bims-paceca Biomed News
on Patient-centred care
Issue of 2022‒04‒17
29 papers selected by
Rob Penfold
Queensland Health
  1. Patients' preferred and perceived decision-making roles, and observed patient involvement in videotaped encounters with medical specialists.
  2. Why Nurses Do Not Report Patient Aggression: A Review and Appraisal of the Literature.
  3. Clinical reasoning as midwifery: A Socratic model for shared decision making in person-centred care.
  4. A Qualitative Analysis of Older Adults' Views of Healthcare Provider Attributes and Communication Skills.
  5. A Meta-Analysis of the Effectiveness of Telemedicine in Glycemic Management among Patients with Type 2 Diabetes in Primary Care.
  6. Instruments Measuring Self-Care in Children and Young Adults With Chronic Conditions: A Systematic Review.
  7. Health Care Quality and Safety in a Correctional System: Creating Goals and Performance Measures for Improvement.
  8. Theoretical model and measurement of shared decision making in web-based pharmaceutical care consultation.
  9. Shared Decision-Making in High-Risk Operation and Carl Rogers' Reflective Listing.
  10. Codesigning a patient support portal with health professionals and men with prostate cancer: An action research study.
  11. A Systematic Review of the Role of Telemedicine in Blood Pressure Control: Focus on Patient Engagement.
  12. The Behavioral Factors That Influence Person-Centered Social Care: A Literature Review and Conceptual Framework.
  13. Effectiveness of a web-based, electronic medical records-integrated patient agenda tool to improve doctor-patient communication in primary care consultations: A pragmatic cluster-randomized controlled trial study.
  14. Nurse-led telehealth interventions for symptom management in patients with cancer receiving systemic or radiation therapy: a systematic review and meta-analysis.
  15. How technology can improve communication and health outcomes in patients with advanced cancer: an integrative review.
  16. Characterizing the Relationship Between Hospital Google Star Ratings, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Scores, and Quality.
  17. Decision aid for prostate cancer screening in Brazil.
  18. Developing a core outcome set for patient-reported symptom monitoring to reduce hospital admissions for patients with heart failure.
  19. Roles of general practitioners in shared decision-making for patients with cancer: A qualitative study.
  20. Towards a patient-centred approach in therapeutic patient education. A qualitative study exploring health care professionals' practices and related representations.
  21. Analyzing Patient Stories on Social Media Using Text Analytics.
  22. Patient Education Interventions Improve A1C Values.
  23. Coproducing and Implementing Person-Centered Key Performance Indicators in Ambulatory Cancer Nursing.
  24. Development of a co-designed, evidence-based, multi-pronged strategy to support normal birth.
  25. Partnership between patients and interprofessional healthcare providers along the multifaceted journey to medication adherence.
  26. Hidden in plain sight? Identifying patient-authored publications.
  27. Training to Promote Empathic Communication in Graduate Medical Education: A Shared Learning Intervention in Internal Medicine and General Surgery.
  28. Similar values, different expectations: How do patients and providers view 'health' and perceive the healthcare experience?
  29. What does the literature mean by social prescribing? A critical review using discourse analysis.
  1. Patient Educ Couns. 2022 Mar 30. pii: S0738-3991(22)00139-2. [Epub ahead of print]
    Patients' preferred and perceived decision-making roles, and observed patient involvement in videotaped encounters with medical specialists.
    Ellen M Driever, Anne M Stiggelbout, Paul L P Brand.
      OBJECTIVE: To assess how patients prefer and perceive medical decision making, which factors are associated with their preferred and perceived decision-making roles, and whether observed involvement reflects patients' perceived role.METHODS: We asked 781 patients visiting a medical specialist from 18 different disciplines to indicate their preferred and perceived decision-making roles. Patient involvement in videotaped consultations was assessed with the OPTION5 instrument.
    RESULTS: Most patients preferred and perceived decision making as shared (SDM; 58% and 43%, respectively), followed by paternalistic (26% and 38%), and informative (16% and 15%). A large minority (n = 103, 21%) of patients preferring shared or informative decision making (n = 482) experienced paternalistic decision making. Mean (SD) OPTION5 scores were highest in consultations which patients perceived as informative (26.0 (19.7)), followed by shared (19.1 (17.2)) and lowest in paternalistic decision making (11.8 (13.4) p < 0.001).
    CONCLUSIONS: Most patients want to be involved in decision making. Patients perceive that the physician makes the decision more often than they prefer, and perceive more involvement in the decision than objective assessment by an independent researcher shows.
    PRACTICE IMPLICATIONS: A clearer understanding of patients' medical decision-making experiences is needed to optimize physician SDM training programmes and patient awareness campaigns.
    Keywords:  Observing patient involvement (OPTION); Patient experiences; Patient involvement; Perceived decision-making role; Preferred decision-making role; Shared decision making
    DOI:  https://doi.org/10.1016/j.pec.2022.03.025
  2. J Nurs Manag. 2022 Apr 11.
    Why Nurses Do Not Report Patient Aggression: A Review and Appraisal of the Literature.
    Scott S Christensen, Barbara L Wilson.
      AIM: To establish the current state of the science about why nurses do or do not report being the victim of patient aggression, a form of type II workplace violence. This aim includes identifying and analyzing current gaps in the literature.BACKGROUND: It is increasingly more common for patients to instigate aggressive acts towards nurses, leading to significant consequences. Nursing victims often do not report acts of patient aggression to others, making it difficult for healthcare leaders and researchers to address this challenge.
    EVALUATION: The review process involved searching five databases, using the PRISMA framework to reduce 355 records to 65 sources for review and synthesis.
    KEY ISSUES: The findings of this review highlight key takeaways about why nursing victims do not report episodes of patient aggression, which include their fears, attitudes, and abilities related to reporting; and their perspective of the patient aggression event. Workplace environments are central to most of these factors, emphasizing the importance of nursing and other healthcare leaders to put systems in place that promote nurse reporting behaviors.
    CONCLUSIONS: Patient aggression is a widespread problem with severe consequences. Review findings can inform future research while having practical relevance for healthcare leaders.
