Rakesh Kumar Sahoo , Krushna Chandra Sahoo , Sapna Negi , Santos Kumar Baliarsingh , Bhuputra Panda , Sanghamitra Pati
{"title":"Health professionals' perspectives on the use of Artificial Intelligence in healthcare: A systematic review","authors":"Rakesh Kumar Sahoo , Krushna Chandra Sahoo , Sapna Negi , Santos Kumar Baliarsingh , Bhuputra Panda , Sanghamitra Pati","doi":"10.1016/j.pec.2025.108680","DOIUrl":"10.1016/j.pec.2025.108680","url":null,"abstract":"<div><h3>Introduction</h3><div>Artificial Intelligence (AI) is fast emerging as a crucial tool for improving patient care and treatment outcomes; however, concerns persist among health professionals about potential compromises in quality care and loss of jobs. The availability of systematic evidence on health professionals' perspectives on AI in healthcare is limited.</div></div><div><h3>Objective</h3><div>This systematic review aims to document the perceived advantages and disadvantages associated with AI applications in healthcare.</div></div><div><h3>Method</h3><div>We conducted a comprehensive search across databases – Embase, PubMed/Medline, IEEE, and Epistemonikos up to November 2023, using 'Artificial Intelligence' AND 'health professionals' as key domains. We searched for studies that describe the perceptions of healthcare professionals towards AI in healthcare.</div></div><div><h3>Findings</h3><div>We identified 3931 records. After screening, 25 articles were selected, and 11 were included in the final review. The studies highlight the benefits of AI in healthcare, such as consultation summaries, data management, patient triaging, and referrals, but also raise concerns about job loss, over-reliance, legal implications, and data privacy concerns.</div></div><div><h3>Conclusion</h3><div>AI enhances care delivery efficiency, and concerns arise due to knowledge and experience gaps. Therefore, healthcare workforce education and skill development are crucial for AI adoption, implementation, and future research.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108680"},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081881","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}
Tanja J. de Rijke , Heleen M.A. Hendriksen , Agnetha D. Fruijtier , Argonde C. van Harten , Mardou S.S.A. van Leeuwenstijn-Koopman , Elsmarieke M. van de Giessen , Calvin Trieu , Denise Visser , Richard L. Street Jr. , Wiesje M. van der Flier , Ellen M.A. Smets , Leonie N.C. Visser
{"title":"Needs expressed by people with subjective cognitive decline during amyloid PET disclosure consultations: An observational study","authors":"Tanja J. de Rijke , Heleen M.A. Hendriksen , Agnetha D. Fruijtier , Argonde C. van Harten , Mardou S.S.A. van Leeuwenstijn-Koopman , Elsmarieke M. van de Giessen , Calvin Trieu , Denise Visser , Richard L. Street Jr. , Wiesje M. van der Flier , Ellen M.A. Smets , Leonie N.C. Visser","doi":"10.1016/j.pec.2025.108668","DOIUrl":"10.1016/j.pec.2025.108668","url":null,"abstract":"<div><h3>Objectives</h3><div>We disclosed amyloid PET results to people with subjective cognitive decline (SCD) and analysed audiotaped consultations. The aim was to examine the needs expressed by people with SCD and their care partners during amyloid PET disclosure consultations, and to explore neurologists’ communication behaviours surrounding these expressions of need.</div></div><div><h3>Methods</h3><div>53 persons with SCD (65 ± 7.6 yrs, 18(34 %) female, MMSE 29 ± 1.4, 14(26 %) amyloid-positive, 10(18.9 %) attended with care partner) who wished to learn their amyloid PET results were included. We audiotaped disclosure consultations (54.7 % face-to-face, 45.3 % telephone). Systematic coding using inductive and deductive elements was performed and followed by thematic analysis by two independent researchers.</div></div><div><h3>Results</h3><div>We observed 1434 needs expressions, on average 27(±23) per consultation. The needs expressed could be categorized into two main overarching themes: the need to feel known and understood (44 %) and the need to know and understand (56 %). Amyloid-positive persons expressed significantly more needs (t (14.3)= -2.249, p = 0.041), especially regarding the need to know and understand. Neurologists frequently responded with ‘providing space’ reactions (68.6 %), which often led to continued discussions about people’s needs.</div></div><div><h3>Conclusion</h3><div>This study shows that people with SCD receiving their amyloid PET-scan results have a considerable number and variety of needs. Despite of the large variation in the content of these needs, we identified two main themes implying that people with SCD do not only want information, but also want to feel known and understood. Although the average number of expressed needs was higher among people with an amyloid positive scan, people with a negative scan also expressed a variety of needs. Further research is needed to inform guidelines for tailoring amyloid PET disclosure consultations to individual needs, thereby enhancing person-centred care in memory clinic settings.</div></div><div><h3>Implications</h3><div>People with SCD, care partners, and neurologists can use these results to prepare for amyloid PET disclosure consultations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108668"},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081882","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}
