Patient Education and Counseling最新文献

{"title":"A description of the development and initial evaluation of a patient navigator delivered patient portal enrollment program","authors":"Alicia K. Matthews ,&nbsp;Caleb Gumbs ,&nbsp;Larisa Burke ,&nbsp;Brittany Harris Vilona ,&nbsp;Alejandra Rodriguez ,&nbsp;Hope Opuada ,&nbsp;Kristina Rowden ,&nbsp;Ezra Root ,&nbsp;Rachel Caskey","doi":"10.1016/j.pec.2025.109343","DOIUrl":"10.1016/j.pec.2025.109343","url":null,"abstract":"<div><h3>Objectives</h3><div>Uptake of electronic patient portals is low in underserved populations. Federally qualified health centers (FQHCs) face unique barriers, including limited digital literacy, language differences, and low trust in technology. This paper describes the development and initial evaluation of a patient navigator program aimed at increasing portal enrollment in three FQHC locations.</div></div><div><h3>Methods</h3><div>Development and implementation followed a seven-step process guided by the Knowledge to Action Framework: (1) stakeholder engagement to identify barriers, (2) literature review to contextualize disparities, (3) resource and workflow assessment, (4) stakeholder feedback to refine the navigator approach, (5) a monitoring system to track enrollment and navigator activities, (6) identification of structural barriers and sustainability strategies, and (7) project evaluation. Navigators were embedded in clinic workflows to assist with MyChart enrollment, provide technical help, and address concerns. Activation rates were assessed with pre-post comparisons and navigator tracking data.</div></div><div><h3>Results</h3><div>Tailored materials, including a MyChart handout and a smaller flyer for login details, were created. Over 12 months, of 1658 eligible patients, 1062 (64 %) accepted navigator assistance; 790 (74 %) successfully activated MyChart. African American (44 % to 49 %) and Latinx (52 % to 60 %) patients showed notable gains, and nearly all (99 %) newly enrolled users accessed MyChart at least once post-activation.</div></div><div><h3>Conclusions</h3><div>Embedding navigators proved feasible for increasing MyChart enrollment in FQHC settings. The structured process highlighted essential considerations for scalability. Future work should examine long-term sustainability and how patient navigation affects broader engagement and health outcomes.</div></div><div><h3>Practice implications</h3><div>By offering real-time, culturally attuned support, navigators can help patients overcome digital literacy barriers, thereby improving enrollment in patient portals. Health systems seeking to reduce disparities may benefit from adopting navigator-led strategies as part of routine care.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109343"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048490","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":"Interventions to support patient decision making about taking part in health research: A systematic review","authors":"Jolyn Hersch ,&nbsp;Lauren O'Hara ,&nbsp;Ilona Juraskova ,&nbsp;Rebekah Laidsaar-Powell ,&nbsp;Nicci Bartley ,&nbsp;Katie Gillies ,&nbsp;Mandy Ballinger ,&nbsp;Wei Wang ,&nbsp;Phyllis Butow","doi":"10.1016/j.pec.2025.109339","DOIUrl":"10.1016/j.pec.2025.109339","url":null,"abstract":"<div><h3>Objectives</h3><div>An important, albeit challenging, aspect of conducting clinical research is achieving informed consent. We systematically reviewed the literature to characterise existing interventions designed to support communication and decision making about participating in health research.</div></div><div><h3>Methods</h3><div>We searched five databases (1990–2025) for peer-reviewed studies about intervention development and/or evaluation, reporting data on acceptability and/or efficacy. Eligible interventions addressed decisions about research participation and aimed to improve decision quality by enabling adult patients to address their information needs (e.g., question prompt list) and/or incorporate their values into decision making (e.g., decision aid). We conducted a narrative synthesis to describe the interventions, summarising findings on their effects where applicable.</div></div><div><h3>Results</h3><div>Eighteen studies met inclusion criteria. In seven studies, interventions targeted a specific clinical study; 11 covered clinical trials generally. Eight tools were printed; ten were digital, incorporating various interactive features. Four interventions addressed racial, ethnic, or cultural diversity. Thirteen papers cited relevant theories or frameworks that informed intervention development. Evidence from controlled studies (n = 11) showed that interventions generally increased knowledge, with little effect on participation rates.