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Jackson SR, Yu P, Armany D, Occhipinti S, Chambers S, Leslie S, Patel MI. eHealth literacy in prostate cancer: A systematic review. PATIENT EDUCATION AND COUNSELING 2024; 123:108193. [PMID: 38354430 DOI: 10.1016/j.pec.2024.108193] [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: 05/25/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE This systematic review (PROSPERO ID: CRD42022226375) aimed to identify the eHealth literacy of men with prostate cancer, and their caregivers. METHODS 8 databases (MEDLINE, SCOPUS, EMBASE, Web Of Science, PsycINFO, ERIC, CINAHL, Cochrane CENTRAL) and grey literature sources (e.g. Google Scholar) were searched from inception to December 2023. Articles were included if assessing eHealth/digital literacy of men with prostate cancer, or their carers', and health outcome associations. Formats such as case reports, and review papers were excluded. Records and full texts underwent independent screening and data extraction. Author disagreements were resolved by discussion. The Mixed Methods Appraisal Tool (MMAT) was used to appraise included literature, with narrative synthesis of results. RESULTS 21,581 records were retrieved, with 7 articles satisfying inclusion criteria. A heterogenous field was characterised with lack of modern eHealth literacy measurement tools identified. Results suggest novice eHealth literacy using web 1.0 technologies. Non-validated measures of literacy demonstrate mixed results, while health outcome effects limited in scope and reliability. CONCLUSION Prostate cancer survivors' eHealth literacy levels is likely novice, and requires further investigation. PRACTICE IMPLICATIONS Digital technologies/resources implemented as part of patient communication practices should be vetted for quality, and tailored to patients' eHealth literacy abilities and/or needs.
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Affiliation(s)
| | - Paul Yu
- Department of Urology Westmead Hospital, University of Sydney, Cnr Hawkesbury Road and, Darcy Rd, Westmead, Sydney, NSW 2145, Australia
| | - David Armany
- Department of Urology Westmead Hospital, University of Sydney, Cnr Hawkesbury Road and, Darcy Rd, Westmead, Sydney, NSW 2145, Australia
| | - Stefano Occhipinti
- School of Applied Psychology, Griffith University, Mt Gravatt, Brisbane, QLD 4122, Australia; Department of English and Communication, International Research Centre for the Advancement of Health Communication, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, 40 Edward St, North Sydney, Sydney, NSW 2060, Australia; Faculty of Health, University of Technology, 15 Broadway, Ultimo, Sydney, NSW 2007, Australia; St Vincent's Health Network, 390 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia
| | - Scott Leslie
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, 145 Missenden Rd, Camperdown, Sydney, NSW 2050, Australia; Faculty of Health and Medicine, University of Sydney, Camperdown, Sydney, NSW 2006, Australia
| | - Manish I Patel
- Department of Urology Westmead Hospital, University of Sydney, Cnr Hawkesbury Road and, Darcy Rd, Westmead, Sydney, NSW 2145, Australia
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Diefenbach MA, Marziliano A, Tagai EK, Pfister H, Lapitan E, Hall SJ, Vira M, Ibrahim S, Aibel K, Kutikov A, Horwitz EM, Miyamoto C, Reese AC, Miller SM. Preference Elicitation and Treatment Decision-Making Among Men Diagnosed With Prostate Cancer: Randomized Controlled Trial Results of Healium. J Med Internet Res 2023; 25:e46552. [PMID: 37862103 PMCID: PMC10625066 DOI: 10.2196/46552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/30/2023] [Accepted: 07/31/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Elicitation of patients' preferences is an integral part of shared decision-making, the recommended approach for prostate cancer decision-making. Existing decision aids for this population often do not specifically focus on patients' preferences. Healium is a brief interactive web-based decision aid that aims to elicit patients' treatment preferences and is designed for a low health literate population. OBJECTIVE This study used a randomized controlled trial to evaluate whether Healium, designed to target preference elicitation, is as efficacious as Healing Choices, a comprehensive education and decision tool, in improving outcomes for decision-making and emotional quality of life. METHODS Patients diagnosed with localized prostate cancer who had not yet made a treatment decision were randomly assigned to the brief Healium intervention or Healing Choices, a decision aid previously developed by our group that serves as a virtual information center on prostate cancer diagnosis and treatment. Assessments were completed at baseline, 6 weeks, and 3 months post baseline, and included decisional outcomes (decisional conflict, satisfaction with decision, and preparation for decision-making), and emotional quality of life (anxiety/tension and depression), along with demographics, comorbidities, and health literacy. RESULTS A total of 327 individuals consented to participate in the study (171 were randomized to the Healium intervention arm and 156 were randomized to Healing Choices). The majority of the sample was non-Hispanic (272/282, 96%), White (239/314, 76%), married (251/320, 78.4%), and was on average 62.4 (SD 6.9) years old. Within both arms, there was a significant decrease in decisional conflict from baseline to 6 weeks postbaseline (Healium, P≤.001; Healing Choices, P≤.001), and a significant increase in satisfaction with one's decision from 6 weeks to 3 months (Healium, P=.04; Healing Choices, P=.01). Within both arms, anxiety/tension (Healium, P=.23; Healing Choices, P=.27) and depression (Healium, P=.001; Healing Choices, P≤.001) decreased from baseline to 6 weeks, but only in the case of depression was the decrease statistically significant. CONCLUSIONS Healium, our brief decision aid focusing on treatment preference elicitation, is as successful in reducing decisional conflict as our previously tested comprehensive decision aid, Healing Choices, and has the added benefit of brevity, making it the ideal tool for integration into the physician consultation and electronic medical record. TRIAL REGISTRATION ClinicalTrials.gov NCT05800483; https://clinicaltrials.gov/study/NCT05800483.
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Affiliation(s)
- Michael A Diefenbach
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Allison Marziliano
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Erin K Tagai
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, United States
| | - Halie Pfister
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Emmanuel Lapitan
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, United States
| | - Simon J Hall
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Smith Institute for Urology, Northwell Cancer Institute, Northwell Health, Manhasset, NY, United States
| | - Manish Vira
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Smith Institute for Urology, Northwell Cancer Institute, Northwell Health, Manhasset, NY, United States
| | - Said Ibrahim
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Kelli Aibel
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Alexander Kutikov
- Department of Urology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, United States
| | - Eric M Horwitz
- Department of Radiation Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, United States
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Curtis Miyamoto
- Department of Radiation Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, United States
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Adam C Reese
- Department of Urology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, United States
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Suzanne M Miller
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, United States
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Marziliano A, Miller SM, Fleisher LG, Ropka ME, Stanton AL, Wen KY, Cornelius T, Lapitan E, Diefenbach MA. Examining the impact of a multimedia intervention on decisional conflict and psychological distress among early-stage breast cancer patients: results from a nationwide RCT. Transl Behav Med 2023; 13:727-735. [PMID: 37379519 PMCID: PMC10538468 DOI: 10.1093/tbm/ibad037] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
We conducted a nationwide, randomized controlled trial to evaluate the impact of Healing Choices, a novel interactive education and treatment decision program rooted in the self-regulation theory framework, on decisional conflict and psychological distress at 2-month post-intervention in women with early-stage breast cancer. Patients were randomized to receive the National Cancer Institute's standard print material (control) or standard print material plus Healing Choices (the intervention). The final sample at 2-month post-intervention consisted of N = 388 participants (intervention: n = 197; control: n = 191). There were no significant differences in decisional conflict or its subscales; however, psychological distress was higher in the intervention group (16.09 ± 10.25) than in the control group (14.37 ± 8.73) at follow-up, B = 1.88, 95% CI [-0.03, 3.80], t(383) = 1.94, p = .05. Upon further examination, we found that engagement with the intervention was low-41%-prompting as-treated analyses, which showed no difference in distress between users and nonusers and a positive impact of Healing Choices on decisional conflict: decisional support subscale: users (35.36 ± 15.50) versus nonusers (39.67 ± 15.99), B = -4.31 (s.e. = 2.09), p = .04. Multiple recommendations for moving ahead stem from this work: (i) intent-to-treat analyses appeared to cause distress, cautioning against interventions that may lead to information overload; (ii) engagement with the intervention is low and future work needs to focus on increasing engagement and monitoring it throughout the study; and (iii) in studies with low engagement, as-treated analyses are critical.
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Affiliation(s)
- Allison Marziliano
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Suzanne M Miller
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Linda G Fleisher
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Mary E Ropka
- Public Health Sciences, University of Virginia School of Medicine, Emeritus, Charlottesville, VA, USA
| | - Annette L Stanton
- Departments of Psychology and Psychiatry/Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Kuang-Yi Wen
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Talea Cornelius
- Division of General Medicine, Department of Medicine, Columbia University, New York, NY, USA
| | - Emmanuel Lapitan
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Michael A Diefenbach
- Institute of Health System Science, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
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Auger C, Guay C, Pysklywec A, Bier N, Demers L, Miller WC, Gélinas-Bronsard D, Ahmed S. What's behind the Dashboard? Intervention Mapping of a Mobility Outcomes Monitoring System for Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13303. [PMID: 36293885 PMCID: PMC9602496 DOI: 10.3390/ijerph192013303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Training and follow-up for older adults who received new assistive technology can improve device use adoption and function, but there is a lack of systematic and coordinated services. To address this gap, the Internet-based MOvIT+™ was designed to provide remote monitoring and support for assistive technology users and their caregivers. This paper presents the intervention mapping approach that was used. In step 1, we established a project governance structure and a logic model emerged from interviews with stakeholders and a systematic review of literature. In step 2, a modified TRIAGE consensus process led to the prioritization of thirty-six intervention components. In step 3, we created use cases for all intervention end users. In step 4, the intervention interface was created through iterative lab testing, and we gathered training resources. In step 5, a two-stage implementation plan was devised with the recruited rehabilitation sites. In step 6, we proposed an evaluation protocol. This detailed account of the development of MOvIT+™ demonstrates how the combined use of an intervention mapping approach and participatory processes with end users can help linking evidence-based, user-centered, and pragmatic reasoning. It makes visible the complexities behind the development of Internet-based interventions, while guiding future program developers.
