METHODS: Theme-oriented discourse analysis of two psychiatric consultation groups: control (n = 17) and intervention (n = 16). In the control group, only a doctor's conversation guide was used; in the intervention group, the conversation guide and a patient decision aid (PDA) were used.
RESULTS: Psychiatrists mainly dominated conversations in both consultation groups. They were less likely to elicit patient treatment-related perspectives in the intervention group as they focused more on delivering the information than obtaining patient perspectives. However, using PDA in the intervention group slightly encouraged patients to participate in decisional talk.
CONCLUSION: The decision support tools did promote SDM performance. Using the conversation guide in both consultation groups encouraged the elicitation of patient perspectives, which helped the psychiatrists in tailoring their recommendations of options based on patient preferences and concerns. Using the PDA in the intervention group created space for treatment discussion and fostered active collaboration in treatment decision making.
PRACTICE IMPLICATIONS: Our findings have implications for SDM communication skills training and critical reflection on SDM practice.
STUDY DESIGN: Cross-sectional, semi-structured online survey.
METHODS: An anonymized, self-administered, semi-structured online survey was conducted via Google Forms between July and October 2024. Survey invitations were distributed via email, professional networks, and social media where appropriate. The survey assessed respondents' demographics, respondents' prior use of QPLs (Yes/No), prior awareness of the existence of QPLs (Yes/No), preferred communication style (single-response, multiple-choice), and perceived barriers and facilitators to implementation (open-ended response). All questions excluding the two open-ended questions were required for submission. Descriptive statistics were used to analyze quantitative data, and thematic analysis following Braun and Clarke's framework was used for open-ended responses.
RESULTS: Among 85 respondents, 84.7% reported being unaware of QPLs, and 22.4% reported having implemented QPLs in their clinical practice. Among respondents who had not implemented QPLs, 68.2% indicated that they were "Somewhat" or "Very" willing to implement them. Most respondents favored communication styles that emphasize sharing information (16.4%), open and inclusive communication (15.6%), and supportive counseling (15.6%). QPLs are aligned with current attitudes toward patient-provider communication in ANCCA countries.
CONCLUSION: There is substantial opportunity to introduce QPLs across ANCCA countries. This study provides foundational evidence to guide their effective implementation, promoting patient-centered care in Asia.
METHOD: Based on The Relationship Intimacy Model of Couple Adaptation to Cancer, the study used purposive sampling to select participants, guided by the principle of maximum variation. Sixteen pairs of patients with gastric cancer and their spouse caregivers, hospitalized in the oncology department of a tertiary hospital in Jingjiang City, Jiangsu Province, between March and July 2023, were chosen for semi-structured face-to-face interviews. Within 24 h after each interview, the recorded data were transcribed and supplemented with field notes. Directed content analysis was used for qualitative content analysis.
RESULTS: The interview data revealed five themes and 12 subthemes: (1) Negative Spousal Communication, which includes (i) lack of awareness of proactive communication, (ii) lack of emotional interaction and patience in exchange, and (iii) substituting conflict for communication; (2) Positive Spousal Communication, which includes (i) appropriate communication topics, (ii) appropriate timing and approach, and (iii) integration with emotional support; (3) Protective Concealment, which includes (i) suppressing emotions and making compromises and (ii) avoiding taboo topics; (4) Negative Spousal Disease Communication, which may lead to reduced psychological adaptation and a decline in couples' relationship intimacy; and (5) Positive Spousal Disease Communication, which may enhance psychological adaptation and strengthen couples' relationship intimacy. During chemotherapy, gastric cancer patients and their spouses experienced positive, negative, and Protective Concealment communication patterns. Both psychological adaptation and relationship intimacy are significantly influenced by spousal disease communication.
CONCLUSIONS: For patients with gastric cancer and their spouses, nurses should focus on the importance of spousal disease communication during chemotherapy, take positive measures to mitigate one-side, conflictual communication and avoidance behaviors, and adopt appropriate communication cut-in content and timing to promote couple communication deeply, with the need to focus on physical and psychological stress of the protective concealment in couple.
METHODS: SHED (n = 3) from passage 4 were expanded in FBS (FBS-SHED) or pHS (pHS-SHED) supplemented media until passage 7. During expansion, the proliferation of SHED was determined. Cells at passage 7 were further expanded in human serum from four individual donors (iHS) for 120 h followed by assessment of cell viability and profiling of the secreted paracrine factors.
RESULTS: Proliferation of SHED was significantly higher (p
Methods: This cross-sectional study was conducted on 377 community dwelling older adults 60 years and over living in Kashan, Iran. A multistage proportional random sampling technique was applied to obtain the sample. The grandparent -grandchildren relationship was measured by a researcher-developed 16-item scale. The data were analyzed using SPSS version 23 and AMOS 23.