</div></div><div><h3>Conclusions and practice implications</h3><div>This review highlights the potential utility of tools for patients considering health research participation, providing an overview of resources available and synthesising key principles for intervention developers. However, most interventions targeted decisions about participation in cancer clinical trials. Future interventions should address other clinical settings and research designs, and emerging areas like genomics and precision medicine. Digital technology can offer opportunities to tailor content, enhance interactivity, and optimise support for diverse communities.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109339"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049301","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":"Demonstrating the need for and the validity and reliability of a supportive message quality measure within the patient-clinician context","authors":"Allyson C. Bontempo","doi":"10.1016/j.pec.2025.109341","DOIUrl":"10.1016/j.pec.2025.109341","url":null,"abstract":"<div><h3>Objective</h3><div>A growing problem in healthcare is interactions in which patients’ symptoms are reportedly invalidated by clinicians. The relational science construct of supportive message quality—or behavior generated to provide aid to others perceived as needing such aid—can be leveraged in the study of invalidation by clinicians, especially for a specific communication interaction. Given a recent call to integrate relational science with clinical communication and the increasing research that situates clinicians as a source of support for patients, the purpose of this study was to test this scale within the novel patient-clinician communication context.</div></div><div><h3>Methods</h3><div>Data were derived from a larger project seeking to construct a measure of invalidating communication. For the present study, the sample was randomly divided into two groups for a calibration (exploratory factor analysis; EFA; <em>n</em> = 235) and validation (confirmatory factor analysis; CFA; <em>n</em> = 244) approach. EFA yielded one factor. CFA was conducted for both a first-order one-factor and three-factor model and a second-order three-factor model.</div></div><div><h3>Results</h3><div>The first-order three-factor model was a better fit than the one-factor model and comparable to the second-order three-factor model. Structural equation modeling testing the second-order three-factor model with satisfaction yielded an acceptable model. Internal consistency was excellent.</div></div><div><h3>Conclusions</h3><div>The adaptation of this scale in the patient-clinician context is one way to assess the health outcomes of clinicians’ message quality toward patients in the assessment of clinician invalidation. It is a step forward in integrating the clinical communication and relational science literatures and expanding how we theorize clinical communication.</div></div><div><h3>Practice Implications</h3><div>Being able to measure supportive message quality in the patient-clinician context can yield novel insights into the physiological mechanisms by which clinicians facilitate or impede patients’ overall well-being, such as increased inflammation, which has been demonstrated in the relational science literature and has implications for patients’ physical health.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109341"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048486","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 cancer literacy predict cancer screening intention or uptake? A systematic review","authors":"Claudia Isonne ,&nbsp;Alessandra Sinopoli ,&nbsp;Andrea Pistollato ,&nbsp;Antonio Sciurti ,&nbsp;Jessica Iera ,&nbsp;Giuseppe Migliara ,&nbsp;Carolina Marzuillo ,&nbsp;Paolo Villari ,&nbsp;Valentina Baccolini","doi":"10.1016/j.pec.2025.109346","DOIUrl":"10.1016/j.pec.2025.109346","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between cancer literacy (CL) and cancer screening behaviors, including screening intention and uptake.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across three databases up to October 2024 (CRD42024500935). Studies were included if they (i) had an observational design, (ii) measured CL using validated or <em>ad hoc</em> tools, and (iii) quantified its association with cancer screening intention and/or uptake. Quality was assessed using the Newcastle-Ottawa Scale. Findings were narratively synthesized by cancer type for each outcome.</div></div><div><h3>Results</h3><div>Six cross-sectional studies met the inclusion criteria: one focused on screening intention, four on screening uptake, and one on both outcomes. Data were available for breast, cervical, colorectal, prostate, and skin cancer. Study quality was heterogeneous, with most studies rated as fair quality and affected by methodological limitations, including reliance on self-reported data, imprecise outcome definitions and measurements, and heterogeneous target populations. While higher levels of CL were linked to increased screening intentions in both included studies, findings on screening uptake were inconsistent across and within cancer types, with significant associations more commonly observed in adjusted analyses. Although a few studies suggested that awareness of the importance of preventive measures may influence screening adherence, the overall results remained inconclusive across all cancer types.