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Dommershuijsen LJ, Dedding CWM, Van Bruchem-Visser RL. Consultation Recording: What Is the Added Value for Patients Aged 50 Years and Over? A Systematic Review. HEALTH COMMUNICATION 2021; 36:168-178. [PMID: 31556750 DOI: 10.1080/10410236.2019.1669270] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This systematic review aimed to provide medical professionals with insight into beneficial and harmful effects of consultation recording for patients aged 50 years and over. This insight could enable medical professionals to decide on whether or not to promote consultation recording in their practice. The systematic literature search was performed in six databases; additional relevant articles were sought using the snowball method. Studies were included that investigated the value of consultation recording for patients aged 50 years and over. The selected studies were analyzed on affective cognitive outcomes, behavioral outcomes, and health outcomes. Twenty-five studies of both qualitative and quantitative design were included. Consultation recordings mainly improved patient satisfaction, recall, fulfillment of information needs, and decision-making. Both positive and negative effects were reported on anxiety. The recordings did not distinctly affect functional outcomes or quality of life. In conclusion, consultation recording positively influenced patients' affective cognitive and behavioral outcomes, and the negative effects of consultation recording were minor. Because of the positive effects of consultation replay, we recommend that doctors promote consultation recording among their patients of 50 years and over. However, more studies are necessary among older patients because this patient population is underrepresented in the current literature.
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Fernandes DT, Prado-Ribeiro AC, Markman RL, Morais K, Moutinho K, Tonaki JO, Brandão TB, Rivera C, Santos-Silva AR, Lopes MA. The impact of an educational video about radiotherapy and its toxicities in head and neck cancer patients. Evaluation of patients' understanding, anxiety, depression, and quality of life. Oral Oncol 2020; 106:104712. [PMID: 32305650 DOI: 10.1016/j.oraloncology.2020.104712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 02/21/2020] [Accepted: 04/08/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Head and neck radiotherapy can cause several toxicities, and its management has important treatment implications. Proper information about treatment is crucial to assist patients by preparing them and enhancing their ability to manage their illness. Thus, this study aimed to verify the impact of an educational video on the improvement of the patient's understanding, satisfaction, quality of life, and influence on their emotional state in different moments of treatment. METHODS A 10 min video about head and neck radiotherapy and its toxicities was produced. A prospective randomized clinical trial was performed in two groups: a control group (n = 65), which received standard verbal and written information, and an experimental group (n = 65), which received standard information and the video. Appropriated questionnaires (HADS, UW-QOLv4, IRTU, and Post-RTU) were applied in four different moments in order to evaluate patients' understanding, anxiety, depression, and quality of life. RESULTS The video improved the understanding of treatment and its side effects. Also, the video group reported better awareness about oral health care during the treatment. Osteoradionecrosis and radiation-related caries were the most unknown side effects. On the other hand, the educational video did not modify the patients' anxiety, depression, and quality of life. All patients reported high satisfaction with the video. CONCLUSIONS Audiovisual tools may improve patients' understanding of radiotherapy and were shown to be a useful tool when used in association with verbal and written information in cancer centers. In addition, information about osteoradionecrosis and radiation-related caries must be reinforced to patients.
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Affiliation(s)
- Diego Tetzner Fernandes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Ana Carolina Prado-Ribeiro
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Renata Lucena Markman
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Karina Morais
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Karina Moutinho
- Department of Radiology and Oncology, Faculdade de Medicina, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Juliana Ono Tonaki
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Cesar Rivera
- Oral Pathology and Medicine Research Group, Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Chile
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil.
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Rieger KL, Hack TF, Beaver K, Schofield P. Should consultation recording use be a practice standard? A systematic review of the effectiveness and implementation of consultation recordings. Psychooncology 2017; 27:1121-1128. [PMID: 29178602 DOI: 10.1002/pon.4592] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/20/2017] [Accepted: 11/10/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To conduct a systematic review of the effectiveness of consultation recordings and identify factors contributing to their successful implementation in health-care settings. METHODS A systematic review was conducted for quantitative studies examining the effectiveness of consultation recordings in health care. Two independent reviewers assessed the relevance and quality of retrieved quantitative studies by using standardized criteria. Study findings were examined to determine consultation recording effectiveness and to identify barriers and facilitators to implementation. A supplementary review of qualitative evidence was performed to further explicate implementation factors. RESULTS Of the 3373 articles retrieved in the quantitative search, 26 satisfied the standardized inclusion criteria (12 randomized controlled trials, 1 quasi-experiment, and 13 cross-sectional studies). Most patients found consultation recordings beneficial. Statistically significant evidentiary support was found for the beneficial impact of consultation recordings on the following patient reported outcomes: knowledge, perception of being informed, information recall, decision-making factors, anxiety, and depression. Implementation barriers included strength of evidence concerns, patient distress, impact of the recording on consultation quality, clinic procedures, medico-legal issues, and resource costs. Facilitators included comfort with being recorded, clinical champions, legal strategies, efficient recording procedures, and a positive consultation recording experience. CONCLUSIONS Consultation recordings are valuable to patients and positively associated with patient-reported outcomes. Successful integration of consultation recording use into clinical practice requires an administratively supported, systematic approach to addressing implementation factors.
