Patient Education and Counseling最新文献

{"title":"Reimagining primary care visits for people living with obesity: A Co-design and validation study","authors":"Kristal Lyn Brown ,&nbsp;Gwyn Cready ,&nbsp;Katie Schmiedicker ,&nbsp;Michelle Vicari ,&nbsp;James Zervios ,&nbsp;Theodore K. Kyle ,&nbsp;Kimberly A. Gudzune","doi":"10.1016/j.pec.2025.109190","DOIUrl":"10.1016/j.pec.2025.109190","url":null,"abstract":"<div><h3>Objective</h3><div>Patients living with obesity may delay primary care visits due to negative experiences, yet their optimal primary care experience has not been defined. Our objective was to describe an ideal primary care visit in collaboration with people living with obesity and determine its validity among a sample of adults with obesity.</div></div><div><h3>Methods</h3><div>We employed a co-design process where participants created an ideal primary care visit scenario that was followed by a 2024 cross-sectional survey of people with obesity for validation. We recruited U.S. adults with obesity who had a primary care visit within 5 years. Participants viewed the ideal scenario and rated its overall quality on a 10-point scale [poor (1) to excellent (10)], which we compared to overall quality reported for their last primary care visit using an unpaired t-test. Participants rated the importance of 13 scenario elements on a 4-point scale (‘not at all important’ to ‘very important’).</div></div><div><h3>Results</h3><div>Among the 250 survey participants, 60 % were aged 46–65 years; 90 % were women; 78 % identified as white. Mean BMI was 36.3 kg/m² (SD 10.3). Mean quality for the ideal primary care visit (9.4 (SD 1.4)) was significantly higher than their last visit (8.0 (SD 2.1)) (p &lt; 0.01). Highly important elements were ‘doctor treats me with care and respect’ (96 %), ‘doctor really listens’ (95 %), and ‘doctor refers to specialists who treat me with care and respect’ (92 %).</div></div><div><h3>Conclusion</h3><div>People living with obesity prefer a primary care visit characterized by respectful treatment and listening. Primary care practices and clinicians should consider incorporating elements from this scenario in their practices.</div></div><div><h3>Practice Implications</h3><div>Our findings underscore the importance of clinician education related to weight stigma and creating an inclusive environment for all patients.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109190"},"PeriodicalIF":2.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205726","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":"Patient-level barriers, related facilitators, and proposed strategies for timely home health care and outpatient appointments for sepsis survivors: Perspectives from healthcare system and home health care informants","authors":"Elaine Sang ,&nbsp;Karen B. Hirschman ,&nbsp;Michael A. Stawnychy ,&nbsp;Sang Bin You ,&nbsp;Katherine S. Pitcher ,&nbsp;Melissa O’Connor ,&nbsp;Sungho Oh ,&nbsp;Jiyoun Song ,&nbsp;Patrik Garren ,&nbsp;Brittany J. Newman ,&nbsp;Kathryn H. Bowles","doi":"10.1016/j.pec.2025.109207","DOIUrl":"10.1016/j.pec.2025.109207","url":null,"abstract":"<div><h3>Objective</h3><div>This study explored the perspectives of healthcare system and home health care (HHC) informants — including leaders, managers, clinicians, sepsis coordinators, and care coordinators — on patient-level barriers, related facilitators, and proposed strategies related to timely HHC nursing visits and outpatient appointments among sepsis survivors. This work is part of a larger qualitative needs assessment within <strong>I</strong>mproving <strong>TR</strong>ansitions <strong>AN</strong>d outcome<strong>S</strong> o<strong>F</strong> s<strong>E</strong>psis su<strong>R</strong>vivors (I-TRANSFER), which aims to implement a sepsis survivor hospital-to-home care transition protocol across five healthcare system-affiliated HHC agency dyads.</div></div><div><h3>Methods</h3><div>Semi-structured interviews informed by the Consolidated Framework for Implementing Research were conducted with informants as part of the I-TRANSFER qualitative needs assessment. Interviews were analyzed via a deductive-inductive coding approach, resulting in 32 themes and subthemes. A targeted query was done to extract data from themes and subthemes relevant to patient engagement in follow-up care.