Patient Education and Counseling最新文献

{"title":"Providing care to cancer patients parenting minor children: A qualitative study on healthcare professionals’ communication practice","authors":"Wiebke Frerichs ,&nbsp;Laura Inhestern ,&nbsp;Lene Marie Johannsen ,&nbsp;Corinna Bergelt","doi":"10.1016/j.pec.2025.108666","DOIUrl":"10.1016/j.pec.2025.108666","url":null,"abstract":"<div><h3>Aim</h3><div>To explore healthcare professionals’ (HCPs) experiences when communicating about child- and family-related aspects in cancer care and their attitudes about the importance of including these aspects in cancer care.</div></div><div><h3>Methods</h3><div>We conduced semi-structured interviews with HCPs working in oncology. Interviews were audio-recorded, transcribed verbatim and analyzed using Kuckartz's method for qualitative content analysis.</div></div><div><h3>Results</h3><div>N = 20 HCPs working in oncology, either inpatient or outpatient setting in the area of Hamburg, Germany participated. N = 7 were nurses, n = 6 psychologists, n = 5 physicians and n = 2 social workers. Results showed that HCPs’ communication about child- and family-related aspects for cancer patients parenting minor children varies widely, influenced by factors such as diagnosis, structural challenges, individual characteristics, or profession. Additionally, their attitudes about how relevant it is to integrate child- and family-related aspects in routine cancer care varies from low relevance (i.e. lower priority, beyond professional role) to high relevance (i.e. palliative cases, children have a right to know).</div></div><div><h3>Conclusion</h3><div>HCPs’ communication practice and views on the importance of addressing child- and family-related aspects in cancer care vary widely and are shaped by various influences.</div></div><div><h3>Practice implication</h3><div>Results emphasize the need for training and resources to enhance HCPs communication competencies to provide family-oriented care proactively.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108666"},"PeriodicalIF":2.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048498","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":"Examining the impact of identity-safety cues on inclusion for adults with higher body weights in healthcare settings","authors":"Veronica Derricks ,&nbsp;Eva S. Pietri ,&nbsp;India R. Johnson ,&nbsp;Daniela Gonzalez","doi":"10.1016/j.pec.2025.108652","DOIUrl":"10.1016/j.pec.2025.108652","url":null,"abstract":"<div><h3>Objectives</h3><div>Adults with higher body weights experience weight stigma in healthcare, which can heighten concerns about treatment in these settings. This study investigates whether a specific strategy—using an identity-safety cue, or a cue which signals that one’s social identity is valued—mitigates these concerns.</div></div><div><h3>Methods</h3><div>527 U.S. adults who self-identified as overweight were randomized to read about a hypothetical physician who endorsed a weight-inclusive clinical approach (identity-safety cue condition) or making health information accessible (control condition). Next, participants read a vignette where the physician attributed their persistent knee pain to their age (control diagnosis), lifestyle habits (ambiguous diagnosis), or body weight (stigmatizing diagnosis).</div></div><div><h3>Results</h3><div>Exposure to the physician who employed the identity-safety (versus control) cue decreased weight stigma concerns, increased perceptions of physician allyship, and promoted identity-safety. While use of the identity-safety cue elicited benefits regardless of the physician’s clinical diagnosis, viewing the identity-safety cue alongside the stigmatizing diagnosis increased perceptions that the physician’s commitment to diversity was dishonest, which subsequently harmed feelings of safety.</div></div><div><h3>Conclusions</h3><div>Use of identity-safety cues in healthcare can effectively promote inclusion for adults with higher body weights. However, perceiving that the physician’s pro-diversity efforts are dishonest can undermine inclusion.</div></div><div><h3>Practice implications</h3><div>To effectively promote inclusion for adults with higher body weights, physicians should employ cues which explicitly signal that their weight identity is valued.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108652"},"PeriodicalIF":2.9,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143331551","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":"From community to scale: Using community engagement to develop and validate a patient-informed cancer communication scale","authors":"Lauren M. Hamel ,&nbsp;Diliara Bagautdinova ,&nbsp;Bill Winkler ,&nbsp;Fred Hardy ,&nbsp;Cindy Sulad ,&nbsp;Marie Lumpkin ,&nbsp;Elisabeth Heath ,&nbsp;Susan Eggly","doi":"10.1016/j.pec.2025.108649","DOIUrl":"10.1016/j.pec.2025.108649","url":null,"abstract":"<div><h3>Objective</h3><div>Racial disparities in clinical communication quality are well-established but most clinical communication assessment tools are created without the collaboration of racially-diverse patient populations. Our objective was to collaborate with Black and White cancer survivors, caregivers, and advocates to develop and validate a tool to assess physicians’ patient-centered communication.