Assessment of patient information needs: A systematic review of measures

Understanding access challenges to low vision care for age-related macular degeneration in Germany: results from an integrated synthesis based on experiences from affected individuals and care providers

PURPOSE

To understand the reasons for the inconsistent and often arbitrary access to low vision care for people with age-related macular degeneration (AMD), this article examines the challenges of access to low vision care from the perspectives of people with AMD, ophthalmologists, opticians and low vision professionals.

METHODS

This article is based on a mixed-methods study that incorporated narrative semi-structured interviews to explore the experiences of individuals diagnosed with AMD, as well as online surveys to evaluate ophthalmologists' and opticians' knowledge of low vision services and expert discussions with low vision professionals. An integrated synthesis approach was employed.

RESULTS

Challenges in accessing low vision care can be categorized into four levels: individual, social, infrastructural, and provider. Individual challenges included information needs, perceptions of support services as stigmatizing or unhelpful, and immobility of the affected individuals. Social networks play a crucial role in supporting or hindering access to care. Limited service availability poses a significant infrastructural challenge. Provider-level issues include communication barriers, knowledge gaps, and insufficient collaboration among low vision providers.

CONCLUSIONS

Our study emphasizes the need for a structured, interdisciplinary rehabilitation approach to improve care for individuals with AMD.

Experiences and expectations of hereditary colorectal cancer patients during the post-genetic test period

Individuals with inherited colorectal cancer (CRC) risk often work with genetic counselors (GCs) who traditionally meet with them prior to genetic testing and then disclose genetic test (GT) results. After results disclosure, many GCs do not typically provide long-term follow-up, and as a result, there is little in the literature regarding how GCs can meet the needs of patients in the post-test period. This mixed methods study aimed to explore the experiences of patients with hereditary CRC syndromes in the post-test period with a focus on identifying areas for improvement following a positive GT result. Participants completed an online survey (N = 17) and optional semi-structured interview (N = 10) focused on patient experiences with GCs, resources received following a positive GT result, degree of perceived support from their GC, and psychosocial considerations associated with GT. The survey data was analyzed using Microsoft Excel to generate descriptive statistics, and the interviews were analyzed using reflexive thematic analysis. Survey results indicated that participants would like an increase in contact with their GC in the post-test period and prefer follow-up visits to be scheduled in advance. Interview results revealed several themes including: meaning making, emotional reaction, impact of GC, recommendations for GC, and perceived health literacy. The data demonstrates a need to reconsider the effectiveness and structure of clinical follow-up after a positive GT disclosure. In the post-test period, GCs should attempt to meet needs specific to the patient in addition to providing follow-up tailored to a patient's emotional state, information needs, and life circumstances. Further needs assessment with greater focus on diverse groups and a larger cohort may be necessary.

Public interest in online searching of asthma information: insights from a Google trends analysis

BACKGROUND

Google Trends (GT) is a free tool that provides insights into the public's interest and information-seeking behavior on specific topics. In this study, we utilized GT data on patients' search history to better understand their questions and information needs regarding asthma.

METHODS

We extracted the relative GT search volume (RSV) for keywords associated with asthma to explore information-seeking behaviors and assess internet search patterns regarding asthma disease from 2004 to 2024 in both English and Persian languages. In addition, a correlation analysis was conducted to assess terms correlated with asthma searches. Then, the AutoRegressive predictive models were developed to estimate future patterns of asthma-related searches and the information needs of individuals with asthma.

RESULTS

The analysis revealed that the mean total RSV for asthma-related keywords over the 20-year period was 41.79 ± 6.07. The researchers found that while asthma-related search volume has shown a consistent upward trend in Persian-speaking countries over the last decade, English-speaking countries have experienced less variability in such searches except for a spike during the COVID-19 pandemic. The correlation analysis of related subjects showed that "air pollution", "infection", and "insomnia" have a positive correlation with asthma. Developing AutoRegressive predictive models on retrieved Google Trends data revealed a seasonal pattern in global asthma-related search interest. In contrast, the models forecasted a growing increase in information-seeking behaviors regarding asthma among Persian-speaking patients over the coming decades.

CONCLUSIONS

There are significant differences in how people search for and access asthma information based on their language and regional context. In English-speaking countries, searches tend to focus on broader asthma-related topics like pollution and infections, likely due to the availability of comprehensive asthma resources. In contrast, Persian speakers prioritize understanding specific aspects of asthma-like symptoms, medications, and complementary treatments. To address these divergent information needs, health organizations should tailor content to these divergent needs.

