Patient Education and Counseling最新文献

{"title":"What is said, meant, heard: Practitioner-patient understanding during delivery of diagnoses in the emergency department","authors":"Sarah N. Fuller,&nbsp;Lourah M. Kelly,&nbsp;Lukas A. McNaboe,&nbsp;Xenia G. Bradley,&nbsp;Charlotte J. Winkler,&nbsp;Caroline E. Wolek,&nbsp;Amber L. Wilkes,&nbsp;Patrick C. Bogui,&nbsp;Perpetual E. Taylor,&nbsp;Geetha R. Nichanametla,&nbsp;David P. Patrick,&nbsp;Matthew Babcock","doi":"10.1016/j.pec.2026.109490","DOIUrl":"10.1016/j.pec.2026.109490","url":null,"abstract":"<div><h3>Background</h3><div>Effective communication between patients and practitioners is essential for patient satisfaction, adherence to the medical plan, and improved health outcomes. Delivering a diagnosis is a necessary component of patient care in the emergency department; however, these conversations can have risk for misunderstandings. This study investigated patient understanding of a new diagnosis in the emergency department and factors that modified this understanding.</div></div><div><h3>Methods</h3><div>Patients and practitioners completed surveys following delivery of a new diagnosis, and descriptions of the diagnosis by both parties were compared and graded for agreement by three external physicians. We examined whether the severity of diagnosis or adhering to a communication framework class influenced patient-practitioner agreement on the new diagnosis.</div></div><div><h3>Results</h3><div>Among 196 encounters, 83.7 % described the same diagnosis given by their practitioner (patient-practitioner agreement). Patient-practitioner agreement was correlated with the patient’s full understanding of their diagnosis (<em>r</em> = .17). Patient and practitioner-rated medical severity were inversely related (ρ=-.39). Practitioner-rated illness severity was related to difficulty receiving the diagnosis (ρ=-.38), difficulty delivering the diagnosis (ρ=.18), and adherence to a communication protocol (ρ=-.16). Multivariable Poisson regressions showed significantly increased practitioner-patient agreement on the new diagnosis when the patient self-reported full understanding of the diagnosis (RR=1.18, <em>p</em> &lt; .05), and significantly decreased practitioner-patient agreement within certain diagnostic classes, specifically cardiac (RR=.71, <em>p</em> &lt; .05) and gastrointestinal (RR=.77, <em>p</em> &lt; .05) relative to musculoskeletal diagnoses.</div></div><div><h3>Conclusion</h3><div>Most patients correctly described a new diagnosis given in the emergency department. However, in cases with misunderstanding, patients were significantly less likely to correctly describe a new diagnosis when they received cardiac and gastrointestinal diagnoses and when they reported anything less than full understanding.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"145 ","pages":"Article 109490"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023489","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":"EngageEMR: Codesigning resources to promote patient and carer engagement with their hospital electronic medical record","authors":"Reema Harrison ,&nbsp;Corey Adams ,&nbsp;Guncag Ozavci ,&nbsp;Nilmini Wickramasinghe ,&nbsp;Kathleen Gray ,&nbsp;Mashreka Sarwar ,&nbsp;Ian Dennis ,&nbsp;Eileen Lam ,&nbsp;stacey Lewis ,&nbsp;Vicky Yuan ,&nbsp;Tracey Bucknall ,&nbsp;Elizabeth Manias","doi":"10.1016/j.pec.2026.109486","DOIUrl":"10.1016/j.pec.2026.109486","url":null,"abstract":"<div><h3>Background</h3><div>The digitisation of patient medical records through electronic medical records (EMRs) has significant implications for healthcare delivery. One key opportunity is enabling patients and families to actively engage with and contribute to their own health information. However, despite this potential, recent evidence shows that patient and family engagement with EMRs remains low. This study used a codesign approach to develop strategies aimed at enhancing patient and family involvement with the EMR.</div></div><div><h3>Methods</h3><div>A two-part project was conducted comprising codesign and a qualitative feasibility and acceptability consultation. 1) Codesign was conducted in two Australian states with patients and carers, healthcare providers, health information specialists, and health system representatives. Online and in-person facilitation of codesign sessions employed synchronous and asynchronous workshops, and asynchronous prototyping to create and refine two prototype resources to promote engagement with EMRs. 2) Focus groups and interviews subsequently assessed the feasibility and acceptability of the codesigned strategies.