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1.
BMC Public Health ; 24(1): 324, 2024 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-38287341

RESUMO

INTRODUCTION: To date, there has been little research on the general health literacy of trans and gender diverse individuals, even though previous research undermines the importance of good health literacy in this sample. The aim of the article is therefore to describe the general health literacy of trans and gender diverse individuals based on a German survey. METHODS: In September 2022, a survey study was conducted in which health literacy was recorded using HLS-EU-16. Data will be presented descriptively; gender differences will be explored using a Χ2- test and a univariate analysis of variance (ANOVA). RESULTS: Out of N = 223 participants, n = 129 individuals (57.8%) identified as non-binary; n = 49 (22.0%) identified themselves as male, while n = 45 (20.2%) identified as female. Mean age was 28.03 years. Overall, 26.4% of all the participants showed an inadequate health literacy, as proposed by the HLS-EU-16. In trend, health-related task related to media use were more often perceived as easy compared to the German general population. CONCLUSION: Individuals, who identify as trans and gender diverse may have a general health literacy below average compared to the German general population. However, tasks related to media use were perceived as easy, which might be a good starting point for health literacy related interventions. TRIAL REGISTRATION: DRKS00026249, Date of registration: 15/03/2022.


Assuntos
Letramento em Saúde , Minorias Sexuais e de Gênero , Humanos , Masculino , Feminino , Adulto , Estudos Transversais , Inquéritos e Questionários , Alemanha
2.
BMC Health Serv Res ; 24(1): 719, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862923

RESUMO

BACKGROUND: The aim of the present study is to investigate the impact of the Covid-19 pandemic on the effectiveness of psychosomatic rehabilitation. METHODS: Between April 2019 and March 2022, a total of 18,388 patients from 7 rehabilitation centres could be included in the study. For each patient, score values from the HEALTH-49 and ICF AT-50 Psych questionnaires were calculated at the beginning and at the end of rehabilitation and the effectiveness of the rehabilitation program was determined by comparing the scores at the beginning and at the end of the rehabilitation programme. Using risk adjusted linear mixed models, three time intervals were compared: a pre-pandemic episode (April 2019 to March 2020), the first year of the pandemic (April 2020 to March 2021) and the second year of the pandemic (April 2021 to March 2022). RESULTS: Overall, it can be stated that the pandemic has substantially impaired the effectiveness of psychosomatic rehabilitation measures. This phenomenon can be observed across a wide range of psychosocial markers and even two years after the start of the pandemic there is no end to the limited effectiveness. With regard to 'psychological and somatoform disorders', for example, there was a relative decrease in the effectiveness of the rehabilitation measure by 11.29% in the first year of the pandemic compared to the pre-pandemic episode, p < 0.001. In the second year of the pandemic, the effectiveness of the rehabilitation measure was still decreased by 8.8% compared to the pre-pandemic episode, p < 0.001. In addition, the evaluations show that a division of the pandemic effect into direct effects (on the individual) and indirect effects (via further complication of the occupational problem environment) can be made and that the pandemic-related complication of the occupational problem environment are still prevalent more than two years after the start of the pandemic. DISCUSSION: The Covid-19 pandemic has had a significant impact on the psychosomatic rehabilitation programs reducing the effectiveness of treatment not only for a short period of time but constantly until March 2022. TRIAL REGISTRATION NUMBER: DRKS00029669; Date of registration: 02/08/2022.


Assuntos
COVID-19 , Pandemias , Transtornos Psicofisiológicos , Humanos , COVID-19/epidemiologia , Alemanha/epidemiologia , Masculino , Feminino , Transtornos Psicofisiológicos/reabilitação , Transtornos Psicofisiológicos/epidemiologia , Pessoa de Meia-Idade , Adulto , SARS-CoV-2 , Inquéritos e Questionários , Idoso , Reabilitação Psiquiátrica
3.
Rehabilitation (Stuttg) ; 60(1): 37-44, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33152780

