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Mohib T, Turin TC. Effective patient-provider relationship can be achieved through a patient-centred approach adopted by the healthcare providers from the start. Evid Based Nurs 2024:ebnurs-2023-103903. [PMID: 38395625 DOI: 10.1136/ebnurs-2023-103903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Affiliation(s)
- Tasmira Mohib
- Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Tanvir C Turin
- Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Department of Family Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
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Coelho J, Moreno Poyato A, Roldán Merino J, Sequeira C, Sampaio F. Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group study. BMC Nurs 2024; 23:9. [PMID: 38163914 PMCID: PMC10759621 DOI: 10.1186/s12912-023-01663-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination. METHODS This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis. RESULTS Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship. CONCLUSION According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students' awareness of the perspective of the relationship with patients with mental health disorder and its relevance.
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Affiliation(s)
- Joana Coelho
- Research and Development Unit, Northern Health Higher School of the Portuguese Red Cross, Oliveira de Azeméis, 3720-126, Portugal.
- Faculty of Medicine, University of Porto, Porto, 4200-319, Portugal.
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, 4200-450, Portugal.
| | - Antonio Moreno Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, Barcelona, 08007, Spain
- NURSEARCH - 2021 SGR 01083, Mental Health, Psychosocial and Complex Nursing Care Research Group, Universitat de Barcelona, Barcelona, 08007, Spain
| | - Juan Roldán Merino
- NURSEARCH - 2021 SGR 01083, Mental Health, Psychosocial and Complex Nursing Care Research Group, Universitat de Barcelona, Barcelona, 08007, Spain
- Campus Docent Sant Joan de Déu, University of Barcelona, Barcelona, 08830, Spain
| | - Carlos Sequeira
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, 4200-450, Portugal
- Nursing School of Porto, Porto, 4200-072, Portugal
| | - Francisco Sampaio
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, 4200-450, Portugal
- Nursing School of Porto, Porto, 4200-072, Portugal
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Abstract
ABSTRACT The passage of the PACT Act of 2022 expanded the services veterans receive through the U.S. Department of Veterans Affairs (VA), ensuring they now qualify for benefits if they've been exposed to certain toxins during their military service. This significant expansion of VA benefits also highlights the need for nurses and other health providers working outside the VA system-who care for millions of veterans-to be well-informed about their patients' military experiences and any potential environmental exposures and health impacts. In this article, the author raises awareness of military environmental exposures and offers guidance about exposure-informed care.
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Affiliation(s)
- Cashmere Miller
- Cashmere Miller is a lieutenant in the U.S. Public Health Service Commissioned Corps and an NP for environmental health at the U.S. Department of Veterans Affairs in Atlanta. Contact author: . The author has disclosed no potential conflicts of interest, financial or otherwise
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Sedlakova J, Westermair AL, Biller-Andorno N, Meier CA, Trachsel M. Comparison of analog and digital patient decision aids for the treatment of depression: a scoping review. Front Digit Health 2023; 5:1208889. [PMID: 37744684 PMCID: PMC10513051 DOI: 10.3389/fdgth.2023.1208889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Patient decision aids (PDAs) are important tools to empower patients and integrate their preferences and values in the decision-making process. Even though patients with mental health problems have a strong interest in being more involved in decision making about their treatment, research has mainly focused on PDAs for somatic conditions. In this scoping review, we focus on patients suffering from depression and the role of PDAs for this patient group. The review offers an overview of digital and analog PDAs, their advantages and disadvantages as well as recommendations for further research and development. Methods A systematic search of the existing literature guided by the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - extension for scoping reviews (PRISMA-ScR) was conducted. Three electronic literature databases with the appropriate thematic focus were searched (PubMed, PsycInfo, and Web of Science). The search strategy used controlled and natural language to search for the key concepts decision aids and depression. The articles were selected in a two-step process guided by predefined inclusion and exclusion criteria. We narratively synthetized information extracted from 40 research articles. Results We included 40 articles in our review. Our review revealed that there is more focus on digital PDAs in research than in clinical practice. Digitalization can enhance the benefits of PDAs by developing tools that are more efficient, interactive, and personalized. The main disadvantages of both types of PDAs for the treatment of depression are related to time, dissemination, and capacity building for the health care providers. Digital PDAs need to be regularly updated, effective strategies for their dissemination and acceptance need to be identified, and clinicians need sufficient training on how to use digital PDAs. There is more research needed to study which forms of PDAs are most appropriate for various patient groups (e.g., older adults, or patients with comorbidities), and to identify the most effective ways of PDAs' integration in the clinical workflow. The findings from our review could be well aligned with the International Patient Decision Aids Standards. Discussion More research is needed regarding effective strategies for the implementation of digital PDAs into the clinical workflow, ethical issues raised by the digital format, and opportunities of tailoring PDAs for diverse patient groups.
