Patient Education and Counseling最新文献

{"title":"Genetic counseling and testing for dementia – A scoping review of patient and relatives experiences and outcomes","authors":"Gary Chen ,&nbsp;Adrienne Sexton","doi":"10.1016/j.pec.2025.109424","DOIUrl":"10.1016/j.pec.2025.109424","url":null,"abstract":"<div><h3>Objective</h3><div>This scoping review aims to map the experiences and outcomes of patients and their families undergoing genetic testing and counseling regarding dementia to inform future research directions and clinical practice.</div></div><div><h3>Methods</h3><div>Rigorous scoping review methodology was followed. Ovid Medline, Embase, PsycINFO, and CINAHL were searched with keywords and MeSH terms related to <em>“genetic testing”, “genetic counseling”, “dementia”, “decision making”,</em> and <em>“patient outcomes”</em> for peer-reviewed studies with adult participants published over the last ten years.</div></div><div><h3>Results</h3><div>Thirty-six articles met inclusion criteria. Narrative synthesis organized findings into temporal categories including motivations for genetic testing, experiences during the testing/counseling process, and outcomes after testing. Common motivators included reducing uncertainty, reproductive planning, life planning, and the prospect of a treatment becoming available in the future. A lack of current treatments and fear that knowledge of genetic risk would be difficult to cope with were common barriers to testing. Patient-centered communication improved satisfaction. Genetic testing was generally psychologically well tolerated, and a wide range of practical responses were reported including changes to lifestyle, diet, advanced care and financial planning, and engaging in clinical trials.</div></div><div><h3>Conclusion</h3><div>This review maps the experiences and outcomes of genetic testing or counseling for people with or at potentially increased genetic risk of dementia. Genetic testing and counseling for directly causal dementia genes and <em>APOE</em> genotype appears well tolerated but long-term outcome data is lacking. Motivations, concerns and perceived benefits of knowing genetic results vary depending on personal, familial and cultural viewpoints. Genetic counseling can help patients and families prepare, reduce decisional regret, and adapt to results.</div></div><div><h3>Practice implications</h3><div>Motivations varied, and a patient-centered approach addressing both information and psychological aspects improves satisfaction. Future longitudinal research should ascertain ways to support individuals from a wide range of demographics with understanding and adjusting to genetic risk information regarding dementia.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109424"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607097","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":"Omnis Salutis: Participatory development of a VA Whole Health patient education and activation intervention","authors":"Samantha M. Hack ,&nbsp;Alicia Lucksted ,&nbsp;Clayton H. Brown ,&nbsp;Sera Havrilla ,&nbsp;Jessica Castillo ,&nbsp;Melanie Bennett","doi":"10.1016/j.pec.2025.109427","DOIUrl":"10.1016/j.pec.2025.109427","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to develop a brief, Veteran-targeted intervention to educate and activate Veteran engagement in patient-centered mental health care and test its feasibility, acceptability, and preliminary efficacy.</div></div><div><h3>Methods</h3><div>Participatory action research methods were used with Veterans, VA clinicians, and VA researchers to develop a Veteran engagement intervention. Once developed, qualitative interviews were conducted with participants in a ten-person acceptability trial. This was followed by a pilot randomized controlled trial (n = 48) to test feasibility and explore preliminary efficacy.</div></div><div><h3>Results</h3><div>Omnis Salutis is a three session, individual intervention grounded in Motivational Interviewing, which aims to help Veterans identify their well-being goals and be an active leader in their mental health care. Acceptability was confirmed in qualitative interviews, with participants noting that Veterans are socialized to hierarchical provider relationships and Omnis Salutis was an effective method of activating Veterans. Feasibility of interventionist training and intervention delivery was demonstrated both in-person and on the telehealth platform with 41 Veterans completing three sessions of the experimental and control conditions and interventionists demonstrating over 90 % fidelity to the intervention. Though not statistically powered, at three months post-exposure, there were small effect size indicating that Omnis Salutis participants may have greater self-reported involvement in care and lower perceptions of their providers’ patient-centeredness than the control.