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Affiliation(s)
- Claudine Auger
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Cassioppée Guay
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Alex Pysklywec
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Nathalie Bier
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada
| | - Louise Demers
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada
| | - William C. Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Dominique Gélinas-Bronsard
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
- School of Physical and Occupational Therapy, McGill University, Montréal, QC H3A 0G4, Canada
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Yang Y, Cheng G, Xing X, Li Z, Zhang W. Application of a multimedia-supported manikin system for preclinical dental training. BMC MEDICAL EDUCATION 2022; 22:693. [PMID: 36167531 PMCID: PMC9513986 DOI: 10.1186/s12909-022-03757-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
AIM In this study, we aimed to describe a multimedia-supported manikin system, compare the new manikin with the traditional manikin and evaluate its effectiveness in preclinical dentistry training. METHODS A total of 150 students participated in this study. Amongst these students, 71 in the 2015-year group used traditional manikins (Group TM) for preclinical training courses (endodontics training courses and prosthodontics training courses), and 79 in the 2016-year group used manikins with a multimedia system (Group MM). The scores of the training courses between the two groups were compared. A questionnaire survey was used to collect opinions of the students in Group MM on their experience of using the multimedia-supported manikin system in the preclinical training. RESULTS In the endodontics training courses, the scores of Group MM were higher than those of Group TM, but there was no significant difference (P = 0.379 > .05). However, the scores of prosthodontics training courses in Group MM were significantly higher than those in Group TM (P = 0.018 < .05). The questionnaire results indicated that the students in Group MM were satisfied with the device in usability, clarity, effectiveness and improvement in operation proficiency. CONCLUSIONS In the groups studied, for preclinical dental training, the multimedia-supported manikin system was a good alternative to traditional manikin in preclinical dentistry training.
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Affiliation(s)
- Yi Yang
- The state key laboratory breeding base of basic science of stomatology (Hubei-MOST) & key lab for oral biomedical engineering of the ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Gu Cheng
- The state key laboratory breeding base of basic science of stomatology (Hubei-MOST) & key lab for oral biomedical engineering of the ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xin Xing
- The state key laboratory breeding base of basic science of stomatology (Hubei-MOST) & key lab for oral biomedical engineering of the ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhi Li
- The state key laboratory breeding base of basic science of stomatology (Hubei-MOST) & key lab for oral biomedical engineering of the ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Oral & Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Wei Zhang
- The state key laboratory breeding base of basic science of stomatology (Hubei-MOST) & key lab for oral biomedical engineering of the ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Marziliano A, Diefenbach MA, Hudson SV, Tagai EK, Handorf EA, Bator A, Miller SM. Demographic and Psychosocial Characteristics Associated With Use of a Prostate Cancer Survivorship Website: Implications From a Multisite Randomized Controlled Trial. J Med Internet Res 2022; 24:e27890. [PMID: 35311678 PMCID: PMC8981019 DOI: 10.2196/27890] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/13/2021] [Accepted: 10/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Many prostate cancer (PC) survivors experience disease and treatment-related symptomatology in both the physical and psychosocial domains. Although the benefits and barriers to using web-based resources for cancer patients are well-documented, less research has focused on the personal characteristics important for efficient tailoring and targeting of information that are associated with usage. Objective We used the Cognitive-Social Health Information Processing (C-SHIP) framework to guide our exploration of personal characteristics associated with use of PROGRESS, an informational PC survivorship website that addresses physical, emotional, interpersonal, and practical concerns relevant for PC survivors. Methods PC survivors (N=217) were randomized to the intervention arm (PROGRESS) of a randomized controlled trial. Of those randomized to the intervention arm, 84 used PROGRESS, and 133 did not use PROGRESS. Multivariable analyses evaluated demographic and psychosocial characteristics (eg, style of coping, health literacy, self-efficacy, affective states of depression, anxiety, and fatigue) associated with website use. Results A larger proportion of non-Hispanic White (68/160, 42.5%), compared with non-Hispanic Black (9/40, 23%), participants used PROGRESS (P<.001). Further, PROGRESS users were older in age (P<.001), had a monitoring style of coping (P=.01), and were less depressed (P=.004), anxious (P=.02), and fatigued (P<.001) than nonusers. Education, income, health literacy, blunting style of coping, self-efficacy, and treatment type (radiation therapy or surgery) were not significantly related to use. On multivariable analyses, race (OR 0.28, P<.001), age (OR 1.05, P<.001), monitoring style of coping (OR 1.27, P=.02), and overall mood (OR 0.98, P<.001) remained significant. Conclusions A combination of monitoring and low levels of negative affect were associated with website use. Additionally, users were older, non-Hispanic White survivors. To ensure that important survivorship-relevant information reaches users, future efforts need to focus on enhancing patient engagement. Trial Registration ClinicalTrials.gov NCT02224482; https://clinicaltrials.gov/ct2/show/NCT02224482
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Affiliation(s)
- Allison Marziliano
- Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Michael A Diefenbach
- Center for Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Erin K Tagai
- Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, Philadelphia, PA, United States
| | - Elizabeth A Handorf
- Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, Philadelphia, PA, United States
| | - Alicja Bator
- Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, Philadelphia, PA, United States
| | - Suzanne M Miller
- Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, Philadelphia, PA, United States
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Rausch AK, Baur H, Reicherzer L, Wirz M, Keller F, Opsommer E, Schoeb V, Vercelli S, Barbero M. Physiotherapists' use and perceptions of digital remote physiotherapy during COVID-19 lockdown in Switzerland: an online cross-sectional survey. Arch Physiother 2021; 11:18. [PMID: 34233763 PMCID: PMC8261812 DOI: 10.1186/s40945-021-00112-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Swiss containment strategy for the COVID-19 pandemic during the first wave in spring 2020 resulted in a moratorium on non-urgent physiotherapy via regular direct patient contact. Consequently, such physiotherapy sessions declined by 84%. This study investigates the impact of this moratorium on the use of digital remote physiotherapy in Switzerland during this period and the perceptions of its use by Swiss physiotherapists (PTs). METHODS A cross-sectional online questionnaire was distributed between June and August of 2020 via the Swiss Physiotherapy Association (physioswiss) and various associations of physiotherapy specialists (e.g., sport, pediatric) working in both inpatient and outpatient settings. The questionnaire was designed to capture the demographics of participants and the perceptions of PTs using 33 questions in the following domains: Demography; Attitudes towards digital technology; Private and professional use of digital technology; Use of digital technology during therapy; and, Support requirements. Closed and open-ended questions were included and the frequency of answers was analyzed. Non-parametric inferential statistics were used to identify differences, where appropriate. The Checklist for Reporting Results of Internet E-Surveys (CHERRIES) was adopted. RESULTS Participants in the survey were 742 PTs (23.5% male, mean age of 43 years, mean working experience of 18 years) from the German-speaking (75.5%), French-speaking (15.1%), and Italian-speaking (9.4%) regions of Switzerland. The percentage of PTs using digital remote therapy increased from 4.9% prior to the lockdown to 44.6% during the lockdown period. The majority of PTs did not consider that digital remote therapy could complement usual physiotherapy practice and did not plan to continue with digital remote therapy after the pandemic. CONCLUSIONS During the lockdown, Swiss PTs adopted various low-cost and easily accessible digital technologies. However, several barriers hampered further implementation of this modality. Specific education and training programs need to be provided among PTs, appropriate digital technologies should be introduced, and a correct reimbursement scheme should be developed. TRIAL REGISTRATION COVIDPhysio Registry of World Physiotherapy, registered 15th June 2020 ( https://world.physio/covid-19-information-hub/covid-19-covidphysio-registry ).
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Affiliation(s)
- Anne-Kathrin Rausch
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Research & Development, Katharina-Sulzer-Platz 9, CH 8401, Winterthur, Switzerland.
| | - Heiner Baur
- Department of Health Professions, Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, CH-30008, Bern, Switzerland
| | - Leah Reicherzer
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Research & Development, Katharina-Sulzer-Platz 9, CH 8401, Winterthur, Switzerland
| | - Markus Wirz
- ZHAW Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Research & Development, Katharina-Sulzer-Platz 9, CH 8401, Winterthur, Switzerland
| | - Fabienne Keller
- School of Health Sciences (HESAV) - University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, CH-1011, Lausanne, Switzerland
| | - Emmanuelle Opsommer
- School of Health Sciences (HESAV) - University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, CH-1011, Lausanne, Switzerland
| | - Veronika Schoeb
- School of Health Sciences (HESAV) - University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, CH-1011, Lausanne, Switzerland
| | - Stefano Vercelli
- Department of Business Economics, Rehabilitation Research Laboratory 2rLab, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Stabile Piazzetta, via Violino 11, CH-6928, Manno/Landquart, Switzerland
| | - Marco Barbero
- Department of Business Economics, Rehabilitation Research Laboratory 2rLab, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Stabile Piazzetta, via Violino 11, CH-6928, Manno/Landquart, Switzerland
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O'Malley DM, Davis SN, Devine KA, Sullivan B, Bator A, Clemow L, Ferrante JM, Findley PA, Miller SM, Hudson SV. Development and usability testing of the e-EXCELS tool to guide cancer survivorship follow-up care. Psychooncology 2019; 29:123-131. [PMID: 31626397 DOI: 10.1002/pon.5222] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/21/2019] [Accepted: 08/31/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study is to describe a user-centered (e.g., cancer survivors and clinicians) development process of an eHealth tool designed to facilitate self-management of cancer survivorship follow-up care. METHODS Guided by Cognitive-Social Health Information Processing (C-SHIP) model and informed by core self-management skills, we engaged in a user-centered design process. In phase I, we conducted in-depth interviews with survivors of breast (n = 33), prostate (n = 4), and colorectal (n = 6) cancers, and (n = 9) primary care providers to develop content and design of the web tool. Phase II utilized iterative user testing interviews (n = 9) to test the web-based tool prototype. Data from both phases were independently coded using a template/content analytic approach. RESULTS The top 5 functions identified in phase I for the web-based platform included: (a) educational materials to learn and prepare for health encounters (80%); (b) questions for health providers (74%); (c) ability to track contact information of providers (67%); (d) provide general information (64%); and, (e) support information (62%). Users of the prototype reported patient burden, tool fatigue, introduction timing of the tool, relevance, and security/privacy as concerns in phase II. CONCLUSIONS This study demonstrates the value of using a theoretically informed and user-centered design process to develop relevant and patient-centered eHealth resources to support cancer survivorship. A larger study is needed to establish the efficacy of this eHealth tool as an intervention to improve adherence to follow-up care guidelines.