Information Needs of Australian Families Living with Craniosynostosis: A Qualitative Study

OBJECTIVE

Craniosynostosis is considered a lifelong condition, yet relatively little focus has been directed toward ascertaining the information needs of Australian families. Thus, the aim of this study was to explore the information needs of Australian parents whose child has been diagnosed with nonsyndromic or syndromic craniosynostosis.

DESIGN

Twenty-one online narrative interviews were conducted with parents of children with craniosynostosis (aged between 4 months and 20 years). Transcripts were analyzed using reflexive thematic analysis and themes were developed.

RESULTS

Four themes were generated: (1) lots of information …. and quickly!; (2) the practicalities of hospital and surgery; (3) guidance on how to talk about my child's condition; and (4) the path is rarely clear. Parents of children with craniosynostosis discussed a range of information that was provided to them, or they would have liked to have been given, following their child's diagnosis. Parents noted that insufficient information was provided by the health system and that they faced considerable difficulties accessing credible information about their child's condition, relevant location-specific surgical options, the treatment process and outcomes.

CONCLUSIONS

Narrative interviews provided detailed insight into the information needs of Australian parents of children diagnosed with craniosynostosis. Although parents were frequently challenged by a lack of information detailing their specific treatment and support options, suggestions relevant to craniofacial providers globally were offered. Further work is now needed to develop and provide these information resources in a timely and easily accessible way.

Psychometric validation of the short version of the Information Needs in Cardiac Rehabilitation scale through a first global assessment

AIMS

Tailored education is recommended for cardiac patients, yet little is known about information needs in areas of the world where it is most needed. This study aims to assess (i) the measurement properties of the Information Needs in Cardiac Rehabilitation short version (INCR-S) scale and (ii) patient's information needs globally.

METHODS AND RESULTS

In this cross-sectional study, English, simplified Chinese, Portuguese, or Korean versions of the INCR-S were administered to in- or out-patients via Qualtrics (January 2022-November 2023). Members of the International Council of Cardiovascular Prevention and Rehabilitation community facilitated recruitment. Importance and knowledge sufficiency of 36 items were rated. Links to evidence-based lay education were provided where warranted. A total of 1601 patients from 19 middle- and high-income countries across the world participated. Structural validity was supported upon factor analysis, with five subscales extracted: symptom response/medication, heart diseases/diagnostic tests/treatments, exercise and return-to-life roles/programmes to support, risk factors, and healthy eating/psychosocial management. Cronbach's alpha was 0.97. Construct validity was supported through significantly higher knowledge sufficiency ratings for all items and information importance ratings for all subscales in cardiac rehabilitation (CR) enrolees vs. non-enrolees (all P < 0.001). All items were rated as very important-particularly regarding cardiac events, nutrition, exercise benefits, medications, symptom response, risk factor control, and CR-but more so in high-income countries in the Americas and Western Pacific. Knowledge sufficiency ranged from 30.0 to 67.4%, varying by region and income class. Ratings were highest for medications and lowest for support groups, resistance training, and alternative medicine.

CONCLUSION

Identification of information needs using the valid and reliable INCR-S can inform educational approaches to optimize patients' health outcomes across the globe.

Expectations concerning cancer treatment: perspectives of medical oncologists and patients on advanced, unresectable lung carcinoma

Introduction

This study seeks to compare expectations regarding systemic cancer treatment for advanced lung cancer from the perspectives of both patient and medical oncologist.

Methods

A cross-sectional study involving 17 medical oncologists from 13 Spanish hospitals between 2021 and 2022. Patients with advanced, unresectable lung cancer were recruited prior to initiating systemic cancer treatment. Both patients and oncologists completed the NEOetic-EIT and the STAR.

Results

Seventeen medical oncologists specializing in lung cancer participated, with a mean age of 36.2 years (range 28-56); 65% were female. The study included 298 patients with advanced, unresectable lung cancer, predominantly non-small cell type (72%), and most at stage IV (77%). Most patients were retired or unemployed (71%), and married or partnered (77%). Treatment approaches varied, with 44% based on biomarkers. Oncologists had greater expectations of positive outcomes for participants with better baseline prognosis, such as ECOG 0, newly diagnosed, locally advanced, unresectable non-small cell lung cancer, and those receiving biomarker-based treatments. In contrast, patients' treatment expectations did not vary based on sociodemographic or clinical factors. Generally, patients had high expectations of cure, in contrast to oncologists' lower expectations, though both anticipated similar quality-of-life improvements. Patients anticipated more side effects than oncologists. Among oncologists, expectations varied by gender and decreased with age and experience, with no differences detected among patients based on gender, age, or doctor-patient relationship.

