Patient Education and Counseling最新文献

{"title":"Shared-decision making in pancreatic cancer: A scoping review","authors":"Patrick L. Quinn ,&nbsp;Shah Saiyed ,&nbsp;Aslam Ejaz","doi":"10.1016/j.pec.2025.108828","DOIUrl":"10.1016/j.pec.2025.108828","url":null,"abstract":"<div><h3>Purpose</h3><div>This review aimed to map the current landscape of literature on informed and shared decision-making (SDM) among patients with pancreatic cancer (PC).</div></div><div><h3>Methods</h3><div>PubMed, Scopus, Embase, and PsycINFO were queried for studies published before January 2024 that measured SDM or evaluated interventions targeted at SDM among patients with PC. Studies were excluded if they focused on clinician decision-making or the quality of education materials. The included studies were evaluated for interventions, assessment type, and key findings.</div></div><div><h3>Results</h3><div>Our initial search identified 1194 studies, with 16 studies meeting our inclusion criteria: 4 cross-sectional, 1 mixed method, 8 qualitative, and 3 experimental. Common themes identified across studies included that there was a subset of patients that did not feel involved in their care, patients felt overwhelmed with information during the initial consultation, patients understood that there were limited treatment options, and patients did not always understand treatment decisions. The experimental studies each evaluated a different intervention (i.e., decision aid, clinician training, or combination) with mixed results.</div></div><div><h3>Conclusions</h3><div>There is limited data regarding SDM in PC, however, common themes found that PC patients commonly did not feel involved in their care. Future research should focus on role congruence in decision-making, patient empowerment, improving the delivery and comprehension of treatment information, and interventions to improve the SDM process.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108828"},"PeriodicalIF":2.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071363","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":"Imagine your immune system is a sports team: Language expectancies in the use of physician analogies and jargon","authors":"Jia Yan ,&nbsp;Sam R. Wilson ,&nbsp;Danni Liao","doi":"10.1016/j.pec.2025.108810","DOIUrl":"10.1016/j.pec.2025.108810","url":null,"abstract":"<div><h3>Objectives</h3><div>The study examined how physicians’ use of analogies, literal language, or medical jargon influences patient attitudes towards health recommendations and perceptions of physician trustworthiness by considering language’s alignment or deviation from patient expectations and subsequent evaluations.</div></div><div><h3>Methods</h3><div>A 3 (physician language: analogies, jargon, literal language) x 2 (health topic: coronary artery disease, influenza vaccine) experiment tested the role of communication unexpectedness and evaluations on patient attitudes and physician trustworthiness. Participants (N = 545) recruited online were instructed to imagine themselves as patients interacting with the physician in a randomly assigned video, in which the physician explained medical information and provided a health recommendation. Participants then reported their attitudes toward the recommended behavior and their perceptions of the physician’s trustworthiness.</div></div><div><h3>Results</h3><div>The physician’s use of analogies or jargon was more unexpected than literal language. Jargon was evaluated more negatively, but analogies were evaluated similarly to literal language. Language type had significant indirect effects on attitudes and perception of physician through unexpectedness, moderated by patient evaluation of communication. When participants evaluated physicians’ communication positively, literal language led to the best outcomes, while jargon led to the worst outcomes through higher unexpectedness. When participants evaluated the style neutrally, jargon resulted in the best outcomes through higher unexpectedness, while literal language led to the worst outcomes.</div></div><div><h3>Conclusions</h3><div>This study highlights the crucial and contingent role of patient expectations and evaluations in shaping the outcomes of physician language strategies. Our findings underscore the complexity of language choice, demonstrating that unexpected communication, even when evaluated positively, may reduce its intended persuasive effect.