Patient Education and Counseling最新文献

{"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}

{"title":"Considering health literacy in communication about medications between nurses and patients with heart failure: A cross sectional observational study","authors":"Anne Geert van Driel ,&nbsp;Ekram Maghroudi ,&nbsp;Annemarie van der Klis ,&nbsp;John de Heide ,&nbsp;Susanne van Hooft ,&nbsp;AnneLoes van Staa ,&nbsp;Tiny Jaarsma","doi":"10.1016/j.pec.2025.108709","DOIUrl":"10.1016/j.pec.2025.108709","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the content, style, and initiation of medication-related discussions between nurses and patients to understand how nurses support patients with heart failure, especially those with inadequate health literacy.</div></div><div><h3>Methods</h3><div>A cross-sectional design was conducted to observe medication-related conversations between nurses and patients with heart failure in four Dutch outpatient clinics. Conversations were audio-recorded and analyzed using MEDICODE, focusing on content, communication style (monologue or a dialogue), and initiation of the content themes. Health literacy was assessed using the NVS-D and the SBSQ. Results between health literacy groups were compared with descriptive analyses.</div></div><div><h3>Results</h3><div>A total of 56 patients and 14 nurses participated in the study. Patients classified by one or both of the instruments as having inadequate health literacy (n = 33; 59 %) were generally older, had lower educational levels, and were more often accompanied by informal caregivers. Key themes discussed in the medication-related conversations included how the medication was identified (‘medication designation), its dosage and instruction, main effects, side effects, attitude or emotions and other (‘various’) themes. The ‘medication designation’ theme was significantly more frequently discussed in the group with adequate health literacy, whereas ‘attitude or emotions’ and ‘various themes’ were more commonly discussed among those with inadequate health literacy. Most conversations were nurse-initiated and tended to be monologues, with nurses mainly serving as information providers.</div></div><div><h3>Conclusions</h3><div>Nurses primarily initiated and dominated medication-related discussions with a focus on factual aspects of medication, while patients initiated more discussions about their concerns regarding medication. While there was overlap in the topics discussed, notable differences emerged between patients with adequate and inadequate health literacy.</div></div><div><h3>Practice Implications</h3><div>Improving communication strategies, such as structuring conversations and adopting dialogic approaches may improve patients’ engagement and understanding of medication use, leading to more effective management of their condition, particularly benefiting patients with lower health literacy.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108709"},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488773","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":"Provider use of a participatory decision-making style with youth with ADHD and their caregivers and visit satisfaction","authors":"Betsy Sleath ,&nbsp;Kathleen C. Thomas ,&nbsp;Delesha M. Carpenter ,&nbsp;Izabela E. Annis ,&nbsp;Gail Tudor ,&nbsp;Imelda Coyne ,&nbsp;Nacire Garcia ,&nbsp;Abena A. Adjei ,&nbsp;Laurel K. Leslie","doi":"10.1016/j.pec.2025.108714","DOIUrl":"10.1016/j.pec.2025.108714","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether youth with ADHD who received a question prompt list and video intervention and their caregivers were more likely to: (a) be asked about their treatment preferences, (b) have their input included into treatment decisions, (c) rate their providers as using more of a participatory decision-making (PDM) style, and (d) be more satisfied with their visits.</div></div><div><h3>Methods</h3><div>Youth with ADHD were randomized to a pre-visit question prompt list intervention or usual care. Visits were audio-recorded; youth were interviewed after visits; caregivers completed questionnaires. Multivariable linear regression was used to analyze the data.</div></div><div><h3>Results</h3><div>102 youth with ADHD and their caregivers participated. Providers included youth and caregiver input into ADHD management decisions during 12 % and 20 % of audio-taped visits, respectively. Youth and caregivers of youth who were in the intervention group were significantly more likely to rate providers as using more of a participatory decision-making style. Black youth and caregivers were significantly less likely to rate their providers as using a participatory style than non-Black youth. Youth and caregiver ratings of provider use of a participatory style were significantly associated with greater visit satisfaction.</div></div><div><h3>Conclusion</h3><div>Both youth and caregivers rated providers high on using a participatory decision-making style. Yet providers could include youth and caregiver input more into ADHD management decisions. Black youth and caregivers rated providers lower on using a participatory decision-making style than non-Black youth and caregivers. Youth and caregivers were more satisfied with visits where they rated their providers as using a more participatory style.</div></div><div><h3>Practice implications</h3><div>Providers should include both youth and caregiver input into ADHD management decisions. Providers should attempt to use a more participatory decision-making style with Black youth and caregivers.