Studies analysing the need for health-related information in Germany - a systematic review

Patients' preferences in therapeutic decision-making in digestive oncology: a single centre cross-sectional observational study

Considering the preferences in Shared Decision Making (SDM) of patients with Digestive Cancer (DC) is crucial to ensure the quality of care. To date, there is limited information on preferences in SDM of patients with DC. The objectives of this study were to describe digestive cancer patients' preference for involvement in therapeutic decision-making and to identify variables associated with these preferences. An observational prospective study in a French university cancer center has been conducted. Patients completed two questionnaires to qualify and quantify their preference for involvement in therapeutic decision-making: the Control Preference Scale (CPS) and the Autonomy Preference Index (API), which is composed of the Decision Making (DM) score and the Information Seeking (IS) score. Associations between these scores and socio-demographic data, disease-related data, coping strategies (Brief-COPE), physical (QLQ-C30) and psychological (HADS) quality of life were tested. One-hundred fifteen patients returned the questionnaires. The majority of patients reported a passive (49.1%) or a collaborative (43.0%) CPS status. The mean DM score was 39.4 Variables associated with decision-making preferences were occupational status and time since diagnosis. The identification of variables associated with patients' preferences for involvement in decision-making can help make clinicians aware of patients' needs and wishes. However, it can only be determined by interviewing the patient individually.

Hospitalization of German and Dutch Nursing Home Residents Depend on Different Long-Term Care Structures: A Systematic Review on Periods of Increased Vulnerability

OBJECTIVE

To investigate proportions of hospitalized nursing home residents during periods of increased vulnerability, ie, the first 6 months after institutionalization and the last 6 months before death, and comparing the figures between Germany and the Netherlands.

DESIGN

Systematic review, registered in PROSPERO (CRD42022312506).

SETTING AND PARTICIPANTS

Newly admitted or deceased residents.

METHODS

We searched MEDLINE via PubMed, EMBASE, and CINAHL from inception through May 3, 2022. We included all observational studies that reported the proportions of all-cause hospitalizations among German or Dutch nursing home residents during these defined vulnerable periods. Study quality was assessed using the Joanna Briggs Institute's tool. We assessed study and resident characteristics and outcome information and descriptively reported them separately for both countries.

RESULTS

We screened 1856 records for eligibility and included 9 studies published in 14 articles (Germany: 8; Netherlands: 6). One study for each country investigated the first 6 months after institutionalization. A total of 10.2% of the Dutch and 42.0% of the German nursing home residents were hospitalized during this time. Overall, 7 studies reported on in-hospital deaths, with proportions ranging from 28.9% to 29.5% for Germany and from 1.0% to 16.3% for the Netherlands. Proportions for hospitalization in the last 30 days of life ranged from 8.0% to 15.7% (Netherlands: n = 2) and from 48.6% to 58.0% (Germany: n = 3). Only German studies assessed the differences by age and sex. Although hospitalizations were less common at older ages, they were more frequent in male residents.

CONCLUSIONS AND IMPLICATIONS

During the observed periods, the proportion of nursing homes residents being hospitalized differed greatly between Germany and the Netherlands. The higher figures for Germany can probably be explained by differences in the long-term care systems. There is a lack of research, especially for the first months after institutionalization, and future studies should examine the care processes of nursing home residents following acute events in more detail.

Usage of Complementary and Alternative Methods, Lifestyle, and Psychological Variables in Cancer Care

BACKGROUND/AIM

People who are undergoing cancer treatment often ask themselves what they can do in addition to conventional medical therapy with regard to nutrition, activity, and complementary methods. However, we know little about the motivation why people opt for one or the other measure. The aim of this study was therefore to examine the extent of physical activity (PA), healthy nutrition, and the use of complementary methods in relation to both demographic and psychological data.

MATERIALS AND METHODS

A questionnaire was used to collect data on demographic data, resilience, coherence, self-efficacy, spirituality, satisfaction, and complementary and alternative medicine (CAM) behavior, PA, and diet. Between March and July 2021, data from 446 patients were collected. Regression models and correlation analyzes were used to examine the associations between CAM use, diet and PA with the other variables surveyed.