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Affiliation(s)
- Kendra L Rieger
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,Psychosocial Oncology and Cancer Nursing Research, I.H. Asper Clinical Research Institute, Winnipeg, Canada.,Research Institute in Oncology and Hematology at Cancer Care Manitoba, Winnipeg, Manitoba, Canada.,School of Health Sciences, University of Central Lancashire, Preston, UK
| | - Kinta Beaver
- School of Health Sciences, University of Central Lancashire, Preston, UK
| | - Penelope Schofield
- Department of Psychology, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Australia.,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
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Barr PJ, Dannenberg MD, Ganoe CH, Haslett W, Faill R, Hassanpour S, Das A, Arend R, Masel MC, Piper S, Reicher H, Ryan J, Elwyn G. Sharing Annotated Audio Recordings of Clinic Visits With Patients-Development of the Open Recording Automated Logging System (ORALS): Study Protocol. JMIR Res Protoc 2017; 6:e121. [PMID: 28684387 PMCID: PMC5519830 DOI: 10.2196/resprot.7735] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/22/2017] [Accepted: 05/23/2017] [Indexed: 01/10/2023] Open
Abstract
Background Providing patients with recordings of their clinic visits enhances patient and family engagement, yet few organizations routinely offer recordings. Challenges exist for organizations and patients, including data safety and navigating lengthy recordings. A secure system that allows patients to easily navigate recordings may be a solution. Objective The aim of this project is to develop and test an interoperable system to facilitate routine recording, the Open Recording Automated Logging System (ORALS), with the aim of increasing patient and family engagement. ORALS will consist of (1) technically proficient software using automated machine learning technology to enable accurate and automatic tagging of in-clinic audio recordings (tagging involves identifying elements of the clinic visit most important to patients [eg, treatment plan] on the recording) and (2) a secure, easy-to-use Web interface enabling the upload and accurate linkage of recordings to patients, which can be accessed at home. Methods We will use a mixed methods approach to develop and formatively test ORALS in 4 iterative stages: case study of pioneer clinics where recordings are currently offered to patients, ORALS design and user experience testing, ORALS software and user interface development, and rapid cycle testing of ORALS in a primary care clinic, assessing impact on patient and family engagement. Dartmouth’s Informatics Collaboratory for Design, Development and Dissemination team, patients, patient partners, caregivers, and clinicians will assist in developing ORALS. Results We will implement a publication plan that includes a final project report and articles for peer-reviewed journals. In addition to this work, we will regularly report on our progress using popular relevant Tweet chats and online using our website, www.openrecordings.org. We will disseminate our work at relevant conferences (eg, Academy Health, Health Datapalooza, and the Institute for Healthcare Improvement Quality Forums). Finally, Iora Health, a US-wide network of primary care practices (www.iorahealth.com), has indicated a willingness to implement ORALS on a larger scale upon completion of this development project. Conclusions Upon the completion of this project we will have developed a novel recording system that will be ready for large-scale testing. Our long-term goal is for ORALS to seamlessly fit into a clinic’s and patient’s daily routine, increasing levels of patient engagement and transparency of care.
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Affiliation(s)
- Paul J Barr
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Michelle D Dannenberg
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Craig H Ganoe
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - William Haslett
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Rebecca Faill
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Saeed Hassanpour
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.,Department of Computer Science, Dartmouth College, Hanover, NH, United States.,Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Amar Das
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.,Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | | | - Meredith C Masel
- Oliver Center for Patient Safety and Quality Healthcare, University of Texas Medical Branch, Galveston, TX, United States
| | | | | | - James Ryan
- Ryan Family Practice, Ludington, MI, United States
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
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Obtel M, Berraho M, Abda N, Quessar A, Zidouh A, Bekkali R, Nejjari C. Factors Associated with Delayed Diagnosis of Lymphomas: Experience with Patients from Hematology Centers in Morocco. Asian Pac J Cancer Prev 2017; 18:1603-1610. [PMID: 28669176 PMCID: PMC6373802 DOI: 10.22034/apjcp.2017.18.6.1603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Moroccan cancer patients usually have to go through several steps before they are diagnosed. It
is important to assess factors associated with diagnosis delay for lymphomas, which might have significant effects
on survival. The aim of this study was to determine factors leading to late diagnosis of lymphomas. Methods: A
cross-sectional study was conducted with three hematology centers in Morocco in 2008, to analyze the impact of
sociodemographic and clinical factors on delay-time from symptoms to diagnosis. Results: A total of 151 patients were
included in the study. Late delay was significantly associated with gender, (for men compared to women: OR=2.46; 95%
CI: 1.06-5.74), to marital status (not married: OR=2.50; 95% CI: 1.06-5.92) and low socioeconomic level (OR=5.82;
95% CI: 2.23-15.17). Late medical delay was significantly associated with having three or more medical visits before
diagnosis (Adjusted OR=5.67; 95% CI: 2.55-12.59). Late total delay was observed for patients with three children or less
(adjusted OR=4.39; 95% CI: 1.32-14.56), those who were non-married (adjusted OR=2.49; 95% CI: 1.07-5.81), had a
non Hodgkin’s lymphoma (Adjusted OR=2.08; 95% CI: 1.06-4.00) or featuring three or more medical visits before the
diagnosis (Adjusted OR=2.13; 95% CI: 0.99-5.88). Conclusion: This analysis provides a basis for understanding the
sources, extent, and root causes of lymphoma diagnostic delays. The findings appear crucial for system-wide interventions
aimed to facilitate clinical management of patients with lymphoma and to improve prognosis and quality of life.
