bims-paceca 2022-09-25 papers

bims-paceca

Biomed News

on Patient-centred care

Issue of 2022–09–25
twelve papers selected by
Rob Penfold, Queensland Health

Decision aids for home and community care: a systematic review.
Use of Patient-Reported Data within the Acute Healthcare Context: A Scoping Review.
Effects of health literacy competencies on patient-centered care among nurses.
Measuring patient-centered care to improve hospital experiences of older adults.
Improving surgical patient education materials using informational design with visual elements.
Impact of Patient Engagement on Healthcare Quality: A Scoping Review.
Addressing barriers to shared decision-making in chronic kidney disease in the United States: An example from a community-based screening programme.
Novel Shared Decision-Making Tool Improves Contraceptive Screening and Right Care during Pregnancy in a Military Hospital: A Quality Improvement Report.
Patient Satisfaction with Telemedicine in Adults with Diabetes: A Systematic Review.
Patient-Centered and Family-Centered Care in the Intensive Care Unit.
Effectiveness of Therapeutic Patient Education Interventions in Obesity and Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Leveraging mHealth and Wearable Sensors to Manage Alcohol Use Disorders: A Systematic Literature Review.

BMJ Open. 2022 Aug 05. 12(8): e061215

Decision aids for home and community care: a systematic review.

Tania Lognon, Karine V Plourde, Emmanuelle Aubin, Anik M C Giguere, Patrick M Archambault, Dawn Stacey, France Légaré.

   OBJECTIVES: Decision aids (DAs) for clients in home and community care can support shared decision-making (SDM) with patients, healthcare teams and informal caregivers. We aimed to identify DAs developed for home and community care, verify their adherence to international DA criteria and explore the involvement of interprofessional teams in their development and use.
DESIGN: Systematic review reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
DATA SOURCES: Six electronic bibliographic databases (MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO and the Cochrane Library) from inception to November 2019, social media and grey literature websites up to January 2021.
ELIGIBILITY CRITERIA: DAs designed for home and community care settings or including home care or community services as options.
DATA EXTRACTION AND SYNTHESIS: Two reviewers independently reviewed citations. Analysis consisted of a narrative synthesis of outcomes and a thematic analysis. DAs were appraised using the International Patient Decision Aid Standards (IPDAS). We collected information on the involvement of interprofessional teams, including nurses, in their development and use.
RESULTS: After reviewing 10 337 database citations and 924 grey literature citations, we extracted characteristics of 33 included DAs. DAs addressed a variety of decision points. Nearly half (42%) were relevant to older adults. Several DAs did not meet IPDAS criteria. Involvement of nurses and interprofessional teams in the development and use of DAs was minimal (33.3% of DAs).
CONCLUSION: DAs concerned a variety of decisions, especially those related to older people. This reflects the complexity of decisions and need for better support in this sector. There is little evidence about the involvement of interprofessional teams in the development and use of DAs in home and community care settings. An interprofessional approach to designing DAs for home care could facilitate SDM with people being cared for by teams.
PROSPERO REGISTRATION NUMBER: CRD42020169450.

Keywords:  MEDICAL EDUCATION & TRAINING; PRIMARY CARE; PUBLIC HEALTH

DOI:  https://doi.org/10.1136/bmjopen-2022-061215
Int J Environ Res Public Health. 2022 Sep 06. pii: 11160. [Epub ahead of print]19(18):

Use of Patient-Reported Data within the Acute Healthcare Context: A Scoping Review.

Kathryn Kynoch, Mary Ameen, Mary-Anne Ramis, Hanan Khalil.

  Patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs) and patient satisfaction surveys provide important information on how care can be improved. However, data collection does not always translate to changes in practice or service delivery. This scoping review aimed to collect, map and report on the use of collected patient-reported data used within acute healthcare contexts for improvement to care or processes. Using JBI methods, an extensive search was undertaken of multiple health databases and trial registries for published and unpublished studies. The concepts of interest included the types and characteristics of published patient experience and PROMs research, with a specific focus on the ways in which data have been applied to clinical practice. Barriers and facilitators to the use of collected data were also explored. From 4057 records, 86 papers were included. Most research was undertaken in North America, Canada or the UK. The Hospital Consumer Assessment of Healthcare Providers and Systems tool (HCAHPS) was used most frequently for measuring patient satisfaction. Where reported, data were applied to improve patient-centred care and utilization of health resources. Gaps in the use of patient data within hospital services are noticeable. Engaging management and improving staff capability are needed to overcome barriers to implementation.

