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Patient Education and Counseling

Jairo N Fuertes, Arielle Toporovsky, Mariela Reyes, Jennifer Bennett Osborne
OBJECTIVE: This article discusses the physician-patient working alliance and reviews the empirical research that has been generated on the working alliance to date. METHODS: The paper presents a brief history of the study of the physician-patient relationship, and discusses constructs that have examined aspects of the relationship, such as empathy, trust, and shared decision-making. Lastly, a meta-analysis was conducted based on the seven empirical studies (a total N of 1023 patients) that have examined the physician-patient working alliance...
October 19, 2016: Patient Education and Counseling
Sobia F Ali-Faisal, Tracey J F Colella, Naomi Medina-Jaudes, Lisa Benz Scott
OBJECTIVE: To determine the effects of patient navigation (PN) on healthcare utilization outcomes using meta-analysis and the quality of evidence. METHODS: Medical and social science databases were searched for randomized controlled trials published in English between 1989 and May 2015. The review process was guided by PRISMA. Included studies were assessed for quality using the Downs and Black tool. Data were extracted to assess the effect of navigation on: health screening rates, diagnostic resolution, cancer care follow-up treatment adherence, and attendance of care events...
October 17, 2016: Patient Education and Counseling
Chloe Fletcher, Ingrid Flight, Janine Chapman, Kate Fennell, Carlene Wilson
OBJECTIVE: To provide an updated synthesis of the literature that investigates the self-reported information needs of people diagnosed with cancer across the cancer continuum. METHODS: We conducted a scoping review of the literature published from August 2003 to June 2015 and expanded an existing typology summarizing the information needs of people diagnosed with cancer. RESULTS: The majority of the included studies (n=104) focused on questions relevant to the diagnosis/active treatment phase of the cancer continuum (52...
October 12, 2016: Patient Education and Counseling
Clare Jackson, Victoria Land, Edward J B Holmes
OBJECTIVE: Communication during labour is consequential for women's experience yet analyses of situated labour-ward interaction are rare. This study demonstrates the value of explicating the interactional practices used to initiate 'decisions' during labour. METHODS: Interactions between 26 labouring women, their birth partners and HCPs were transcribed from the British television programme, One Born Every Minute. Conversation analysis was used to examine how decisions were initiated and accomplished in interaction...
October 11, 2016: Patient Education and Counseling
Magnolia Cardona-Morrell, Gustavo Benfatti-Olivato, Jesse Jansen, Robin M Turner, Diana Fajardo-Pulido, Ken Hillman
OBJECTIVE: To describe the range of decision aids (DAs) available to enable informed choice for older patients at the end of life and assess their effectiveness or acceptability. METHODS: Search strategy covered PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews, CINAHL and PsycInfo between 1995 and 2015. The quality criteria framework endorsed by the International Patient Decision Aids Standards (IPDAS) was used to assess usefulness. RESULTS: Seventeen DA interventions for patients, their surrogates or health professionals were included...
October 11, 2016: Patient Education and Counseling
Lise Paquet, Lisa Simmonds, Charles Yang, Shailendra Verma
OBJECTIVES: 1) To describe how women at high-risk for breast cancer (BC) perceive their at-risk status and the options available to manage this risk, before and after risk counselling; 2) to explore the contributions of pre-counselling demographic, clinical, cognitive and emotional factors to post-counselling risk management intentions. METHODS: 58 of 173 eligible patients (34%) enrolled and were asked to fill surveys including measures of 1) subjective risk, 2) illness (being at high-risk for BC) and 3) treatment (surveillance, lifestyle modifications, and chemoprevention) cognitions, 4) BC fear and 5) future risk management intentions, prior to and 3 months after risk consultation...
October 11, 2016: Patient Education and Counseling
Katelyn A Grayson-Sneed, Sandi W Smith, Robert C Smith
OBJECTIVE: To develop a more reliable coding method of medical interviewing focused on data-gathering and emotion-handling. METHODS: Two trained (30h) undergraduates rated videotaped interviews from 127 resident-simulated patient (SP) interactions. Trained on 45 videotapes, raters coded 25 of 127 study set tapes for patient-centeredness. Guetzkow's U, Cohen's Kappa, and percent of agreement were used to measure raters' reliability in unitizing and coding residents' skills for eliciting: agenda (3 yes/no items), physical story (2), personal story (6), emotional story (15), using indirect skills (4), and general patient-centeredness (3)...
