Patient Education and Counseling最新文献

{"title":"Risk communication - the science of making \"meaningful numbers\" or the art of making \"meaningful pictures\"?","authors":"Adrian Edwards","doi":"10.1016/j.pec.2025.109280","DOIUrl":"10.1016/j.pec.2025.109280","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"109280"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repositioning parents in pediatric pain discourse: A communication imperative for inclusive clinical practice.","authors":"Rio Saputra, Shirly Rizki Kusumaningrum, Arifin Nur Budiono","doi":"10.1016/j.pec.2025.109302","DOIUrl":"10.1016/j.pec.2025.109302","url":null,"abstract":"<p><p>While pediatric pain assessment increasingly emphasizes child self-report, current practices often inadequately integrate parental perspectives, potentially limiting comprehensive pain understanding. This correspondence responds to recent evidence by Lee et al. on parental roles in pediatric pain communication. We argue that existing pain assessment practices, which often inconsistently integrate perspectives from children, parents, and clinicians, can lead to fragmented evaluations. We propose a triangulative communication model that positions parents as epistemic partners, asserting that valuable longitudinal information from parents is often missed in clinical encounters. We advocate for reframing divergent parent-child narratives not as problematic, but as opportunities for a richer and more complete understanding of the pain experience. To operationalize this shift, we propose specific, evidence-based interventions including structured parental assessment tools, provider training on multi-perspective evaluation, and modifications to electronic health records. This paradigmatic shift toward inclusive family engagement holds implications beyond pediatric rheumatology, offering a comprehensive and ethically sound approach to family-centered care while honoring both parental expertise and a child's voice in clinical decision-making.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"109302"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constructing an intervention to foster posttraumatic growth in people living with a life limiting illness and receiving palliative care: Participatory action research.","authors":"Melanie R Lovell, Kerry N Warner, Peter Archer, Rebecca McCabe, Philip J Siddall","doi":"10.1016/j.pec.2025.109297","DOIUrl":"10.1016/j.pec.2025.109297","url":null,"abstract":"<p><strong>Objectives: </strong>People living with cancer and other life limiting illnesses often experience spiritual and existential distress. This distress may be linked to trauma related to the disease, treatment or preexisting posttraumatic stress, which may be exacerbated. Interventions based on posttraumatic growth have proven to be successful in promoting psychological, spiritual and existential wellbeing in people suffering chronic pain and spinal cord injury. This project aimed to design and develop an intervention to promote psychological and spiritual well-being in people with a life-limiting illness receiving palliative care by drawing on the principles of posttraumatic growth.</p><p><strong>Methods: </strong>Action research cycles, based on a participatory health perspective to include those living with life limiting illness and/or practitioners associated with their care in all stages of the study, were used to design and develop an intervention based on posttraumatic growth principles. People experienced in delivering palliative care services in hospital and/or community settings (N = 30) and those suffering life limiting illnesses and receiving palliative care (N = 9) participated in this study. Two pilot programs were run.</p><p><strong>Results: </strong>Participatory action research, used iteratively in two pilot programs, was employed to design and develop a novel intervention based on posttraumatic growth suitable for use in the palliative care context.</p><p><strong>Conclusions: </strong>This intervention developed using a posttraumatic growth framework has the capacity to improve the lives of people living with a life-limiting illness while receiving palliative care.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"109297"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special section examining risk discussions across clinical specialties using conversation analysis: From information transfer to an interactional perspective.","authors":"Maddie Tremblett, Laura Jenkins, Jonathan Potter, Alexa Hepburn","doi":"10.1016/j.pec.2025.109283","DOIUrl":"10.1016/j.pec.2025.109283","url":null,"abstract":"<p><p>Risk and uncertainty are pervasive in clinical settings, from diagnosis to treatment decision-making and disease management. Accordingly, risk communication has attracted a sustained interest, and is predominantly characterised by information transfer, with a focus on how messages are framed and received. Conversation analysis (CA) provides a different approach to analysing communication, examining the complexities of how risk is broached, is calibrated to individual contexts, and is sensitively negotiated across clinical