Special Section: Review articles on decision making and patient education interventions

2017 ◽  
Vol 100 (12) ◽  
pp. 2157-2158
Author(s):  
Arnstein Finset
Keyword(s):  
Decision Making ◽  
Patient Education ◽  
Special Section ◽  
Review Articles ◽  
Education Interventions

Cognitive-behavioral and patient education interventions in cardiac catheterization procedures: The Palo Alto Medical Psychology Project.

1979 ◽  
Vol 47 (1) ◽  
pp. 49-58 ◽  
Author(s):  
Philip C. Kendall ◽  
Linda Williams ◽  
Terry F. Pechacek ◽  
Lewis E. Graham ◽  
Catherine Shisslak ◽  
...  
Keyword(s):  
Patient Education ◽  
Cardiac Catheterization ◽  
Cognitive Behavioral ◽  
Medical Psychology ◽  
Palo Alto ◽  
Education Interventions

scholarly journals Facilitating Team-Based Care Coordination and Collaboration in Myelofibrosis: Findings from a Quality Improvement Study in Three US Community Oncology Systems

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 32-33
Author(s):  
Srdan Verstovsek ◽  
Anne Jacobson ◽  
Jeffrey D Carter ◽  
Tamar Sapir
Keyword(s):  
Decision Making ◽  
Quality Improvement ◽  
Patient Education ◽  
Care Coordination ◽  
Research Funding ◽  
Practice Patterns ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Community Oncology ◽  
Centered Care

Background Care coordination can be especially challenging in the setting of rare malignancies such as myelofibrosis (MF), where hematology/oncology teams have limited experience working together to implement rapidly evolving standards of care. In this quality improvement (QI) initiative, we assessed barriers to patient-centered MF care in 3 community oncology systems and conducted team-based audit-feedback (AF) sessions within each system to facilitate improved care coordination. Methods Between 1/2020 and 3/2020, 31 hematology/oncology healthcare professionals (HCPs) completed surveys designed to characterize self-reported practice patterns, challenges, and barriers to collaborative MF care in 3 community oncology systems (Table 1). Building on findings from the team-based surveys, 39 HCPs from these centers participated in AF sessions to reflect on their own practice patterns and to prioritize areas for improved MF care delivery. Participants developed team-based action plans to overcome identified challenges, including barriers to effective risk stratification, care coordination, and shared decision-making (SDM) for patients with MF. Surveys conducted before and after the small-group AF sessions evaluated changes in participants' beliefs and confidence in delivering collaborative, patient-centered MF care. Results Team-Based Surveys: HCPs identified managing MF-associated anemia and other disease symptoms (42%), providing individualized care despite highly variable clinical presentations (29%), and developing institutional expertise despite low patient numbers (16%) as the most pressing challenges in MF care. For patients who are candidates for JAK inhibitor therapy, HCPs reported most commonly relying on current guidelines (71%) and clinical evidence (61%) to guide treatment selection. HCPs also considered drug safety/tolerability profiles (55%), personal or institutional experience (13%), and out-of-pocket costs for patients (13%); no participants (0%) reported incorporating patient preference into their decision-making. Teams were underutilizing SDM and patient-centered care resources; fewer than 50% reported providing tools to support adherence (48%), visual aids for patient education (47%), financial toxicity counseling (40%), resources for managing MF-related fatigue (36%), or counseling to reduce risk factors for CVD, bleeding, and thrombosis (26%). Small-Group AF Sessions: Across the 3 oncology centers, teams participating in the AF sessions (Table 1) shared a self-reported caseload of 97 patients with MF per month. HCPs reported a meaningful shift in beliefs regarding the importance of collaborative care: following the AF sessions, 100% of HCPs agreed or strongly agreed that collaboration across the extended oncology care team is essential for achieving MF treatment goals, an increase from 71% prior to the AF sessions (Figure 1). Participants also reported increased confidence in their ability to perform each of 6 aspects of evidence-based, collaborative, patient-centered care (Figure 2). In selecting which aspects of patient-centered care to address with their clinical teams, HCPs most commonly prioritized individualizing treatment decision-making based on patient- and disease-related factors (57%), followed by providing adequate patient education about treatment options and potential side effects (24%) and engaging patients in SDM (18%). To achieve these goals, 73% of HCPs committed to sharing their action plans with additional clinical team members; others committed to creating a quality task force to oversee action-plan implementation (15%) and securing buy-in from leadership and stakeholders (9%). Conclusions As a result of participating in this community-based QI initiative, hematology/oncology HCPs demonstrated increased confidence in their ability to deliver patient-centered MF care and improved commitment to team-based collaboration. Remaining practice gaps and challenges can inform future QI programs. Study Sponsor Statement The study reported in this abstract was funded by an independent educational grant from Incyte Corporation. The grantors had no role in the study design, execution, analysis, or reporting. Disclosures Verstovsek: ItalPharma: Research Funding; CTI Biopharma Corp: Research Funding; Promedior: Research Funding; Gilead: Research Funding; NS Pharma: Research Funding; Celgene: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Genentech: Research Funding; Sierra Oncology: Consultancy, Research Funding; PharmaEssentia: Research Funding; AstraZeneca: Research Funding; Incyte Corporation: Consultancy, Research Funding; Blueprint Medicines Corp: Research Funding; Protagonist Therapeutics: Research Funding; Roche: Research Funding.

