METHODS: Cross sectional analyses of N = 345 adult cancer survivors (5 years post cancer diagnosis) attending follow-ups at University Malaya Medical Centre, Malaysia. Face-to face-interviews were conducted using the 30-item Cancer Health Literacy Test and the Patient-Practitioner Orientation Scale to determine preference for patient-centered care.
RESULTS: Cancer survivors' preference for patient-centered care was associated with a higher cancer health literacy score, higher educational level, being employed, breast cancer diagnosis, and not desiring psychological support [F (14, 327) = 11.25, p
METHODS: A cross-sectional study was conducted in an urban, public primary care clinic. Convenience sampling was used to recruit participants, and audio-recorded consultations were scored for SDM levels by two independent raters using the OPTION tool. Univariate and multivariate analysis was conducted to determine factors significantly associated with SDM levels.
RESULTS: 199 patients and 31 doctors participated. Mean consultation time was 14.3 min (+ SD 5.75). Patients' age ranged from 18 to 87 years (median age of 57.5 years). 52.8 % of patients were female, with three main ethnicities (Malay, Chinese, Indian). The mean OPTION score was found to be 7.8 (+ SD 3.31) out of 48. After a multivariate analysis, only patient ethnicity (β= -0.142, p
METHODS: The Q methodology was used where 37 opinion statements were ranked in order of importance in a unimodal shaped grid. Results were explored using the Centroids factor extraction and Varimax rotation.
RESULTS: Four-three persons living with haemodialysis, mean age± SD= 56.58 ± 10.22 years, participated in the study. Five-factors were identified: living in the present, family preference, self preservation, power vs. control and autonomy in decision making, loaded by eleven, four, four, three and three participants with 16 individuals not loading significantly and two were confounded. Preferences for remaining positive in the face of illness through a healthy lifestyle and preserving relationships and autonomy were demonstrated.
CONCLUSIONS: End-of-life discussions are potentially inhibited by preferences to live for the present which should be explored in future studies.
PRACTICE IMPLICATION: Statement sets may be used to help facilitate end-of-life discussions through identification of opinion groups. Establishing preferences may guide identification of those willing to initiate discussions.
METHODS: A shared decision-making scale was developed using a qualitative research derived model and refined using Rasch and factor analysis. The scale was used by staff in the hospital for four consecutive years (n = 152, 121, 119 and 121) and by two independent patients' and carers' samples (n = 223 and 236).
RESULTS: Respondents had difficulty determining what constituted a decision and the scale was redeveloped after first use in patients and carers. The initial focus on shared decision-making was changed to shared problem-solving. Two factors were found in the first staff sample: shared problem-solving and shared decision-making. The structure was confirmed on the second patients' and carers' sample and an independent staff sample consisting of the first data-points for the last three years. The shared problem-solving and decision-making scale (SPSDM) demonstrated evidence of convergent and divergent validity, internal consistency, measurement invariance on longitudinal data and sensitivity to change.
CONCLUSIONS: Shared problem-solving was easier to measure than shared decision-making in this context.
PRACTICE IMPLICATIONS: Shared problem-solving is an important component of collaboration, as well as shared decision-making.
METHODS: A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the "Managing Patients on Chemotherapy" module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted.
RESULTS: Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P
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.
METHODS: The decision aid prototype was developed following a literature review and six focus groups. Alpha testing assessed its comprehensibility, acceptability, usability and desirability through user-centered cognitive interviews. Beta-testing evaluated preliminary evidence on its efficacy using the SDM Scale and PDMS. Feasibility was assessed by timing the consultation.
RESULTS: The alpha testing demonstrated that the decision aid was patient-oriented, comprehensible, comprehensive, concise and objective with an appealing design. Beta-testing indicated that PtDA significantly increased patients satisfaction with SDM from patients' [83.32 (13.92) vs 85.76 (13.80); p
METHODS: Through 25 semi-structured in-depth interviews, themes were identified using thematic analysis, guided by the Technology Readiness and Acceptance Model (TRAM).
RESULTS: Anticipated convenience and benefits, openness to new technologies acted as drivers, while limited digital literacy and concerns about data privacy and security served as inhibitors of readiness to adopt health apps. Acceptance was influenced by elements related to medication, patient, healthcare professional, family and app aspects. The identified barriers were related to patient, smartphone and monetary factors. Patients perceived the need to adopt digital apps were for those with poor adherence, complex medication regimen and forgetfulness issues. However, concerns about effectively implementing this approach were noted as T2DM patients were predominantly late middle-aged adults who faced technical challenges, leading to combination approach between digital technology and conventional patient education and counselling.
