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Romero V, Donaldson H. Human-centred design thinking and public health education: A scoping review. Health Promot J Austr 2024; 35:688-700. [PMID: 37643841 DOI: 10.1002/hpja.802] [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: 06/15/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
ISSUE ADDRESSED Human-centred design thinking (HCDT) is gaining traction to develop appropriate public health interventions. The HCDT process helps frame problems with intention and encourages experimentation through collaboration. Public health graduates need an expanded toolkit to solve both the complex known problems of today, and the adaptability to solve the unknown problems of tomorrow. But how is the health promotion workforce being prepared with this innovation capability? This scoping review aims to provide a pedagogical understanding of teaching HCDT in public health education. METHODS The Arksey & O'Malley framework is used to structure this review. Peer-reviewed articles written from 2000 to 2023 across eight databases were analysed. The data extracted included: author/year, setting, aim/purpose, participants, HCDT framework, HCDT methods, outcomes and challenges. RESULTS Nine relevant publications were included from a total of 208 records. The first reported use of HCDT in public health and health promotion teaching was in 2015. Teaching inspiration drew from established HCDT frameworks: d.school and IDEO which promote the iterative process of empathy/inspiration, ideation and testing/implementation. CONCLUSIONS HCDT has been used for both designing public health curricula and for teaching students to apply it in their practice. First, HCDT methods can be used to problem-solve teaching and learning issues such as creating inviting learning environments and designing an HCDT unit. Second, the teaching of HCDT can prepare and equip the public health workforce to solve problems requiring tailored solutions from an empathetic and iterative stance working as a team. The teaching and practice of HCDT exemplifies the process of social innovation in health promotion. SO WHAT?: As an emerging field, future studies and applications should include clarifying and evaluating the HCDT stages used. More publications will enable a fuller understanding and potentially advocate the necessity of teaching and learning HCDT in public health and health promotion.
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Affiliation(s)
- Vivian Romero
- Central Queensland University, Melbourne, Victoria, Australia
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Azman N, Leong Bin Abdullah MFI, Musa KI, Hassan N, Mohd Shariff N. Prospective cohort study of unmet supportive care needs, post-traumatic growth, coping strategy and social supports among patients with breast cancer: The PenBCNeeds study. J Psychosoc Oncol 2024:1-21. [PMID: 38449103 DOI: 10.1080/07347332.2024.2325498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE While the unmet healthcare needs are still being improved upon, the wellbeing of cancer patients has increasingly become a prime concern in Malaysia. The objective of this study is to ascertain the trend of unmet supportive care needs, post-traumatic growth (P T G), coping strategies, and social supports among patients with breast cancer over the three time points of treatment: T1 at early diagnosis, T2 for three months after diagnosis, and T3 for six months after diagnosis. METHODS A total of 240 cancer patients participated in this prospective cohort study, with follow-up visits from October 2019 until July 2021. Data were collected using several instruments: Brief COP E, the Source of Social Support Scale (SSSS), the Post-Traumatic Growth Inventory - Short Form (P T GI-SF), and a Malay version of the 34-Item Shortform Supportive Care Need Survey (SCNS-SF34). RESULTS The results indicated a significant change from T1 to T3 for all domains of the unmet needs (p-value < 0.001), except for the sexual domain. A lower SCNS-SF34 score resulted from more unfavorable social support. The P T GI-SF results indicated a trend toward meeting the unmet needs, and a higher SCNS-SF-34 score predicted a considerably higher P T GI-SF score. CONCLUSIONS Our study findings suggest that majority of the factors evaluated in terms of unmet needs among cancer patients have undergone considerable changes.
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Affiliation(s)
- Nizuwan Azman
- Unit of Biostatistics and Bioinformatics, Division of Research and Networking, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Malaysia
| | | | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Norsuraya Hassan
- Faculty of Health Sciences, Universiti Teknologi MARA, Cawangan Pulau Pinang, Kepala Batas, Malaysia
| | - Noorsuzana Mohd Shariff
- Department of Community Health, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Malaysia
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Naqvi WM, Naqvi I, Mishra GV, Vardhan V. The Dual Importance of Virtual Reality Usability in Rehabilitation: A Focus on Therapists and Patients. Cureus 2024; 16:e56724. [PMID: 38646260 PMCID: PMC11032731 DOI: 10.7759/cureus.56724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Virtual reality (VR) has advanced in medical education and rehabilitation from basic graphical applications due to its ability to generate a virtual three-dimensional (3D) environment. This environment is mostly used to practice professional skills, plan surgery procedures, simulate surgeries, display 3D anatomy, and rehabilitate various disorders. VR has transformed the field of rehabilitation therapy by providing immersive and engaging experiences that go beyond traditional bounds, significantly improving patient care and therapeutic results. Considering the direct impact of VR on the efficacy of the treatment for both therapists and patients, its dual significance for usability and user experience cannot be overstated. The purpose of this article is to determine the synergistic association between VR accessibility and the rehabilitation process, highlighting the significance of VR technology in designing the future of rehabilitation therapy and demonstrating how advancing VR technology can improve therapeutic outcomes despite overcoming obstacles encountered during VR usage. In conclusion, VR offers a personalized, efficient, interesting, and engaging rehabilitative environment for patients, while also assisting therapists in cultivating empathy and efficiency and encouraging innovative approaches in treatment procedures.
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Affiliation(s)
- Waqar M Naqvi
- Interdisciplinary Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, ARE
| | - Ifat Naqvi
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vishnu Vardhan
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Ouattara M, Sié A, Seynou M, Kagoné M, Bountogo M, Kouanda I, Ouédraogo R, Bangha M, Juma K, Athero S. Profil des utilisatrices et facteurs associés à la satisfaction des clientes de la qualité des soins après avortement au Burkina Faso: étude transversale menée dans six régions. Sex Reprod Health Matters 2024; 31:2272483. [PMID: 38189431 PMCID: PMC10810668 DOI: 10.1080/26410397.2023.2272483] [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: 01/09/2024] Open
Abstract
RésuméMalgré la dépénalisation de l'avortement et la gratuité des soins après avortement (SAA), les femmes Burkinabè vivent des relations difficiles avec les soignants. Cette étude vise à déterminer le profil des femmes recevant des SAA, leur perception de la qualité des SAA et ses déterminants dans des structures sanitaires publiques et confessionnelles du pays. Une enquête quantitative a été menée auprès de 2174 femmes vues pour des SAA et recrutées de façon exhaustive de 2018 à 2020. Un questionnaire structuré a été administré à la sortie des soins. Une analyse uni-, bi- et multivariée a été faite. La majorité des clientes de SAA vivait en milieu rural (55%), avait 25 ans et plus (60%), vivait en couple (87%) et était sans-emploi (59%). La grossesse était non désirée chez 17% des femmes et 4% d'entre elles souhaitaient avorter. La satisfaction globale de la qualité des SAA était de 84%. Dans l'analyse multivariée, ses déterminants étaient la résidence en milieu rural (OR = 1.80 [1.38; 2.34]), un niveau scolaire primaire (OR = 1.48 [1.06; 2.07]) ou secondaire (OR = 1.95 [1.38; 2.74]), et avoir eu au moins un enfant (OR = 1.43 [1.02; 2.00]). Les facteurs associés à une faible satisfaction des SAA étaient une grossesse non désirée (OR = 0.64 [0.46; 0.89]) ou avoir souhaité avorter (OR = 0.09 [0.05; 0.16]). Le niveau de satisfaction globale est acceptable mais faible chez les clientes ayant souhaité avorter. Il est fondamental d'organiser un programme de formation des professionnels des SAA sur la communication, la relation interpersonnelle et l'empathie pendant les soins de santé.