encounters. This special section showcases original research that significantly advances our insights into risk communication, offering novel and rigorous insights from a spectrum of actual clinical encounters. Seven original papers present analyses of authentic recordings of clinical encounters in the U.K., USA, and Sweden across a range of clinical specialties (primary care, obstetrics, nephrology, paediatrics, and neurology). The nature of the risks varies from immediate and high-stakes situations (such as during labour and delivery), to more distal severe risks (seizure-related unexpected death or fatal anaphylaxis). Other studies examine the likelihood of illness development. Collectively, these studies illustrate the projectability of risk, the collaborative construction of (and resistance to) risk-oriented lifestyle behaviours, and the ways in which patient/carer concerns or worries are invoked. They highlight practices for gathering risk-related information, and the pivotal ways in which risk discussions can facilitate shared decision-making. Studies also show practical ways clinicians sensitively address severe outcomes or morally charged matters of risk-relevant lifestyle behaviours, carefully progressing from establishing a patient's current understanding to providing recommendations. The final paper explores how these types of studies can be translated into training. A guest commentary provides a broad reflection on how CA investigations advance the field of risk communication. Overall, this special section highlights the promise of interactional studies in clinical risk communication, provides recommendations for future research, and calls for the systematic integration of this knowledge into clinical practice.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"109283"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring modifiable lifestyle risk-talk in mild cognitive impairment diagnosis consultations: a conversation analytic approach.","authors":"Danielle Jones, Rachael Drewery, Karen Windle, Rose McCabe, Jemima Dooley, Felicity Slocombe, Andreia Fonseca de Paiva","doi":"10.1016/j.pec.2025.109285","DOIUrl":"10.1016/j.pec.2025.109285","url":null,"abstract":"<p><strong>Objectives: </strong>Approximately 20 % of the UK population aged ≥ 65 have Mild Cognitive Impairment (MCI), with 1 in 10 progressing to dementia. Fourteen modifiable risk factors, encompassing: less education, hearing loss, high LDL cholesterol, depression, traumatic brain injury, physical inactivity, diabetes, smoking, hypertension, obesity, excessive alcohol consumption, social isolation, air pollution, and visual loss account for around 45 % of worldwide dementias. There is growing consensus that interventions targeting risk behaviours may prevent or delay dementia and reduce the likelihood that MCI will progress to dementia. Healthcare professionals, especially in memory assessment services, play a crucial role in communicating dementia risk. This study explores the placement, form, and function of discussions about modifiable lifestyle dementia risks during consultations in which individuals are being diagnosed with MCI.</p><p><strong>Methods: </strong>The data were 43 MCI diagnostic feedback consultations, video-recorded in nine UK-based memory assessment services from 2014 to 2015. All data are British English. Conversation analytic methods were used to identify recurrent interactional practices related to lifestyle risk-talk.</p><p><strong>Results: </strong>Clinicians lead risk-talk discussions throughout the consultations. Three activities of risk-talk were identified: (1) risk identification - clinicians elicit the nature of patient's risk behaviors; (2) risk categorisation - informing patients about the risks of dementia; and (3) risk management - clinicians recommend strategies for dementia risk reduction. Clinicians tailor these discussions to each patient, focusing on their specific risk factors, or provide generic advice in the absence of identifiable risks.</p><p><strong>Conclusions: </strong>This study broadens the understanding of risk-talk activities and how they are delivered interactionally. It demonstrates how healthcare professionals skillfully integrate risk-talk throughout consultations while managing the inherent uncertainty surrounding health risks. It highlights the moral, interactional, and social delicacy of these exchanges.</p><p><strong>Practical implications: </strong>Tailored messaging about lifestyle risks and modifications can be delicately incorporated throughout healthcare consultations, providing strategies for dementia risk reduction.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"109285"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk assessment as routine: A conversation analysis of midwives' risk surveillance practices in midwife-led care during labour.","authors":"Clare Jackson","doi":"10.1016/j.pec.2025.109279","DOIUrl":"10.1016/j.pec.2025.109279","url":null,"abstract":"<p><strong>Objective: </strong>This study examines how risk surveillance and management are interactionally accomplished in midwife-led intrapartum care. Using conversation analysis, the paper explores how midwives initiate risk assessment activities, announce outcomes, and navigate cases where potential risks are detected.