Patient Education and Counseling最新文献

{"title":"The argumentative role of patient companions in (shared) decision-making","authors":"Lotte van Poppel ,&nbsp;Roosmaryn Pilgram","doi":"10.1016/j.pec.2024.108623","DOIUrl":"10.1016/j.pec.2024.108623","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to examine the type of involvement of patient companions in the argumentative exchanges in consultations and explore when their contributions should be taken into account in shared decision-making (SDM).</div></div><div><h3>Methods</h3><div>A qualitative analysis was carried out using transcribed medical consultations (N = 10) between health professionals (doctors at a regional Dutch hospital), adult patients and informal patient companions. Insights from argumentation theory were used to develop an inventory of twelve theoretically distinct discussion situations involving patient companions, distinguishing possible discussion roles, disagreement types and coalition formations.</div></div><div><h3>Results</h3><div>Consultations contained on average 4.3 discussion situations. In most discussions (37.21 %) the health professional adopted a standpoint, and the patient and their companion only expressed doubt. More complex cases occurred when one of the three parties, including the companion, opposed opinions of the other parties (in 34.88 % of the situations found) and when coalitions were formed (possible in 18.60 % of the situations found). We found that disagreements occurred or were anticipated by all three parties and involved standpoints about the diagnosis as well as treatment options.</div></div><div><h3>Conclusion</h3><div>Using the pragma-dialectical argumentation theory as an analytical framework reveals that patient companions can substantially influence treatment decision-making during medical consultation. This influence is contingent upon the specific role they assume in the discussion, the type of disagreement with the health professional and patient, and the formation of coalitions with these parties.</div></div><div><h3>Practice implications</h3><div>The contributions by patient companions should be considered in SDM if the companion forms a coalition with the patient. If the companion does not form a coalition, the contributions might have a bearing on SDM as well, but their acceptability and relevance for the treatment decision should be checked by the health professional. In general, it is desirable to explicitly establish the role of patient companions in consultations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108623"},"PeriodicalIF":2.9,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911089","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":"Non-comparability and unplannability as material topoi in antenatal care conversations","authors":"Elisabeth Kleschatzky,&nbsp;Kati Hannken-Illjes","doi":"10.1016/j.pec.2024.108624","DOIUrl":"10.1016/j.pec.2024.108624","url":null,"abstract":"<div><h3>Objective</h3><div>This paper studies argumentation and its function to establish common ground in pregnancy counseling conversations during the third trimester of the pregnancy, focusing on two material topoi: Non-comparability and Unplannability.</div></div><div><h3>Methods</h3><div>We take a conversation-analytical and interactional approach and draw on 37 natural occurring counseling conversations, videorecorded during two periods at a university hospital. The conversations are typically between the midwife and the pregnant woman. The data has been transcribed using the system GAT 2.</div></div><div><h3>Results</h3><div>The analysis shows on the one hand that argumentation functions as a process through which common ground can be established. The participants develop the topoi collaboratively, thereby also mitigating open dissensus. On the other hand the study shows the challenge during the conversations to prepare for an event while at the same time stressing that it remains non-comparable to past experiences and escapes planning.</div></div><div><h3>Discussion</h3><div>Our analysis shows that non-comparability and unplannability as material topoi are closely connected and established by way of co-construction.</div></div><div><h3>Practice implications</h3><div>We suggest that the tension of (un-)plannability is something midwives should be made aware of in order to be able to use it deliberately during the conversations by including authentic conversational data into communication training sessions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108624"},"PeriodicalIF":2.