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Affiliation(s)
- Majdouline Obtel
- Laboratory of Community Health, Clinical Research and et Epidemiology; Department of Public Health, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.,Laboratory of Biostatistics, Clinical Research and et Epidemiology; Department of Public Health, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.
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Naehrig DN, Koh ES, Vogiatzis M, Yanagisawa W, Kwong C, Shepherd HL, Milross C, Dhillon HM. Impact of cognitive function on communication in patients with primary or secondary brain tumours. J Neurooncol 2016; 126:299-307. [PMID: 26498590 DOI: 10.1007/s11060-015-1964-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 10/19/2015] [Indexed: 11/12/2022]
Abstract
Communication support tools (CST) improve patient outcomes in oncology including: knowledge, satisfaction, self-management, and adherence to planned treatment. Little is known about communication support tools use in patients with primary or secondary brain tumours. We aimed to explore cognitive function and communication support tool use in this population. This prospective survey involved patients, caregivers and health professionals. Questionnaires were completed after initial brain radiotherapy consultation and 1-2 weeks later. Patients completed the Montreal Cognitive Assessment (MoCA). Descriptive statistics are reported. Fifty-three patients participated, median age 62 years, ECOG status 0-2 (90 %), with 75 % having secondary brain metastasis. 21/53 (40 %) patients reported needing help reading medical information. Only 28 % patients had normal cognition (MoCA score ≥ 26/30). Initially, 82 % of patients and 87 % of caregivers reported the consultation was 'extremely/quite clear, and 69 % of their health professionals thought consultation 'extremely/quite clear' to patient. At follow-up, fewer patients (75 %) reported health professionals' explanation as 'extremely/quite clear'. Although patients recalled discussed illness and treatment details, 82 % recalled treatment-related side effects and management thereof by 46 %. CST use was reported by 22 % patients, 19 % caregivers, and 27 %health professionals. When used, tools improved understanding according to 92 % patients, 100 % caregivers, and 91 % health professionals. The majority of patients have some level of cognitive impairment. Information discussed appears clear to most patients, but this is not sustained, and recall of treatment toxicity management is poor. Few CSTs are used in consultations, but when used, are reported as helpful by all.
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7
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Benson K, Nanan R. Recording consultations: a win-win situation for physicians and patients. Med J Aust 2016; 204:175-6. [PMID: 26985839 DOI: 10.5694/mja15.00750] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 12/08/2015] [Indexed: 11/17/2022]
Affiliation(s)
| | - Ralph Nanan
- Charles Perkins Centre, University of Sydney, Sydney, NSW
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8
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Bergenmar M, Johansson H, Wilking N, Hatschek T, Brandberg Y. Audio-recorded information to patients considering participation in cancer clinical trials - a randomized study. Acta Oncol 2014; 53:1197-204. [PMID: 24909376 DOI: 10.3109/0284186x.2014.921726] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Patient information in cancer clinical trial is challenging. The value of audio-recording interventions for patients considering participating in clinical trials is unclear. The primary aim of this randomized study was to investigate effects of audio-recorded information on knowledge and understanding in patients considering participation in a clinical trial. MATERIAL AND METHODS Patients scheduled for information about a phases 2 or 3 trial by one of the 13 participating oncologists at the Department of Oncology during the study period (2008-2013) were eligible. The intervention consisted of an audio-recording on compact disc (CD) of the information at the medical consultation in which the patients were informed about a trial. Knowledge and understanding was measured by the questionnaire, Quality of Informed Consent. RESULTS A total of 130 patients were randomized, 70% of the calculated sample size (n = 186). Sixty-seven patients were randomized to the intervention. In total, 101 patients (78%) completed questionnaires. No statistical significant differences were found between the groups with respect to knowledge and understanding. The level of knowledge was relatively high, with the exceptions of the risks associated with, and the unproven nature of, the trial. Overall, patients who declined participation scored statistically significant lower on knowledge. CONCLUSION The present study was underpowered and the results should therefore be interpreted with caution. Still, 130 patients were included with a response rate of 78%. A CD including the oral information about a clinical trial did not show any effects on knowledge or understanding. However, the levels of knowledge were high, possible due to the high levels of education in the study group. Information on risks associated with the trial is still an area for improvement.