RESULTS

CAM usage could only be predicted based on the patient's spirituality. Women used CAM more often and ate more healthily. Healthy eating was also related to younger age, shorter medical history, resilience, satisfaction, and coherence. In addition, the results showed that daily PA was related to the level of resilience, spirituality, and self-efficacy.

CONCLUSION

Which people or why patients use CAM remains a question to be further investigated. Our data suggest that CAM seeks to address similar needs that others find in spirituality. In order to promote a healthy diet and PA in cancer patients in the future, various psychological variables seem conceivable. Resilience stands out, which is related to an overall healthier lifestyle.

Informational needs of individuals from families harboring BRCA pathogenic variants: A systematic review and content analysis

PURPOSE

Personalized information is paramount to patient-centered communication and decision-making regarding risk management in hereditary cancer syndromes. This systematic review identified information needs of individuals from families harboring BRCA pathogenic variants and compared findings based on gender (women vs men) and clinical characteristics (patients with cancer vs previvors and BRCA heterozygotes vs untested relatives).

METHODS

We screened 8115 studies identified from databases and citation searching. The quality of selected studies was assessed using the Mixed Methods Appraisal Tool. Narrative synthesis was conducted based on content analysis.

RESULTS

From 18 selected studies including 1063 individuals, we identified 9 categories of information needs. Risk of bias in the selected studies was moderate. Men, untested relatives, and racial and ethnic minorities were underrepresented. Frequently required information was personalized cancer risk and risk-reducing strategies, including decision-making, family implications of hereditary cancers, psychological issues, and cascade testing. Subgroup analyses showed that information needs depended on gender, personal cancer history, and cascade testing in relatives.

CONCLUSION

We identified comprehensive and detailed informational needs of individuals from families harboring BRCA pathogenic variants and gaps in international guidelines. Needs for personalized information varied based on gender, health, and genetic testing status. Findings of this study have implications for genetic counseling, tailoring educational materials, and personalizing interventions.

Knowledge of HbA1c and LDL-C treatment goals, subjective level of disease-related information and information needs in patients with atherosclerotic cardiovascular disease

BACKGROUND/HYPOTHESIS

Risk factor control of diabetes mellitus (DM) and especially dyslipidemia remains unsatisfactory in patients with atherosclerotic cardiovascular disease (ASCVD). We aimed to analyze the knowledge of low-density lipoprotein cholesterol (LDL-C) and glycated hemoglobin (HbA1c) treatment goals, subjective level of information, and information needs in very high-risk patients with ASCVD.

METHODS

ASCVD patients (n = 210; 75 ± 9 years; 71.4% male; 89.5% coronary disease) with DM (96.7% type 2) completed a questionnaire assessing knowledge of HbA1c and LDL-C treatment goals and subjective level of information and information needs on disease-related topics of DM and ASCVD. Serum LDL-C and HbA1c were measured.

RESULTS

HbA1c goal (<7.0% in 60.6%) was attained more frequently than LDL-C goal (<70 mg/dl in 39.9%; p < .01). Significantly more participants named the correct goal for HbA1c compared to LDL-C (52.9% vs. 2.4%; p < .01). Subjective levels of information were higher and information needs were lower for DM than for ASCVD (p < .01 for all topics). No associations of knowledge of treatment goals and level of information with the attainment of treatment goals for HbA1c and LDL-C were found. However, in multivariate regression, higher levels of education were associated with knowledge of treatment goals (HbA1c: odds ratio [OR] 1.32, 95% confidence interval [CI] 1.01-1.72, p = .04; LDL-C: OR 2.32, 95% CI 1.07-5.03; p = .03).

CONCLUSION

In very high-risk patients with ASCVD, a deficit of knowledge of treatment goals to control dyslipidemia exists when compared to DM, patients felt significantly better informed for topics of DM than for ASCVD and display higher information needs for topics of ASCVD.

Structured diabetes self-management education and its association with perceived diabetes knowledge, information, and disease distress: Results of a nationwide population-based study

OBJECTIVE

To evaluate, how participation in structured diabetes self-management education (DSME) programs is associated with perceived level of knowledge about diabetes, information needs, information sources and disease distress.

