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Owokuhaisa J, Turyakira E, Ssedyabane F, Tusubira D, Kajabwangu R, Musinguzi P, Galiwango M, Randall TC, Kakongi N, Castro CM, Atukunda EC, Maling S. Barriers and facilitators of retention in care after cervical cancer screening: patients' and healthcare providers' perspectives. BMC Womens Health 2024; 24:516. [PMID: 39272088 PMCID: PMC11401415 DOI: 10.1186/s12905-024-03343-1] [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: 11/08/2023] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Cervical cancer continues to threaten women's health, especially in low-resource settings. Regular follow-up after screening and treatment is an effective strategy for monitoring treatment outcomes. Consequently, understanding the factors contributing to patient non-attendance of scheduled follow-up visits is vital to providing high-quality care, reducing morbidity and mortality, and unnecessary healthcare costs in low-resource settings. METHODS A descriptive qualitative study was done among healthcare providers and patients who attended the cervical cancer screening clinic at Mbarara Regional Referral Hospital in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analysed in line with the social-ecological model to identify barriers and facilitators. RESULTS We conducted 23 in-depth interviews with 5 healthcare providers and 18 patients. Health system barriers included long waiting time at the facility, long turnaround time for laboratory results, congestion and lack of privacy affecting counselling, and healthcare provider training gaps. The most important interpersonal barrier among married women was lacking support from male partners. Individual-level barriers were lack of money for transport, fear of painful procedures, emotional distress, and illiteracy. Inadequate and inaccurate information was a cross-cutting barrier across the individual, interpersonal, and community levels of the socio-ecological model. The facilitators were social support, positive self-perception, and patient counselling. CONCLUSIONS Our study revealed barriers to retention in care after cervical cancer screening, including lack of partner support, financial and educational constraints, and inadequate information. It also found facilitators that included social support, positive self-perception, and effective counselling.
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Affiliation(s)
- Judith Owokuhaisa
- Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Eleanor Turyakira
- Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Frank Ssedyabane
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Deusdedit Tusubira
- Department of Biochemistry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Rogers Kajabwangu
- Department of Obstetrics & Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Pius Musinguzi
- Department of Nursing, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Martin Galiwango
- Department of Electrical and Electronics Engineering, Faculty of Applied Sciences and Technology, Mbarara University of Science of Science and Technology, Mbarara, Uganda
| | - Thomas C Randall
- Department of Global Health and Social Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nathan Kakongi
- Department of Biochemistry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Cesar M Castro
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Esther C Atukunda
- Faculty of Medicine, Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Samuel Maling
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Giannopoulos E, Moody L, MacKinnon R, Gill B, Giuliani ME, Papadakos JK. Evaluating cancer patient-reported experience measures against health literacy best practices. Support Care Cancer 2024; 32:631. [PMID: 39227513 DOI: 10.1007/s00520-024-08838-z] [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: 05/02/2024] [Accepted: 08/26/2024] [Indexed: 09/05/2024]
Abstract
PURPOSE Positive patient experiences can lead to better adherence to cancer treatment and greater patient health outcomes. The primary aim of this descriptive study was to determine whether commonly used cancer PREMs have been developed according to health literacy best practices. The secondary and third aims were to examine the development of PREMs and to assess their comprehensiveness against principles of patient-centered care. METHODS To assess adherence to best practice literacy principles regarding readability and understandability of commonly used cancer PREMs, three validated readability calculators and a validated instrument were utilized. To better understand how PREMs were developed, data about survey items, patient involvement, and expert consultation were collected. Finally, the Picker framework was used to evaluate the comprehensiveness of PREMs against principles of patient-centered care. RESULTS Thirty-five PREMs studies met inclusion criteria for the study. The mean reading grade level of cancer PREMs was 9.7 (SD = 0.75, range = 8.2-11.2) with best practice recommendation being a grade 6 reading grade level. Twenty-eight PREMs were rated on understandability, with a mean score of 74% (SD = 10.6, range = 46-93%, with optimal score of greater than 80%). The mean number of items across PREMs was 49 (SD = 31, range = 13-136). Recommendations for the number of items to include in a questionnaire is 25-30 items. Most PREMs (n = 33, 94.3%) asked ≥ 1 double-barreled question. All PREMs addressed ≥ 2 patient-centered care principles. CONCLUSION Cancer PREMs included in this study did not meet evidence-informed thresholds for readability and understandability. As such, it is possible that there may be gaps in how we understand the care experiences of low health literacy populations. Future development of PREMs should engage patients with low health literacy to ensure their perspectives are accurately captured and that PREMs are designed to meet the needs of all patients.