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Affiliation(s)
- Mia Bergenmar
- Department of Oncology, Karolinska University Hospital , Stockholm , Sweden
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9
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Tsulukidze M, Durand MA, Barr PJ, Mead T, Elwyn G. Providing recording of clinical consultation to patients - a highly valued but underutilized intervention: a scoping review. PATIENT EDUCATION AND COUNSELING 2014; 95:297-304. [PMID: 24630697 DOI: 10.1016/j.pec.2014.02.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 02/09/2014] [Accepted: 02/23/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The benefits of providing patients with recorded clinical consultations have been mostly investigated in oncology settings, generally demonstrating positive outcomes. There has been limited synthesis of evidence about the practice in wider context. Our aim was to summarize, in a scoping review, the evidence about providing consultation recordings to patients. METHODS We searched seven literature databases. Full text articles meeting the inclusion criteria were retrieved and reviewed. Arksey and O'Malley's framework for scoping studies guided the review process and thematic analysis was undertaken to synthesize extracted data. RESULTS Of 5492 abstracts, 33 studies met the inclusion criteria. Between 53.6% and 100% (72% weighted average) of patients listened to recorded consultations. In 60% of reviewed studies patients shared the audio-recordings with others. Six themes identified in the study provided evidence for enhanced information recall and understanding by patients, and positive reactions to receiving recorded consultations. There has been limited investigation into the views of providers and organizations. Medico-legal concerns have been reported. CONCLUSION Patients place a high value on receiving audio-recordings of clinical consultations and majority benefit from listening to consultation recordings. PRACTICE IMPLICATIONS Further investigation of the ethical, practical and medico-legal implications of routinely providing recorded consultations is needed.
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Affiliation(s)
- Maka Tsulukidze
- The Dartmouth Center for Health Care Delivery Science, Dartmouth College, USA
| | | | - Paul J Barr
- The Dartmouth Center for Health Care Delivery Science, Dartmouth College, USA
| | - Thomas Mead
- Biomedical Libraries, Dartmouth College, USA
| | - Glyn Elwyn
- The Dartmouth Center for Health Care Delivery Science, Dartmouth College, USA; The Cochrane Institute for Primary Care and Public Health, Cardiff University, UK.
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10
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González-Arriagada WA, de Andrade MAC, Ramos LMA, Bezerra JRS, Santos-Silva AR, Lopes MA. Evaluation of an educational video to improve the understanding of radiotherapy side effects in head and neck cancer patients. Support Care Cancer 2013; 21:2007-15. [DOI: 10.1007/s00520-013-1730-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 01/28/2013] [Indexed: 11/28/2022]
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Recordings of consultations are beneficial in the transition from curative to palliative cancer care: A pilot-study in patients with oesophageal or head and neck cancer. Eur J Oncol Nurs 2012; 16:109-14. [DOI: 10.1016/j.ejon.2011.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2010] [Revised: 04/03/2011] [Accepted: 04/12/2011] [Indexed: 11/18/2022]
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Dimoska A, Butow PN, Lynch J, Hovey E, Agar M, Beale P, Tattersall MHN. Implementing patient question-prompt lists into routine cancer care. PATIENT EDUCATION AND COUNSELING 2012; 86:252-258. [PMID: 21741195 DOI: 10.1016/j.pec.2011.04.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Revised: 04/06/2011] [Accepted: 04/08/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To examine the feasibility and acceptability of routine provision of patient question prompt lists (QPLs) to promote patient participation and patient-clinician communication in medical consultations. METHODS Four cancer centres across NSW, Australia (two rural, two urban) were invited to participate, involving distribution of QPLs to patients seeing a medical or radiation oncologist, or palliative care clinician. Patients rated their satisfaction after their next consultation. Cancer specialists provided their views at the end of the study. RESULTS Sixty-four percent (389/606) of patients attending consultations received a QPL. Of patients offered a QPL (426), 91% accepted. Of 139 patients surveyed post-consultation, 89% reported reading the QPL and, of these, 44% referred to the QPL during the consultation at least once. All of 10 cancer specialists providing their views post-implementation reported that QPL implementation in routine practice was feasible and did not strain resources. CONCLUSIONS Cancer patients and cancer specialists showed support for routine dissemination of the QPL. PRACTICE IMPLICATIONS For successful implementation of evidence-based tools we recommend promotion by local clinical champions, negotiation with clinic staff about dissemination methods, raised patient awareness through on-site project facilitators, media, consumer and support groups, and availability of resources in hard copy and via online sources.
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Affiliation(s)
- Aneta Dimoska
- Centre for Medical Psychology and Evidence-based Medicine (CeMPED), School of Psychology, University of Sydney, NSW, Australia
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13
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McCormack LA, Treiman K, Rupert D, Williams-Piehota P, Nadler E, Arora NK, Lawrence W, Street RL. Measuring patient-centered communication in cancer care: a literature review and the development of a systematic approach. Soc Sci Med 2011; 72:1085-95. [PMID: 21376443 DOI: 10.1016/j.socscimed.2011.01.020] [Citation(s) in RCA: 215] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 11/07/2010] [Accepted: 01/15/2011] [Indexed: 11/19/2022]
Abstract
Patient-centered communication (PCC) is a critical element of patient-centered care, which the Institute of Medicine (Committee on Quality of Health Care in America, 2001) promulgates as essential to improving healthcare delivery. Consequently, the US National Cancer Institute's Strategic Plan for Leading the Nation (2006) calls for assessing the delivery of PCC in cancer care. However, no comprehensive measure of PCC exists, and stakeholders continue to embrace different conceptualizations and assumptions about how to measure it. Our approach was grounded in the PCC conceptual framework presented in a recent US National Cancer Institute monograph (Epstein & Street, 2007). In this study, we developed a comprehensive inventory of domains and subdomains for PCC by reviewing relevant literature and theories, interviewing a limited number of cancer patients, and consulting experts. The resulting measurement domains are organized under the six core functions specified in the PCC conceptual framework: exchanging information, fostering healing relationships, recognizing and responding to emotions, managing uncertainty, making decisions, and enabling patient self-management. These domains represent a promising platform for operationalizing the complicated PCC construct. Although this study focused specifically on cancer care, the PCC measurements are relevant to other clinical contexts and illnesses, given that patient-centered care is a goal across all healthcare. Finally, we discuss considerations for developing PCC measures for research, quality assessment, and surveillance purposes. United States Department of Health and Human Services, National Institutes of Health, National Cancer Institute (2006). The NCI Strategic Plan for Leading the Nation: To Eliminate the Suffering and Death Due to Cancer. NIH Publication No. 06-5773.