</div></div><div><h3>Results</h3><div>In all, 47 consumers and 22 healthcare providers participated (n = 69); 31 in codesign and 38 in the feasibility study. Two resources were codesigned: the EngageEMR Consumer Information Video and the EngageEMR Infographic to provide information about EMRs for consumers. The EngageEMR Consumer Information Video provides visual, brief information about EMRs, their purpose and the ways in which consumers can interact with and use these systems in their care. The EngageEMR Infographic provides in-depth content about a range of aspects of EMRs and their distinction from other clinical information systems and services. Focus group and interview participants indicated the tools are valued and feasible for use.</div></div><div><h3>Conclusions</h3><div>Accessible, consumer-facing information about the purpose of EMRs and opportunities for their use during care is limited. The codesigned strategies provide an opportunity for people accessing hospital care to better understand and utilise their health information. Using such tools may enhance safety and quality of care, particularly among populations who are at greater risk of low-quality care. Evaluative studies are required to determine the effectiveness of the resources for improving knowledge about EMRs, self-efficacy arising from their use, and their contribution to better quality care.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"145 ","pages":"Article 109486"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020419","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":"Multi-methods development and validation of a tool for use in measuring serious illness communication competence: Assessment of clinical encounters – Communication tool (ACE-CT)","authors":"Anish K. Arora ,&nbsp;Hsien Seow ,&nbsp;Daryl Bainbridge ,&nbsp;Kulamakan Kulasegaram ,&nbsp;Tavis Apramian ,&nbsp;Nadia Incardona ,&nbsp;Leah Steinberg ,&nbsp;Justin Sanders ,&nbsp;Zhimeng Jia ,&nbsp;Oren Levine ,&nbsp;Jessica Simon ,&nbsp;Karen Zhang ,&nbsp;Zelda Freitas ,&nbsp;Clare Fuller ,&nbsp;Amanda Lee Roze des Ordons ,&nbsp;Jill Dombroski ,&nbsp;Jeff Myers","doi":"10.1016/j.pec.2025.109465","DOIUrl":"10.1016/j.pec.2025.109465","url":null,"abstract":"<div><h3>Objectives</h3><div>The assessment of serious illness communication (SIC) competence has, to date, primarily utilized tools that are profession-specific and not explicitly designed using competency-based or person-centered frameworks. To address these gaps, we developed and validated a new tool, the Assessment of Clinical Encounters – Communication Tool (ACE-CT).</div></div><div><h3>Methods</h3><div>We convened a national panel of interprofessional SIC experts to develop and validate the ACE-CT using a three-phase multi-method approach. Phase 1 focused on item development through review of existing validated tools, and a Bayesian process in which panel members assessed item quality and item-domain correlation. Phase 2 involved item refinement and preliminary validation through stimulated recall interviews using a think-aloud technique. Phase 3 consisted of psychometric analyses for which panel members used the tool to assess video-recorded standardized patient encounters from interprofessional clinicians completing a SIC professional development intervention.</div></div><div><h3>Results</h3><div>In Phase 1, 37 relevant items from previously validated tools were identified, of which 11 items were removed due to redundance. Through the Bayesian process, 14 items were removed and 1 item was generated. Through Phase 2, 2 items were generated, 2 items were combined into 1, and remaining items were refined to optimize measurability and understandability. In Phase 3, reliability was demonstrated through evidence of high internal consistency and moderate reproducibility, both over time and across raters. The tool was found to be responsive and have sound construct validity through evidence of congruence, convergence and credibility. Raters found the tool to be intuitive, easy to complete, and that it accurately captured their perception of the quality of communication observed.</div></div><div><h3>Conclusions</h3><div>The ACE-CT provides a reliable and valid approach to assessing SIC competence among interprofessional clinicians.</div></div><div><h3>Practical Implications</h3><div>Through its person-centered orientation, the ACE-CT provides an opportunity to objectively assess elements of SIC that patients and families value.