</div></div><div><h3>Conclusions</h3><div>Omnis Salutis was developed to support recent Veterans preference for multi-faceted mental health care which supports their functional recovery, and VA’s efforts to create a patient-centered, Whole Health system of care.</div></div><div><h3>Practice implications</h3><div>Providers should be aware that Veterans have been socialized in a hierarchical health care system. Veterans may need additional time and education to understand the patient-centered approach and learn new ways of engaging in health care. Further research is needed to determine if Omnis Salutis increases patients’ ability to effectively participate in health care encounters and self-care behaviors by increasing their ability to identify and communicate their health care goals and motivations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109427"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688542","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":"Co-creating gender affirming survey questions: A participatory qualitative study","authors":"Jessica R. Gorman ,&nbsp;Stephanie L. Corey ,&nbsp;Scotty Kupsch ,&nbsp;Tayler Thompson ,&nbsp;Jackilen Shannon ,&nbsp;Jonathan Garcia","doi":"10.1016/j.pec.2025.109416","DOIUrl":"10.1016/j.pec.2025.109416","url":null,"abstract":"<div><h3>Purpose</h3><div>Research with transgender and gender diverse (TGD) communities is sparse, and measures of gender may systematically exclude marginalized groups. Therefore, the purpose of this study was to collaborate with community advisors and participants to develop a new set of affirming survey items to measure gender.</div></div><div><h3>Methods</h3><div>A purposive sample of 37 participants (cisgender (n = 9), transgender and gender diverse (n = 28)) were recruited through participants in existing research and outreach through community partners and networks. We first conducted individual interviews to test and refine gender measurement items and response options. Participants were invited back to participate in one of 5 focus groups to review and refine items. Data analysis was iterative, with ongoing feedback from a Community Advisory Board (CAB).</div></div><div><h3>Results</h3><div>Participant feedback emphasized the need for clear, resonant wording and the importance of establishing trust and transparency when collecting data about gender and sex assigned at birth. The process yielded co-created questions and response options with an introductory text to affirm confidentiality, the voluntary nature of disclosing, reason for the research, and why it is important to collect this information.</div></div><div><h3>Conclusion</h3><div>The resulting survey questions assessing gender and sex assigned at birth will be included in a population-based cohort study to establish response rates, describe participant characteristics, and develop new research questions in consultation with our CAB. Our results can also inform the way gender is assessed in clinical settings.</div></div><div><h3>Practice Implications</h3><div>Researchers and health care teams should carefully consider the wording used to assess gender and be aware that safety, rapport, voluntariness, and confidentiality are of paramount importance when collecting data about gender.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109416"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624754","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":"Structured pharmaceutical interviews enhance knowledge and medication adherence in DOAC therapy: Insights from the EDUC-AOD study","authors":"Samuel D. Cohen ,&nbsp;François Bouvier ,&nbsp;Claire-Marie Tissot ,&nbsp;Alice Viallet ,&nbsp;Caroline Leiterer ,&nbsp;Frédéric Tacco ,&nbsp;Jean-Marc Dauchot ,&nbsp;François Kramp ,&nbsp;Catherine Verret ,&nbsp;Solenne Martin ,&nbsp;Hubert Nielly ,&nbsp;Albert Boccara","doi":"10.1016/j.pec.2025.109423","DOIUrl":"10.1016/j.pec.2025.109423","url":null,"abstract":"<div><h3>Objective</h3><div>Direct oral anticoagulants (DOACs) are first-line therapies for atrial fibrillation and venous thromboembolism. Structured pharmaceutical interviews (SPIs) aim to enhance patient knowledge of DOAC therapy, thereby improving medication adherence and reducing both disease-related and treatment-related complications. The EDUC-AOD study was conducted to assess the impact of SPIs on patient knowledge, medication adherence, and clinical complications.</div></div><div><h3>Methods</h3><div>Patients newly prescribed DOACs were enrolled from two centers, with only one center delivering SPIs. The primary objective was to evaluate the impact of SPIs on patients’ knowledge and medication adherence at 3 months, using standardized questionnaires. Secondary objectives included evaluating the impact of SPIs on clinical complications, as well as knowledge and medication adherence at 6 months. Multivariate logistic regression analysis, adjusted for propensity score, was used to identify predictors of improved knowledge and adherence.