Genevieve Leung , Dennis Dea , Evelyn Y. Ho , Lisa Diamond , Maria E. Garcia , Leah Karliner
{"title":"Partial language concordance in primary care communication: What is lost, what is gained, and how to optimize","authors":"Genevieve Leung , Dennis Dea , Evelyn Y. Ho , Lisa Diamond , Maria E. Garcia , Leah Karliner","doi":"10.1016/j.pec.2025.108678","DOIUrl":"10.1016/j.pec.2025.108678","url":null,"abstract":"<div><h3>Objective</h3><div>In healthcare encounters, partial language concordance occurs when clinicians have some linguistic ability in the patient’s preferred non-English language or patients have some linguistic ability in English or another language (e.g., Mandarin when their preferred language is Cantonese). While the best practice is to work with qualified professional interpreters in these cases, oftentimes visits occur without qualified interpretation. This paper seeks to understand how these partially concordant visits are conducted and how they may be optimized to meet legal standards of non-discrimination.</div></div><div><h3>Methods</h3><div>19 partially concordant primary care visits with Chinese speaking patients were analyzed using discourse analysis.</div></div><div><h3>Results</h3><div>Findings illustrate expected communication challenges and unexpected benefits of partial language concordance. While partial language concordance can facilitate rapport building, vocabulary and fluency limitations can also open the door to miscommunication. We also observed how implicit and explicit request of a qualified interpreter to be on standby during the visit can be utilized by the physician to facilitate communication.</div></div><div><h3>Conclusions</h3><div>Communication might be optimized by the inclusion of a qualified interpreter with an explicit discussion at the beginning defining interpreter roles.</div></div><div><h3>Practice Implications</h3><div>Discussions with interpreters and how they can best engage throughout could retain the rapport created by a shared language, while minimizing miscommunication and errors.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108678"},"PeriodicalIF":2.9,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420150","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}
Sarah Bigi , Vittorio Ganfi , Sibilla Parlato , Valentina Piunno , Maria Grazia Rossi
{"title":"Expression of patient and caregiver uncertainty in view of decision-making in online health communities","authors":"Sarah Bigi , Vittorio Ganfi , Sibilla Parlato , Valentina Piunno , Maria Grazia Rossi","doi":"10.1016/j.pec.2025.108659","DOIUrl":"10.1016/j.pec.2025.108659","url":null,"abstract":"<div><h3>Objectives</h3><div>On the backdrop of the current debate on shared-decision making in healthcare, we are interested in understanding how uncertainty is managed when patients and/or their caregivers resort to online health communities (OHCs) for advice regarding decisions on aspects of the disease they are not fully sure of. More specifically, we present initial results concerning the expression of uncertainty in OHCs regarding decisions that have to be made about a specific illness. Our goal is to observe how patients and/or their caregivers express uncertainty regarding information they received from specialists. This can help us understand how non-experts try to cope with information they do not fully understand.</div></div><div><h3>Methods</h3><div>Based on a collection of interactional data taken from two Italian OHCs, our analysis focuses on the sequences in which someone asks for advice on a certain line of action and obtains an answer. We follow a mainly qualitative approach, which includes case-based qualitative analyses. More specifically, we observe uses and functions of some lexical items (<em>evidentemente</em> (lit., evidently), <em>teoricamente</em> (lit., theoretically)) and syntactic structures (specifically clauses containing the verb <em>dire</em> (to say)) that convey a sense of uncertainty in relation to information provided by others.</div></div><div><h3>Results</h3><div>Our results show different types of uncertainty, providing insights into the effort non-experts make in dealing with expert knowledge and unclear situations determined by the illness and its management.</div></div><div><h3>Implications for clinical practice</h3><div>Our results can be used to improve healthcare professionals’ training regarding their role as mediators between specialized and everyday knowledge.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108659"},"PeriodicalIF":2.9,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076252","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}