Keywords:  PREMs; PROMs; patient satisfaction; patient-reported data; patient-reported experience; scoping review

DOI:  https://doi.org/10.3390/ijerph191811160
BMC Health Serv Res. 2022 Sep 19. 22(1): 1172

Effects of health literacy competencies on patient-centered care among nurses.

Yaki Yang.

   BACKGROUND: This study aims to identify the relationship between health literacy competencies and patient-centered care by clinical nurses.
METHODS: The participants were 180 nurses working at three university hospitals located in G City and J Province, South Korea. Self-evaluation questionnaires were used to collect data that were collected from June 1 to 30, 2021. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression with SPSS 26.0.
RESULTS: The mean of health literacy competencies was 3.19 (4 point scale) and the mean of patient-centered care was 3.48 (5 point scale). There were significant positive relationships between health literacy competencies and patient-centered care by clinical nurses (r = .50, p < .001). Factors influencing the health literacy competencies of clinical nurses were identified as education level (university) (β = .82), education level (masters) (β = .74), prior health literacy knowledge (β = .52), and health literacy competencies (β = .44). The explanatory power of this regression model was 36%, which was statistically significant (F = 17.65, p < .001).
CONCLUSION: Clinical nurses' health literacy competencies should be developed to improve patient-centered care. Nursing education programs should emphasize the integration of health literacy into the nursing school curriculum.

Keywords:  Clinical competency; Health literacy; Nurses; Patient-centered care

DOI:  https://doi.org/10.1186/s12913-022-08550-w
J Am Geriatr Soc. 2022 Sep 20.

Measuring patient-centered care to improve hospital experiences of older adults.

Aanand D Naik.

DOI: https://doi.org/10.1111/jgs.18048
Am J Surg. 2022 Aug 28. pii: S0002-9610(22)00506-2. [Epub ahead of print]

Improving surgical patient education materials using informational design with visual elements.

Teressa A Duong, Lauren T Gleason, Kara Kichler, Elle R Kaplan, Connie C Shao, Isabel C Dos Santos Marques, Christine S Chen, Burke Smith, Melanie S Morris, Robert H Hollis, Daniel I Chu.

Patient education materials (PEMs) serve as a foundation for educating patients and families across all surgical fields but are often not understandable. The National Institute of Health (NIH) recommends that PEMs be written at a grade 6-7 reading level; however, most current materials exceed that measure.3 Lack of understandable and appropriate surgical PEMs compounds the difficulties that low health literacy patients face with resultant poor surgical outcomes.2,3 The challenge for surgeons is to adequately educate patients pre-operatively and post-operatively on the complexities of surgery. Another challenge is to compact decades of education and training into an easy-to-understand medium for patients. To address this challenge, many physicians have utilized visual aids to improve PEM efficacy. While visual aids are a critical piece of education materials, they must be designed intentionally to be effective. The most important consideration is that the PEM communicates the information clearly to users. With this in mind, we created a framework for productive utilization of visual aids by integrating the C.A.R.P. graphic design technique into an existing surgical PEM to enhance communication and understandability.

DOI: https://doi.org/10.1016/j.amjsurg.2022.08.009
J Patient Exp. 2022 ;9 23743735221125439

Impact of Patient Engagement on Healthcare Quality: A Scoping Review.

Sima Marzban, Marziye Najafi, Arjola Agolli, Ensieh Ashrafi.

  Patient engagement (PE) is a well-known strategy introduced and implemented by pharmaceutical and medical device companies for patient compliance and adherence to treatment protocols during clinical trials and care processes. This can affect a wider range of outcomes such as the quality of treatment decisions and quality of care outcomes. Few studies have paid attention to it. The involvement of patient is one of the crucial stakeholders of health care in their treatment that makes controversial opinions about the potential outcomes of their engagement in various aspects of healthcare. This scoping review was conducted in 2022 to collect the results of PE. The search was performed in the MEDLINE and Web of Sciences databases. The selected documents were categorized and reported by the direct content analysis method. Out of 3974 published documents, 17 articles were selected. Findings are categorized into 4 groups: (1) Health outcome, (2) patient compliance, (3) self-efficiency, and (4) return on investment. PE can improve both treatment outcomes and consequently patient satisfaction and health, as well as the productivity of the service provider. However, increasing self-care and patient adherence are among the positive effects of this engagement on the patient, and return on investment is still a challenge for PE.