Results: The mean age of the respondents was 70.42(SD = 8.20) years. About 62% of the respondents were female and 60.7% were married. The average score of grandparents-grandchild relationship was 67.60(SD = 12.47). The multiple linear regression analysis revealed a significant model (F (11, 365) = 19.05, P < 0.001), where information communication technology of grandparents, geographical distance between grandparents and grandchildren, and the quality of relationship between grandparents and parents of grandchildren were the most important predictors of the grandparents-grandchildren relationship.
Conclusion: The findings from the current study showed that status of grandparents-grandchildren relationship is moderate to high and influenced by some factors. It is, therefore, suggested that policymakers pay more attention to strengthening grandparent-grandchild relationship by providing educational programs for families and encouraging the elderly to learn and use information communication technology.
OBJECTIVE: To investigate the impact of customized CMI (C-CMI) on health-related quality of life (HRQoL) among type 2 diabetes mellitus (T2DM) patients in Qatar.
METHODS: This was a randomized controlled intervention study, in which the intervention group patients received C-CMI and the control group patients received usual care. HRQoL was measured using the EQ-5D-5L questionnaire and EQ visual analog scale (EQ-VAS) at three intervals [i.e. baseline, after 3 months and 6 months].
RESULTS: The EQ-5D-5L index value for the intervention group exhibited sustained improvement from baseline to the third visit. There was a statistically significant difference between groups in the HRQoL utility value (represented as EQ index) at 6 months (0.939 vs. 0.796; p = 0.019). Similarly, the intervention group compared with the control group had significantly greater EQ-VAS at 6 months (90% vs. 80%; p = 0.003).
CONCLUSIONS: The impact of C-CMI on health outcomes of T2DM patients in Qatar reported improvement in HRQoL indicators among the intervention patients. The study built a platform for health policymakers and regulatory agencies to consider the provision of C-CMI in multiple languages.
Methods: A total of 568 adolescents were participated in quantitative surveys, and of these participating adolescents, 6 were further invited to join focus group interviews.
Findings: Quantitative findings supported the mediating role of communication disturbance in the relationships between phone obsession and familial connectedness, school connectedness, and self-connectedness, but not for friendship connectedness. Qualitative findings further elucidated the detrimental effect of phone obsession on their sense of belonging from the perspectives of adolescents.
Conclusion: This study reaffirms that phubbing behaviour is predictive of social disconnectedness. Therefore, preventive and treatment interventions should be developed to avoid and control a potential risk of social disconnectedness epidemics attribute to phubbing.
BACKGROUND: Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician- and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of endocrinologists came together at an international meeting held in India to develop tool kits that would aid a practitioner in implementing insulin motivation strategies at different stages of the journey through insulin therapy, including pre-initiation, initiation, titration and intensification. During the meeting, emphasis was placed on the challenges and limitations faced by both physicians and patients with diabetes during each stage of the journey through insulinization.
REVIEW RESULTS: After review of evidence and discussions, the expert group provided recommendations on strategies for improved insulin acceptance, empowering behavior change in patients with DM, approaches for motivating patients to initiate and maintain insulin therapy and best practices for insulin motivation at the pre-initiation, initiation, titration and intensification stages of insulin therapy.
CONCLUSIONS: In the management of DM, bringing in positive behavioral change by motivating the patient to improve treatment adherence helps overcome insulin distress and achieve treatment goals.
METHODS: We surveyed one key stakeholder from each of 27 countries with expertise in survivorship care on questions including the components/structure of follow-up care, delivery of treatment summaries and survivorship care plans, and involvement of primary care in survivorship. Descriptive analyses were performed to characterize results across countries and variations between the WHO income categories (low, middle, high). We also performed a qualitative content analysis of narratives related to survivorship care challenges to identify major themes.
RESULTS: Seven low- or /lower-middle-income countries (LIC/LMIC), seven upper-middle-income countries (UMIC), and 13 high-income countries (HICs) were included in this study. Results indicate that 44.4% of countries with a National Cancer Control Plan currently address survivorship care. Additional findings indicate that HICs use guidelines more often than those in LICs/LMICs and UMICs. There was great variation among countries regardless of income level. Common challenges include issues with workforce, communication and care coordination, distance/transportation issues, psychosocial support, and lack of focus on follow-up care.
CONCLUSION: This information can guide researchers, providers, and policy makers in efforts to improve the quality of survivorship care on a national and global basis. As the number of cancer survivors increases globally, countries will need to prioritize their long-term needs. Future efforts should focus on efforts to bridge oncology and primary care, building international partnerships, and implementation of guidelines.