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061325","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":"Personalized patient education for subacromial pain syndrome: The role of and spiritual alignment","authors":"Muhammad Taufiqurrahman,&nbsp;Tamama Rofiqah,&nbsp;Tamama Hafizah","doi":"10.1016/j.pec.2024.108631","DOIUrl":"10.1016/j.pec.2024.108631","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108631"},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899738","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":"Enhancing gender sensitivity in transgender and gender-diverse patient communication","authors":"Elni Yakub,&nbsp;Isnaria Rizki Hayati,&nbsp;Rikas Saputra ,&nbsp;Yenni Lidyawati","doi":"10.1016/j.pec.2024.108621","DOIUrl":"10.1016/j.pec.2024.108621","url":null,"abstract":"<div><div>This article examines the communication preferences of transgender and genderdiverse individuals in the health system context. Findings suggest the importance of gender sensitivity and confident communication styles in improving patient experience. The article recommends case-based training to understand the dynamics of intersectionality and the development of communication aids to improve health literacy. This study highlights the need for longitudinal research to deepen understanding of changing communication preferences in this group.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108621"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899686","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":"Shared decision-making, anxiety, and post-traumatic growth among parents in the context of their child's medical care: The moderating role of parental style","authors":"Ofir Negri-Schwartz ,&nbsp;Tal Shilton ,&nbsp;Mariela Mosheva ,&nbsp;Doron Gothelf ,&nbsp;Ilanit Hasson-Ohayon","doi":"10.1016/j.pec.2024.108620","DOIUrl":"10.1016/j.pec.2024.108620","url":null,"abstract":"<div><h3>Aim</h3><div>The importance of parents' involvement in their child's medical care has been extensively discussed in the literature, and studies have indicated the need to expand the active role of parents in decision-making processes regarding such care. However, parents' <em>actual</em> wish to be active and informed in this context remains underexplored. The aim of the current study was to explore this gap by investigating the association between parents’ shared decision-making (SDM) experience and their well-being during the course of their child’s medical care, with a focus on parents' clinical decision-making style as a possible moderator.</div></div><div><h3>Method</h3><div>A total of 150 parents of children under the age of 18, who utilized various medical care services, participated in the study.</div></div><div><h3>Results</h3><div>Shared decision-making was found to be associated with parents’ anxiety levels during their child’s medical treatment, as well as with their post-traumatic growth (PTG). A moderating effect of clinical decision-making style was also found; namely, the relations between SDM, anxiety during the child’s treatment, and PTG were different among parents with a passive style than among parents with a shared-active style.</div></div><div><h3>Conclusions</h3><div>The findings emphasize the personalized nature of SDM, suggesting that its benefits are associated with parental preferences and attitudes. Healthcare professionals should assess parents’ actual desire to be involved in SDM in order to tailor services effectively.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108620"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899704","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":"Equity in breast density notification in Australia: A focus group study exploring the impact and needs amongst culturally and linguistically diverse (CALD) women","authors":"Brooke Nickel ,&nbsp;Claire Hudson ,&nbsp;Jennifer Isautier ,&nbsp;Kirsten McCaffery ,&nbsp;Allan Ben Smith ,&nbsp;Paula Legerton ,&nbsp;Tong Li ,&nbsp;Shu Wang ,&nbsp;Nehmat Houssami","doi":"10.1016/j.pec.2024.108628","DOIUrl":"10.1016/j.pec.2024.108628","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous research suggests a one-size-fits-all approach to breast density notification may disadvantage culturally and linguistically diverse (CALD) women. This study aimed to qualitatively explore CALD women’s understanding and views of breast density, attitudes towards health services access, acceptability of notification and preferences for breast density communication ahead of population-based notification in Australia.</div></div><div><h3>Methods</h3><div>Online focus groups were conducted with CALD women of breast screening age (40–74 years) who spoke one of the five languages with the lowest English proficiency in Australia (Korean, Mandarin, Cantonese, Vietnamese and Arabic). Focus group sessions were in-language and incorporated an evidence-based presentation interspersed with group discussions which were audio-recorded, transcribed and analysed thematically.</div></div><div><h3>Results</h3><div>Thematic analysis revealed four themes indicating participants had overall strong desires to be informed of breast density, despite some associated worry. CALD women may also face significant barriers to understanding and accessing breast density information and seeking supplemental screening.