October 11, 2016: Patient Education and Counseling
Shreya Kangovi, Nandita Mitra, Robyn A Smith, Raina Kulkarni, Lindsey Turr, Hairong Huo, Karen Glanz, David Grande, Judith A Long
OBJECTIVE: Growing interest in collaborative goal-setting has raised questions. First, are patients making the 'right choices' from a biomedical perspective? Second, are patients and providers setting goals of appropriate difficulty? Finally, what types of support will patients need to accomplish their goals? We analyzed goals and action plans from a trial of collaborative goal-setting among 302 residents of a high-poverty urban region who had multiple chronic conditions. METHODS: Patients used a low-literacy aid to prioritize one of their chronic conditions and then set a goal for that condition with their primary care provider...
September 25, 2016: Patient Education and Counseling
Áine Lorié, Diego A Reinero, Margot Phillips, Linda Zhang, Helen Riess
OBJECTIVE: To conduct a systematic review of studies examining how culture mediates nonverbal expressions of empathy with the aim to improve clinician cross-cultural competency. METHODS: We searched three databases for studies of nonverbal expressions of empathy and communication in cross-cultural clinical settings, yielding 16,143 articles. We examined peer-reviewed, experimental or observational articles. Sixteen studies met inclusion criteria. RESULTS: Nonverbal expressions of empathy varied across cultural groups and impacted the quality of communication and care...
September 25, 2016: Patient Education and Counseling
Lixin Song, Christina Tyler, Margaret F Clayton, Eleanor Rodgiriguez-Rassi, Latorya Hill, Jinbing Bai, Raj Pruthi, Donald E Bailey
OBJECTIVE: To analyze the effects of a decision aid on improving patients' and family members' information giving and question asking during consultations for prostate cancer treatment decision-making. METHODS: This study is a secondary analysis of archived audio-recorded real-time consultation visits with participants from a randomized clinical trial. Participants were randomly assigned into three groups: TD-intervention targeted patient-only; TS-intervention targeted patients and family members; and control-a handout on staying healthy during treatment...
September 23, 2016: Patient Education and Counseling
Fiona Wood, Katie Phillips, Adrian Edwards, Glyn Elwyn
OBJECTIVE: We aimed to observe how an Option Grid™ decision aid for clinical encounters might be used where an interpreter is present, and to assess the impact of its use on shared decision making. METHODS: Data were available from three clinical consultations between patient, clinician (a physiotherapist), and interpreter about knee osteoarthritis. Clinicians were trained in the use of an Option Grid decision aid and the tool was used. Consultations were audio-recorded, transcribed, and translated by independent translators into English...
September 22, 2016: Patient Education and Counseling
Tonia Crawford, Peter Roger, Sally Candlin
OBJECTIVE: Patient education is an important part of nurses' roles; however the inconsistent quality of communication skills, including those of registered nurses (RNs) from culturally and linguistically diverse (CALD) backgrounds, risk patient safety. Empowerment in patient education has been found to influence patients' self-efficacy and participation in decision-making. Discourse analysis of a whole interaction is used in this paper to trace the consequences of patient education where empowering discourse is displayed by an RN from a CALD background...
September 22, 2016: Patient Education and Counseling
Hope Foley, Amie Steel
OBJECTIVE: This review aims to describe the prevalence of empathy, empowerment and patient-centred clinical care experienced by patients in complementary medicine (CM) consultations. METHODS: A systematic review was undertaken of original research exploring patient perceptions of CM clinical care. Ten databases were searched: Alt HealthWatch, AMED, CINAHL Plus, MEDLINE Complete, Cochrane Library, PubMed, Proquest Medical Collection, PsycInfo, Social Sciences Citation Index and Psychology Collection...