    IMPLICATIONS FOR NURSING MANAGEMENT: Healthcare leaders need to consider how workplace structures, practices, and cultures can encourage or stifle nurse reporting behaviors. By understanding nurse reporting behaviors, processes can be developed to promote nursing victim reporting and deter patient aggression.
    Keywords:  Workplace violence; aggression; nurse-patient relations; nurses; safety management
    DOI:  https://doi.org/10.1111/jonm.13618
  3. Nurs Philos. 2022 Apr 13. e12390
    Clinical reasoning as midwifery: A Socratic model for shared decision making in person-centred care.
    Julie D Gunby, Jennifer Ryan Lockhart.
      Shared decision making has become the standard of care, yet there remains no consensus about how it should be conducted. Most accounts are concerned with threats to patient autonomy, and they address the dangers of a power imbalance by foregrounding the patient as a person whose complex preferences it is the practitioner's task to support. Other corrective models fear that this level of mutuality risks abdicating the practitioner's responsibilities as an expert, and they address that concern by recovering a nuanced but genuinely directive clinical role. Cribb and Entwistle helpfully categorize models of shared decision making as 'narrower' and 'broader' and praise the latter's 'open-ended and fully dialogical ways of relating'. However, they stop short of providing a philosophical account of how that dialogue works. In this paper, a nurse-midwife and a philosopher collaborate to argue that the Socratic model of dialogue offers a solution to the practitioner-patient dilemma. In the Theaetetus, Socrates compares dialogical reasoning to 'midwifery with all its standard features'. By means of a three-way analogy, elements of midwifery practice are used to illuminate features of Socrates' claim that his dialogue is like midwifery; those features are then translated into an approach to shared decision making as the 'midwifery of good thinking' which both midwives and physicians would do well to adopt. A key concept that emerges is the need for practitioners to make a risk-confidence assessment of the particular content of any decision to appropriately modulate their role in the practice of shared decision making.
    Keywords:  Plato; Socrates; dialogue; midwifery; person-centred care; risk assessment; shared decision making
    DOI:  https://doi.org/10.1111/nup.12390
  4. J Patient Exp. 2022 ;9 23743735221092564
    A Qualitative Analysis of Older Adults' Views of Healthcare Provider Attributes and Communication Skills.
    Brittany Stewart, Paige Hanke, Megan Kucemba, Diane L Levine, Jennifer Mendez, Aline H Saad.
      Understanding factors that improve patients' healthcare experiences are essential for healthcare providers (HCPs) caring for older adults (OAs). Previous data supports that effective patient-centered care leads to a better understanding of patients' experiences, values, and preferences. The aim of this study was to evaluate OAs views of HCPs attributes and communication skills to better understand patient's views about their HCP interactions. Qualitative analysis of the data revealed five key themes that emerged: professionalism, patient rapport, patient-centered care, empathy, and communication. Addressing and optimizing performance in these areas could improve patient experiences and support enhanced training for healthcare students.
    Keywords:  communication; interprofessional education; older adults; patient experiences; patient-centered care
    DOI:  https://doi.org/10.1177/23743735221092564
  5. Int J Environ Res Public Health. 2022 Mar 31. pii: 4173. [Epub ahead of print]19(7):
    A Meta-Analysis of the Effectiveness of Telemedicine in Glycemic Management among Patients with Type 2 Diabetes in Primary Care.
    Anqi Zhang, Jinsong Wang, Xiaojuan Wan, Ziyi Zhang, Shuhan Zhao, Zihe Guo, Chufan Wang.
      Introduction: Telemedicine interventions are gradually being used in primary health care to help patients with type 2 diabetes receive ongoing medical guidance. The purpose of this study was to analyze the effectiveness of using telemedicine in primary health care for the management of patients with type 2 diabetes. Methods: A systematic search was conducted from database inception to August 2021 in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, EBSCO, CNKI, Wanfang Data, VIP, and CBM. Data extraction and quality assessment were performed for studies that met the inclusion criteria. The meta-analysis was performed using Review Manager 5.4 (Cochrane) and Stata v.16.0SE (College Station, TX, USA). Results: A total of 32 articles were included in this study. Analysis showed a reduction in glycated hemoglobin, fasting glucose, and postprandial glucose after the telemedicine intervention. Systolic blood pressure and self-efficacy improved significantly, but there was no significant improvement in weight, lipid metabolism, or diabetes awareness. Subgroup analysis based on the duration of intervention showed significant improvement in glycated hemoglobin at 6 months of intervention. Conclusions: Telemedicine interventions may help patients with type 2 diabetes to effectively control blood glucose and improve self-management in primary health care. There is only moderate benefit, and the benefit may not be sustained beyond 6 months. However, the evidence for the improvement in lipid metabolism is insufficient and further studies are needed.
    Keywords:  meta-analysis; primary health care; telemedicine; type 2 diabetes
    DOI:  https://doi.org/10.3390/ijerph19074173
  6. Front Pediatr. 2022 ;10 832453
    Instruments Measuring Self-Care in Children and Young Adults With Chronic Conditions: A Systematic Review.
    Valentina Biagioli, Giuseppina Spitaletta, Valeria Kania, Rachele Mascolo, Orsola Gawronski, Annachiara Liburdi, Giulia Manzi, Michele Salata, Ercole Vellone, Emanuela Tiozzo, Immacolata Dall'Oglio.
      Children and young adults (CYAs) with chronic conditions need to engage in self-care to improve their quality of life. This study aimed to retrieve the literature on instruments to assess self-care in CYAs living with chronic conditions and evaluate the psychometric proprieties of the instruments retrieved. A systematic literature review was conducted on six databases to identify peer-reviewed papers that described or used an evaluation instrument of self-care in CYAs with chronic conditions. Twenty-three articles describing 11 instruments of self-care were identified. Five instruments (45.45%) were developed for specific diseases, while six (54.54%) for various chronic illnesses. Most of the instruments were focused on treatment adherence within self-care maintenance (i.e., behaviors to maintain illness stability), excluding the monitoring of clinical parameters or the management of exacerbations. This review provides an overview of available instruments that measure self-care in CYAs with chronic conditions, which health professionals could use for patient education.