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"144 ","pages":"Article 109465"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884626","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":"Decision‐making delays in endovascular treatment for acute ischemic stroke: A qualitative study of perspectives from family surrogates, physicians, and nurses","authors":"Yitao Zhou ,&nbsp;Yangbin Zhou ,&nbsp;Huijie Yang ,&nbsp;Ganying Huang","doi":"10.1016/j.pec.2025.109462","DOIUrl":"10.1016/j.pec.2025.109462","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the reasons for decision-making delays in endovascular treatment (EVT) for acute ischemic stroke (AIS), from the perspectives of surrogate decision-makers, physicians, and nurses.</div></div><div><h3>Methods</h3><div>This descriptive qualitative study included semi-structured interviews conducted with surrogate decision-makers for patients undergoing endovascular thrombectomy for AIS, as well as the attending physicians and nurses. Participants were recruited using purposive sampling to ensure a diverse representation of perspectives. The data were analysed applying thematic analysis.</div></div><div><h3>Results</h3><div>Our analysis revealed three main themes and seven subthemes: (1) Theme 1, Dynamic decision-making influenced by multiple factors. Family-centered collaborative decision-making; The unique position of surrogate decision-makers; Economic pressure in decision-making. (2) Theme 2, Limited support. Unfamiliar illness and environment; The marginalized role of patients in decision-making processes. (3) Theme 3, Building “bridges” of trust. The importance of doctors; Be patient.</div></div><div><h3>Conclusion</h3><div>Decision-making delays in EVT stem from intertwined cultural, informational, and support-related factors influencing surrogate judgment in time-critical stroke care. Targeted improvements in rapid communication, role clarification, and decision support are essential to reduce treatment delays. These findings offer practical direction for designing strategies and policies to optimize surrogate decision-making and improve access to timely EVT.</div></div><div><h3>Practice implications</h3><div>Healthcare providers should target specific causes of surrogate decision-making delays including family-centered collaborative processes, insufficient support for surrogate decision-makers and trust gaps with medical staff when designing interventions. This study provides targeted references for clinical practices to shorten surrogate decision-making time. It also offers a reference basis for formulating policies to address key barriers in surrogate decision-making delays such as economic pressure and unclear decision-making roles.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"144 ","pages":"Article 109462"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do I want my providers to know? Co-designing education with older adults living with HIV","authors":"Kristina M. Kokorelias ,&nbsp;Christine Sheppard ,&nbsp;Dean Valentine ,&nbsp;Andrew Eaton ,&nbsp;Marina Wasilewski ,&nbsp;Rabea Parpia ,&nbsp;Esther Su ,&nbsp;Paige Brown ,&nbsp;Erica Dove ,&nbsp;Alice Zhabokritsky ,&nbsp;Luxey Sirisegaram","doi":"10.1016/j.pec.2025.109444","DOIUrl":"10.1016/j.pec.2025.109444","url":null,"abstract":"<div><h3>Objectives</h3><div>To co-design an educational resource for primary healthcare providers in partnership with older adults living with HIV, with the aim of addressing key gaps in provider knowledge and enhancing the delivery of holistic, person-centered care.</div></div><div><h3>Methods</h3><div>A qualitative descriptive study using a co-design methodology was conducted with 12 older adults (aged ≥50) living with HIV in Ontario, Canada. Participants were recruited through purposive sampling to reflect diverse lived experiences. An in-person, arts-based workshop included patient experience mapping, small group discussions, and creative artmaking to explore healthcare experiences and education priorities. Qualitative analysis was iteratively integrated into the co-design process, informing the development of a provider-facing educational pamphlet, which underwent iterative refinement based on feedback from participants and external primary care and geriatric providers.</div></div><div><h3>Results</h3><div>Participants emphasized the need for long-term, HIV-informed care that affirms identity, fosters trust, and addresses fragmented care. Six core domains emerged as priorities for provider education: physical health, emotional health, mental health, social connection, spiritual well-being, and community support. Participants also highlighted the importance of addressing stigma, promoting cultural humility, and recognizing the cumulative impacts of aging with HIV. The final educational pamphlet used a circular, rainbow-themed design to reflect the interconnectedness of these domains and the diversity of the community. The resource was well-received by participants and external clinical reviewers for its clarity, relevance, and patient-centered approach.