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Affiliation(s)
- Mamadou Ouattara
- Chercheur, MD, épidémiologiste et Biostatisticien, Centre de recherche en santé de Nouna, Nouna, Burkina Faso. Correspondence:
- Chercheur, Directeur, MD, épidémiologiste, Centre de recherche en santé de Nouna, Nouna, Burkina Faso
| | - Ali Sié
- Scientifique d'appui (Guest Scientist), Institut de santé mondiale de Heidelberg, Heidelberg, Allemagne
- Chercheur associé, Université de Californie à San Francisco, San Francisco, États-Unis
- Chercheure, épidémiologiste, Centre de recherche en santé de Nouna, Nouna, Burkina Faso
| | - Mariam Seynou
- Enseignant chercheur, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - Moubassira Kagoné
- Chercheur, socio-anthropologue, Centre de recherche en santé de Nouna, Nouna, Burkina Faso
| | - Mamadou Bountogo
- Chercheure, épidémiologiste, Centre de recherche en santé de Nouna, Nouna, Burkina Faso
| | - Idrissa Kouanda
- Gestionnaire des bases de données, Centre de recherche en santé de Nouna, Nouna, Burkina Faso
| | - Ramatou Ouédraogo
- Chercheure, socio-anthropologue, Centre africain de recherche sur la population et la santé, Nairobi, Kenya
| | - Martin Bangha
- Chercheur, démographe, Centre africain de recherche sur la population et la santé, Nairobi, Kenya
| | - Kenneth Juma
- Statisticien, Centre africain de recherche sur la population et la santé, Nairobi, Kenya
| | - Sherine Athero
- Gestionnaire des bases de données, Centre africain de recherche sur la population et la santé, Nairobi, Kenya
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Khalil GE, McLean D, Ramirez E, Mihaj PP, Zhao B, Dhar B, Khan M. Developing a text-message library for tobacco prevention among adolescents: A qualitative study. PLoS One 2024; 19:e0296503. [PMID: 38175835 PMCID: PMC10766181 DOI: 10.1371/journal.pone.0296503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION Communicating the risks associated with nicotine and tobacco use to adolescents can be challenging, especially with the current tobacco market's attempt to capture the attention of youths. Text message interventions have emerged to address the need to improve tobacco risk communication. This article informs the design of a message library for tobacco risk communication that is based on the transtheoretical model and addresses the risk of multiple tobacco products. METHODS We draw findings from this study from two phases. Phase 1 involved six remote focus group discussions (n = 25) and an in-depth interview, and Phase 2 involved online ideation sessions (n = 11) that led to the current version of the messages. We conducted the study within a larger project for the design and testing of a tobacco prevention program. With thematic analysis and the affinity mapping technique, two research team members identified repeated topics and relevant quotes to organize them into themes and subthemes. RESULTS In Phase 1, thematic analysis revealed four major themes: 1) Adolescents' gap in tobacco knowledge, 2) Social influence and popularity, 3) Attitude toward marketing, and 4) Text message framing preferences. During Phase 2, participants generated 1-to-7 iterations of the original messages. Votings and discussions resulted in a library of 306 messages under 7 sections, categorized based on the processes of change from the transtheoretical model. CONCLUSION The current study presents key insights crucial for developing and evaluating a library of tobacco prevention text messages that is scientifically valid and successfully resonates with today's adolescents. Our future plan is to go beyond this initial message development and vet the message library by adolescents and expert reviewers in tobacco risk communication. Future research may consider developing messages that are tailored based on gender, ethnicity, and other factors that are predictive of tobacco use.
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Affiliation(s)
- Georges Elias Khalil
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, United States of America
| | - David McLean
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, United States of America
| | - Erica Ramirez
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, United States of America
| | - Paris Piere Mihaj
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, United States of America
| | - Bairu Zhao
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, United States of America
| | - Biswadeep Dhar
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, United States of America
| | - Meerah Khan
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, United States of America
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Jin J, Ikeda H. The Role of Empathic Communication in the Relationship between Servant Leadership and Workplace Loneliness: A Serial Mediation Model. Behav Sci (Basel) 2023; 14:4. [PMID: 38275346 PMCID: PMC10812758 DOI: 10.3390/bs14010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Researchers have increasingly concentrated on loneliness in the workplace as a crucial factor influencing the mental health of employees and the viability of telework. In contrast, the current understanding of the strategies mitigating workplace loneliness and how leaders utilize their behaviors to impact followers' loneliness remains limited. Since servant leadership values the emotional needs of followers and displays a high level of empathy, this study investigated the direct and indirect effects of servant leadership on workplace loneliness. In this study, 267 employees (mean age = 31.5 years) from 28 provinces in China were recruited to participate in this survey. We proposed that servant leaders motivate their own empathic communication and other followers' empathic communication to reduce lonely followers' workplace loneliness. This research further examined the relationship between the leader's and colleagues' empathic communication, and the two jointly mediate the connection between servant leadership and followers' workplace loneliness. We constructed a serial mediation model to examine the relationships between servant leadership, leader's empathic communication, colleagues' empathic communication, and workplace loneliness. The results indicate that servant leadership creates a cycle of empathy and provides insights into building a culture of empathy to improve employee well-being.
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Affiliation(s)
- Jiaying Jin
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka 8190382, Japan
| | - Hiroshi Ikeda
- Faculty of Human-Environment Studies, Kyushu University, Fukuoka 8190382, Japan
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Sheffer CE, Shevorykin A, Freitas-Lemos R, Vantucci D, Carl E, Bensch L, Marion M, Erwin DO, Smith PH, Williams JM, Ostroff JS. Advancing Proficiencies for Health Professionals in the Treatment of Tobacco Use Among Marginalized Communities: Development of a Competency-Based Curriculum and Virtual Workshop. Subst Abus 2023; 44:313-322. [PMID: 37842906 DOI: 10.1177/08897077231200987] [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: 10/17/2023]
Abstract
BACKGROUND Tobacco-related disparities are a leading contributor to health inequities among marginalized communities. Lack of support from health professionals is one of the most cited barriers to tobacco cessation reported by these communities. Improving the proficiencies with which health professionals incorporate social and cultural influences into therapeutic interactions has the potential to address this critical barrier. In general, training to improve these proficiencies has shown promise, but the specific proficiencies required for treating tobacco use among marginalized communities are unknown. This project aimed to develop a competency-based curriculum to improve these proficiencies among health professionals with experience and training in the evidence-based treatment of tobacco use, and then pilot test the content delivered via an expert review of a virtual, self-paced workshop. METHODS We used the Delphi Technique to systematically identify the specific competencies and corresponding knowledge and skill sets required to achieve these proficiencies. Educational content was developed to teach these competencies in a virtual workshop. The workshop was evaluated by 11 experts in the field by examining pre- and post-training changes in perceived knowledge, skill, and confidence levels and other quantitative and qualitative feedback. Repeated measures analysis of variance and paired sample t-tests were used to examine pre-post training differences. RESULTS Six competencies and corresponding skill sets were identified. After exposure to the virtual workshop, the experts reported significant increases in the overall proficiency for each competency as well as increases in nearly all levels of knowledge, skill, and confidence within the competency skill sets. Qualitative and quantitative findings indicate that content was relevant to practice. CONCLUSIONS These findings provide preliminary support for 6 competencies and skills sets needed to improve therapeutic interpersonal interactions that recognize the importance of social and cultural influences in the treatment of tobacco use.
