bims-paceca 2022-07-31 papers

bims-paceca

Biomed News

on Patient-centred care

Issue of 2022–07–31
twelve papers selected by
Rob Penfold, Queensland Health

Approaches to Improvement of Digital Health Literacy (eHL) in the Context of Person-Centered Care.
Shared decision-making to improve medication adherence.
A Meta-Synthesis Study of Person-Centered Care Experience from the Perspective of Nursing Home Residents.
Recent Trends in Health Literacy Research, Health Status of the Population and Disease Prevention: An Editorial.
Developing catalyst films of health experiences: an analysis of a robust multi-stakeholder involvement journey.
Engaging patients, families and professionals at the bedside using whiteboards.
"Who are you calling a used car salesman!?!""Selling" the Patient Experience to Physicians in Training.
Bringing the patient voice into the operating room: engaging patients in surgical safety research with the Operating Room Black Box®.
Characteristics and 10 key components of interpersonal caring: a narrative review.
Listening to the patient voice adds value to cancer clinical trials.
Doctor! Did you Google my symptoms? A qualitative study of patient perceptions of doctors' point-of-care information seeking.
Association between Health Literacy and Prevalence of Obesity, Arterial Hypertension, and Diabetes Mellitus.

Int J Environ Res Public Health. 2022 Jul 07. pii: 8309. [Epub ahead of print]19(14):

Approaches to Improvement of Digital Health Literacy (eHL) in the Context of Person-Centered Care.

Theresa Sophie Busse, Julia Nitsche, Sven Kernebeck, Chantal Jux, Jürgen Weitz, Jan P Ehlers, Ulrich Bork.

  The skills, knowledge and resources to search for, find, understand, evaluate and apply health information is defined as health literacy (HL). If individuals want to use health information from the Internet, they need Digital Health Literacy (eHL), which in addition to HL also includes, for example, media literacy. If information cannot be found or understood by patients due to low (e)HL, patients will not have the opportunity to make informed decisions. In addition, many health apps for self-management or prevention also require (e)HL. Thus, it follows that active participation in healthcare, in terms of Person-Centered Care (PCC) is only possible through (e)HL. Currently, there is a great need to strengthen these competencies in society to achieve increased empowerment of patients and their health. However, at the same time, there is a need to train and improve competencies in the field of healthcare professionals so that they can counsel and guide patients. This article provides an overview with a focus on HL and eHL in healthcare, shows the opportunities to adapt services and describes the possible handling of patients with low (e)HL. In addition, the opportunities for patients and healthcare professionals to improve (e)HL are highlighted.

Keywords:  digital medicine; eHealth; education; ehealth literacy; health literacy; mHealth; technology

DOI:  https://doi.org/10.3390/ijerph19148309
Nurse Pract. 2022 Aug 01. 47(8): 41-47

Shared decision-making to improve medication adherence.

Jason T Slyer.

ABSTRACT: Shared decision-making is recommended in many clinical practice guidelines. Using a case study of medication adherence, this paper demonstrates how providers can utilize the concepts of shared decision-making to improve treatment decisions and increase patient self-efficacy in carrying out the plan of care.

DOI: https://doi.org/10.1097/01.NPR.0000841928.60278.75
Int J Environ Res Public Health. 2022 Jul 14. pii: 8576. [Epub ahead of print]19(14):

A Meta-Synthesis Study of Person-Centered Care Experience from the Perspective of Nursing Home Residents.

Eun-Young Kim, Sung-Ok Chang.

   PURPOSE: To systematically review and synthesize the evidence for the experience of person-centered care from the perspective of nursing home residents to understand their views in depth.
METHODS: The seven steps of Nobit and Hare's meta-ethnography, a well-known meta-synthesis method, were applied. We used four databases for the literature search (PubMed, Web of Science, EMBASE, and CINAHL).
RESULTS: A total of seven studies were included for review. As a result of synthesizing the results, three themes ("promotion of mutual understanding through communication", "care that acknowledges the independence of residents" and "finding the optimized state") and six sub-themes were derived.
CONCLUSIONS: This study has provided an in-depth understanding of person-centered care and will contribute to increasing its practical application.

Keywords:  nursing homes; person-centered care; qualitative research; systematic review

DOI:  https://doi.org/10.3390/ijerph19148576
Int J Environ Res Public Health. 2022 Jul 10. pii: 8436. [Epub ahead of print]19(14):

Recent Trends in Health Literacy Research, Health Status of the Population and Disease Prevention: An Editorial.