</div></div><div><h3>Conclusions</h3><div>Co-designing education with older adults living with HIV resulted in a resource that reflects their lived experiences and care priorities. This approach demonstrates how participatory methods can bridge gaps between patient needs and provider practice.</div></div><div><h3>Practice Implications</h3><div>This resource may improve provider awareness and empathy, inform training curricula, and promote inclusive care practices. Implementation in primary care settings is planned, along with future evaluation of its impact on provider knowledge and patient experience.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"144 ","pages":"Article 109444"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738591","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":"Gender affirming and non-affirming language and the healthcare experiences of transgender and gender non-binary individuals: A systematic review","authors":"Vi Nguyen ,&nbsp;Enny Das ,&nbsp;Charlie Loopuijt","doi":"10.1016/j.pec.2025.109449","DOIUrl":"10.1016/j.pec.2025.109449","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies have identified the crucial role of provider-client communication in healthcare experiences, but there lacks a comprehensive overview regarding the experiences of transgender and gender non-binary (TGNB) individuals. This review aimed to gain insights into best practices and pitfalls in language and communication with TGNB individuals across various healthcare domains.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted using two databases (PubMed and CINAHL) and following the PRISMA and the Cochrane guidelines, with search terms such as “communication”, “patient-provider”, “transgender” and “non-binary”. The final sample comprised 22 peer-reviewed publications on language and communication with TGNB individuals in various healthcare domains (e.g., primary care, gender/reproductive care, nursing, pharmacy, mental health, genetic counseling, cancer screening). Using a narrative synthesis framework, we thematically analyzed the findings.</div></div><div><h3>Results</h3><div>We identified and categorized recurring patterns of language and communication into three themes: (1) personalized communication, (2) communication about the healthcare provider’s (HCP’s) knowledge, and (3) assumption-related discriminatory behaviors toward the client. These themes were central in studying provider-client interactions and TGNB clients’ healthcare experiences.</div></div><div><h3>Conclusion</h3><div>The literature review and synthesis showed that affirming interactions were characterized by HCPs’ ability to express interest and intention in caring for TGNB clients, communicate knowledge and expertise, and most importantly, address clients respectfully. The findings also revealed that TGNB individuals often faced critical shortcomings in healthcare, such as discrimination and HCPs’ lack of knowledge and awareness.</div></div><div><h3>Practice implications</h3><div>We argued that a cultural shift toward the person-centered framework is necessary across all healthcare domains to improve TGNB clients’ experiences. Within this framework, we highlighted two recommendations: following the client’s lead with language and allyship. Additionally, comprehensive and periodic trainings on transgender themes should be accessible to all medical staff. More broadly, the review shed light on what could be the root cause for discrimination in healthcare based on sex and gender.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"144 ","pages":"Article 109449"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738590","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":"It is time to recognise shared decision-making as a complex intervention","authors":"Joanne E. Butterworth ,&nbsp;Karen Mattick ,&nbsp;Suzanne H. Richards","doi":"10.1016/j.pec.2025.109447","DOIUrl":"10.1016/j.pec.2025.109447","url":null,"abstract":"<div><h3>Objective</h3><div>Shared decision-making (SDM) is a core component of personalised health care. Populations continue to diversify in their health and social care needs. We argue that established SDM models (focusing on the interaction between patient and practitioner) do not reflect the complexity of patient presentations nor the wider influences on patients’ health and health care encounters. The route from SDM to positive health and health service outcomes are currently obscured. For SDM to be utilised without limit, and for SDM to impact health care policy, it is best understood as a complex intervention.