Keywords:  impact; involvement; participation; patient engagement; patient-centered outcomes; stakeholder engagement

DOI:  https://doi.org/10.1177/23743735221125439
Health Soc Care Community. 2022 Sep 23.

Addressing barriers to shared decision-making in chronic kidney disease in the United States: An example from a community-based screening programme.

Nhu Dang, Anthony Zhong, Li-Li Hsiao.



Keywords:  chronic kidney disease; community-based volunteer programme; shared decision-making

DOI:  https://doi.org/10.1111/hsc.14036
J Midwifery Womens Health. 2022 Sep 18.

Novel Shared Decision-Making Tool Improves Contraceptive Screening and Right Care during Pregnancy in a Military Hospital: A Quality Improvement Report.

Jamie Guertin, Kalena Lanuza.

   INTRODUCTION: Unintended pregnancy rates in the military remain high compared with rates outside of the military in the United States (54%-60% vs 45%-50%, respectively). Contraceptive counseling in conjunction with shared decision-making is recommended to improve military unintended pregnancy rates. Best counseling practices and decision aids for contraceptive counseling are unknown in military and nonmilitary populations. Pregnancy may be an opportune time to complete contraceptive counseling because of regularly scheduled prenatal visits, and counseling during pregnancy is associated with higher postpartum contraception use. A quality initiative was implemented to improve contraceptive screening and counseling during pregnancy for servicewomen and nonservicewomen in a clinic setting.
PROCESS: The initiative included 4 patient-centered core interventions: a patient screening, a shared decision-making tool, a right care checklist, and a team engagement plan, across 4 rapid plan-do-study-act cycles.
OUTCOMES: Contraceptive screening rates and delivery of right care improved from 37% to 79% in the pregnant patients over 90 days; 81% of patients screened positive for contraception needs; 89% of patients made a same-day decision about their contraception plan after completing the tool; and 92% of patients had a contraception plan documented in the electronic health record by the health care provider prior to birth.
DISCUSSION: Results demonstrated that contraception screening rates and right care improved with initiative interventions for servicewomen and nonservicewomen. A novel shared decision-making tool presented 18 contraception methods, risks and benefits, and tiered effectiveness that aided the majority of patients in a same-day decision with high patient satisfaction. Provider counseling was also simplified without delay in clinic time. Contraceptive counseling completed with a shared decision-making tool may benefit military and civilian populations during pregnancy. Additional research is needed to examine the best time to conduct counseling during pregnancy and the long-term rates of contraceptive use or unplanned pregnancy following counseling events.

Keywords:  SQUIRE; contraception; decision aid; military; pregnancy; quality improvement; shared decision-making

DOI:  https://doi.org/10.1111/jmwh.13403
Healthcare (Basel). 2022 Sep 02. pii: 1677. [Epub ahead of print]10(9):

Patient Satisfaction with Telemedicine in Adults with Diabetes: A Systematic Review.

Hidetaka Hamasaki.

  Patient satisfaction assessment is essential for improving the quality of healthcare. Diabetes management using telemedicine technology is promising in the 21st century. However, the number of randomised controlled trials (RCTs) examining the effect of telemedicine on satisfaction in patients with diabetes is limited. This systematic review aimed to summarise the current evidence on patient satisfaction with telemedicine in adults with diabetes and discuss related issues and future directions of telemedicine in patients with diabetes. The author systematically searched PubMed/MEDLINE, Embase and The Cochrane Library, and a total of six RCTs were eligible for this review. Patient satisfaction with telemedicine was as high as conventional face-to-face care; however, telemedicine appeared not to significantly increase patient satisfaction compared with conventional face-to-face care in the included studies. Significant heterogeneity was noted between the studies, including participants' age, study duration, the method of assessing patient satisfaction and types of telemedicine. Further studies are required to provide firm evidence to healthcare providers who are willing to use telemedicine in diabetes management. Telemedicine technology has been advancing and is a key tool in providing high-quality healthcare to patients with diabetes in the 21st century.