</div></div><div><h3>Results</h3><div>Sixty-one interviews were conducted with 91 informants. The four themes included Patient Behaviors, Decisions, and Preferences; Care Coordination; Patient Education; and Access to Care. Patient-level barriers include refusal or delay of HHC, missed outpatient appointments, scheduling difficulties, low health literacy, language barriers, competing health priorities, transportation issues, financial difficulties, and not having an outpatient provider. Facilitators and proposed strategies include proactive patient education, building clinician-patient trust, leveraging technology, implementing dedicated scheduler and sepsis patient education roles, building population health programs, and partnering with community organizations.</div></div><div><h3>Conclusion</h3><div>Findings highlight common challenges and offer actionable strategies to engage sepsis survivors in their follow-up care. They have important implications for patient education delivery, discharge planning, social determinants of health, and technology to enhance hospital-to-home care transitions.</div></div><div><h3>Practice Implications</h3><div>Recommendations include hiring dedicated schedulers, early screening for patient learning barriers, expanding sepsis coordinator roles, using telehealth and text-messaging, and strengthening community partnerships.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109207"},"PeriodicalIF":2.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211926","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":"Medication-related health literacy in patients on hemodialysis assessed with the RALPH interview guide","authors":"Francisca J. van den Oever ,&nbsp;Erwin C. Vasbinder ,&nbsp;Yvonne C. Schrama ,&nbsp;Ellen S. Koster ,&nbsp;Boudewijn B. Visscher ,&nbsp;Patricia M.L.A. van den Bemt ,&nbsp;Teun van Gelder","doi":"10.1016/j.pec.2025.109203","DOIUrl":"10.1016/j.pec.2025.109203","url":null,"abstract":"<div><h3>Objectives</h3><div>To study medication-related health literacy (HL) among patients on hemodialysis using phosphate-binding medication (PBM) and explore its association with medication adherence.</div></div><div><h3>Methods</h3><div>This planned sub-study was part of a prospective intervention study in patients on hemodialysis with a high serum phosphate concentration and high PBM pill burden. Functional, communicative, and critical medication-related HL were assessed using the Recognizing and Addressing Limited Pharmaceutical Literacy interview guide, and self-reported PBM adherence was evaluated using the MARS-5 (Medication Adherence Report Scale-5) questionnaire. Primary outcome was the proportion of patients who perceived difficulties in ≥ 1 HL domain, secondary outcome was the prevalence of perceived difficulties within the HL domains. Exploratory outcome was the association between medication-related HL and self-reported adherence to PBM. Data analysis was performed using descriptive statistics and univariable and multivariable logistic regression. Covariates for logistic regression were age, gender, number of medications, and PBM and total pill burden.</div></div><div><h3>Results</h3><div>Of the 75 patients, 81 % perceived difficulties, mainly in the critical domain. Around 65 % of the patients experienced difficulties assessing the applicability and reliability of information. 26.7 % of the patients had a MARS-5 score ≤ 22 and were classified as non-adherent. No association was found between medication-related HL in general and medication adherence (OR 1.13, 95 %CI 0.31–4.10). However, age was significantly associated with adherence (OR 1.05, 95 %CI 1.02–1.09).</div></div><div><h3>Conclusions</h3><div>Over 80 % of patients on hemodialysis using PBM experience difficulties in using and applying medication and treatment information. These results suggest that patients on hemodialysis need more support to effectively use this information.</div></div><div><h3>Practice implications</h3><div>Healthcare professionals should guide patients in the adequate use and application of treatment information, to improve the effective use of PBM. Universal use of HL-sensitive communication strategies in patients on dialysis, including the teach-back method, could enhance patient understanding and engagement, potentially improving self-management and medication adherence.