</div></div><div><h3>Discussion</h3><div>SDM as a complex intervention is characterised by multiple interacting components, influenced by agents acting at several levels of a socioecological model (personal-, interpersonal-, organisational-, societal-, policy- level). The components have non-linear pathways (from cause to effect) existing within and interacting with the context in which SDM is implemented. SDM components are tailorable: Tailoring can enable personalised care for individuals and effect changes in desired outcomes for specific populations and settings. The development of programme theory, for example utilising logic modelling, will be essential for articulating and planning the evaluation of these complex pathways. A standardised framework of SDM outcomes, spanning the socioecological model, would guide the assessment of SDM process and effect. Programme theory, logic modelling, and consistent assessment will together reveal the route to positive outcomes for patients, carers, practitioners and health services and, in turn, will impact policy.</div></div><div><h3>Conclusion</h3><div>It is time to recognise SDM as a complex intervention. Simplistic definitions should no longer be attempted. SDM should be conceptualised as being wider than the consultation itself with components that are defined by and tailored to the context of its adoption, implementation and sustainability, considering influences that span the socioecological model of the health care system.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"144 ","pages":"Article 109447"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738589","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":"Teach-back techniques in telehealth: A review and insights for future directions","authors":"Faith A. Albertson ,&nbsp;Wafa Alnakhi ,&nbsp;Shanikque Barksdale ,&nbsp;Shannon Stark Taylor ,&nbsp;Shaniece Criss ,&nbsp;Daniela B. Friedman ,&nbsp;Karen A. Kemper ,&nbsp;Lorie Donelle ,&nbsp;Wanda Thompson ,&nbsp;Phyllis MacGilvray ,&nbsp;Nabil Natafgi","doi":"10.1016/j.pec.2025.109453","DOIUrl":"10.1016/j.pec.2025.109453","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The rapid expansion of telehealth during the COVID-19 pandemic has created new challenges in patient-provider communication due to the absence of in-person interactions and visual cues. Teach-back, a method where patients repeat information to confirm understanding, is a promising tool for improving communication in virtual care. This review evaluates the effectiveness of teach-back techniques in telehealth settings.</div></div><div><h3>Methods</h3><div>A search of four databases (CINAHL, EMBASE, PsycINFO, PubMed) was conducted, yielding 10 studies that met the inclusion criteria. The article inclusion/exclusion criteria consisted of the following: (1) telehealth services topic; (2) direction provision related to teach-back; and (3) English, peer-reviewed, empirical journal publication. Risk of bias in included studies was assessed using established tools for randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and qualitative studies. Data synthesis followed the PICO framework, and thematic analysis was used to compare outcomes across studies.</div></div><div><h3>Results</h3><div>Included studies which varied in design, modality, and telehealth specialty. Teach-back was consistently associated with improved patient knowledge, confidence, and self-management, as well as clinical outcomes such as better glycemic control and medication adherence. Overall evidence quality was moderate, with common limitations including small sample sizes and brief follow-up periods.</div></div><div><h3>Conclusions and practice implications</h3><div>Teach-back is effective in enhancing patient understanding and outcomes in telehealth settings. However, variability in study design and implementation highlights the need for standardized protocols and additional research. Provider training in effective virtual teach-back strategies may enhance patient comprehension, strengthen communication, and advance health equity in telehealth delivery.