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Affiliation(s)
- Eleni Giannopoulos
- Cancer Health Literacy Research Centre, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
| | - Lesley Moody
- Ambulatory Care, Princess Margaret Cancer Centre, Toronto, Canada
- Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
| | - Rebecca MacKinnon
- Cancer Health Literacy Research Centre, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
- School of Public Health, University of Guelph, Guelph, Canada
| | - Bhajan Gill
- Cancer Health Literacy Research Centre, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
- School of Public Health, University of Western Ontario, Toronto, Canada
| | - Meredith E Giuliani
- Cancer Health Literacy Research Centre, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- The Institute for Education Research, University Health Network, Toronto, Canada
| | - Janet K Papadakos
- Cancer Health Literacy Research Centre, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada.
- Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada.
- The Institute for Education Research, University Health Network, Toronto, Canada.
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Rosa Filezio M, Sharma N, Thull-Freedman J, Ferri-de-Barros F, Santana MJ. Enhancing informed consent through multimedia tools in pediatric spinal surgery: a comprehensive review. Front Pediatr 2024; 12:1357462. [PMID: 39100648 PMCID: PMC11294088 DOI: 10.3389/fped.2024.1357462] [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] [Received: 12/18/2023] [Accepted: 06/28/2024] [Indexed: 08/06/2024] Open
Abstract
Pediatric spine surgery is a high complexity procedure that can carry risks ranging from pain to neurological damage, and even death. This comprehensive mini review explores current best practice obtaining valid and meaningful informed consent (IC) prior to pediatric spinal surgery, including modalities that support effective comprehension and understanding. An evaluation of the literature was performed to explore understanding of surgical IC by patients or their guardians and the role of multimedia tools as a possible facilitator. The evidence discussed throughout this review, based on legal and ethical perspectives, reveals challenges faced by patients and guardians in achieving comprehension and understanding, especially when facing stressful medical situations. In this context, the introduction of multimedia tools emerges as a patient-centered strategy to help improve comprehension and decrease pre-operative uncertainty. This review highlights the need for a tailored approach in obtaining IC for pediatric patients and suggests a potential role of shared decision-making (SDM) in the surgical discussion process.
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Affiliation(s)
- Marina Rosa Filezio
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Surgery, University ofCalgary, Calgary, AB, Canada
| | - Nishan Sharma
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jennifer Thull-Freedman
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Maria J. Santana
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
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Venosa M, Cerciello S, Zoubi M, Petralia G, Vespasiani A, Angelozzi M, Romanini E, Logroscino G. Readability and Quality of Online Patient Education Materials Concerning Posterior Cruciate Ligament Reconstruction. Cureus 2024; 16:e58618. [PMID: 38770469 PMCID: PMC11103262 DOI: 10.7759/cureus.58618] [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: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Objective This study aimed to assess the quality of online patient educational materials regarding posterior cruciate ligament (PCL) reconstruction. Methods We performed a search of the top-50 results on Google® (terms: "posterior cruciate ligament reconstruction," "PCL reconstruction," "posterior cruciate ligament surgery," and "PCL surgery") and subsequently filtered to rule out duplicated/inaccessible websites or those containing only videos (67 websites included). Readability was assessed using six formulas: Flesch-Kincaid Reading Ease (FRE), Flesch-Kincaid Grade Level (FKG), Gunning Fog Score (GF), Simple Measure of Gobbledygook (SMOG) Index, Coleman-Liau Index (CLI), Automated Readability Index (ARI); quality was assessed using the JAMA benchmark criteria and recording the presence of the HONcode seal. Results The mean FRE was 49.3 (SD 11.2) and the mean FKG level was 8.09. These results were confirmed by the other readability formulae (average: GF 8.9; SMOG Index 7.3; CLI 14.7; ARI 6.5). A HONcode seal was available for 7.4 % of websites. The average JAMA score was 1.3. Conclusion The reading level of online patient materials concerning PCL reconstruction is too high for the average reader, requiring high comprehension skills. Practice implications Online medical information has been shown to influence patient healthcare decision processes. Patient-oriented educational materials should be clear and easy to understand.
