Patient Education and Counseling最新文献

{"title":"Real needs of end-stage kidney disease patients awaiting kidney transplantation in China: A qualitative study","authors":"Menglin Yuan ,&nbsp;Xin Zhou ,&nbsp;Rui Luo ,&nbsp;Jiaao Lou ,&nbsp;Qifa Ye ,&nbsp;Xiaoyan Chen ,&nbsp;Bilong Feng","doi":"10.1016/j.pec.2025.108717","DOIUrl":"10.1016/j.pec.2025.108717","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the true needs of patients awaiting kidney transplantation in China through the language used by them. We addressed the literature gap concerning this critical aspect of patient care and counselling.</div></div><div><h3>Methods</h3><div>We interviewed 32 individuals—22 who were on the waiting list for a kidney transplant and 10 were kidney transplant recipients. The obtained data were analysed using Colaizzi seven-step method.</div></div><div><h3>Results</h3><div>Four themes encompassing 86 coded statements were identified and crosschecked with each participant for validation.The waiting period needs of the participants fell into four distinct categories: emotional support, informational, medical support, and social support needs.</div></div><div><h3>Conclusion</h3><div>We can determine the needs of patients by interpreting their linguistic cues with a nuanced understanding.Transplant professionals must (1) understand patients’ needs from their perspective; (2) recognise the dynamic changes in their emotional support demands; and (3) determine each patient’s informational needs, their willingness to receive medical support, and the current state of their social support.</div></div><div><h3>Practice Implications</h3><div>Our results offer insights for transplant professionals to better support patients awaiting kidney transplantation, highlighting the need to routinely attend to their unmet emotional, informational, medical and social support needs. This will enable patients to better prepare for transplantation while anticipating the arrival of a matched kidney.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108717"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A theory-based educational intervention to increase mothers’ intention to vaccinate their daughters against human papillomavirus: A randomised controlled trial","authors":"Areej Alqethami ,&nbsp;Eman Alhalal","doi":"10.1016/j.pec.2025.108731","DOIUrl":"10.1016/j.pec.2025.108731","url":null,"abstract":"<div><h3>Objective</h3><div>The current study aimed to examine the effectiveness of a web-based educational intervention based on the theory of planned behaviour (TPB) in enhancing mothers’ knowledge of human papillomavirus (HPV) and its vaccine, attitudes towards the HPV vaccine, subjective norms, perceived behavioural control, and intention to vaccinate their daughters against HPV.</div></div><div><h3>Method</h3><div>A randomised controlled trial was conducted. The sample comprised 214 mothers of adolescents from 10 intermediate schools in Saudi Arabia. After collecting baseline data, the participants were randomly assigned to control and intervention groups. The TPB-based intervention was delivered online to the intervention group, and post-test data were collected from both groups. A mixed-effects model of covariance was used to test the effect of the intervention.</div></div><div><h3>Results</h3><div>There were no significant differences between the two groups at baseline. One month after delivery, the intervention was found to have a significant effect on mothers’ knowledge (F (1, 211.15) = 72.40, <em>p</em> &lt; .001), attitudes (F (1, 211.11) = 110.57, <em>p</em> &lt; .001), subjective norms (F (1, 211) = 34.55, <em>p</em> &lt; .001), perceived control behaviour (F (1, 211.12) = 144.01, <em>p</em> &lt; .001), and intention to vaccinate their daughters against HPV (F (1, 211.05) = 113.64, <em>p</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The study showed that the web-based intervention based on the TPB was effective in increasing mothers’ knowledge, attitude, subjective norms, perceived control behaviour, and intention to vaccinate their daughters after 1 month.</div></div><div><h3>Practice implications</h3><div>The findings underscore the significance of popularising and implementing such interventions to boost HPV vaccine coverage among adolescents.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108731"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552100","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":"Optimising invitation and advance notification letters to increase bowel cancer screening participation: A qualitative analysis","authors":"Katelyn Collins ,&nbsp;Michael Ireland ,&nbsp;Laura Anderson ,&nbsp;Carlene Wilson ,&nbsp;Natalie Taylor ,&nbsp;Bianca Viljoen ,&nbsp;Mark Jenkins ,&nbsp;Belinda Goodwin","doi":"10.1016/j.pec.2025.108729","DOIUrl":"10.1016/j.pec.2025.108729","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore how letters distributed in population bowel cancer screening programmes could be modified to increase bowel cancer screening uptake, from the perspective of screening invitees.