospital, Turku, Finland.
| | - Jenna Poraharju
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Daniela Cabutto
- eHealth Lab Research Group, School of Health Sciences and eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Carme Carrion
- eHealth Lab Research Group, Faculty of Health Sciences Studies, E-Health Center, School of Health Sciences and eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Leeni Lehtiö
- Turku University Library, University of Turku, Turku, Finland
| | - Sónia Moretó
- eHealth Lab Research Group, School of Health Sciences and eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
- Wellbeing Services County of Satakunta, Pori, Finland
| | - Virpi Sulosaari
- Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
- Research Advancing Supportive Cancer and Palliative care (CARE) - research group, Turku, Finland
- European Oncology Nursing Society, Brussels, Belgium
| | - Heli Virtanen
- Department of Nursing Science, University of Turku, Turku, Finland
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Han J, Zhou X, Tang D, Liu T, Liu K. Shared decision-making and its influencing factors among parents of children with cancer in China: A cross-sectional study. Eur J Oncol Nurs 2024; 69:102512. [PMID: 38394935 DOI: 10.1016/j.ejon.2024.102512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 01/08/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE This study aimed at exploring SDM implementation and its influencing factors, and preferences towards SDM among parents of children with cancer in China. DESIGN AND METHODS This cross-sectional study recruited 204 participants from 2 grade-A tertiary hospitals in Guangzhou, China. The preferences towards decision-making, the status of SDM were measured by CPS-P and SDM-Q-9. The nurse support were measure by NPST, the needs of parents were measured by Questionnaire for Needs of Parents Whose Children are in PICU, and sociodemographic and disease-related questionnaires were used to investigate general information of children and parents. Descriptive statistics, univariate analysis, and multivariable linear regression were used for data analysis. RESULTS Of 204 participants, about half of parents (55.4 %) tended to choose SDM, however, 40.2 % of them still show passive attitudes. The mean SDM-Q-9 score was 31.07 ± 8.74, and the result showed that age (β = 2.480, P<0.05), relapse (β = 4.407, P<0.01), course of disease (β = -5.213, P<0.01), relationships with doctors (β = -4.05, P<0.05), trust in doctors (β = -2.796, P<0.05), and communication and information support from nurses (β = 0.651, P<0.01) were the main factors influencing SDM for parents. CONCLUSIONS Over half of Chinese parents tended to choose SDM, but their real participation in SDM is unsatisfactory. Parents who were older, had good relationships with doctors, trusted in doctors, received more communication and information support from nurses, and whose children had shorter course of disease, suffered relapses, participated in SDM better.
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Affiliation(s)
- Jinna Han
- School of Nursing, Sun Yat-sen University, Guangdong, China.
| | - Xuezhen Zhou
- Nursing Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Dongyan Tang
- Pediatric Hematology Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Ting Liu
- Pediatric Hematology Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China
| | - Ke Liu
- School of Nursing, Sun Yat-sen University, Guangdong, China.
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Ritaccio G, Barritt Iv AS, Conklin JL, Richardson DR, Evon DM, Sanoff HK, Basch E, Wheeler SB, Moon AM. Scoping review of values elicitation tools for treatment decisions in hepatocellular carcinoma. BMC Gastroenterol 2024; 24:90. [PMID: 38418997 PMCID: PMC10900684 DOI: 10.1186/s12876-024-03167-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Treatment choices in hepatocellular carcinoma (HCC) involve consideration of tradeoffs between the benefits, toxicities, inconvenience, and costs. Stated preference elicitation methods have been used in the medical field to help evaluate complex treatment decision-making. The aim of this study was to conduct a scoping review to assess the evidence base for the use of preference elicitation tools or willingness to pay/willingness to accept methods for HCC treatment decision-making from both the patient and provider perspective. METHODS We performed a scoping review to identify abstracts or manuscripts focused on the role preference elicitation tools or willingness to pay/willingness to accept methods for HCC treatment options among patients, caregivers, and/or providers. Two researchers independently screened full-text references and resolved conflicts through discussion. We summarized key findings, including the type and setting of preference-elicitation tools used for HCC treatment decisions. RESULTS Ten published abstracts or manuscripts evaluated the role of preference elicitation tools for HCC treatments. The studies revealed several attributes that are considered by patients and providers making HCC treatment decisions. Many of the studies reviewed suggested that while patients place the most value on extending their overall survival, they are willing to forgo overall survival to avoid risks of treatments and maintain quality of life. Studies of physicians and surgeons found that provider preferences are dependent on patient characteristics, provider specialty, and surgeon or hospital-related factors. CONCLUSION This scoping review explored both patient and physician preferences towards treatment modalities in all stages of HCC. The studies revealed a large scope of potential attributes that may be important to patients and that many patients are willing to forgo survival to maintain quality of life. Further research should explore both preference elicitation of currently available and emerging therapies for HCC as well as the use of this data to develop patient-facing tools to assist in navigating treatment options.