    Keywords:  adolescent; chronic disease; instruments; parent; pediatric; self-care; self-management; young adult
    DOI:  https://doi.org/10.3389/fped.2022.832453
  7. J Correct Health Care. 2022 Feb 28.
    Health Care Quality and Safety in a Correctional System: Creating Goals and Performance Measures for Improvement.
    Jennifer Neely, Rupa Sampath, Geri Kirkbride, Steve L Meeks, Marianne L Durham.
      This article summarizes a collaboration between the Illinois Department of Corrections and an academic partner, University of Illinois at Chicago College of Nursing (UIC Nursing), to deliver a quality improvement (QI) and patient safety plan to the state. Included is a description of the need for meaningful data-driven QI as a method to deliver health care to the incarcerated population. An overview of the assessment, gap analysis, and collaboration between partners to develop a mission, vision, and performance dashboard with a beginning set of measures is presented. The dashboard with performance measures was developed to highlight the priorities of the organization and to focus improvement work to meet those goals. Next step recommendations for UIC Nursing to consult on implementation priorities and training are described.
    Keywords:  correctional health care; dashboard; patient safety; performance measurement; quality
    DOI:  https://doi.org/10.1089/jchc.20.07.0058
  8. Digit Health. 2022 Jan-Dec;8:8 20552076221089794
    Theoretical model and measurement of shared decision making in web-based pharmaceutical care consultation.
    Haihong Chen, Yuqi Xiong, Zinan Zhang, Qian Zhou, Dan Wang, Xuemei Wang, Xinping Zhang.
      Objectives: We aimed to construct a theoretical model and an observer-based measurement of shared decision making (SDM) in web-based pharmaceutical care consultation.Methods: We first constructed a theoretical model through analysis of SDM models and interviews with 24 key informants. Then, the initial measurement was formulated, and the content was evaluated by 16 key informants alone. A cross-sectional study was executed, where 300 provider-patient encounters were collected at the online platform 'Good Doctor Website', for reliability and validity assessment. Content validity was evaluated by appropriateness score, that is the median of 7-9 and without disagreement. Interrater reliability was evaluated by Spearman correlation coefficient using 30 out of 300 samples. Single indicator validity was tested by Pearson correlation analysis, and convergent validity was evaluated by the Multiple Indicators Multiple Causes (MIMIC) model using 300 samples.
    Results: Theoretical model constructed included four elements: 'comprehensive understanding of the patient's condition', 'exchanging ideas on medication options', 'achieving a medication plan', and 'providing decision support'. Measurement constructed included four dimensions and 19 items, and four dimensions were in accordance with four elements of the theoretical model. We found median scores of these dimensions and items were 7-9 and without disagreement, indicating good content validity. Spearman correlation coefficients of 19 items were greater than 0.750, suggesting good interrater reliability. Pearson coefficients between 19 items and their external variables were significant (p < 0.001), and MIMIC model results showed that the R 2 values of dimensions 1-4 were over 0.5, indicating good single indicator validity and convergent validity.
    Conclusions: Characteristics of web-based pharmaceutical care consultation, highlighting the importance of medication history, medication regimen, and detailed medication plan, were observed in the theoretical model. Measurement constructed had good reliability and validity and may be used by health policymakers to improve the quality of pharmaceutical care consultation online.
    Keywords:  Shared decision making; internet; measurement; pharmaceutical care consultation; theoretical model
    DOI:  https://doi.org/10.1177/20552076221089794
  9. J Am Coll Surg. 2022 May 01. 234(5): 973
    Shared Decision-Making in High-Risk Operation and Carl Rogers' Reflective Listing.
    Alain Braillon.
      
    DOI:  https://doi.org/10.1097/XCS.0000000000000074
  10. Health Expect. 2022 Apr 11.
    Codesigning a patient support portal with health professionals and men with prostate cancer: An action research study.
    Benjamin Shemesh, Jacinta Opie, Ellie Tsiamis, Darshini Ayton, Prassannah Satasivam, Paula Wilton, Karla Gough, Katrina Lewis, Colin O'Brien, Max Shub, Amanda Pomery, Christopher Mac Manus, Jeremy Millar, Susan Evans.
      INTRODUCTION: The supportive care needs of men with prostate cancer (PCa) have been well documented, but little is known about how an online portal may address these. This study sought to determine priority issues facing men with PCa, barriers and enablers to accessing care and whether health professionals (HPs) and men would support the inclusion of a patient-reported outcome (PRO) comparator tool.METHODS: We conducted four online focus groups with HPs recruited from healthcare services in Victoria, followed by seven online codesign workshops with men with PCa, recruited through the Victorian Prostate Cancer Outcomes Registry, Prostate Cancer Foundation Australia and the Cancer Council Victoria. Men were eligible to participate if they had lived experience of PCa and access to the internet. We analysed focus groups thematically. Workshops were analysed using descriptive-content analysis.
    RESULTS: HPs (n = 39) highlighted that men had shifting priorities over time, but noted the importance of providing information to men in lay terms to assist in treatment decision-making and side-effect management. HPs identified key enablers to men accessing support services such as practice nurses, partners and having men share their stories with each other. HPs raised financial, cultural, geographic and emotional barriers to accessing supportive care. Inclusion of a PRO comparator tool received mixed support from HPs, with 41% (n = 16) supportive, 49% (n = 19) unsure and 10% (n = 4) not supportive. Men involved in workshops (n = 28) identified informational needs to assist in treatment decision-making and side-effect management as the top priority throughout care. Men described support groups and practice nurses as key enablers. Short consultation times and complex information were described as barriers. Unlike HPs, all men supported the inclusion of a PRO comparator tool in a portal.
    CONCLUSIONS: Our findings suggest that a patient support portal should provide information in lay terms that address the shifting priorities of men with PCa. Men with PCa would welcome the development of a portal to centralize support information and a PRO comparator tool to prompt health-seeking behaviour. Future research will implement these findings in the development of a portal, and pilot and evaluate the portal within a population-based sample.