METHODS

We included 796 ever- and 277 never-DSME participants of the population-based survey "Disease knowledge and information needs - Diabetes mellitus (2017)" from Germany. Data on perceived level of diabetes knowledge (12 items), information needs (11 items), information sources (13 items) and disease distress (2 indices) were collected. Multiple logistic regression analyses were used to examine the association of DSME-participation with these outcomes.

RESULTS

DSME-participants showed a higher level of diabetes knowledge compared to never-DSME participants, particularly in aspects concerning diabetes in general (odds ratio 2.53; 95% confidence intervals 1.48-4.33), treatment (2.41; 1.36-4.26), acute complications (1.91; 1.07-3.41) and diabetes in everyday life (1.83; 1.04-3.22). DSME-participants showed higher information needs regarding late complications (1.51; 1.04-2.18) and acute complications (1.71; 1.71-2.48) than DSME never participants. DSME-participants more frequently consulted diabetologists (5.54; 3.56-8.60) and diabetes care specialists (5.62; 3.61-8.75) as information sources. DSME participation was not associated with disease distress.

CONCLUSION

DSME is a valuable tool for improving individual knowledge about diabetes. However, DSME should focus more on psychosocial aspects to reduce the disease burden.

Patient satisfaction, needs, and preferences concerning information dispensation at the emergency department: a cross-sectional observational study

Background

Patient satisfaction is an important indicator of emergency care quality and has been associated with information dispensation at the emergency department (ED). Optimal information dispensation could improve patient experience and expectations. Knowing what kind of information patients want to receive and the preferred way of information dispensation are essential to optimize information delivery at the ED. The purpose of this cross-sectional observational study was to evaluate patient satisfaction concerning information dispensation (including general, medical, and practical information), the need for additional information, and preferences with regard to the way of information dispensation at the ED of a teaching hospital in the Netherlands.

Results

Four hundred twenty-three patients (patients ≥ 18 years with Glasgow Coma Scale 15) were enrolled (response rate 79%). The median patient satisfaction score concerning the overall information dispensation at the ED was 7.5 on a rating scale 0–10. Shorter length of ED stay was associated with higher patient satisfaction in multivariate analysis (P < 0.001). The majority of respondents were satisfied regarding medical (n = 328; 78%) and general information (n = 233; 55%). Patients were less satisfied regarding practical information (n = 180; 43%). Respondents who indicated that they received general, medical and practical information were significantly more often satisfied compared to patients who did not receive this information (P < 0.001). Two thirds (n = 260; 62%) requested more general information. Half of the respondents (n = 202; 48%) requested more practical information and a third (n = 152; 36%) requested more medical information. The preferred way for receiving information was orally (n = 189; 44.7%) or by leaflets (n = 108; 25.5%).

Conclusion

The majority of respondents were satisfied concerning information dispensation at the ED, especially regarding medical information. Respondents requested more general and practical information and preferred to receive the information orally or by leaflets.

[Quality in home care: review of relevant structural-, process- and outcome-related aspects of care]

INTRODUCTION

Being cared for in one's own home environment is of great significance for many people in need of care. In addition to care provided by relatives, the care provided by professional home care services is also important. More and more people in need of care are being cared for by relatives together with or solely through such home care services. Because of this, the issue of quality and quality measurement in home care has become increasingly important. The prerequisite for measuring and assessing quality is the definition of specific requirements for medical and nursing care. A comprehensive quality framework for home care has not yet been developed. The aim of this review is to provide an overview of the current situation in home care and to identify relevant aspects of care subsequently. Finally, these aspects of care should be presented in a framework model.

METHODS

In order to describe the situation in home care, a review was conducted based on the Joanna Briggs Institute methodology of a scoping review. The literature was analysed, and the relevant aspects of care were derived by using an inductive approach. Furthermore, these aspects of care were assigned to quality dimensions defined for health care (e. g., patient safety, patient-centeredness) and merged into a quality model of home care.

RESULTS

A total of 222 publications were included, and 17 aspects of home care were identified. These involved structural aspects of care and aspects of care for shaping relationships with people in need of care and their family carers, as well as aspects of support for people in need of care and their family carers. Furthermore, process-related and outcome-related aspects of care were identified. The comparison of these aspects with the defined quality dimensions showed that each of these quality dimensions is covered by at least one aspect of care. This results in a comprehensive quality model for home care which can serve as a framework for measuring and assessing quality in home care.