</div></div><div><h3>Conclusions</h3><div>This review suggests a positive association between higher CL and cancer screening intentions, although the evidence is limited. The role of CL in screening uptake remains uncertain, indicating that additional factors may influence adherence. Given the limited evidence, methodological variability, and study limitations, further research employing more robust and standardized approaches is essential to better understand the role of CL in cancer-related behaviors.</div></div><div><h3>Practical Implications</h3><div>Improving CL may have a role in shaping cancer screening behaviors, particularly in promoting screening intention. More rigorous research is needed to clarify the role of CL in screening behaviors.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109346"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049300","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":"Real-world comparison of phone versus video consultation in a tobacco treatment program during the COVID-19 pandemic","authors":"Diane Beneventi ,&nbsp;George Kypriotakis ,&nbsp;Chris Kotsen ,&nbsp;Maher Karam-Hage ,&nbsp;Jason D. Robinson ,&nbsp;Jennifer A. Minnix ,&nbsp;Paul M. Cinciripini","doi":"10.1016/j.pec.2025.109347","DOIUrl":"10.1016/j.pec.2025.109347","url":null,"abstract":"<div><h3>Objective</h3><div>In addition to increased morbidity and mortality, continued smoking after a cancer diagnosis results in the added risks of cancer recurrence, adverse side effects, and decreased effectiveness of first line treatments. Combining counseling and U.S. Food and Drug Administration–approved pharmacotherapy is best practice in the treatment of tobacco use disorder (TUD). The COVID-19 pandemic ushered in a dramatic shift toward provision of care through telehealth platforms. We examined whether providing an initial consultation by phone versus video impacted the efficacy of tobacco treatment and to identify patients likely to choose these modalities.</div></div><div><h3>Methods</h3><div>In response to the pandemic, MD Anderson Cancer Center's Tobacco Research and Treatment Program (TRTP) shifted 100 % of its services to fully remote telehealth platforms. Because requirements for a face-to-face visit were suspended by the Texas state government during the pandemic, we were able to provide the initial consultation by phone or video. Data were collected from 5/1/2020 through 4/30/2021 for patients enrolled in the comprehensive program of the TRTP. Patients selected the telehealth modality they were most comfortable with. Abstinence rates at 3, 6, and 9 months and treatment engagement, defined as total number of counseling sessions attended, were compared between the groups with phone versus video consultations.</div></div><div><h3>Results</h3><div>Abstinence rates at 3, 6, and 9 months and treatment engagement were similar in the phone (N = 504) and video (N = 284) groups. Patients in the phone group were more likely to be White and older.</div></div><div><h3>Conclusion</h3><div>Initial consultation via phone versus video did not affect patients’ ability to achieve abstinence during subsequent phone-based tobacco treatment and did not affect patients’ engagement.</div></div><div><h3>Practice Implications</h3><div>These results establish the efficacy of phone-delivered tobacco treatment, including the provision of medication for patients with cancer, and can inform policy regarding requirements for such care after the pandemic.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109347"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049074","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":"Finding the right words: A skills-based curriculum using verbal procedures to address implicit bias in clinical encounters","authors":"Cristina M. Gonzalez ,&nbsp;Jessica Dennehy ,&nbsp;Ryan Wilkerson ,&nbsp;Joseph Ravenell ,&nbsp;Renee L. Williams ,&nbsp;Richard E. Greene","doi":"10.1016/j.pec.2025.109335","DOIUrl":"10.1016/j.pec.2025.109335","url":null,"abstract":"<div><h3>Introduction</h3><div>Implicit bias can influence patient-clinician communication through clinician implicit bias (actual) or patients’ perception of bias (perceived). Few curricula focus on skills to address implicit bias. We developed and evaluated a skills-based curriculum addressing implicit bias in clinical encounters.