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Ceylan H, Kosar Sahin C, Aydin Acar C. The effect of WhatsApp-based training on nurses' genetic knowledge levels and awareness in Turkey: A quasi-experimental study. NURSE EDUCATION TODAY 2024; 144:106442. [PMID: 39383658 DOI: 10.1016/j.nedt.2024.106442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 09/11/2024] [Accepted: 09/29/2024] [Indexed: 10/11/2024]
Abstract
BACKGROUND Genetics plays an important role in healthcare, and it is crucial for nurses to have a good understanding of this field. However, studies have shown that nurses often lack genetic knowledge and awareness. Furthermore, innovative educational approaches, such as WhatsApp-based education, have been proposed to address this knowledge gap, unlike traditional educational methods. These approaches use technology and interactive platforms to engage nurses in dynamic and immersive learning experiences. AIM This study aimed to examine the impact of WhatsApp-based training on nurses' genetic knowledge levels and awareness. METHOD A quasi-experimental pre-test-post-test design was used. A total of 121 registered nurses participated in a WhatsApp-based training program comprising presentations on genetic issues. Data were collected using Genetics and Genomics in Nursing Practice Survey. Values, means, percentage frequency distributions, and paired-sample t-tests were used. RESULTS In the pre-training period, the mean knowledge score of the nurse group was found to be 3.31 ± 1.30 in the pre-training period and 9.58 ± 1.73 in the post-training period. The applied WhatsApp-based training was found to have an effect size of 0.752 on the GGNPS (Genetics and Genomics in Nursing Practice Survey) knowledge score of the sample group (F = 374.882, p = 0.000). In the post-training period, there were significant increases in all the GGNPS items. CONCLUSION WhatsApp-based educational programs have the potential to improve nurses' genetic knowledge and awareness. To fulfill the expanding needs of the nursing profession and to enhance patient care outcomes, this study emphasizes the importance of incorporating innovative educational tools into nursing education.
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Affiliation(s)
- Hatice Ceylan
- Department of Nursing, Bucak School of Health, Burdur Mehmet Akif Ersoy University, Burdur, Turkey; Burdur Mehmet Akif Ersoy University, Bucak School of Health, 15300 Campus, Burdur, Turkey.
| | - Cansu Kosar Sahin
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey; Manisa Celal Bayar University, 45000, Campus, Manisa, Turkey
| | - Cigdem Aydin Acar
- Department of Nursing, Bucak School of Health, Burdur Mehmet Akif Ersoy University, Burdur, Turkey; Burdur Mehmet Akif Ersoy University, Bucak School of Health, 15300 Campus, Burdur, Turkey; Department of Health and Biomedical Sciences, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
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Spencer M, Cruickshank V, Kemp N, Nash R. Community voices in health literacy: a qualitative exploration into perceptions of a health literacy mediator. Health Promot Int 2024; 39:daae130. [PMID: 39397747 PMCID: PMC11471997 DOI: 10.1093/heapro/daae130] [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] [Indexed: 10/15/2024] Open
Abstract
Health literacy is a vital asset needed to empower individuals to take control of their health. An individual's health literacy is the ability to find, use and apply health information and services to manage their health. They interact with the health services and members of their community who can offer additional support. Creating the role of a health literacy mediator (HLM) may help to improve health literacy outcomes for all. For this role to be accepted by individuals within a community, the community itself should be involved in the development of the roles and associated responsibilities. The aim of this study was to engage with community members to acquire their perspectives on the potential of this role. Qualitative semi-structured online interviews were used to engage in discussions with local community members. This study implemented a constructivist epistemology with qualitative research design. Data were thematically analysed to identify evolving themes that were important to the HLM role. The analysis identified three main themes that need to be considered when adopting an HLM role: (i) health empowerment of individuals, organizations and communities, (ii) meeting the needs of the community and (iii) addressing the existing barriers in navigating and accessing the healthcare system. Those working in the health promotion space must adopt novel and innovative ways to improve HL on both a local and an international scale. This study concluded that for the role of a HLM to be accepted, it would need to encompass these attributes.
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Affiliation(s)
- Madeline Spencer
- School of Medicine, College of Health and Medicine, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7001, Australia
| | - Vaughan Cruickshank
- School of Education, College of Arts, Law and Education, University of Tasmania, Newnham Drive, Newnham, Tasmania 7001, Australia
| | - Nenagh Kemp
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Grosvenor Street, Sandy Bay, Tasmania 7001, Australia
| | - Rosie Nash
- School of Medicine, College of Health and Medicine, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7001, Australia
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Pot M, Spalletta O, Green S. Precision medicine in primary care: How GPs envision "old" and "new" forms of personalization. Soc Sci Med 2024; 358:117259. [PMID: 39181083 DOI: 10.1016/j.socscimed.2024.117259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/13/2024] [Accepted: 08/15/2024] [Indexed: 08/27/2024]
Abstract
Visions of precision or personalized medicine (PM) are gaining currency around the globe. While the potential of PM in specialist medicine has been in focus, primary care is also considered to be a fruitful area for the application of PM. "Low-tech" forms of personalization and attention to individual patients are already central features of primary care practice, and primary care thus constitutes an area in which "old" and "new" forms of personalization (may) come together. Against this backdrop, we explore general practitioners' (GPs) views on PM and how they envision the future of personalization in primary care. We draw on 45 qualitative interviews with GPs from Austria, Denmark, and the United States. Along the lines of major "promises" of PM-tailoring treatment decisions, improving disease prevention, empowering patients-we show that in some areas GPs consider PM to be a continuation or extension of existing practices of personalization, while in other cases, GPs envision that PM may negatively disrupt current forms of personalization in primary care. We suggest that this ambivalent stance towards PM can be understood through the lens of GPs' views on core values and practices of primary care.
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Affiliation(s)
- Mirjam Pot
- University of Vienna, Department of Political Science, Austria; European Centre for Social Welfare Policy and Research, Austria.
| | - Olivia Spalletta
- University of Copenhagen, Department of Science Education, Section for History and Philosophy of Science, Denmark; University of Copenhagen, Department of Public Health, Centre for Medical Science and Technology Studies, Denmark
| | - Sara Green
- University of Copenhagen, Department of Science Education, Section for History and Philosophy of Science, Denmark; University of Copenhagen, Department of Public Health, Centre for Medical Science and Technology Studies, Denmark
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Fan PEM, Lim SH, Sim GHJ, Poticar MJS, Kam WF, Leong YFR, Choy XYS, Ong LT, Wang X, Lau SS, Ng GN, Ayre TC, Ang SY. Experience of a tertiary acute care hospital in Southeast Asia in initiating patient engagement with the aid of digital solutions. FRONTIERS IN HEALTH SERVICES 2024; 4:1416386. [PMID: 39411515 PMCID: PMC11474461 DOI: 10.3389/frhs.2024.1416386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 09/05/2024] [Indexed: 10/19/2024]
Abstract
Introduction With the goal of patient engagement, an initiative was formulated to equip each patient in the general wards with a tablet whereby they can access their health information and patient education materials and communicate with their healthcare team. This paper presented the methodology of the implementation efforts as well as an evaluation of the preliminary outcomes. Methods The process of hospital-wide implementation was shared using the implementation research logic model. The bedside tablets were rolled out hospital-wide in a step-wedge manner over 12 months. Barriers and facilitators to this implementation were discussed together with strategies to optimize the situation. Preliminary outcomes of the implementation were evaluated using the RE-AIM framework. Results The initial adoption rate for the bedside tablet was low. Additional strategies, such as survey audits and provision of feedback, development of education materials for patients, facilitation, and purposefully re-examining the implementation strategies, were used to improve adoption. The trend of adoption increased over the course of 2 years from the start of implementation. Discussion The initial lower adoption rates may reflect Singapore's paternalistic healthcare culture. While this implementation was driven by the need to move away from paternalism and toward patient engagement, more time is required for significant cultural change.