</div></div><div><h3>Practice implications</h3><div>Healthcare professionals should assess patient preferences when making their language choice. Interventions that train physicians to recognize and respond to patient expectations should ensure more tailored and effective communication approaches, ultimately enhancing patient trust, comprehension, and adherence to medical recommendations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108810"},"PeriodicalIF":2.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098749","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":"Practice recommendations for contextualizing explanations of headache pain within a biopsychosocial model","authors":"Amy C. Lang ,&nbsp;Eva C. Igler ,&nbsp;Nina G. Linneman ,&nbsp;Chasity T. Brimeyer ,&nbsp;Amy L. Drendel ,&nbsp;W. Hobart Davies","doi":"10.1016/j.pec.2025.109175","DOIUrl":"10.1016/j.pec.2025.109175","url":null,"abstract":"<div><h3>Objective</h3><div>The current study aimed to identify non-dismissive language and synthesize practice recommendations for medical providers to use when discussing potential psychological etiologies of chronic pain.</div></div><div><h3>Methods</h3><div>Community-recruited emerging adults (18- to 25-year-olds; <em>N</em> = 138; 68 % female) participated in the current study as part of a larger online survey. Participants were randomly assigned to read either a “dismissive” (i.e., attributed pain to primarily psychological etiologies) or “biopsychosocial” (i.e., provided a more nuanced explanation of the complex interplay between psychological and physiological etiologies of pain) vignette describing hypothetical patient-provider interactions regarding -chronic daily headache complaints.</div></div><div><h3>Results</h3><div>Participants who read the biopsychosocial vignette and male participants reported significantly more positive reactions (e.g., more satisfaction, higher likelihood of continued care). Qualitative results showed that participants who read the dismissive vignette were more likely to feel their time had been wasted and obligated to explain their pain further.</div></div><div><h3>Conclusions</h3><div>Hypothetical provider explanations of psychological etiologies of chronic daily headache pain were received more positively when contextualized within a biopsychosocial framework.</div></div><div><h3>Practice implications</h3><div>This article presents practice recommendations for how medical providers should introduce potential psychological etiologies of a patient’s headache pain experience in a non-dismissive manner to decrease the likelihood of provider-generated pain dismissal experiences.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 109175"},"PeriodicalIF":2.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071364","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 if you were the patient?\" A mixed methods study on improving hospital workers' awareness of the patient experience through virtual reality","authors":"Hafize Demirci ,&nbsp;Noureddine Achbab ,&nbsp;Judith Weeda ,&nbsp;Eva van de Korput ,&nbsp;Iris Dekker ,&nbsp;Anne M. Eskes ,&nbsp;Marlies P. Schijven","doi":"10.1016/j.pec.2025.108827","DOIUrl":"10.1016/j.pec.2025.108827","url":null,"abstract":"<div><h3>Objective</h3><div>A hospital visit can be stressful and challenging for patients. Understanding the patient experience is crucial for improving care. The main purpose of this study is to gain insight into whether the use of a Virtual Reality (VR) movie about the patient journey through the hospital enhances hospital workers' awareness of patients' experiences and influences their behaviour.</div></div><div><h3>Methods</h3><div>A mixed methods study was conducted at Amsterdam UMC, the Netherlands. The study used qualitative, and quantitative methods to evaluate the impact of the VR movie “Through the Eyes of the Patient”. Inclusion criteria were employees of Amsterdam UMC, regardless of role. Exclusion criteria included epilepsy, severe dizziness, or physical limitations affecting VR use. Participants had to complete an evaluation form with both closed and open-ended questions. Data were analyzed using thematic and statistical methods to evaluate the effectiveness of VR in increasing awareness of patients' experiences and influencing their behaviour.</div></div><div><h3>Results</h3><div>A total of 194 hospital workers participated in the study. For the qualitative analysis, data from 171 participants were utilized. Five main themes emerged from the thematic analysis: (1)Evoking emotions; (2)Change of perspective; (3)Regard for the patient; (4)Call for actions; (5)Virtual Reality as an appropriate tool. More than half of the participants acknowledged that the VR movie improved their understanding of the patient experience during a hospital visit or outpatient stay. The mean rating for the VR movie was 8.4 (SD 0.88).