</div></div><div><h3>Materials &amp; Methods</h3><div>A 60-minute session was delivered to 4 cohorts of learners (N = 458, ranging from first-year medical students to attendings) in academic medical settings. All had prior exposure to the topic of implicit bias. Instruction grounded in the Implicit Bias Recognition and Management framework described the impact of actual and perceived bias and patients’ recommendations for restoring rapport once bias had impacted an encounter. Through audience response systems or role-plays with feedback, participants developed verbal procedures—personalized, verbatim statements to restore patient rapport when implicit bias has impacted an encounter. Learners submitted their verbal procedures online, which were then coded to identify helpful and unhelpful elements. Investigators coded verbal procedures and assigned point values for “helpful” and “unhelpful” elements resulting in scores from −1–6.</div></div><div><h3>Results</h3><div>Each approach yielded helpful elements. Overall, of submitted verbal procedures, 91.3 % were “helpful” and 8.6 % “unhelpful.” Compared to audience response systems, verbal procedures developed through role-plays included significantly more “helpful” elements (2.21/1.29, p = 0.003 and 2.46/1.87 p = 0.009).</div></div><div><h3>Conclusions</h3><div>Findings suggest learners can develop verbatim statements to restore rapport with patients in a single session if those learners have prior foundational knowledge about implicit bias and its relevance to healthcare disparities.</div></div><div><h3>Practice Implications</h3><div>Teaching verbal procedures could expand skill-building opportunities within implicit bias curricula.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109335"},"PeriodicalIF":3.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048485","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 experience and satisfaction in Chilean hospitals: Insights for enhancing person-centered care","authors":"Verónica Fuentes ,&nbsp;Alicia Núñez","doi":"10.1016/j.pec.2025.109332","DOIUrl":"10.1016/j.pec.2025.109332","url":null,"abstract":"<div><h3>Objective</h3><div>This study examines the relationship between patient satisfaction and various domains of patient experience in Chilean hospitals, aiming to provide evidence to enhance person-centered care. Methods: Using a culturally adapted survey, data were collected from 758 recently discharged patients from two high-complexity hospitals. A generalized ordered logit model was applied to analyze the impact of different experience dimensions on overall satisfaction.</div></div><div><h3>Results</h3><div>The findings show that eight experience variables significantly influence satisfaction: room cleanliness, information about medication side effects, clear communication from treating doctors, feedback provided to family members, two-way communication with clinical staff, patient involvement in treatment decisions, resolution of the medical issue, and the absence of conflicting information. Notably, effective communication with patients and families emerged as a key determinant of satisfaction.</div><div>Subgroup analyses revealed important variations based on age and education level. For example, patients aged 26 or younger placed less value on communication and information than older groups, possibly due to cultural norms around medical decision-making. Patients with lower education levels valued participation in care decisions more, but were less influenced by the information provided.</div></div><div><h3>Conclusions</h3><div>These results highlight the multidimensional nature of patient satisfaction and reinforce the need for differentiated strategies in hospitals. Practice Implications: Effective communication, patient engagement, and attention to demographic characteristics are essential to improving satisfaction and achieving more person-centered healthcare.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109332"},"PeriodicalIF":3.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026451","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":"Investigating the role of physician communication behaviors on the use of telehealth visits by older Black Americans with chronic conditions","authors":"Carolyn M. Tucker ,&nbsp;Guillermo M. Wippold ,&nbsp;Stephen Anton ,&nbsp;Kirsten Klein ,&nbsp;Ji-Hyun Lee ,&nbsp;Derek Li ,&nbsp;Duane Mitchell ,&nbsp;Ann-Marie Knight ,&nbsp;Eric B. Stewart ,&nbsp;Kaylyn A. Garcia","doi":"10.1016/j.pec.2025.109334","DOIUrl":"10.1016/j.pec.2025.109334","url":null,"abstract":"<div><h3>Background</h3><div>Older Black Americans experience barriers to healthcare, including patient-provider communication challenges that often deter uptake of telehealth services. This study investigated the effects of varying verbal and nonverbal communication on study participants’ (a) likelihood of using telehealth, and (b) likelihood of having a telehealth visit with the physician.