</div></div><div><h3>Conclusions</h3><div>Although CALD women have a strong desire to be notified of their breast density, increased anxiety and confusion may exacerbate health inequalities and barriers women from these communities already face.</div></div><div><h3>Practice implications</h3><div>This study highlights the need for careful consideration of breast density and supplemental screening communications for CALD women.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108628"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899730","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 reasoned treatment decision-making on parent-related outcomes: Results from a video-vignette experiment in neonatal care","authors":"Nanon H.M. Labrie ,&nbsp;Anne A.M.W. van Kempen ,&nbsp;Marleen Kunneman ,&nbsp;Sylvia A. Obermann-Borst ,&nbsp;Liesbeth M. van Vliet ,&nbsp;Nicole R. van Veenendaal ,&nbsp;the IMPACT-Group","doi":"10.1016/j.pec.2024.108625","DOIUrl":"10.1016/j.pec.2024.108625","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the effects of clinicians’ provision of (un)reasonable arguments on parent-related outcomes in neonatal (intensive) care (NICU), starting from the NICU Communication Framework.</div></div><div><h3>Methods</h3><div>A video-vignette experiment, in which we systematically varied clinicians’ use of (<em>reasonable, unreasonable, no</em>) argumentation across two non-acute and two acute decision-making scenarios (3×4 design). Reasonable arguments were medically appropriate and constructive reasons to support the treatment plan, as defined by an expert panel. Based on argumentation theory, unreasonable arguments included hindering appeals to authority or the self-evident nature of the treatment plan. Parents of preterm infants completed an online survey, viewing 1 of 12 video-vignettes and answering questions pertaining to their <em>communication stress, understanding, agreement</em>, <em>participation</em> in communication<em>, empowerment</em>, <em>trust</em> and <em>satisfaction</em> with communication.</div></div><div><h3>Results</h3><div>N = 163 parents completed the full survey. We found statistically significant (p &lt; 0.001) and large (η²: 0.13–0.38) effects of clinicians’ use of argumentation across all parent-related outcomes. <em>Reasonable</em> argumentation led to lower <em>communication stress</em> and higher <em>understanding, agreement, participation</em> in communication<em>, empowerment, trust</em>, and <em>satisfaction</em> with communication than <em>no</em> argumentation. In turn, <em>no argumentation</em> led to improved outcomes compared to <em>unreasonable</em> argumentation. This pattern was similar across non-acute and acute scenarios.</div></div><div><h3>Conclusion</h3><div>Clinicians’ use of <em>reasonable</em> argumentation has a consistently strong and positive impact on parent-related outcomes in neonatal care.</div></div><div><h3>Practice implications</h3><div>We argue that <em>reasoned decision-making</em> should be considered a good clinical practice, core to patient-centered communication. Our findings provide a starting point for (1) determining good argumentative practices and (2) designing evidence-based clinical argumentation trainings.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"133 ","pages":"Article 108625"},"PeriodicalIF":2.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886373","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":"Patient at community clinics: Recommendations for advancing health literacy","authors":"Michelle Palmborg ,&nbsp;Carolina Fernandez-Branson ,&nbsp;Luisa Pessoa-Brandao","doi":"10.1016/j.pec.2024.108618","DOIUrl":"10.1016/j.pec.2024.108618","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess community clinics in enhancing health literacy among underserved patients. We focus on patient-provider communication at these clinics to understand how this communication may foster or hinder health literacy and how the organizational health literacy of clinics may be improved.</div></div><div><h3>Methods</h3><div>We surveyed 303 patients at three community clinics to evaluate providers' communication behaviors related to health literacy. The city health department entered surveys into SurveyMonkey™ and analyzed them using Stata/SE™. The analysis included frequencies of all variables for all participants and by clinic. Qualitative methods were also used.</div></div><div><h3>Results</h3><div>Community clinics are trusted care sources; however, around 13 % of patients reported rarely or never being encouraged to ask questions, 20 % reported providers spoke too fast, and 17 % reported that medical staff were not always informative. Patients needing an interpreter reported more communication problems than those not requiring one, making these results more salient.