</div></div><div><h3>Conclusion</h3><div>Based on the results of our research, the VR movie 'Through the Eyes of the Patient' appears to be effective in raising awareness among hospital employees. VR technology has proven to be a valuable tool to achieve this.</div></div><div><h3>Clinical implications</h3><div>VR is an accessible tool for engaging many employees, making it a valuable addition to formal healthcare training and orientation programs for new hospital workers.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108827"},"PeriodicalIF":2.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942430","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":"Clinicians’ use of metaphoric language in conversations with families of critically ill patients in the intensive care unit","authors":"Marij A. Hillen ,&nbsp;Maria Grazia Rossi ,&nbsp;Aranka Akkermans ,&nbsp;Leonie A.L. Baatenburg de Jong ,&nbsp;Jolanda H.M. Dobbe ,&nbsp;Tanja Henkel ,&nbsp;Vicky Lehmann ,&nbsp;Susan J. Oudbier ,&nbsp;Tanja J. de Rijke ,&nbsp;Ellen M.A. Smets ,&nbsp;Thomas G.V. Cherpanath ,&nbsp;Marc van Heerde ,&nbsp;Anton H. van Kaam ,&nbsp;Moniek van de Loo ,&nbsp;Marcus J. Schultz ,&nbsp;Job B.M. van Woensel ,&nbsp;Sanne Prins ,&nbsp;Mirjam A. de Vos","doi":"10.1016/j.pec.2025.108813","DOIUrl":"10.1016/j.pec.2025.108813","url":null,"abstract":"<div><h3>Objectives</h3><div>During conversations with families of critically ill patients in intensive care units (ICUs), clinicians’ metaphoric language use may facilitate families’ understanding, but also has potential drawbacks. We sought to obtain insights regarding how ICU clinicians use metaphors regarding patients’ disease and treatment trajectory.</div></div><div><h3>Methods</h3><div>We identified clinicians’ metaphor use in <em>N=</em>101 audio-recorded neonatal, pediatric, and adult ICU family conversations about life-sustaining treatments. Using qualitative content analyses, each metaphor’s semantic domain, disease phase, and dialogical function were coded. Overarching themes and patterns were analyzed.</div></div><div><h3>Results</h3><div>Journey metaphors (<em>N</em> = 140 in <em>N</em> = 54 conversations) most frequently referred to the semantic domains boundary, path and bridge. Although most functioned to convey clinical information (72 %), metaphors were mainly presented in an emotionally charged way, serving to manage families’ perceptions. As patients’ conditions deteriorated, metaphors more often functioned to prepare families for medical limits. Metaphors were sometimes potentially unclear. Others suggested high patient agency, starkly contrasting with patients’ unconscious state.</div></div><div><h3>Conclusions</h3><div>Metaphors related to ICU patients’ disease and treatment trajectory are common. They may clarify information or strengthen clinicians’ arguments but can also cause confusion and thereby hinder decision-making.</div></div><div><h3>Practice implications</h3><div>Enhancing clinicians’ awareness about their metaphor use may promote more effective information exchange and decision-making.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108813"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947174","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":"Training in motivational interviewing for pediatricians was associated with a higher uptake of health behavior and lifestyle treatment: Results from the KP Wellness Coaching for Families and Kids (WC4K) Program","authors":"Eden Moore ,&nbsp;Jessica Vallejo ,&nbsp;Margo A. Sidell ,&nbsp;Xia Li ,&nbsp;Emerson Delacroix ,&nbsp;Deborah R. Young ,&nbsp;Poornima Kunani ,&nbsp;Ken Resnicow ,&nbsp;Corinna Koebnick","doi":"10.1016/j.pec.2025.109173","DOIUrl":"10.1016/j.pec.2025.109173","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the association between motivational interviewing (MI) training for pediatricians and the caregiver’s uptake of health behavior and lifestyle treatment (HBLT) during the Wellness Coaching for Kids (WC4K) implementation study.</div></div><div><h3>Methods</h3><div>Pediatricians from 24 (of 49) randomly assigned pediatric clinics across Southern California were trained in MI to motivate and refer eligible caregivers to engage in HBLT beginning in 2022. Eligible children were 3–8 years old at the time of their caregiver’s referral to HBLT, with a body mass index (BMI) ≥ 85th percentile for age and sex. Two years after the program started, we analyzed the proportion of referred caregivers who engaged in HBLT coaching by the pediatricians’ MI-training status.