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  1. Sheeran N, Jones L, Corbin B, Melville C
    Aust J Prim Health, 2024 Nov;30.
    PMID: 39607817 DOI: 10.1071/PY24100
    Background Abortion care is typically undertaken by doctors; however, alternate models, including nurse-led care, are increasingly seen as viable alternatives. However, attitudes towards the leadership of alternate models can be a barrier to change. We explored the acceptability of different models of abortion care, and whether attitudes differed by health profession for those working in sexual and reproductive health. Methods Our mixed method survey explored how doctors, nurses/midwives and those working in administrative roles in primary care in Australia felt about three models of abortion care: doctor-led, nurse-led and self-administered. ANOVAs compared favourability ratings and attitude strength across groups, and qualitative data exploring how they felt about each model was thematically analysed using Leximancer. Results Attitudes towards doctor-led and nurse-led models of care were overwhelmingly positive. However, doctors perceived doctor-led care more favourably than other professionals, and felt it provides a more holistic, safer experience, that opportunistically facilitated discussions about other sexual and reproductive health matters. Self-administered care was perceived unfavourably by ~60% of participants, and was associated with significant safety concerns. Conclusions Most health professionals working in sexual and reproductive health care perceive that nurse-led models of care are viable and acceptable, although doctors feel there are additional benefits to the current model. Self-administered abortion is overwhelmingly perceived as unsafe. Nurse-led care models could increase access to safe abortion in Australia, and are perceived favourably by those working in sexual and reproductive health care.
  2. Eigeland JA, Sheeran N, Jones L, Moffitt RL
    Patient Educ Couns, 2024 Nov 14;131:108492.
    PMID: 39612863 DOI: 10.1016/j.pec.2024.108492
    OBJECTIVE: Several tools exist to measure the physician-patient relationship; however few are specific to those with chronic physical health conditions, and none to date have been derived from the patient's perspective. This research aimed to develop and validate a patient-informed tool for measuring the physician-patient relationship with patients who have a chronic physical health condition.

    METHODS: Study 1: An Australian sample of participants with a diagnosed chronic physical health condition and a self-reported good physician-patient relationship completed a three round Delphi poll to determine items of the chronic condition physician-patient relationship scale (CC-PPR). Fifty-two participants completed round one, 33 completed round two, and 24 completed all three rounds. Study 2: Exploratory and confirmatory factor analysis were conducted on a separate sample (N = 226) to explore the factor structure of the CC-PPR.

    RESULTS: The CC-PPR comprised 22 items within a single-factor structure which demonstrated high internal consistency (Cronbach's α = 0.97) and sound convergent validity.

    DISCUSSION: The CC-PPR reliably measures observable, concrete, and specific physician behaviours that patients with chronic physical health conditions believe are critical in forming a good physician-patient relationship. The CC-PPR has potential application in research, educational, and self-assessment contexts, including for the evaluation and development of competence in post-graduate and professional settings.

  3. Pines R, Sheeran N, Jones L, Pearson A, Pamoso AH, Jin YB, et al.
    Med Care Res Rev, 2023 Apr;80(2):205-215.
    PMID: 35815591 DOI: 10.1177/10775587221108749
    Inadequate consideration has been given to patient preferences for patient-centered care (PCC) across countries or cultures in our increasingly global society. We examined what 1,698 participants from the United States, Hong Kong, Philippines, and Australia described as important when making health care decisions. Analysis of frequencies following directed content coding of open-ended questions revealed differences in patients' preferences for doctor behaviors and decision-making considerations across countries. Being well informed by their doctor emerged as most important in decision-making, especially in Hong Kong. Participants in Australia and the United States wanted their doctor to meet their emotional needs. The safety and efficacy of treatments were the most common consideration, especially for Hong Kong. Findings suggest that doctors should focus on information exchange and identifying patient concerns about efficacy, lifestyle impact, cost, and recovery speed. Rather than assuming patients prefer shared decision-making, doctors must assess patient's decision control preferences.
  4. Sheeran N, Jones L, Pines R, Jin B, Pamoso A, Eigeland J, et al.
    J Commun Healthc, 2023 Jul;16(2):186-196.
    PMID: 37401877 DOI: 10.1080/17538068.2022.2095098
    BACKGROUND: Patient-centered care (PCC) is the prevailing model of care globally. However, most research on PCC has been conducted in Westernized countries or has focused on only two facets of PCC: decision-making and information exchange. Our study examined how culture influences patients' preferences for five facets of PCC, including communication, decision-making, empathy, individualized focus, and relationship.

    METHODS: Participants (N = 2071) from Hong Kong, the Philippines, Australia, and the U.S.A. completed an online survey assessing their preferences for exchange of information, autonomy in decision-making, expression and validation of their emotions, focus on them as an individual, and the doctor-patient relationship.

    RESULTS: Participants from all four countries had similar preferences for empathy and shared decision-making. For other facets of PCC, participants in the Philippines and Australia expressed somewhat similar preferences, as did those in the U.S.A. and Hong Kong, challenging East-West stereotypes. Participants in the Philippines placed greater value on relationships, whereas Australians valued more autonomy. Participants in Hong Kong more commonly preferred doctor-directed care, with less importance placed on the relationship. Responses from U.S.A. participants were surprising, as they ranked the need for individualized care and two-way flow of information as least important.

    CONCLUSIONS: Empathy, information exchange, and shared decision-making are values shared across countries, while preferences for how the information is shared, and the importance of the doctor-patient relationship differ.

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