Conclusion

This study reveals the complex expectations of patients and oncologists in advanced lung cancer treatment. It underscores the need for effective communication in oncology to align patient expectations with clinical realities.

A systematic review on factors influencing Middle Eastern women's utilization of healthcare services: The promise of mHealth

Objectives

The 2030 Sustainable Development Agenda stresses a feminist approach for healthcare services. Cultural and religious influences impact utilization of healthcare services by Muslim women within the Middle East, posing unique challenges. This paper aimed to investigate the factors influencing Middle Eastern women's utilization of healthcare services within the region.

Methods

In the year 2024, a systematic review was conducted. PubMed, Scopus, ProQuest, and the Cochrane Database of Systematic Reviews were searched for this purpose. The quality of the included articles was assessed using the Accuracy, Coverage, Objectivity, Date, Significance (ACODS) checklist. Subsequently, the Joffe method of thematic analysis was employed to analyze the data obtained from the review.

Results

A final selection comprising 59 studies was made for inclusion in the research. The studies demonstrated a high level of quality, and the risk of bias within them was deemed acceptable. The thematic analysis revealed seven principal themes, which encompassed Demographic Factors, Level of Education and Awareness, Sources of Information, Risk Factors, Personal Factors, Level of Service Access and Quality, and Organizational Factors.

Conclusions

This study highlighted key factors influencing women's utilization of healthcare in the Middle East and potentially the healthcare systems with a large number of Middle Eastern female immigrants around the globe: educational factors such as awareness campaigns and patient education, and personal barriers like fear and cultural norms. Moreover, Telehealth, particularly mHealth, was suggested to enhance women's participation and utilization of healthcare services. Further research is needed to explore this assertion with greater precision.

Relevance of meeting general outpatients' information needs to their perceptions of healthcare quality in a hospital in Ghana: a Healthcare Quality Survey using modified SERVQUAL analysis

BACKGROUND

Patients determine quality of healthcare by their perception of the gap between the healthcare they experience/receive and that which they expect. This can be influenced by the ability of healthcare staff to adequately communicate information about the healthcare provided. This study assessed the level of relevance of meeting patients' information needs with respect to their assessment of healthcare quality in a private hospital's general outpatient department in Ghana.

DESIGN

Study design was cross-sectional using exit self-administered questionnaires among 390 outpatients. Healthcare quality was measured using a modified form of the Service Quality model gap analysis (gap between experience and expectations). A negative gap signifies unmet patient expectations. Microsoft Excel and Stata V.15.0 were used for analysis using t-test and multiple linear regression. A p value ≤0.05 denotes statistical significance.

FINDINGS

The mean percentage of patients' expectations of quality of healthcare was 87.6% (SE 0.031), while patient experience was 86.0% (SE 0.029), with a significant negative gap of -0.08 (p<0.002). Their highest expectation of the quality of healthcare was for their information needs to be met, with a mean score of 4.44 (SE 0.03). Two of the four items under the information needs dimension that showed no statistically significant gaps were 'saying all their problems' (gap=0.00; p<0.9) and 'explanation of treatment/medications' (gap=0.01; p<0.6). Those with statistically significant negative gaps were 'explanation of investigations and procedures' (gap=-0.18; p<0.0001) and 'explanation of the diagnoses' (gap=-0.11; p<0.02), signifying unmet expectations.

CONCLUSIONS

The outpatient's greatest need for quality healthcare in this study was for their information needs to be met. Providing information on patient diagnoses and investigations are the areas least likely to be adequately communicated to patients.

Patients' experiences of patient-centred care in hospital setting: A systematic review of qualitative studies

BACKGROUND

Patient-centred care (PCC) has been proposed as an appropriate approach for addressing current shifts in healthcare needs. Although the importance of PCC is generally recognised, PCC is poorly understood by patients in the hospital settings.

OBJECTIVES

To identify patients' experiences of PCC in hospital settings.

METHODOLOGICAL DESIGN

This systematic review followed the Joanna Briggs Institute's (JBI) guidance for systematic reviews of qualitative evidence and the PRISMA checklist for reporting systematic reviews. The search strategy included peer-reviewed qualitative studies published after 2010 in English or Finnish. The databases searched were SCOPUS, MEDLINE, CINAHL and Medic. Unpublished studies and grey literature were searched in MedNar. Ten qualitative studies were included, and their quality was assessed by two independent reviewers using JBI quality assessment criteria. The data were analysed using thematic analysis.

SETTING AND PARTICIPANTS

Studies were included if they had explored adult patient experiences of PCC in hospital settings.