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Affiliation(s)
| | - Shu Hui Lim
- Nursing Division, Singapore General Hospital, Singapore, Singapore
| | | | | | - Wee Fang Kam
- Division of Nursing, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Yee Fenn Rena Leong
- Division of Nursing, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Xin Yi Selene Choy
- Division of Nursing, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Lay Teng Ong
- Division of Nursing, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Xia Wang
- Nursing Division, Changi General Hospital, Singapore, Singapore
| | - Soy Soy Lau
- Nursing Division, Changi General Hospital, Singapore, Singapore
| | - Gaik Nai Ng
- Nursing Division, Singapore General Hospital, Singapore, Singapore
| | | | - Shin Yuh Ang
- Nursing Division, Singapore General Hospital, Singapore, Singapore
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Bergholtz J, Wolf A, Crine V, Cleeve H, Santana MJ, Björkman I. Patient and public involvement in healthcare: a systematic mapping review of systematic reviews - identification of current research and possible directions for future research. BMJ Open 2024; 14:e083215. [PMID: 39304210 PMCID: PMC11418490 DOI: 10.1136/bmjopen-2023-083215] [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: 12/14/2023] [Accepted: 08/30/2024] [Indexed: 09/22/2024] Open
Abstract
OBJECTIVES To provide an overview of patient and public involvement (PPI) in the mesolevel and macrolevel of healthcare (different from PPI in research) and identify directions for future research by mapping contexts, terminology, conceptual frameworks, measured outcomes and research gaps. DESIGN Mapping review of systematic reviews. A patient coresearcher (JB) was involved in all stages. A broad search strategy was applied to capture the variation in terminology. DATA SOURCES MEDLINE, CINAHL and PsycINFO were searched from 1 January 2001 to 5 December 2022. ELIGIBILITY CRITERIA We included systematic reviews of empirical studies focusing on PPI in the mesolevel and macrolevel of healthcare. DATA EXTRACTION AND SYNTHESIS Three independent reviewers used standardised methods to screen studies and extract data. Thematic categories were created inductively through iteration. The results were organised in narrative, visual or tabular formats. RESULTS 4419 identified records were screened. 37 systematic reviews were eligible for inclusion. Most studies were narrative syntheses (N=26). Identified context categories were PPI for healthcare quality improvement (22%), patient safety (8%), community-based initiatives (27%), peer support (16 %) and education of healthcare professionals (27%). A wide range of terms was used to discuss PPI, with community participation being the most common. 28 reviews reported on frameworks, conceptual guidance and/or policy documents. Nine different types of outcomes were identified. The research gap pointed out most frequently is the lack of studies of robust designs that allow for replication and long-term follow-up, followed by studies on cost-effectiveness and resources needed. There is a need for consensus on the use of terminology. CONCLUSIONS This mapping review sheds light on the evolving landscape of PPI in healthcare. To advance the field, future research should prioritise rigorous study designs, cost-effectiveness assessments and consensus-building efforts to create a more unified and impactful approach for PPI in healthcare.
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Affiliation(s)
- Jana Bergholtz
- Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care, Gothenburg, Sweden
- Sahlgrenska Academy, University of Gothenburg Institute of Health and Care Sciences, Gothenburg, Sweden
| | - Axel Wolf
- Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care, Gothenburg, Sweden
- Sahlgrenska Academy, University of Gothenburg Institute of Health and Care Sciences, Gothenburg, Sweden
| | - Vanessa Crine
- Department of Medical and Translational Biology, Umeå University, Umea, Sweden
| | - Helena Cleeve
- University of Gothenburg Department of Sociology and Work Science, Gothenburg, Sweden
| | - Maria-Jose Santana
- Cumming School of Medicine, University of Calgary Department of Community Health Sciences, Calgary, Alberta, Canada
- Patient Engagement Team, Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit, Calgary, Alberta, Canada
| | - Ida Björkman
- Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care, Gothenburg, Sweden
- Sahlgrenska Academy, University of Gothenburg Institute of Health and Care Sciences, Gothenburg, Sweden
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Brands MR, Haverman L, Muis JJ, Driessens MHE, Meijer S, van der Meer FJM, de Jong M, van der Bom JG, Cnossen MH, Fijnvandraat K, Gouw SC. Toward Personalized Care and Patient Empowerment and Perspectives on a Personal Health Record in Hemophilia Care: Qualitative Interview Study. JMIR Hum Factors 2024; 11:e48359. [PMID: 39226550 PMCID: PMC11408883 DOI: 10.2196/48359] [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: 04/20/2023] [Revised: 11/07/2023] [Accepted: 06/28/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND To enable personalized treatment and shared decision-making in chronic care, relevant health information is collected. However, health information is often fragmented across hospital information systems, digital health apps, and questionnaire portals. This also pertains to hemophilia care, in which scattered information hampers integrated care. We intend to co-design a nationwide digital personal health record (PHR) for patients to help manage their health information. For this, user perspectives are crucial. OBJECTIVE This study aims to assess patients' and health care providers' perspectives regarding the use of a PHR in hemophilia care in the Netherlands, required functionalities, and expectations and concerns. METHODS In this semistructured interview study, 19 pediatric and adult persons with hemophilia, parents, and women with other inherited bleeding disorders, as well as 18 health care providers working within and outside of hemophilia treatment centers, participated. Perspectives of patients and providers were explored separately. To explore requirements, participants were asked to prioritize functionalities. RESULTS Participants expected a PHR would increase the transparency of health information, improve patients' understanding of their illness, and help the coordination of care between health care providers and institutions. Prioritized functionalities included the integration of relevant health information and patient-entered data. Formulated expectations and concerns focused on 4 themes: usability, safety, inclusiveness, and implementation. While patients expressed worries over medicalization (ie, more confrontational reminders of their illness), providers were concerned about an increased workload. CONCLUSIONS People with hemophilia, their parents, and health care providers welcomed the development of a PHR, as they expected it would result in better coordinated care. Formulated expectations and concerns will contribute to the successful development of a PHR for persons with hemophilia, and ultimately, for all persons with a chronic condition.
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Affiliation(s)
- Martijn R Brands
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | - Lotte Haverman
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Child and Adolescent Psychiatry & Psychological Care, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | - Jelmer J Muis
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Child and Adolescent Psychiatry & Psychological Care, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | | | - Stephan Meijer
- Netherlands Hemophilia Patient Society, Nijkerk, Netherlands
| | - Felix J M van der Meer
- HemoNED Foundation, Leiden, Netherlands
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | | | - Johanna G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Marjon H Cnossen
- Department of Pediatric Hematology and Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
| | - Samantha C Gouw
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden University, Leiden, Netherlands
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Bastiany A, Towns C, Kimmaliardjuk DM, Kalenga CZ, Burgess SN. Engaging women in decision-making about their heart health: a literature review with patients' perspective. Can J Physiol Pharmacol 2024; 102:431-441. [PMID: 38815591 DOI: 10.1139/cjpp-2023-0471] [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: 06/01/2024]
Abstract
Cardiovascular disease (CVD) remains the leading cause of death globally. Although the burden of CVD risk factors tends to be lower in women, they remain at higher risk of developing complications when affected by these risk factors. There is still a lack of awareness surrounding CVD in women, both from a patient's and a clinician's perspective, especially among visible minorities. However, women who are informed about their heart health and who engage in decision-making with their healthcare providers are more likely to modify their lifestyle, and improve their CVD risk. A patient-centered care approach benefits patients' physical and mental health, and is now considered gold-standard for efficient patient care. Engaging women in their heart health will contribute in closing the gap of healthcare disparities between men and women, arising from sociocultural, socioeconomic, and political factors. This comprehensive review of the literature discusses the importance of engaging women in decision-making surrounding their heart health and offers tools for an effective and culturally sensitive patient-provider relationship.
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Affiliation(s)
- Alexandra Bastiany
- Thunder Bay Regional Health Sciences Centre, Department of Cardiology, Northern Ontario School of Medicine University (NOSMU), Thunder Bay, ON, Canada
| | - Cindy Towns
- Wellington Hospital, Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | | | - Cindy Z Kalenga
- Libin Cardiovascular Institute, Cumming School of Medicine, Calgary, AB, Canada
| | - Sonya N Burgess
- Nepean Hospital, Department of Cardiology, University of Sydney, Sydney, NSW, Australia
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Hutchinson A, Khaw D, Malmstrom-Zinkel A, Winter N, Dowling C, Botti M, McDonall J. Embedding the Use of Patient Multimedia Educational Resources Into Cardiac Acute Care: Prospective Observational Study. JMIR Nurs 2024; 7:e54317. [PMID: 39024556 PMCID: PMC11294779 DOI: 10.2196/54317] [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: 11/06/2023] [Revised: 03/07/2024] [Accepted: 04/17/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Multimedia interventions may play an important role in improving patient care and reducing the time constraints of patient-clinician encounters. The "MyStay Cardiac" multimedia resource is an innovative program designed to be accessed by adult patients undergoing cardiac surgery. OBJECTIVE The purpose of this study was to evaluate the uptake of the MyStay Cardiac both during and following the COVID-19 pandemic. METHODS A prospective observational study design was used that involved the evaluation of program usage data available from the digital interface of the multimedia program. Data on usage patterns were analyzed for a 30-month period between August 2020 and January 2023. Usage patterns were compared during and following the lifting of COVID-19 pandemic restrictions. Uptake of the MyStay Cardiac was measured via the type and extent of user activity data captured by the web-based information system. RESULTS Intensive care unit recovery information was the most accessed information, being viewed in approximately 7 of 10 usage sessions. Ward recovery (n=124/343, 36.2%), goal (n=114/343, 33.2%), and exercise (n=102/343, 29.7%) information were routinely accessed. Most sessions involved users exclusively viewing text-based information (n=210/343, 61.2%). However, in over one-third of sessions (n=132/342, 38.5%), users accessed video information. Most usage sessions occurred during the COVID-19 restriction phase of the study (August 2020-December 2021). Sessions in which video (P=.02, phi=0.124) and audio (P=.006, phi=0.161) media were accessed were significantly more likely to occur in the restriction phase compared to the postrestriction phase. CONCLUSIONS This study found that the use of digital multimedia resources to support patient education was well received and integrated into their practice by cardiac nurses working in acute care during the COVID-19 pandemic. There was a pattern for greater usage of the MyStay Cardiac during the COVID-19 pandemic when access to the health service for nonfrontline, essential workers was limited.