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Affiliation(s)
- Michele Venosa
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
- Department of Orthopaedics, RomaPro, Polo Sanitario San Feliciano, Rome, ITA
| | - Simone Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, ITA
- Orthopaedic Department, Casa di Cura Villa Betania, Rome, ITA
| | - Mohammad Zoubi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
| | - Giuseppe Petralia
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
| | - Andrea Vespasiani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
| | - Massimo Angelozzi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
| | - Emilio Romanini
- Department of Orthopaedics, RomaPro, Polo Sanitario San Feliciano, Rome, ITA
- Department of Orthopaedics, Italian Working Group on Evidence-Based Orthopaedics (GLOBE), Rome, ITA
| | - Giandomenico Logroscino
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ITA
- Department of Minimally Invasive and Computer-Assisted Orthopaedic Surgery, San Salvatore Hospital, L'Aquila, ITA
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Shepherd T, Trinder M, Theophilus M. Does virtual reality in the preoperative setting for colorectal cancer surgery improve patient understanding? A randomized pilot study. ANZ J Surg 2024; 94:391-396. [PMID: 37994285 DOI: 10.1111/ans.18787] [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: 04/27/2023] [Revised: 10/29/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Virtual reality (VR) enhanced radiology could help improve communication with colorectal cancer patients and therefore increase understanding in the perioperative setting. The objective of this pilot trial is to assess the feasibility of conducting a randomized control trial in terms of recruitment, use and acceptability of the VR technology and validity of data collection methods. METHODS A prospective, single-centre randomized control trial was conducted at St John of God Midland Hospital in Western Australia from November to December 2021. After standard informed consent with their surgeon, elective patients planned for resection of colorectal cancer were randomized to either 'standard consent' (shown computed tomography (CT) images only) or 'VR consent' (shown CT images and immersive VR models). RESULTS Nine patients were recruited (four control; five intervention). There was a trend towards improved patient reported understanding without reaching statistical significance. Most patients preferred the use of VR as compared to CT as an educational tool during the consent process (P = 0.03). There were no adverse effects. CONCLUSION VR was well tolerated and patients enjoyed using the technology. Its use in an outpatient clinic setting for elective colorectal cancer surgery is feasible. Improvement in patient understanding using VR compared to standard consent processes in colorectal surgery should be tested in a statistically powered, high quality study design.