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Affiliation(s)
- Gabrielle Ritaccio
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, 8009 Burnett Womack Bldg, CB#7584, Chapel Hill, NC, 27599-7584, USA
| | - A Sidney Barritt Iv
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, 8009 Burnett Womack Bldg, CB#7584, Chapel Hill, NC, 27599-7584, USA
- UNC Liver Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jamie L Conklin
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel R Richardson
- Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Donna M Evon
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, 8009 Burnett Womack Bldg, CB#7584, Chapel Hill, NC, 27599-7584, USA
- UNC Liver Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Hanna K Sanoff
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Ethan Basch
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Stephanie B Wheeler
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew M Moon
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, 8009 Burnett Womack Bldg, CB#7584, Chapel Hill, NC, 27599-7584, USA.
- UNC Liver Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
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Yang W, Li B, Liu M, Tong D, Zou Y, Li X, Xie L. Quality evaluation of health information about breast cancer treatment found on WeChat public accounts. Arch Public Health 2023; 81:170. [PMID: 37715269 PMCID: PMC10503205 DOI: 10.1186/s13690-023-01184-2] [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: 12/24/2022] [Accepted: 09/05/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND With growing cases of breast cancer, WeChat public account, an important information publishing platform of WeChat, has become a breast cancer treatment health information provider to a huge audience. It is essential for health information to possess high-level accuracy and reliability. This work evaluates the quality of health information on breast cancer treatment in WeChat public accounts (WPAs), to benefit the patients while making treatment decisions and provide WPA authors with suggestions on publishing high-quality treatment health information. METHODS With "breast cancer" as keywords, searches were implemented on weixin.sogou.com and the WeChat app. The WPAs oriented to patients with breast cancer were selected, and the four latest articles of each WPA were included in a set to be evaluated with DISCERN. RESULTS A total of 37 WPAs and 136 articles published by them were included. The accounts operated by individual users were 54%. The median of overall quality of 136 articles was 44 (interquartile range = 10.75) and ranked as "fair", of which only 28 (21%) were of "good" or higher quality. Among these articles, 74 (54%) were related to medical treatments, and 13 of them mentioned clinical trials; 36 (27%) dealt with surgery. 101 (74.26%) omitted additional sources of information; 102 (75%) did not explicitly suggest shared decision-making. A significant difference was not found in the dimensions "reliability of the articles" and "specific details of information on treatment choices" between the distinct categories of account subjects and various treatment options (P > 0.05). CONCLUSIONS The quality of the articles on breast cancer treatment health information in WPAs was moderate. WPA producers should focus on improving the reliability of information and providing more details on treatment options, to assist patients in making optimal decisions during treatment.
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Affiliation(s)
- Wenjuan Yang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Bingyan Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Min Liu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Dongtong Tong
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yang Zou
- School of Nursing, Anhui Medical University, Hefei, China
| | - Xing Li
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lunfang Xie
- School of Nursing, Anhui Medical University, Hefei, China.
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Ge J, Fontil V, Ackerman S, Pletcher MJ, Lai JC. Clinical decision support and electronic interventions to improve care quality in chronic liver diseases and cirrhosis. Hepatology 2023:01515467-990000000-00546. [PMID: 37611253 PMCID: PMC10998693 DOI: 10.1097/hep.0000000000000583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/17/2023] [Indexed: 08/25/2023]
Abstract
Significant quality gaps exist in the management of chronic liver diseases and cirrhosis. Clinical decision support systems-information-driven tools based in and launched from the electronic health record-are attractive and potentially scalable prospective interventions that could help standardize clinical care in hepatology. Yet, clinical decision support systems have had a mixed record in clinical medicine due to issues with interoperability and compatibility with clinical workflows. In this review, we discuss the conceptual origins of clinical decision support systems, existing applications in liver diseases, issues and challenges with implementation, and emerging strategies to improve their integration in hepatology care.