    PATIENT OR PUBLIC CONTRIBUTION: This project adopted a codesign approach including both men with PCa and HPs involved in PCa care. Men with PCa also formed part of the study's steering committee and consumer advisory groups. HPs were consulted in a serious of online focus groups. Subsequently, men with PCa and their support persons participated in workshops. Men with PCa were also involved in the preparation of this manuscript.
    Keywords:  action research study; codesign; patient-reported outcomes; prostate cancer; support portal
    DOI:  https://doi.org/10.1111/hex.13444
  11. Curr Hypertens Rep. 2022 Apr 12.
    A Systematic Review of the Role of Telemedicine in Blood Pressure Control: Focus on Patient Engagement.
    Ahmad Khanijahani, Nesli Akinci, Eric Quitiquit.
      PURPOSE OF REVIEW: To systematically review and synthesize the existing evidence on the effects of different telemedicine interventions on improving patient engagement among patients with hypertension. Patient engagement is defined as patients' knowledge, skills, ability, and willingness to manage their healthcare within the context of interventions designed to promote positive patient behaviors.RECENT FINDINGS: Telemedicine is a rapidly growing method of healthcare services delivery. Telemedicine interventions are mainly used to facilitate communication between the patient and provider, measure, record, and track blood pressure, and educate and train patients about managing their blood pressure. Findings from several studies indicate the evidence of patient engagement, adherence to the care plan, improvement in knowledge about blood pressure, and patient satisfaction with telemedicine interventions for blood pressure. Telemedicine interventions need to be customized depending on patient demographics and socioeconomic characteristics such as age and education level to ensure optimal patient engagement.
    Keywords:  Blood pressure; Hypertension; Patient adherence; Patient engagement; Telehealth; Telemedicine
    DOI:  https://doi.org/10.1007/s11906-022-01186-5
  12. Int J Environ Res Public Health. 2022 Apr 04. pii: 4334. [Epub ahead of print]19(7):
    The Behavioral Factors That Influence Person-Centered Social Care: A Literature Review and Conceptual Framework.
    Eugene Tay, Ivo Vlaev, Sebastiano Massaro.
      The last decade has seen numerous policy reforms to emplace person-centered social care. Consequently, the public has been given more information, choice, and autonomy to decide how best they want to be cared for later in life. Despite this, adults generally fail to plan or prepare effectively for their future care needs. Understanding the behavioral antecedents of person-centered decision-making is thus critical for addressing key gaps in the provision of quality social care. To this end, we conducted a literature review of the psychological and health sciences with the aim of identifying the aspects that influence person-centered decision-making in social care. Using an established theoretical framework, we distilled nine behavioral factors-knowledge, competency, health, goal clarity, time discounting, familiarity, cognitive biases, cognitive overload, and emotion-associated with "Capability," "Opportunity," "Motivation," and "Behavior" that explained person-centered decision-making in social care. These factors exist to different degrees and change as a person ages, gradually impacting their ability to obtain the care they want. We discuss the role of carers and the promise of shared decision-making and conclude by advocating a shift from personal autonomy to one that is shared with carers in the delivery of quality social care.
    Keywords:  advance planning; aging population; decision-making; elderly care; nudging
    DOI:  https://doi.org/10.3390/ijerph19074334
  13. Int J Med Inform. 2022 Apr 08. pii: S1386-5056(22)00075-2. [Epub ahead of print]162 104761
    Effectiveness of a web-based, electronic medical records-integrated patient agenda tool to improve doctor-patient communication in primary care consultations: A pragmatic cluster-randomized controlled trial study.
    Yew Kong Lee, Chirk Jenn Ng, Mohamed Reza Syahirah, Tun Firzara Abdul Malik, Thiam Kian Chiew, Ping Yein Lee, Adina Abdullah, Charity Lee, Khalid Khaizura, Mohd Yamin Ahmad, Mohamad Zahir Ahmad.
      BACKGROUND: Doctors may struggle to identify patient agendas during busy primary care consultations. Therefore, an online patient agenda tool (the Values in Shared Interactions Tool- VISIT) was developed which allowed patients to enter their agenda items pre-consultation for doctors to view on their electronic medical records (EMR). This study aimed to measure the impact of this EMR-integrated website on patient satisfaction, number of agenda items discussed and consultation time.METHODS: An unblinded cluster-randomized controlled trial was conducted in a university-based primary care clinic between June-October 2019. Twenty-five family medicine trainees were randomized into using the VISIT tool (intervention) and usual care (control). Descriptive analysis showed significant differences between arms for age, occupation and mobile device proficiency scores. These were entered as covariates in trial analyses. Primary outcome was mean self-reported patient satisfaction score using the Healthcare Provider-Patient Communication (HCPPC) questionnaire, secondary outcomes were mean agenda items per consultation and mean consultation time.
    RESULTS: The intervention arm had 12 doctors and 109 patients; the control arm had 13 doctors and 137 patients. Participation rates were 25.5% for intervention vs 53.6% for control. There was no difference between arms for patient satisfaction scores (133.3, 95% CI: 130.67-135.88 intervention vs 134.0, 95% CI: 131.76-136.29 control, P =.680) and consultation duration (15.83 min, 95% CI: 13.66-17.99 intervention vs 15.45 min, 95% CI: 13.57-17.34 control, P =.805). Mean number of agenda items discussed was higher in the intervention arm (2.25 items, 95% CI: 2.06-2.44 intervention vs 1.94 items, CI 95%: 1.78-2.11, P =.024).
    CONCLUSIONS: Integrating patient agendas into the EMR did not affect patient satisfaction compared to usual care but was associated with a slightly increased number of agenda items without an increase in consultation time. This shows it may be useful for a busy primary care setting with multiple comorbidities and short consultation times.
    Keywords:  Electronic medical records; Patient agenda; Patient portal; Patient satisfaction; Web application
    DOI:  https://doi.org/10.1016/j.ijmedinf.2022.104761
  14. Support Care Cancer. 2022 Apr 14.
    Nurse-led telehealth interventions for symptom management in patients with cancer receiving systemic or radiation therapy: a systematic review and meta-analysis.