</div></div><div><h3>Methods</h3><div>A panel of Black and White cancer survivors, caregivers, and advocates (<em>n</em> = 11) and researchers observed and discussed video-recorded patient-physician cancer clinical interactions to generate and refine a list of physician communication behaviors considered critical for high-quality patient-centered communication. Raters applied the 22-item scale (Patient-Informed Cancer Communication Scale; PICCS) assessing physicians’ patient-centered communication to video-recorded interactions (<em>n</em> = 61) from a larger study. We determined constructs using scale development and factor analysis and validated the scale through correlation with existing scales.</div></div><div><h3>Results</h3><div>Factor analysis identified five factors: <em>treatment options; clinical relationship; prognosis and goals of treatment; explanations;</em> and <em>context</em>. <em>Treatment options, prognosis and goals of treatment</em>, and the <em>full scale</em> correlated with a validated patient active participation scale. <em>Clinical relationship</em> and <em>context</em> correlated with a validated physicians’ patient-centered communication scale.</div></div><div><h3>Conclusion</h3><div>This community-engaged research produced a reliable and valid scale to assess physician patient-centered communication in the context of Black and White people with cancer.</div></div><div><h3>Practice Implications</h3><div>With further validation work, this scale can be used to train and assess physician communication quality when discussing cancer treatment in diverse cancer patient populations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108649"},"PeriodicalIF":2.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015020","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":"Racial equity in and through medical interaction scholarship: A scoping review","authors":"Maria K. Venetis,&nbsp;Shawnika J. Hull,&nbsp;Haley Nolan-Cody,&nbsp;Jorlanditha T. Austin,&nbsp;M.J. Salas,&nbsp;ShuXian (Jenny) Mai,&nbsp;Lillianna Shields,&nbsp;Cimmiaron F. Alvarez","doi":"10.1016/j.pec.2025.108648","DOIUrl":"10.1016/j.pec.2025.108648","url":null,"abstract":"<div><h3>Objective</h3><div>We conducted a systematic scoping review to characterize the landscape of communication scholarship within racial health equity in and through the patient-provider interaction.</div></div><div><h3>Methods</h3><div>We employed three waves of data collection to identify relevant articles (<em>N</em> = 454) about racial equity within provider-patient interactions. We iteratively developed a codebook concerning article characteristics, coding for journal names, data source, descriptive characteristics for the study samples, and presence of theory and equity in sections of the manuscripts.</div></div><div><h3>Results</h3><div>This search identified studies (<em>N</em> = 206) that were published in 76 peer-reviewed scientific journals. The majority of studies reported primary data analyses and used survey and interview methodology. Many studies examined participants as patients generally rather than in reference to particular health conditions. Among those with a specific health condition, the largest proportion focused on cancer control. Very few studies included samples with Native American and Pacific Island heritage. Most studies included cisgender men and/or women, but <em>none</em> included transgender men or women. The vast majority of research focused on the patient experience; few centered on providers’ and caregivers’ experiences. The body of scholarship was largely atheoretical; the most frequently noted constructs were patient-provider communication (including patient-centered communication and patient-centered care), implicit/explicit racial bias, shared decision-making. There was wide variation in the extent to which equity was woven through the manuscripts. Equity is typically mentioned in the literature review, and racial identity in the sample may serve as a marker of racialized experiences.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the need for the development of theory that elevates the centrality of health equity to attend to the bi- or multi-directional flow of communication that shapes the quality of these interactions.</div></div><div><h3>Practice Implications</h3><div>These insights can serve as a strong foundation for the development of interventions to address equity in clinical interactions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108648"},"PeriodicalIF":2.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043019","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":"Applying dynamic dyadic systems to explore features of relationship-centered care among Spanish and non-Spanish speaking patients","authors":"Marie C. Haverfield ,&nbsp;Yuwei Li ,&nbsp;Rachyl Pines ,&nbsp;Tyler Kyte ,&nbsp;Daria Titova ,&nbsp;Jennifer A. Theiss","doi":"10.1016/j.pec.2025.108650","DOIUrl":"10.1016/j.pec.2025.108650","url":null,"abstract":"<div><h3>Objective</h3><div>Relationship-centered care (RCC) positions the exchange between patient and provider as central to patient care. Due to limitations in analytical approach, how the relational exchange develops throughout the clinical visit remains unclear. Dynamic dyadic systems (DDS) perspectives overcome these limitations to reveal interdependencies and evolving patterns in turn-taking sequences within dyads. We applied DDS analyses to examine how features of RCC manifest during clinical visits with Spanish-speaking Latinx and English-speaking non-Latinx patients.