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Affiliation(s)
- Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | - Darian Vantucci
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lindsey Bensch
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Matthew Marion
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Deborah O Erwin
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Philip H Smith
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, OH, USA
| | - Jill M Williams
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Winter R, Ward A, Norman RI, Howick J. A survey of clinical empathy training at UK medical schools. BMC MEDICAL EDUCATION 2023; 23:40. [PMID: 36658502 PMCID: PMC9850684 DOI: 10.1186/s12909-022-03993-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The benefits of enhancing practitioner empathy include better patient outcomes and improved job satisfaction for practitioners. Evidence suggests empathy can be taught and empathy is listed as an outcome for graduates in the General Medical Council requirements. Despite this, empathy training is not mandatory on medical school curricula and the extent to which medical students are given empathy-specific training is unknown. AIM To conduct a survey of empathy training currently offered to medical students in UK medical schools. METHODS An invitation to participate in an online survey was sent to all UK medical schools (n = 40). The survey was developed through a consultancy and pilot process to ensure validity and reliability. Questions explored what empathy-focused training is offered, and asked educators whether or not they believed that current provision of empathy training is sufficient. In parallel, medical school websites were searched to identify what information regarding empathy-focused training is described as being part of the degree course. Descriptive statistics were used to describe empathy training delivery from the results of the online materials survey and closed survey questions. Thematic analysis was used to explore free text comments. RESULTS Response rate was 70% (28/40), with 28 medical schools included in the analysis. Twenty-six schools reported that their undergraduate curriculum included some form of empathy-focused training with variation in what, when and how this is delivered. Thematic analysis revealed two overarching themes with associated sub-themes: (i) empathy-focused training and development (considering where, when and how empathy training should be integrated); (ii) challenges presented by including empathy on the curriculum (considering the system, students and faculty). All schools agreed empathy training should be on the undergraduate curriculum. CONCLUSION This is the first nationwide survey of empathy-focused training at UK medical schools. While some form of empathy-focused training appears to be provided on the undergraduate curriculum at most UK medical schools, empathy is rarely specifically assessed. Most medical educators do not feel their school does enough to promote empathy and the majority would like to offer more.
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Affiliation(s)
- Rachel Winter
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, George Davies Centre, University of Leicester, University Road, LE1 7RH, Leicester, England.
| | - Andy Ward
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, George Davies Centre, University of Leicester, University Road, LE1 7RH, Leicester, England
| | - Robert I Norman
- Leicester Medical School, College of Life Sciences University of Leicester, George Davies Centre, LE1 7RH, Leicester, England
| | - Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, George Davies Centre, University of Leicester, University Road, LE1 7RH, Leicester, England
- The Oxford Empathy Programme, Faculty of Philosophy, University of Oxford, OX2 6GG, Oxford, England
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Seidenfeld J, Ramos K, Bruening RA, Sperber NR, Stechuchak KM, Hastings SN. Patient experiences of a care transition intervention for Veterans to reduce emergency department visits. Acad Emerg Med 2023; 30:388-397. [PMID: 36630213 DOI: 10.1111/acem.14661] [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: 09/02/2022] [Revised: 12/19/2022] [Accepted: 01/08/2023] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Care transition interventions (CTIs) are used to improve outcomes after an emergency department (ED) visit. A recent randomized controlled trial of a Veterans Health Administration (VHA) CTI titled Discharge Information and Support for Patients receiving Outpatient care in the ED (DISPO ED) demonstrated no difference in repeat ED visits. However, changes in health care utilization are not the only measures of a CTI worth evaluation, and there is interest in using patient-centered outcomes to assess CTIs as well. To inform future CTI design and outcome measure selection, the study aims were to understand how patients experienced the CTI and what elements they valued. METHODS This was a qualitative study of participants randomized to the intervention arm of the DISPO ED trial using semistructured interviews. The interview guide included questions about clinical health and other issues addressed by the study nurse, the most and least helpful aspects of the intervention, and impacts of the intervention on their perceptions of self-management. Interviews were analyzed using directed content analysis. RESULTS Our sample comprised 24 participants, with average age of 61 years, 58% male, and 50% Black or African American. We identified six major themes related to (1) experiences during the intervention and (2) elements they valued. Patients reported clinical health coaching recommendations covering a wide range of topics as well as care coordination actions such as appointment scheduling. Valuable elements of the intervention highlighted personal characteristics of the study nurse that promoted a sense of interpersonal connection and empathy in their interactions. CONCLUSIONS Intervention users described assistance with care coordination as well as clinical concerns. We identified aspects that were highly valued by the participants, such as interpersonal support and empathy from the interventionist. These findings suggest the need for more comprehensive nonutilization outcome measures for CTIs to capture the patient's perspective.
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Affiliation(s)
- Justine Seidenfeld
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, North Carolina, USA.,Department of Emergency Medicine, Durham VA Health Care System, Durham, North Carolina, USA.,Division of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Katherine Ramos
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, North Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Center for the Study of Human Aging and Development, Duke University School of Medicine, Durham, North Carolina, USA
| | - Rebecca A Bruening
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, North Carolina, USA
| | - Nina R Sperber
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, North Carolina, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Karen M Stechuchak
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, North Carolina, USA
| | - Susan N Hastings
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, North Carolina, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Center for the Study of Human Aging and Development, Duke University School of Medicine, Durham, North Carolina, USA.,Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, North Carolina, USA
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Kanagasabai PS, Filoche S, Grainger R, Henry C, Hay-Smith J. Interventions to improve access to care for abnormal uterine bleeding: A systematic scoping review. Int J Gynaecol Obstet 2023; 160:38-48. [PMID: 35429335 PMCID: PMC10084285 DOI: 10.1002/ijgo.14224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Women with abnormal uterine bleeding (AUB) experience barriers to accessing healthcare services. OBJECTIVES To identify and describe the evidence on interventions to improve healthcare access of women with AUB. SEARCH STRATEGY A systematic search of databases including Medline, CINAHL, EMBASE, Scopus, and Cochrane register for clinical trials on February 26, 2021. SELECTION CRITERIA Studies including women with AUB and investigating an intervention to improve access at the levels of individual patient, community, organization, health system, or medical education. DATA COLLECTION AND ANALYSIS Data extraction and descriptive analysis of the country, study design, settings, participant characteristics, intervention, outcome measures, and key findings. MAIN RESULTS We identified 20 studies and most interventions (13 studies) targeted organizational changes. Creating a multidisciplinary team, bringing services together and developing a care pathway improved the availability of services. Management of AUB in an outpatient setting improved the affordability. The use of decision aids improved patient engagement in consultations. There is a lack of interventions at an individual or community level targeting health literacy, health beliefs, social acceptability, and opportunity to reach and pay for services. CONCLUSIONS Community-based culturally-adapted interventions focusing on access to women with different socio-economic and cultural backgrounds should be investigated.
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Affiliation(s)
| | - Sara Filoche
- Department of Obstetrics, Gynaecology and Women's Health, University of Otago Wellington, Wellington, New Zealand
| | - Rebecca Grainger
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Claire Henry
- Department of Obstetrics, Gynaecology and Women's Health, University of Otago Wellington, Wellington, New Zealand
| | - Jean Hay-Smith
- Rehabilitation Teaching and Research Institute, University of Otago Wellington, Wellington, New Zealand
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11
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Winter R, Leanage N, Roberts N, Norman RI, Howick J. Experiences of empathy training in healthcare: A systematic review of qualitative studies. PATIENT EDUCATION AND COUNSELING 2022; 105:3017-3037. [PMID: 35811257 DOI: 10.1016/j.pec.2022.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/27/2022] [Accepted: 06/26/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To synthesise qualitative studies reporting student, practitioner, or patient experiences of empathy-training in healthcare. METHODS We included qualitative studies exploring (i) student or practitioner experiences of empathy training, or (ii) patient experiences of being treated by someone who has undergone empathy training. We used the Critical Appraisal Skills Programme (CASP) tool to assess study quality. Thematic synthesis was used to integrate findings from studies and to generate new insights. RESULTS Our search yielded 2768 citations, of which 23 (1487 participants) met inclusion criteria. Two clusters of themes were identified from included studies. Firstly, themes related to practitioner/trainee professionalism and wellbeing, where the main finding was that participants experienced benefit from therapeutic empathy training. Secondly, themes related to the understanding and treatment of patients, where the main finding was practitioners' deeper recognition of the positive impact of empathic care. CONCLUSIONS This review found that taking part in empathy-focused training can benefit practitioner/student personal growth and professional development, and benefits patient care. This review is limited by the difficulty in defining empathy and heterogeneity amongst included studies. PRACTICE IMPLICATIONS These results support a rationale for empathy training and the development of a framework to ensure training is having the desired effect.