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Affiliation(s)
- Denalee M O'Malley
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Stacy N Davis
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,School of Public Health, Health Behavior, Society, and Policy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Katie A Devine
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Brittany Sullivan
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Alicja Bator
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Lynn Clemow
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Jeanne M Ferrante
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Patricia A Findley
- Rutgers School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Suzanne M Miller
- Fox Chase Cancer Center/Temple Health, Philadelphia, Pennsylvania
| | - Shawna V Hudson
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,School of Public Health, Health Behavior, Society, and Policy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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9
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Leach CR, Diefenbach MA, Fleszar S, Alfano CM, Stephens RL, Riehman K, Hudson SV. A user centered design approach to development of an online self‐management program for cancer survivors: Springboard Beyond Cancer. Psychooncology 2019; 28:2060-2067. [DOI: 10.1002/pon.5193] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/22/2019] [Accepted: 07/28/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Corinne R. Leach
- Behavioral and Epidemiology Research GroupAmerican Cancer Society Atlanta Georgia
| | | | - Sara Fleszar
- Department of Psychological SciencesUniversity of California Merced California
| | - Catherine M. Alfano
- Behavioral and Epidemiology Research GroupAmerican Cancer Society Atlanta Georgia
| | - Robert L. Stephens
- Behavioral and Epidemiology Research GroupAmerican Cancer Society Atlanta Georgia
| | - Kara Riehman
- Behavioral and Epidemiology Research GroupAmerican Cancer Society Atlanta Georgia
| | - Shawna V. Hudson
- Family Medicine and Community HealthRutgers Robert Wood Johnson Medical School New Brunswick New Jersey
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Forbes CC, Finlay A, McIntosh M, Siddiquee S, Short CE. A systematic review of the feasibility, acceptability, and efficacy of online supportive care interventions targeting men with a history of prostate cancer. J Cancer Surviv 2019; 13:75-96. [PMID: 30610736 PMCID: PMC6394465 DOI: 10.1007/s11764-018-0729-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/19/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE To examine the feasibility, acceptability, and efficacy of online supportive care interventions targeting prostate cancer survivors (PCS). METHODS Studies were identified through structured searches of PubMed, Embase and PsycINFO databases, and bibliographic review. Inclusion criteria were (1) examined feasibility, acceptability, or efficacy of an online intervention designed to improve supportive care outcomes for PCS; (2) presented outcome data collected from PCS separately (if mixed cancer); and (3) evaluated efficacy outcomes using randomized controlled trial (RCT) design. RESULTS Sixteen studies met inclusion criteria; ten were classified as RCTs. Overall, 2446 men (average age 64 years) were included. Studies reported on the following outcomes: feasibility and acceptability of an online intervention (e.g., patient support, online medical record/follow-ups, or decision aids); reducing decisional conflict/distress; improving cancer-related distress and health-related quality of life; and satisfaction with cancer care. CONCLUSION We found good preliminary evidence for online supportive care among PCS, but little high level evidence. Generally, the samples were small and unrepresentative. Further, inadequate acceptability measures made it difficult to determine actual PCS acceptability and satisfaction, and lack of control groups precluded strong conclusions regarding efficacy. Translation also appears minimal; few interventions are still publicly available. Larger trials with appropriate control groups and greater emphasis on translation of effective interventions is recommended. IMPLICATIONS FOR CANCER SURVIVORS Prostate cancer survivors have a variety of unmet supportive care needs. Using online delivery to improve the reach of high-quality supportive care programs could have a positive impact on health-related quality of life among PCS.
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Affiliation(s)
- Cynthia C. Forbes
- Hull York Medical School, University of Hull, Allam Medical Building 3rd Floor, Cottingham Road, Kingston-Upon-Hull, East Yorkshire HU6 7RX UK
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia Canada
| | - Amy Finlay
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Megan McIntosh
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Shihab Siddiquee
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Camille E. Short
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
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11
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Diefenbach MA, Benedict C, Miller SM, Stanton AL, Ropka ME, Wen KY, Fleisher LG, Mohamed NE, Hall SJ. Examining the impact of a multimedia intervention on treatment decision-making among newly diagnosed prostate cancer patients: results from a nationwide RCT. Transl Behav Med 2018; 8:876-886. [PMID: 29982747 PMCID: PMC6248862 DOI: 10.1093/tbm/iby066] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Men diagnosed with early stage prostate cancer face multiple treatment options, each with distinctive side effects that have significant implications for post-treatment quality of life. Healing Choices for Men with Prostate Cancer is a multimedia educational and decision aid program. This nation-wide randomized controlled trial evaluated the impact of Healing Choices on reducing decisional conflict and distress. Eligible prostate cancer patients who called the National Cancer Institute's Cancer Information Service (CIS) were invited to participate. After a baseline interview, participants were randomized to usual personalized consultation with a CIS specialist (comparison condition) or CIS personalized consultation plus the Healing Choices program (intervention condition). The Decision Conflict Scale and Impact of Event Scale assessed decisional conflict about prostate cancer treatment and cancer-related distress, respectively. Analyses evaluated group differences at 2 months postenrollment. Hypothesized moderation of intervention effects by demographic and clinical characteristics were evaluated. The final sample consisted of N = 349 participants (intervention: n = 181; comparison n = 168). Men were on average 64 years old, primarily White, and well educated. The difference in total decisional conflict was not significant (DCS total score; F[1,311] = .99, p = .32). The difference in cancer-related distress at 2 months between the intervention and the comparison groups was not significant (F[1,337] = .01, p = .93). Evaluation of specific decision processes indicated a significant effect on levels of perceived decisional support (intervention, M = 34.8, SD = 15.7; comparison, M = 38.3, SD = 16.1; F[1,337] = 3.74, p = .05). The intervention effect was greatest for nonwhite minority participants (b = -9.65, SE = 4.67) and those with lower educational attainment (b = 3.87, SE = 2.21). This interactive, comprehensive education and decision aid program may be most effective for a subset of prostate cancer patients in need of educational and decisional support.
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Affiliation(s)
- Michael A Diefenbach
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY
- Center for Health Innovations and Outcomes Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Catherine Benedict
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY
- Center for Health Innovations and Outcomes Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Suzanne M Miller
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA
| | - Annette L Stanton
- Departments of Psychology and Psychiatry/Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles, CA
| | - Mary E Ropka
- Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA
| | - Kuang-Yi Wen
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA
| | - Linda G Fleisher
- Department of Biomedical and Health Informatics, The Center for Injury Research and Prevention, Office of Digital Health, Philadelphia, PA
| | - Nihal E Mohamed
- Department of Urology, Mount Sinai School of Medicine, New York, NY
| | - Simon J Hall
- The Arthur Smith Institute for Urology, Northwell Health, New York, NY
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12
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Lee HY, Kim J, Sharratt M. Technology use and its association with health and depressive symptoms in older cancer survivors. Qual Life Res 2017; 27:467-477. [PMID: 29128998 DOI: 10.1007/s11136-017-1734-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Acknowledging the expanding influence of technology in the promotion of health and wellness, this study assessed the role of information and communication technology (ICT) use in the lives of older cancer survivors. METHODS A community sample of cancer survivors aged 65 and older (N = 1411) was extracted from a 2011 U.S. National Health and Aging Trends Study dataset. Weighted multiple regression and multinomial logistic regression analyses were performed to explore the relationships between survey respondents' ICT use and their self-rated health status and depressive symptoms. RESULTS The majority of respondents reported rarely or never engaging in ICT use. Greater use of communication technology such as emailing or texting was associated with decreased risk for severe depressive symptoms and higher self-rated health status. Information technology use was not associated with depressive symptoms and self-rated health status. CONCLUSIONS Investigation into reasons behind older cancer survivors' apparent low rates of engagement with ICT is warranted, particularly the examination of access as a potential barrier. Findings indicated that frequent use of communication technology was positively linked with mental and physical wellness. The nature of the relationships between communication technology use and physical and mental health merits further research, helping to determine whether community-based educational efforts to improve technology access and skills may benefit the growing population of older cancer survivors.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities, 105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN, 55108, USA.
| | - Jeehoon Kim
- Department of Sociology, Social Work, and Criminology, Idaho State University, Pocatello, ID, USA
| | - Monica Sharratt
- School of Social Work, University of Minnesota, Twin Cities, 105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN, 55108, USA
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13
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Hälleberg Nyman M, Frank C, Langius-Eklöf A, Blomberg K, Sundberg K, Wengström Y. Patients' Perspective on Participation in Care With or Without the Support of a Smartphone App During Radiotherapy for Prostate Cancer: Qualitative Study. JMIR Mhealth Uhealth 2017; 5:e107. [PMID: 28747294 PMCID: PMC5553005 DOI: 10.2196/mhealth.6829] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 03/10/2017] [Accepted: 06/06/2017] [Indexed: 12/29/2022] Open
Abstract
Background Patients with prostate cancer are often cared for as outpatients during radiotherapy, which can be an aggravating circumstance for patient participation. There is a need to evaluate whether an interactive smartphone app could enable participation in care, specifically during treatment for prostate cancer. The interactive app (Interaktor) used in this study is developed in codesign with patients and health care professionals; it includes daily reports of symptoms, a risk assessment model, evidence-based self-care advice, along with the provision of immediate access to clinicians. Objective The aim of this study was to explore how patients with prostate cancer perceived their participation with or without the support of the smartphone app during radiotherapy. Methods A total of 28 prostate cancer patients receiving adjuvant radiotherapy were interviewed about their perceived participation in their own care. All the patients interviewed in this study participated in an intervention study where the control group received standard care that comprised having access to a contact nurse to turn to with any concerns during their treatment. In addition to standard care, the patients in the intervention group received the app downloaded in a smartphone. The patients’ age ranged between 57 and 77 years; 17 patients used the smartphone app. The interviews were analyzed with directed qualitative content analysis. Results The four dimensions of patient participation, which include mutual participation, fight for participation, requirement for participation, and participation in getting basic needs satisfied, were confirmed as valid perspectives in the interviews with the patients with prostate cancer, irrespective of whether they used the smartphone app. However, the patients who had used the smartphone app described it as a facilitating factor, especially for mutual participation. Conclusions Using innovative ways to communicate with patients, such as an interactive app for symptom management with contact with health care in real time, can successfully help achieve increased patient participation in care.