</div></div><div><h3>Results</h3><div>Among 233 pediatricians from 24 intervention clinics, 53 % (n = 123) participated in MI training, and 44 % (n = 102) referred at least one caregiver to HBLT coaching. Out of 19,888 eligible children, 10.3 % (n = 2045) were referred to wellness coaching (reached). The reach was higher in MI-trained compared to untrained pediatricians (20.4 ± 10.1 % and 7.0 ± 10.2 %, respectively, p = 0.003). Among those referred, 49.9 % (n = 1021) scheduled a coaching appointment, and 43.3 % (n = 886) received at least one coaching call (uptake). The uptake among caregivers with MI-trained pediatricians was significantly higher (aOR 2.3; 95 %CI 1.4, 3.6) than among those with untrained pediatricians.</div></div><div><h3>Conclusion</h3><div>Caregiver uptake of HBLT was higher when referred by MI-trained pediatricians, suggesting MI can be successful in brief interventions to engage families in initiating HBLT for childhood obesity in primary care.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 109173"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116806","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 patients keep: A reflection on language and agency in clinical encounters","authors":"Melissa C. Leeolou","doi":"10.1016/j.pec.2025.108816","DOIUrl":"10.1016/j.pec.2025.108816","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108816"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942429","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":"Psychosocial impacts of, and barriers to, lung cancer screening: An international qualitative study of multidisciplinary health professionals’ perspectives","authors":"Kathleen McFadden ,&nbsp;Brooke Nickel ,&nbsp;Nehmat Houssami ,&nbsp;Nicole M. Rankin ,&nbsp;Rachael H. Dodd","doi":"10.1016/j.pec.2025.109172","DOIUrl":"10.1016/j.pec.2025.109172","url":null,"abstract":"<div><h3>Objectives</h3><div>Many lung cancer screening (LCS) programs are in development following landmark trials demonstrating the effectiveness of screening for reducing lung cancer mortality. Psychosocial aspects are important considerations for LCS services, both for harms to participants and as barriers to appropriate uptake. This study investigated the psychosocial impacts and determinants of LCS for screening participants from the perspective of an international, multidisciplinary sample of healthcare professionals.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with health professionals involved in LCS delivery or design, or with LCS-eligible populations (including primary care practitioners, respiratory physicians, nurses, trial assistants/coordinators, and researchers). Participants were sampled to include perspectives across different countries, trials/programs, and policy landscapes. Data was analysed thematically.</div></div><div><h3>Results</h3><div>Twenty-seven participants were interviewed. Most were from England (n = 11) and Australia (n = 10), with representation across seven established LCS trials/programs. Themes generated were: (a) anxiety and fear are central to screening experiences; (b) positive psychological responses to LCS are common; (c) ingrained lung cancer fatalism underpins anxiety; (d) smoking stigma is pervasive and interacts with LCS invitation; (e) influence of family and community; (f) issues specific to LCS-eligible populations; and (g) psychosocial impacts are diverse and moderated by certain factors. Themes each included psychosocial barriers to engagement (e.g., fear of cancer, nihilism, lack of social support). Key service design recommendations were developed from findings (e.g., public awareness campaigns to reduce fatalistic perceptions).</div></div><div><h3>Conclusion</h3><div>Psychosocial responses to LCS are diverse, complex and uniquely influenced by smoking-based eligibility criteria and lung cancer fatalism. Similarities in perspectives across an international sample of multidisciplinary healthcare professionals suggest the potential for best-practice guidelines for optimising psychosocial outcomes and determinants of LCS.</div></div><div><h3>Practice implications</h3><div>Findings include key recommendations to inform LCS practice and service design. Further research investigating and testing communication strategies targeting (a) stigma and fatalism, and (b) risk and ineligibility, is needed.