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Affiliation(s)
- Lauren A McCormack
- Health Communication Program, RTI International, 3040 Cornwallis Road, RTP, NC 27709, USA.
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Alexander SC, Sullivan AM, Back AL, Tulsky JA, Goldman RE, Block SD, Stewart SK, Wilson-Genderson M, Lee SJ. Information giving and receiving in hematological malignancy consultations. Psychooncology 2011; 21:297-306. [PMID: 21294221 DOI: 10.1002/pon.1891] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 11/05/2010] [Accepted: 11/12/2010] [Indexed: 11/12/2022]
Abstract
PURPOSE Little is known about communication with patients suffering from hematologic malignancies, many of whom are seen by subspecialists in consultation at tertiary-care centers. These subspecialized consultations might provide the best examples of optimal physician-patient communication behaviors, given that these consultations tend to be lengthy, to occur between individuals who have not met before and may have no intention of an ongoing relationship, and which have a goal of providing treatment recommendations. The aim of this paper is to describe and quantify the content of the subspecialty consultation in regards to exchanging information and identify patient and provider characteristics associated with discussion elements. METHODS Audio-recorded consultations between 236 patients and 40 hematologists were coded for recommended communication practices. Multilevel models for dichotomous outcomes were created to test associations between patient, physician and consultation characteristics and key discussion elements. RESULTS Discussions about the purpose of the visit and patient's knowledge about their disease were common. Other elements such as patient's preference for his/her role in decision-making, preferences for information, or understanding of presented information were less common. Treatment recommendations were provided in 97% of the consultations and unambiguous presentations of prognosis occurred in 81% of the consultations. Unambiguous presentations of prognosis were associated with non-White patient race, lower educational status, greater number of questions asked, and specific physician provider. CONCLUSION Although some communication behaviors occur in most consultations, others are much less common and could help tailor the amount and type of information discussed. Approximately half of the patients are told unambiguous prognostic estimates for mortality or cure.
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Affiliation(s)
- Stewart C Alexander
- Center for Health Services Research, Durham VA Medical Center, Durham, NC, USA.
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Rushmer R, Themessel-Huber M, Coyle J, Humphris G, Dowell J, Williams B. Is the routine recording of primary care consultations possible … and desirable? Lessons for researchers from a consultation with multiple stakeholders. PATIENT EDUCATION AND COUNSELING 2011; 82:247-253. [PMID: 20547028 DOI: 10.1016/j.pec.2010.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 04/08/2010] [Accepted: 04/22/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To explore stakeholders' attitudes towards routine, longitudinal recording of primary care consultations for research purposes, and to identify legal, ethical, and practical barriers and facilitators. METHODS 183 stakeholders (including patients, researchers and practice staff) were identified using a purposeful sampling strategy. Stakeholders participated in focus groups and interviews. The data was analysed thematically in an iterative manner with themes and questions from earlier discussions being raised with later participants. RESULTS Most participants supported the creation of a database and believed it would benefit patient care. They suggested it could be used to train doctors, aid understanding of conditions, and feed information back to practices to improve performance. However, enthusiasm was tempered by concerns about the ownership security and access of the data; quality and limitations of the dataset; impact on behaviour; and workload. Safeguards were suggested that protected vulnerable individuals, enabled participation, gave control to participants, and clarified data use. CONCLUSION The findings show that collecting such longitudinal data is possible, valuable and acceptable providing certain safeguards are in place. PRACTICE IMPLICATIONS Future studies employing routine recordings of consultations should: Attend to confidentiality, access and governance of the archive. Collect quality data, and store it securely.
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Affiliation(s)
- Rosemary Rushmer
- Centre for Public Policy and Health, School of Medicine and Health, Wolfson Research Institute, University of Durham, Stockton-on-Tees, UK.