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Affiliation(s)
- Anastasia Hutchinson
- Centre for Quality and Patient Safety Research-Epworth Partnership, Institute of Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Damien Khaw
- Centre for Quality and Patient Safety Research-Epworth Partnership, Institute of Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia
| | | | - Natalie Winter
- Centre for Quality and Patient Safety Research-Epworth Partnership, Institute of Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Chantelle Dowling
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Mari Botti
- Centre for Quality and Patient Safety Research-Epworth Partnership, Institute of Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia
| | - Joanne McDonall
- Centre for Quality and Patient Safety Research-Epworth Partnership, Institute of Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
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Åkesson KS, Hansson EE, Pawlikowska T, Sundén A, Stigmar K, Ageberg E. Factors associated with empowerment after participating in a supported osteoarthritis self-management program: An explorative study. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100464. [PMID: 38584596 PMCID: PMC10998234 DOI: 10.1016/j.ocarto.2024.100464] [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: 10/17/2023] [Accepted: 03/18/2024] [Indexed: 04/09/2024] Open
Abstract
Objective To explore factors associated with change in empowerment in patients that have participated in a 3-month Supported Osteoarthritis Self-Management Program (SOASP). Further, to evaluate empowerment in the longer term. Design An explorative analysis including patients from a cohort study conducted in primary healthcare in Sweden was performed. Univariable linear regression models were performed to assess associations between demographics and patient-reported outcome measures (explanatory factors), respectively, and change in empowerment from baseline to 3-month follow-up (outcome variable). Long-term follow-up of empowerment was at 9 months. Results Self-reported increase in enablement at the 3-month follow-up was associated with a greater improvement in empowerment (B = 0.041, 95% CI (0.011, 0.07), p = 0.008). Living alone was associated with less improvement in empowerment (B = -0.278, 95% CI (-0.469, -0.086), p = 0.005) compared to living together. Physical exercise >120 min per week at baseline was associated with less improvement in empowerment (B = -0.293, 95% CI (-0.583, -0.004), p = 0.047) compared to reporting no exercise at baseline. No other associations were observed (p > 0.05). Empowerment improved from baseline to the 3-month follow-up (mean 0.20 (SD 0.5), p < 0.001) but there was no change from baseline to the 9-month follow-up (mean 0.02 (SD 0.6), p = 0.641). Conclusions Self-reported increased enablement may lead to greater improvement in empowerment after SOASP. Greater efforts may be needed to support those that live alone, are physically active, and to sustain empowerment in the longer term after SOASP. More research is needed on empowerment to provide personalized support for patients with OA after SOASP.
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Affiliation(s)
| | - Eva Ekvall Hansson
- Department of Health Sciences, Health Science Centre, Box 157, SE-221 00, Lund, Sweden
| | - Teresa Pawlikowska
- Health Professions Education Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anne Sundén
- Department of Health Sciences, Health Science Centre, Box 157, SE-221 00, Lund, Sweden
| | - Kjerstin Stigmar
- Department of Health Sciences, Health Science Centre, Box 157, SE-221 00, Lund, Sweden
| | - Eva Ageberg
- Department of Health Sciences, Health Science Centre, Box 157, SE-221 00, Lund, Sweden
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Provenzano M, Cillara N, Podda M, Cicalò E, Sotgiu G, Fransvea P, Poillucci G, Sechi R, Deserra A, Jiménez-Herrera M. Association between patient activation and delayed discharge in elective laparoscopic cholecystectomy: A prospective cohort analysis. Int J Nurs Stud 2024; 154:104751. [PMID: 38642474 DOI: 10.1016/j.ijnurstu.2024.104751] [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: 07/19/2023] [Revised: 02/24/2024] [Accepted: 03/02/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Improving patient activation may be an effective way to reduce healthcare costs and improve patient outcomes after surgery. OBJECTIVE To determine whether preoperative patient activation is associated with delayed discharge (i.e., length of stay >24 h) after elective laparoscopic cholecystectomy. Postoperative symptoms, unscheduled access to healthcare facilities within seven days of surgery, unplanned hospital readmissions, and postoperative complications were analyzed as secondary outcomes. DESIGN This cohort study was a secondary analysis of the DeDiLaCo study (Delayed Discharge after day-surgery Laparoscopic Cholecystectomy) collecting data of patients undergoing elective laparoscopic cholecystectomy during 2021 in Italy. Data was analyzed from June 2022 to April 2023. SETTING 90 Italian surgical centers participating in the study. PARTICIPANTS 4708 adult patients with an instrumental diagnosis of gallbladder disease and undergoing laparoscopic cholecystectomy. Patient activation was assessed using the Italian translation of Patient Activation Measure in the preoperative setting. RESULTS Of 4532 cases analyzed the median (IQR) Patient Activation Measure score was 80.3 (71.2-92.3). Participants were on average 55.5 years of age and 58.1 % were female. Two groups based on the activation level were created: 270 (6 %) had low activation, and 4262 had high activation. The low activation level was associated with the likelihood of delayed discharge (odds ratio [OR] 1.47, 95 % CI, 1.11-1.95; P = .008), higher symptom burden (OR 1.99, 95 % CI 1.49-2.66, P < .0001), and unplanned healthcare utilization within seven days after hospital discharge (OR 1.85, 95 % CI, 1.29-2.63; P = .001). There was no difference between the high and low activation groups in the incidence of postoperative complications (OR 1.28, 95 % CI, 0.95-1.73; P = .10) and hospital readmission after discharge (OR 0.95, 95 % CI, 0.30-3.05; P = .93). CONCLUSIONS Our results suggest that patients with low activation have 1.47 times the risk of delayed discharge compared with patients with higher activation, almost twice the risk of the onset of postoperative symptoms, and 1.85 times the risk of unscheduled use of hospital services. Screening for patient activation in the preoperative setting could not only identify patients not suitable for early discharge, but more importantly, help physicians and nurses develop tailored interventions.
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Affiliation(s)
- Maria Provenzano
- Department of Surgery, Santissima Trinità Hospital, Cagliari, Italy; Universitat Rovira i Virgili, Tarragona, Spain.
| | - Nicola Cillara
- Department of Surgery, Santissima Trinità Hospital, Cagliari, Italy
| | - Mauro Podda
- Department of Surgical Science, University of Cagliari, Italy
| | - Enrico Cicalò
- Department of Architecture, Design and Urban Planning, University of Sassari, Italy
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - Pietro Fransvea
- Emergency Surgery and Trauma, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | | - Raffaele Sechi
- Department of Surgery, Santissima Trinità Hospital, Cagliari, Italy
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Lonardo A, Bril F, Caldwell SH, Eslam M, Fan JG, Gish RG, Gronbaek H, Sanal MG, Stefan N, Suzuki A, Targher G, Tilg H, Yu ML, Zheng MH, George J. Researchers call for more flexible editorial conduct rather than abruptly adopting only the new MASLD nomenclature. J Hepatol 2024; 80:e192-e194. [PMID: 38336589 DOI: 10.1016/j.jhep.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 02/12/2024]
Affiliation(s)
| | - Fernando Bril
- University of Alabama at Birmingham (UAB), Birmingham, AL, United States
| | | | - Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia
| | - Jian-Gao Fan
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Robert G Gish
- Loma Linda University, Loma Linda, CA, United States; University of Nevada, Reno and Las Vegas, NV, United States; Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, United States; Hepatitis B Foundation, Doylestown, PA, United States
| | - Henning Gronbaek
- Aarhus University Hospital and Clinical Institute, Department of Hepatology & Gastroenterology, Aarhus University, Denmark
| | | | - Norbert Stefan
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University of Tübingen, Tübingen, Germany
| | - Ayako Suzuki
- Gastroenterology, Duke University, Durham, NC, United States
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Ming-Lung Yu
- School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, Taiwan; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital; College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, China
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia
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12
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Olde Wolsink-van Harlingen A, Groen-van de Ven L, Vissers K, Hasselaar J, Jukema J, Uitdehaag M. Challenges to Exploring the Patient Perspective in Palliative Care Conversations: A Qualitative Study Among Chronic Obstructive Pulmonary Disease and Chronic Heart Failure Patients and Their Health Care Professionals. Palliat Med Rep 2024; 5:150-161. [PMID: 38596696 PMCID: PMC11002561 DOI: 10.1089/pmr.2023.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 04/11/2024] Open
Abstract
Objectives The aim of this study was to reveal the challenges faced in exploring the patient's perspective as experienced by patients with chronic obstructive pulmonary disease or chronic heart failure and their health care professionals (HCPs), including the circumstances under which these challenges are experienced during palliative care conversations. Methods This is a qualitative, explorative study in the Netherlands using purposive sampling to create diversity in demographic variables of both patients and HCPs. Semistructured interviews with 12 patients and 7 HCPs were carried out with the use of topic lists. All interviews were audiorecorded, verbatim transcribed, and thematically analyzed. Results Patients find it challenging to express their wishes, preferences, and boundaries and say what is really preoccupying them, especially when they do not feel a good connection with their HCP. HCPs find it challenging to get to know the patient and discuss the patient's perspective particularly when patients are not proactive, open or realistic, or unable to understand or recall information. Conclusions Patients and HCPs seem to share the same aim: patients want to be known and understood and HCPs want to know and understand the patient as a unique individual. At the same time, they seem unable to personalize their conversations. To move beyond this impasse patients and HCPs need to take steps and be empowered to do so.