RESULTS

A thematic analysis produced 14 subthemes which were grouped into five analytical themes: the presence of the professional, patient involvement in care, receiving information, the patient-professional relationship and being seen as a person.

CONCLUSIONS AND IMPLICATIONS

This review suggests that the implementation and provision of PCC in hospitals is incomplete and patients' involvement in their own care should be in the focus of PCC. The majority of patients experienced receiving PCC, but others did not. The need for improvement of patient involvement was strongly emphasised. Patients highlighted the importance of professionals being present and spending time with patients. Patients felt well-informed about their care but expressed the need for better communication. Meaningful patient-professional relationships were brokered by professionals demonstrating genuine care and respecting the patient as an individual. To improve the implementation of PCC, patient experiences should be considered in the development of relevant hospital care strategies. In addition, more training in PCC and patient-professional communication should be provided to health care professionals.

Understanding patients' perspectives when unprepared for the emergence of a parastomal bulge-a qualitative study

AIM

The aim was to investigate patients' experiences of being prepared for the development of a parastomal bulge in relation to a stoma.

METHODS

The paper draws on a qualitative interview study conducted with 20 Danish patients participating in five focus groups. Analysis was performed using a phenomenological-hermeneutic approach.

RESULTS

We identified three themes. The first theme is 'The unforeseen bulge gives rise to increasing concern and a search for an explanation'. Patients searched for explanations in their own life and suspected that their behaviour or previous illness induced the bulge. The second theme is 'Missing or confusing information leads to counterproductive behaviour'. Patients lacked information on the prevention and treatment of parastomal bulging which led to disappointment with healthcare professionals. The third theme is 'Weighing the pros and cons of life with the bulge against the gamble of surgical repair'. Some patients came to terms with their situation, but for others a deadlocked situation arose when surgical repair was not an option.

CONCLUSION

Healthcare communication directly impacts on patients' experiences and outcomes. When unprepared for the emergence of a parastomal bulge, patients' emotional and psychological well-being are affected and likewise patients' possibility of using their own health beliefs as a preventive strategy. To preserve patient autonomy, satisfaction and well-being, surgeons and stoma nurses should provide patients with tailored information bearing in mind the current lack of clear evidence on the prevention and treatment of parastomal bulging.

The information needs of people with degenerative cervical myelopathy: A qualitative study to inform patient education in clinical practice

BACKGROUND

Individuals with lifelong illnesses need access to adequate information about their condition to make optimal health decisions. Degenerative Cervical Myelopathy (DCM) is the most common form of spinal cord dysfunction in adults worldwide. Its chronic and debilitating nature, varied impact, clinical trajectory, and management options necessitate appropriate informational support to sustain effective clinical and self-directed care strategies. However, before clinicians can meet patients' information needs, they must first have an understanding of their baseline requirements. This study explores the information needs of people with DCM (PwCM). In doing so, it provides a starting point for the development of patient education and knowledge management strategies in clinical practice.

METHODS

Semi-structured interviews with PwCM were conducted using an interview guide. Interviews were audio-recorded and transcribed verbatim. Thematic analysis according to Braun and Clarke's six-phase approach was used to analyse the data. Findings were reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

RESULTS

Twenty PwCM (65% female, 35% male), with ages ranging from 39 to 74 years old participated in the interviews. The findings indicated that the provision of information to PwCM during clinical interactions varies. Accordingly, PwCM's information needs were broad-ranging, as was the nature of the information they found useful. Three main themes were identified (1) Variation in the provision of information to PwCM during clinical interactions, (2) Variations in the information needs of PwCM, and (3) Information that PwCM find useful.

CONCLUSION

Efforts must turn to adequately educating patients at the time of the clinical encounter. A comprehensive and consistent patient-centered information exchange in DCM is necessary to achieve this.

Ebenen der Explizierbarkeit für medizinische künstliche Intelligenz: Was brauchen wir normativ und was können wir technisch erreichen?

Definition of the problem

The umbrella term “explicability” refers to the reduction of opacity of artificial intelligence (AI) systems. These efforts are challenging for medical AI applications because higher accuracy often comes at the cost of increased opacity. This entails ethical tensions because physicians and patients desire to trace how results are produced without compromising the performance of AI systems. The centrality of explicability within the informed consent process for medical AI systems compels an ethical reflection on the trade-offs. Which levels of explicability are needed to obtain informed consent when utilizing medical AI?