    Chanel Kwok, Charlena Degen, Narges Moradi, Dawn Stacey.
      PURPOSE: Patients receiving cancer treatments experience many treatment-related symptoms. Telehealth is increasingly being used to support symptom management. The overall aim was to determine the effectiveness of nurse-led telehealth symptom management interventions for patients with cancer receiving systemic or radiation therapy compared to usual care on health service use, quality of life, and symptom severity.METHODS: A systematic review was conducted following the Cochrane Handbook and PRISMA reporting guidelines. Five electronic databases were searched. Two independent reviewers screened articles and extracted data. Meta-analysis was performed if data were clinically and methodologically homogeneous. Subanalysis was conducted on reactive and scheduled telehealth interventions.
    RESULTS: Of 7749 citations screened, 10 studies were included (8 randomized control trials, 2 quasi-experimental). Five were reactive telehealth interventions with patient-initiated contact and five evaluated scheduled telehealth interventions initiated by nurses. Compared to usual care (typically patient-initiated calls), nurse-led telehealth interventions for symptom management showed no statistically significant difference in hospitalizations, emergency department visits, or unscheduled clinic visits. Two of three studies of reactive telehealth interventions showed improved quality of life. All telehealth interventions showed reduction in the severity of most symptoms. Pain severity was significantly reduced (standard mean difference - 0.54; 95% CI - 0.88, - 0.19). Significant heterogeneity prevented meta-analysis for most outcomes.
    CONCLUSION: Few studies evaluated nurse-led telehealth interventions for cancer symptom management. Compared to usual care, patients exposed to telehealth interventions had reduced symptom severity and no difference in health services use. Future research should focus on better reporting intervention characteristics and consistently measuring outcomes.
    Keywords:  Chemotherapy; Nurses; Oncology; Radiation therapy; Symptom management; Telehealth
    DOI:  https://doi.org/10.1007/s00520-022-07052-z
  15. Support Care Cancer. 2022 Apr 12.
    How technology can improve communication and health outcomes in patients with advanced cancer: an integrative review.
    Natasha Ansari, Christina M Wilson, Mallorie B Heneghan, Kathie Supiano, Kathi Mooney.
      OBJECTIVE: Patients facing an advanced cancer diagnosis require clear communication with their clinicians. Technology has been utilized in many different capacities to navigate communication in cancer care, but few authors examine the specific areas of communication from a theoretical perspective. The purpose of this literature review was to (1) identify articles focused on technology-based communication strategies to improve health outcomes in individuals with advanced cancer, and (2) using Epstein and Street's framework, identify areas in which technology-based communication has been used to improve health outcomes, and (3) identify gaps that exist in technology-based communication care in patients with advanced cancer.METHODS: A systematic search was conducted which returned 446 articles. Using Epstein and Street's 2007 framework, the final sample was 39.
    RESULTS: Nine clinical trials, 29 observational studies, and 1 case study were identified. The articles were categorized into one area within Epstein and Street's areas of communication. Many of the articles examined the patient's and provider's acceptability and feasibility of technology-based methods of communication, while other articles examined their efficacy.
    CONCLUSIONS: While research studies were identified in each of the areas of communication, the majority of technology-based communication strategies were focused on the exchange of information between patients and their providers. Further research and the development of technology-based communication interventions assessed through clinical trials are needed in the areas of healing relationships and making decisions in cancer care. Additionally, the communication strategies found effective at improving health outcomes in advanced cancer should begin implementation into clinical practice, therefore reaching more patients.
    Keywords:  Cancer; Internet; Palliative; Technology; Telemedicine; eHealth
    DOI:  https://doi.org/10.1007/s00520-022-07037-y
  16. J Patient Exp. 2022 ;9 23743735221092604
    Characterizing the Relationship Between Hospital Google Star Ratings, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Scores, and Quality.
    Michael I Ellenbogen, Paul M Ellenbogen, Nayoung Rim, Daniel J Brotman.
      Google searches for hospitals typically yield a Google star rating (GSR). These ratings are an important source of information for consumers. The degree to which GSRs are associated with traditional quality measures has not been evaluated recently. We sought to characterize the relationship between a hospital's GSR, its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, and Centers for Medicare and Medicaid Services (CMS) quality measures. We found a moderate association between a hospital's GSR and its HCAHPS score. The relationship between a hospital's GSR and CMS quality measures was statistically significant, but the magnitude was quite low. Our findings suggest that consumers should not use GSRs as a hospital quality proxy.
    Keywords:  Google star ratings; online hospital reviews; patient safety; patient satisfaction
    DOI:  https://doi.org/10.1177/23743735221092604
  17. Rev Saude Publica. 2022 ;pii: S0034-89102022000100216. [Epub ahead of print]56 19
    Decision aid for prostate cancer screening in Brazil.
    Renata Oliveira Maciel Dos Santos, Mirhelen Mendes de Abreu, Arn Migowski, Elyne Montenegro Engstrom.
      OBJECTIVE: To present the development and validation processes of a decision aid for prostate cancer screening in Brazil.METHODS: Study with qualitative-participatory design for the elaboration of a decision aid for prostate cancer screening, with the participation of a group of men and physicians inserted in primary health care in 11 Brazilian states. Evidence synthesis, field testing, and use in clinical scenarios were performed to adapt the content, format, language, and applicability towards the needs of the target audience in the years 2018 and 2019. The versions were subsequently evaluated by the participants and modified based on the data obtained.
    RESULTS: We elaborated an unprecedented tool in Brazil, with information about the tests used in the screening, comparison of their possible benefits and harms and a numerical infographic with the consequences of this practice. We verified the decision aid usability to assist in the communication between the doctor and the man in the context of primary health care, besides identifying the need for greater discussion about sharing decisions in clinical scenarios.
    CONCLUSION: The tool was easy to use, objective, and has little interference in consultation time. It is a technical-scientific material, produced by research, with the participation of its main target audience and which is available free of charge for use in Brazilian clinical scenarios.