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Affiliation(s)
- Annet Olde Wolsink-van Harlingen
- Research Group Smart Health, Saxion University of Applied Sciences, Deventer/Enschede, the Netherlands
- Department of Anesthesiology, Pain and Palliative Medicine, Radboudumc University Medical Center, Nijmegen, the Netherlands
| | - Leontine Groen-van de Ven
- Research Group Living Well with Dementia, Windesheim University of Applied Sciences, Zwolle, the Netherlands
| | - Kris Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboudumc University Medical Center, Nijmegen, the Netherlands
| | - Jeroen Hasselaar
- Department of Anesthesiology, Pain and Palliative Medicine, Radboudumc University Medical Center, Nijmegen, the Netherlands
- Nivel Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Jan Jukema
- Research Group Smart Health, Saxion University of Applied Sciences, Deventer/Enschede, the Netherlands
| | - Madeleen Uitdehaag
- Department of Anesthesiology, Pain and Palliative Medicine, Radboudumc University Medical Center, Nijmegen, the Netherlands
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13
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Berger-Estilita J, Marcolino I, Radtke FM. Patient-centered precision care in anaesthesia - the PC-square (PC) 2 approach. Curr Opin Anaesthesiol 2024; 37:163-170. [PMID: 38284262 PMCID: PMC10911256 DOI: 10.1097/aco.0000000000001343] [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: 01/30/2024]
Abstract
PURPOSE OF REVIEW This review navigates the landscape of precision anaesthesia, emphasising tailored and individualized approaches to anaesthetic administration. The aim is to elucidate precision medicine principles, applications, and potential advancements in anaesthesia. The review focuses on the current state, challenges, and transformative opportunities in precision anaesthesia. RECENT FINDINGS The review explores evidence supporting precision anaesthesia, drawing insights from neuroscientific fields. It probes the correlation between high-dose intraoperative opioids and increased postoperative consumption, highlighting how precision anaesthesia, especially through initiatives like Safe Brain Initiative (SBI), could address these issues. The SBI represents multidisciplinary collaboration in perioperative care. SBI fosters effective communication among surgical teams, anaesthesiologists, and other medical professionals. SUMMARY Precision anaesthesia tailors care to individual patients, incorporating genomic insights, personalised drug regimens, and advanced monitoring techniques. From EEG to cerebral/somatic oximetry, these methods enhance precision. Standardised reporting, patient-reported outcomes, and continuous quality improvement, alongside initiatives like SBI, contribute to improved patient outcomes. Precision anaesthesia, underpinned by collaborative programs, emerges as a promising avenue for enhancing perioperative care.
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Affiliation(s)
- Joana Berger-Estilita
- Institute of Anaesthesiology and Intensive Care, Salemspital, Hirslanden Medical Group
- Institute for Medical Education, University of Bern, Bern, Switzerland
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, Porto, Portugal
| | - Isabel Marcolino
- Institute of Anaesthesiology and Intensive Care, Spital Limmattal, Schlieren, Switzerland
| | - Finn M. Radtke
- Department of Anaesthesia and Intensive Care, Hospital of Nykøbing Falster, University of Southern Denmark, Odense, Denmark
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14
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Campinha-Bacote J. Promoting Health Equity Among Marginalized and Vulnerable Populations. Nurs Clin North Am 2024; 59:109-120. [PMID: 38272576 DOI: 10.1016/j.cnur.2023.11.009] [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: 01/27/2024]
Abstract
This article calls for a closer examination of health equity regarding the disparities and inequities in health care among marginalized and vulnerable populations. A review of strategies to improve culturally responsive care to these populations will be examined. This examination includes a discussion of the need for structural competence and the ongoing debate around the concepts of cultural competence and cultural humility. Cultural competemility, a new paradigm of thought regarding the relationship between cultural competence and cultural humility, will be proposed. This article culminates with downstream, midstream, and upstream approaches reducing the magnitude of inequity among marginalized and vulnerable populations.
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15
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Sadri H, Fraser ND. The role of innovative technologies in reducing health system inequity. Healthc Manage Forum 2024; 37:101-107. [PMID: 37861228 DOI: 10.1177/08404704231207509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
The scarcity of Health Human Resources (HHR), regional disparities, and decentralized healthcare systems have profoundly affected health equity in Canada. Adequate HHR allocation is essential for equitable healthcare delivery, and the COVID-19 pandemic has revealed the importance of resilient and culturally diverse organizational HHR. Geography and infrastructure shortcomings aggravate healthcare equity. This study examines the role of innovative technologies in reducing inequity and provides four practice-based examples in different therapeutic areas. Long-term solutions such as collaborative networks, infrastructure improvements, and effective HHR planning can mitigate current challenges. However, in the short and medium terms, advanced medical technologies, digital health, and artificial intelligence can reduce health inequities by improving access, reducing disparities, optimizing resource utilization, and providing skill development opportunities for healthcare professionals.
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Affiliation(s)
| | - Neil D Fraser
- Independent MedTech Consultant, Toronto, Ontario, Canada
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16
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Yang S, Yu B, Liao K, Qiao X, Fan Y, Li M, Hu Y, Chen J, Ye T, Cai C, Ma C, Pang T, Huang Z, Jia P, Reinhardt JD, Dou Q. Effectiveness of a socioecological model-guided, smart device-based, self-management-oriented lifestyle intervention in community residents: protocol for a cluster-randomized controlled trial. BMC Public Health 2024; 24:32. [PMID: 38166669 PMCID: PMC10763380 DOI: 10.1186/s12889-023-17073-w] [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: 09/06/2023] [Accepted: 10/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Healthy lifestyles are crucial for preventing chronic diseases. Nonetheless, approximately 90% of Chinese community residents regularly engage in at least one unhealthy lifestyle. Mobile smart devices-based health interventions (mHealth) that incorporate theoretical frameworks regarding behavioral change in interaction with the environment may provide an appealing and cost-effective approach for promoting sustainable adaptations of healthier lifestyles. We designed a randomized controlled trial (RCT) to evaluate the effectiveness of a socioecological model-guided, smart device-based, and self-management-oriented lifestyles (3SLIFE) intervention, to promote healthy lifestyles among Chinese community residents. METHODS This two-arm, parallel, cluster-RCT with a 6-month intervention and 6-month follow-up period foresees to randomize a total of 20 communities/villages from 4 townships in a 1:1 ratio to either intervention or control. Within these communities, a total of at least 256 community residents will be enrolled. The experimental group will receive a multi-level intervention based on the socioecological model supplemented with a multi-dimensional empowerment approach. The control group will receive information only. The primary outcome is the reduction of modifiable unhealthy lifestyles at six months, including smoking, excess alcohol consumption, physical inactivity, unbalanced diet, and overweight/obesity. A reduction by one unhealthy behavior measured with the Healthy Lifestyle Index Score (HLIS) will be considered favorable. Secondary outcomes include reduction of specific unhealthy lifestyles at 3 months, 9 months, and 12 months, and mental health outcomes such as depression measured with PHQ-9, social outcomes such as social support measured with the modified Multidimensional Scale of Perceived Social Support, clinical outcomes such as obesity, and biomedical outcomes such as the development of gut microbiota. Data will be analyzed with mixed effects generalized linear models with family and link function determined by outcome distribution and accounting for clustering of participants in communities. DISCUSSION This study will provide evidence concerning the effect of a mHealth intervention that incorporates a behavioral change theoretical framework on cultivating and maintaining healthy lifestyles in community residents. The study will provide insights into research on and application of similar mHealth intervention strategies to promote healthy lifestyles in community populations and settings. TRIAL REGISTRATION NUMBER ChiCTR2300070575. Date of registration: April 17, 2023. https://www.chictr.org.cn/index.aspx .
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Affiliation(s)
- Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
- Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, 610106, China.
- Respiratory Department, Chengdu Seventh People's Hospital, Chengdu, 610021, China.
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan University, Wuhan, China.
| | - Bin Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, 610207, China
| | - Kai Liao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
- West China Tianfu Hospital, Sichuan University, Chengdu, 610200, China
| | - Xu Qiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, 610207, China
| | - Yunzhe Fan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Ming Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Yuekong Hu
- West China Tianfu Hospital, Sichuan University, Chengdu, 610200, China
| | - Jiayan Chen
- School of Public Health & Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, 330006, China
| | - Tingting Ye
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Changwei Cai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Chunlan Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Tong Pang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Zixing Huang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
- West China Tianfu Hospital, Sichuan University, Chengdu, 610200, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan University, Wuhan, China
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430072, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, 610207, China.
- Department of Rehabilitation Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, 210009, China.