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Affiliation(s)
| | - Catharina Frank
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Karin Blomberg
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Kay Sundberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Kristiansen AM, Svanholm JR, Schjødt I, Mølgaard Jensen K, Silén C, Karlgren K. Patients with heart failure as co-designers of an educational website: implications for medical education. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:47-58. [PMID: 28237976 PMCID: PMC5346182 DOI: 10.5116/ijme.5898.309e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 02/06/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To identify the learning needs of patients with heart failure between outpatients follow-up visits from their perspective and to ascertain what they emphasize as being important in the design of an educational website for them. METHODS We conducted a two-step qualitative study at Aarhus University Hospital, Denmark. Twenty patients with heart failure participated either in focus group interviews, diary writing, or video-recorded design sessions. Data on learning needs were collected in step 1 and analyses, therefore, helped develop the preliminary prototypes of a website. In step 2, patients worked on the prototypes in video-recorded design sessions, employing a think-aloud method. The interviews were transcribed and a content analysis was performed on the text and video data. RESULTS Patients' learning needs were multifaceted, driven by anxiety, arising from, and often influenced by, such daily situations and contexts as the medical condition, medication, challenges in daily life, and where to get support and how to manage their self-care. They emphasized different ways of adapting the design to the patient group to enable interaction with peers and professionals and specific interface issues. CONCLUSIONS This study provided insights into the different learning needs of patients with heart failure, how managing daily situations is the starting point for these needs and how emotions play a part in patients' learning. Moreover, it showed how patient co-designers proved to be useful for understanding how to design a website that supports patients' learning: insights, which may become important in designing online learning tools for patients.
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Affiliation(s)
| | | | - Inge Schjødt
- Department of Cardiology, Aarhus University Hospital, Denmark
| | | | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden
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15
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Corradini N, Dagorne L, Retailleau M, Rédini F, Sudour-Bonnange H, Gofti-Laroche L, Le Rhun A, Gaspar N. [Which approach of therapeutic education (TE) for adolescents and young adults with cancer? Experience from the TE working group of "Go-AJA"]. Bull Cancer 2016; 103:966-978. [PMID: 27863724 DOI: 10.1016/j.bulcan.2016.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/03/2016] [Accepted: 10/06/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Therapeutic education (TE) is a practice developed over 40 years at an international level to give people with chronic illness the skills necessary to help them better manage their disease. The lengthening survival time of cancer patients as well as changes in the patient-caregiver relationship have contributed to the development of TE in oncologic diseases. Every year in France, about 1900 adolescents and young adults (15-25 years old) are diagnosed with cancer which is the second leading cause of death in this age group. The observed survival rates for these patients are lower when compared with children's. Some of the hypotheses put forward to explain this difference include a lack of constancy in care and a non-following treatment, as failure to adhere to therapies is common in this age group. "Go-AJA", an interdisciplinary national organization established in 2012, aims to improve the quality of care and treatment results for AYA living with cancer. Therapeutic education for AYA in oncology is an active working group of "Go-AJA" and intends to draw recommendations and to improve adapted communication on different education topics. Elaboration and preparation of TE programs by skilled multidisciplinary teams engaged in interactive educational actions is the first and most crucial step. MATERIALS AND METHODS The TE "Go-AJA" working group has federated pediatric and adult oncologists, nurses, psychologists, TE professionals, and resource patients, thanks to the commitment of professionals from the 8 national teams supported by the National Cancer Institute. Physical meetings and conference calls were organized from 2012 to 2015 to construct TE tools and programs for AYA with cancer. RESULTS A competence referential was built and adapted to AYA population with cancer, after focused groups organized in 2 main oncology centers with on-therapy sarcoma patients and members of the multidisciplinary TE working group. Tools were validated and adapted to adolescents or young adults with cancer, to help in the 4 stages of TE: the "educational diagnosis" allowing the caregiver to better understand the patient in his life journey with the disease; the "therapeutic alliance" allowing to agree with the patient on his/her priorities; the "implementation" which is an action step: information, awareness, learning and psychosocial support. The final step called "assessment" allows the caregiver to take stock on the changes and difficulties with the patient. TE for AYA with cancer included individual and/or group sessions to improve self-care skills: knowledge about the disease (group sessions "what is cancer?" with use of microscopes to visualize sarcoma cells, and guided tours in a tumor research laboratory), and details about the treatment and its consequences (workshops about "management of febrile neutropenia"). Moreover, TE aimed to enrich the field of coping skills, in particular to improve the coordination and experience of cares between the different complex and varied network of care (group and/or individual sessions focused on physical rehabilitation, and adapted school/professional orientation). CONCLUSION Regardless of the care system, care workers dedicated to AYA with cancer should use TE-specific actions to reinforce treatment participation and therapeutic relationships. This active multidisciplinary TE working group dedicated to AYA with cancer elaborated TE programs by skilled multidisciplinary teams engaged in interactive educational actions. After this work of a national TE organization, more studies using methodological tools are still required to evaluate the impact of such implemented programs on the treatment results and the quality of life.
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Affiliation(s)
- Nadège Corradini
- Institut d'hémato-oncologie pédiatrique, centre Léon-Bérard, dispositif AJA en cancérologie, 28, prom. Léa-et-Napoléon-Bullukian, 69008 Lyon, France.
| | - Loïc Dagorne
- Cancer campus Gustave-Roussy, département de cancérologie de l'enfant et l'adolescent, équipe transversale SPIAJA, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - Marielle Retailleau
- CHU de Nantes, hôpital mère-enfant, département d'oncologie pédiatrique, quai Moncousu, 44093 Nantes cedex 1, France
| | - Françoise Rédini
- Faculté de médecine, Inserm UMR957, « laboratoire de PHysiopathologie de la résorption osseuse et thérapie des tumeurs osseuses primitives », 1, rue Gaston Veil, 44035 Nantes cedex 1, France
| | - Hélène Sudour-Bonnange
- Centre Oscar-Lambret, unité d'oncologie pédiatrique, équip'AJA, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - Leila Gofti-Laroche
- CHU Grenoble Alpes, hôpital couple enfant, équipe AJA Arc Alpin, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France
| | - Anne Le Rhun
- CHU, hôpital Saint-Jacques, département de santé publique, unité d'éducation thérapeutique, bâtiment Louis-Philippe, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France
| | - Nathalie Gaspar
- Cancer campus Gustave-Roussy, département de cancérologie de l'enfant et l'adolescent, équipe transversale SPIAJA, 114, rue Edouard-Vaillant, 94800 Villejuif, France
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Enard KR, Dolan Mullen P, Kamath GR, Dixon NM, Volk RJ. Are cancer-related decision aids appropriate for socially disadvantaged patients? A systematic review of US randomized controlled trials. BMC Med Inform Decis Mak 2016; 16:64. [PMID: 27267490 PMCID: PMC4896023 DOI: 10.1186/s12911-016-0303-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 05/10/2016] [Accepted: 06/01/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM) is considered a key component of high quality cancer care and may be supported by patient decision aids (PtDAs). Many patients, however, face multiple social disadvantages that may influence their ability to fully participate in SDM or to use PtDAs; additionally, these social disadvantages are among the determinants of health associated with greater cancer risk, unwarranted variations in care and worse outcomes. The purpose of this systematic review is to describe the extent to which disadvantaged social groups in the United States (US) have been included in trials of cancer-related PtDAs and to highlight strategies, lessons learned and future opportunities for developing and evaluating PtDAs that are appropriate for disadvantaged populations. METHODS We selected cancer-related US studies from the Cochrane 2014 review of PtDAs and added RCTs meeting Cochrane criteria from searches of PubMed, CINAHL, PsycINFO (January 2010 to December 2013); and reference lists. Two reviewers independently screened titles/abstracts; three reviewers independently screened full text articles, performed data extraction and assessed: 1) inclusion of participants based on seven indicators of social disadvantage (limited education; female gender; uninsured or Medicaid status; non-U.S. nativity; non-White race or Hispanic ethnicity; limited English proficiency; low-literacy), and 2) attention to social disadvantage in the development or evaluation of PtDAs. RESULTS Twenty-three of 39 eligible RCTs included participants from at least one disadvantaged subgroup, most frequently racial/ethnic minorities or individuals with limited education and/or low-literacy. Seventeen studies discussed strategies and lessons learned in attending to the needs of disadvantaged social groups in PtDA development; 14 studies targeted disadvantaged groups or addressed subgroup differences in PtDA evaluation. CONCLUSIONS The diversity of the US population is represented in a majority of cancer-related PtDA RCTs, but fewer studies have tailored PtDAs to address the multiple social disadvantages that may impact patients' participation in SDM. More detailed attention to the comprehensive range of social factors that determine cancer risk, variations in care and outcomes is needed in the development and evaluation of PtDAs for disadvantaged populations. TRIAL REGISTRATION Registered 24 October 2014 in PROSPERO International prospective register of systematic reviews ( CRD42014014470 ).