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Affiliation(s)
- Rachel Winter
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom.
| | - Navin Leanage
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford OX1 3BG, United Kingdom
| | - Robert I Norman
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom
| | - Jeremy Howick
- Faculty of Philosophy, University of Oxford, Oxford OX2 6GG, United Kingdom
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12
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Ten-year mixed-method evaluation of prelicensure health professional student self-reported learning in an interfaculty pain curriculum. Pain Rep 2022; 7:e1030. [PMID: 36128043 PMCID: PMC9478270 DOI: 10.1097/pr9.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/21/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction: Student perspectives on interprofessional pain education are lacking. Objectives: The purpose of this study was to evaluate ratings of knowledge acquisition and effective presentation methods for prelicensure health professional students attending the University of Toronto Centre for the Study of Pain Interfaculty Pain Curriculum (Canada). Methods: A 10-year (2009–2019) retrospective longitudinal mixed-methods approach comprising analysis and integration of quantitative and qualitative data sets was used to evaluate 5 core University of Toronto Centre for the Study of Pain Interfaculty Pain Curriculum learning sessions. Results: A total of 10, 693 students were enrolled (2009–2019) with a mean annual attendance of 972 students (±SD:102). The mean proportion of students rating “agree/strongly agree” for knowledge acquisition and effective presentation methods across sessions was 79.3% (±SD:3.4) and 76.7% (±SD:6.0), respectively. Knowledge acquisition or presentation effectiveness scores increased, respectively, over time for 4 core sessions: online self-study pain mechanisms module (P = 0.03/P < 0.001), online self-study opioids module (P = 0.04/P = 0.019), individually selected in-person topical pain sessions (P = 0.03/P < 0.001), and in-person patient or interprofessional panel session (P = 0.03). Qualitative data corroborated rating scores and expanded insight into student expectations for knowledge acquisition to inform real-world clinical practice and interprofessional collaboration; presentation effectiveness corresponded with smaller session size, individually selected sessions, case-based scenarios, embedded knowledge appraisal, and opportunities to meaningfully interact with presenters and peers. Conclusion: This study demonstrated positive and increasing prelicensure student ratings of knowledge acquisition and effective presentation methods across multifaceted learning sessions in an interfaculty pain curriculum. This study has implications for pain curriculum design aimed at promoting students' collaborative, patient-centered working skills. See commentary: Trouvin A-P. “Ten-year mixed method evaluation of prelicensure health professional student self-reported learning in an interfaculty pain curriculum”: a view on pain education. PAIN Rep 2022;7:e1031. Students attending learning sessions at the University of Toronto Interfaculty Pain Curriculum (2009–2019) in Toronto, Canada, self-report high ratings of knowledge acquisition and effective presentation methods.
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13
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Hori M, Yoshikawa E, Hayama D, Sakamoto S, Okada T, Sakai Y, Fujiwara H, Takayanagi K, Murakami K, Ohnishi J. Sense of Coherence as a Mediator in the Association Between Empathy and Moods in Healthcare Professionals: The Moderating Effect of Age. Front Psychol 2022; 13:847381. [PMID: 35548503 PMCID: PMC9083206 DOI: 10.3389/fpsyg.2022.847381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/31/2022] [Indexed: 12/03/2022] Open
Abstract
While empathy is considered a critical determinant of the quality of medical care, growing evidence suggests it may be associated with both one’s own positive and negative moods among healthcare professionals. Meanwhile, sense of coherence (SOC) plays an essential role in the improvement of both psychological and physical health. Reportedly, individual SOC reaches full stability after around age 30. The aim of this study was first to evaluate the mediatory role of SOC on the association between empathy and individual moods among 114 healthcare professionals in a general hospital, and then to examine the moderating effect of age on this association. Participants completed a range of self-report demographic questionnaires, Empathy Process Scale (EPS), the 13-item Antonovsky’s SOC, and Profile of Mood States (POMS). Findings showed that SOC mediated the relations between empathy (EPS) and both POMS-Vigor (POMS-V: self-vigor mood) and POMS-Depression (POMS-D: self-depression mood). Notably, moderated mediation analysis revealed that there was a significant interaction (age × SOC) on self-vigor mood (POMS-V) in healthcare professionals. The indirect effect of empathy (EPS) on self-vigor mood (POMS-V) through SOC was significant at over mean age “32.83.” Although there was no significant interaction with age regarding the indirect effect of empathy (EPS) on self-depression mood (POMS-D), in the sub-category level analysis of empathy (EPS), we found a significant interaction item [age × empathy for other’s negative affect (EPS-N)] on SOC. This indirect effect was also significant at over mean age “32.83.” Taken, together, the current study highlighted the significant mediator of SOC on that empathy amplifies self-vigor mood and attenuates self-depression mood as a protective factor among the Japanese healthcare professionals. Some components of these processes may depend on the moderating role of age, indicating that we may need to consider the SOC development with age for more effective empathy performance interventions among healthcare professionals.
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Affiliation(s)
- Miyo Hori
- Foundation for Advancement of International Science, Tsukuba, Japan
| | - Eisho Yoshikawa
- Department of Medical Psychology, Nippon Medical School, Tokyo, Japan.,Department of Neuropsychology, Nippon Medical School, Tokyo, Japan
| | - Daichi Hayama
- Faculty of Commerce, Chuo Gakuin University, Chiba, Japan
| | - Shigeko Sakamoto
- Foundation for Advancement of International Science, Tsukuba, Japan
| | - Tsuneo Okada
- Department of Rehabilitaion, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Yoshinori Sakai
- Department of Gastroenterology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | | | | | - Kazuo Murakami
- Foundation for Advancement of International Science, Tsukuba, Japan
| | - Junji Ohnishi
- Foundation for Advancement of International Science, Tsukuba, Japan.,Department of Food and Nutrition, Tokyo Kasei University, Tokyo, Japan
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14
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Jemal K, Samuel A, Geta A, Desalegn F, Gebru L, Tadele T, Genet E, Abate M, Tafesse N. Evaluation of compassionate and respectful care implementation status in model healthcare facilities: a cross-sectional study. Arch Public Health 2022; 80:84. [PMID: 35296349 PMCID: PMC8924571 DOI: 10.1186/s13690-022-00845-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Compassionate respectful, and caring (CRC) creates a pleasant environment for health workforce (HWF), customers, and families. For the past five years, the Ethiopian Ministry of Health (EMoH) has developed a CRC plan to improve person-centered care. Therefore, we aimed to assess the implementation status of CRC and associated factors in the 16 model health facilities (MHFs) in Ethiopia. Methods A cross-sectional study was employed from February to April 2021. A structured and semi-structured questionnaire was used to assess the level of CRC implementation in model health care facilities. Epi-data version 4.3 and SPSS version 26 software were used for data entry and analysis, respectively. Binary logistic regressions analysis was used and significance was obtained at the odds ratio with a 95% confidence interval and P-value < 0.05. Results A total of 429 HWF participated in a self-administered questionnaire. The prevalence of compassionate and respectful care among HWF were 60.4%, and 64% respectively. Nurse professionals, midwives, having training on CRC, leader promoting CRC, having a conducive working environment and burnout management for HWF were significantly associated with compassionate care practice. Leaders promoting CRC, having a conducive working environment, and burnout management for HWF were significantly associated with respectful care practice. Conclusion The findings identified distinct issues related to CRC implementation in each 16 MHF. Addressing HWF skill gaps, a conducive working environment, and burnout management are encouraged CRC continuity. Incorporate CRC in pre-service education, health system strengthening, and motivating HWF are important for CRC strategic implementation.