</div></div><div><h3>Results</h3><div>From January 2021 to June 2023, 145 patients were enrolled: 68 in the intervention group and 77 in the control group. At 3 months, the intervention group demonstrated significantly higher rates of satisfactory knowledge (74 % vs. 12 %, p &lt; 0.001) and good medication adherence (86 % vs. 64 %, p = 0.008). SPIs were significant predictors of satisfactory knowledge (OR = 23.6, 95 % CI [8.3–81.1], p &lt; 0.001) and good medication adherence (OR = 3.5, 95 % CI [1.4–10.0], p = 0.012). Treatment indication (OR = 4.9, 95 % CI [1.7–16.3], p = 0.005) and lower HAS-BLED score (OR = 0.4, 95 % CI [0.1–1.0], p = 0.039) were also associated with improved outcomes. At 6 months, the intervention group experienced significantly fewer clinical complications (0 vs. 9, p = 0.010).</div></div><div><h3>Conclusion</h3><div>SPIs substantially enhance patients’ knowledge and adherence to DOAC therapy and reduce clinical complications. Integrating SPIs into routine care may optimize anticoagulant management. Further randomized trials are needed to confirm these findings.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109423"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736651","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":"Financial toxicity and related factors: A cross-sectional study among family caregivers of cancer patients","authors":"Xiao Miao ,&nbsp;Liang Ma ,&nbsp;Na Lv ,&nbsp;Fengqin Xu ,&nbsp;Jia Sun ,&nbsp;Susu Zhu","doi":"10.1016/j.pec.2025.109426","DOIUrl":"10.1016/j.pec.2025.109426","url":null,"abstract":"<div><h3>Aims</h3><div>To examine the relationships among financial toxicity, social support, general self-efficacy, and patients’ socioeconomic status among family caregivers of cancer patients.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted (July–September 2024) with 210 family caregivers from a Chinese hospital. Socio-demographics and disease characteristics questionnaires were completed by each participant, the financial toxicity scale for cancer family caregivers, the Social Support Rating Scale (SSRS), the General Self-Efficacy Scale, and the Socioeconomic Status. Correlation and multivariable linear regression analyses were performed using SPSS 26.0.</div></div><div><h3>Results</h3><div>Caregivers reported substantial financial toxicity, with a mean score of 60.02 ± 10.45, approaching the upper limit of the scale (80 points). Regression analysis identified four key predictors: lower self-efficacy (β = −0.417, <em>P</em> &lt; 0.001), catastrophic health expenditures (β = −0.231, <em>P</em> &lt; 0.001), lack of commercial insurance (β = 0.127, <em>P</em> = 0.024), and reduced household income (β = −0.172, <em>P</em> = 0.002). Financial toxicity showed significant negative correlations with social support (r = -0.226), self-efficacy (r = -0.567), and patient socioeconomic status (r = -0.215) (all <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Self-efficacy is a key modifiable factor in mitigating financial toxicity among cancer caregivers.</div></div><div><h3>Practice Implications</h3><div>Interventions should incorporate self-efficacy enhancement, insurance guidance, and income-protection strategies to reduce caregiver burden.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109426"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624658","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":"Key factors in shared decision making between people with osteoarthritis and physiotherapists: A narrative study using storytelling","authors":"J. Jager ,&nbsp;I. Rosbergen ,&nbsp;G. van der Sluis ,&nbsp;N.L.U. van Meeteren ,&nbsp;P.C. Siemonsma","doi":"10.1016/j.pec.2025.109421","DOIUrl":"10.1016/j.pec.2025.109421","url":null,"abstract":"<div><h3>Objectives</h3><div>To improve the quality of shared decision-making (SDM), this study examined factors perceived by people with osteoarthritis (PwOA) and physiotherapists to influence shared decision making (SDM), and how these perceptions align with a widely used SDM model.</div></div><div><h3>Methods</h3><div>Using a qualitative storytelling approach, we collected narratives from 10 PwOA and 7 physiotherapists in the Netherlands. Participants shared personal narratives of lived experiences (\"stories\") related to SDM in physiotherapy practice, resulting in 144 unique stories, of which 118 were related to decision-making and included for further analysis. These stories were analyzed through a seven-phase thematic analysis by a multidisciplinary research team (n = 12). Themes were plotted onto the SDM model of Moore and Kaplan.