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Affiliation(s)
- Kimberly R Enard
- Department of Health Management and Policy, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, USA.
| | - Patricia Dolan Mullen
- Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health, 7000 Fannin Street, UCT Suite 2522, Houston, TX, 77030, USA
| | - Geetanjali R Kamath
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Unit 1444, Houston, TX, USA
| | - Nickell M Dixon
- Michigan Department of Health and Human Services, 201 Townsend Street, Lansing, MI 48913, USA
| | - Robert J Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Unit 1444, Houston, TX, USA
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Syrowatka A, Krömker D, Meguerditchian AN, Tamblyn R. Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses. J Med Internet Res 2016; 18:e20. [PMID: 26813512 PMCID: PMC4748141 DOI: 10.2196/jmir.4982] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/01/2015] [Accepted: 12/21/2015] [Indexed: 11/13/2022] Open
Abstract
Background Patient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids. Objective The first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making. Methods Relevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making. Results Of 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however, some features performed better than others. Integration of content control improved quality of decision making (SMD 0.59 vs 0.23 for knowledge; SMD 0.39 vs 0.29 for decisional conflict). In contrast, tailoring reduced quality of decision making (SMD 0.40 vs 0.71 for knowledge; SMD 0.25 vs 0.52 for decisional conflict). Similarly, patient narratives also reduced quality of decision making (SMD 0.43 vs 0.65 for knowledge; SMD 0.17 vs 0.46 for decisional conflict). Results were varied for different types of explicit values clarification, feedback, and social support. Conclusions Integration of media rich or interactive features into computer-based decision aids can improve quality of preference-sensitive decision making. However, this is an emerging field with limited evidence to guide use. The systematic review and thematic synthesis identified features that have been integrated into available computer-based decision aids, in an effort to facilitate reporting of these features and to promote integration of such features into decision aids. The meta-analyses and associated subgroup analyses provide preliminary evidence to support integration of specific features into future decision aids. Further research can focus on clarifying independent contributions of specific features through experimental designs and refining the designs of features to improve effectiveness.
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Affiliation(s)
- Ania Syrowatka
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.
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Badr H, Carmack CL, Diefenbach MA. Psychosocial interventions for patients and caregivers in the age of new communication technologies: opportunities and challenges in cancer care. JOURNAL OF HEALTH COMMUNICATION 2015; 20:328-42. [PMID: 25629218 PMCID: PMC4361271 DOI: 10.1080/10810730.2014.965369] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Interactive health communication technologies (IHCTs) present a new opportunity and challenge for cancer control researchers who focus on couple- and family-based psychosocial interventions. In this article, the authors first present findings from a systematic review of 8 studies that used IHCTs in psychosocial interventions with cancer patients and their caregivers. Although this research area is still in its infancy, studies suggest that it is feasible to incorporate IHCTs in such interventions, that IHCTs are generally well accepted by patients and caregivers, and that the choice of technology is largely dependent on intervention target (i.e., patient, caregiver, or both) and outcomes (e.g., decision making, symptom management, lifestyle behaviors). A major research gap has been the lack of integration of Web 2.0 technologies (e.g., social media), despite the fact that social support and communication are frequently targeted components of interventions that involve cancer patients and their caregivers. Given this, the authors next present findings from a qualitative study that they conducted to describe the different needs and preferences of 13 cancer survivors and 12 caregivers with regard to social media use. Last, the authors discuss some of the opportunities and challenges of using IHCTs in psychosocial interventions for cancer patients and their caregivers and propose directions for future research.
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Affiliation(s)
- Hoda Badr
- a Department of Oncological Sciences , Mount Sinai School of Medicine , New York , New York , USA
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Older adults: Are they ready to adopt health-related ICT? Int J Med Inform 2013; 82:e209-31. [DOI: 10.1016/j.ijmedinf.2011.03.002] [Citation(s) in RCA: 313] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 08/16/2010] [Accepted: 03/10/2011] [Indexed: 11/22/2022]
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Berry DL, Halpenny B, Hong F, Wolpin S, Lober WB, Russell KJ, Ellis WJ, Govindarajulu U, Bosco J, Davison BJ, Bennett G, Terris MK, Barsevick A, Lin DW, Yang CC, Swanson G. The Personal Patient Profile-Prostate decision support for men with localized prostate cancer: a multi-center randomized trial. Urol Oncol 2013; 31:1012-21. [PMID: 22153756 PMCID: PMC3349002 DOI: 10.1016/j.urolonc.2011.10.004] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 10/04/2011] [Accepted: 10/04/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The purpose of this trial was to compare usual patient education plus the Internet-based Personal Patient Profile-Prostate, vs. usual education alone, on conflict associated with decision making, plus explore time-to-treatment, and treatment choice. METHODS A randomized, multi-center clinical trial was conducted with measures at baseline, 1-, and 6 months. Men with newly diagnosed localized prostate cancer (CaP) who sought consultation at urology, radiation oncology, or multi-disciplinary clinics in 4 geographically-distinct American cities were recruited. Intervention group participants used the Personal Patient Profile-Prostate, a decision support system comprised of customized text and video coaching regarding potential outcomes, influential factors, and communication with care providers. The primary outcome, patient-reported decisional conflict, was evaluated over time using generalized estimating equations to fit generalized linear models. Additional outcomes, time-to-treatment, treatment choice, and program acceptability/usefulness, were explored. RESULTS A total of 494 eligible men were randomized (266 intervention; 228 control). The intervention reduced adjusted decisional conflict over time compared with the control group, for the uncertainty score (estimate -3.61; (confidence interval, -7.01, 0.22), and values clarity (estimate -3.57; confidence interval (-5.85,-1.30). Borderline effect was seen for the total decisional conflict score (estimate -1.75; confidence interval (-3.61,0.11). Time-to-treatment was comparable between groups, while undecided men in the intervention group chose brachytherapy more often than in the control group. Acceptability and usefulness were highly rated. CONCLUSION The Personal Patient Profile-Prostate is the first intervention to significantly reduce decisional conflict in a multi-center trial of American men with newly diagnosed localized CaP. Our findings support efficacy of P3P for addressing decision uncertainty and facilitating patient selection of a CaP treatment that is consistent with the patient values and preferences.
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Affiliation(s)
- Donna L Berry
- Dana-Farber Cancer Institute, Phyllis F. Cantor Center, Boston, MA 02215, USA.
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Lambert SD, Girgis A, Turner J, Regan T, Candler H, Britton B, Chambers S, Lawsin C, Kayser K. "You need something like this to give you guidelines on what to do": patients' and partners' use and perceptions of a self-directed coping skills training resource. Support Care Cancer 2013; 21:3451-60. [PMID: 23955024 DOI: 10.1007/s00520-013-1914-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 07/12/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aims to report on the acceptability of a self-directed coping skills intervention, called Coping-Together, for patients affected by cancer and their partners, including the strengths and limitations of the intervention design. METHODS This initial version of Coping-Together included a series of four booklets, which aimed to provide practical coping strategies for the day-to-day management of common physical and psychosocial challenges. Thirty semi-structured interviews were conducted with 27 patients and/or 14 partners. Interviews were audiorecorded, transcribed verbatim, and analyzed for content. RESULTS Participants endorsed the self-directed format, and the focus of Coping-Together on practical information was a feature that set it apart from other resources. The majority of participants interviewed felt that the proposed coping strategies were "doable"; however, only half of the participants reported learning new coping skills after reading the booklets. Additional benefits of reading the booklets were increasing awareness of challenges to prepare for, giving hope that something can help you "pull through", providing a sense of normality, connecting patients and partners to people and services, and complementing support received from health professionals. Despite the general acceptability of the intervention, some aspects of its design were criticized, including the workbook-like exercises, expectations about using the resource together, level of guidance provided, and amount of information included. In general, most participants felt that too much negative information was included, whereas more experiential information was desired. CONCLUSIONS Preliminary evaluation of Coping-Together supported its practical approach and highlighted improvements to enhance its contribution to patient and partner coping.
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Affiliation(s)
- Sylvie D Lambert
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University Street, Montreal, Quebec, H3A 2A7, Canada,
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Paterson BL, Brewer J, Stamler LL. Engagement of parents in on-line social support interventions. J Pediatr Nurs 2013; 28:114-24. [PMID: 22710151 DOI: 10.1016/j.pedn.2012.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 04/28/2012] [Accepted: 05/15/2012] [Indexed: 10/28/2022]
Abstract
The purpose of this scoping review was to determine what the relevant research informs us about which parents of children with chronic disease and/or disability are likely to engage in an on-line social support program and why they choose to be engaged. The review included 16 peer-reviewed research reports about on-line social support offered to parents of children with chronic disease and/or disability. It was conducted using scoping review approaches recommended by H. Arskey and L. O'Malley (2005). A key finding of this review is that it appears that the development of on-line social support interventions for parents may not have integrated what is known in the field of Internet technology as necessary to engage users. This has implications for nurses wishing to provide on-line social support for parents. As well, it highlights future directions for research, including investigations of which parents are likely to engage in on-line social support interventions and the features of the intevention that will attract and sustain them as participants.