CONCLUSION

The aspects of care identified can be used for the development of instruments such as routine data-based quality indicators and thus allow for the measurement, presentation and assessment of quality in home care.

Opt-in or opt-out health-care communication? A cross-sectional study

BACKGROUND

Patients need medication and medical condition-related information to better self-manage their health. Health-care professionals (HCPs) should be able to actively provide information outside of one-on-one consultations; however, patient consent may be required.

OBJECTIVE

To investigate the Australian public's preferences, and factors that may influence their preferences, towards an opt-in versus an opt-out approach to health communication.

DESIGN

A cross-sectional study using a structured questionnaire administered via Computer-Assisted Telephone Interviewing.

SETTING AND PARTICIPANTS

Participants across Australia who were adults, English-speaking and had a long-term medical condition.

MAIN OUTCOME MEASURES

Preferences for opt-in vs opt-out approach to receiving follow-up tailored information.

RESULTS

A total of 8683 calls were made to achieve the required sample size of 589 completed surveys. Many (346/589; 58.7%) indicated that they were interested in receiving tailored, ongoing follow-up information from their HCP. Nearly half (n = 281; 47.7%) preferred an opt-in service and 293/589 (49.7%) an opt-out service for receiving follow-up information. Reasons for preferring an opt-in service were being in control of the information received (n = 254); able to make a decision that is best for them (n = 245); opt-in service would save time for HCPs (n = 217); they may not want or need the information (n = 240). Many (n = 255) felt that an opt-out service should be part of the normal duty of care of their HCP and believed (n = 267) that this approach would ensure that everyone has access to information.

CONCLUSIONS

Respondents were interested in receiving tailored information outside of consultation times. However, preferences for an opt-in or opt-out approach were divided.

Cancer patients' perspective on shared decision-making and decision aids in oncology

Purpose

Shared Decision-Making (SDM) enhances patients’ satisfaction with a decision, which in turn increases compliance with and adherence to cancer treatment. SDM requires a good patient-clinician relationship and communication, patients need information matching their individual needs, and clinicians need support on how to best involve the individual patient in the decision-making process. This survey assessed oncological patients’ information needs and satisfaction, their preferred information in patient decision aids (PDAs), and their preferred way of making decisions regarding their treatment.

Methods

Questionnaires were distributed among attendees of a lecture program on complementary and alternative medicine in oncology of which 220 oncological patients participated.

Results

Participants reported a generally high need for information—correlating with level of education—but also felt overwhelmed by the amount. The latter proved particularly important during consultation. Use of PDAs increased satisfaction with given information but occurred in less than a third of the cases. Most requested contents for PDAs were pros and cons of treatment options and lists of questions to ask. The vast majority of patients preferred SDM to deciding alone. None wanted their physician to decide for them.

Conclusions

There is a high demand for SDM but a lack of conclusive evidence on the specific information needs of different types of patients. Conversation between patients and clinicians needs encouragement and support. PDAs are designed for this purpose and have the potential to increase patient satisfaction. Their scarce use in consultations calls for easier access to and better information on PDAs for clinicians.

Explaining variation in health information seeking behaviour - Insights from a multilingual survey

OBJECTIVE

How best to provide an increasingly diverse population with health information has become a major concern for health policy makers in Europe and beyond. Our study aims to investigate factors explaining variation in people's health information seeking behaviour. Our findings can be used to identify target groups for policy interventions that aim to provide health information efficiently.

METHODS

Cross-sectional, paper-based, multilingual survey of a random sample of enrolees of two statutory health insurers in Hamburg, Germany. Data were collected from September to December 2017. Multivariable logistic regression was used to examine sociodemographic and health-related individual characteristics and their associations with participants' choice of ten sources of health information.

FINDINGS

Participants' choice of information sources differed significantly across the following sociodemographic and health-related characteristics: age, gender, immigration status, education, employment status, marital status and general state of health. Immigrants and individuals with low educational attainment were most likely to use emergency departments as sources of health information.

CONCLUSION

Policy interventions aiming to manage the use of health information sources should focus on immigrants and individuals with low educational attainment. Providing multilingual, low-threshold counselling and information services could be an efficient way to reduce short-term costs of health information seeking behaviour to health insurers or other payers of care while improving patient empowerment.