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Does dictating the letter to the GP in front of a follow-up patient improve satisfaction with the consult? A randomised controlled trial. Eur Arch Otorhinolaryngol 2009; 267:619-23. [PMID: 19562361 DOI: 10.1007/s00405-009-1020-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Accepted: 06/10/2009] [Indexed: 10/20/2022]
Abstract
Various studies have shown that receiving a copy of the letter to the General Practitioner (GP) improves patient satisfaction with the consult. We aimed to establish whether dictating the letter to the GP in front of a listening patient does likewise. Follow-up patients have shorter allotted consultation times. This may contribute to dissatisfaction, hence the choice of our target group. One hundred consecutive follow-up patients who met the eligibility criteria were randomised to listen to the GP letter or not. Immediately after the consult, they were asked to fill in a questionnaire which, in addition to enquiring about various aspects of the consult asked them to quantify their overall satisfaction by means of a ten-point graded visual analogue score. Forty-nine patients received dictation. The mean age and sex distribution of the two groups were matched. The median overall satisfaction in the dictation and non-dictation groups were ten and eight, respectively, this was statistically significant. There was no significant difference between patients' rating of whether the consult had addressed their ailment adequately, explanation(s) given or the length of consult. Sixty-one percent of patients in the non-dictation group would like to have listened to the dictation, whilst all patients in the dictation group found it useful. This study is the first of its kind in the ENT population. Dictating a letter to the GP in front of a listening patient led to a statistically significant improvement in satisfaction independent of possible confounding aspects of the consult.
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Fagerlind H, Lindblad ÅK, Bergström I, Nilsson M, Nauclér G, Glimelius B, Ring L. Patient-physician communication during oncology consultations. Psychooncology 2008; 17:975-85. [DOI: 10.1002/pon.1410] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
BACKGROUND Many people find it difficult to remember information provided during medical consultations. One way of improving this may be to provide a record of the conversation. OBJECTIVES This review examined the effects of providing recordings or summaries of their consultations to people with cancer and their families. SEARCH STRATEGY We searched the following sources: The Cochrane Library (issue 2 2007); MEDLINE (1966 to 29 May 2007); CINAHL (1982 to 29 May 2007); Dissertation Abstracts (1861 to 29 May 2007; Index to Theses 29 May 2007; EMBASE (1985 to 29 May 2007); PsycINFO (1967 to 29 May 2007); AMED (1985 to 29 May 2007); British Nursing Index (1985 to May 2007); SCI-EXPANDED, SSCI (1986 to 3 June 2007); and Sociological Abstracts (1998 to 29 May 2007). For the initial (1999) publication of this review we also searched the following databases: Sociofile; Cancerlit; IAC Health & Wellness; JICST; Pascal; ERIC; ASSIA; Linguistics and Language Behavior Abstracts; Mental Health Abstracts; CAB Health; DHSS-Data; MANTIS. SELECTION CRITERIA Randomised and quasi-randomised controlled trials that evaluate the effects of providing recordings (for example, audiotapes) or summaries (for example, a letter with reminders of key points) of consultations to people with cancer or their families. DATA COLLECTION AND ANALYSIS Two authors assessed studies for inclusion. Data were extracted by one author and checked by another author. We assessed study quality on seven criteria. We used a systematic approach to data extraction to produce a descriptive summary of studies, and present a narrative synthesis of the results. MAIN RESULTS We included sixteen controlled trials involving 2318 adult participants. The studies measured diverse outcomes. Many of the participants found recordings or summaries of their consultations valuable, with between 60% and 100% of participants (across twelve studies) reading the summary or listening to the recording at least once. The recordings were used to help inform family and friends (range 41.5% to 94.4% of participants in nine studies). Five out of nine studies reported better recall of information for those receiving recordings or summaries. Three out of ten studies found that participants provided with a recording or summary were more satisfied. No studies (out of ten) found any statistically significant difference between groups in terms of anxiety or depression. Three studies evaluated the effects on quality of life, but found no main effects. No study evaluated the intervention's effects on survival. AUTHORS' CONCLUSIONS The provision of recordings or summaries of key consultations may benefit most adults with cancer. Although more research is needed to improve our understanding of these interventions, most patients find them very useful. Practitioners should consider offering people recordings or written summaries of their consultations.
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Affiliation(s)
- Marie Pitkethly
- Tayside Centre for General Practice, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee, Tayside, UK, DD2 4BF.
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Themessl-Huber M, Humphris G, Dowell J, Macgillivray S, Rushmer R, Williams B. Audio-visual recording of patient-GP consultations for research purposes: a literature review on recruiting rates and strategies. PATIENT EDUCATION AND COUNSELING 2008; 71:157-168. [PMID: 18356003 DOI: 10.1016/j.pec.2008.01.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 01/16/2008] [Accepted: 01/17/2008] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To identify ethical processes and recruitment strategies, participation rates of studies using audio or video recording of primary health care consultations for research purposes, and the effect of recording on the behaviour, attitudes and feelings of participants. METHODS A structured literature review using Medline, Embase, Cochrane Library, and Psychinfo. This was followed by extensive hand search. RESULTS Recording consultations were regarded as ethically acceptable with some additional safeguards recommended. A range of sampling and recruitment strategies were identified although specific detail was often lacking. Non-participation rates in audio-recording studies ranged from 3 to 83% for patients and 7 to 84% for GPs; in video-recording studies they ranged from 0 to 83% for patients and 0 to 93% for GPs. There was little evidence to suggest that recording significantly affects patient or practitioner behaviour. CONCLUSIONS Research involving audio or video recording of consultations is both feasible and acceptable. More detailed reporting of the methodical characteristics of recruitment in the published literature is needed. PRACTICE IMPLICATIONS Researchers should consider the impact of diverse sampling and recruitment strategies on participation levels. Participants should be informed that there is little evidence that recording consultations negatively affects their content or the decisions made. Researchers should increase reporting of ethical and recruitment processes in order to facilitate future reviews and meta-analyses.