scholarly journals A personalized, web-based breast cancer decision making application: a pre-post survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kirk D. Wyatt ◽  
Sarah M. Jenkins ◽  
Matthew F. Plevak ◽  
Marcia R. Venegas Pont ◽  
Sandhya Pruthi
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Patient Education ◽  
Knowledge Transfer ◽  
Shared Decision Making ◽  
Mobile Applications ◽  
Shared Decision ◽  
Point Scale ◽  
Web Based ◽  
Amount Of Information

Abstract Background Every case of breast cancer is unique, and treatment must be personalized to incorporate a woman’s values and preferences. We developed an individually-tailored mobile patient education application for women with breast cancer. Methods Pre-post surveys were completed by 255 women who used the tool. Results Patients thought the application included helpful information (N = 184, 72%) and was easy to navigate (N = 156, 61%). Most patients thought the amount of information in the tool was “about right” (N = 193, 87%). Decision making confidence increased by an average of 0.8 points (10-point scale) following a consultation and use of the tool (p < 0.001). Conclusions Tailored mobile applications may optimize care by facilitating shared decision making and knowledge transfer, and they may also enhance the experience of patients as they navigate through their breast cancer journey.

Gender Differences in End-of-Life Care in Older Mexican American Adults

2020 ◽  
Vol 35 (4) ◽  
pp. 256-266
Author(s):  
Evangeline M. Ortiz-Dowling ◽  
Janice D. Crist ◽  
Kimberly Shea ◽  
Linda R. Phillips
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Health Care Professionals ◽  
Mexican Americans ◽  
Mexican American ◽  
A Priori ◽  
The United States ◽  
Review Articles ◽  
And Gender ◽  
Eol Care

Mexican Americans (MAs), 1 of 10 subgroups of Latinos, are the largest and fastest growing Latino subgroup in the United States; yet, their access to end-of-life (EOL) care using hospice services is low. An investigation was needed into extant research-based knowledge about factors influencing EOL care decisions among MAs to guide health-care professionals in assisting MAs to make timely, acceptable, and satisfactory EOL care decisions. To determine whether gender was an influence on EOL decision-making among older MAs, CINAHL and PubMed were searched for articles published between 1994 and 2018. Relevant sources were also identified through the reference lists of review articles. Reports were included if they were written in English, involved participants aged 50 years and older who identified themselves as MA, and data derived directly from participants. Reports in which MAs were not equally represented in the sample, large databases, and instrumentation development and testing articles were excluded. Of the 345 unduplicated articles identified in our electronic search and the 47 identified through review articles, 22 met the inclusion criteria. Content analysis was conducted using a priori codes from the Ethno-Cultural Gerontological Nursing Model (ECGNM). Only 8 (36%) of the 22 articles reported on MA older adults’ gendered experiences related to EOL decision-making. Results indicate an association between gender and EOL decision-making. As the older MA population grows, tackling disparities in EOL services use requires attention to how culture and gender influence EOL decision-making and care.

scholarly journals Improving gout education from patients’ perspectives: a focus group study of Māori and Pākehā people with gout

2018 ◽  
Vol 10 (3) ◽  
pp. 194 ◽  
Author(s):  
Cassandra J. Rolston ◽  
Tamlin S. Conner ◽  
Lisa K. Stamp ◽  
Tia Neha ◽  
Suzanne Pitama ◽  
...  
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Patient Education ◽  
Primary Care Providers ◽  
Care Providers ◽  
Multiple Sources ◽  
Focus Group Study ◽  
Face To Face ◽  
Gout Patient ◽  
Education Interventions

ABSTRACT INTRODUCTION Gout is a common form of arthritis that is typically managed in primary care. Gout management guidelines emphasise patient education for successful treatment outcomes, but there is limited literature about the educational experiences of people living with gout in New Zealand, particularly for Māori, who have higher gout prevalence and worse gout outcomes than Pākehā. AIM To explore gout patient education in primary care from the perspectives of Māori and Pākehā people with gout. METHODS In total, 69 people with gout were recruited through primary care providers in three locations across New Zealand. Nine semi-structured focus groups were run with Māori and Pākehā participants in separate groups. RESULTS Thematic analysis yielded two themes in relation to gout education: (i) ‘Multiple sources of gout education’; and (ii) ‘Gaps in gout knowledge’. Participants received education from general practitioners, educational resources, family and friends, and their own experiences. Māori participants preferred information to be kanohi-ki-te-kanohi (face-to-face) and with significant others present where necessary. Participants disclosed gaps in gout’s epidemiology and management. Pākehā and Māori participants reported limited understanding of the genetic basis of gout or the biological underpinnings of the condition and its treatments, but learned treatment adherence through experience. DISCUSSION Despite improved gout patient education, knowledge gaps remain and may contribute to poor medication adherence. Gout patient education interventions need to be tailored to culture and incorporate suitable methods of disseminating information about gout management.

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