Arguments

We proceed in five steps: First, we map the terms commonly associated with explicability as described in the ethics and computer science literature, i.e., disclosure, intelligibility, interpretability, and explainability. Second, we conduct a conceptual analysis of the ethical requirements for explicability when it comes to informed consent. Third, we distinguish hurdles for explicability in terms of epistemic and explanatory opacity. Fourth, this then allows to conclude the level of explicability physicians must reach and what patients can expect. In a final step, we show how the identified levels of explicability can technically be met from the perspective of computer science. Throughout our work, we take diagnostic AI systems in radiology as an example.

Conclusion

We determined four levels of explicability that need to be distinguished for ethically defensible informed consent processes and showed how developers of medical AI can technically meet these requirements.

The handling of biopharmaceuticals used in home-based therapy for cancer patients

BACKGROUND

Due to their low bioavailability, biopharmaceuticals are typically administered via injection or infusion in a hospital setting. Home-based therapy could be a valuable alternative for cancer patients. However, when exposed to stressors, such as high or low temperatures, particles can form in the biopharmaceutical solution, compromising the safety and efficacy of the biopharmaceutical.

AIM

This research investigated current practises with ready-to-administer biopharmaceuticals to determine if it is possible to offer cancer patients home-based therapy with monoclonal antibodies.

METHODS

First, a questionnaire was conducted with the survey tool Survalyzer among Amsterdam UMC patients receiving immunoglobulins at home. Secondly, a web-based questionnaire (Survalyzer) was sent to pharmacists throughout Europe with a home-based therapy programme in place.

RESULTS

The patient questionnaire (n = 52) showed that the biopharmaceutical is stored outside the recommended temperature range by 38% of the patients. Additionally, 17% of the patients do not recall getting any information on how to store their biopharmaceuticals, and 23% would like more information on the subject. Furthermore, the questionnaire amongst pharmacists (n = 21) showed that there is a lack of resources and logistical challenges when home-based therapy is applied to biopharmaceuticals used in cancer therapy.

CONCLUSION

Home-based therapy with monoclonal antibodies for cancer patients is challenging to implement.

Physician-directed information prescription service. A scoping review

OBJECTIVE

This scoping review aims to identify and map the characteristics of research studies, types, delivery methods, and team members of physician-directed information prescription services.

METHODS

Following the PRISMA-ScR checklist, a systematic search was performed on Web of Science, Scopus, Library, Information Science & Technology Abstracts (LISTA), and PubMed/Medline from 1990 to 2021.

RESULTS

37 studies were included in the final analysis. Five types of providing information prescription were recognized: typical, oral, web-based, electronic, and mixed methods. Physicians, nurses, and librarians were the most agreed-upon professionals in information prescription delivery teams. The steps of prescribing information were needs assessment, content production, information evaluation, prescribing information, follow-up, and documentation.

DISCUSSION

This review presents a synthesis of the process of information prescription. It is suggested to determine the effective information prescription type, provide methods and develop the service according to patients' preferences and characteristics.

PRACTICE IMPLICATIONS

Results of this study can be used to identify the challenges, the competent individuals, roles, and steps of information prescription service, as well as design and develop the protocol, model, and flowchart of it.

Self-reported medication information needs among medication users in a general population aged 40 years and above - the Tromsø study

PURPOSE

To determine the prevalence and associated factors of self-reported medication information needs among medication users in a general population aged 40 years and above - The Tromsø Study.

METHODS

Cross-sectional study of medication users (n = 10,231) among participants in the Tromsø Study, a descriptive analysis of questionnaire data and multivariable logistic regression (n = 9,194).

RESULTS

Sixteen percent of medication users expressed a need for more information about own medications. Overall, medication users agreed to a higher degree to have received information from the GP compared to the pharmacy. Concerned medication users and those disagreeing to have received information about side effects had the highest odds for needing more information (OR 5.07, 95% CI 4.43-5.81) and (OR 2.21, 95% CI 1.83-2.68), respectively. Medication users who used heart medications (e.g., nitroglycerin, antiarrhythmics, anticoagulants) (OR 1.71, 95% CI 1.46-2.01), medication for hypothyroidism (OR 1.36, 95% CI 1.13-1.64) or had moderately health anxiety had expressed need for medication information. Whereas medication users with lower education, those that never used internet to search for health advice, and medication users who disagreed to have received information about reason-for-use were associated with lower odds (OR 0.75, 95% CI 0.62-0.91), (OR 0.85, 95% CI 0.74-0.98) and (OR 0.68, 95% CI 0.53-0.88), respectively.

CONCLUSION

This study demonstrated that there is need for more information about own medications in a general population aged 40 years and above and shed light on several characteristics of medication users with expressed information need which is important when tailoring the right information to the right person.