</div></div><div><h3>Methods</h3><div>Sixty-three people aged 48–74 years discussed their preferences regarding letter design and content during semi-structured interviews aided by various example letters designed to notify of, or invite participants to, the Australian National Bowel Cancer Screening Programme (NBCSP). Deductive thematic analysis, informed by the Integrated Screening Action Model (I-SAM), was used to interpret participant feedback and provide recommendations for improvements to the letters in alignment with the theoretical stages of bowel cancer screening behaviour (engaging, deciding, and completing the screening kit).</div></div><div><h3>Results</h3><div>Participants generally agreed that effective letters should feature a clear, eye-catching design to enhance initial engagement. Messages targeting emotional barriers and content tailored to prior screening history were seen as crucial to drive screening decision-making. Finally, step-by-step instructions, deadlines, and reminders were identified as facilitators of kit completion, bridging the gap between intention and action.</div></div><div><h3>Conclusions</h3><div>The findings of this study align with the I-SAM framework for understanding the progression of screening behaviours and highlight key design elements that can enhance the effectiveness of bowel cancer screening invitations. The design and messaging within screening letters has the potential to address common concerns and encourage screening participation.</div></div><div><h3>Practice implications</h3><div>The simplification of letter design, and integration of tailored messaging strategies, simple kit instructions, reminders, and deadlines could boost engagement and help bridge the intention-behaviour gap, driving increased screening participation.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108729"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining telephone and online channels: Experiences of the Dutch STI sex information helpline","authors":"Filippo Zimbile ,&nbsp;Marjan Mientjes ,&nbsp;Silke David ,&nbsp;Rik Crutzen","doi":"10.1016/j.pec.2025.108728","DOIUrl":"10.1016/j.pec.2025.108728","url":null,"abstract":"<div><h3>Introduction</h3><div>The Dutch STI Sex Information Helpline has gradually expanded its telephone services to include online services via email and online chat. In addition, a thematic broadening of AIDS and HIV-related support took place, covering almost all Sexual and Reproductive Health and Rights topics. Since 2015, the helpline collaborates closely with public sexual health clinics' nurses to provide online chat-services.</div></div><div><h3>Objectives</h3><div>This article explores similarities and differences among callers, emailers, and chatters, including their background characteristics, reasons for contact, characteristics of the contacts, satisfaction with the service, and channel preferences. Furthermore, it describes how nurses evaluate national cooperation in the online chat-service and the added value they perceive in relation to their work at the public sexual health clinics.</div></div><div><h3>Methods</h3><div>In this mixed method cross-sectional design study registration data of the Helpline of 2018 (N = 17.585) is analysed in combination with analyses of a client satisfaction study among users of all three channels in 2018 (N = 488). In addition, an online evaluation survey was conducted among nurses who participate in the online chat-service in 2022 (N = 35).</div></div><div><h3>Results</h3><div>This study shows that online chat is the most frequently used channel, yet there is substantial demand for email and telephone services. Channel selection depends on the background characteristics of clients, the content of the help request and personal preferences and needs. Users equally rate all channels positively. Nurses assess their participation in the chat-service as an added value to their work in the clinics and endorse the importance of national cooperation.</div></div><div><h3>Conclusions</h3><div>Offering sexual health information services via phone, online chat, and email allows a helpline to serve a diverse public. Despite online chat being the most popular, usage and satisfaction is high across all channels, indicating effective user choice. A mix of channels does not only extends a helpline's reach, it also enhances the accessibility of public sexual health care through its connecting role.</div></div><div><h3>Practical implications</h3><div>While online chat is popular, it also consumes a considerable amount of professionals' time. This requires an efficient strategy for offering the three channels in a coherent manner.