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Affiliation(s)
- Kemal Jemal
- Department of Nursing, College of medical and Health Sciences, Salale University, Fitche, Ethiopia.
| | - Assegid Samuel
- Ministry of Health Ethiopia, Human Resource Development Directorate, Addis Ababa, Ethiopia
| | - Abiyu Geta
- Ministry of Health Ethiopia, Human Resource Development Directorate, Addis Ababa, Ethiopia
| | - Fantanesh Desalegn
- Ministry of Health Ethiopia, Human Resource Development Directorate, Addis Ababa, Ethiopia
| | - Lidia Gebru
- Ministry of Health Ethiopia, Human Resource Development Directorate, Addis Ababa, Ethiopia
| | - Tezera Tadele
- Ministry of Health Ethiopia, Human Resource Development Directorate, Addis Ababa, Ethiopia
| | - Ewnetu Genet
- Ministry of Health Ethiopia, Human Resource Development Directorate, Addis Ababa, Ethiopia
| | - Mulugeta Abate
- Ethiopian Public Health Association, Addis Ababa, Ethiopia
| | - Nebiyou Tafesse
- Department of Public Health, Menelik II Medical and Health Sciences College, Kotebe University of Education, Addis Ababa, Ethiopia
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15
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Posttraumatic growth and its association with unmet supportive care needs and fear of cancer progression among head and neck cancer patients. PLoS One 2022; 17:e0265502. [PMID: 35290419 PMCID: PMC8923508 DOI: 10.1371/journal.pone.0265502] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/02/2022] [Indexed: 01/04/2023] Open
Abstract
Background and aims The assessment of supportive care needs and fear of cancer progression are important variables to be considered when evaluating the psychological aspects of cancer patients. However, data on how these variables affect posttraumatic growth (PTG) are lacking. This study aimed to investigate the level of PTG among head and neck cancer (HNC) patients within the first year of cancer diagnosis and to determine the association between unmet supportive care needs, fear of cancer progression, and the level of PTG. Methods Participants were administered socio-demographic and clinical characteristics questionnaire; the 34-item Supportive Care Needs Survey (SCNS-34) to measure the unmet needs; 12-item Fear of Progression Questionnaire-Short Form (FoP-Q-SF) to measure the fear of progression of cancer; and the Posttraumatic Growth Inventory—Short Form (PTGI-SF) to measure the degree of PTG. Results A total of 190 HNC participants reported a mean total PTGI-SF score of 39.3 (standard deviation = 9.5). General linear model revealed that higher degree of patients’ physical and daily living unmet needs and fear of cancer progression significantly predicted lower PTG, after controlling for sociodemographic and clinical factors. Conclusion HNC patients within the first year of cancer diagnosis reported a high level of PTG. Despite that, psychosocial intervention for HNC patients should emphasize on counteracting patients’ physical and daily living unmet needs and fear of cancer progression to improve the psychological well-being of patients.
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16
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Leverton M, Burton A, Beresford-Dent J, Rapaport P, Manthorpe J, Mansour H, Guerra Ceballos S, Downs M, Samus Q, Dow B, Lord K, Cooper C. 'You can't just put somebody in a situation with no armour'. An ethnographic exploration of the training and support needs of homecare workers caring for people living with dementia. DEMENTIA 2021; 20:2982-3005. [PMID: 34111969 PMCID: PMC8678657 DOI: 10.1177/14713012211023676] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Homecare workers carry out complex work with people living with dementia, while under-supported, undervalued and undertrained. In this ethnographic study, we explore the skills, training and support needs of homecare workers supporting people living with dementia. RESEARCH DESIGN AND METHODS We conducted 82 interviews with people living with dementia (n = 11), family caregivers (n = 22), homecare staff (n = 30) and health and social care professionals (n = 19) and conducted 100-hours of participant observations with homecare workers (n = 16). We triangulated interview and observational findings and analysed data thematically. RESULTS We developed four themes: 1) 'Navigating the homecare identity and role': describing challenges of moving between different role identities and managing associated expectations, 2) 'Developing and utilising relational and emotional skills': boundaries between caring and getting emotionally involved felt blurred and difficult to manage, 3) 'Managing clients who resist care': homecare workers experienced clients' reactions as challenging and felt "thrown to the wolves" without sufficient training, and 4) 'Drawing on agency and team support': homecare work could be isolating, with no shared workplace, busy schedules and limited opportunity for peer support. DISCUSSION AND IMPLICATIONS It is important that training and support for homecare workers addresses the relational, emotional and rights-based aspects of the role. Where a flexible, responsive, person-centred service is required, corresponding training and support is needed, alongside organisational practices, taking account of the broader context of the homecare sector.
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Affiliation(s)
- Monica Leverton
- Division of Psychiatry, 4919University College London, London, UK
| | - Alexandra Burton
- Division of Psychiatry, 4919University College London, London, UK
| | | | - Penny Rapaport
- Division of Psychiatry, University College London, London, UK
| | - Jill Manthorpe
- NIHR Policy Research Unit on Health and Social Care Workforce, 4616King's College London, London, UK
| | - Hassan Mansour
- Division of Psychiatry, 4616University College London, London, UK
| | | | - Murna Downs
- Centre for Applied Dementia Studies, 1905University of Bradford, Bradford, UK
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Briony Dow
- National Ageing Research Institute, Parkville, VIC, Australia; 2281University of Melbourne, Parkville, VIC, Australia; Deakin University, Waurn Ponds, VIC, Australia
| | - Kathryn Lord
- Centre for Applied Dementia Studies, 1905University of Bradford, Bradford, UK
| | - Claudia Cooper
- Division of Psychiatry, 1905University College London, London, UK
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17
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Hall JA, Schwartz R, Duong F, Niu Y, Dubey M, DeSteno D, Sanders JJ. What is clinical empathy? Perspectives of community members, university students, cancer patients, and physicians. PATIENT EDUCATION AND COUNSELING 2021; 104:1237-1245. [PMID: 33234440 DOI: 10.1016/j.pec.2020.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/06/2020] [Accepted: 11/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To explore what undergraduates, community members, oncology patients, and physicians consider empathic behavior in a physician. METHODS 150 undergraduates, 152 community members, 95 physicians, and 89 oncology patients rated 49 hypothetical physician behaviors for how well they fit their personal definition of physician empathy. Dimensions of empathy were explored and compared across groups. RESULTS Three dimensions of empathy were Conscientious and Reassuring, Relationship Oriented, and Emotionally Involved. Relationship Oriented was the most strongly endorsed, followed by Emotionally Involved, with Conscientious and Reassuring coming in last. There were no group differences for Conscientious and Reassuring, but the Relationship Oriented factor was more endorsed by the clinical groups (physicians and patients) than the non-clinical groups. The Emotionally Involved factor was endorsed by physicians notably more than by patients. CONCLUSION What is considered clinical empathy is not the same across individuals and stakeholder groups. PRACTICE IMPLICATIONS Physicians and patients differ in how much they include the physicians' emotionality and emotion-related actions in their definition of empathy. Communication training for physicians that emphasizes behaviors associated with empathy (listening, understanding a person's feelings and perspectives, and showing interest in and concern for the whole person) may enhance patients' perception of clinical empathy.
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Affiliation(s)
- Judith A Hall
- Department of Psychology, Northeastern University, Boston, MA, USA.
| | | | - Fred Duong
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Yuan Niu
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Manisha Dubey
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - David DeSteno
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Justin J Sanders
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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18
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Ilhan E, Pacey V, Brown L, Spence K, Gray K, Rowland JE, White K, Hush JM. Neonates as intrinsically worthy recipients of pain management in neonatal intensive care. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2021; 24:65-72. [PMID: 33034802 DOI: 10.1007/s11019-020-09982-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
One barrier to optimal pain management in the neonatal intensive care unit (NICU) is how the healthcare community perceives, and therefore manages, neonatal pain. In this paper, we emphasise that healthcare professionals not only have a professional obligation to care for neonates in the NICU, but that these patients are intrinsically worthy of care. We discuss the conditions that make neonates worthy recipients of pain management by highlighting how neonates are (1) vulnerable to pain and harm, and (2) completely dependent on others for pain management. We argue for a relational account of ethical decision-making in the NICU by demonstrating how an increase in vulnerability and dependence may be experienced by the healthcare community and the neonate's family. Finally, an ethical framework for decisions around neonatal pain management is proposed, focussing on surrogate decision-making and the importance of compassionate action through both a reflective and an affective empathy. As empathy can be highly motivating against pain, we propose that, in addition to educational programs that raise awareness and knowledge of neonatal pain and pain management, healthcare professionals must cultivate empathy in a collective manner, where all members of the NICU team, including parents, are compassionate decision-makers.