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Affiliation(s)
- Markus Themessl-Huber
- School of Nursing & Midwifery, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, UK.
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Barclay JS, Blackhall LJ, Tulsky JA. Communication Strategies and Cultural Issues in the Delivery of Bad News. J Palliat Med 2007; 10:958-77. [PMID: 17803420 DOI: 10.1089/jpm.2007.9929] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Good communication is a fundamental skill for all palliative care clinicians. Patients present with varied desires, beliefs, and cultural practices, and navigating these issues presents clinicians with unique challenges. This article provides an overview of the evidence for communication strategies in delivering bad news and discussing advance care planning. In addition, it reviews the literature regarding cultural aspects of care for terminally ill patients and their families and offers strategies for engaging them. Through good communication practices, clinicians can help to avoid conflict and understand patients' desires for end of life care.
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Affiliation(s)
- Joshua S Barclay
- Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27705-3860, USA.
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Gaston CM, Mitchell G. Information giving and decision-making in patients with advanced cancer: a systematic review. Soc Sci Med 2006; 61:2252-64. [PMID: 15922501 DOI: 10.1016/j.socscimed.2005.04.015] [Citation(s) in RCA: 247] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2004] [Accepted: 04/12/2005] [Indexed: 11/21/2022]
Abstract
Patients with advanced, non-curable cancer face difficult decisions on further treatment, where a small increase in survival time must be balanced against the toxicity of the treatment. If patients want to be involved in these decisions, in keeping with current notions of autonomy and empowerment, they also require to be adequately informed both on the treatments proposed and on their own disease status and prognosis. A systematic review was performed on decision-making and information provision in patients with advanced cancer. Studies of interventions to improve information giving and encourage participation in decision-making were reviewed, including both randomised controlled trials and uncontrolled studies. Almost all patients expressed a desire for full information, but only about two-thirds wished to participate actively in decision-making. Higher educational level, younger age and female sex were predictive of a desire to participate in decision-making. Active decision-making was more common in patients with certain cancers (e.g. breast) than others (e.g. prostate). A number of simple interventions including question prompt sheets, audio-taping of consultations and patient decision aids have been shown to facilitate such involvement.
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White P, Singleton A, Jones R. Copying referral letters to patients: the views of patients, patient representatives and doctors. PATIENT EDUCATION AND COUNSELING 2004; 55:94-98. [PMID: 15476995 DOI: 10.1016/j.pec.2003.08.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2003] [Accepted: 08/06/2003] [Indexed: 05/24/2023]
Abstract
To discover the views of patients, patient representatives and doctors on copying referral letters to patients. A three-part study: an analysis of 50 GP referral letters against a standard template; 35 patient interviews using a semi-structured questionnaire in outpatient waiting rooms; 3 focus groups of patients, patient representatives and doctors. There was general agreement that copying referral letters to patients could improve information and decision sharing with patients. Copying referral letters could provide an opportunity for patients to correct mistakes, prepare for their appointments and have a personal record that they could keep and show to others. However, there were concerns about letter content, particularly medical terminology, character judgements and "sensitive" patient information. It was also recognised that providing more information to patients could increase patient anxiety. The style and content of some referral letters may need to change. This is particularly relevant where certain types of information included in referral letters could cause distress for patients or influence the time that patients have to wait for their outpatient appointments.
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Affiliation(s)
- Philip White
- Guy's, King's & St. Thomas' School of Medicine, 70 Beauval Road, East Dulwich, London SE22 8UQ, UK.
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White P. Copying referral letters to patients: prepare for change. PATIENT EDUCATION AND COUNSELING 2004; 54:159-161. [PMID: 15288909 DOI: 10.1016/s0738-3991(03)00203-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2002] [Revised: 04/03/2003] [Accepted: 06/09/2003] [Indexed: 05/24/2023]
Abstract
The National Health Service (NHS) Plan for England has directed that from April 2004 clinicians will offer patients the opportunity to receive copies of letters that are written about them. Patients like to have more information and patients who have received copies of letters have found them useful. It is hoped that copying letters will improve relationships between doctors and patients, encourage patients to be better informed, and improve the quality of information provided to patients. Relatively little empirical research has been performed in this area but what exists is generally supportive. Attention will need to be paid to issues of confidentiality, the language and content of letters, and individuals who may have difficulty obtaining information from letters. This initiative is one of many that the NHS has introduced to enhance openness, honesty and the quality of information provided to patients.
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Affiliation(s)
- Philip White
- Department of General Practice and Primary Care, Guy's, King's and St. Thomas' School of Medicine, 5 Lambeth walk, London SE11 5SP, UK.