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109203"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205728","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":"Does health literacy mediate the relationship between socioeconomic status and navigation in the healthcare system? The French national health literacy survey (HLS19)","authors":"Rajae Touzani ,&nbsp;Camelia Protopopescu ,&nbsp;Alexandra Rouquette ,&nbsp;Cécile Allaire ,&nbsp;Agnès Dumas ,&nbsp;Jean-Benoit Hardouin ,&nbsp;Julien Mancini","doi":"10.1016/j.pec.2025.109204","DOIUrl":"10.1016/j.pec.2025.109204","url":null,"abstract":"<div><h3>Objective</h3><div>Navigational health literacy (HL), a specific form of HL, refers specifically to the skills required to navigate effectively healthcare systems, access services and make informed healthcare decisions. While general and navigational HL are related and share common predictive factors, little is known about whether socioeconomic factors have a residual, specific effect on the ability to navigate the healthcare system after accounting for general HL.</div><div>The aim of this study was to investigate the socioeconomic and chronic conditions variables associated with the ability to navigate the healthcare system in the French population, controlling for the mediating role of general HL.</div><div>Methods</div><div>A cross-sectional study, as a part of France's participation in the European Health Literacy Survey 2019–2021, involved 2 003 participants. Structural equation modeling was used to examine the direct and indirect effects of socioeconomic and health status variables on navigational HL level, considering general HL as a mediator on these relationships. Given the different healthcare needs and utilization patterns between French men and women, the analysis was stratified by gender to account for these differences.</div><div>Results</div><div>General HL was found to be a significant mediator for the relationships between socioeconomic factors and navigational HL in both men and women. Financial difficulties only had an indirect effect on navigational HL, completely mediated by general HL. Similarly, subjective social status showed complete mediation by general HL in women, with 64 % of the total effect mediated, whereas in men, mediation was partial, with 56 % of the total effect mediated by general HL.</div><div>Conclusions</div><div>This study underscores the pivotal role of general HL as a mediator in the relationships between socioeconomic factors and navigational HL. Interventions aimed at enhancing general HL could substantially improve the ability to navigate the healthcare system, leading to more efficient healthcare navigation and better health outcomes.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109204"},"PeriodicalIF":2.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205727","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":"Cross-sectional examination of therapy knowledge and preferred sources among American adults not receiving mental healthcare","authors":"Taylor R. Rodriguez ,&nbsp;Allison E. Bond ,&nbsp;Michael D. Anestis ,&nbsp;Joye C. Anestis","doi":"10.1016/j.pec.2025.109187","DOIUrl":"10.1016/j.pec.2025.109187","url":null,"abstract":"<div><h3>Objective</h3><div>The aims of the study are to examine existing knowledge about mental health therapy options, and how this differs across demographic groups; examine differences in confidence to describe therapies; and explore preferred sources for therapy information.</div></div><div><h3>Methods</h3><div>A survey was conducted online in 2023 via probability-based sampling and weighted relative to the 2021 American Community Survey. Participants were 4795 US adults who reported no prior mental healthcare.</div></div><div><h3>Results</h3><div>Most endorsed knowledge of therapy options (75.7 %; <em>n</em> = 3630) but low confidence (median=2.00 [“somewhat unsure”]) in their ability to describe them, and this differed across groups (e.g., younger adults more confident than older adults). Most preferred therapy sources were mental health professionals (51.0 %), physicians (26.8 %), or independent online research (12.0 %). Least preferred sources include internet content creators and teachers/professors (both: 0.1 % [<em>n</em> = 3]).</div></div><div><h3>Conclusion</h3><div>Many people are aware of therapy options but lack confidence in this knowledge which may impact help-seeking; messaging to increase mental healthcare utilization should consider elevating and partnering with preferred sources.</div></div><div><h3>Practice implications</h3><div>Psychoeducation is crucial to help the public with informed treatment decision making. Results show the most preferred source to teach about therapy is mental health professionals themselves. The effectiveness of psychoeducation can likely be increased when partnering and highlighting these sources.