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Affiliation(s)
- Emre Ilhan
- Faculty of Medicine, Health and Human Sciences, Department of Health Professions, Macquarie University, Sydney, NSW, Australia.
- Faculty of Medicine, Health and Human Sciences, Department of Health Professions, Macquarie University, Ground Floor, 75 Talavera Road, Sydney, NSW, 2109, Australia.
| | - Verity Pacey
- Faculty of Medicine, Health and Human Sciences, Department of Health Professions, Macquarie University, Sydney, NSW, Australia
| | - Laura Brown
- Faculty of Medicine, Health and Human Sciences, Department of Health Professions, Macquarie University, Sydney, NSW, Australia
| | - Kaye Spence
- Children's Hospital at Westmead, Grace Centre for Newborn Intensive Care, Sydney, NSW, Australia
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Kelly Gray
- Faculty of Medicine, Health and Human Sciences, Department of Health Professions, Macquarie University, Sydney, NSW, Australia
| | - Jennifer E Rowland
- Faculty of Medicine, Health and Human Sciences, Department of Health Professions, Macquarie University, Sydney, NSW, Australia
| | - Karolyn White
- Research Ethics and Integrity, Macquarie University, Sydney, NSW, Australia
| | - Julia M Hush
- Faculty of Medicine, Health and Human Sciences, Department of Health Professions, Macquarie University, Sydney, NSW, Australia
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19
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Smith KA, Bishop FL, Dambha-Miller H, Ratnapalan M, Lyness E, Vennik J, Hughes S, Bostock J, Morrison L, Mallen C, Yardley L, Everitt H, Little P, Howick J. Improving Empathy in Healthcare Consultations-a Secondary Analysis of Interventions. J Gen Intern Med 2020; 35:3007-3014. [PMID: 32666488 PMCID: PMC7572919 DOI: 10.1007/s11606-020-05994-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 06/15/2020] [Indexed: 11/25/2022]
Abstract
A recent systematic review of randomised trials suggested that empathic communication improves patient health outcomes. However, the methods for training healthcare practitioners (medical professionals; HCPs) in empathy and the empathic behaviours demonstrated within the trials were heterogeneous, making the evidence difficult to implement in routine clinical practice. In this secondary analysis of seven trials in the review, we aimed to identify (1) the methods used to train HCPs, (2) the empathy behaviours they were trained to perform and (3) behaviour change techniques (BCTs) used to encourage the adoption of those behaviours. This detailed understanding of interventions is necessary to inform implementation in clinical practice. We conducted a content analysis of intervention descriptions, using an inductive approach to identify training methods and empathy behaviours and a deductive approach to describe the BCTs used. The most commonly used methods to train HCPs to enhance empathy were face-to-face training (n = 5), role-playing (n = 3) and videos (self or model; n = 3). Duration of training was varied, with both long and short training having high effect sizes. The most frequently targeted empathy behaviours were providing explanations of treatment (n = 5), providing non-specific empathic responses (e.g. expressing understanding) and displaying a friendly manner and using non-verbal behaviours (e.g. nodding, leaning forward, n = 4). The BCT most used to encourage HCPs to adopt empathy behaviours was "Instruction on how to perform behaviour" (e.g. a video demonstration, n = 5), followed by "Credible source" (e.g. delivered by a psychologist, n = 4) and "Behavioural practice" (n = 3 e.g. role-playing). We compared the effect sizes of studies but could not extrapolate meaningful conclusions due to high levels of variation in training methods, empathy skills and BCTs. Moreover, the methods used to train HCPs were often poorly described which limits study replication and clinical implementation. This analysis of empathy training can inform future research, intervention reporting standards and clinical practice.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Lucy Yardley
- University of Southampton , Southampton, UK
- University of Bristol , Bristol, UK
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Russ V, Kovshoff H, Brown T, Abbott P, Hadwin JA. Exploring the Role of Empathy in Understanding the Social-Cognitive Profile for Individuals Referred for Autism Spectrum Disorders Assessment in Adulthood. J Autism Dev Disord 2020; 50:1470-1478. [PMID: 30051187 PMCID: PMC7211188 DOI: 10.1007/s10803-018-3693-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study explored the social-cognitive profile of 173 adults referred for an autism assessment. We considered key dimensional traits (autism, empathy and systemising) to understand social cognition in adults diagnosed with an autism spectrum condition compared with those who were referred for, but did not receive a diagnosis. There were no significant social cognitive differences between groups on measures of emotion recognition and social inference. Adults with a confirmed diagnosis, however, reported fewer empathising traits which were positively associated with social-cognitive understanding. Empathising partially mediated the relationship between diagnostic group and social-cognition. Lower empathising traits in individuals diagnosed in adulthood may be important in understanding challenges with social adaptability. The findings have implications for assessment and highlight the role of empathy in developing social understanding in autism.
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Affiliation(s)
- Victoria Russ
- Developmental Laboratory, Department of Psychology, Centre for Innovation in Mental Health, University of Southampton, Southampton, S017 1BJ, UK.
| | - Hanna Kovshoff
- Developmental Laboratory, Department of Psychology, Centre for Innovation in Mental Health, University of Southampton, Southampton, S017 1BJ, UK
| | - Tony Brown
- Autism Diagnostic Research Centre, 9-19 Rose Road, Southampton, SO14 6TE, UK
| | - Patricia Abbott
- Autism Diagnostic Research Centre, 9-19 Rose Road, Southampton, SO14 6TE, UK
| | - Julie A Hadwin
- Developmental Laboratory, Department of Psychology, Centre for Innovation in Mental Health, University of Southampton, Southampton, S017 1BJ, UK
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21
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Winter R, Issa E, Roberts N, Norman RI, Howick J. Assessing the effect of empathy-enhancing interventions in health education and training: a systematic review of randomised controlled trials. BMJ Open 2020; 10:e036471. [PMID: 32978187 PMCID: PMC7520826 DOI: 10.1136/bmjopen-2019-036471] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To estimate the effect of empathy interventions in health education and training from randomised controlled trials (RCTs). METHODS MEDLINE, PsycINFO, EMBASE, CINAHL and Cochrane databases were searched from inception to June 2019 for RCTs investigating the effect of empathy-enhancing interventions in medical and healthcare students and professionals. Studies measuring any aspect of 'clinical empathy' as a primary or secondary outcome were included. Two reviewers extracted data and assessed the risk of bias of eligible studies using the Cochrane Risk of Bias Tool. Random effects meta-analyses of the impact of empathy training on participants' empathy levels were performed. RESULTS Twenty-six trials were included, with 22 providing adequate data for meta-analysis. An overall moderate effect on participant empathy postintervention (standardised mean difference 0.52, 95% CI 0.36 to 0.67) was found. Heterogeneity across trial results was substantial (I2=63%). Data on sustainability of effect was provided by 11 trials and found a moderate effect size for improved empathy up until 12 weeks (0.69, 95% CI 0.23 to 1.15), and a small but statistically significant effect size for sustainability at 12 weeks and beyond (standardised mean difference 0.34, 95% CI 0.11 to 0.57). In total, 15 studies were considered to be either unclear or high risk of bias. The quality of evidence of included studies was low. CONCLUSION Findings suggest that empathy-enhancing interventions can be effective at cultivating and sustaining empathy with intervention specifics contributing to effectiveness. This review focuses on an important, growing area of medical education and provides guidance to those looking to develop effective interventions to enhance empathy in the healthcare setting. Further high-quality trials are needed that include patient-led outcome assessments and further evaluate the long-term sustainability of empathy training. PROTOCOL REGISTRATION NUMBER PROSPERO (CRD42019126843).