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Affiliation(s)
- Jana Sedlakova
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zürich, Switzerland
| | - Anna Lisa Westermair
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zürich, Switzerland
- Clinical Ethics Unit, University Hospital of Basel (USB), Basel, Switzerland
- Clinical Ethics Unit, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
| | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zürich, Switzerland
| | - Christoph A. Meier
- Department of Internal Medicine, University Hospital Zurich (USZ), Zürich, Switzerland
- Medical Faculty, University of Geneva, Geneva, Switzerland
| | - Manuel Trachsel
- Clinical Ethics Unit, University Hospital of Basel (USB), Basel, Switzerland
- Clinical Ethics Unit, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
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Björkelund C, Saxvik A, Svenningsson I, Petersson EL, Wiegner L, Larsson M, Törnbom K, Wikberg C, Ariai N, Nejati S, Hensing G, Hange D. Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability - a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project. BMJ Open 2023; 13:e074137. [PMID: 37295824 PMCID: PMC10277141 DOI: 10.1136/bmjopen-2023-074137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVES To study whether early and enhanced cooperation within the primary care centres (PCC) combined with workplace cooperation via a person-centred employer dialogue meeting can reduce days on sick leave compared with usual care manager contact for patients on sick leave because of common mental disorders (CMD). Secondary aim: to study lapse of CMD symptoms, perceived Work Ability Index (WAI) and quality of life (QoL) during 12 months. DESIGN Pragmatic cluster randomised controlled trial, randomisation at PCC level. SETTING 28 PCCs in Region Västra Götaland, Sweden, with care manager organisation. PARTICIPANTS 30 PCCs were invited, 28 (93%) accepted invitation (14 intervention, 14 control) and recruited 341 patients newly sick-listed because of CMD (n=185 at intervention, n=156 at control PCCs). INTERVENTION Complex intervention consisting of (1) early cooperation among general practitioner (GP), care manager and a rehabilitation coordinator, plus (2) a person-centred dialogue meeting between patient and employer within 3 months. CONTROL GROUP regular contact with care manager. MAIN OUTCOME MEASURES 12 months net and gross number of sick leave days at group level. SECONDARY OUTCOMES 12 months depression, anxiety, stress symptoms, perceived WAI and QoL (EuroQoL-5 Dimensional, EQ-5D). RESULTS No significant differences were found between intervention and control groups concerning days of sick leave (intervention net days of sick leave mean 102.48 (SE 13.76) vs control 96.29 (SE 12.38) p=0.73), return to work (HR 0.881, 95% CI 0.688 to 1.128), or CMD symptoms, WAI or EQ-5D after 12 months. CONCLUSIONS It is not possible to speed up CMD patients' return to work or to reduce sick leave time by early and enhanced coordination among GP, care manager and a rehabilitation coordinator, combined with early workplace contact over and above what 'usual' care manager contact during 3 months provides. TRIAL REGISTRATION NUMBER NCT03250026.