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Affiliation(s)
- Talia Shepherd
- General Surgery Department, SJOG Midland Public and Private Hospital, Midland, Western Australia, Australia
| | - Matthew Trinder
- General Surgery Department, SJOG Midland Public and Private Hospital, Midland, Western Australia, Australia
| | - Mary Theophilus
- General Surgery Department, SJOG Midland Public and Private Hospital, Midland, Western Australia, Australia
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Nunes WB, Firmino RT, Marinho AMCL, Barreto LDS, Sousa MLC, Silva SED, Costa EMMDB, Perazzo MF, Granville-Garcia AF. Clarity of publications on HPV in Instagram profiles of official health agencies in Brazil. Braz Oral Res 2023; 37:e103. [PMID: 38055521 DOI: 10.1590/1807-3107bor-2023.vol37.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/02/2023] [Indexed: 12/08/2023] Open
Abstract
The study analyzed the clarity of publications on human papillomavirus (HPV) in the Instagram profiles of official Brazilian health agencies. An infodemiological study analyzed publications on HPV in the 81 Instagram profiles selected from the Health Ministry, States' Health Departments, and dental councils and associations. The following data were collected: classification of content, type of profiles, type of media, how the content was addressed, number of posts, frequency, likes, comments, viewings, and hashtags, and how the HPV vaccine was addressed. The clarity of the educational publications was assessed using the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis was performed with Spearman's correlation and the Mann-Whitney test (p < 0.05). A total of 504 publications on HPV were found. The average number of likes was 528.3 (SD = 2388.2) and the average BR-CDC-CCI score was 67.1 (SD = 14.1). The quality and clarity of the information was considered adequate (BR-CDC-CCI score ≥ 90) in 6.9% of the publications. A weak positive correlation was found between the number of likes and both the BR-CDC-CCI score (r = 0.195) and number of posts (r = 0.124). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score (72.9) compared to the other profiles analyzed (p = 0.01). Most publications concerned government actions, had low engagement, and written educational information was of low clarity and quality. However, the effort to reach the population was evident, with an increase in publications over the years.
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Affiliation(s)
- Wanúbia Barbosa Nunes
- Universidade Estadual da Paraíba - UEPB, Post-Graduation Program in Dentistry, Campina Grande, PB, Brazil
| | - Ramon Targino Firmino
- Universidade Federal de Campina Grande - UFCG, Academic Unit of Biological Sciences, Patos, PB, Brazil
| | | | - Lílian de Sá Barreto
- Universidade Estadual da Paraíba - UEPB, Department of Dentistry, Campina Grande, PB, Brazil
| | | | - Samara Ellen da Silva
- Universidade Estadual da Paraíba - UEPB, Department of Dentistry, Campina Grande, PB, Brazil
| | | | - Matheus França Perazzo
- Universidade Federal de Goiás - UFG, Dental School, Department of Oral Health, Goiânia, GO, Brazil
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Muleka N, Maanaso B, Phoku M, Mphasha MH, Makwela M. Infant and Young Child Feeding Knowledge among Caregivers of Children Aged between 0 and 24 Months in Seshego Township, Limpopo Province, South Africa. Healthcare (Basel) 2023; 11:healthcare11071044. [PMID: 37046971 PMCID: PMC10094686 DOI: 10.3390/healthcare11071044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/26/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Appropriate infant and young child feeding (IYCF) involves the initiation of breastfeeding within an hour of delivery, exclusive breastfeeding for 6 months, introduction of complementary feeding at 6 months while continuing breastfeeding for 2 years or beyond. Adequate IYCF knowledge among caregivers is associated with improved practices, lowers risk of kids developing malnutrition, infection, morbidity, and mortality. Early introduction of solid foods, mixed feeding, inadequate breastfeeding, and complementary feeding are all prevalent in South Africa. These are related to caregivers' lack of IYCF knowledge. Hence, this study aims to determine the IYCF knowledge level of caregivers of children under 24 months in the semiurban Seshego Township, South Africa. METHODOLOGY Quantitative and cross-sectional design was applied. A total of 86 caregivers were selected using simple random sampling, which is representative of a target population of 110. Structured questionnaire was utilised to gather data, and analysed through statistical software, using descriptive and inferential statistics. Chi-square test was used to calculate associations at 95% confidence interval, where a p-value of < 0.05 was considered statistically significant. RESULTS Findings show that 67% of participants had good IYCF knowledge (a score of 81 to 100%) and there was a significant relationship between knowledge and education (p = 0.001). Moreover, 40.7% did not know that exclusive breastfeeding should be up to 6 months, and 90% mentioned that breastmilk protects the child against diseases. Most participants (82.6%) know that complementary feeding should be introduced at 6 months with continuation of breastfeeding. CONCLUSIONS Caregivers know that breastfeeding should begin immediately after birth, and that it protects against diseases. Moreover, they know that solid food should be introduced at 6 months. However, there is still a need to strengthen IYCF education, particularly on exclusive breastfeeding. Interventions to improve IYCF knowledge should be intertwined with improving educational and health literacy on breastfeeding and complementary feeding.