Keywords:  digital health; information technology; patient satisfaction; telemedicine; type 1 diabetes; type 2 diabetes

DOI:  https://doi.org/10.3390/healthcare10091677
Clin Chest Med. 2022 Sep;pii: S0272-5231(22)00043-0. [Epub ahead of print]43(3): 539-550

Patient-Centered and Family-Centered Care in the Intensive Care Unit.

Katharine E Secunda, Jacqueline M Kruser.

  Patient-centered and family-centered care (PFCC) is widely recognized as integral to high-quality health-care delivery. The highly technical nature of critical care puts patients and families at risk of dehumanization and renders the delivery of PFCC in the intensive care unit (ICU) challenging. In this article, we discuss the history and terminology of PFCC, describe interventions to promote PFCC, highlight limitations to the current model, and offer future directions to optimize PFCC in the ICU.

Keywords:  Behavior and behavior mechanisms; Family-centered care; Humanization; Palliative care; Patient-centered care; Professional–patient relationship; Respect

DOI:  https://doi.org/10.1016/j.ccm.2022.05.008
Nutrients. 2022 Sep 15. pii: 3807. [Epub ahead of print]14(18):

Effectiveness of Therapeutic Patient Education Interventions in Obesity and Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Jorge C Correia, Ahmed Waqas, Teoh Soo Huat, Karim Gariani, François R Jornayvaz, Alain Golay, Zoltan Pataky.

  Diabetes mellitus (DM) and obesity account for the highest burden of non-communicable diseases. There is increasing evidence showing therapeutic patient education (TPE) as a clinically and cost-effective solution to improve biomedical and psychosocial outcomes among people with DM and obesity. The present systematic review and meta-analysis present a critical synthesis of the development of TPE interventions for DM and obesity and the efficacy of these interventions across a range of biomedical, psychosocial and psychological outcomes. A total of 54 of these RCTs were identified among patients with obesity and diabetes and were thus qualitatively synthesized. Out of these, 47 were included in the quantitative synthesis. There was substantial heterogeneity in the reporting of these outcomes (I2 = 88.35%, Q = 317.64), with a significant improvement noted in serum HbA1c levels (standardized mean difference (SMD) = 0.272, 95% CI: 0.118 to 0.525, n = 7360) and body weight (SMD = 0.526, 95% CI: 0.205 to 0.846, n = 1082) in the intervention group. The effect sizes were comparable across interventions delivered by different modes and delivery agents. These interventions can be delivered by allied health staff, doctors or electronically as self-help programs, with similar effectiveness (p < 0.001). These interventions should be implemented in healthcare and community settings to improve the health outcomes in patients suffering from obesity and DM.

Keywords:  diabetes mellitus; disease management; meta-analysis; obesity; patient education; self-management

DOI:  https://doi.org/10.3390/nu14183807
Healthcare (Basel). 2022 Sep 01. pii: 1672. [Epub ahead of print]10(9):

Leveraging mHealth and Wearable Sensors to Manage Alcohol Use Disorders: A Systematic Literature Review.

Clemens Scott Kruse, Jose A Betancourt, Stephanie Madrid, Christopher William Lindsey, Vanessa Wall.

   BACKGROUND: Alcohol use disorder (AUD) is a condition prevalent in many countries around the world, and the public burden of its treatment is close to $130 billion. mHealth offers several possible interventions to assist in the treatment of AUD.
OBJECTIVES: To analyze the effectiveness of mHealth and wearable sensors to manage AUD from evidence published over the last 10 years.
METHODS: Following the Kruse Protocol and PRISMA 2020, four databases were queried (PubMed, CINAHL, Web of Science, and Science Direct) to identify studies with strong methodologies (n = 25).
RESULTS: Five interventions were identified, and 20/25 were effective at reducing alcohol consumption. Other interventions reported a decrease in depression and an increase in medication compliance. Primary barriers to the adoption of mHealth interventions are a requirement to train users, some are equally as effective as the traditional means of treatment, cost, and computer literacy.
CONCLUSION: While not all mHealth interventions demonstrated statistically significant reduction in alcohol consumption, most are still clinically effective to treat AUD and provide a patient with their preference of a technologically inclined treatment Most interventions require training of users and some technology literacy, the barriers identified were very few compared with the litany of positive results.

Keywords:  alcohol use disorder; eHealth; mHealth; substance use disorder; telemedicine; wearable sensors

DOI:  https://doi.org/10.3390/healthcare10091672