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Affiliation(s)
- Cecilia Björkelund
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ausra Saxvik
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Irene Svenningsson
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| | - Eva-Lisa Petersson
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| | - Lilian Wiegner
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Larsson
- Section for rehabilitation and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Karin Törnbom
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Social Work, University of Gothenburg, Goteborg, Sweden
| | - Carl Wikberg
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nashmil Ariai
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Shabnam Nejati
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Dominique Hange
- Primary Health Care/School of Public Health and Community Medicine/Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Xu RH, Wang LL, Zhou LM, Wong ELY, Wang D. Assessment of eHealth literacy to reduce financial toxicity and improve shared decision-making in cancer patients: A cross-sectional study. Digit Health 2023; 9:20552076231181475. [PMID: 37334320 PMCID: PMC10272650 DOI: 10.1177/20552076231181475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/25/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives This study aimed to investigate the associations between eHealth literacy, preferences for financial decision-making, and financial toxicity (FT) in a sample of Chinese cancer patients. Methods Eligible cancer patients were invited to participate in a cross-sectional survey from January to April 2021. Three measures (eHealth literacy scale, control preference scale, and COST) were used to analyze patients' eHealth literacy, decisional preferences, and FT, respectively. Wilcoxon signed-rank test and Kruskal-Wallis H test assessed the differences between population subgroups. Binary logistic and multivariate linear regression models were used to assess the relationships between eHealth literacy, decisional preferences, and FT. Results A total of 590 cancer patients completed the questionnaire. We found that high FT was associated with poor ECOG performance, severe cancer stage, and longer cancer duration. Patients who preferred to adopt collaborative attitude toward decision-making showed a significantly higher eHealth literacy. However, there was an inverse relationship between eHealth literacy and a patient-driven attitude toward decision-making in female cancer patients. Regression analysis indicated that patients who were highly educated and actively employed might report a higher eHealth literacy. A significant relationship was found between high eHealth literacy and low FT. However, this relationship became insignificant when the background characteristics of cancer patients were taken into account. Conclusions A relationship between enhanced eHealth literacy, preference for collaborative decision-making, and low risk of FT is identified. Practical implication Interventions to improve patients' ability to use quality and reliable web-based information on cancer care should be encouraged.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ling-ling Wang
- Department of Blood Transfusion Medicine, School of Medicine, Nanjing University, Nanjing, China
| | - Ling-ming Zhou
- Department of Human Resource, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Eliza Lai-yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
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Taple BJ, Haldar S, Tandon SD, Reddy M, Mohr DC, Miller ES. A qualitative examination of the implementation of a perinatal collaborative care program. Prim Health Care Res Dev 2022; 23:e51. [PMID: 36043371 DOI: 10.1017/S146342362200038X] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
AIM To identify implementation strategies for collaborative care (CC) that are successful in the context of perinatal care. BACKGROUND Perinatal depression is one of the most common complications of pregnancy and is associated with adverse maternal, obstetric, and neonatal outcomes. Although treating depressive symptoms reduces risks to mom and baby, barriers to accessing psychiatric treatment remain. CC has demonstrated benefit in primary care, expanding access, yet few studies have examined the implementation of CC in perinatal care which presents unique characteristics and challenges. METHODS We conducted qualitative interviews with 20 patients and 10 stakeholders from Collaborative Care Model for Perinatal Depression Support Services (COMPASS), a perinatal collaborative care (pCC) program implemented since 2017. We analyzed interview data by employing the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to organize empirically selected implementation strategies from Expert Recommendations for Implementing Change (ERIC) to create a guide for the development of pCC programs. FINDINGS We identified 14 implementation strategies used in the implementation of COMPASS. Strategies were varied, cutting across ERIC domains (eg, plan, educate, finance) and across EPIS contexts (eg, inner context - characteristics of the pCC program). The majority of strategies were identified by patients and staff as facilitators of pCC implementation. In addition, findings show opportunities for improving the implementation strategies used, such as optimal dissemination of educational materials for obstetric clinicians. The implementation of COMPASS can serve as a model for the process of building a pCC program. The identified strategies can support the implementation of this evidence-based practice for addressing postpartum depression.
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