Agnieszka Barańska, Anna Kłak.

One challenge for the development of healthcare systems worldwide is to shape society's health literacy [...].

DOI: https://doi.org/10.3390/ijerph19148436
Res Involv Engagem. 2022 Jul 29. 8(1): 34

Developing catalyst films of health experiences: an analysis of a robust multi-stakeholder involvement journey.

Sarah Davis, Nancy Pandhi, Barbara Warren, Njeri Grevious, Madison Crowder, Haley Ingersoll, Elizabeth Perry, Andrew Sussman, Rachel Grob.

   BACKGROUND: Those whose lives are most directly impacted by health care-patients, caregivers, and frontline staff-are ideally situated to improve patient health care services and care quality. Despite a proliferation of literature on both Patient and Public Involvement (PPI) and clinical quality improvement (QI), concrete strategies regarding how to involve patients remain elusive.
AIM: Research suggests catalyst films, comprised of rigorously-analyzed interview data from diverse patients about their experiences with health and health care ("catalyst films") are a promising way to bring actionable patient feedback to QI. To date, such films have been crafted primarily by researchers. This project aimed to inform the science of engagement through analyzing how deliberate PPI informed the process of creating catalyst films.
METHODS: PPI methods included: research team norming activities through a project charter and role delineation process; key informant interviews; participant-ambassador videotaped interviews; clinician and research focus groups; and inclusion of advisors on the research team. Content studied for the analysis presented here included team meeting notes, interview and focus group transcripts, and documentation from a facilitated discussion about team processes. These data were analyzed to determine the impact of our PPI process. Member checking verified themes and lessons learned.
RESULTS: PPI shaped team deliberations and final products in substantial ways, including: what material to include in catalyst films and the tone they should convey; multiple issues regarding representation; and our collective understanding of how catalyst films could be used in the United States. Specific discussions addressed: how to include the optimal mix of interview segments that describe experiences with those that more directly point towards care improvement strategies; and how to balance positive and negative feedback from patients about experiences with care. Team process issues included ensuring equity in involvement despite team members having differing and sometimes multiple roles that complicated power dynamics and processes.
CONCLUSIONS: Multiple forms and degrees of PPI resulted in significant influence on catalyst films and companion materials. Our project thus provides proof of concept for PPI in creation of video products for QI which have traditionally been crafted by researchers. The model we developed, and document in this paper, can be adapted by others creating research-derived video products. Our findings can also inform future research on how co-designing catalyst films enhances their value for QI and the application of co-designed catalyst film use in QI. Lastly, it can guide those engaged in QI and medical education in their selection of film products focused on patient experiences.

Keywords:  Catalyst film; Co-design; DIPEx methodology; Film; Patient and public involvement; Quality improvement; Trigger film; Video; Visual participatory methods

DOI:  https://doi.org/10.1186/s40900-022-00369-3
J Interprof Care. 2022 Jul 26. 1-10

Engaging patients, families and professionals at the bedside using whiteboards.

Susan Law, Rosetta Antonacci, Ilja Ormel, Marcela Hidalgo, Julia Ma, Alina Dyachenko, Devon Laframboise, Elaine Doucette.

  Health-care systems around the world are striving to be patient-centered, and there is growing evidence that engaging patients and families in their care, as well as in efforts to redesign services, contributes to improved outcomes and experiences for patients and providers. This patient-oriented care movement includes efforts to improve the quality of information and communication between health-care professionals and patients as well as families and caregivers. Whiteboards have emerged as a best practice in hospitals to promote engagement and improve information and communication, yet with limited empirical evidence regarding their value to patients, families, or interprofessional teams. We introduced whiteboards on an acute medical unit at a community hospital and conducted an evaluation using a pre-post design collecting both qualitative and quantitative data. Baseline and post-implementation data were collected via qualitative interviews with patients/family and providers and using the Canadian Patient Experience Survey; focus groups were held with staff and members of the care team. Qualitative results highlighted improvements in communication between the care team and patients as well as family members. Implications for practice include attention to patient/family empowerment and safety, adherence to guidance for good communication, and support for regular training and education in the use of communication tools for members of the interprofessional team.