- Swiss Paraplegic Research, 6207, Nottwil, Switzerland.
- Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland.
| | - Qingyu Dou
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
- National Clinical Research Center of Geriatrics, Geriatric Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Beeckman D, Cooper M, Greenstein E, Idensohn P, Klein RJ, Kolbig N, LeBlanc K, Milne C, Treadwell T, Weir D, White W. The role community-based healthcare providers play in managing hard-to-heal wounds. Int Wound J 2024; 21:e14402. [PMID: 37715348 PMCID: PMC10788587 DOI: 10.1111/iwj.14402] [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: 06/20/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/17/2023] Open
Abstract
It is common for community-based healthcare providers (CHPs)-many of whom have not received specialised training in wound care-to deliver initial and ongoing management for various wound types and diverse populations. Wounds in any setting can rapidly transition to a stalled, hard-to-heal wound (HTHW) that is not following a normal healing trajectory. Failure to recognise or address issues that cause delayed healing can lead to increased costs, healthcare utilisation and suffering. To encourage early intervention by CHPs, a panel of wound care experts developed actionable evidence-based recommendations for CHPs delineating characteristics and appropriate care in identifying and treating HTHWs. A HTHW is a wound that fails to progress towards healing with standard therapy in an orderly and timely manner and should be referred to a qualified wound care provider (QWCP) for advanced assessment and diagnosis if not healed or reduced in size by 40%-50% within 4 weeks. HTHWs occur in patients with multiple comorbidities, and display increases in exudate, infection, devitalised tissue, maceration or pain, or no change in wound size. CHPs can play an important initial role by seeing the individual's HTHW risk, addressing local infection and providing an optimal wound environment. An easy-to-follow one-page table was developed for the CHP to systematically identify, evaluate and treat HTHWs, incorporating a basic toolkit with items easily obtainable in common office/clinic practice settings. A flow chart using visual HTHW clinical cues is also presented to address CHPs with different learning styles. These tools encourage delivery of appropriate early interventions that can improve overall healthcare efficiency and cost.
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Affiliation(s)
- Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary CareGhent UniversityGhentBelgium
- Swedish Centre for Skin and Wound Research (SCENTR), School of Health SciencesÖrebro UniversityÖrebroSweden
| | | | | | | | - Robert J. Klein
- Department of SurgeryUniversity of South Carolina School of MedicineGreenvilleSouth CarolinaUSA
| | | | | | - Catherine Milne
- Connecticut Clinical Nursing Associates, LLCBristolConnecticutUSA
| | | | - Dot Weir
- Saratoga Hospital Center for Wound Healing and Hyperbaric MedicineSaratoga SpringsNew YorkUSA
| | - Wendy White
- Wendy White WoundCareMurwillumbahNew South WalesAustralia
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Stichler JF, Pelletier LR. Applying the Patient Empowerment, Engagement, and Activation Survey to Improve Patient Outcomes. J Nurs Adm 2023; 53:668-674. [PMID: 37983606 DOI: 10.1097/nna.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
This article focuses on applying the patient empowerment, engagement, and activation (PEEA) model as an implementation strategy to achieve patient- or person-centered care. There is substantial evidence linking PEEA to improved patient care outcomes and reduced healthcare costs. Interrelationships among the 3 concepts are discussed and how the PEEA survey can be used to evaluate patients' activation for self-care postdischarge and their perceptions of nurses' empowering and engaging them during the care encounter.
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Affiliation(s)
- Jaynelle F Stichler
- Author Affiliations: Consultant (Dr Stichler) and Clinical Nurse Specialist (Pelletier), Terrence and Barbara Caster Institute for Nursing Excellence, Sharp Prebys Innovation and Education Center, San Diego, California
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Hong WZ, Phua J. Value the patient as a person: Answering the call for a person-centred model of care. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:635-638. [PMID: 38920151 DOI: 10.47102/annals-acadmedsg.2023188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
There has been a change in patients’ attitudes towards healthcare professionals in recent decades, coupled with an increasingly evident shift in the care paradigm. In 2015, the World Health Organization released a framework of care that recommends healthcare professionals consciously consider the perspectives of individuals, carers, families and communities. Practitioners and policymakers are graduating from a more prescriptive culture towards a more consultative form of practice known as person-centred care (PCC),1 where a person—more than a patient—is valued as an active participant in the health service and an expert of their perceptions and experiences.2 PCC advocates for more equality in the doctor-patient relationship.
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Affiliation(s)
- Wei Zhen Hong
- Division of Renal Medicine, Department of Medicine, Alexandra Hospital, Singapore
| | - Jason Phua
- Division of Respiratory and Critical Care Medicine, Department of Medicine, Alexandra Hospital, Singapore
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Brown C, Roucoux G, Rousset-Torrente O, Ali S, Yombo-Kokule L, Chaplin J, Chassany O, Duracinsky M. Fostering Patient-Clinician Communication to Promote Rapid HIV, Hepatitis B Virus, and Hepatitis C Virus Diagnostic Testing: Conceptual Development of a Multilingual App. JMIR Form Res 2023; 7:e49251. [PMID: 37971810 PMCID: PMC10690526 DOI: 10.2196/49251] [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: 05/23/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Migrants are disproportionately affected by HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV). Clinicians, at times, fail to offer rapid diagnostic testing (RDT) for these viruses when a language barrier exists in the patient-clinician relationship, therefore creating missed testing opportunities. Although their effectiveness has been demonstrated elsewhere, conventional, in-person interpreters are costly and underused in practice. Furthermore, clinicians often call upon ad hoc interpreters, which introduces complexities in the clinical relationship. Digital solutions exist to diminish the burden of language barriers; however, the challenges of developing a multilingual and multicultural app have yet to be documented with respect to RDT in the nonfrancophone migrant population in France. OBJECTIVE Our goal was to design a multilingual app to overcome language barriers, health literacy barriers, and fears related to being tested to promote RDT of HIV, HBV, and HCV in the nonfrancophone migrant population in France. METHODS A combination of qualitative methods, agile development, and user-centered design was used. We conducted 2 focus groups (FGs) with 12 participants, including physicians, nurses, and social workers conducting RDT, as well as 1 modified Delphi survey with 68 participants including physicians and nurses. FGs explored the content (risk factors and medical history), functions (cultural adaptation and instant translation), and interface ergonomics (graphics and font) needed in the app. The Delphi presented 95 content items that the researchers sought to include in the app. RESULTS Using FGs to inform the Delphi survey, we scientifically determined the app's content consisting of 95 items using expert consensus, developed a mock-up, and conducted initial user testing. We created an app that contains both migrant and clinician interfaces and includes a sociodemographic, risk assessment, health literacy, and testing barrier questionnaires available in 11 languages. Educational content is related to HIV, HBV, and HCV, along with the ability to understand whether the migrant agrees to be tested. CONCLUSIONS This study allowed us to conceptualize a multilingual app that aims to increase the acceptance of RDT for HIV, HBV, and HCV. The specific features of the Assistant intelligent au dépistage des allophones app were designed to overcome the testing barriers in the nonfrancophone migrant population. The next phase will be an implementation study, as we intend to validate our app.
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Affiliation(s)
- Carter Brown
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - Guillaume Roucoux
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Olivia Rousset-Torrente
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Saleh Ali
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - Lisa Yombo-Kokule
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - John Chaplin
- Institute of Health and Care Sciences, University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Olivier Chassany
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Martin Duracinsky
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, General Administration of Public Assistance of Paris, Le Kremlin,-Bicêtre, France
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Ng APP, Cheng JKY, Lam JSM, Wong CKH, Cheng WHG, Tse ETY, Chao DVK, Choi EPH, Wong RSM, Lam CLK. Patient enablement and health-related quality of life for patients with chronic back and knee pain: a cross-sectional study in primary care. Br J Gen Pract 2023; 73:e867-e875. [PMID: 37845085 PMCID: PMC10587904 DOI: 10.3399/bjgp.2022.0546] [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: 11/03/2022] [Accepted: 05/12/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Chronic back and knee pain impairs health- related quality of life (HRQoL) and patient enablement can improve HRQoL. AIM To determine whether enablement was a moderator of the effect of chronic back and knee pain on HRQoL. DESIGN AND SETTING A cross-sectional study of Chinese patients with chronic back and knee problems in public primary care clinics in Hong Kong. METHOD Each participant completed the Chinese Patient Enablement Instrument-2 (PEI-2), the Chinese Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Pain Rating Scale (PRS). Multivariable regression examined the effects of PRS score and PEI-2 score on WOMAC total score. A moderation regression model and simple slope analysis were used to evaluate whether the interaction between enablement (PEI-2) and pain (PRS) had a significant effect on HRQoL (WOMAC). RESULTS Valid patient-reported outcome data from 1306 participants were analysed. PRS score was associated with WOMAC total score (β = 0.326, P<0.001), whereas PEI-2 score was associated inversely with WOMAC total score (β = -0.260, P<0.001) and PRS score. The effect of the interaction between PRS and PEI-2 (PRS × PEI-2) scores on WOMAC total score was significant (β = -0.191, P<0.001) suggesting PEI-2 was a moderator. Simple slope analyses showed that the relationship between PRS and WOMAC was stronger for participants with a low level of PEI-2 (gradient 3.056) than for those with a high level of PEI-2 (gradient 1.746). CONCLUSION Patient enablement moderated the impact of pain on HRQoL. A higher level of enablement can lessen impairment in HRQoL associated with chronic back and knee pain.