Roland Grad , Amrita Sandhu , Dorsa Majdpour , Sarah Kitner , Charo Rodriguez , Glyn Elwyn
{"title":"Perspectives of family physician educators on shared decision making in preventive health care: A Qualitative Descriptive Inquiry","authors":"Roland Grad , Amrita Sandhu , Dorsa Majdpour , Sarah Kitner , Charo Rodriguez , Glyn Elwyn","doi":"10.1016/j.pec.2025.108681","DOIUrl":"10.1016/j.pec.2025.108681","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the views of family physician (FP) educators on shared decision making (SDM).</div></div><div><h3>Methods</h3><div>Qualitative descriptive study. Individual interviews were recorded with FPs in active practice who were also educators of Family Medicine residents. Data were analyzed following the phases of practical thematic analysis.</div></div><div><h3>Results</h3><div>15 practicing FP educators in a clinic setting were interviewed; nine female and six male FPs with practice experience averaging 19 years. We identified five themes, which we then grouped in two major categories: (i) Conceptual ideas about SDM and (ii) Challenges in putting SDM into practice. In the conceptual idea category: (1) Participants held different understandings of SDM and did not have consensus about when SDM should be achieved in clinical practice <em>(difficulty conceptualizing what SDM is, understanding of SDM changes over time, SDM requires clinical equipoise)</em>. (2) Participants identified why SDM is important <em>(patient-centred care)</em>. Themes in the putting SDM into practice category (ii) were: (3) When to engage in SDM is influenced by multiple factors <em>(system factors, research-based evidence)</em> as well as (4) patient factors <em>(social or contextual factors, discordance or misalignment between doctor and patient on a specific decision, patient safety)</em>. (5) Resources and strategies are needed to put SDM into action.</div></div><div><h3>Conclusion</h3><div>An inconsistent understanding of SDM among FP educators, as well as several other challenges, helps explain why SDM has been difficult to implement in practice.</div></div><div><h3>Practice implications</h3><div>Physician educators will appreciate how this study unveils challenges to enhancing resident training for the use of SDM in primary care.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108681"},"PeriodicalIF":2.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076254","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}
Emily K. Spotts , Franklin G. Miller , Andrew L. Geers
{"title":"Individual difference factors that predict evaluations and acceptance of authorized concealment for the reduction of nocebo side effects","authors":"Emily K. Spotts , Franklin G. Miller , Andrew L. Geers","doi":"10.1016/j.pec.2025.108676","DOIUrl":"10.1016/j.pec.2025.108676","url":null,"abstract":"<div><h3>Objectives</h3><div>Authorized concealment is a shared decision-making technique in which a clinician asks a patient if they would prefer not to be informed about all possible treatment side effects, so as to minimize nocebo effects. The present research assessed individual difference variables that predict evaluations and receptivity of authorized concealment.</div></div><div><h3>Methods</h3><div>A demographically diverse national community US sample of 1012 adults (ages ranging from 18 to 94; <em>M</em>=43.2) learned about nocebo effects and then evaluated and estimated their likelihood of consenting to four possible methods of authorized concealment. A range of self-reported psychological, health, and demographic variables were tested as predictor variables.</div></div><div><h3>Results</h3><div>The strongest and most reliable outcomes were that greater trust in doctors and a greater desire to avoid side effect knowledge predicted positive evaluations of authorized concealment and estimated personal use of authorized concealment. There was some evidence that women, those of older age, reporting better health, and using medicine more regularly, had a more positive response to authorized concealment, but these effects were dependent upon the specific method of authorized concealment described.</div></div><div><h3>Conclusions</h3><div>Individual difference variables can predict openness to authorized concealment.</div></div><div><h3>Practice Implications</h3><div>This knowledge may benefit clinicians who consider employing this shared decision-making technique with patients.