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108714"},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510138","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 proposal to involve people living with rare and complex conditions in the development of clinical practice guidelines","authors":"Anabel Granja-Dominguez ,&nbsp;Carmen Martin-Gomez ,&nbsp;Juan Darío Ortigoza-Escobar ,&nbsp;Rocío Rodriguez-Lopez ,&nbsp;Lourdes Gonzalez-Bermudez ,&nbsp;Stefania Dantone ,&nbsp;Stefano Pavanello ,&nbsp;Juan Antonio Blasco-Amaro","doi":"10.1016/j.pec.2025.108708","DOIUrl":"10.1016/j.pec.2025.108708","url":null,"abstract":"<div><h3>Objective</h3><div>Develop a proposal to involve people living with rare and complex conditions in the development of clinical practice guidelines (CPGs) based on a systematic review of qualitative literature.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using medical subject heading-term and text-word search strategies to identify qualitative literature on patient living with rare diseases (PLWRD) involvement during CPG development and in research studies. Databases were searched for literature in English or Spanish, published until April 2024.</div></div><div><h3>Results</h3><div>64 publications were included in this review, underscoring the critical importance of PLWRD involvement in the CPGs development. The studies reported different strategies to facilitate the involvement of patients and collect relevant information from the patient community. The Guideline Development Group and the Core Writing Group should include representatives of the patient community, closely communicating with a patient advisory group to facilitate a broader patient perspective. Patient representatives should be engaged throughout all stages of CPG development, from defining the scope to implementation.</div></div><div><h3>Conclusion</h3><div>This proposal offers a framework for actively involve PLWRD throughout the CPGs development process, aiming to produce more inclusive and practical recommendations that better reflect real-world patient needs.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108708"},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488770","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":"Influence of patient-oriented organizational climate on physicians’ patient-centered behavior: The mediating role of patient-centeredness self-efficacy","authors":"Dongxue Chen ,&nbsp;Lushaobo Shi ,&nbsp;Ting Li ,&nbsp;Manru Fu ,&nbsp;Xingming Wang ,&nbsp;Yucai Zhang ,&nbsp;Kangmei Kong ,&nbsp;Dong Wang","doi":"10.1016/j.pec.2025.108711","DOIUrl":"10.1016/j.pec.2025.108711","url":null,"abstract":"<div><h3>Objective</h3><div>Existing literature highlights the benefits of organizational climate, but research gaps exist regarding how a patient-oriented organizational climate captures the sub-dimensions of physicians’ patient-centered behavior. We explored the mediating role of patient-centeredness self-efficacy between them.</div></div><div><h3>Methods</h3><div>Utilizing the Patient-Oriented Organizational Climate Scale, Self-efficacy in Patient-Centeredness Questionnaire, and Doctor Interaction Behavior Evaluation Scale, we surveyed 1394 physicians from grade ⅢA general hospitals in Guangdong Province, China from July to September 2022, employing stratified proportional sampling.</div></div><div><h3>Results</h3><div>Patient-oriented organizational climate was positively associated with patient-centered behavior. Patient-centeredness self-efficacy partially mediated their relationship, with varying effects on different dimensions of patient-centered behavior; further, it could partially mediate the association between patient-oriented organizational climate and dialogue and transparency dimensions, but played a full mediating role between patient-oriented organizational climate and access and risk assessment dimensions.</div></div><div><h3>Conclusion</h3><div>These findings underscore the importance of establishing a patient-oriented organizational climate and fostering patient-centeredness self-efficacy in shaping patient-centered behavior, as they differ in impact on the dimensions of patient-centered behavior.</div></div><div><h3>Practice Implications</h3><div>Targeted interventions are necessary to clarify the definitions of patient-centered behavior and consider it as a multidimensional construct.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108711"},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488783","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":"Web-based educational tools and decision aids for patients with advanced cancer: A systematic review","authors":"Phoebe Ullrich ,&nbsp;Henrike Voß ,&nbsp;Laura Unsöld ,&nbsp;Michael Thomas ,&nbsp;Matthias Villalobos","doi":"10.1016/j.pec.2025.108706","DOIUrl":"10.1016/j.pec.2025.108706","url":null,"abstract":"<div><h3>Objectives</h3><div>To provide an overview of existing interactive web-based educational tools and decision aids for patients with advanced cancer and to evaluate their development process, content, feasibility, usability, and effectiveness.</div></div><div><h3>Methods</h3><div>Systematic literature search from inception to November 2023; screening with Covidence software; narrative analysis of results and quality assessment with the SUNDAE checklist.</div></div><div><h3>Results</h3><div>Sixteen web-based tools were identified: Seven for breast cancer, six for other specific cancers, and three for mixed populations. Studies predominantly used literature reviews, focus groups, and/or pre-existing tools for the development. The tools were heterogeneous and not all integrated aspects of end-of-life care. User tests included controlled trials, prospective interventional cohort studies, and a retrospective observational study, involving a total of 6192 patients. Results showed partially low adoption and infrequent use. Feasibility and usability were positively rated with high rates of user satisfaction. Preparation for and involvement in decision-making was partially supported by increased knowledge and improved doctor-patient relationships. Effects on involvement and self-efficacy in decision-making, participation, and distress were uncertain. Effects on quality of life, hope, anxiety, engagement in palliative care/advance directives, and survival were not found.