September 22, 2016: Patient Education and Counseling
Janine Vetsch, Joanna E Fardell, Claire E Wakefield, Christina Signorelli, Gisela Michel, Jordana K McLoone, Thomas Walwyn, Heather Tapp, Jo Truscott, Richard J Cohn
OBJECTIVE: This mixed-method study assessed 1) survivors' and parents' information needs; and 2) associations between unmet information needs and clinical and socio-demographic characteristics. METHODS: Stage 1: CCS and parents of CCS, >5years post-diagnosis completed a questionnaire on information needs, overall health and perceived risk. Predictors for unmet information needs were assessed by multivariable regression. Stage 2: participants were interviewed in-depth on these topics...
September 22, 2016: Patient Education and Counseling
Annelie J Sundler, Jessica Höglander, Jakob Håkansson Eklund, Hilde Eide, Inger K Holmström
OBJECTIVE: This study aims to a) explore to what extent older persons express emotional cues and concerns during home care visits; b) describe what cues and concerns these older persons expressed, and c) explore who initiated these cues and concerns. METHODS: A descriptive and cross-sectional study was conducted. Data consisted of 188 audio recorded home care visits with older persons and registered nurses or nurse assistants, coded with the Verona coding definitions on emotional sequences (VR-CoDES)...
September 20, 2016: Patient Education and Counseling
Alice Grady, Mariko Carey, Jamie Bryant, Rob Sanson-Fisher, Breanne Hobden
OBJECTIVES: To examine the: 1) methodological quality of interventions examining strategies to improve patient-practitioner communication involving treatment decisions; 2) effectiveness of strategies to improve patient-practitioner communication involving treatment decisions; and 3) types of treatment decisions (emergency/non-emergency) in the included studies. METHODS: Medline, PsychINFO, CINAHL, and Embase were searched to identify intervention studies. To be included, studies were required to examine patient-practitioner communication related to decision making about treatment...
September 20, 2016: Patient Education and Counseling
Alex Ghanouni, Ella Nuttall, Jane Wardle, Christian von Wagner
OBJECTIVE: Determine whether (fictitious) health screening test benefits affect perceptions of (unrelated) barriers, and barriers affect perceptions of benefits. METHODS: UK adults were recruited via an online survey panel and randomised to receive a vignette describing a hypothetical screening test with either high or low benefits (higher vs. lower mortality reduction) and high or low barriers (severe vs. mild side-effects; a 2×2 factorial design). ANOVAs compared mean perceived benefits and barriers scores...
September 17, 2016: Patient Education and Counseling
Samantha R Paige, Janice L Krieger, Michael Stellefson, Julia M Alber
BACKGROUND: Chronic disease patients are affected by low computer and health literacy, which negatively affects their ability to benefit from access to online health information. OBJECTIVE: To estimate reliability and confirm model specifications for eHealth Literacy Scale (eHEALS) scores among chronic disease patients using Classical Test (CTT) and Item Response Theory techniques. METHODS: A stratified sample of Black/African American (N=341) and Caucasian (N=343) adults with chronic disease completed an online survey including the eHEALS...
September 16, 2016: Patient Education and Counseling
Diana J Burgess, Mary Catherine Beach, Somnath Saha
Like the population at large, health care providers hold implicit racial and ethnic biases that may contribute to health care disparities. Little progress has been made in identifying and implementing effective strategies to address these normal but potentially harmful unconscious cognitive processes. We propose that meditation training designed to increase healthcare providers' mindfulness skills is a promising and potentially sustainable way to address this problem. Emerging evidence suggests that mindfulness practice can reduce the provider contribution to healthcare disparities through several mechanisms including: reducing the likelihood that implicit biases will be activated in the mind, increasing providers' awareness of and ability to control responses to implicit biases once activated, increasing self-compassion and compassion toward patients, and reducing internal sources of cognitive load (e...
September 15, 2016: Patient Education and Counseling
Mirjam P Fransen, Evelien Dekker, Daniëlle R M Timmermans, Ellen Uiters, Marie-Louise Essink-Bot
OBJECTIVE: To explore the accessibility of standardized printed information materials of the national Dutch colorectal cancer screening program among low health literate screening invitees and to assess the effect of the information on their knowledge about colorectal cancer and the screening program. METHODS: Linguistic tools were used to analyze the text and design characteristics. The accessibility, comprehensibility and relevance of the information materials were explored in interviews and in observations (n=25)...
September 5, 2016: Patient Education and Counseling
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