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Affiliation(s)
- Amy Pui Pui Ng
- Department of Family Medicine, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - John King Yiu Cheng
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Joyce Sau Mei Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health (D4H) Hong Kong Science and Technology Park, Sha Tin, Hong Kong SAR, China
| | - Will Ho Gi Cheng
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Emily Tsui Yee Tse
- Department of Family Medicine, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine & Primary Health Care, Kowloon East Cluster, Hospital Authority, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Rosa Sze Man Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
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22
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Miró Catalina Q, Femenia J, Fuster-Casanovas A, Marin-Gomez FX, Escalé-Besa A, Solé-Casals J, Vidal-Alaball J. Knowledge and Perception of the Use of AI and its Implementation in the Field of Radiology: Cross-Sectional Study. J Med Internet Res 2023; 25:e50728. [PMID: 37831495 PMCID: PMC10612005 DOI: 10.2196/50728] [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: 07/11/2023] [Revised: 08/31/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Artificial Intelligence (AI) has been developing for decades, but in recent years its use in the field of health care has experienced an exponential increase. Currently, there is little doubt that these tools have transformed clinical practice. Therefore, it is important to know how the population perceives its implementation to be able to propose strategies for acceptance and implementation and to improve or prevent problems arising from future applications. OBJECTIVE This study aims to describe the population's perception and knowledge of the use of AI as a health support tool and its application to radiology through a validated questionnaire, in order to develop strategies aimed at increasing acceptance of AI use, reducing possible resistance to change and identifying possible sociodemographic factors related to perception and knowledge. METHODS A cross-sectional observational study was conducted using an anonymous and voluntarily validated questionnaire aimed at the entire population of Catalonia aged 18 years or older. The survey addresses 4 dimensions defined to describe users' perception of the use of AI in radiology, (1) "distrust and accountability," (2) "personal interaction," (3) "efficiency," and (4) "being informed," all with questions in a Likert scale format. Results closer to 5 refer to a negative perception of the use of AI, while results closer to 1 express a positive perception. Univariate and bivariate analyses were performed to assess possible associations between the 4 dimensions and sociodemographic characteristics. RESULTS A total of 379 users responded to the survey, with an average age of 43.9 (SD 17.52) years and 59.8% (n=226) of them identified as female. In addition, 89.8% (n=335) of respondents indicated that they understood the concept of AI. Of the 4 dimensions analyzed, "distrust and accountability" obtained a mean score of 3.37 (SD 0.53), "personal interaction" obtained a mean score of 4.37 (SD 0.60), "efficiency" obtained a mean score of 3.06 (SD 0.73) and "being informed" obtained a mean score of 3.67 (SD 0.57). In relation to the "distrust and accountability" dimension, women, people older than 65 years, the group with university studies, and the population that indicated not understanding the AI concept had significantly more distrust in the use of AI. On the dimension of "being informed," it was observed that the group with university studies rated access to information more positively and those who indicated not understanding the concept of AI rated it more negatively. CONCLUSIONS The majority of the sample investigated reported being familiar with the concept of AI, with varying degrees of acceptance of its implementation in radiology. It is clear that the most conflictive dimension is "personal interaction," whereas "efficiency" is where there is the greatest acceptance, being the dimension in which there are the best expectations for the implementation of AI in radiology.
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Affiliation(s)
- Queralt Miró Catalina
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| | - Joaquim Femenia
- Faculty of Medicine, University of Vic-Central University of Catalonia, Vic, Spain
| | - Aïna Fuster-Casanovas
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Francesc X Marin-Gomez
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| | - Anna Escalé-Besa
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia, Vic, Spain
| | - Jordi Solé-Casals
- Data and Signal Processing group, Faculty of Science, Technology and Engineering, University of Vic-Central University of Catalonia, Vic, Spain
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Josep Vidal-Alaball
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia, Vic, Spain
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23
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Bakwa Kanyinga F, Gogovor A, Dofara SG, Gadio S, Tremblay M, Daniel SJ, Rivest LP, Légaré F. Evaluating the impact of continuing professional development courses on physician behavioral intention: a pre-post study with follow-up at six months. BMC MEDICAL EDUCATION 2023; 23:629. [PMID: 37661265 PMCID: PMC10476392 DOI: 10.1186/s12909-023-04597-3] [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] [Received: 03/14/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Continuing professional development (CPD) for health professionals includes educational activities to maintain or improve skills. We evaluated the impact of a series of CPD courses by identifying factors influencing physicians' intention to adopt targeted behaviors and assessing self-reported behavior adoption six months later. METHODS In this pre-post study, eligible participants attended at least one in-person course at the Fédération des Médecins Spécialistes du Québec annual meeting in November 2019. Before and afterwards, participants completed CPD-REACTION, a validated questionnaire based on Godin's integrated model for health professional behavior change that measures intention and psychosocial factors influencing intention. We used Wilcoxon signed-rank test to compare pre- and post-course intention scores and linear regression analyses to identify factors influencing intention. We also compared the post-course intention scores of participants reporting a behavior change six months later with the scores of those reporting no behavior change six months later. Qualitative data was collected only six months after courses and responses to open-ended questions were analyzed using the Theoretical Domains Framework. RESULTS A total of 205/329 course attendees completed CPD-REACTION (response rate 62.3%). Among these participants, 158/329 (48%) completed the questionnaire before CPD courses, 129/329 (39.2%) only after courses and 47/329 (14.3%) at 6 months. Study population included 192 physicians of whom 78/192(40.6%) were female; 59/192(30.7%) were between 50 and 59 years old; and 72/192 (37.5%) were surgical specialist physicians. Mean intention scores before (n = 158) and after (n = 129) courses were 5.74(SD = 1.52) and 6.35(SD = 0.93) respectively. Differences in mean (DM) intention before and afterwards ranged from - 0.31(p = 0.17) to 2.25(p = 0.50). Multivariate analysis showed that beliefs about capabilities (β = 0.15, p = 0.001), moral norm (β = 0.75, p < 0.0001), and beliefs about consequences (β = 0.11, p = 0.04) influenced post-course intention. Post-course intention was correlated with behavior six months later (DM = 0.63; p = 0.02). Qualitative analysis showed that facilitators to behavior adoption after six months were most often related to the TDF domains of beliefs about capabilities. Most frequent barriers to adoption related to lack of resources. CONCLUSIONS Overall, scores for intention to adopt targeted behaviors increased after the courses. CPD providers could increase participants' intention by including interventions that emphasize beliefs about capabilities, moral norm and beliefs about consequences.
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Affiliation(s)
- Felly Bakwa Kanyinga
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, G1J 2G1, Canada
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada
| | - Amédé Gogovor
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, G1J 2G1, Canada
| | - Suélène Georgina Dofara
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada
| | - Souleymane Gadio
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada
| | - Martin Tremblay
- Continuing Professional Development Directorate, Fédération des Médecins Spécialistes du Québec, Montreal, QC, H5B 1G8, Canada
| | - Sam J Daniel
- Continuing Professional Development Directorate, Fédération des Médecins Spécialistes du Québec, Montreal, QC, H5B 1G8, Canada
| | - Louis-Paul Rivest
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - France Légaré
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada.
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, G1J 2G1, Canada.
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24
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Di Tosto G, Hefner JL, Walker DM, Gregory ME, McAlearney AS, Sieck CJ. Development of a conceptual model of the capacity for patients to engage in their health care: a group concept mapping study. BMC Health Serv Res 2023; 23:846. [PMID: 37563581 PMCID: PMC10413602 DOI: 10.1186/s12913-023-09785-x] [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: 10/06/2022] [Accepted: 07/05/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Patient engagement is seen as a necessary component in achieving the triple aim of improved population health, improved experience of care, and lower per capita health care costs. While there has been a substantial increase in the number of tools and patient-centered initiatives designed to help patients participate in health decisions, there remains a limited understanding of engagement from the perspective of patients and a lack of measures designed to capture the multi-faceted nature of the concept. METHODS Development of a concept map of patient engagement followed a five-step modified Group Concept Mapping (GCM) methodology of preparation, generation, structuring, analysis and interpretation. We engaged a Project Advisory Committee at each step, along with three rounds of survey collection from clinicians and patients for element generation (272 clinicians, 61 patients), statement sorting (30 clinicians, 15 patients), and ranking and rating of statements (159 clinicians, 67 patients). The survey of three separate samples, as opposed to focus groups of 'experts,' was an intentional decision to gain a broad perspective about the concept of patient engagement. We conducted the structure and analysis steps within the groupwisdom concept mapping software. RESULTS The final concept map comprised 47 elements organized into 5 clusters: Relationship with Provider, Patient Attitudes and Behaviors, Access, Internal Resources and External Resources. There was considerable agreement in the way elements in each cluster were rated by patients and clinicians. An analysis of the importance of the constitutive elements of patient engagement relative to their addressability highlighted actionable items in the domain of Relationship with Provider, aimed at building trust and enabling patients to ask questions. At the same time, the analysis also identified elements traditionally considered barriers to engagement, like personal access to the internet and the patient's level of digital literacy, as difficult to address by the healthcare system, but also relatively less important for patients. CONCLUSIONS Through our GCM approach, incorporating perspectives of both patients and clinicians, we identified items that can be used to assess patient engagement efforts by healthcare systems. As a result, our study offers specific insight into areas that can be targeted for intervention by healthcare systems to improve patient engagement.