</p><p><strong>Method: </strong>The data were 37 audio/video-recorded interactions between midwives and labouring women in two UK midwife-led units. Conversation analytic methods were used to identify recurrent interactional practices. All data are British English.</p><p><strong>Results: </strong>Midwives routinely construct risk surveillance as a taken-for-granted aspect of care through practices including presumptive scheduling and pronouncing initiation of activities. When no issues are detected, midwives might either treat outcomes as unremarkable by not announcing them or employ closing-implicative positive assessments. Announcements of deviations from the norm are typically delayed, delicately delivered and lead to recommendations for further investigations or interventions.</p><p><strong>Conclusion: </strong>Midwives treat risk surveillance as a routine institutional requirement while working to minimise its disruption to labouring people. Risk surveillance comprises a significant portion of midwife-led care and midwives navigate potentially conflicting demands between enacting their duty to conduct risk assessments while upholding midwifery philosophy of care.</p><p><strong>Practice implications: </strong>Consideration should be given to women's limited optionality in engaging in risk assessments and conversation analytic insights can inform relevant training.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"109279"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating shared decision-making in lung cancer screening: Insights into barriers, training, and referral propensity among clinicians.","authors":"Lisa Carter-Bawa, Jennifer Elston Lafata, James E Slaven, Patrick O Monahan, Ana Guadalupe Vielma, Karen J Wernli, Susan Brandzel, Hongyuan Gao, Susan M Rawl","doi":"10.1016/j.pec.2025.109303","DOIUrl":"10.1016/j.pec.2025.109303","url":null,"abstract":"<p><strong>Objectives: </strong>Shared decision-making (SDM) is critical in lung cancer screening (LCS), enabling clinicians to guide patients through complex benefit-risk discussions. Despite its endorsement by professional organizations and its Medicare reimbursement requirement, SDM implementation in clinical practice remains inconsistent. This cross-sectional study evaluated factors influencing clinician knowledge, attitudes, and referral behaviors regarding LCS within a decentralized screening program.</p><p><strong>Methods: </strong>We surveyed 125 primary care clinicians (PCCs) in a large integrated health system, linking responses to electronic health record data to assess LCS referral propensity. Clinicians reported perceived barriers to SDM, attitudes toward SDM and LCS, and knowledge via clinical vignettes. Multivariable analyses identified key predictors of attitudes and behaviors.</p><p><strong>Results: </strong>Findings revealed that perceived barriers to SDM, particularly time burden, significantly influenced attitudes toward LCS (β = -0.334, p < 0.001) and referral propensity (β = -0.305, p = 0.0005). Formal training in SDM for LCS was positively associated with favorable SDM attitudes (β = 0.035, p = 0.0248), emphasizing the potential of targeted interventions. Time burden emerged as a critical determinant of perceived barriers (β = 0.728, p < 0.001), highlighting the need for systemic and educational solutions.</p><p><strong>Conclusions: </strong>These results underscore the importance of reducing SDM-related time burdens and enhancing training to improve clinician engagement and screening outcomes. Innovative strategies, such as patient-tailored pre-visit education and team-based care models, could mitigate barriers and promote more effective SDM implementation. Future research should explore longitudinal and multi-system analyses to refine interventions and optimize LCS processes.</p><p><strong>Practice implications: </strong>By addressing systemic and individual barriers, health systems can enhance SDM efficacy, increasing LCS uptake and improving care for screening-eligible populations. This study offers actionable insights for advancing patient-centered approaches in LCS and broader preventive health initiatives.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"109303"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the digital health literacy and potential solutions to support people with complex chronic conditions to engage with digital models of care.","authors":"Jaimon T Kelly, Liam J Caffery, Emma E Thomas, Soraia de Camargo Catapan, Anthony C Smith, Nicole Isbel, Hannah Mayr, Lindsey Webb, Katrina L Campbell, Graeme A Macdonald, Jeff S Coombes, Shelley E Keating, Ingrid J Hickman","doi":"10.1016/j.pec.2025.109278","DOIUrl":"10.1016/j.pec.2025.109278","url":null,"abstract":"<p><strong>Objective: </strong>To assess digital health literacy among patients with complex chronic conditions and to identify priority areas for enhancement.