Information needs of parents of children with congenital anomalies across Europe: a EUROlinkCAT survey

BACKGROUND

Parents of children who have a congenital anomaly can experience significant worry about their child's health. Access to clear, helpful, and trustworthy information can provide a valuable source of support. In this study the aim was to explore the information needs of parents/carers of children with congenital anomalies across Europe.

METHOD

A cross-sectional online survey was developed in nine languages to measure parents' information needs, including: (1) the 'helpfulness'/'trustworthiness' of information received from eight relevant sources, and (2) overall satisfaction with information received. Parents/carers of children (0-10 years) with cleft lip, spina bifida, congenital heart defect [CHD] requiring surgery, and/or Down syndrome were recruited online via relevant organisations in 10 European countries from March-July 2021. Quantitative analyses using multivariable logistic regressions were performed.

RESULTS

One thousand seventy parents/carers of children with a cleft lip (n = 247), spina bifida (n = 118), CHD (n = 366), Down syndrome (n = 281), and Down syndrome with CHD (n = 58) were recruited in Poland (n = 476), the UK (n = 120), Germany (n = 97), the Netherlands/Belgium (n = 74), Croatia (n = 68), Italy (n = 59), other European countries (n = 92), and not specified/non-European countries (n = 84). Most participants were mothers (92%) and aged 31-40 years (71%). Participants were most likely to rate support groups (63%), patient organisations (60%), specialist doctors/nurses (58%), and social media (57%) as 'very helpful' information sources. 'Very trustworthy' ratings remained high for specialist doctors/nurses (61%), however, they declined for support groups (47%), patient organisations (48%), and social media (35%). Germany had the highest proportion of participants who were 'very satisfied' (44%, 95% CI = 34%-54%) with information, whereas this percentage was lowest in Croatia (11%, 95% CI = 3%-19%) and Poland (15%, 95% CI = 11%-18%). Parents of children with Down syndrome had significantly lower satisfaction ratings than parents of children with CHD; 13% (95% CI = 8%-18%) reported being 'very satisfied' compared to 28% (95% CI = 23%-33%) in the CHD group.

CONCLUSIONS

Findings suggest that informal sources of information (e.g. support groups) are of value to parents, however, they are not deemed as trustworthy as specialist medical sources. Satisfaction ratings differed across countries and by anomaly, and were particularly low in Croatia and Poland, as well as for parents of children with Down syndrome, which warrants further investigation.

Examining the Development of Information Needs Assessment Questionnaires in Oncology: Protocol for a Scoping Review

BACKGROUND

Information needs are one of the most prevalent unmet supportive care needs of those living with cancer, including patients and their informal caregivers. Understanding how existing questionnaires for evaluating information needs have been developed is important for guiding appropriate use and informing future research. A literature review examining how information needs assessment questionnaires for use in the cancer context have been developed, with a specific focus on how questionnaire items have been identified, does not exist.

OBJECTIVE

This scoping review will examine how questionnaires for assessing the information needs of those living with cancer have been developed with special focus on how patients, informal caregivers, and health care professionals have been involved in the selection and identification of questionnaire items.

METHODS

This review will include published studies describing the development and validation of information needs assessment questionnaires for use in the oncology context. MEDLINE (Ovid), Embase (Ovid), CINAHL, Scopus, Web of Science, the Cochrane Database of Systematic Reviews, and PsycInfo will be searched. Articles published at any point up to the date of the search will be eligible for inclusion. One person will screen titles and abstracts, and 2 people will screen and extract data from full-text articles.

RESULTS

Results are expected to be available in early 2023. Summary tables and a narrative summary will be used to describe results.

CONCLUSIONS

This scoping review will assist in identifying appropriate information needs assessment tools to incorporate into clinical and research contexts in oncology. It will also identify if additional information needs assessment tools are needed.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/35639.

Development and content validity of the Experienced Patient-Centeredness Questionnaire (EPAT)-A best practice example for generating patient-reported measures from qualitative data

Introduction

To effectively foster patient‐centeredness (PC), it is crucial to measure its implementation. So far, there is no German measure to assess PC comprehensively. The aim of this study is to develop and select items for the Experienced Patient‐Centeredness (EPAT) Questionnaire, a patient‐reported experience measure (PREM). The EPAT intends to assess PC from the perspective of adult patients treated for different chronic diseases in inpatient and outpatient settings in Germany. Furthermore, we aim at providing a best‐practice example for developing PREMs from qualitative data.