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109187"},"PeriodicalIF":2.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196077","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":"Attitudes towards different weight loss approaches among adults with type 2 diabetes and obesity","authors":"Stephanie A. Hooker ,&nbsp;Lilian Chumba ,&nbsp;Heidi Ekstrom ,&nbsp;Mary Sue Beran ,&nbsp;Nicolaas P. Pronk ,&nbsp;Jennifer Vesely ,&nbsp;Patrick J. O’Connor","doi":"10.1016/j.pec.2025.109193","DOIUrl":"10.1016/j.pec.2025.109193","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to understand how patients with type 2 diabetes (T2D) and obesity view weight loss treatments (lifestyle changes, metabolic bariatric surgery [MBS], and anti-obesity medications [AOM]) in the context of shared decision-making conversations.</div></div><div><h3>Methods</h3><div>Patients (N = 30) with T2D and obesity participated in semi-structured qualitative interviews focused on attitudes and informational needs related to MBS, AOM, and lifestyle approaches, as well as comfort in discussing weight loss with primary care clinicians (PCCs). Themes were generated using inductive content analysis.</div></div><div><h3>Results</h3><div>Two main themes emerged: (1) The way PCCs and patients discuss weight loss in the context of diabetes influence patients’ willingness to try weight loss treatments, and (2) although patients’ attitudes towards treatments vary, most patients prefer using lifestyle changes first, then AOM, and finally MBS. Within the first theme, subthemes included PCCs need to approach weight loss conversations with sensitivity and tangible solutions; personal stories influence attitudes towards MBS and AOM; patients may be more open to trying MBS and AOM if they are reframed as treatments for diabetes; and patients want to compare risks and benefits of each option.</div></div><div><h3>Conclusions</h3><div>Patients with T2D and obesity are open to discussing weight loss with their PCCs and prefer lifestyle approaches, followed by AOM and then MBS. PCCs may use these findings to improve the quality of shared decision-making conversations about weight loss in T2D.</div></div><div><h3>Practice implications</h3><div>Providing information to support shared decision-making about weight loss treatments is warranted.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109193"},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184585","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":"‘Getting it write’ in an era of online electronic health records access in primary care: A qualitative study exploring the needs and requirements of underserved patients and carers","authors":"Gail Davidge ,&nbsp;Charlotte Blease ,&nbsp;Lindsey Brown ,&nbsp;Goran Nenadic ,&nbsp;Caroline Sanders ,&nbsp;Brian McMillan","doi":"10.1016/j.pec.2025.109192","DOIUrl":"10.1016/j.pec.2025.109192","url":null,"abstract":"<div><h3>Objectives</h3><div>Most adult patients in England now have access to their primary care electronic health record (EHR), including free-text consultation notes, via the NHS App or other online services. As EHRs were not designed for patient audiences, this study aimed to explore patients’ and carers’ perspectives and understanding of simulated consultation notes.</div></div><div><h3>Methods</h3><div>One interview and five focus groups were conducted with 26 patients and carers from a purposive sample of underserved communities in England between April and May 2023. Participants’ understanding and views were elicited regarding five vignettes about patient consultation scenarios and corresponding simulated primary care EHR entries. Verbatim transcripts were analysed inductively using thematic analysis.</div></div><div><h3>Results</h3><div>Most participants struggled to fully understand the simulated consultation notes, particularly medical acronyms, clinician shorthand and non-clinical abbreviations. Participants also identified issues which may cause unintended offence or anxiety, and made suggestions about how EHRs may be improved to meet the needs of patient audiences and maintain positive patient-clinician relationships.</div></div><div><h3>Conclusions</h3><div>Opening up online record access to include patient audiences necessitates a significant cultural shift in the way that consultation notes are written and used. Participants proposed technological and documentation adaptations to enhance understanding, support diverse patient needs and maintain positive patient-clinician relationships.