    DOI:  https://doi.org/10.11606/s1518-8787.2022056003467
  18. Eur J Cardiovasc Nurs. 2022 Apr 11. pii: zvac019. [Epub ahead of print]
    Developing a core outcome set for patient-reported symptom monitoring to reduce hospital admissions for patients with heart failure.
    Claire A Lawson, Carolyn Lam, Tiny Jaarsma, Umesh Kadam, Anna Stromberg, Mohammad Ali, Wan Ting Tay, Louise Clayton, Kamlesh Khunti, Iain Squire.
      AIMS: In patients with heart failure (HF), hospitalization rates are increasing, particularly for non-HF causes and over half may be avoidable. Self-monitoring of symptoms plays a key part in the early identification of deterioration. Our objective was to develop expert consensus for a core outcome set (COS) of symptoms to be monitored by patients, using validated single-item patient-reported outcome measures (PROMs), focused on the key priority of reducing admissions in HF.METHODS AND RESULTS: A rigorous COS development process incorporating systematic review, modified e-Delphi and nominal group technique (NGT) methods. Participants included 24 HF patients, 4 carers, 29 HF nurses, and 9 doctors. In three Delphi and NGT rounds, participants rated potential outcomes on their importance before a HF or a non-HF admission using a 5-point Likert scale. Opinion change between rounds was assessed and a two-thirds threshold was used for outcome selection.Item generation using systematic review identified 100 validated single-item PROMs covering 34 symptoms or signs, relevant to admission for people with HF. De-duplication and formal consensus processes, resulted in a COS comprising eight symptoms and signs; shortness of breath, arm or leg swelling, abdomen bloating, palpitations, weight gain, chest pain, anxiety, and overall health. In the NGT, a numerical rating scale was selected as the optimal approach to symptom monitoring.
    CONCLUSION: Recognition of a range of HF-specific and general symptoms, alongside comorbidities, is an important consideration for admission prevention. Further work is needed to validate and integrate the COS in routine care with the aim of facilitating faster identification of clinical deterioration.
    Keywords:  Consensus; Heart failure; Patient-reported outcomes measures
    DOI:  https://doi.org/10.1093/eurjcn/zvac019
  19. Eur J Cancer Care (Engl). 2022 Apr 13. e13594
    Roles of general practitioners in shared decision-making for patients with cancer: A qualitative study.
    Inger L Abma, Lianne C G Roelofs, Marion B van der Kolk, Sasja F Mulder, Henk J Schers, Rosella P M G Hermens, Philip J van der Wees.
      OBJECTIVE: The shared decision-making (SDM) process for the treatment of pancreatic and oesophageal cancer primarily takes place with healthcare professionals (HCPs) in the hospital setting. This study aims to explore the perspectives of general practitioners (GPs) on their possible roles during this SDM process, their added value and their requirements for involvement in SDM.METHODS: Semi-structured interviews were conducted with 12 GPs about their views on SDM for patients with cancer. The interviews were analysed by two researchers using an inductive open coding approach.
    RESULTS: Five potential roles in SDM were described by the interviewed GPs, of which the role as 'coach' of the patient was mentioned by all. GPs see their main added value as their long-standing relationship with the patient. To be able to participate optimally in SDM, GPs indicated that they need to be kept up to date during the patient's care process and should receive enough medical information about treatment options and contextual information.
    CONCLUSION: GPs see different potential roles for themselves when involved in SDM. Hospital HCPs that want to facilitate GP involvement should take the initiative, provide the GPs with enough and timely information and must be easy to consult.
    Keywords:  general practitioner; oesophageal cancer; pancreatic cancer; primary care involvement; shared decision-making; treatment decision
    DOI:  https://doi.org/10.1111/ecc.13594
  20. Chronic Illn. 2022 Apr 13. 17423953221088629
    Towards a patient-centred approach in therapeutic patient education. A qualitative study exploring health care professionals' practices and related representations.
    Sandrine Roussel, Mariane Frenay.
      OBJECTIVES: This study aimed to explore the practice-representation links among Health Care Professionals (HCP)s practising Therapeutic Patient Education (TPE). Understanding these links might actually help to address the challenges of TPE implementation, particularly the patient-centred dimension.METHODS: A qualitative study using individual interviews was conducted with HCPs practising in French-speaking Belgium or in France. Data analysis was carried out in two steps: to draw up a typology of educational practices (including variations) and, in line with the Social Representation Theory, to identify possible related social representations.
    RESULTS: The typology, based on HCP-Patient power distribution, was built from 26 interviews. Four types and nine subtypes were identified. Besides the power distribution, practice (sub)types were also specific regarding communication modes, consideration for patients' representations, motivational approach, personalization, complexity of methods and learning contents, and practice reflexivity. Practices were seldom constant. Three variations were highlighted: within a subtype, between different subtypes, and between education and technical care. Both practice subtypes and variations were related to specific decisive representations.
    DISCUSSION: Representations related to practices and those related to practices variations offer new perspectives for TPE implementation. There is no panacea for achieving more patient-centred approaches; tailored strategies based on practice subtypes are needed.
    Keywords:  Therapeutic patient education; patient-HCP relations; patient-centred approach; perception; qualitative research
    DOI:  https://doi.org/10.1177/17423953221088629
  21. J Healthc Inform Res. 2021 Dec;5(4): 382-400
    Analyzing Patient Stories on Social Media Using Text Analytics.
    Moutasem A Zakkar, Daniel J Lizotte.