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Arnold RM, Kellum J. Moral justifications for surrogate decision making in the intensive care unit: implications and limitations. Crit Care Med 2003; 31:S347-53. [PMID: 12771581 DOI: 10.1097/01.ccm.0000065123.23736.12] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Because patients are often unable to participate in the end-of-life decision making, caregivers turn to close family members to participate in discussions regarding care in the intensive care unit. This article describes the moral justifications for families being given considerable decision-making authority. However, embedded within these justifications are also some limitations to surrogate decision making. Rather than attempt to dogmatically resolve these thorny cases regarding a surrogate's request for what healthcare providers believe are unreasonable requests, we believe more attention should be paid to how healthcare providers and intensive care units can promote a surrogate's ability to make ethical decisions. We end by offering a number of specific suggestions for improving communication with surrogates.
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Affiliation(s)
- Robert M Arnold
- Department of Medicine, University of Pittsburgh Cancer Institute, PA 15213, USA
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Scott JT, Harmsen M, Prictor MJ, Entwistle VA, Sowden AJ, Watt I. Recordings or summaries of consultations for people with cancer. Cochrane Database Syst Rev 2003:CD001539. [PMID: 12804411 DOI: 10.1002/14651858.cd001539] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Many people find it difficult to remember information provided during medical consultations. One way of improving this may be to provide a record of the conversation. OBJECTIVES This review examined the effects of providing recordings or summaries of their consultations to people with cancer and their families. SEARCH STRATEGY We searched the following sources: The Cochrane Library (issue 4 2002); MEDLINE (1966 to January week 1 2003); CINAHL (1982 to December week 4 2002); Dissertation Abstracts (1861 to week 2 2003); EMBASE (1985 to week 2 2003); PsycINFO (1967 to January week 2 2003); AMED (1985 to December 2002); and Sociological Abstracts (1998 to week 2 2003). For the initial (1999) publication of this review we also searched the following databases: Sociofile; Cancerlit; IAC Health & Wellness; JICST; Pascal; ERIC; ASSIA; Linguistics and Language Behavior Abstracts; Mental Health Abstracts; CAB Health; DHSS-Data; MANTIS. SELECTION CRITERIA Randomised and non-randomised controlled trials that evaluate the effects of providing recordings (e.g. audiotapes) or summaries (e.g. letter with reminders of key points) of consultations to people with cancer or their families. Two reviewers assessed studies for inclusion. DATA COLLECTION AND ANALYSIS Data were extracted by one reviewer and checked by another reviewer. The quality of studies was assessed on six criteria. MAIN RESULTS Twelve studies satisfied the selection criteria. All involved adult participants. The studies did not all measure similar outcomes. In seven studies, between 83% and 96% of participants found recordings or summaries of their consultations valuable. Five out of nine studies reported better recall of information for those receiving recordings or summaries. Four out of seven studies found that participants provided with a recording or summary were more satisfied with the information received. No studies (out of seven) found any statistically significant effect on anxiety or depression. One study evaluated the effects on quality of life, but found no main effects. No study evaluated the effects on survival. REVIEWER'S CONCLUSIONS The provision of recordings or summaries of key consultations may benefit most adults with cancer. Although more research is needed to improve our understanding of these interventions, most patients find them very useful. Practitioners should consider offering people tape recordings or written summaries of their consultations
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Affiliation(s)
- J T Scott
- School of Public Health, University of California, Berkeley, Warren Hall, Room 408, Berkeley, California 94707-7360, USA.
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Tattersall MHN, Butow PN. Consultation audio tapes: an underused cancer patient information aid and clinical research tool. Lancet Oncol 2002; 3:431-7. [PMID: 12142173 DOI: 10.1016/s1470-2045(02)00790-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Patients with cancer are known to value consultation audio tapes as an information aid and frequently accept the offer to tape record their consultations with oncologists. Systematic reviews have shown that providing patients with an audio tape of their consultations improves how much information they remember. In surveys, many Australian doctors were unenthusiastic about providing consultation audio tapes to patients citing issues such as patient confidentiality and medico-legal concerns as reasons for their reluctance. In addition to clinical benefits, consultation audio tapes are a valuable research tool for documenting information provision and analysing the interactions between patients and oncologists. For example, audio tapes of clinical-trial consultations have raised concerns about the quality of informed consent given by patients. Consultation audio tapes have also been used to monitor strategies for improving patient understanding. In three randomised trials, provision of a question prompt sheet significantly increased the number of questions asked by patients about their prognosis, suggesting that this topic was not generally discussed adequately. Oncologists should consider installing audiotaping facilities and offer all patients a tape of their consultation. Furthermore, scientists who investigate doctor-patient interactions should consider using consultation audio tapes as a research tool.
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Tattersall MHN, Butow PN, Clayton JM. Insights from cancer patient communication research. Hematol Oncol Clin North Am 2002; 16:731-43. [PMID: 12170578 DOI: 10.1016/s0889-8588(02)00022-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Good communication skills are essential for all aspects of patient care in a palliative setting. A considerable body of evidence has accrued in the general oncology literature concerning doctor-patient and doctor-doctor communication. Many of the models and methods explored in the oncology setting may be applied usefully to palliative care; however palliative care is unique in some aspects and has its own particular challenges. Further evidence is needed to guide palliative care and other health care professionals in communicating effectively and sensitively with palliative care patients while holding a balance between telling the truth and maintaining hope.
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Affiliation(s)
- Martin H N Tattersall
- Department of Cancer Medicine, Blackburn Building, DO6, University of Sydney, NSW 2006, Australia.
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