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Affiliation(s)
- Gennaro Di Tosto
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4100, Columbus, OH, USA.
| | - Jennifer L Hefner
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Daniel M Walker
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4100, Columbus, OH, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Megan E Gregory
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ann Scheck McAlearney
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4100, Columbus, OH, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Cynthia J Sieck
- Center for Health Equity, Dayton Children's Hospital, Dayton, OH, USA
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25
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Rawal S. Physician empathy in patient empowerment … and patient empowerment in physician empathy. MEDICAL EDUCATION 2023; 57:694-696. [PMID: 37150535 DOI: 10.1111/medu.15098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 05/09/2023]
Abstract
Rawal argues for the importance of physician empathy in fostering patient engagement and empowerment, being mindful of tools that may facilitate patient empowerment but pose risks of physician burnout and loss of empathy.
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Affiliation(s)
- Surabhi Rawal
- Division of Pediatric Hematology Oncology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
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26
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Wade-Mcbane K, King A, Urch C, Johansson L, Wells M. Is personalised prehabilitation feasible to implement for patients undergoing oncological treatment for lung cancer at a London teaching hospital? Protocol of a feasibility trial. BMJ Open 2023; 13:e072367. [PMID: 37460263 PMCID: PMC10357652 DOI: 10.1136/bmjopen-2023-072367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION There is significant potential to improve outcomes for patients with lung cancer in terms of quality of life and survival. There is some evidence that prehabilitation can help, but, to date, this has only been tested in surgical populations, despite 70%-80% of patients with lung cancer in the UK receiving non-surgical treatment. The physiological and psychological benefits of prehabilitation seen in surgical patients could be extrapolated to those receiving non-surgical treatment, particularly in such a poor prognosis group. With patients and healthcare professionals, we have co-designed a personalised and evidence-based prehabilitation programme. This draws on a conceptual framework that aligns with patient values and needs as well as functional goals. We aim to investigate whether this programme is feasible to implement and evaluate in clinical practice. METHODS AND ANALYSIS An open-label, single-group feasibility study incorporating quantitative assessments, a qualitative free text questionnaire and reflective field notes. Thirty participants will be recruited over an eight-month period from a single London teaching hospital. All recruited participants will receive a personalised prehabilitation programme during their oncological treatment. This includes a one-hour face-to-face appointment prior to, at week three and at week six of their treatment regimen as well as a weekly telephone call. Interventions including nutrition, physical activity and psychological well-being are stratified according to a patient's priorities, level of readiness and expressed needs. The primary outcome will be feasibility of the personalised prehabilitation programme in clinical practice by investigating areas of uncertainty regarding patient recruitment, attrition, treatment fidelity, intervention adherence and acceptability of study outcome measures. Secondary outcomes will include quality of life, functional capacity and grip strength. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Health Research Authority (reference number 22/PR/0390). Results of this study will be disseminated through publication in peer-reviewed articles, presentations at scientific conferences and in collaboration with patient and public involvement representatives. TRIAL REGISTRATION NUMBER NCT05318807.
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Affiliation(s)
- Kelly Wade-Mcbane
- Department of Nutrition and Dietetics, Imperial College Healthcare NHS Trust, London, UK
| | - Alex King
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Catherine Urch
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Lina Johansson
- Department of Nutrition and Dietetics, Imperial College Healthcare NHS Trust, London, UK
| | - Mary Wells
- Department of Surgery and Oncology, Nursing Directorate, Imperial College Healthcare NHS Trust, London, UK
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Lazarus JV, Janamnuaysook R, Caswell G. A people-centred health system must be the foundation for person-centred care in the HIV response. J Int AIDS Soc 2023; 26 Suppl 1:e26125. [PMID: 37408462 PMCID: PMC10323313 DOI: 10.1002/jia2.26125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 07/07/2023] Open
Affiliation(s)
- Jeffrey V. Lazarus
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH)New YorkNew YorkUSA
- Barcelona Institute of Global Health (ISGlobal)Hospital ClínicUniversity of BarcelonaBarcelonaSpain
- Faculty of Medicine and Health SciencesUniversity of BarcelonaBarcelonaSpain
| | - Rena Janamnuaysook
- Institute of HIV Research and InnovationBangkokThailand
- Center of Excellence in Transgender HealthChulalongkorn UniversityBangkokThailand
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28
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Qu Z, Oedingen C, Bartling T, Krauth C, Schrem H. Systematic review on the involvement and engagement of patients as advisers for the organisation of organ transplantation services. BMJ Open 2023; 13:e072091. [PMID: 37164468 PMCID: PMC10173988 DOI: 10.1136/bmjopen-2023-072091] [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: 05/12/2023] Open
Abstract
OBJECTIVES This systematic review aims to derive practical lessons from publications on patient involvement and engagement in the organisation of organ transplantation services. DESIGN This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Inclusion criteria for the analysis of publications in English cited in the databases PubMed and Web of Science until 6 December 2022 required that patients participated as advisers in the organisation of organ transplantation services. Quality assessment was performed using the Guidance for Reporting Involvement of Patients and the Public (GRIPP) 2 small form and the Critical Appraisal Skills Programme (CASP) tool for the assessment of the risks of bias. RESULTS Deployed search strings identified 2263 records resulting in a total of 11 articles. The aims and strategies, deployed methods, observed effects, observed barriers and proposed improvements for the future varied vastly. All reported that well-developed programmes involving and engaging patients at an organisational level provide additional benefits for patients and foster patient-centred care. Lessons learnt include: (1) to empower patients, the information provided to them should be individualised to prioritise their needs; (2) financial as well as organisational resources are important to successfully implement patient involvement and engagement; (3) systematic feedback from patients in organisational structures to health providers is required to improve clinical workflows and (4) the consideration of ethical issues and the relationship between investigators and participating patients should be clarified and reported. CONCLUSIONS Actionable management recommendations could be derived. The quantitative impact on clinical outcome and economic clinical process improvements remains to be investigated. Study quality can be improved using the GRIPP 2 guidance and the CASP tool. PROSPERO REGISTRATION NUMBER CRD42022186467.
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Affiliation(s)
- Zhi Qu
- Transplant Center, Hannover Medical School, Hannover, Germany
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Carina Oedingen
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Tim Bartling
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Christian Krauth
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Harald Schrem
- General, Visceral and Transplant Surgery, Medical University Graz, Graz, Austria
- Transplant Center Graz, Medical University Graz, Graz, Austria
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Leonardsen ACL, Bååth C, Helgesen AK, Grøndahl VA, Hardeland C. Person-Centeredness in Digital Primary Healthcare Services-A Scoping Review. Healthcare (Basel) 2023; 11:healthcare11091296. [PMID: 37174838 PMCID: PMC10178010 DOI: 10.3390/healthcare11091296] [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: 04/05/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Background: Transformation toward digital services offers unique opportunities to meet the challenges of responding to changing public healthcare needs and health workforce shortages. There is a knowledge gap regarding digital health and person or patient-centered care. Aim: The aim of the current scoping review was to obtain an overview of existing research on person or patient centeredness in digital primary healthcare services. Design: A scoping review following the five stages by Arksey and O'Malley. Methods: Literature searches were conducted in the databases PubMed, Scopus (Elsevier), APA PsychInfo (Ovid), Embase (Ovid), Cinahl (Ovid) and Cochrane Library in June 2022. The Preferred Reporting Items for Systematic reviews and Meta-Analyzes extension for Scoping Reviews (PRISMA-ScR) Checklist was followed. Results: The electronic database searches identified 782 references. A total of 116 references were assessed in full text against the inclusion and exclusion criteria. Finally, a total of 12 references were included. The included papers represent research from 2015 to 2021 and were conducted in eight different countries, within a variety of populations, settings and digital solutions. Four themes providing knowledge about current research on patient or person centeredness and digital primary health care were identified: 'Accessibility', 'Self-management', 'Digitalization at odds with patient centeredness' and 'Situation awareness'. The review underlines the need for further research on these issues.