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108728"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to shared decision making: A qualitative study of families who delivered at the cusp of viability","authors":"Katarina S. Schneiderman ,&nbsp;Alexa P. Henderson ,&nbsp;Katherine P. Himes","doi":"10.1016/j.pec.2025.108715","DOIUrl":"10.1016/j.pec.2025.108715","url":null,"abstract":"<div><h3>Objectives</h3><div>There is limited data regarding patients’ experiences with periviable counseling. Exploring patient perspectives helps us improve provider communication and may aid in supporting high-quality decision-making. Our study explored patient-identified sources of support and conflict during discussions with their healthcare team when delivering during the periviable period with the goal of improving high-quality shared decision making (SDM).</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews of birthing people who delivered between 20 0/7 and 25 6/7 weeks gestational age from 2010 to 2014. Interviews focused on shared decision making at the time of periviable birth with an emphasis on the three-talk model of SDM. Interviews were coded to perform thematic analysis<u>.</u></div></div><div><h3>Results</h3><div>We interviewed 20 patients who delivered during the periviable period and 6 important others. Participants valued providers aiding in their emotional processing. Conversely, participants identified lack of clarity during counseling and an emphasis on hopelessness as barriers to SDM.</div></div><div><h3>Conclusion(s)</h3><div>Participants highlighted the importance of using easy-to-understand language and focusing on hope. Finally, families emphasized the importance of explicitly eliciting values that might inform their choice and the positive impact of nursing staff.</div><div>Practice Implications: Our findings underscore the importance of using a SDM model for periviability counseling and highlight areas for improvement.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108715"},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552147","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":"Systematic review of observational coding systems to assess patient-healthcare professional interactions","authors":"Marij A. Hillen ,&nbsp;Kerri-Anne R. Mitchell ,&nbsp;Barbara C. Schouten ,&nbsp;John W. Cyrus ,&nbsp;Richard F. Brown ,&nbsp;Arwen H. Pieterse","doi":"10.1016/j.pec.2025.108718","DOIUrl":"10.1016/j.pec.2025.108718","url":null,"abstract":"<div><h3>Objectives</h3><div>Systematic coding is used to study interactions between patients and healthcare professionals from an independent observer perspective. Many coding systems are available, but an up-to-date overview is lacking. We aimed to: (1) provide a comprehensive overview of systems for systematic coding of patient-healthcare professional interactions; and describe their 2) general characteristics and development, and 3) validation and adaptation.</div></div><div><h3>Methods</h3><div>We systematically searched peer-reviewed empirical articles in five databases (Cochrane, Embase, PubMed/Medline, CINAHL, PsychINFO) using variations of the following keywords: (i) patient and/or other stakeholder, (ii) healthcare professional (iii), interactions in healthcare, (iv) coding tool, and (v) development and/or validation. All titles/abstracts and full-texts were screened independently and in duplicate. Additionally, coding systems were identified through an earlier review, an open-access research database, and a forward-reference search of all included coding systems up to that point. For all eligible systems, we extracted characteristics and psychometric properties.</div></div><div><h3>Results</h3><div>From a total of 6950 identified articles from literature databases, 188 full-text articles were screened. Thirty-five articles were included from additional sources. In total, we included 124 articles describing 98 coding systems. Systems were highly variable in terms of topic (e.g., patient-centered communication, shared decision making, behavior change counseling), clinical context (e.g., oncology, pediatrics, generic), rigor of development and reporting, coding complexity, and extent of psychometric testing. Inter-rater reliability was reported for most coding systems; only few were tested for other types of reliability or for validity.</div></div><div><h3>Conclusions</h3><div>A plethora of coding systems are available, but more systematic reporting and psychometric testing are urgently needed to enhance evidence of validity. Testing may initially focus on the most relevant and broadly applicable coding systems.</div></div><div><h3>Practice implications</h3><div>These results can aid researchers in selecting the most suitable coding system for their purposes. Researchers may consider using or adapting existing systems, before developing new coding systems.