Methods

The development process comprised a three‐phase mixed‐method design: (1) preparation, (2) item generation and (3) item selection and testing of content validity. We generated items using qualitative content analysis based on information from focus groups, key informant interviews and literature search. We selected items using relevance rating and cognitive interviews. Participants were patients from four chronic disease groups (cancer, cardiovascular disease, mental disorder, musculoskeletal disorder) and healthcare experts (e.g., clinicians, researchers, patient representatives).

Results

We conducted six focus groups with a total of 40 patients, key informant interviews with 10 experts and identified 48 PREMs from international literature. After team discussion, we reached a preliminary pool of 152 items. We conducted a relevance rating with 32 experts and 34 cognitive interviews with 21 patients. We selected 125 items assessing 16 dimensions of PC and showed high relevance and comprehensibility.

Conclusions

The EPAT questionnaire is currently undergoing psychometric testing. The transparent step‐by‐step report provides a best practice example that other researchers may consider for developing PREMs. Integrating literature and experts with a strong focus on patient feedback ensured good content validity. The EPAT questionnaire will be helpful in assessing PC in routine clinical practice in inpatient and outpatient settings for research and quality improvement.

Patient or Public Contribution

Patients were not involved as active members of the research team. While developing the funding proposal, we informally reached out to several patient organizations who all gave us positive feedback on the study aims, thereby confirming their relevance. Those patient organizations endorsed the funding proposal with formal letters of support and supported recruitment by disseminating advertisements for study participation.

The effectiveness of preoperative education interventions on improving perioperative outcomes of adult patients undergoing cardiac surgery: a systematic review and meta-analysis

BACKGROUND

Cardiac surgeries pose as an emotional experience for patients. Preoperative education is known to positively alter people's perceptions, emotions, and mitigate surgical distress. However, this intervention's effectiveness in improving perioperative outcomes among patients undergoing cardiac surgery lacked rigorous statistical synthesis and remains inconclusive.

AIMS

The aim was to synthesize the effectiveness of preoperative education on improving perioperative outcomes [anxiety, depression, knowledge, pain intensity, pain interference with daily activities, postoperative complications, length of hospitalization, length of intensive care unit (ICU) stay, satisfaction with the intervention and care, and health-related quality of life] among patients undergoing cardiac surgery.

METHODS

This systematic review and meta-analysis conducted a comprehensive search of nine electronic databases (PubMed, EMBASE, Scopus, MEDLINE, CINAHL, Cochrane CENTRAL, Web of Science, PsycINFO, and ERIC) and grey literature for randomized controlled trials examining the preoperative educational interventional effects on patients undergoing cardiac surgery from inception to 31 December 2020. The studies' quality was evaluated using Cochrane Risk-of-Bias Tool 1 (RoB1). Meta-analyses via RevMan 5.4 software synthesized interventional effects.

RESULTS

Twenty-two trials involving 3167 participants were included. Preoperative education had large significant effects on reducing post-intervention preoperative anxiety (P = 0.02), length of ICU stay (P = 0.02), and improving knowledge (P < 0.00001), but small significant effect sizes on lowering postoperative anxiety (P < 0.0001), depression (P = 0.03), and enhancing satisfaction (P = 0.04).

CONCLUSIONS

This review indicates the feasibility of preoperative education in clinical use to enhance health outcomes of patients undergoing cardiac surgery. Future studies need to explore knowledge outcomes in-depth and more innovative technologies in preoperative education delivery.

Adequacy of measures of informed consent in medical practice: A systematic review

As a critical component of medical practice, it is alarming that patient informed consent does not always reflect (1) adequate information provision, (2) comprehension of provided information, and (3) a voluntary decision. Consequences of poor informed consent include low patient satisfaction, compromised treatment adherence, and litigation against medical practitioners. To ensure a well-informed, well-comprehended, and voluntary consent process, the objective and replicable measurement of these domains via psychometrically sound self-report measures is critical. This systematic review aimed to evaluate the adequacy of existing measures in terms of the extent to which they assess the three domains of informed consent, are psychometrically sound and acceptable for use by patients. Extensive searching of multiple databases (PsychINFO, PubMed, Sociological Abstracts, CINAHL, AMED) yielded 10,000 potential studies, with 16 relevant scales identified. No existing scale was found to measure all three consent domains, with most only narrowly assessing aspects of any one domain. Information provision was the most frequently assessed domain, followed by comprehension, and then voluntariness. None of the identified scales were found to have adequate evidence for either high quality psychometric properties or patient user acceptability. No existing scale is fit for purpose in comprehensively assessing all domains of informed consent. In the absence of any existing measure meeting the necessary criteria relating to information, comprehension and voluntariness, there is an urgent need for a new measure of medical consent to be developed that is psychometrically sound, spans all three domains and is acceptable to patients and clinicians alike. These findings provide the impetus and justification for the redesign of the informed consent process, with the aim to provide a robust, reliable and replicable process that will in turn improve the quality of the patient experience and care provided.