Importance of and Satisfaction with Information about Their Disease in Cancer Patients

To learn more about information needs and satisfaction with provided information among cancer patients and whether dissatisfaction with information has any association with how therapy decisions are made. An online survey was conducted during March 2015 and January 2016 by the German non-profit patient organization "Das Lebenshaus e.V." among their members with rare solid tumors. A total of 338 records was analyzed. The majority found information on their disease important and was satisfied with the provided information. The participants were less satisfied with the information concerning management of side effects than with other aspects of information (p < .001). Support groups, lectures, and the oncologist were rated as the most helpful sources of information followed by a second opinion and media. Participants who were dissatisfied with the information more often made the decision on the treatment alone by themselves (p < .001). Our results show a high satisfaction with disease-related information among our study participants. Improvements could be made by offering more information on the management of side effects and by giving more information about support groups, reliable websites, and other helpful media.

An integrative review on the information and communication needs of parents of children with cancer regarding the use of complementary and alternative medicine

Background

Parents often choose Complementary and Alternative Medicine (CAM) as a supportive agent with the aim to reduce cancer treatment-related symptoms in their children. Therefore, it is necessary to understand parents´ information and communication needs regarding CAM. The aim of the present study was to review the research literature as to identify the information and communication needs of parents of children with cancer, and the children themselves, regarding the use of CAM.

Methods

An integrative systematic review design was chosen. Searches were performed in AMED, CAMbase, CINAHL (Ebsco), EMBASE, PubMed and PsycInfo, Theme eJournals and Karger. The search was limited to studies published in English, German, Dutch, and the Scandinavian languages. Using predefined inclusion and exclusion criteria, two reviewers independently screened the title and abstracts of the relevant papers. A data extraction form and critical appraisal checklists were used to extract data for analysis, and a mixed methods synthesis was applied.

Results

Out of 24 studies included, 67% were of quantitative and 33% of qualitative study design. Five main themes emerged from the analysis of 21 studies: Information on CAM, sources of CAM information, communication about CAM, informed decision-making on CAM, and Risk/benefit of CAM. The majority of the parents did not disclose the CAM use of their children because they feared negative reactions from the attending oncologist. To make informed treatment decisions for their children, parents wanted unbiased information about CAM and would act accordingly. They demand open communication about these modalities and respect for the family’s autonomy when choosing CAM for their children.

Conclusion

There is an urgent need for parents of children with cancer for high quality information on CAM from reliable and scientific sources. Development of authoritative evidence-based decision tools is thus warranted to enable health care professionals and parents of children with cancer to make well informed, individual decisions concerning CAM.

Information and Training Needs of Pediatric Oncologists in Complementary and Integrative Medicine: A Cross-Sectional Study

More than one third of all German pediatric patients with cancer use complementary and integrative medicine (CIM). Parents want to discuss the topic of CIM with their pediatric oncologists (POs); however, POs mostly do not feel confident discussing these topics. POs report openness to receiving further information and training, but CIM training opportunities in medical education seem rare. We investigated POs' information and training needs and preference patterns regarding CIM training content with a paper-based or online survey. A total of 101 POs from Germany completed the survey. Only 11.4% agreed to being sufficiently informed of CIM. The participants stated needing further CIM information very often (8.6%), often (38.7%), or occasionally (44.1%). They considered an overview of CIM therapies and information about relaxation methods, herbal remedies, and acupuncture for cancer-related symptoms such as lack of appetite, nausea, or vomiting as most important in CIM training material, and also the topics of adverse effects and summary of evidence. Finally, POs reported on clinical situations in which a need for further information on CIM emerged. The results of our study indicate that there is a need for a structured training that offers knowledge and skills on the subject of patient counseling on CIM in pediatric oncology.

Patient decision aids: a content analysis based on a decision tree structure

INTRODUCTION

This paper presents the preliminary results of a decision-tree analysis of Patient Decision Aids (PDA). PDAs are online or offline tools used to structure health information, elicit relevant values and emphasize the decision as a process, in ways that help patients make more informed health decisions individually or with relevant others.