</div></div><div><h3>Methods</h3><div>We analyzed transcripts from 13 primary care visits (5 with Latinx patients, 8 with non-Latinx patients). Interaction turns totaled N = 2394 units of analysis. Dyadic time series plots examined the trajectory of clinical encounters and contributions made by patients and providers. Sequence analysis identified distinct turn patterns—or conversational motifs among dyads.</div></div><div><h3>Results</h3><div>Conversational motifs reflected four patterns. In our example, motif distribution differed such that with Latinx Spanish-speaking patients, the provider largely engaged in patient-focused probing dialogue, while relational features of communication were underrepresented. In contrast, with non-Latinx English-speaking patients, providers engaged in more instructive exchange.</div></div><div><h3>Conclusion</h3><div>Results support DDS to analyze patient-provider communication by illustrating interdependencies in reciprocal exchange and inequities in RCC delivery.</div></div><div><h3>Practice implications</h3><div>Findings demonstrate opportunities for behavioral change to enhance cultural sensitivity in the delivery of care.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108650"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076243","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":"Diversity, equity, and inclusion in patient engagement in healthcare interactions","authors":"Maria K. Venetis,&nbsp;Shawnika J. Hull","doi":"10.1016/j.pec.2025.108647","DOIUrl":"10.1016/j.pec.2025.108647","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108647"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030233","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":"Promoting interactional health equity through (Complementary and Integrative Health) talk during clinical encounters","authors":"Evelyn Y. Ho ,&nbsp;Christopher J. Koenig","doi":"10.1016/j.pec.2025.108651","DOIUrl":"10.1016/j.pec.2025.108651","url":null,"abstract":"<div><h3>Objectives</h3><div>Complementary and Integrative Health (CIH) is recognized as a set of modalities to bolster health and well-being often outside of standard biomedical practice. How people discuss CIH with their biomedical providers is a microcosm for health communication more generally. In this Discussion, we propose a revision of the Street et al. (2009) conceptual framework to illustrate how CIH talk during a clinical encounter has the potential to contribute to (or detract from) interactional health equity.</div></div><div><h3>Methods</h3><div>We use discourse analytic techniques to re-analyze two digitally recorded biomedical encounters.</div></div><div><h3>Results</h3><div>Two case studies are re-analyzed to illustrate how clinician-client conversation about CIH during a clinical encounter might lead to interactional health equity.</div></div><div><h3>Conclusions</h3><div>Interactions with clinicians can be challenging due to differences in knowledge about biomedicine, administrative processes, and even navigating interpersonal relationships. How a clinician responds can either center a biomedical agenda in the Voice of Medicine or help ratify a patient’s agenda in the Voice of the Lifeworld. How clinicians and patients negotiate CIH talk is conceptually linked with immediate interactional outcomes.</div></div><div><h3>Practice implications</h3><div>In populations in which patients/caregivers or their extended communities may already have low trust in biomedicine, a mistrustful therapeutic alliance, or history of discrimination, disattention of the Lifeworld and avoiding talk about CIH has the possibility of exacerbating inequities. Every turn at talk during a clinical encounter has the potential to foster increased social participation which, in turn, may contribute to health outcomes and influence patient and community well-being at individual, community, and institutional levels. CIH talk can open space for patients to actively participate in healthcare by incorporating the patients’ Lifeworld into the clinical encounter and can contribute to <em>interactional health equity</em> within clinical encounters.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108651"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042937","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":"The ecological model of communication in medical encounters: A scoping review","authors":"Lillie D. Williamson ,&nbsp;Lynne M. Cotter ,&nbsp;Brook L. Couch ,&nbsp;Grace K. Herndon","doi":"10.1016/j.pec.2025.108646","DOIUrl":"10.1016/j.pec.2025.108646","url":null,"abstract":"<div><h3>Objective</h3><div>The ecological model of communication in medical encounters (EMCME) could provide a framework for examining issues related to health equity in healthcare interactions. This study seeks to understand how scholarship has engaged with the model and the extent of its use in health equity work.</div></div><div><h3>Methods</h3><div>A scoping review of the EMCME was conducted using three major databases: Scopus, Web of Science, and Google Scholar in September 2023. Databases were searched for works citing the article explicating the model.