Keywords:  Whiteboards; action research; communication; interprofessional teams; mixed methods; patient-centered practice

DOI:  https://doi.org/10.1080/13561820.2022.2074379
Am J Med. 2022 Jul 23. pii: S0002-9343(22)00537-X. [Epub ahead of print]

"Who are you calling a used car salesman!?!""Selling" the Patient Experience to Physicians in Training.

Amgad N Makaryus.

DOI: https://doi.org/10.1016/j.amjmed.2022.06.025
Res Involv Engagem. 2022 Jul 23. 8(1): 32

Bringing the patient voice into the operating room: engaging patients in surgical safety research with the Operating Room Black Box®.

Cole Etherington, Maxime Lê, Laurie Proulx, Sylvain Boet.

   BACKGROUND: Surgery is one of the most common patient experiences in the health care system. Yet, efforts to engage patients in surgical safety research have not matched those of other health care fields. This is a critical issue given the nature of surgery inhibits patients' abilities to advocate for themselves as they are typically under anesthetic when the procedure is performed. We partnered with patients throughout our research program, which uses the Operating Room Black Box® to enhance surgical patient safety through transparent and proactive analysis of human factors to detect and prevent avoidable errors.
MAIN BODY: In this article, we outline the need for, and our approach to, patient engagement in surgical safety research. Our approach included a series of planned activities and skill development opportunities designed to build capacity and bring together patients, clinicians, and researchers to inform research and practice. We also conducted evaluation surveys during the first year of our program, which have indicated a positive experience by both patient partners and the research team.
CONCLUSION: We believe our approach can serve as an important first step toward building a model for patient engagement in the surgical safety field and could significantly contribute to improved quality of care and outcomes for surgical patients.

Keywords:  Healthcare delivery; Operating rooms; Patient engagement; Patient participation; Patient safety; Quality improvement; Surgical safety

DOI:  https://doi.org/10.1186/s40900-022-00367-5
J Educ Eval Health Prof. 2022 ;19 17

Characteristics and 10 key components of interpersonal caring: a narrative review.

Susie Kim.

  This paper aims to help people understand better the lives of people who are mentally ill by describing the general concept of the Interpersonal Caring Theory (ICT) and deducing 10 key components of interpersonal caring. The literature review described the definition of interpersonal caring, and its assumptions and characteristics. Furthermore, the authors' experience with patient care suggested the critical components of interpersonal caring, which is the compassion-based therapeutic actions/behaviors through the collaborative partnership developed between nurse and client. Essential characteristics of interpersonal caring include the following: person-to-person interaction between nurse and patient, genuine love and concern toward the person, conveying trust and hope, transcending space, time, and culture, holistic approach expressed through a comprehensive and dynamic mode of communication, helping the patient focus on their self-worth, and providing culturally relevant and sensitive nursing. Ten key components of interpersonal caring in ICT include noticing, participating, sharing, active listening, companioning, complimenting, comforting, hoping, forgiving, and accepting. Interpersonal caring results from the blended understanding of the empirical, aesthetic, ethical, and intuitive aspects of a given clinical situation, and a nexus of pre-conditions, content, feelings, and sense of self-worth/self-esteem.

Keywords:  Communication; Interpersonal caring; Mentally ill persons; Patient care; Trust

DOI:  https://doi.org/10.3352/jeehp.2022.19.17
J Natl Cancer Inst. 2022 Jul 28. pii: djac128. [Epub ahead of print]

Listening to the patient voice adds value to cancer clinical trials.

Michael D Brundage, Norah L Crossnohere, Jennifer O'Donnell, Samantha Cruz Rivera, Roger Wilson, Albert W Wu, Moher David, Derek Kyte, Bryce B Reeve, Alexandra Gilbert, Ronald C Chen, Melanie J Calvert, Claire Snyder.