METHOD

Twenty PDAs are randomly selected from the International Patient Decision Aids Standards (IPDAS) ( https://decisionaid.ohri.ca/AZlist.html ) approved list. An evaluation tool is built bottom-up and top-down and results are described in terms of communicating uncertainty, completeness of the decision tree, ambiguous or misleading phrasing, overall strategies suggested within personal stories.

RESULTS

Twelve of the analyzed PDAs had branches of the decision tree which were not discussed in the tool and 6 had logically ambiguous phrasing. Many tools included dichotomous options, when the option range was wider. Several options were clustered within the "Do not take/Do not do" option and thus the PDA failed to provide all comparisons necessary to make a decision. Some tools employ expressions that do not differentiate between lack of information and known negative effects. Other tools provide unequal amounts or non-comparable bits of information about the options.

CONCLUSION

These results indicate a very loose range of interpretations of what constitutes an option, a treatment, and a treatment option. It thus emphasizes a gap between theory and practice in the evaluation of PDAs. Future developments of PDA evaluation tools should keep track of missing decision tree branches, accurate communication of uncertainty, ambiguity, and lack of knowledge and consider using measures for evaluating the completeness of the option spectrum at an agreed period in time.

A scoping review of consumer needs for cancer information

OBJECTIVE

This study was a scoping review of research on cancer-related health information seeking and needs of patients, survivor, non-patients, and caregivers.

METHODS

This study used the COSI model to search for articles published from 2007 to 2017.

RESULTS

In total, 117 articles with titles and abstracts including the following terms were selected: cancer, health, information, seeking. Non-patients obtained information from the Internet, doctors, and media, whereas patients obtained information from doctors, the Internet, and media. Information needs were the highest for treatment, prognosis, and psychosocial support. Patients had the highest need for information on prognosis and treatment, whereas non-patients had the highest need for general cancer information, prevention, and cancer examination. Caregivers sought information about treatment, psychosocial support, and prevention.

CONCLUSION

This study revealed an increase in the number of research articles identifying cancer patients' information needs. Cancer patients rely on health professionals for information; thus, relevant materials are needed. Furthermore, not only medical but also psychosocial support information is needed.

PRACTICE IMPLICATIONS

There is a need for cancer information from health professionals, and thus for patient-centered training materials. Furthermore, a survey system to evaluate consumers' cancer information needs should be developed.

Addressing Unmet Information Needs: Results of a Clinician-Led Consultation Service About Complementary and Alternative Medicine for Cancer Patients and Their Relatives

Purpose. To report on a telephone consultation service with cancer patients and their relatives about complementary and alternative medicine (CAM) between 1999 and 2011. Methods. We offered a Germany-wide, free-of-charge telephone consultation service about CAM led by oncology clinicians from a comprehensive cancer center. The consultations followed a patient-centered approach with the aim to provide guidance and evidence-based information. Sociodemographic, disease-related data as well as information about the consultations’ content were collected in a standardized manner, and feedback questionnaires were sent out immediately after the consultations. Results. Overall, 5269 callers from all over Germany used the service (57% patients, 43% relatives). The “big 4” cancer types (breast, gastrointestinal, prostate, and lung) accounted for 55% of all calls. In 67% of calls, patients had just received the diagnosis or commenced anticancer therapy; 69% of patients had advanced or metastatic diseases. More than half of the callers (55%) had vague concerns like “what else can I do?” rather than specific questions related to CAM. The consultations covered a broad spectrum of issues from CAM therapies to cancer treatment and measures supportive of health, nutrition, and psychosocial support. Callers highly valued the service. Conclusions. Consulting about CAM addresses important unmet needs from cancer patients and their relatives. It provides clinicians with the opportunity to engage in open and supportive dialogues about evidence-based CAM to help with symptom management, psychological support, and individual self-care. Consulting about CAM cannot be separated from consulting about conventional care and should be provided from the beginning of the cancer journey.

Prevalence and correlates of patient-centred preparatory information provision to computed tomography and magnetic resonance imaging outpatients: A cross-sectional study

OBJECTIVE

Responsiveness to information preferences is key to high-quality, patient-centred care. This study examined the top ten preparatory information items not delivered in accordance with medical imaging outpatients' preferences, and patient characteristics associated with reporting a greater number of unmet information preferences.