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Affiliation(s)
- Ndivhudzannyi Muleka
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0790, South Africa
| | - Baatseba Maanaso
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0790, South Africa
| | - Mafiwa Phoku
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0790, South Africa
| | | | - Maishataba Makwela
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0790, South Africa
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Stumpe TR, Graf AM, Melton CD, Devarakonda AK, Steflik MJ, Blair JA, Parada SA, Davis JM. Assessment of quality, absorbability, and educational value of YouTube videos regarding ankle fractures. J Orthop 2023; 38:32-37. [PMID: 36942091 PMCID: PMC10023895 DOI: 10.1016/j.jor.2023.02.016] [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] [Received: 12/09/2022] [Accepted: 02/27/2023] [Indexed: 03/23/2023] Open
Abstract
Aims & objectives YouTube is a non-peer-reviewed platform with a large library of healthcare-related videos which attempt to provide educational content. The goal of this study is to analyze the quality, absorbability, and educational content of videos available to patients on YouTube regarding ankle fractures. Materials & methods On May 31, 2022, over 550 videos populated the initial search of "ankle fracture" within YouTube's platform. The first 100 videos were reviewed, and 62 videos were included in the final analysis. Video characteristics were recorded and evaluated. Videos were assessed using three objective scoring systems: (1) the Journal of American Medical Association (JAMA) benchmark criteria, (2) the Patient Education Materials Assessment Tool for audio and visual materials (PEMAT), and (3) the novel Ankle Fracture Content Score (AFCS). Results Each scoring system had high internal consistency and interrater reliability. The mean JAMA, PEMAT understandability, PEMAT actionability, and AFCS were 2.92, 61.85%, 16.38%, and 4.67, respectively. No association was seen between video popularity metrics and quality of information. The understandability of the patient-targeted videos was greater than those targeted at healthcare professionals (P = 0.049). Conclusion The information regarding ankle fractures available on YouTube for patient education is poor with no correlation between quality and popularity. This study illustrates the need for future collaboration between YouTube and trusted medical societies to provide patients with the highest quality information.
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Affiliation(s)
- Tanner R. Stumpe
- Medical College of Georgia at Augusta University, Department of Orthopaedic Surgery, 1120 15 Street, Augusta, GA, 30912, USA
| | - Austin M. Graf
- Medical College of Georgia at Augusta University, Department of Orthopaedic Surgery, 1120 15 Street, Augusta, GA, 30912, USA
| | - Christopher D. Melton
- Medical College of Georgia at Augusta University, Department of Orthopaedic Surgery, 1120 15 Street, Augusta, GA, 30912, USA
| | - Aditya K. Devarakonda
- Medical College of Georgia at Augusta University, Department of Orthopaedic Surgery, 1120 15 Street, Augusta, GA, 30912, USA
| | - Michael J. Steflik
- Medical College of Georgia at Augusta University, Department of Orthopaedic Surgery, 1120 15 Street, Augusta, GA, 30912, USA
| | - James A. Blair
- Medical College of Georgia at Augusta University, Department of Orthopaedic Surgery, 1120 15 Street, Augusta, GA, 30912, USA
| | - Stephen A. Parada
- Medical College of Georgia at Augusta University, Department of Orthopaedic Surgery, 1120 15 Street, Augusta, GA, 30912, USA
| | - Jana M. Davis
- Medical College of Georgia at Augusta University, Department of Orthopaedic Surgery, 1120 15 Street, Augusta, GA, 30912, USA
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Gasteiger C, Perera A, Yielder R, Scholz U, Dalbeth N, Petrie KJ. Using family-centered communication to optimize patient-provider-companion encounters about changing to biosimilars: A randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2023; 106:142-150. [PMID: 36400636 DOI: 10.1016/j.pec.