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108676"},"PeriodicalIF":2.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048530","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":"Effectiveness of tailored interventions on quality of life in cancer survivors: A systematic review","authors":"Ye Sol Lee , Gi Won Choi , Bohye Kim","doi":"10.1016/j.pec.2025.108674","DOIUrl":"10.1016/j.pec.2025.108674","url":null,"abstract":"<div><h3>Objectives</h3><div>This systematic review aimed to identify effective components and assess the statistical, practical, and clinical significance of tailored interventions for enhancing cancer survivors’ quality of life.</div></div><div><h3>Methods</h3><div>Twenty-four clinical trials were selected based on search results from five databases. Study quality was assessed using the Cochrane Risk of Bias Tool 2.0, and data were synthesized through qualitative analysis.</div></div><div><h3>Results</h3><div>Most trials focused on post-treatment cancer survivors with a single type of cancer. Tailored interventions included physical activity, nutrition, psychosocial change, and symptom management, utilizing education, counseling, feedback, and monitoring. These interventions improved social and physical aspects of quality of life, as well as overall health status. Remote, iterative tailored interventions positively impacted the social aspects of quality of life for cancer survivors. Interventions incorporating theoretical determinants such as readiness to change and self-efficacy were notably effective in enhancing quality of life.</div></div><div><h3>Conclusions</h3><div>This review indicates that tailored interventions leveraging theoretical determinants to boost motivation and using remote, interactive modes can improve quality of life among cancer survivors. Additional rigorous studies with longer follow-ups are needed to confirm the long-term effects of these interventions.</div></div><div><h3>Practice implications</h3><div>The findings provide insights into essential intervention components and research approaches for planning tailored interventions to improve quality of life for cancer survivors. Notably, this review identified minimal clinically important differences for a range of quality of life measures specific to cancer survivors.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108674"},"PeriodicalIF":2.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069143","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}
Brooke Nickel , Julie Ayre , M Luke Marinovich , David P. Smith , Karen Chiam , Christoph I. Lee , Timothy J. Wilt , Melody Taba , Kirsten McCaffery , Nehmat Houssami
{"title":"Are AI chatbots concordant with evidence-based cancer screening recommendations?","authors":"Brooke Nickel , Julie Ayre , M Luke Marinovich , David P. Smith , Karen Chiam , Christoph I. Lee , Timothy J. Wilt , Melody Taba , Kirsten McCaffery , Nehmat Houssami","doi":"10.1016/j.pec.2025.108677","DOIUrl":"10.1016/j.pec.2025.108677","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess whether information from AI chatbots on benefits and harms of breast and prostate cancer screening were concordant with evidence-based cancer screening recommendations.</div></div><div><h3>Methods</h3><div>Seven unique prompts (four breast cancer; three prostate cancer) were presented to ChatGPT in March 2024. A total of 60 criteria (30 breast; 30 prostate) were used to assess the concordance of information. Concordance was scored between 0 and 2 against the United States Preventive Services Task Force (USPSTF) breast and prostate cancer screening recommendations independently by international cancer screening experts.</div></div><div><h3>Results</h3><div>43 of 60 (71.7 %) criteria were completely concordant, 3 (5 %) were moderately concordant and 14 (23.3 %) were not concordant or not present, with most of the non-concordant criteria (9 of 14, 64.3 %) being from prompts for the oldest age groups. ChatGPT hallucinations (i.e., completely made up, non-sensical or irrelevant information) were found in 9 of 60 criteria (15 %).</div></div><div><h3>Conclusions</h3><div>ChatGPT provided information mostly concordant with USPSTF breast and prostate cancer screening recommendations, however, important gaps exist. These findings provide insights into the role of AI to communicate cancer screening benefits and harms and hold increased relevance for periods of guideline change.</div></div><div><h3>Practice implications</h3><div>AI generated information on cancer screening should be taken in conjunction with official screening recommendations and/or information from clinicians.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108677"},"PeriodicalIF":2.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042825","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}