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108718"},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared decision making for people living with multimorbidity: A concept analysis","authors":"Shupeng Shi ,&nbsp;Xingzhou Liu ,&nbsp;Yongjie Li ,&nbsp;Chuan Yang","doi":"10.1016/j.pec.2025.108712","DOIUrl":"10.1016/j.pec.2025.108712","url":null,"abstract":"<div><h3>Objective</h3><div>As part of patient-centered care, shared decision making (SDM)—where healthcare professionals (HCPs) and patients collaboratively choose treatments based on medical evidence and patient preferences—is essential for patients with multimorbidity facing varied benefits and risks. However, there is no clear conceptual understanding of what it represents. This study aims to analyze SDM concept for individuals with multimorbidity, clarifying key elements and guiding effective patient engagement in complex care decisions.</div></div><div><h3>Methods</h3><div>A concept analysis was undertaken using Walker and Avant's approach based on a literature review.</div></div><div><h3>Results</h3><div>SDM is a fundamental concept in health promotion for people with multimorbidity, assisting patients and HCPs in defining priorities, making choices, developing strategies, and executing them to improve health. Four core attributes were identified: (1) partnership based on mutual trust; (2) multidimensional information exchange; (3) complex trade-offs; (4) iterative communication and evaluation. Antecedents were divided into factors (complexity of diseases and multiple health needs from patients; communication skills from HCPs; consultation time, training and policy from health system). Consequences included patient autonomy and improved decision-making quality, patient satisfaction and symptom relief, and efficient utilization of medical resources.</div></div><div><h3>Conclusions</h3><div>Our findings offer insights into refining the concept of SDM in the context of multimorbidity. This concept analysis serves as a foundation for instrument development to measure the effects or attributes of the concept and highlights the need for future practical research on SDM that goes beyond involvement and engagement.</div></div><div><h3>Practice implications</h3><div>To implement SDM effectively for multimorbid patients, healthcare systems should enhance HCPs' communication skills, allocate sufficient consultation time to address complex needs, support SDM through policy, and develop tools to assess decision quality, patient satisfaction, and medical resource utilization.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108712"},"PeriodicalIF":2.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681350","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-centered communication and cancer information-seeking experiences among cancer survivors: A population-based study in the United States","authors":"Asos Mahmood ,&nbsp;Satish Kedia ,&nbsp;Deborah O. Ogunsanmi ,&nbsp;Umar Kabir ,&nbsp;Coree Entwistle","doi":"10.1016/j.pec.2025.108710","DOIUrl":"10.1016/j.pec.2025.108710","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate associations between patient-centered communication (PCC) and two elements of cancer information-seeking experience (i.e., effort and frustration) among cancer survivors.</div></div><div><h3>Methods</h3><div>We utilized secondary data from the U.S. National Cancer Institute’s Health Information National Trends Survey ([HINTS5 cycles 2 (2018) and 4 (2020)], and [HINTS6 (2022)]) for 1346 self-identified cancer survivors (aged ≥18 years) who reported ever seeking cancer information from any source and ≥one healthcare provider visit during the past 12 months. We fit multivariable logistic regression models to compute adjusted odds ratios (aORs) and associated 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Approximately 40 % of cancer survivors reported that it took them significant effort to seek needed cancer information, and 33.8 % felt frustrated doing so. With each unit increase on the PCC score scale, cancer survivors were about 1.5 % and almost 2.0 % less likely to perceive extra effort in seeking cancer information (aOR=0.986; 95 % CI: 0.977, 0.996) or report frustration while doing so (aOR=0.981; 95 % CI: 0.973, 0.990), respectively.</div></div><div><h3>Conclusions</h3><div>The findings demonstrate that better PCC is associated with improved cancer information-seeking experiences.</div></div><div><h3>Practice implications</h3><div>PCC could potentially empower cancer survivors to take a more active role in self-care and decision-making while reducing uncertainty and optimizing cancer information-seeking experiences.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108710"},"PeriodicalIF":2.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488772","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":"Questions older people and caregivers ask about kidney therapies: A computer-assisted analysis","authors":"Rebecca Allen ,&nbsp;Alex Nakonechnyi ,&nbsp;Sally A. Norton ,&nbsp;Fahad Saeed","doi":"10.1016/j.pec.2025.108713","DOIUrl":"10.1016/j.pec.2025.108713","url":null,"abstract":"<div><h3>Background</h3><div>Older adults with advanced chronic kidney disease (CKD) face complex and often overwhelming decisions regarding kidney therapy (KT), yet little is known about the specific information they and their caregivers seek during these discussions. Understanding informational needs is critical for improving shared decision-making.