</div></div><div><h3>Practice implications</h3><div>To fully realise the benefits of patient online records access, it is important for consultation notes to be written in a way that patients find meaningful, while maintaining their clinical integrity. To optimise NHS England’s investment in this policy and avoid exacerbating health inequalities, it is essential to ensure all patients can access the benefits of online access to their EHR. Healthcare professionals need to be supported to manage the challenges of writing consultation notes for patient audiences, while continuing to maintain effective clinical care.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109192"},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169951","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 cross-sectional study to assess patients’ perception of physicians’ communication skills: 15 minutes is what it takes","authors":"Namra Qadeer Shaikh ,&nbsp;Noreen Afzal ,&nbsp;Komal Abdul Rahim ,&nbsp;Maryam Pyar Ali Lakhdir ,&nbsp;Asma Altaf Hussain Merchant ,&nbsp;Ali Aahil Noorali ,&nbsp;Iqra Fatima Munawar Ali ,&nbsp;Saad bin Zafar Mahmood ,&nbsp;Saqib Kamran Bakhshi ,&nbsp;Muhammad Tariq ,&nbsp;Adil H. Haider","doi":"10.1016/j.pec.2025.109191","DOIUrl":"10.1016/j.pec.2025.109191","url":null,"abstract":"<div><h3>Objectives</h3><div>Patient satisfaction with physicians’ communication skills is imperative to patient centered care and improving healthcare outcomes. We aimed to assess patients’ perception of resident-physicians’ communication skills and factors associated with satisfactory communication.</div></div><div><h3>Methods</h3><div>Using a cross-sectional survey design, data were collected at one of the largest academic medical centers in a low-and-middle-income country. Participants were out-patients with at least two prior follow-up visits in clinics and in-patients admitted for at least 48 hours, recruited via convenience sampling. Patient-reported ratings of residents’ communication skills were measured using the Communication Assessment Tool (CAT). This rating categorized as either excellent (cumulative average score ≥4) or poor (cumulative average score ≤3) on a five-point Likert scale was the primary outcome. Data were analyzed using Stata. An adjusted multivariable model with patient (sex, age, marital status, education level), resident (department, frequency and duration of interaction with the patient) and system (outpatient/inpatient) related factors was built to determine their associations with excellent/poor patient-resident communication.</div></div><div><h3>Results</h3><div>A total of 434 patients (61.29 % females; 38.71 % males, mean age: 42.5 ± 0.83 years) were surveyed. Patient-resident interaction time was the most significant factor associated with patients’ satisfaction with residents’ communication skills when adjusted for patient gender, age, marital status, specialty visited, number of visits and days admitted. Regression analysis showed that patients rated residents who spent at least 15 minutes with them as excellent [OR = 1.86 (1.05 – 2.97)]. Inpatient care settings [OR = 0.59 (0.35–0.98)] and increasing levels of patient education [OR= 1.78 (1.06–2.97)] and were significantly associated with poor patient ratings.</div></div><div><h3>Conclusions</h3><div>Residents who interacted with patients for at least 15 minutes received a higher satisfactory communication skills rating by patients.</div></div><div><h3>Practice implications</h3><div>Knowledge of a specific time target can help healthcare structures schedule resident workload assignments to ensure effective patient physician communication and thus improve healthcare outcomes.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109191"},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196076","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":"What do people really know about shared decision-making? – Developing and validating a questionnaire","authors":"Jolijn B. Thijs ,&nbsp;Loes J. Peters ,&nbsp;Robert Lindeboom ,&nbsp;Patrick Somai ,&nbsp;Dirk T. Ubbink","doi":"10.1016/j.pec.2025.109182","DOIUrl":"10.1016/j.pec.2025.109182","url":null,"abstract":"<div><h3>Background</h3><div>The current level of shared decision-making (SDM) in healthcare remains below expectations, necessitating an evaluation. Current methods of measuring SDM measure perceived levels of SDM without verifying whether individuals truly understand the concept of SDM. Thus, a tool is needed that measures patients' comprehension of the SDM-concept.