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To explore whether family-centered communication impacts decisions and optimizes patient-companion-provider consultations. METHODS A parallel, two-arm randomized controlled trial was conducted with 108 participants acting as patients with inflammatory arthritis or companions. Pairs attended a mock consultation where a physician explained the change from a bio-originator to a biosimilar using family-centered or patient-only communication. Participants reported their willingness to transition, risk perceptions, understanding and social support, and completed various scales including the Patient Perception Scale. Interviews helped understand perceptions towards the consultation. RESULTS Family-centered communication did not impact willingness to change or cognitive risk perceptions compared to patient-only communication. However, it improved emotional risk perceptions (p = 0.047, Cohen's d=.55) and satisfaction with communication (p = 0.015, Cohen's d=.71). Feeling the explanation was reassuring was associated with less worry (p = 0.004). Receiving emotional support (p = 0.014) and companions asking fewer questions (p = 0.046) were associated with higher recall. The intervention improved companion involvement (p < 0.001, Cohen's d= 1.23) and support (p = 0.002, Cohen's d=.86). Interviews showed that encouraging questions, inclusive body language, and acknowledging companions facilitated involvement. CONCLUSION Family-centered communication augments patient-companion-provider encounters but does not influence willingness to change treatment. PRACTICE IMPLICATIONS Practitioners can use family-centered communication when discussing biosimilars but should provide reassurance, encourage emotional support, and summarize key points to improve understanding.
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Affiliation(s)
- Chiara Gasteiger
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Anna Perera
- School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Rachael Yielder
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Urte Scholz
- University Research Priority Program "Dynamics of Healthy Aging," University of Zurich, Zurich, Switzerland; Department of Psychology - Applied Social and Health Psychology, University of Zurich, Zurich, Switzerland
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Rheumatology, Auckland District Health Board, Auckland, New Zealand
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Does virtual reality in the perioperative setting for patient education improve understanding? A scoping review. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Keers G, Yamada K, Pickles K, Bell K, Black K, Bateson D, Dodd RH. Understanding women's choices for management of cervical intraepithelial neoplasia 2 (CIN2): Qualitative analysis of a randomised experimental study. Aust N Z J Obstet Gynaecol 2021; 62:125-132. [PMID: 34625954 DOI: 10.1111/ajo.13440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/14/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Active surveillance for cervical intraepithelial neoplasia 2 (CIN2) would allow time for most cases to regress naturally and in turn avoid potentially unnecessary and harmful treatment. AIM To determine reasons for choosing active surveillance over surgery among women given a hypothetical diagnosis of CIN2. MATERIALS AND METHODS Women residing in Australia aged 25-40 years with no prior diagnosis of cervical cancer, cervical abnormality CIN2 or above, and/or previous hysterectomy, were randomised to one of four identical hypothetical scenarios of testing human papillomavirus (HPV)-positive: high-grade cytology and a diagnosis of CIN2 that used alternate terminology to describe resolution of abnormal cells and/or inclusion of an overtreatment statement. Participants selected active surveillance or surgery after viewing the scenario and free-text reason/s for their choice were thematically analysed. RESULTS Of the 1638 women randomised, 79% (n = 1293) opted for active surveillance. The most common reasons for choosing active surveillance included concerns about surgery and associated risks, preferring to 'wait and see', trusting the doctor's recommendations and having an emotional response toward surgery. For women who chose surgery, being risk-averse, addressing the issue straight away and perceiving surgery to be the better option for them were the most common themes identified. CONCLUSION When presented with balanced information on the benefits and harms of different management options for CIN2 and given a choice, most women in this hypothetical situation chose active surveillance over surgery. Addressing women's concerns about active surveillance may open up the possibility that if deemed safe, it could be an acceptable alternative for women.