</div></div><div><h3>Objectives</h3><div>To identify and compare questions asked by patients and caregivers during KT decision-making visits.</div></div><div><h3>Methods</h3><div>A dataset of 36 transcribed kidney therapy (KT) decision-making focused outpatient palliative care encounters—conducted by a single clinician in patient homes and/or a single clinic—was analyzed using computational linguistic techniques supplemented by manual verification. Participants included 25 patients aged ≥ 75 years with an estimated glomerular filtration rate ≤ 25 ml/min/1.73 m², identified by nephrologists as needing KT decision-making support. Caregivers (n = 15) were included when present. All patients received a decision aid and question prompt list. Visits were led by a nephrologist board-certified in palliative care.</div></div><div><h3>Results</h3><div>Across 36 visits, 640 questions were recorded, averaging 17.78 per visit. The presence of a caregiver did not significantly affect the number of questions patients asked (10.42 vs. 10.00). Patients were more likely to ask conversational cooperation questions (37 % vs. caregivers' 19 %), while caregivers focused more on dialysis (38 % vs. patients' 25 %). Both groups asked a similar amount of questions about chronic kidney disease (patients 11 %, caregivers 10 %) and conservative kidney management (patients 4 %, caregivers 5 %). End-of-life inquiries were minimal, with patients asking 4 % of questions and caregivers none.</div></div><div><h3>Conclusions</h3><div>Patients and caregivers have different information needs during KT decision-making, highlighting the importance of addressing educational, decisional, and EOL planning gaps.</div></div><div><h3>Practice Implications</h3><div>Targeted educational interventions that address patients' and caregivers' unique preferences and information gaps are essential, including question prompt lists and decision aids with coaching, which AI-driven approaches could further optimize.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108713"},"PeriodicalIF":2.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488774","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":"Perceptions of blame among black women during prenatal care: A mixed methods study","authors":"Emily Dove-Medows ,&nbsp;Alison R. Walsh ,&nbsp;Francesca A. Williamson","doi":"10.1016/j.pec.2025.108707","DOIUrl":"10.1016/j.pec.2025.108707","url":null,"abstract":"<div><h3>Objective</h3><div>There is evidence that prenatal health care providers may disproportionately attribute adverse pregnancy and birth outcomes to individual-level factors during clinical encounters with Black women, as opposed to citing the complex mechanisms by which racism shapes maternal health inequities in the US. This focus perpetuates the false narrative that Black women are responsible for their exposure to risks, potentially resulting in feelings of blame. The purpose of this mixed methods study was to explore experiences of blame-related communication during Black women’s prenatal care encounters.</div></div><div><h3>Methods</h3><div>Data for this study come from a cross-sectional, mixed methods study of Black women’s prenatal care experiences, including communication about pregnancy risks and blame. Blame was measured with survey and interview questions which assessed responses to communication about blame, exposure to risks, and pregnancy complications. Thematic analysis was used to analyze interview data (N = 17) that also explored strategies for alleviating feelings of blame. Mixed methods analysis compared congruency in blame experiences across survey and interview data.</div></div><div><h3>Results</h3><div>Nine (53 %) participants described experiencing blame during prenatal care. Four themes developed that identified experiences of blame and responses to blame-alleviation through communication practices. Mixed methods results describe differences across qualitative and quantitative approaches and how provider-perpetrated and self-blame give rise to internalized blame for adverse pregnancy conditions.</div></div><div><h3>Conclusions</h3><div>Participants perceived blame when provider communication focused on individual-level factors and excluded discussion about the role of structural and interpersonal racism in shaping pregnancy health. High levels of survey and interview blame data incongruency suggest that quantitative blame measures inadequately capture experiences of blame during prenatal care.</div></div><div><h3>Practice Implications</h3><div>Two communication practices that may reduce blame during prenatal care are proposed: direct communication about the relationship between racism and health, and telling patients, “it’s not your fault,” when unexpected complications arise.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108707"},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488771","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}