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Affiliation(s)
- Ann-Chatrin Linqvist Leonardsen
- Faculty of Health, Welfare and Organization, Ostfold University College, P.O. Box 700, 1757 Halden, Norway
- Department of Anesthesia, Ostfold Hospital Trust, P.O. Box 300, 1714 Grålum, Norway
| | - Carina Bååth
- Faculty of Health, Welfare and Organization, Ostfold University College, P.O. Box 700, 1757 Halden, Norway
- Faculty of Health, Science, and Technology, Department of Health Sciences, Karlstad University, SE-651 88 Karlstad, Sweden
| | - Ann Karin Helgesen
- Faculty of Health, Welfare and Organization, Ostfold University College, P.O. Box 700, 1757 Halden, Norway
| | - Vigdis Abrahamsen Grøndahl
- Faculty of Health, Welfare and Organization, Ostfold University College, P.O. Box 700, 1757 Halden, Norway
| | - Camilla Hardeland
- Faculty of Health, Welfare and Organization, Ostfold University College, P.O. Box 700, 1757 Halden, Norway
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Kapeller A, Loosman I. Empowerment through health self-testing apps? Revisiting empowerment as a process. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2023; 26:143-152. [PMID: 36592301 PMCID: PMC9806806 DOI: 10.1007/s11019-022-10132-w] [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] [Received: 06/30/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 05/13/2023]
Abstract
Empowerment, an already central concept in public health, has gained additional relevance through the expansion of mobile health (mHealth). Especially direct-to-consumer self-testing app companies mobilise the term to advertise their products, which allow users to self-test for various medical conditions independent of healthcare professionals. This article first demonstrates the absence of empowerment conceptualisations in the context of self-testing apps by engaging with empowerment literature. It then contrasts the service these apps provide with two widely cited empowerment definitions by the WHO, which describe the term as a process that, broadly, leads to knowledge and control of health decisions. We conclude that self-testing apps can only partly empower their users, as they, we argue, do not provide the type of knowledge and control the WHO definitions describe. More importantly, we observe that this shortcoming stems from the fact that in the literature on mHealth and in self-testing marketing, empowerment is understood as a goal rather than a process. This characterises a shift in the meaning of empowerment in the context of self-testing and mHealth, one that reveals a lack of awareness for relational and contextual factors that contribute to empowerment. We argue that returning to a process-understanding of empowerment helps to identify these apps' deficits, and we conclude the article by briefly suggesting several strategies to increase self-testing apps' empowerment function.
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Affiliation(s)
- Alexandra Kapeller
- Department of Thematic Studies – Technology and Social Change, Linköping University, Linköping, Sweden
| | - Iris Loosman
- Department of Philosophy and Ethics, Eindhoven University of Technology, Eindhoven, The Netherlands
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Saut AM, Ho LL, Berger S, Berssaneti FT. How did healthcare professionals define patient engagement in quality management? A survey study. BMC Health Serv Res 2023; 23:173. [PMID: 36803492 PMCID: PMC9942306 DOI: 10.1186/s12913-023-09098-z] [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: 07/20/2022] [Accepted: 01/24/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Patient and family engagement (PFE) can positively impact the patient experience and care process outcomes. There is no unique type of PFE, and the process is usually defined by the quality management department or professionals responsible for this process in the hospital. The objective of this study is to define PFE in quality management based on the professional's perspective. METHOD A survey was carried out with 90 professionals from Brazilian hospitals. There were two questions aimed at understanding the concept. The first was a multiple-choice question to identify synonyms. The second was an open-ended question to develop the definition. A content analysis methodology was employed by applying techniques for thematic and inferential analysis. RESULTS Three words were classified as synonyms by more than 60% of respondents: involvement, participation, and centered care. The participants described patient participation at both the individual (related to the treatment) and organizational levels (related to quality improvement). The PFE in the treatment is related to the development, discussion and decision-making about the therapeutic plan, participation in each step of care, and knowledge of the institution's quality and safety processes. At the organizational level, engagement in quality improvement includes the involvement of the P/F in all processes of the institution, from strategic planning to the design or improvement processes, as well as active participation in institutional committees or commissions. CONCLUSION The professionals defined engagement in two levels (individual and organizational) and the results suggest that their point of view can influence the practice in the hospitals. Professionals of hospitals that implemented mechanisms of consult defined PFE more in the individual level. On the other hand, professionals of hospitals that implemented mechanisms of involvement considered PFE more focus in the organizational level.
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Affiliation(s)
- Ana Maria Saut
- Polytechnic School - Production Engineering Department, University of São Paulo (USP), Av. Prof. Luciano Gualberto, 1380, São Paulo, 05508-010, Brazil. .,Engineering School - Production Engineering Coordination, Mackenzie Presbyterian University, São Paulo, Brazil.
| | - Linda Lee Ho
- grid.11899.380000 0004 1937 0722Polytechnic School - Production Engineering Department, University of São Paulo (USP), Av. Prof. Luciano Gualberto, 1380, São Paulo, 05508-010 Brazil
| | - Simone Berger
- grid.11899.380000 0004 1937 0722Polytechnic School - Production Engineering Department, University of São Paulo (USP), Av. Prof. Luciano Gualberto, 1380, São Paulo, 05508-010 Brazil
| | - Fernando Tobal Berssaneti
- grid.11899.380000 0004 1937 0722Polytechnic School - Production Engineering Department, University of São Paulo (USP), Av. Prof. Luciano Gualberto, 1380, São Paulo, 05508-010 Brazil
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Supporting care engagement in primary care; the development of a maturity matrix. PLoS One 2023; 18:e0279542. [PMID: 36602972 PMCID: PMC9815637 DOI: 10.1371/journal.pone.0279542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/10/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Care engagement or active patient involvement in healthcare contributes to the quality of primary care, but organisational preconditions in routine practice need to be aligned. A Maturity Matrix for Care Engagement to assess and discuss these preconditions in the general practice team was developed and tested on feasibility and acceptability in general practice. METHODS AND FINDINGS A systematic user-centred approach was applied, starting with a scoping literature search to describe the domains on the horizontal axis of the maturity matrix. The domains and growing steps (vertical axis) were refined by patients (n = 16) and general practice staff (n = 11) in three focus group discussions and reviewed by six experts (local facilitators and scientists). Seven domains could be distinguished: Personalised Care, Shared Decision Making, Self-Management, Patient as Partner, Supportive Means, Patient Environment, and Teamwork among Healthcare Professionals. The growing steps described three to six activities per domain (n = 32 in total) that contribute to care engagement. Local facilitators implemented the tool in two general practice teams according to a user guide, starting with a two-hour kick-off meeting on care engagement. In the next step, practitioners, nurses and assistants in each practice indicated their score on the domains individually. The scores were discussed in the facilitated practice meeting which was aimed at SMART improvement plans. Feasibility and acceptability were assessed in interviews showing that the tool was well received by the pilot practices, although the practice assistants had difficulties scoring some of the activities as they did not always relate to their daily work. An assessment after three months showed changes in practice organisation towards increased care engagement. CONCLUSIONS The maturity matrix on care engagement is a tool to identify the organisational practice maturity for care engagement. Suggested adaptations must be implemented before large-scale testing.
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Chebil D, Belhadj M, Aidi M, Hannachi H, Barhoumi T, Merzougui L. Patients' perception of the quality of care at the Ibn Al Jazzar University Hospital in Kairouan, Tunisia. LA TUNISIE MEDICALE 2022; 100:618-625. [PMID: 36571730 PMCID: PMC9744126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIM This study aims to evaluate the level of satisfaction of patients hospitalized at Ibn Al Jazzar University Hospital of Kairouan in 2018. METHODS It's a descriptive cross-sectional study including all patients hospitalized at Ibn Al Jazzar University Hospital in Kairouan over a period of three months, from January 1 to March 31, 2018. The survey was conducted using a questionnaire made up of 27 items to explore seven specific dimensions of satisfaction. RESULTS A total of 640 patients was included in the study. The overall satisfaction rate was 41.7%. The dimensions of globality and hospital stay were the least appreciated by hospitalized patients with respective satisfaction rates of 14.4% and 18.3%. Access to care was the most appreciated area with a satisfaction rate of 58.9%. the lowest satisfaction rates, among the items studied at the Kairouan University Hospital in 2018 were: «the places of visits» (9%), «the quality of the catering» (20%), « tranquillity" (23%), and "attentiveness of staff to patient needs" (23%). CONCLUSION At Ibn Al Jazzar University hospital of Kairouan, patient satisfaction was low regarding the quality of the services provided, particularly for areas related to the conditions of stay and the globality of care. Intervention measures based on these shortcomings should be undertaken.
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Affiliation(s)
- Dhekra Chebil
- 1. Service de médecine préventive, Hôpital Universitaire Ibn Al Jazzar de Kairouan, Tunisie.,2. Faculté de médecine de Sousse, Université de Sousse, Tunisie.
| | - Maha Belhadj
- 2. Faculté de médecine de Sousse, Université de Sousse, Tunisie.
| | - Mokhtar Aidi
- 3. Hôpital universitaire Ibn Al Jazzar de Kairouan, Tunisie.
| | - Hajer Hannachi
- 1. Service de médecine préventive, Hôpital Universitaire Ibn Al Jazzar de Kairouan, Tunisie.
| | | | - Latifa Merzougui
- 1. Service de médecine préventive, Hôpital Universitaire Ibn Al Jazzar de Kairouan, Tunisie.,2. Faculté de médecine de Sousse, Université de Sousse, Tunisie.
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