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Affiliation(s)
- Gemma Keers
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kozue Yamada
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kristen Pickles
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Katy Bell
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsten Black
- Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Deborah Bateson
- Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,Family Planning New South Wales, Sydney, New South Wales, Australia
| | - Rachael H Dodd
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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Bulmash B, Ben-Assuli O, Amar M. Fear of Hospital-Acquired Infections: The Combined Impact of Patient's Hygiene Sensitivity and Perceived Staff Preventive Behavior. J Community Health 2021; 45:1211-1219. [PMID: 32533287 DOI: 10.1007/s10900-020-00857-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Over the years, the public has paid growing attention to hospital-acquired infections (HAIs). Currently, infection prevention and control are considered a number one national priority in leading developed countries. However, while some hospital visitors are knowledgeable of the topic, others may be ignorant or careless as regards sterility and hygiene-related matters. This study, conducted in Israel, compared people cognizant of hygiene-related issues to those who are less so, in an attempt to account for differences in terms of attitudes and perceptions regarding the hospital environment. Based on Endsley's (in: Proceedings of the IEEE 1988 national aerospace and electronics conference, IEEE, 1988, 1995) situation awareness concept, we hypothesized that people attending the hospital with different hygiene schema would react differently when faced with HAI-related triggers. Based on a survey of 208 respondents, the results support the hypotheses, and showed a significant moderating effect of hygiene-sensitivity on the relationship between the staffs' hospital acquired infection-related proactive behavior and avoidance tendencies among hospital visitors. Theoretical as well as practical recommendations are discussed.
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Affiliation(s)
- Ben Bulmash
- Faculty of Technology Management, Holon Institute of Technology (HIT), 52 Golomb St., 58102, Holon, Israel.
| | - Ofir Ben-Assuli
- Faculty of Business Administration, Ono Academic College, 104 Zahal Street, 55000, Kiryat Ono, Israel
| | - Moty Amar
- Faculty of Business Administration, Ono Academic College, 104 Zahal Street, 55000, Kiryat Ono, Israel
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Phillips S, Wyatt LC, Turner MM, Trinh-Shevrin C, Kwon SC. Patient-provider communication patterns among Asian American immigrant subgroups in New York City. PATIENT EDUCATION AND COUNSELING 2021; 104:1049-1058. [PMID: 33097362 PMCID: PMC8021612 DOI: 10.1016/j.pec.2020.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/22/2020] [Accepted: 10/02/2020] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Patient-provider communication is essential for patient-centered care, yet Asian American immigrant populations face barriers. We aim to describe: 1) patient-reported communication-related characteristics for 16 disaggregated Asian American subgroups; and 2) the association of patient comprehension of provider communication with socio-demographics, language proficiency and concordance, and perceived cultural sensitivity in this population. METHODS Descriptive statistics are presented for 1269 Asian American immigrants responding to cross-sectional, venue-sampled surveys conducted in New York City. Logistic regression models examine predictors of low comprehension of provider communication. RESULTS Approximately 11% of respondents reported low comprehension of provider communication: lowest among South Asians and highest among Southeast Asians. Eighty-four percent were language-concordant with their provider, 90.1% agreed that their provider understood their background and values, and 16.5% felt their provider looked down on them. Low comprehension of provider communication was significantly associated with Southeast Asian subgroup, less education, limited English proficiency, public health insurance, patient-provider language discordance, and perceived low cultural understanding. CONCLUSION Among our sample, language and cultural sensitivity are associated with comprehension of provider communication. PRACTICE IMPLICATIONS Strategies improving language access and cultural sensitivity may be important for Asian immigrant patients. These could include interpretation services, bilingual community-based providers, and cultural sensitivity training.
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Affiliation(s)
| | - Laura C Wyatt
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Monique M Turner
- Department of Communication, Michigan State University, East Lansing, MI, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Simona C Kwon
- Department of Population Health, New York University School of Medicine, New York, NY, USA.
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