</p><p><strong>Methods: </strong>A mixed methods approach was used, integrating a: 1) quantitative assessment of digital health literacy using a modified version of the eHealth Literacy Scale (eHEALS), and 2) qualitative focus groups to determine digital health literacy priority areas and potential solutions to help patients with chronic kidney disease and chronic liver disease.</p><p><strong>Results: </strong>Sixty-seven individuals completed the eHEALS survey and 15 participated in the focus groups. The median eHEALS score was 29.0 (IQR 24,32) out of a possible score of 40, with 58 % of participants scoring above the median. The highest scoring items of the eHEALS were related to knowledge of availability of digital health information (question 1) and use of digital devices (question 2), with 69 % and 63 % of participants scoring agree and strongly agree, respectively. The lowest scoring eHEALS items were the ability to assess digital information quality (question 7), and confidence in using digital devices (question 8), with 49 % and 39 % of participants scoring agree and strongly agree, respectively. Seven out of 10 eHEALS items were identified as priority areas for addressing digital health literacy in chronic conditions.</p><p><strong>Conclusion: </strong>This study highlights the challenges for digital health literacy for patients with complex chronic disease tend to relate to assessing information quality and confidence in using digital health.</p><p><strong>Practical implications: </strong>Participant priorities also encompassed the ability to: utilize digital tools to seek health-related information, evaluate information credibility and quality, confidently use digital information, and recognize the significance of online information access. Several addressable solutions were suggested by participants, which focused on targeted education for healthcare providers and transparent endorsement of online health information supported and provided by the health service.</p>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"109278"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “‘About the patient, not for the patient’: A qualitative study on medical reports in hepatology” [Patient Educ Couns 142 (2026) 109363]","authors":"Michela Monaci ,&nbsp;Mateus Eduardo Romão ,&nbsp;Sarah Bigi ,&nbsp;Beatrice Credi ,&nbsp;Marko Korenjak ,&nbsp;Serena Barello","doi":"10.1016/j.pec.2025.109384","DOIUrl":"10.1016/j.pec.2025.109384","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"142 ","pages":"Article 109384"},"PeriodicalIF":3.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review on palliative care communication in the South African setting","authors":"Siobhan de Lange ,&nbsp;Jennifer Watermeyer","doi":"10.1016/j.pec.2025.109378","DOIUrl":"10.1016/j.pec.2025.109378","url":null,"abstract":"<div><h3>Objectives</h3><div>Effective communication is crucial in palliative care, allowing patients opportunities to make decisions that preserve their personal integrity during significant and life-changing events. How patients communicate and what they prioritise in conversation with a medical professional is affected by a variety of sociocultural factors, expectations and health literacy levels. Communication therefore needs to be understood in the specific context within which it occurs. This review aimed to map existing empirical studies on palliative care communication in the South African context specifically, and is the first scoping review of this kind.</div></div><div><h3>Methods</h3><div>Arksey and O’Malley’s scoping review guidelines were followed, with the PRISMA-ScR checklist. English-language South Africa-specific empirical studies from 1994 onwards were identified from PubMed, Web of Science, EBSCO and Google Scholar. A search string optimisation procedure was used. Initially, 235 total hits were obtained, from which duplicates, articles irrelevant to the search criteria, and multi-site studies were removed.</div></div><div><h3>Results</h3><div>Full-length, original research studies located in South Africa and focused on palliative care were retained, in which communication or decision-making was a main focus, resulting in 9 articles. A need for greater research capacity and dedicated research spaces for palliative care communication was identified. Certain areas were recognised as requiring specific research focus going forward, such as communication in perinatal palliative care, the timing of certain care conversations, and the communication experiences of patients and their family members, as opposed to healthcare professionals. A lack of locally adapted tools to support palliative communication was noted.</div></div><div><h3>Conclusions</h3><div>Both local and international literature concur that an individualised approach to communication in palliative care is needed. Research on palliative care communication in South Africa is crucial for developing contextually appropriate policy, clinical practice and training, thereby helping healthcare professionals to navigate these complicated conversations more effectively.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"142 ","pages":"Article 109378"},"PeriodicalIF":3.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}