METHODS

Magnetic resonance imaging and computed tomography outpatients were recruited consecutively in one major public hospital waiting room. Participants self-administered a touchscreen computer questionnaire assessing their sociodemographic and scan characteristics, and unmet preferences for 33 guideline-endorsed preparatory information items.

RESULTS

Of 317 eligible patients, 280 (88%) consented to participate. Given equal rankings, the top ten unmet information preferences included 13 items which were endorsed by at least 25% of participants, and commonly related to receiving 'too little' information. One item related to the pre-scan period, seven items to the scan period and five items to the post-scan period. None of the patient characteristics examined were significantly associated with reporting a greater number of unmet information preferences.

CONCLUSION

There is room to improve responsiveness to medical imaging outpatients' preparatory information preferences. Improvements should be targeted at individuals, rather than groups defined by sociodemographic or scan characteristics.

PRACTICE IMPLICATIONS

A standardised approach to addressing individual patient's information preferences is needed.

First results from the study 'Disease knowledge and information needs - Diabetes mellitus (2017)'

Very little research has been undertaken into what people in Germany know about diabetes, the information they may require about the condition, where they look for such information and how they rate the information currently available. In 2017, the Robert Koch Institute (RKI) carried out a nationwide telephone survey aimed at answering these questions. The study entitled 'Disease knowledge and information needs - Diabetes mellitus (2017)' focused on people aged at least 18 years. A total of 2,327 people without diabetes and 1,479 people with diagnosed diabetes were interviewed for the study. First results show that 56.7% of people without diabetes and 92.8% of those with diabetes rate their knowledge about the condition as 'very good' or 'good'. People without diabetes were found to have the strongest need for information in terms of 'lifestyle changes, health promotion and disease prevention', whereas respondents with diabetes stressed the strongest need for information about 'treatment and therapy'. Almost a third of respondents without diabetes have actively sought information about diabetes at least once, mostly via print media. Patients with diabetes stated that their general practitioner was their most frequent source of information about the condition. In both groups, about half of respondents reported that they found it difficult to judge the trustworthiness of the information published in the media about diabetes. The results of the study form part of the German National Diabetes Surveillance, which is coordinated by the RKI. The data are also intended to be used by the Federal Centre for Health Education to develop a strategy to improve the information provided about diabetes.

Information needs in people with diabetes mellitus: a systematic review

BACKGROUND

The purpose of this study was to identify and analyse currently available knowledge on information needs of people with diabetes mellitus, also considering possible differences between subgroups and associated factors.

METHODS

Twelve databases including MEDLINE, EMBASE and the Cochrane Library were searched up until June 2015. Publications that addressed self-reported information needs of people with diabetes mellitus were included. Each study was assessed by using critical appraisal tools, e.g. from the UK National Institute for Health and Care Excellence. Extraction and content analysis were performed systematically.

RESULTS

In total, 1993 publications were identified and 26 were finally included. Nine main categories of information needs were identified, including 'treatment-process', 'course of disease', 'abnormalities of glucose metabolism' and 'diabetes through the life cycle'. Differences between patient subgroups, such as type of diabetes or age, were sparsely analysed. Some studies analysed associations between information needs and factors such as participation preferences or information seeking. They found, for example, that information needs on social support or life tasks were associated with information seeking in Internet forums.

CONCLUSION

Information needs in people with diabetes mellitus, appear to be high, yet poorly investigated. Research is needed regarding differences between diverse diabetes populations, including gender aspects or changes in information needs during the disease course.

SYSTEMATIC REVIEW REGISTRATION

The review protocol has been registered at Prospero ( CRD42015029610 ).

[How do authors of systematic reviews restrict their literature searches when only studies from Germany should be included?]

INTRODUCTION

The use of search filters (e. g. for study types) facilitates the process of literature searching. Regional limits might be helpful depending on the research question. Regional search filters are already available for some regions, but not for Germany. Our aim is to give an overview of applied search strategies in systematic reviews (SRs) focusing on Germany.

METHODS

We searched Medline (via Pubmed) applying a focused search strategy to identify SRs focusing on Germany in January 2016. Study selection and data extraction were performed by two reviewers independently. The search strategies with a focus on Germany were analyzed in terms of reasonableness and completeness relying on the Peer Review of Electronic Search Strategies (PRESS) criteria. A narrative evidence synthesis was performed.