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 109172"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069179","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":"Metaphors as communication tools in fertility care and assisted reproductive technologies in Portugal","authors":"Catarina Delaunay ,&nbsp;Luís Gouveia","doi":"10.1016/j.pec.2025.108812","DOIUrl":"10.1016/j.pec.2025.108812","url":null,"abstract":"<div><h3>Objective</h3><div>Metaphors are ubiquitous in healthcare communication. In fertility care and assisted reproductive technologies (ART), literature highlights a variety of metaphors in public, patient, and professional discourses. This paper explores the construction of figurative discourse in ART settings, aiming to understand how metaphors influence users’ perception and interpretation.</div></div><div><h3>Methods</h3><div>In-depth, semi-structured interviews were conducted with ART patients and medical professionals. Transcripts were thematically analyzed to identify and interpret the use and impact of metaphors in communicative interactions within ART.</div></div><div><h3>Results</h3><div>A total of 74 ART users and 49 health professionals were interviewed. Thematic analysis revealed eight recurrent metaphors across three main themes: Acknowledging reproductive processes (“Chicken’s eggs”, “Warm Oven”, “Seed/Flower”); Grasping the embryo’s potential (“Pretty embryos”, “Winners”, “Babies”); Naturalizing the strangeness (“Aliens”, “Eskimos/Igloo Children”).</div></div><div><h3>Conclusion</h3><div>Beyond symbolic meanings, metaphors function as communication tools in clinical encounters, combining various types of knowledge and communicative practices. Their use in ART discourses helps render complex medical language intelligible to users, significantly shaping how treatments are communicated, perceived, and experienced. Metaphors can translate clinical concepts into relatable terms, enhancing lay understanding. However, they may also contribute to distress in the event of treatment failure.</div></div><div><h3>Practice Implications</h3><div>By improving understanding of ART procedures and outcomes through the careful use of metaphors, medical professionals can support more effective informed consent or dissent. Training in metaphorical awareness and communication strategies may enhance healthcare providers’ ability to improve patient experiences and promote well-being.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108812"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942432","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 to what matters for people with osteoporosis in clinical consultations with and without conversation aids: A videographic analysis","authors":"Ashley Hawarden ,&nbsp;Laurna Bullock ,&nbsp;Montserrat León García ,&nbsp;Sandra A. Hartasanchez ,&nbsp;Andrea Maraboto ,&nbsp;Clare Jinks ,&nbsp;Marleen Kunneman ,&nbsp;Ian Hargraves ,&nbsp;Rob Horne ,&nbsp;Victor M. Montori ,&nbsp;Zoe Paskins","doi":"10.1016/j.pec.2025.109171","DOIUrl":"10.1016/j.pec.2025.109171","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate if, and how, clinicians elicit and address health and medicine beliefs in osteoporosis consultations, and to evaluate the impact of a conversation aid (CA) on clinician behaviour.</div></div><div><h3>Methods</h3><div>Secondary analysis of 107 video-recorded consultations from two trials evaluating CAs, using a bespoke coding tool to record the presence or absence of clinician shared decision-making (SDM) behaviours. In addition to descriptive statistics, Fisher’s exact test examined differences between consultations with and without CAs.</div></div><div><h3>Results</h3><div>Clinicians framed osteoporosis as a bone density (92 %) and/or fracture risk problem (78 % overall (96 % usual care vs 62 % aided, p &lt; 0.001)). Biopsychosocial consequences of fractures were rarely mentioned. Clinicians asked questions to elicit beliefs in 58 % of consultations, most commonly general views on medications (47 % usual care vs 26 % aided, p = 0.03). Clinicians rarely asked about beliefs related to osteoporosis (n = 3), perceived need for (n = 1), concerns about (n = 5), or practical issues (n = 6) with medication. Clinicians used persuasion techniques more commonly in aided consultations (88 % vs 64 %, p = &lt;0.001). Patient understanding was infrequently checked (12 %).</div></div><div><h3>Conclusions</h3><div>Clinicians miss opportunities to support patients to get the best from osteoporosis medications by tailoring communications to address necessity, beliefs, concerns and practicalities.</div></div><div><h3>Practice implications</h3><div>We need better methods for supporting clinicians in eliciting patient beliefs about osteoporosis and the medications recommended to treat it, including their need, safety, and practical issues.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 109171"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071365","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}