Use of Standardized and Non-Standardized Tools for Measuring the Risk of Falls and Independence in Clinical Practice

(1) Background: The use of standardized tools is regarded as the basis for an evidence-based assessment. The tools enable monitoring of complex events and the effectiveness of adopted interventions. Some healthcare facilities use standardized tools such as the Morse Fall Scale, but many use non-standardized tools created based on patient needs. Our study question was, why are non-standardized tools used when standardized tools are more beneficial and can be statistically evaluated and compared to other results; (2) Methods: We used a quantitative, non-standardized questionnaire to survey 1200 nurses, which was representative sample for the entire Czech Republic. All questionnaires were assessed in two phases (a) the frequency evaluation and descriptive analysis, and (b) hypotheses testing and correlation analyses; (3) Results: We found that the Conley Scale, Barthel test, and IADL test were preferred by many nurses. Furthermore, we found that nurses using standardized assessment scales noticed risk factors significantly more frequently but regarded the increased complexity of care to be psychologically demanding. (4) Conclusions: In patients with physical disabilities, both types of tools (internal non-standardized and standardized) are used to assess the risk of falls and independence; nurses generally welcomed the increase use of standardized tools in their facilities.

Information needs and oral epithelial dysplasia: Development and psychometric evaluation of a novel instrument

OBJECTIVES

Oral epithelial dysplasia (OED) can lead to significant information needs (IN) related to the risk of cancer development, the need for long-term monitoring and potential intervention. The present study aimed to develop and perform preliminary psychometric testing for a novel IN instrument specific to OED.

SUBJECTS AND METHODS

Patients diagnosed with OED were invited to complete the Oral Epithelial Dysplasia Informational Needs Questionnaire (ODIN-Q), which was developed based on a known theoretical framework and with items generated via expert input and the literature. Face validity and content validity were initially assessed prior to finalisation of the tool. ODIN-Q was tested for internal consistency and test-retest reliability along with construct validity.

RESULTS

ODIN-Q consists of 35 items, categorised under six domains, and rated by dual 4-point Likert scales (amount of information received and degree of importance). Internal consistency (Cronbach's alpha) was rated "excellent" for the scale (0.93) and both subscales (0.92/0.94). For test-retest reliability, moderate agreement was found (κ = 0.49-0.53). Regarding construct validity, a significant but limited relationship was found between ODIN-Q and the Krantz Health Opinion Survey.

CONCLUSION

ODIN-Q showed adequate psychometric properties of reliability and validity. Further validation is, however, needed to assess its structural validity and responsiveness.

Information Needs of Black Prostate Cancer Patients Receiving Treatment Within the South African Public Healthcare System

Introduction

Prostate cancer is the leading cancer type in black South African men. The South African public healthcare sector serves more than 84% of the population, which includes many of these men. Previous evidence suggests that patients’ information needs are influenced by culture. No studies could be found that explored the information needs of black men diagnosed with prostate cancer in a developing country from the patients’ perspectives. Therefore, this study set out to investigate the information needs of black men diagnosed with prostate cancer in a South African public healthcare setting.

Methods

Nine participants who had completed a radical course of external beam radiation therapy for prostate cancer were interviewed. These participants had gained experience from their cancer journey in this setting and could therefore provide information-rich perspectives about their information needs from the time of diagnosis to end of treatment. Interviews were conducted in the participants’ preferred language, with three interviews conducted in Zulu with an English translator.

Results

Important themes that emerged included patients' desire to receive more information regarding what was happening in the diagnosis stage, the implications of having prostate cancer and the origin of their symptoms. The participants expressed a need to understand the potential side effects of radiation therapy, the reason for bladder filling and on-treatment set-up imaging verification. Participants also wanted to know how they should care for themselves and adjust their lifestyles, and required more information about follow-up tests and appointments.

Conclusion

In South Africa, black men with prostate cancer expressed the need for more information about the implications of a prostate cancer diagnosis, the reasons for these treatments and what they were expected to do. They also require information about where to go and what will happen in the different parts of the healthcare system with regard to the diagnosis and treatment of the prostate cancer. Communities should also be educated about cancer to avoid misconceptions. In South Africa, healthcare workers should consider the life-worlds of black men in the public healthcare system when attending to their information needs.