</div></div><div><h3>Results</h3><div>Analysis revealed six main themes: Decision-making as a reciprocal process (four aspects, 51 stories); Influence of patient expectations on decisions (four aspects, 48 stories); Communication and information provision (two aspects, 39 stories); Patients' voice and identity (three aspects, 33 stories); Relationship between patient and healthcare provider (two aspects, 26 stories); External factors influencing decisions (two aspects, 23 stories). Twelve aspects were shared by both PwOA and physiotherapists, one was exclusive to PwOA, and four were unique to physiotherapists. All aspects fit within Moore and Kaplan's SDM model; 12 aligned with specific stages, while five spanned multiple stages.</div></div><div><h3>Conclusions</h3><div>The study unravels the complex nature of SDM in physiotherapy. Storytelling revealed that factors like (power) dynamics as well as the physical environment seem to influence decision-making. Explicitly addressing these dynamics might provide opportunities for strengthening theoretical SDM models, clinical training, and SDM in real-world practice.</div></div><div><h3>Practice implications</h3><div>Greater attention to relational dynamics, patient expectations, and context have the potential to enhance the quality of SDM between PwOA and physiotherapists.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109421"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624661","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":"Designing a lifestyle intervention to optimise cardiometabolic health in high-risk prenatal and postnatal women: A pre-implementation study","authors":"Elaine K. Osei-Safo ,&nbsp;Angela Melder ,&nbsp;Frances Taylor ,&nbsp;Kaylee Slater ,&nbsp;Anjana Reddy ,&nbsp;Lisa Moran ,&nbsp;Sarah Lang","doi":"10.1016/j.pec.2025.109422","DOIUrl":"10.1016/j.pec.2025.109422","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore key stakeholder’s perspectives and co-design the design, content and delivery of a lifestyle intervention to optimise cardiometabolic health during and after pregnancy for women at risk or diagnosed with gestational diabetes mellitus (GDM) and/or hypertensive disorders of pregnancy (HDP).</div></div><div><h3>Methods</h3><div>Pre-implementation qualitative study using co-design workshops (n = 2) and semi-structured interviews (n = 6). Workshop discussions and interviews were audio recorded, transcribed and thematically analysed using template analysis.</div></div><div><h3>Results</h3><div>Women with prior cardiometabolic pregnancy complications (n = 11) and research partners (n = 13) participated. Participants reported liking that the intervention fills a healthcare gap and highlighted the importance of a holistic, user-friendly, patient-centred, culturally diverse approach to intervention design, content and delivery. Delivery by female healthcare professionals who utilise good risk communication skills, display empathy and understanding was recommended to empower and support women with the knowledge, resources and skills to take ownership of their health and reduce cardiometabolic risks.</div></div><div><h3>Conclusion</h3><div>This research supported the co-design of a lifestyle intervention to reduce cardiometabolic risks in women at risk or diagnosed with GDM and/or HDP.</div></div><div><h3>Practice implications</h3><div>The findings demonstrate the importance of stakeholder engagement in intervention design and the need for a patient-centred approach when developing lifestyle interventions for pregnant and postpartum women at risk of cardiometabolic conditions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109422"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579893","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":"Improv in health professions education special interest group: Creating community and collaboration","authors":"Amy Zelenski ,&nbsp;Ankit Mehta ,&nbsp;Anne Graff LaDisa ,&nbsp;Shannon Hanson ,&nbsp;Sarah Shepherd","doi":"10.1016/j.pec.2025.109450","DOIUrl":"10.1016/j.pec.2025.109450","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109450"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924355","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 role of congruency in patient-doctor interactions: Insights from rare cancer consultations","authors":"Katelijne Sanctorum,&nbsp;An Jacobs","doi":"10.1016/j.pec.2025.109433","DOIUrl":"10.1016/j.pec.2025.109433","url":null,"abstract":"<div><h3>Objectives</h3><div>This study<span><span>¹</span></span> aims to examine the preferences of patients with rare cancers in their interactions with medical specialists and to analyse the extent to which these preferences are reflected in patients’ actual experiences. It further explores how prior experiences contribute to the development of these preferences.