</div></div><div><h3>Objective</h3><div>To develop and validate a questionnaire that can assess the extent to which patients and the general public understand the concept of SDM, and to identify individual characteristics related to SDM-knowledge.</div></div><div><h3>Methods</h3><div>Developing the questionnaire was theory- and evidence-based, using established guidelines for questionnaire development, while integrating conceptual models for structuring SDM-knowledge. The questionnaire was tested and refined through expert reviews, pilot tests, and two validation studies. Clinimetric analyses included item analysis, internal consistency assessment (Cronbach's alpha), Rasch model testing, and hypothesis testing.</div></div><div><h3>Results</h3><div>A 24-item Shared Decision-Making Knowledge Questionnaire (SDM-K-Q) was developed, based on the responses of 210 patients and visitors of a large university hospital. It demonstrated good validity and reliability (Cronbach's alpha = 0.70 and Rasch model acceptance). Mean SDM-knowledge level among participants was 73.8 %. Significant predictors of SDM-knowledge included higher educational levels, healthcare occupation, and consistent appointment preparation, whereas a migration background was inversely correlated.</div></div><div><h3>Discussion</h3><div>The questionnaire appears to be an innovative, reliable tool to measure SDM-knowledge as a single construct and was able to differentiate between specific groups. Consistency was based on single administration. Further validation efforts should solidify effectiveness and establish threshold values to differentiate SDM-knowledge.</div></div><div><h3>Practical value</h3><div>The SDM-K-Q tool can appreciate the extent to which patients understand the concept of SDM. It may help identify knowledge gaps and evaluate the impact of educational interventions. Further utilization of the SDM-K-Q can assist in developing SDM implementation strategies.</div></div><div><h3>Funding</h3><div>This research did not receive any funding.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"138 ","pages":"Article 109182"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139285","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":"Use of metaphor in provider-patient communication in medical settings: A systematic review","authors":"Xingbing Liu (刘兴兵)","doi":"10.1016/j.pec.2025.109184","DOIUrl":"10.1016/j.pec.2025.109184","url":null,"abstract":"<div><h3>Background</h3><div>Metaphors are extensively utilized by those studying and practicing medicine. Those metaphors employed in provider-patient communication in medical settings are particularly significant due to their dynamic and interactive nature, and their direct contribution to the completion of core medical tasks and the quality of provider-patient interaction and relationship.</div></div><div><h3>Objective</h3><div>We aim to: (1) to identify and summarize existing literature on the use of metaphors in patient-provider communication in medical settings; (2) discuss the implications of these studies for medical research and practice; and (3) provide recommendations for future research in this area.</div></div><div><h3>Methods</h3><div>The Chinese National Knowledge Infrastructure and the Web of Science Core Collections were systematically searched, and the obtained literature was combined with the online resource \"Metaphor in Health Discourse and Communication\". The resultant literature was then screened according to preset inclusion and exclusion criteria.</div></div><div><h3>Results</h3><div>Of 265 articles identified, 16 studies were found to completely meet our purpose and inclusion criteria. Analysis revealed 7 major themes, including the metaphor’s facilitating functions, harmful effects, differences between providers and patients etc. Metaphors were found to enhance provider-patient relationship and communication and promote shared understanding and decision-making.</div></div><div><h3>Conclusion</h3><div>Metaphors play a significant role in provider-patient communication in medical settings, offering both benefits and challenges. Future research can further explore other aspects of metaphor use in medical settings, and update the research methodology and approaches by collecting larger, balanced samples of metaphor, conducting quantitative analyses of metaphor efficacy, and doing multimodal analysis of metaphor use.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 109184"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169566","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}