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Affiliation(s)
- Jin Ge
- Department of Medicine, Division of Gastroenterology and Hepatology, University of California – San Francisco, San Francisco, California, USA
| | - Valy Fontil
- Department of Medicine, NYU Grossman School of Medicine and Family Health Centers at NYU-Langone Medical Center, Brooklyn, New York, USA
| | - Sara Ackerman
- Department of Social and Behavioral Sciences, University of California – San Francisco, San Francisco, California, USA
| | - Mark J. Pletcher
- Department of Epidemiology and Biostatistics, University of California – San Francisco, San Francisco, California, USA
| | - Jennifer C. Lai
- Department of Medicine, Division of Gastroenterology and Hepatology, University of California – San Francisco, San Francisco, California, USA
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Ajitsaria P, Lott N, Baker A, Lacey J, Magnusson M, Douglas JL, Healey P, Tan-Gore E, Szwec SV, Barker D, Deeming S, Tavener M, Smith S, Gani J, Attia J. Protocol paper for SMART OPS: Shared decision-making Multidisciplinary Approach - a Randomised controlled Trial in the Older adult Population considering Surgery. BMJ Open 2023; 13:e070159. [PMID: 37407039 DOI: 10.1136/bmjopen-2022-070159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
INTRODUCTION The Australian population presenting with surgical pathology is becoming older, frailer and more comorbid. Shared decision-making is rapidly becoming the gold standard of care for patients considering high-risk surgery to ensure that appropriate, value-based healthcare decisions are made. Positive benefits around patient perception of decision-making in the immediacy of the decision are described in the literature. However, short-term and long-term holistic patient-centred outcomes and cost implications for the health service require further examination to better understand the full impact of shared decision-making in this population. METHODS We propose a novel multidisciplinary shared decision-making model of care in the perioperative period for patients considering high-risk surgery in the fields of general, vascular and head and neck surgery. We assess it in a two arm prospective randomised controlled trial. Patients are randomised to either 'standard' perioperative care, or to a multidisciplinary (surgeon, anaesthetist and end-of-life care nurse practitioner or social worker) shared decision-making consultation. The primary outcome is decisional conflict prior to any surgical procedure occurring. Secondary outcomes include the patient's treatment choice, how decisional conflict changes longitudinally over the subsequent year, patient-centred outcomes including life impact and quality of life metrics, as well as morbidity and mortality. Additionally, we will report on healthcare resource use including subsequent admissions or representations to a healthcare facility up to 1 year. ETHICS AND DISSEMINATION This study has been approved by the Hunter New England Human Research Ethics Committee (2019/ETH13349). Study findings will be presented at local and national conferences and within scientific research journals. TRIAL REGISTRATION NUMBER ACTRN12619001543178.
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Affiliation(s)
- Pragya Ajitsaria
- Department of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Natalie Lott
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Angela Baker
- Department of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Jeanette Lacey
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - Monique Magnusson
- Department of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia
| | | | - Paul Healey
- Department of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Eileen Tan-Gore
- Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Stuart V Szwec
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Daniel Barker
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Simon Deeming
- Health Research Economics, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Meredith Tavener
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Steve Smith
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - Jon Gani
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - John Attia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Liao YL, Wang TJ, Su CW, Liang SY, Liu CY, Fan JY. Efficacy of a Decision Support Intervention on Decisional Conflict Related to Hepatocellular Cancer Treatment: A Randomized Controlled Trial. Clin Nurs Res 2023; 32:233-243. [PMID: 36082423 DOI: 10.1177/10547738221121447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to investigate the efficacy of decision support intervention on treatment knowledge, decision self-efficacy, decisional conflict, and decision satisfaction in patients with hepatocellular cancer. The study was a randomized controlled trial. In all, 69 patients with hepatocellular carcinoma (HCC) were recruited and randomly assigned to a decision support group or a control group. Data were collected at baseline, post-test, and follow-up using self-report questionnaires. After controlling for baseline scores, the between-group difference (95% confidence interval [CI]) for treatment-related knowledge in post-test scores was 11.9 (6.1, 17.8). After controlling for baseline scores, the between-group difference (95% CI) for decisional conflict was -7.0 (-12.0, -2.0). There was no statistically significant between-group difference in decision self-efficacy and decision satisfaction. Findings supported the efficacy of decision support intervention to improve treatment knowledge and reduce decisional conflict but had no significant effect on decision self-efficacy and decision satisfaction in patients with HCC.
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Affiliation(s)
- Yueh-Ling Liao
- Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan
| | - Tsae-Jyy Wang
- National Taipei University of Nursing and Health Sciences, Taipei
| | - Chien-Wei Su
- Taipei Veterans General Hospital, Taipei
- National Yang Ming Chiao Tung University, Taipei
- National Tsing Hua University, Hsinchu
| | - Shu-Yuan Liang
- National Taipei University of Nursing and Health Sciences, Taipei
| | - Chieh-Yu Liu
- National Taipei University of Nursing and Health Sciences, Taipei
| | - Jun-Yu Fan
- Chang Gung University of Science and Technology Linkou Campus, Taoyuan
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