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Marcus AC, Diefenbach MA, Stanton AL, Miller SM, Fleisher L, Raich PC, Morra ME, Perocchia RS, Tran ZV, Bright MA. Cancer patient and survivor research from the cancer information service research consortium: a preview of three large randomized trials and initial lessons learned. JOURNAL OF HEALTH COMMUNICATION 2013; 18:543-62. [PMID: 23448232 PMCID: PMC4242510 DOI: 10.1080/10810730.2012.743629] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The authors describe 3 large randomized trials from the Cancer Information Service Research Consortium. Three web-based multimedia programs are being tested to help newly diagnosed prostate (Project 1) and breast cancer patients (Project 2) make informed treatment decisions and breast cancer patients prepare for life after treatment (Project 3). Project 3 also tests a telephone callback intervention delivered by a cancer information specialist. All participants receive standard print material specific to each project. Preliminary results from the 2-month follow-up interviews are reported for the initial wave of enrolled participants, most of whom were recruited from the Cancer Information Service (1-800-4-CANCER) telephone information program (Project 1: n =208; Project 2: n =340; Project 3: n =792). Self-reported use of the multimedia program was 51%, 52%, and 67% for Projects 1, 2, and 3, respectively. Self-reported use of the print materials (read all, most, or some) was 90%, 85%, and 83% for Projects 1, 2, and 3, respectively. The callback intervention was completed by 92% of Project 3 participants. Among those using the Cancer Information Service Research Consortium interventions, perceived usefulness and benefit was high, and more than 90% reported that they would recommend them to other cancer patients. The authors present 5 initial lessons learned that may help inform future cancer communications research.
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Affiliation(s)
- Alfred C Marcus
- University of Colorado Cancer Center, University of Colorado, Denver, 12474 E. 19th Avenue, Mail Stop F427, Room 141, Aurora, CO 80045, USA.
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Sebrow D, Lavery HJ, Brajtbord JS, Hobbs A, Levinson AW, Samadi DB. Monitoring Validated Quality of Life Outcomes After Prostatectomy: Initial Description of Novel Online Questionnaire. Urology 2012; 79:314-9. [DOI: 10.1016/j.urology.2011.08.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 08/10/2011] [Accepted: 08/26/2011] [Indexed: 10/14/2022]
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Diefenbach MA, Mohamed NE, Butz BP, Bar-Chama N, Stock R, Cesaretti J, Hassan W, Samadi D, Hall SJ. Acceptability and preliminary feasibility of an internet/CD-ROM-based education and decision program for early-stage prostate cancer patients: randomized pilot study. J Med Internet Res 2012; 14:e6. [PMID: 22246148 PMCID: PMC3846339 DOI: 10.2196/jmir.1891] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 09/26/2011] [Accepted: 09/27/2011] [Indexed: 11/17/2022] Open
Abstract
Background Prostate cancer is the most common cancer affecting men in the United States. Management options for localized disease exist, yet an evidence-based criterion standard for treatment still has to emerge. Although 5-year survival rates approach 98%, all treatment options carry the possibility for significant side effects, such as erectile dysfunction and urinary incontinence. It is therefore recommended that patients be actively involved in the treatment decision process. We have developed an Internet/CD-ROM-based multimedia Prostate Interactive Educational System (PIES) to enhance patients’ treatment decision making. PIES virtually mirrors a health center to provide patients with information about prostate cancer and its treatment through an intuitive interface, using videos, animations, graphics, and texts. Objectives (1) To examine the acceptability and feasibility of the PIES intervention and to report preliminary outcomes of the program in a pilot trial among patients with a new prostate cancer diagnosis, and (2) to explore the potential impact of tailoring PIES treatment information to participants’ information-seeking styles on study outcomes. Methods Participants (n = 72) were patients with newly diagnosed localized prostate cancer who had not made a treatment decision. Patients were randomly assigned to 3 experimental conditions: (1) control condition (providing information through standard National Cancer Institute brochures; 26%), and PIES (2) with tailoring (43%) and (3) without tailoring to a patient’s information-seeking style (31%). Questionnaires were administrated before (t1) and immediately after the intervention (t2). Measurements include evaluation and acceptability of the PIES intervention, monitoring/blunting information-seeking style, psychological distress, and decision-related variables (eg, decisional confidence, feeling informed about prostate cancer and treatment, and treatment preference). Results The PIES program was well accepted by patients and did not interfere with the clinical routine. About 79% of eligible patients (72/91) completed the pre- and post-PIES intervention assessments. Patients in the PIES groups compared with those in the control condition were significantly more likely to report higher levels of confidence in their treatment choices, higher levels of helpfulness of the information they received in making a treatment decision, and that the information they received was emotionally reassuring. Patients in the PIES groups compared with those in the control condition were significantly less likely to need more information about treatment options, were less anxious about their treatment choices, and thought the information they received was clear (P < .05). Tailoring PIES information to information-seeking style was not related to decision-making variables. Conclusions This pilot study confirms that the implementation of PIES within a clinical practice is feasible and acceptable to patients with a recent diagnosis of prostate cancer. PIES improved key decision-making process variables and reduced the emotional impact of a difficult medical decision.
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Affiliation(s)
- Michael A Diefenbach
- Mount Sinai School of Medicine, Departments of Urology & Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029-0751, United States.
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Smith CA, Hetzel S, Dalrymple P, Keselman A. Beyond readability: investigating coherence of clinical text for consumers. J Med Internet Res 2011; 13:e104. [PMID: 22138127 PMCID: PMC3278090 DOI: 10.2196/jmir.1842] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 07/08/2011] [Accepted: 08/10/2011] [Indexed: 11/23/2022] Open
Abstract
Background A basic tenet of consumer health informatics is that understandable health resources empower the public. Text comprehension holds great promise for helping to characterize consumer problems in understanding health texts. The need for efficient ways to assess consumer-oriented health texts and the availability of computationally supported tools led us to explore the effect of various text characteristics on readers’ understanding of health texts, as well as to develop novel approaches to assessing these characteristics. Objective The goal of this study was to compare the impact of two different approaches to enhancing readability, and three interventions, on individuals’ comprehension of short, complex passages of health text. Methods Participants were 80 university staff, faculty, or students. Each participant was asked to “retell” the content of two health texts: one a clinical trial in the domain of diabetes mellitus, and the other typical Visit Notes. These texts were transformed for the intervention arms of the study. Two interventions provided terminology support via (1) standard dictionary or (2) contextualized vocabulary definitions. The third intervention provided coherence improvement. We assessed participants’ comprehension of the clinical texts through propositional analysis, an open-ended questionnaire, and analysis of the number of errors made. Results For the clinical trial text, the effect of text condition was not significant in any of the comparisons, suggesting no differences in recall, despite the varying levels of support (P = .84). For the Visit Note, however, the difference in the median total propositions recalled between the Coherent and the (Original + Dictionary) conditions was significant (P = .04). This suggests that participants in the Coherent condition recalled more of the original Visit Notes content than did participants in the Original and the Dictionary conditions combined. However, no difference was seen between (Original + Dictionary) and Vocabulary (P = .36) nor Coherent and Vocabulary (P = .62). No statistically significant effect of any document transformation was found either in the open-ended questionnaire (clinical trial: P = .86, Visit Note: P = .20) or in the error rate (clinical trial: P = .47, Visit Note: P = .25). However, post hoc power analysis suggested that increasing the sample size by approximately 6 participants per condition would result in a significant difference for the Visit Note, but not for the clinical trial text. Conclusions Statistically, the results of this study attest that improving coherence has a small effect on consumer comprehension of clinical text, but the task is extremely labor intensive and not scalable. Further research is needed using texts from more diverse clinical domains and more heterogeneous participants, including actual patients. Since comprehensibility of clinical text appears difficult to automate, informatics support tools may most productively support the health care professionals tasked with making clinical information understandable to patients.
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Affiliation(s)
- Catherine Arnott Smith
- School of Library and Information Studies, University of Wisconsin-Madison, Madison, WI 53706, United States.
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Allen JD, Berry DL. Multi-media support for informed/shared decision-making before and after a cancer diagnosis. Semin Oncol Nurs 2011; 27:192-202. [PMID: 21783010 DOI: 10.1016/j.soncn.2011.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To define and distinguish informed decision-making (IDM) from shared decision-making (SDM) and review the evidence for technology-based interventions designed to facilitate informed decisions about cancer screening and treatment. DATA SOURCES Peer-reviewed research articles from Medline and other data sources accessible through pubmed.gov. CONCLUSION There is evidence that multi-media decision aids (DAs) or support systems can improve quality of decision-making in terms of enhancing knowledge relevant to decision-making, reducing decisional conflict, and customizing education and coaching of patients with cancer. IMPLICATIONS FOR NURSING PRACTICE Nurses have a key role to play in designing, deploying, monitoring, and evaluating multi-media DAs in oncology practice settings. DAs are an adjunct to interpersonal education, providing information to patients in both the clinical setting and in more familiar settings without the time constraints of clinical encounters. Nurses can adopt such DAs and support systems and work with patients to ensure that information has been comprehended, that values have been considered, and that patients play an active role in the decision-making process as they desire.
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Comparison of a Computer Assisted Learning Program to Standard Education Tools in Hospitalized Heart Failure Patients. Eur J Cardiovasc Nurs 2011; 10:187-93. [DOI: 10.1016/j.ejcnurse.2010.07.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 07/01/2010] [Accepted: 07/02/2010] [Indexed: 11/20/2022]
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Abstract
To meet the needs of low-literacy, underserved, Mexican-American patients, this transdisciplinary team created a freestanding computer kiosk. Smoking awareness and cessation were the topic chosen. Focus groups were used to inform the design and creation of each screen to include appropriate culturally based images and messages. A kiosk was placed in a primary care clinic in a West Texas city. User feedback was collected, showing that this method of patient education is acceptable.
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Abstract
To meet the needs of low-literacy, underserved, Mexican-American patients, this transdisciplinary team created a freestanding computer kiosk. Smoking awareness and cessation were the topic chosen. Focus groups were used to inform the design and creation of each screen to include appropriate culturally based images and messages. A kiosk was placed in a primary care clinic in a West Texas city. User feedback was collected, showing that this method of patient education is acceptable.