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Affiliation(s)
- Rachel Winter
- College of Life Sciences, University of Leicester, Leicester, UK
| | - Eyad Issa
- College of Life Sciences, University of Leicester, Leicester, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Robert I Norman
- College of Life Sciences, University of Leicester, Leicester, UK
| | - Jeremy Howick
- Faculty of Philosophy, University of Oxford, Oxford, UK
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22
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Starr LT, Magan KC. Model of Empathic Pain Assessment and Treatment in Persons With Dementia. Res Gerontol Nurs 2020; 13:264-276. [PMID: 32286670 DOI: 10.3928/19404921-20200402-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 02/04/2020] [Indexed: 12/21/2022]
Abstract
The current article presents an evidence-based model for understanding clinical empathy's relationship with the assessment and treatment of pain in persons with advanced dementia. A literature review informed creation of an interdisciplinary conceptual framework of clinician empathy in pain assessment and treatment among persons with advanced dementia. Driven by observation of behaviors indicating pain in persons with dementia unable to self-report, the model represents the cognitive, affective, ethical, and behavioral components of clinical empathy involved in assessing and treating pain, relevant patient outcomes, and contextual factors influencing empathy and outcomes; and provides a framework for testing clinical empathy interventions to improve adverse outcomes in persons with advanced dementia. Understanding the relationship between clinician empathy and the assessment and treatment of pain in persons with advanced dementia may improve care quality and help reduce pain behaviors in this patient population. This model may be used to inform pain research in persons with dementia and develop clinical interventions and clinician education programs. [Research in Gerontological Nursing, 13(5), 264-276.].
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Bion J, Brookes O, Brown C, Tarrant C, Archer J, Buckley D, Buckley LM, Clement I, Evison F, Smith FG, Gibbins C, Hayton EJ, Jones J, Lilford R, Mullhi R, Packer G, Perkins GD, Shelton J, Snelson C, Sullivan P, Vlaev I, Wolstenholme D, Wright S. A framework and toolkit of interventions to enhance reflective learning among health-care professionals: the PEARL mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background
Although most health care is high quality, many patients and members of staff can recall episodes of a lack of empathy, respect or effective communication from health-care staff. In extreme form, this contributes to high-profile organisational failures. Reflective learning is a universally promoted technique for stimulating insight, constructive self-appraisal and empathy; however, its efficacy tends to be assumed rather than proven. The Patient Experience And Reflective Learning (PEARL) project has used patient and staff experience to co-design a novel reflective learning framework that is based on theories of behaviour and learning.
Objective
To create a toolkit to help health-care staff obtain meaningful feedback to stimulate effective reflective learning that will promote optimal patient-, family- and colleague-focused behaviours.
Design
A 3-year developmental mixed-methods study with four interlinked workstreams and 12 facilitated co-design meetings. The Capability, Opportunity, Motivation – Behaviour framework was used to describe factors influencing the behaviour of reflection.
Setting
This took place at five acute medical units and three intensive care units in three urban acute hospital trusts in England.
Participants
Patients and relatives, medical and nursing staff, managers and researchers took part.
Data sources
Two anonymous surveys, one for patients and one for staff, were developed from existing UK-validated instruments, administered locally and analysed centrally. Ethnographers undertook interviews and observed clinical care and reflective learning activities in the workplace, as well as in the co-design meetings, and fed back their observations in plenary workshops.
Main outcome measures
Preliminary instruments were rated by participants for effectiveness and feasibility to derive a final set of tools. These are presented in an attractively designed toolbox with multiple sections, including the theoretical background of reflection, mini guides for obtaining meaningful feedback and for reflecting effectively, guides for reflecting ‘in-action’ during daily activities, and a set of resources.
Results
Local project teams (physicians, nurses, patients, relatives and managers) chaired by a non-executive director found the quarterly reports of feedback from the patient and staff surveys insightful and impactful. Patient satisfaction with care was higher for intensive care units than for acute medical units, which reflects contextual differences, but in both settings quality of communication was the main driver of satisfaction. Ethnographers identified many additional forms of experiential feedback. Those that generated an emotional response were particularly effective as a stimulus for reflection. These sources of data were used to supplement individual participant experiences in the nine local co-design meetings and four workshops to identify barriers to and facilitators of effective reflection, focusing on capability, opportunity and motivation. A logic model was developed combining the Capability, Opportunity, Motivation – Behaviour framework for reflection and theories of learning to link patient and staff experience to changes in downstream behaviours. Participants proposed practical tools and activities to enhance reflection ‘in-action’ and ‘on-action’. These tools were developed iteratively by the local and central project teams.
Limitations
Paper-based surveys were burdensome to administer and analyse.
Conclusions
Patients and health-care staff collaborated to produce a novel reflective learning toolkit.
Future work
The toolkit requires evaluating in a cluster randomised controlled trial.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 32. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Julian Bion
- Department of Anaesthesia & Intensive Care Medicine, University of Birmingham, Birmingham, UK
| | - Olivia Brookes
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Celia Brown
- Population Evidence and Technologies, University of Warwick, Coventry, UK
| | - Carolyn Tarrant
- Social Science Applied to Healthcare Improvement Research (SAPPHIRE) Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Julian Archer
- Royal Australasian College of Surgeons, Melbourne, VIC, Australia
| | - Duncan Buckley
- Patient and Public Involvement Representative, Birmingham, UK
| | | | - Ian Clement
- Critical Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Felicity Evison
- Informatics Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Fang Gao Smith
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Chris Gibbins
- Acute Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Emma-Jo Hayton
- Acute Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jennifer Jones
- Social Science Applied to Healthcare Improvement Research (SAPPHIRE) Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Richard Lilford
- Warwick Centre for Applied Health Research and Delivery, University of Warwick, Coventry, UK
| | - Randeep Mullhi
- Critical Care, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Greg Packer
- Critical Care, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Gavin D Perkins
- Critical Care Medicine, Warwick Medical School, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Jonathan Shelton
- Critical Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Catherine Snelson
- Acute Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Critical Care, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Paul Sullivan
- Acute Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Ivo Vlaev
- Behavioural Science Group, University of Warwick, Coventry, UK
| | - Daniel Wolstenholme
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber, Sheffield, UK
| | - Stephen Wright
- Critical Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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24
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Sur D. Interprofessional Intentional Empathy Centered Care (IP-IECC) in healthcare practice: A grounded theory study. J Interprof Care 2020; 35:175-184. [PMID: 32363960 DOI: 10.1080/13561820.2020.1752162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Training interprofessional healthcare teams continues to advance practice for patient-centered care. Empathy research is also advancing and has been explored in social work, psychology, and other healthcare areas. However, in the absence of understanding empathy in an interprofessional setting, educators are limited in preparing teams to develop empathy as part of core competencies. This grounded theory study explored how interprofessional healthcare teams conceptualize and operationalize empathy in their practice. Data were collected using six focus groups and 24 semi-structured interviews with healthcare professionals working in an interprofessional setting in Ontario, Canada. A grounded theory of interprofessional intentional empathy center care can be used to explain the conceptualization and operationalization of empathy in practice. Findings showed that collective empathy in an interprofessional team model contributes to improved patient outcomes. Furthermore, empathy is not accidental and must be cultivated through intentional and genuine team experiences. This study can be used to more effectively integrate empathy in interprofessional healthcare education and praxis.