</div></div><div><h3>Methods</h3><div>Inclusion criteria were: (a) self-identified as Black, (b) age 55 years or older, (c) had obesity, and at least one other metabolic risk factor, and (d) had not used in-person health care or telehealth in the past three years. Participants were randomized to one of three groups, and each of these groups watched one of three videos in which a White male physician explained telehealth services to an older Black man using (1) direct, yet professional communication style characteristic of a typical clinical encounter, (2) verbal communication style aligned with patient-centered care, yet nonverbal behaviors misaligned with patient-centered care, or (3) microaggressive communication. Pre- and post- measures were collected.</div></div><div><h3>Results</h3><div>110 (mean age = 66.6) older Black adults participated. Participants who viewed the direct, yet professional communication video reported a significantly higher likelihood of using telehealth services following the video. No such significant change occurred in participants who viewed the other two videos. Those who watched the direct, yet professional or verbally patient-centered communication video reported a significantly higher likelihood of having a telehealth appointment with the physician in the video compared to those who watched the microaggressive video.</div></div><div><h3>Conclusions</h3><div>This study found that older Black adults are more likely to use telehealth services when physicians communicate in a manner that is straightforward and includes direct messaging. Additionally, misaligned verbal and nonverbal behaviors may undermine a patient-centered communication style. Practice Implications This understanding may promote future use of telehealth services among the high risk population of older Black adults.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109334"},"PeriodicalIF":3.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Guided Self-Determination – What does “guided” mean in connection with self-determination?” [Patient Educ Couns 141 (2025) 109306]","authors":"Vibeke Zoffmann ,&nbsp;Jeanette Finderup ,&nbsp;Rikke Jørgensen ,&nbsp;Emilie Marqvorsen ,&nbsp;Anne Sophie Mathiesen ,&nbsp;Mette Juul Rothmann ,&nbsp;Bodil Rasmussen ,&nbsp;Jeanette Bresson Ladegaard Knox","doi":"10.1016/j.pec.2025.109317","DOIUrl":"10.1016/j.pec.2025.109317","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109317"},"PeriodicalIF":3.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996378","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":"Actual concordance between veterans’ with Gulf War Illness and their providers’ illness perceptions is not related to patient satisfaction nor treatment adherence","authors":"Rachel L. Boska ,&nbsp;L. Alison Phillips ,&nbsp;Laura M. Lesnewich ,&nbsp;Katharine J. Bloeser ,&nbsp;Yong Lin ,&nbsp;Peter J. Bayley ,&nbsp;Drew A. Helmer ,&nbsp;Lisa M. McAndrew","doi":"10.1016/j.pec.2025.109329","DOIUrl":"10.1016/j.pec.2025.109329","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with persistent physical symptom (PPS) conditions, such as Gulf War Illness (GWI), report disagreement or “non-concordance” with their providers about PPS conditions and dissatisfaction with healthcare. When patients perceive concordance with their providers about their PPS condition, they have increased satisfaction and adherence. While literature supports perceived concordance, there is a lack of research on actual concordance (i.e., the congruence of patients’ and providers’ perceptions of the patients’ illness).</div></div><div><h3>Methods</h3><div>Among dyads of Veterans with GWI and their provider, we tested the hypotheses that greater actual concordance would be associated with greater Veterans’ satisfaction and adherence. We also explored the relationship of actual concordance with Veterans’ and providers’ perceived concordance.</div></div><div><h3>Results</h3><div>Correlations suggest there is little agreement between Veterans and providers regarding GWI illness perceptions or perceptions of concordance. Polynomial regression analyses showed that actual concordance was not significantly related to Veterans’ satisfaction, adherence, or perceptions of concordance, nor to providers’ perceptions of concordance.</div></div><div><h3>Conclusion</h3><div>Although literature finds Veterans’ <em>perceived</em> concordance with their provider about PPS influences patients’ experiences of care, our results suggest that <em>actual</em> concordance may have limited influence on experiences of care and either Veterans’ or providers’ perceived concordance. That is, the results suggest there does not need to be objective agreement between patients and providers about PPS, rather patients’ perception of agreement influences their satisfaction and adherence.</div></div><div><h3>Practice implications</h3><div>Our results suggest that patients with PPS and their providers may have difficulties in estimating if there is shared agreement in the relationship and demonstrate the importance of explicitly assessing patients’ perceptions of concordance.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109329"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092920","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}