</div></div><div><h3>Results</h3><div>The search returned 336 unique documents. After inclusion and exclusion criteria were applied, 85 documents remained and were analyzed. Many pieces described the model or used the model to frame their work; far fewer pieces used the model to test empirical relationships. Most works, however, focused on a single context: interpersonal. Twenty-five works directly used the model in relation to health equity.</div></div><div><h3>Conclusion</h3><div>There are several contexts of the model that remain underexplored. More attention to these contexts may not only help to better the clinical encounter but advance health equity.</div></div><div><h3>Practice implications</h3><div>Increased use of the full EMCME in all facets – research, practice, and teaching – could provide a framework for framing and organizing work around health equity.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108646"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075676","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":"Effects of warning information at medication initiation on deprescribing intentions in older adults: A hypothetical vignette","authors":"Sarah E. Vordenberg ,&nbsp;Kari Ostaszewski ,&nbsp;Vincent D. Marshall ,&nbsp;Brian J. Zikmund-Fisher ,&nbsp;Kristie Rebecca Weir","doi":"10.1016/j.pec.2025.108654","DOIUrl":"10.1016/j.pec.2025.108654","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore to what degree providing patients warning information about the long-term risks of a medication would affect their subsequent desire to discontinue it.</div></div><div><h3>Methods</h3><div>We conducted a vignette-based online experiment in which participants aged ≥ 65 years from the United States were asked to imagine starting and subsequently stopping omeprazole. Participants were randomized to one of four vignettes about starting omeprazole (potential long-term harms or no harm information; OTC vs. prescription). Participants reported interest in stopping omeprazole on a 6-point Likert scale. We calculated descriptive statistics and used logistic regression to compare participants with high (scores 4–6) versus low agreement (scores 1–3) with stopping.</div></div><div><h3>Results</h3><div>Participants (n = 1245) had a median age of 70 years. After adjusting for demographic characteristics, older adults who received warning information when starting the medication were more likely to agree to stop omeprazole (OR 1.21, 95 % C.I. 1.02, 1.43). Willingness to stop omeprazole was higher among women (vs. men), among respondents with higher literacy, and among those who had never or previously used PPIs (vs current use).</div></div><div><h3>Conclusion</h3><div>Warning information about potential long-term risks when initiating a medication may increase the likelihood of subsequently stopping a medication when recommended by a PCP.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108654"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014976","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":"“The doctor will see you now… but not for long”: Linking physicians’ racial attitudes and patients’ discrimination experiences to racial disparities in the duration of medical consultations","authors":"Emerson Do Bú ,&nbsp;Susan Eggly ,&nbsp;Louis Penner ,&nbsp;Nao Hagiwara","doi":"10.1016/j.pec.2025.108653","DOIUrl":"10.1016/j.pec.2025.108653","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between non-Black physicians’ racial attitudes, Black patients’ discrimination experiences, and consultation duration in diverse clinical settings.</div></div><div><h3>Methods</h3><div>Secondary analyses were conducted on data from three prior studies involving non-Black primary care physicians (Study 1: <em>n</em> = 14, Study 2: <em>n</em> = 5) and their Black patients (Study 1: <em>n</em> = 118, Study 2: <em>n</em> = 31), as well as 15 non-Black oncologists and their 72 Black patients (Study 3). Data included physician and patient surveys, along with video-recorded consultations.</div></div><div><h3>Results</h3><div>Study 1 revealed that, relative to other physicians, physicians whose racial attitudes fit an aversive racist profile (i.e., low explicit racial bias, high implicit bias) had longer consultations with Black patients who reported more (vs<em>.</em> fewer) discrimination experiences. Study 2 and 3 found that physicians’ implicit racial bias is negatively associated with consultation duration. Finally, a meta-analysis supported the effects of aversive racism and patients’ discrimination experiences on consultation duration.</div></div><div><h3>Discussion</h3><div>These findings demonstrate how physicians’ racial attitudes and patients’ discrimination experiences can affect medical consultation duration—an important aspect of patient-provider communication quality.</div></div><div><h3>Practical value</h3><div>These results provide initial evidence for the importance of helping physicians manage the negative consequences of their implicit bias within the current structural constraints of limited medical consultation time and empowering Black patients to advocate for their healthcare needs.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108653"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014994","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}