      Patients can use social media to describe their healthcare experiences. Several social media platforms, such as the Care Opinion platform, host large volumes of patient stories. However, the large number of these stories and the healthcare system's workload make exploring these stories a difficult task for healthcare providers and administrators. This study uses text mining for analyzing patient stories on the Care Opinion platform and exploring healthcare experiences described in these stories. We collected 367,573 stories, which were posted between September 2005 and September 2019. Topic modeling (Latent Dirichlet Allocation) and sentiment analysis were used to analyze the stories. Sixteen topics were identified representing five aspects of the healthcare experience: communication between patients and providers, quality of clinical services, quality of non-clinical services, human aspects of healthcare experiences, and patient satisfaction. There was also a clear sentiment in 99% of the stories. More than 55% of the stories that describe the patient's request for information, the patient's description of treatment, or the patient's making of an appointment had a negative sentiment, which represents patient dissatisfaction. The study provides insights into the content of patient stories and demonstrates how topic modeling and sentiment analysis can be used to analyze large volumes of patient stories and provide insights into these stories. The findings suggest that these stories are not general social media posts; instead, they describe elements of healthcare experiences that can be helpful for quality improvement.Supplementary Information: The online version contains supplementary material available at 10.1007/s41666-021-00097-5.
    Keywords:  Patient experience; Patient stories; Social media; Text mining; Topic modeling
    DOI:  https://doi.org/10.1007/s41666-021-00097-5
  22. Am Fam Physician. 2022 Apr 01. 105(4): 428-429
    Patient Education Interventions Improve A1C Values.
    Sean Llewellyn, Melissa Neuman, Corey Lyon, Kristen DeSanto.
      
  23. Cancer Nurs. 2022 Apr 09.
    Coproducing and Implementing Person-Centered Key Performance Indicators in Ambulatory Cancer Nursing.
    Brighide Lynch, Tanya V McCance.
      BACKGROUND: Policy advocates person-centered healthcare for people living with cancer. Although nurses and patients alike recognize that a good care experience cannot be measured solely by clinical outcomes, the difficulty in finding indicators that measure the delivery of effective person-centered care remains a challenge.OBJECTIVE: The aim of this study was to explore the impact of a coproduced implementation project using the person-centered nursing key performance indicators to support the development of person-centered practice across ambulatory chemotherapy units.
    METHODS: The study adopted an evaluation approach derived from work of the Medical Research Council. A mobile app was used to collect and analyze 3 cycles of data using 4 measurement tools, with the aim of informing quality improvement activities. Six implementation teams were recruited from chemotherapy units across a region in the United Kingdom. Qualitative interviews were used to evaluate the experience of participants.
    RESULTS: Data analysis revealed 4 themes: building relationships that nurture the care experience, inspiring nursing staff to flourish, shaping practice and service changes through the nature of the conversations, and becoming person-centered through coproduction.
    CONCLUSION: This study provides evidence of the value of implementing these person-centered key performance indicators using a model of coproduction in cancer nursing. The data generated by the key performance indicators offer valuable feedback to nurses that can inform the development of person-centered practice and contribute to an enhanced patient experience.
    IMPLICATIONS FOR PRACTICE: This study provides an innovative and transferable approach for implementing relevant and appropriate key performance indicators within cancer nursing, which can contribute to developing person-centered cultures.
    DOI:  https://doi.org/10.1097/NCC.0000000000001094
  24. Aust N Z J Obstet Gynaecol. 2022 Apr 13.
    Development of a co-designed, evidence-based, multi-pronged strategy to support normal birth.
    Jyai Allen, Jocelyn Toohill, Debra K Creedy, Emily J Callander, Jenny Gamble.
      Australia's caesarean section (CS) rate has been steadily increasing for decades. In response to this, we co-designed an evidence-based, multi-pronged strategy to increase the normal birth rate in Queensland and reduce the need for CS. We conducted three workshops with a multi-stakeholder group to identify a broad range of options to reduce CS, prioritise these options, and achieve consensus on a final strategy. The strategy comprised of: universal access to midwifery continuity-of-care and choice of place of birth; multi-disciplinary normal birth education; resources to facilitate informed decision-making; respectful maternity care and positive workplace culture; and establishment of a Normal Birth Collaborative.
    Keywords:  birth; caesarean section; health services; maternity; pregnancy; women
    DOI:  https://doi.org/10.1111/ajo.13529
  25. Br J Clin Pharmacol. 2022 Apr 15.
    Partnership between patients and interprofessional healthcare providers along the multifaceted journey to medication adherence.
    Marie P Schneider, Michel Burnier.
      
    Keywords:  continuity of patient care; interprofessional collaboration; interprofessionality; medication adherence; multi-level intervention; partnership with patients; patient-centred care
    DOI:  https://doi.org/10.1111/bcp.15325
  26. Res Involv Engagem. 2022 Apr 11. 8(1): 12
    Hidden in plain sight? Identifying patient-authored publications.
    Jacqui Oliver, Dawn Lobban, Laura Dormer, Joanne Walker, Richard Stephens, Karen Woolley.
      BACKGROUND: Patient advocates are increasingly authoring peer-reviewed publications that could enhance patient care and understanding of the lived experience. Although patient authorship may be seen as an innovation in the peer-reviewed publication environment and some may not be aware of or accept patient authorship, we know patient-authored publications exist. However, identifying patient-authored publications is often challenging and time-consuming.MAIN BODY: In this commentary, we propose a definition for a patient author and patient-authored publications. We outline factors driving the increase in patient authorship, including patient interest, recognition of the value of including the patient voice and major funders recognising the importance of involving patient advocates in research. Evidence and experience-based guidance on patient authorship is emerging, and we highlight practical guidance for patient advocates on authoring peer-reviewed publications. To gain a better understanding of patient authorship, an efficient method is needed to identify patient-authored publications. A dataset on patient-authored publications could be used for a range of quantitative and qualitative research studies. The affiliation search function in PubMed can provide an easy, and reproducible way to identify a dataset of patient-authored publications in the international peer-reviewed literature, but only if patient authors include a standard metatag, (e.g. Patient Author) as one of their listed affiliations, combined with other affiliations as appropriate. From 2020 to 2021, there was a nine-fold increase in patient-authored publications in PubMed identified using the Patient Author tag. We recognize that terminology can be contentious and some authors may prefer alternative metatags. Further efforts are required to gain consensus on a suitable, standard metatag or set of metatags to use to show the true extent of patient authorship.