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Berry DL, Halpenny B, Wolpin S, Davison BJ, Ellis WJ, Lober WB, McReynolds J, Wulff J. Development and evaluation of the personal patient profile-prostate (P3P), a Web-based decision support system for men newly diagnosed with localized prostate cancer. J Med Internet Res 2010; 12:e67. [PMID: 21169159 PMCID: PMC3056527 DOI: 10.2196/jmir.1576] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 06/22/2010] [Accepted: 11/03/2010] [Indexed: 11/18/2022] Open
Abstract
Background Given that no other disease with the high incidence of localized prostate cancer (LPC) has so many treatments with so few certainties related to outcomes, many men are faced with assuming some responsibility for the treatment decision along with guidance from clinicians. Men strongly consider their own personal characteristics and other personal factors as important and influential to the decision. Clinical researchers have not developed or comprehensively investigated interventions to facilitate the insight and prioritizing of personal factors along with medical factors that are required of a man in preparation for the treatment decision. Objectives The purpose of this pilot study was to develop and evaluate the feasibility and usability of a Web-based decision support technology, the Personal Patient Profile-Prostate (P3P), in men newly diagnosed with LPC. Methods Use cases were developed followed by infrastructure and content application. The program was provided on a personal desktop computer with a touch screen monitor. Participant responses to the query component of P3P determined the content of the multimedia educational and coaching intervention. The intervention was tailored to race, age, and personal factors reported as influencing the decision. Prepilot usability testing was conducted using a “think aloud” interview to identify navigation and content challenges. These issues were addressed prior to deployment in the clinic. A clinical pilot was conducted in an academic medical center where men sought consultation and treatment for LPC. Completion time, missing data, and acceptability were measured. Results Prepilot testing included 4 men with a past diagnosis of LPC who had completed therapy. Technical navigation issues were documented along with confusing content language. A total of 30 additional men with a recent diagnosis of LPC completed the P3P program in clinic prior to consulting with a urologist regarding treatment options. In a mean time of 46 minutes (SD 13 minutes), participants completed the P3P query and intervention components. Of a possible 4560 items for 30 participants, 22 (0.5%) were missing. Acceptability was reported as high overall. The sections of the intervention reported as most useful were the statistics graphs, priority information topics, and annotated external website links. Conclusions The P3P intervention is a feasible and usable program to facilitate treatment decision making by men with newly diagnosed LPC. Testing in a multisite randomized trial with a diverse sample is warranted.
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Affiliation(s)
- Donna L Berry
- Dana-Farber Cancer Institute, Boston, United States.
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Taylor KL, Davis KM, Lamond T, Williams RM, Schwartz MD, Lawrence W, Feng S, Brink S, Birney A, Lynch J, Regan J, Dritschilo A. Use and evaluation of a CD-ROM-based decision aid for prostate cancer treatment decisions. Behav Med 2010; 36:130-40. [PMID: 21186436 DOI: 10.1080/08964289.2010.525263] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The survival advantages associated with different treatments for localized prostate cancer (PCa) continue to be uncertain. We evaluated patients' use of an interactive CD-ROM-based decision aid designed to improve informed decision making about PCa treatment. Newly diagnosed, early-stage PCa patients who had not made a treatment decision completed a baseline telephone interview (N = 132), were mailed the CD-ROM, and completed a one-month follow-up interview (N = 120; 91%). Compared to non-users (21%), CD-users (79%) preferred to make an independent rather than a shared treatment decision (OR = 3.5, CI 1.2,10.5). The majority of users (63%-90%) responded positively regarding the length and clarity of the information. Further, 76% reported using the CD as much/more than other information sources. A preference for having less decisional control predicted greater satisfaction with the CD (F[7,87] = 4.75, p < .05). Electronic utilization data revealed that the topics most accessed concerned treatment information and that users spent over an hour using the CD (median = 72 minutes). This electronic educational tool was well-accepted by patients and may be particularly useful for patients who desire less control over their treatment decisions and who are less proactive in seeking information on their own.
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Affiliation(s)
- Kathryn L Taylor
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
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Joshi A, Arora M, Dai L, Price K, Vizer L, Sears A. Usability of a patient education and motivation tool using heuristic evaluation. J Med Internet Res 2009; 11:e47. [PMID: 19897458 PMCID: PMC2802560 DOI: 10.2196/jmir.1244] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 09/17/2009] [Accepted: 10/09/2009] [Indexed: 11/26/2022] Open
Abstract
Background Computer-mediated educational applications can provide a self-paced, interactive environment to deliver educational content to individuals about their health condition. These programs have been used to deliver health-related information about a variety of topics, including breast cancer screening, asthma management, and injury prevention. We have designed the Patient Education and Motivation Tool (PEMT), an interactive computer-based educational program based on behavioral, cognitive, and humanistic learning theories. The tool is designed to educate users and has three key components: screening, learning, and evaluation. Objective The objective of this tutorial is to illustrate a heuristic evaluation using a computer-based patient education program (PEMT) as a case study. The aims were to improve the usability of PEMT through heuristic evaluation of the interface; to report the results of these usability evaluations; to make changes based on the findings of the usability experts; and to describe the benefits and limitations of applying usability evaluations to PEMT. Methods PEMT was evaluated by three usability experts using Nielsen’s usability heuristics while reviewing the interface to produce a list of heuristic violations with severity ratings. The violations were sorted by heuristic and ordered from most to least severe within each heuristic. Results A total of 127 violations were identified with a median severity of 3 (range 0 to 4 with 0 = no problem to 4 = catastrophic problem). Results showed 13 violations for visibility (median severity = 2), 38 violations for match between system and real world (median severity = 2), 6 violations for user control and freedom (median severity = 3), 34 violations for consistency and standards (median severity = 2), 11 violations for error severity (median severity = 3), 1 violation for recognition and control (median severity = 3), 7 violations for flexibility and efficiency (median severity = 2), 9 violations for aesthetic and minimalist design (median severity = 2), 4 violations for help users recognize, diagnose, and recover from errors (median severity = 3), and 4 violations for help and documentation (median severity = 4). Conclusion We describe the heuristic evaluation method employed to assess the usability of PEMT, a method which uncovers heuristic violations in the interface design in a quick and efficient manner. Bringing together usability experts and health professionals to evaluate a computer-mediated patient education program can help to identify problems in a timely manner. This makes this method particularly well suited to the iterative design process when developing other computer-mediated health education programs. Heuristic evaluations provided a means to assess the user interface of PEMT.
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Affiliation(s)
- Ashish Joshi
- Department of Information Systems, University of Maryland, Baltimore County, Baltimore, MD 21250, USA.
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Marschollek M, Mix S, Wolf KH, Effertz B, Haux R, Steinhagen-Thiessen E. ICT-based health information services for elderly people: Past experiences, current trends, and future strategies. ACTA ACUST UNITED AC 2009; 32:251-61. [PMID: 18072003 DOI: 10.1080/14639230701692736] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Diefenbach M, Turner G, Carpenter KM, Sheldon LK, Mustian KM, Gerend MA, Rini C, von Wagner C, Gritz ER, McQueen A, Prayor-Patterson HM, Miller SM. Cancer and patient-physician communication. JOURNAL OF HEALTH COMMUNICATION 2009; 14 Suppl 1:57-65. [PMID: 19449269 PMCID: PMC2791918 DOI: 10.1080/10810730902814079] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
As patients are increasingly involved in the selection of their care, communication between health care providers and patients takes on new importance. The present article reviews the most common approaches to improve patient communication, distinguishing among patient-directed and provider-directed approaches, as well as introducing multimedia programs designed to enhance communication. We conclude by delineating new critical areas for future research including peer-to-peer patient communication and the challenges brought on by new technologies.
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Finkelstein J, Lapshin O, Cha E. Feasibility of promoting smoking cessation among methadone users using multimedia computer-assisted education. J Med Internet Res 2008; 10:e33. [PMID: 18984556 PMCID: PMC2630834 DOI: 10.2196/jmir.1089] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Revised: 09/27/2008] [Accepted: 09/29/2008] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of smoking is very high among methadone users. As a method of delivering health education, computers can be utilized effectively. However computer-assisted education in methadone users has not been evaluated systematically. Objective This study was aimed at assessing feasibility and patient acceptance of an interactive educational module of a multi-component smoking cessation counseling computer program for former illicit drug users treated in an outpatient methadone clinic. Methods The computer-mediated education for hazards of smoking utilized in this study was driven by major constructs of adult learning theories. The program interface was tailored to individuals with minimal computer experience and was implemented on a touch screen tablet PC. The number of consecutive methadone-treated current smokers enrolled in the study was 35. After providing socio-demographic and smoking profiles, the patients were asked to use the educational program for 40 minutes. The impact of the computer-mediated education was assessed by administering a pre- and post-intervention Hazards of Smoking Knowledge Survey (HSKS). An attitudinal survey and semi-structured qualitative interview were used after the educational session to assess the opinions of participants about their educational experience. Results The computer-mediated education resulted in significant increase of HSKS scores from 60.5 ± 16.3 to 70.4 ± 11.7 with t value 3.69 and P < .001. The majority of the patients (78.8%) felt the tablet PC was easy to use, and most of the patients (91.4%) rated the educational experience as good or excellent. After controlling for patient baseline characteristics, the effect of computer-mediated education remained statistically significant. Conclusions Computer-assisted education using tablet PCs was feasible, well-accepted, and an effective means of providing hazards of smoking education among methadone users.
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Affiliation(s)
- Joseph Finkelstein
- Department of General Internal Medicine, John Hopkins University, Baltimore, MD 21287, USA.