</div></div><div><h3>Conclusions</h3><div>Despite high user satisfaction and adequate feasibility and usability, the evidence for other outcomes is diverse and low for long-term implementation. Tools are very heterogeneous in cancer entities and content. Although targeting patients with advanced cancer not all tools integrate aspects of palliative care and end-of-life.</div></div><div><h3>Practice implications</h3><div>In advanced cancer care, patient involvement in decision-making is complex. Web-based solutions are promising because of easy accessibility and dissemination and the ability to adapt information to patients’ needs and new treatment developments. Still, only a few evidence-based web-based educational tools and decision aids are available. Filling this gap is essential to empower patients to make informed and goal-concordant treatment decisions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108706"},"PeriodicalIF":2.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436896","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":"Can shared decision-making interventions increase trust/trustworthiness in the physician-patient encounter? A scoping review","authors":"Natalie Strokes ,&nbsp;Caroline Lloyd ,&nbsp;Abigail L. Girardin ,&nbsp;Carol Sánchez Santana ,&nbsp;Courtney W. Mangus ,&nbsp;Kelsie E. Mitchell ,&nbsp;Amber R. Hughes ,&nbsp;Becky Baltich Nelson ,&nbsp;Bridget Gunn ,&nbsp;Elizabeth M. Schoenfeld","doi":"10.1016/j.pec.2025.108705","DOIUrl":"10.1016/j.pec.2025.108705","url":null,"abstract":"<div><h3>Objectives</h3><div>To summarize the existing literature on the impact of shared decision-making (SDM) interventions on patient trust, with a focus on the specific characteristics that influence the effectiveness of each intervention regarding the outcome of trust.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of the literature with the aid of a research librarian. Data was extracted via Covidence regarding the characteristics of the study including interventions performed, trust scale used, primary and secondary outcomes, and effect size.</div></div><div><h3>Results</h3><div>From 6090 articles, 97 met criteria for full text review and 20 met inclusion criteria. Sixteen of these were original studies while the remaining 4 were secondary analyses. Eight studies reported a statistically significant increase in trust within the intervention group compared to controls while 12 reported no statistically significant changes. None had trust as a primary outcome.</div></div><div><h3>Conclusion</h3><div>Interventions aimed at increasing SDM have the ability to increase trust, but do not always succeed at doing so.</div></div><div><h3>Practice implications</h3><div>The results indicate that increasing SDM can improve trust in the physician-patient relationship, especially when SDM results in improved communication from clinicians. Further studies should look at populations with low baseline trust since a ceiling effect can occur with trust scales.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108705"},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488769","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":"Dismissive medicine and gaslighting of patients by physicians – A bioethics lens","authors":"Gillie Gabay","doi":"10.1016/j.pec.2025.108701","DOIUrl":"10.1016/j.pec.2025.108701","url":null,"abstract":"<div><h3>Objectives</h3><div>This Discussion paper seeks to raise awareness of the phenomena of dismissive medicine (DM) and medical gaslighting (MG) and their underlying threats to principles of Bioethics. DM refers to mistreatment and negative patient-physician interactions. In most studies on DM, patients perceived physicians as invalidating their illness, as uniformed, as blaming and stigmatizing them, misunderstanding their condition, insensitive, rushing the visit, refusing to discuss pain, rude, and failing to maintain eye contact, listen, and to provide appropriate information about causes and treatments. A special case of DM is MG, referring to the experience of patients when their medical complaints and suffering are discounted, doubted, questioned, second guessed, or denied by physicians causing patients self-doubts. DM and MG may occur, at times, unintentionally Durbhakula and Fortin <span><span>[1]</span></span> and Fielding-Singh and Dmowska <span><span>[2]</span></span>, resulting in severe ramifications. Surprisingly, existing reports focused on the clinical, economic, psychological, and emotional ramifications of DM and MG (Braeuninger-Weimer et al., 2019; Burke, 2019; Street et al., 2019; Merone et al., 2022; Claréus and Renström, 2019; Sheehan, 2020; Turan et al., 2019; Penner and Paul, 2017; Au et al., 2022; Dolezal, 2022; Shapiro and Hayburn, 2024; Fuss et al., 2024; Hunt, 2022) <span><span>[3]</span></span>, <span><span>[4]</span></span>, <span><span>[5]</span></span>, <span><span>[6]</span></span>, <span><span>[7]</span></span>, <span><span>[8]</span></span>, <span><span>[9]</span></span>, <span><span>[10]</span></span>, <span><span>[11]</span></span>, <span><span>[12]</span></span>, <span><span>[13]</span></span>, <span><span>[14]</span></span>, <span><span>[15]</span></span>, rather than on the infringement of bioethics, which is the focus of this Discussion paper.</div></div><div><h3>Conclusions</h3><div>DM and MG not only cause patients to feel stigma, prejudice, shame, and blame, and develop fear of seeking clinical help but also, constitute infringements of beneficence, non-malfeasance, respect for patient right of autonomy, and distributive justice in patient care. This Discussion paper calls for more education about the implicit ethical aspects of these phenomena and policy modifications to efface DM and MG.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108701"},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420149","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}