</div></div><div><h3>Methods</h3><div>In-depth, semi-structured interviews (n = 24) were conducted with patients diagnosed with a rare cancer syndrome and with healthcare professional<strong>s</strong> (n = 8). The interviews were analysed and coded using the constructing grounded theory (CGT).</div></div><div><h3>Results</h3><div>Six interaction patterns were identified, varying along a spectrum from patient-centred to doctor-centred approaches. Among these, two emerged as most prevalent within the study group: collaborative congruent and active incongruent. Patients describing collaboratively interaction experiences possess strong health literacy skills and actively participate in consultations, particularly in the exchange and co-construction of information. In contrast, those experiencing active incongruency report dissatisfaction with the level of engagement permitted by the medical team as their informational and decision-making needs remain insufficiently addressed.</div></div><div><h3>Conclusions</h3><div>Patients with rare cancers actively engage in knowledge-building efforts, which can shape their expectations regarding interaction opportunities during medical consultations. It is essential for clinicians to recognise and assess patients’ and caregivers’ expectations regarding information provision and involvement in care and treatment decisions.</div></div><div><h3>Practice implications</h3><div>Tailoring communication strategies to align with patients’ interaction preferences can strengthen trust, enhance understanding, support decision-making and facilitate more effective coping with the disease.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109433"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684325","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":"Understanding experiences and impact of triadic communication for young people with cancer, supporters and healthcare professionals. A qualitative enquiry","authors":"Deborah J. Critoph ,&nbsp;Rachel M. Taylor ,&nbsp;Helen Hatcher ,&nbsp;Robbie Duschinsky ,&nbsp;Lawrence Fayers ,&nbsp;Luke A.M. Smith ,&nbsp;Anna Spathis","doi":"10.1016/j.pec.2025.109418","DOIUrl":"10.1016/j.pec.2025.109418","url":null,"abstract":"<div><h3>Objectives</h3><div>Triadic communication, when a third person (supporter) is present, is prevalent in adolescent and young adult cancer (AYAC) care. Limited research has examined triadic communication and these encounters are poorly understood. Furthermore, healthcare professionals find triadic communication with AYAC difficult and there are few opportunities for training. A multiphase qualitative study was undertaken involving young people with cancer, their supporters, and professionals. This aimed to gain a greater understanding of triadic communication, namely the impact supporters have on young people in communication with professionals.</div></div><div><h3>Methods</h3><div>Twenty-seven semi-structured interviews were undertaken, involving nine young person-supporter-professional triads. Focus groups with young people (n = 4), supporters (n = 3) and professionals (n = 6) were conducted. All were recorded and analysed using framework analysis.</div></div><div><h3>Results</h3><div>Four themes were identified. Young people are disempowered in triadic communication by multiple factors including shock, ill health, indirect communication and protectionism. Supporters who are not parents are important but can be sidelined by professionals and parents, and parents of adult children continue to seek communication from professionals. Professionals perceived multi-level threats that collectively hindered communication, including experience, fluctuating confidence and difficult requests from parents. Differing perspectives and responses to threat led to pervasive tension and conflict.</div></div><div><h3>Conclusions</h3><div>Young people experience considerable unmet needs in relation to triadic communication. Their perspective was not always elicited, and they could experience limited involvement, especially during high threat in the cancer journey. Sometimes communication did not adhere to legal frameworks and this increased young people’s vulnerability and limited autonomy.</div></div><div><h3>Practice implications</h3><div>Professionals should enable young people to communicate in the presence of a supporter and elicit the patient’s perspective. Training professionals in triadic communication is of critical importance and this must include how to elicit the young person’s perspective, navigating different agendas, offering explicit one to one time alone and communicating within legal frameworks.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"143 ","pages":"Article 109418"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642140","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}