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Fleisher L, Buzaglo J, Collins M, Millard J, Miller SM, Egleston BL, Solarino N, Trinastic J, Cegala DJ, Benson AB, Schulman KA, Weinfurt KP, Sulmasy D, Diefenbach MA, Meropol NJ. Using health communication best practices to develop a web-based provider-patient communication aid: the CONNECT study. PATIENT EDUCATION AND COUNSELING 2008; 71:378-387. [PMID: 18417312 PMCID: PMC2509582 DOI: 10.1016/j.pec.2008.02.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Accepted: 02/21/2008] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Although there is broad consensus that careful content vetting and user testing is important in the development of technology-based educational interventions, often these steps are overlooked. This paper highlights the development of a theory-guided, web-based communication aid (CONNECT), designed to facilitate treatment decision-making among patients with advanced cancer. METHODS The communication aid included an on-line survey, patient skills training module and an automated physician report. Development steps included: (1) evidence-based content development; (2) usability testing; (3) pilot testing; and (4) patient utilization and satisfaction. RESULTS Usability testing identified some confusing directions and navigation for the on-line survey and validated the relevance of the "patient testimonials" in the skills module. Preliminary satisfaction from the implementation of the communication aid showed that 66% found the survey length reasonable and 70% found it helpful in talking with the physician. Seventy percent reported the skills module helpful and about half found it affected the consultation. CONCLUSION Designing patient education interventions for translation into practice requires the integration of health communication best practice including user feedback along the developmental process. PRACTICE IMPLICATIONS This developmental process can be translated to a broad array of community-based patient and provider educational interventions.
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Affiliation(s)
- Linda Fleisher
- Fox Chase Cancer Center, Philadelphia, PA 19012, United States.
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Carretier J, Fervers B. Pour un partage du savoir et la construction d’une nouvelle relation entre les malades et leurs proches. PSYCHO-ONCOLOGIE 2008. [DOI: 10.1007/978-2-287-72408-4_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Carey M, Schofield P, Jefford M, Krishnasamy M, Aranda S. The development of audio-visual materials to prepare patients for medical procedures: an oncology application. Eur J Cancer Care (Engl) 2008; 16:417-23. [PMID: 17760928 DOI: 10.1111/j.1365-2354.2006.00772.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This paper describes a systematic process for the development of educational audio-visual materials that are designed to prepare patients for potentially threatening procedures. Literature relating to the preparation of patients for potentially threatening medical procedures, psychological theory, theory of diffusion of innovations and patient information was examined. Four key principles were identified as being important: (1) stakeholder consultation, (2) provision of information to prepare patients for the medical procedure, (3) evidence-based content, and (4) promotion of patient confidence. These principles are described along with an example of the development of an audio-visual resource to prepare patients for chemotherapy treatment. Using this example, practical strategies for the application of each of the principles are described. The principles and strategies described may provide a practical, evidence-based guide to the development of other types of patient audio-visual materials.
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Affiliation(s)
- M Carey
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
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Wolf MS, Williams MV, Parker RM, Parikh NS, Nowlan AW, Baker DW. Patients' shame and attitudes toward discussing the results of literacy screening. JOURNAL OF HEALTH COMMUNICATION 2007; 12:721-732. [PMID: 18030638 DOI: 10.1080/10810730701672173] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We investigated patients' willingness to have their reading ability documented in their medical records and the degree of shame and embarrassment associated with such disclosure. Structured interviews were conducted among a consecutive sample of 283 primary care patients at an urban public hospital. Patients' literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). Self-report of degree of shame and embarrassment related to literacy skills was measured using an orally administered questionnaire. Fifty-one percent of patients had low literacy skills (< or =sixth grade) and 27.9% were assessed as having marginal literacy (seventh-eighth grade). Half (47.6%) of patients reading at or below the third-grade level admitted feeling ashamed or embarrassed about their difficulties reading, compared with 19.2% of those reading at the fourth-sixth-grade level and 6.5% of those reading at the seventh-eighth-grade level (p < 0.001). More than 90% of patients with low or marginal literacy reported it would be helpful for the doctor or nurse to know they did not understand some medical words. Patients with limited literacy were more likely to report feelings of shame as a result of disclosure (p < 0.05). Health care providers must recognize the potential shame patients might experience as a result of literacy screening.
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Affiliation(s)
- Michael S Wolf
- Health Literacy and Learning Program, Division of General Internal Medicine, Northwestern University, Chicago, Illinois, USA.
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Evans R, Elwyn G, Edwards A, Watson E, Austoker J, Grol R. Toward a model for field-testing patient decision-support technologies: a qualitative field-testing study. J Med Internet Res 2007; 9:e21. [PMID: 17627930 PMCID: PMC2047286 DOI: 10.2196/jmir.9.3.e21] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Revised: 05/28/2007] [Accepted: 05/28/2007] [Indexed: 11/28/2022] Open
Abstract
Background Field-testing is a quality assurance criterion in the development of patient decision-support technologies (PDSTs), as identified in the consensus statement of the International Patient Decision Aids Standards Collaboration. We incorporated field-testing into the development of a Web-based, prostate-specific antigen PDST called Prosdex, which was commissioned as part of the UK Prostate Cancer Risk Management Programme. Objectives The aim of this study was to develop a model for the future field-testing of PDSTs, based on the field-testing of Prosdex. Our objectives were (1) to explore the reactions of men to evolving prototypes of Prosdex, (2) to assess the effect of these responses on the development process, and (3) to develop a model for field-testing PDSTs based on the responses and their effect on the development process. Methods Semistructured interviews were conducted with the men after they had viewed evolving prototypes of Prosdex in their homes. The men were grouped according to the prototype viewed. Men between 40 and 75 years of age were recruited from two family practices in different parts of Wales, United Kingdom. In the interviews, the men were asked for their views on Prosdex, both as a whole and in relation to specific sections such as the introduction and video clips. Comments and technical issues that arose during the viewings were noted and fed back to the developers in order to produce subsequent prototypes. Results A total of 27 men were interviewed, in five groups, according to the five prototypes of Prosdex that were developed. The two main themes from the interviews were the responses to the information provided in Prosdex and the responses to specific features of Prosdex. Within these themes, two of the most frequently encountered categories were detail of the information provided and balance between contrasting viewpoints. Criticisms were encountered, particularly with respect to navigation of the site. In addition, we found that participants made little use of the decision-making scale. The introduction of an interactive contents page to prototype 2 was the main change made to Prosdex as a result of the field-testing. Based on our findings, a model for the field-testing of PDSTs was developed, involving an exploratory field-testing stage between the planning stage and the development of the first prototype, and followed by the prototype field-testing stage, leading to the final PDST. Conclusions In the field-testing of Prosdex, a Web-based prostate-specific antigen PDST, the responses of interviewed men were generally favorable. As a consequence of the responses, an interactive contents page was added to the site. We developed a model for the future field-testing of PDSTs, involving two stages: exploratory field-testing and prototype field-testing.
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Affiliation(s)
- Rhodri Evans
- Department of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK.
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Leeman-Castillo BA, Corbett KK, Aagaard EM, Maselli JH, Gonzales R, Mackenzie TD. Acceptability of a bilingual interactive computerized educational module in a poor, medically underserved patient population. JOURNAL OF HEALTH COMMUNICATION 2007; 12:77-94. [PMID: 17365350 DOI: 10.1080/10810730601096630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We evaluated the acceptability and impact of an audiovisual, bilingual, interactive computer module relating to appropriate antibiotic use. In winter 2001, adults seeking urgent care for acute respiratory infections at an inner-city urgent care clinic were invited to complete the computer module and survey (N = 296). After responding to questions about their symptoms, patients were provided information about their illness and appropriate antibiotic use, and then asked several questions about the acceptability of the module. The main outcomes, reflecting qualities known to enhance diffusion of innovations, were "learning something new about colds and flu" and trusting the computer information. Spanish-language respondents (16%) were much less likely to report prior computer experience, more likely to need help, and strongly preferred answering to a person compared with English-language respondents. In multivariable analysis, Spanish-language respondents were more likely to report learning something new (OR = 5.0; 95% CI: 2.0, 12.4) and trusting the information (OR = 2.5; 95% CI: 1.0, 6.0). We conclude that an interactive computer module was well received among a medically underserved urgent care clinic population. Benefits appear greatest among populations having the least experience with this medium.
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Creating animated medical images (Part 1). Biomed Imaging Interv J 2006; 2:e32. [PMID: 21614231 PMCID: PMC3097622 DOI: 10.2349/biij.2.2.e32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2006] [Revised: 06/20/2006] [Accepted: 06/23/2006] [Indexed: 11/18/2022] Open
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Grunwald T, Corsbie-Massay C. Guidelines for cognitively efficient multimedia learning tools: educational strategies, cognitive load, and interface design. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2006; 81:213-23. [PMID: 16501261 DOI: 10.1097/00001888-200603000-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The field of medical education has consistently embraced new technologies in an attempt to improve the training process of our nation's doctors. There are thousands of available multimedia learning tools (MMLTs), but no quantitative scale exists to assess their efficiency and overall educational value. The authors review existing literature and suggest guidelines for creating cognitively efficient medical MMLTs. In 2004, the authors searched PubMed to identify articles regarding mutimedia learning, including educational strategies and existing MMLTs. The primary search terms included "multimedia learning," "cognitive load," and "surgical education." The resulting articles were evaluated and reviewed for educational and interface design techniques, and a list of common features was generated. The authors cross-referenced these features with extensive theories of cognitive load to create a list of methods that demonstrated improved learning. Techniques common to existing MMLTs often neglect to account for theories of cognitive load and may be detrimental to the learning process. The authors outlined important educational considerations and guidelines for the design of effective MMLTs. With large resources being spent to produce MMLTs, more research is necessary to establish successful design techniques. The authors summarized existing research, outlined educational issues in multimedia design, and proposed future directions for study.
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Affiliation(s)
- Tiffany Grunwald
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA.
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