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Affiliation(s)
- Deepy Sur
- Ontario Association of Social Workers, Toronto, Canada
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Brookes O, Brown C, Tarrant C, Archer J, Buckley D, Buckley LM, Clement I, Evison F, Gao Smith F, Gibbins C, Hayton E, Jones J, Lilford R, Mullhi R, Packer G, Perkins G, Shelton J, Snelson C, Sullivan P, Vlaev I, Wolstenholme D, Wright SE, Bion J. Patient experience and reflective learning (PEARL): a mixed methods protocol for staff insight development in acute and intensive care medicine in the UK. BMJ Open 2019; 9:e030679. [PMID: 31345985 PMCID: PMC6661565 DOI: 10.1136/bmjopen-2019-030679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/19/2019] [Accepted: 06/25/2019] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Patient and staff experiences are strongly influenced by attitudes and behaviours, and provide important insights into care quality. Patient and staff feedback could be used more effectively to enhance behaviours and improve care through systematic integration with techniques for reflective learning. We aim to develop a reflective learning framework and toolkit for healthcare staff to improve patient, family and staff experience. METHODS & ANALYSIS Local project teams including staff and patients from the acute medical units (AMUs) and intensive care units (ICUs) of three National Health Service trusts will implement two experience surveys derived from existing instruments: a continuous patient and relative survey and an annual staff survey. Survey data will be supplemented by ethnographic interviews and observations in the workplace to evaluate barriers to and facilitators of reflective learning. Using facilitated iterative co-design, local project teams will supplement survey data with their experiences of healthcare to identify events, actions, activities and interventions which promote personal insight and empathy through reflective learning. Outputs will be collated by the central project team to develop a reflective learning framework and toolkit which will be fed back to the local groups for review, refinement and piloting. The development process will be mapped to a conceptual theory of reflective learning which combines psychological and pedagogical theories of learning, alongside theories of behaviour change based on capability, opportunity and motivation influencing behaviour. The output will be a locally-adaptable workplace-based toolkit providing guidance on using reflective learning to incorporate patient and staff experience in routine clinical activities. ETHICS & DISSEMINATION The PEARL project has received ethics approval from the London Brent Research Ethics Committee (REC Ref 16/LO/224). We propose a national cluster randomised step-wedge trial of the toolkit developed for large-scale evaluation of impact on patient outcomes.
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Affiliation(s)
- Olivia Brookes
- Research, Development & Innovation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Celia Brown
- Warwick Medical School (WMS), The University of Warwick, Warwick, UK
| | | | - Julian Archer
- Royal Australasian College of Surgeons, Melbourne, Victoria, Australia
- Peninsula College of Medicine and Dentistry, Plymouth, UK
| | | | | | - Ian Clement
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Felicity Evison
- Department of Health Informatics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Fang Gao Smith
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK
| | - Chris Gibbins
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Emma Hayton
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Richard Lilford
- Division of Health and Population Sciences, University of Warwick, Coventry, UK
| | - Randeep Mullhi
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Greg Packer
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Gavin Perkins
- Clinical Trials Unit, University of Warwick, Birmingham, UK
| | - Jonathan Shelton
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | | | | | - Ivo Vlaev
- Warwick Business School, Coventry, UK
| | | | - Stephen E Wright
- Anaesthesia, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
| | - Julian Bion
- Intensive Care Medicine, University of Birmingham, Birmingham, UK
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26
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Salvarani V, Rampoldi G, Ardenghi S, Bani M, Blasi P, Ausili D, Di Mauro S, Strepparava MG. Protecting emergency room nurses from burnout: The role of dispositional mindfulness, emotion regulation and empathy. J Nurs Manag 2019; 27:765-774. [PMID: 30887587 DOI: 10.1111/jonm.12771] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/15/2019] [Accepted: 03/14/2019] [Indexed: 11/29/2022]
Abstract
AIM To verify the role of dispositional mindfulness, difficulties in emotion regulation and empathy in explaining burnout levels of emergency room (ER) nurses. BACKGROUND Many studies have examined the variables that can affect burnout amongst ER nurses, but little is known about factors that can protect ER nurses against work-related stress. METHOD A multi-centre cross-sectional design was used. Burnout level intensity, dispositional mindfulness facets, difficulties in emotion regulation and empathy dimensions were assessed using valid and reliable self-report questionnaires in a sample of ER nurses (N = 97) from three different hospitals. RESULTS Higher dispositional mindfulness and cognitive empathy levels and lower difficulties in emotion regulation, were negatively associated with emotional exhaustion levels. CONCLUSION ER nurses with more mindful, emotion regulation and empathy skills are more able to manage work-related distress. IMPLICATIONS FOR NURSING MANAGEMENT Experiential interventions to promote mindfulness skills, emotion regulation variability and flexibility in a clinical context and the cognitive side of empathy are recommended for ER nurses to reduce professional distress, and to enhance personal and work satisfaction. Future research should assess the effectiveness of new multi-factorial interventions which combine the development of mindfulness, emotion regulation and empathy skills in ER nurses.
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Affiliation(s)
- Valerio Salvarani
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Giulia Rampoldi
- Department of Human Sciences for Education, University of Milano - Bicocca, Milano, Italy
| | - Stefano Ardenghi
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Marco Bani
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Paola Blasi
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Davide Ausili
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Stefania Di Mauro
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy.,Clinical Psychology Unit, San Gerardo Hospital, Monza, Italy
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Howick J, Moscrop A, Mebius A, Fanshawe TR, Lewith G, Bishop FL, Mistiaen P, Roberts NW, Dieninytė E, Hu XY, Aveyard P, Onakpoya IJ. Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis. J R Soc Med 2018; 111:240-252. [PMID: 29672201 DOI: 10.1177/0141076818769477] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Practitioners who enhance how they express empathy and create positive expectations of benefit could improve patient outcomes. However, the evidence in this area has not been recently synthesised. Objective To estimate the effects of empathy and expectations interventions for any clinical condition. Design Systematic review and meta-analysis of randomised trials. Data sources Six databases from inception to August 2017. Study selection Randomised trials of empathy or expectations interventions in any clinical setting with patients aged 12 years or older. Review methods Two reviewers independently screened citations, extracted data, assessed risk of bias and graded quality of evidence using GRADE. Random effects model was used for meta-analysis. Results We identified 28 eligible (n = 6017). In seven trials, empathic consultations improved pain, anxiety and satisfaction by a small amount (standardised mean difference -0.18 [95% confidence interval -0.32 to -0.03]). Twenty-two trials tested the effects of positive expectations. Eighteen of these (n = 2014) reported psychological outcomes (mostly pain) and showed a modest benefit (standardised mean difference -0.43 [95% confidence interval -0.65 to -0.21]); 11 (n = 1790) reported physical outcomes (including bronchial function/ length of hospital stay) and showed a small benefit (standardised mean difference -0.18 [95% confidence interval -0.32 to -0.05]). Within 11 trials (n = 2706) assessing harms, there was no evidence of adverse effects (odds ratio 1.04; 95% confidence interval 0.67 to 1.63). The risk of bias was low. The main limitations were difficulties in blinding and high heterogeneity for some comparisons. Conclusions Greater practitioner empathy or communication of positive messages can have small patient benefits for a range of clinical conditions, especially pain. Protocol registration Cochrane Database of Systematic Reviews (protocol) DOI: 10.1002/14651858.CD011934.pub2.
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Affiliation(s)
- Jeremy Howick
- 1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Andrew Moscrop
- 1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Alexander Mebius
- 1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Thomas R Fanshawe
- 1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - George Lewith
- 2 Psychology, University of Southampton, Southampton SO17 1BJ, UK
| | | | - Patriek Mistiaen
- 3 Belgian Health Care Knowledge Centre (KCE), Brussels B-1000, Belgium
| | - Nia W Roberts
- 4 Bodleian Health Care Libraries, University of Oxford, Oxford OX1 2JD, UK
| | - Eglė Dieninytė
- 5 Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania
| | - Xiao-Yang Hu
- 2 Psychology, University of Southampton, Southampton SO17 1BJ, UK
| | - Paul Aveyard
- 1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Igho J Onakpoya
- 1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
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Silver J, Caleshu C, Casson-Parkin S, Ormond K. Mindfulness Among Genetic Counselors Is Associated with Increased Empathy and Work Engagement and Decreased Burnout and Compassion Fatigue. J Genet Couns 2018; 27:1175-1186. [DOI: 10.1007/s10897-018-0236-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 02/06/2018] [Indexed: 12/18/2022]
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