</div></div><div><h3>Conclusions</h3><div>Community clinics serving low-income patients can enhance personal and organizational health literacy by improving patient-provider communication such as active listening, encouraging patients to ask questions, and addressing language barriers.</div></div><div><h3>Practice implications</h3><div>Advancing health literacy impacts community and public health initiatives, improves health disparities, builds patient-provider trust, and improves health systems.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"132 ","pages":"Article 108618"},"PeriodicalIF":2.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873271","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":"Development and testing of a generic patient decision aid for end-of-life care","authors":"Hanne Irene Jensen ,&nbsp;Sarah Leeth Hansen Farmer ,&nbsp;Lillian Oxholm Skaarup ,&nbsp;Anders Løkke ,&nbsp;Anette Hygum ,&nbsp;Mette Jo Ipsen ,&nbsp;Lisbeth Høilund Gamst ,&nbsp;Maybritt Brunsgård Klausen","doi":"10.1016/j.pec.2024.108608","DOIUrl":"10.1016/j.pec.2024.108608","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to develop and test a patient decision aid for end-of-life care to be used when some or all life-sustaining treatments have been withheld or withdrawn.</div></div><div><h3>Methods</h3><div>A multi-professional, multi-sectorial group together with patients and relatives used a systematic process to develop and test the patient decision aid, including alpha and beta testing.</div></div><div><h3>Results</h3><div>Healthcare professionals, patients and relatives were involved in the development and testing. The final Decision Helper included three areas with nine options: follow-up (outpatient clinic and general practitioner), palliative care (primary care, specialised palliative care team, hospital admission and hospice) and treatment level (intensive care, resuscitation attempt and nutrition via feeding tube). Most participants agreed that the amount of information in the Decision Helper was appropriate, that it clearly presented benefits and disadvantages and that it was useful in the value clarification process, helping to verbalise preferences and what is most important for patients.</div></div><div><h3>Conclusions</h3><div>Most patients and healthcare professionals found that the decision aid would be helpful in facilitating shared decision-making in an end-of-life conversation.</div></div><div><h3>Practice implications</h3><div>The decision aid will be usable in different healthcare setting ensuring that end-of-life care is in accordance with patients’ wishes.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"132 ","pages":"Article 108608"},"PeriodicalIF":2.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873269","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":"Recommending surgical or non-surgical treatments in medical consultations: The case in Chinese contexts","authors":"Lu Liu,&nbsp;Wen Ma","doi":"10.1016/j.pec.2024.108606","DOIUrl":"10.1016/j.pec.2024.108606","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the design and delivery of surgical and non-surgical treatment recommendations in China.</div></div><div><h3>Methods</h3><div>We examined 936-minute recordings of medical consultations using conversation analysis. Data were collected from two tertiary hospitals in China. They are authentic interactions from the departments of orthopedics and proctology.</div></div><div><h3>Results</h3><div>Non-surgical treatment recommendations are proposed after diagnoses delivery. They are delivered in straightforward and simple form, and as already determined. Surgical treatment recommendations are proposed early and sometimes occupy the diagnostic slot. They are delivered in straightforward, simple, but mitigated form. These recommendations are formulated as a matter that is not fully settled and requires further discussions.</div></div><div><h3>Conclusions</h3><div>Patients’ stances toward specific treatments are made manifest in the tailoring of doctors’ recommendations. The formulations of treatment recommendations exhibit doctors’ understanding of what patients are anticipating or resisting. Chinese patients’ preference for non-surgical treatments over surgery is reflected in how doctors present the recommendations for surgical and non-surgical treatments.</div></div><div><h3>Practice implications</h3><div>Patients’ concerns vary depending on the treatments recommended. Doctors should incorporate these concerns into their medical advice. In China, for non-surgical patients, the focus is on clearly explaining the treatment plan. For surgical patients, doctors should first assist them in making informed treatment decisions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"132 ","pages":"Article 108606"},"PeriodicalIF":2.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866104","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}