RESULTS

In total, 36 SRs (13 written in English) were included. 78% were published in 2012 or later. The majority (89%) of SRs utilized at least two different sources for their search with databases and checking references being the most common. 17 SRs did not use any truncations, ten SRs did not restrict their search to Germany, six SRs reported to have searched for German OR Germany. Only ten articles searched for the term Germany (occasionally jointly with the term Deutschland) without any use of an adjective such as German.

DISCUSSION

There is a high interest in regionally focused SRs. The identified search strategies revealed a need for improvement. It would be helpful to develop a regional search filter for Germany that is able to identify studies performed in Germany.

Unmet information needs and limited health literacy in newly diagnosed breast cancer patients over the course of cancer treatment

OBJECTIVE

To investigate unmet information needs in newly diagnosed breast cancer patients over the course of cancer treatment and its association with health literacy.

METHODS

We present results from a prospective, multicenter cohort study (PIAT). Newly diagnosed breast cancer patients (N=1060) were surveyed directly after breast cancer surgery, 10 and 40 weeks later. Pooled linear regression modeling was employed analyzing changes in unmet information needs over time and its association with health literacy.

RESULTS

Unmet information needs on side effects and medication and medical examination results and treatment options were high and increased during the first 10 weeks after breast cancer surgery. Considering health promotion and social issues, unmet information needs started high and decreased during post-treatment. Patients with limited health literacy had higher unmet information needs.

CONCLUSION

Our results indicate a mismatch in information provision and breast cancer patients' information needs. Patients with limited health literacy may be at a distinct disadvantage in having their information needs met over the course of breast cancer treatment.

PRACTICE IMPLICATIONS

Strategies are needed to reduce unmet information needs in breast cancer patients considering treatment-phase and health literacy and thereby enable them to better cope with their diseases.

Determinants of patients' needs in asthma treatment: a cross-sectional study

Patients' needs in asthma remain insufficiently understood and met. We therefore aimed to investigate the potential determinants of patients' needs in asthma treatment. Our study was based on survey data on 189 adults with asthma. Needs were measured using the 13-item Needs in Asthma Treatment questionnaire, which yields a total score and subscale-specific scores ('exacerbations', 'patient expertise', 'handling drugs' and 'drug effects'). We considered age, sex, education, years since diagnosis and anxiety/depression (measured by the Patient Health Questionnaire-4) as potential determinants. Associations were estimated by multivariable linear regression. Overall, we observed that younger age, poor mental health and a more recently established asthma diagnosis were independently associated with increased needs. Information on drug effects was an exception to this pattern as the need in that domain was solely determined by sex (being greater in men). In conclusion, our study provides novel evidence on patient characteristics that are associated with needs in asthma treatment. If confirmed by future studies, our observations may assist healthcare professionals to identify asthma patients with potentially elevated information, support and training needs and could contribute to the development of tailored interventions.

Assessment of information needs in diabetes: Development and evaluation of a questionnaire

AIM

To develop a questionnaire suitable for assessing the information needs of individuals with diabetes mellitus types 1 and 2 in diverse healthcare settings (e.g. primary care or long-term care) and at different time points during the course of the disease.

METHODS

The initial questionnaire was developed on the basis of literature search and analysis, reviewed by clinical experts, and evaluated in two focus groups. The revised version was pilot-tested on 39 individuals with diabetes type 2, type 1 and gestational diabetes.

RESULTS

The final questionnaire reveals the most important information needs in diabetes. A choice task, a rating task and open-ended questions are combined. First, participants have to choose three topics that interest them out of a list with 12 general topics and specify in their own words their particular information needs for the chosen topics. They are then asked how informed they feel with regard to all topics (4-point Likert-scale), and whether information is currently desired (yes/no). The questionnaire ends with an open-ended question asking for additional topics of interest.

CONCLUSIONS

Careful selection of topics and inclusion of open-ended questions seem to be essential prerequisites for the unbiased assessment of information needs. The questionnaire can be applied in surveys in order to examine patterns of information needs across various groups and changes during the course of the disease. Such knowledge would contribute to more patient-guided information, counselling and support.