CONCLUSION: The findings highlighted the factors influencing patient's readiness, acceptance, and barriers on effective utilisation of digital health solutions in managing adherence issues.
PRACTICAL IMPLICATIONS: The elements of TRAM provide guidance for strategic actions to enhance digital health technology adoption among T2DM patients.
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.
METHODS: A scoping review was carried out and adhered to the Preferred Reporting System for Meta-Analysis. A comprehensive search strategy of four databases; PubMed, Medline, CINAHL Plus and Scopus, from January 2011 to June 2021 was applied. Thematic analysis was used to analyse the data.
RESULTS: Ten journal articles were included, and four themes were identified; patient experiences using communication methods, practitioners' cultural competence in Deaf culture, inherent challenges of communication methods, and extrinsic factors. Professional interpreters are often regarded as the preferred modality of communication but writing and lip-reading were commonly used in healthcare settings, with video remote interpreting the least common.
CONCLUSION: Healthcare professionals need to appreciate the heterogeneity of Deaf patients and their communication methods and adopt a more person-centred approach.
PRACTICE IMPLICATIONS: This review provides up-to-date insight on Deaf patient-physician interactions and provisional recommendations for practice, education and policy.
METHODS: This systematic review focused on synthesizing qualitative data and was registered with PROSPERO under the protocol registration number xxx. Searched 7 databases for qualitative studies on MBIs & cancer patients (17 studies, 365 patients). Analyzed data using themes & assessed confidence in findings.
RESULTS: Thematic analysis using NVivo software revealed four significant themes: (1) benefits and positive outcomes (e.g., symptom improvement, team support, positive experiences), (2) challenges and difficulties (e.g., practice challenges, negative experiences), (3) the journey of change and acceptance (e.g., shifts in perception, personal growth, and acceptance), and (4) adaptations and recommendations (e.g., program modification and flexibility).
CONCLUSION: Mindfulness-based interventions have the potential to offer cancer patients positive emotional experiences, increased team support, and opportunities for personal growth, self-discovery, and acceptance. This, in turn, can help them manage the psychological distress associated with cancer. Customizing programs to align with individual patients' needs and preferences can enhance engagement and effectiveness.
PRACTICE IMPLICATIONS: Integrating MBIs into Patient Education and Counseling, tailored to individual needs and with ongoing support, can enhance cancer care. Group interventions foster peer support and effectiveness. Training providers and ensuring accessibility are crucial. Research and customization to patients' journeys optimize outcomes and satisfaction. A patient-centered approach is essential for positive experiences and improved clinical outcomes.
METHODS: A comprehensive systematic literature search was conducted from January 2000 to February 2023 across Web of Science, Google Scholar, and MEDLINE via PubMed. The review sought studies on technology-based exercise prescriptions for adults ≥ 18 years, evaluating features that enhance motivation or adherence.
RESULTS: Out of 1724 articles reviewed, 45 met the criteria, demonstrating that mobile applications, exercise gaming, wearable trackers, and websites are commonly used technologies for prescribing exercise in healthcare setting. Common features, special features, and motivating features were found to be important in all technology-based exercise tools to enhance users' adherence and motivation.
CONCLUSION: This review provides a comprehensive overview of the technological types and approaches that can support and improve exercise adherence among health service users. The findings also emphasize on specific features that can address current gaps in technology-driven fitness interventions.
PRACTICE IMPLICATIONS: Healthcare professionals should make informed decisions when recommending these tools to health service users, since technology does play a significant role in promoting long-term adherence to exercise programs.
METHODS: We searched 6 electronic databases to identify randomised controlled trials assessing the impact of using technology in vaccine safety communication. The Cochrane Collaboration's tool for assessing risk of bias was used to evaluate each study.
RESULTS: We included 22 studies involving 27,109 participants from 8 countries; 15 studies assessed the use of videos and 7 examined innovative technologies. Using videos significantly improved knowledge (n = 3) and participant engagement (n = 2) compared to printed material. Among the innovative technologies, the use of virtual reality, and smartphone applications incorporating social networking or gamification significantly increased vaccination knowledge, confidence, and engagement. The studies showed that narrative messaging increased perceived disease severity (n = 2) and vaccination intention (n = 2).
CONCLUSIONS: While the use of innovative technologies is increasing, videos currently remain the most popular technology for vaccine safety communication. Communication technology, particularly with narrative messaging, improves patient engagement and comprehension.
PRACTICE IMPLICATIONS: Health authorities should increase focus on using videos and smartphone applications for vaccine safety communication. Collaboration among stakeholders is essential to develop guidelines on effective message content to complement the technology.