    CONCLUSION: Patient authorship is not only legitimate, but it also exemplifies the principles of diversity, equity and inclusion. Stakeholders in the publication community need to review their policies and procedures to identify and address barriers to patient authorship. Patient advocates, funders, researchers and publishers could all help to promote awareness and acceptance of patient authorship and the merits of using a standard metatag or set of metatags, so that patient-authored publications are no longer hidden in plain sight.
    Keywords:  Authorship; Diversity; Equity and inclusion; Patient and public involvement; Patient author; PubMed; Publications
    DOI:  https://doi.org/10.1186/s40900-022-00346-w
  27. Palliat Med Rep. 2022 ;3(1): 26-35
    Training to Promote Empathic Communication in Graduate Medical Education: A Shared Learning Intervention in Internal Medicine and General Surgery.
    Bethany J Lockwood, Jillian Gustin, Nicole Verbeck, Kara Rossfeld, Kavitha Norton, Todd Barrett, Richard Potts, Robert Towner-Larsen, Brittany Waterman, Steven Radwany, Christopher Hritz, Sharla Wells-Di Gregorio, Scott Holliday.
      Background: Empathic communication skills have a growing presence in graduate medical education to empower trainees in serious illness communication.Objective: Evaluate the impact, feasibility, and acceptability of a shared communication training intervention for residents of different specialties.
    Design: A randomized controlled study of standard education v. our empathic communication skills-building intervention: VitalTalk-powered workshop and formative bedside feedback using a validated observable behavioral checklist.
    Setting/Subjects: During the 2018-2019 academic year, our intervention was implemented at a large single-academic medical center in the United States involving 149 internal medicine and general surgery residents.
    Measurements: Impact outcomes included observable communication skills measured in standardized patient encounters (SPEs), and self-reported communication confidence and burnout collected by surveys. Analyses included descriptive and inferential statistics, including independent and paired t tests and multiple regression model to predict post-SPE performance.
    Results: Of residents randomized to the intervention, 96% (n = 71/74) completed the VitalTalk-powered workshop and 42% (n = 30/71) of those residents completed the formative bedside feedback. The intervention demonstrated a 33% increase of observable behaviors (p < 0.001) with improvement in all eight skill categories, compared with the control who only showed improvement in five. Intervention residents demonstrated improved confidence in performing all elicited communication skills such as express empathy, elicit values, and manage uncertainty (p < 0.001).
    Conclusions: Our educational intervention increased residents' confidence and use of essential communication skills. Facilitating a VitalTalk-powered workshop for medical and surgical specialties was feasible and offered a shared learning experience for trainees to benefit from expert palliative care learning outside their field.
    Keywords:  communication training; empathy; graduate medical education; shared learning
    DOI:  https://doi.org/10.1089/pmr.2021.0036
  28. Health Expect. 2022 Apr 12.
    Similar values, different expectations: How do patients and providers view 'health' and perceive the healthcare experience?
    Nabil Natafgi, Olayinka Ladeji, Shanikque Blackwell, Yoon Duk Hong, Gail Graham, Marcia Cort, C Daniel Mullins.
      INTRODUCTION: No one can argue on the importance of health in one's life. However, the value of health in the context of other priorities for individuals is not always as clear. Further, patients' experience with the healthcare system is rarely contrasted with the service providers' expectations. The aim of this paper is to examine and compare patients' and providers' own definitions of health and their perceptions of the healthcare delivery experience from the lens of residents and providers in West Baltimore, Maryland.METHODS: This was a qualitative study with semi-structured focus groups (15 sessions) and individual in-depth interviews (21 interviews) with 94 participants. Two independent coders thematically analysed the transcripts.
    RESULTS: Patients identified five areas where health systems can help them stay healthy or become healthier: affordability and costs of care; accessibility; clinician/patient communication; addressing social determinants; and stigma and trust. Providers acknowledged that the healthcare experience is not always perfect. While the medical team focuses on conversations that enhance medical care, patients are expecting providers to touch on subjects beyond medical care.
    CONCLUSIONS: Patients and providers need to consider that although they have a common value towards health, there is still a gap in what users expect and what providers can offer. To further align those expectations, there is a need for increasing involvement of patient in care administration and improving dialogue between the parties about these differences.
    PATIENT OR PUBLIC CONTRIBUTION: A Stakeholder Advisory Board (SAB)-comprised of a patient, two community leaders, a physician and two healthcare administrators-was instrumental in codeveloping the study material (e.g., interview guides), engaging patients in the research process, identifying participants and codeveloping dissemination material. Two SAB members-Gail Graham, a patient consultant/professor, and Marcia Cort, a physician-are coauthors.
    Keywords:  health values; patient engagement; patient experiences; patient-provider expectations; urban communities
    DOI:  https://doi.org/10.1111/hex.13493
  29. Sociol Health Illn. 2022 Apr 11.
    What does the literature mean by social prescribing? A critical review using discourse analysis.
    Sara Calderón-Larrañaga, Trish Greenhalgh, Sarah Finer, Megan Clinch.
      Social prescribing (SP) seeks to enhance the role of the voluntary and community sector in addressing patients' complex needs in primary care. Using discourse analysis, this review investigates how SP is framed in the scientific literature and explores its consequences for service delivery. Theory driven searches identified 89 academic articles and grey literature that included both qualitative and quantitative evidence. Across the literature three main discourses were identified. The first one emphasised increasing social inequalities behind escalating health problems and presented SP as a response to the social determinants of health. The second one problematised people's increasing use of health services and depicted SP as a means of enhancing self-care. The third one stressed the dearth of human and relational dimensions in general practice and claimed that SP could restore personalised care. Discourses circulated unevenly in the scientific literature, conditioned by a wider political rationality which emphasised individual responsibility and framed SP as 'solution' to complex and contentious problems. Critically, this contributed to an oversimplification of the realities of the problems being addressed and the delivery of SP. We propose an alternative 'care-based' framing of SP which prioritises (and evaluates) holistic, sustained and accessible practices within strengthened primary care systems.
    Keywords:  discourse analysis; literature review; primary health care; social prescribing
    DOI:  https://doi.org/10.1111/1467-9566.13468
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