Randomized clinical trials are critical for evaluating the safety and efficacy of interventions in oncology and informing regulatory decisions, practice guidelines, and health policy. Patient-reported outcomes (PROs) are increasingly used in randomized trials to reflect the impact of receiving cancer therapies from the patient perspective and can inform evaluations of interventions by providing evidence that cannot be obtained or deduced from clinicians' reports or from other biomedical measures. This commentary focuses on how PROs add value to clinical trials by representing the patient voice. We employed two previously published descriptive frameworks (addressing how PROs are used in clinical trials and how PROs have an impact, respectively) and selected nine clinical trial publications that illustrate the value of PROs according to the framework categories. These include three trials where PROs were a primary trial endpoint, three trials where PROs as secondary endpoints supported the primary endpoint, and three trials where PROs as secondary endpoints contrast the primary endpoint findings in clinically important ways. The nine examples illustrate that PROs add valuable data to the care and treatment context by informing future patients about how they may feel and function on different treatments and by providing clinicians with evidence to support changes to clinical practice and shared decision-making. Beyond the patient and clinician, PROs can enable administrators to consider the cost-effectiveness of implementing new interventions, and contribute vital information to policy-makers, health technology assessors, and regulators. These examples provide a strong case for the wider implementation of PROs in cancer trials.

DOI: https://doi.org/10.1093/jnci/djac128
BMJ Open. 2022 Jul 27. 12(7): e061090

Doctor! Did you Google my symptoms? A qualitative study of patient perceptions of doctors' point-of-care information seeking.

Isaac Tranter, Mieke L van Driel, Ben Mitchell.

   OBJECTIVE: To explore patient perceptions regarding doctors' information seeking during consultations.
DESIGN AND SETTING: Qualitative interviews with participants from six general practice waiting rooms in South East Queensland, Australia. Participants were asked about their experiences and opinions, and to comment on short videos of simulated consultations in which a doctor sought information. The interviews were analysed through a process of iterative thematic analysis using the framework of Braun and Clarke.
PARTICIPANTS: The 16 participants were purposively sampled including 5 men and 11 women from a diverse range of educational and age groups.
RESULTS: How a doctor's need to look up information impacted patient impressions of competence and trust was an overarching theme. The four dominant themes include: the trust a patient has in the doctor before the consultation, whether the doctor is expected to know the answer to a question without searching, has the doctor added value to the consultation by searching and the consultation skills used in the process.
CONCLUSIONS: Patient trust is fundamental to positive perceptions of general practitioners' information seeking at the point-of-care. Communication is key to building this trust. Understanding the patient's agenda, listening, assessing thoroughly and being honest and transparent about the need to seek information all contribute to a positive experience.

Keywords:  information management; primary care; world Wide Web technology

DOI:  https://doi.org/10.1136/bmjopen-2022-061090
Int J Environ Res Public Health. 2022 Jul 24. pii: 9002. [Epub ahead of print]19(15):

Association between Health Literacy and Prevalence of Obesity, Arterial Hypertension, and Diabetes Mellitus.

Božica Lovrić, Harolt Placento, Nikolina Farčić, Metka Lipič Baligač, Štefica Mikšić, Marin Mamić, Tihomir Jovanović, Hrvoje Vidić, Sandra Karabatić, Sabina Cviljević, Lada Zibar, Ivan Vukoja, Ivana Barać.

   BACKGROUND: Health literacy (HL) is linked to many health outcomes, including self-management of chronic diseases. The aim of this study was to assess the association of health literacy with the prevalence of obesity, arterial hypertension (AH), and type 2 diabetes mellitus (T2DM).
METHODS: This cross-sectional, single-center study included 500 patients (42.2% male and 57.8% females; median age, 63 years (interquartile range, 42-73)) hospitalized at General County Hospital in Požega, Croatia, between July and October 2020. The Short Assessment of Health Literacy for Croatian Adults (SAHLCA-50) questionnaire was used. Descriptive statistics (median with interquartile range (IQR), frequency, and percentages) and binary logistic regression were utilized.
RESULTS: Patients with AH had an inadequate level of health literacy as compared to those without AH (32 vs. 40 points; Mann-Whitney U test, p < 0.001). Patients with T2DM scored 31 points versus 39 points in patients without T2DM (Mann-Whitney U test, p < 0.001). Patients suffering from both AH and T2DM scored 31 points versus 33 points in those with either AH or T2DM and 41 points in patients without AH and T2DM (Kruskal-Wallis test, p < 0.001). There were no statistically significant differences in SAHLCA-50 scores according to the patient body mass index.
CONCLUSIONS: An inadequate level of health literacy is significantly associated with AH and T2DM but not with obesity. Male gender, low level of education, rural place of residence, retirement, and older age are significant predictors of inadequate health literacy.

Keywords:  arterial hypertension; diabetes mellitus; health literacy; obesity

DOI:  https://doi.org/10.3390/ijerph19159002