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"144 ","pages":"Article 109453"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840946","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":"Participating in decision-making at the end of life: The self-reported ability of people with cancer across 11 countries","authors":"Yassin Engelberts ,&nbsp;Judith A.C. Rietjens ,&nbsp;Laura A. Hartman ,&nbsp;Claudia Fischer ,&nbsp;Melanie Joshi ,&nbsp;Vilma A. Tripodoro ,&nbsp;Pilar Barnestein-Fonseca ,&nbsp;Dröfn Birgisdóttir ,&nbsp;Dagny Faksvåg Haugen ,&nbsp;Antoine Elyn ,&nbsp;Stephen Mason ,&nbsp;Agnes van der Heide ,&nbsp;Ida J. Korfage","doi":"10.1016/j.pec.2025.109446","DOIUrl":"10.1016/j.pec.2025.109446","url":null,"abstract":"<div><h3>Objectives</h3><div>Uncertainty among healthcare providers about patients’ ability to make care decisions is a barrier to shared decision-making. We aimed to assess the self-reported decision-making ability of patients with cancer at the end of life.</div></div><div><h3>Methods</h3><div>Data from 11 countries of adults with a limited life expectancy and cancer as the primary diagnosis were used. Participants completed a questionnaire, including one item on decision-making ability and two on decision-making preferences. Correlations between self-reported ability and preferences were tested using Kendall’s tau. Associations between decision-making ability and patient characteristics were determined using mixed-effects ordinal regression models.</div></div><div><h3>Results</h3><div>The sample (n = 1076, 53 % identified as men) had a mean age of 69 years (SD: 11.5). Among them, 80 % reported being able to make decisions about their life and care <em>most of the time</em>, 14 % <em>some of the time</em>, 5 % <em>only a little of the time,</em> and 2 % <em>never</em>. Regarding preferences, 95 % preferred to be involved in decision-making and 44 % preferred the doctors to make the decisions. These preferences were weakly correlated with decision-making ability (Kendall’s tau: 0.13 and −0.11, respectively). Feeling able to make decisions was less likely for those institutionalized (versus living with relatives, OR: 0.26, 95 % CI: 0.12;0.55), those with tertiary education (versus primary/no education, OR: 0.43, 95 % CI: 0.22;0.85) and those without clear understanding of their health (versus those with understanding, OR: 0.29, 95 % CI: 0.16;0.52).</div></div><div><h3>Conclusions</h3><div>Although most patients felt able to make decisions about their care, two out of every ten did not. About five out of ten preferred their doctors to make decisions.</div></div><div><h3>Practice implications</h3><div>As almost all patients want to be involved in decisions, we suggest that providers discuss with patients how decisions will be made. This may enable providers to identify patients’ needs and adapt the decision-making process to their abilities and preferences.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"144 ","pages":"Article 109446"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783392","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":"Adapting TikTok and behavioral economics for youth-centered HIV prevention and PrEP education in the Philippines","authors":"Artemio M. Gonzales Jr. ,&nbsp;Arnold Jann L. Cariaso,&nbsp;Rica Abigail T. Dagos,&nbsp;Mira Lei M. Balinjare,&nbsp;Genesis A. Ysibido","doi":"10.1016/j.pec.2025.109441","DOIUrl":"10.1016/j.pec.2025.109441","url":null,"abstract":"<div><div>Social media platforms such as TikTok offer new opportunities for youth-centered HIV prevention and pre-exposure prophylaxis (PrEP) education. Prior evidence shows that young people respond best to short, authentic, and gain-framed messaging. This study aims to contextualize these findings within the Philippine setting and propose strategies that align with youth behavior, local policies, and national health priorities. Relevant literature on behavioral economics, HIV prevention, and digital engagement among Filipino youth and cis-MSM was reviewed and interpreted alongside existing education policies. Evidence demonstrates that gain-framed, relatable, and peer-influenced messaging can enhance PrEP awareness and engagement. Integration into school curricula and multilingual delivery further strengthens reach of PrEP awareness and engagement. Adapting behavioral economics and social media strategies to the Philippine context can support inclusive, culturally aligned HIV prevention and guide future research under the national priorities.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"144 ","pages":"Article 109441"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685716","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}