RESUMO

PURPOSE: The medication adherence of people with chronic diseases is often deficient. The present study investigated facilitators and barriers of the implementation of prescribed medication among rehabilitants with cardiological diseases in medical rehabilitation. METHODS: In total, 22 rehabilitants with cardiological diseases in medical rehabilitation were interviewed by means of a guided interview. All interviews were digitally recorded and literally translated. The analysis of the interviews was software-based (MAXQDA 12) according to the comprehensive content-analytic approach of Mayring. The main categories (barriers/facilitators) were deductively and the subcategories inductively developed. RESULTS: In total, 698 passages were coded in 22 documents, on average 32 per interview (SD=13.2, range 12-65). The 370 entries in the main category barriers are divided into 13 subcategories (e. g. carelessness, lack of information, reservations, burdens, forgetfulness). The 328 statements given in the main category facilitators could be allocated to 14 subcategories (e. g. individual strategies, knowledge, aids, patient insight into the necessity of treatment, communication). CONCLUSION: The findings suggest that a lack of medication adherence can be improved, in particular through individualized multi-level barrier management.


Assuntos
Reabilitação Cardíaca , Doenças Cardiovasculares/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Doenças Cardiovasculares/psicologia , Doença Crônica , Alemanha , Humanos , Adesão à Medicação/psicologia , Pesquisa Qualitativa , Tradução
4.
Z Kinder Jugendpsychiatr Psychother ; 49(5): 213-226, 2021 May.
Artigo em Alemão | MEDLINE | ID: mdl-33993737

RESUMO

The desire and the experience of participation among children and adolescents in inpatient mental healthcare Abstract. Objective: Children have the right to participate in decisions that affect them. However, the stages and domains of participation relevant within inpatient child and adolescent psychiatry have rarely been empirically investigated. The present study closes this research gap. Method: A prospective, multicenter, questionnaire-based survey was conducted. The questionnaire comprised 100 items, summarized in 16 scales, to assess the desire and the experience of participation. The data were quantitively evaluated. Results: 81 children and adolescents from 5 psychiatric hospitals took part in the study. Overall, they wished more participation than experienced. The higher the level of participation, the greater the difference was between wish and reality. The desire for participation is particularly high for decisions regarding communication with family and friends. The largest difference between desire and experience related to respectful and trusting interaction with patients, and for female patients, this difference was even higher. Conclusion: Participation means more than informed consent. There is still potential for expanding participation in child and adolescent psychiatry, especially at higher levels of participation and concerning decisions about communication with family and friends. A respectful and trusting interaction with patients, regardless of age, sex, or illness, is fundamental.


Assuntos
Pacientes Internados , Serviços de Saúde Mental , Adolescente , Psiquiatria do Adolescente , Criança , Tomada de Decisões , Feminino , Humanos , Estudos Prospectivos
5.
Rehabilitation (Stuttg) ; 59(1): 26-33, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31117132

RESUMO

PURPOSE: The aim of this study was the development and psychometric evaluation of a questionnaire which measures barriers and facilitators of medication adherence of patients with cardiovascular diseases in medical rehabilitation. METHODS: A total of 133 inpatients in medical rehabilitation returned the questionnaire in a cross-sectional study in one center of cardiological rehabilitation. The dimensional analysis of the instrument was conducted by explorative factor analysis (EFA). RESULTS: The questionnaire "Freiburger Fragebogen zur Medikamentenadhärenz (FF-MedAd)" consists of 30 items distributed among 8 factors. Five of these factors represent barriers (e. g. forgetting/interchanging) and 3 facilitators (e. g. trust, communication) of medication adherence. Five scales have acceptable to good internal consistency with Cronbachs α between 0.72 and 0.87. Three scales were just below the acceptable range (0.61-0.67). Correlations between the FF-MedAd scales indicate the factorial validity of the questionnaire. CONCLUSION: The psychometric results of the FF-MedAd to measure self-estimated medication adherence of patients with cardiovascular diseases were satisfactory.


Assuntos
Reabilitação Cardíaca , Doenças Cardiovasculares , Estudos Transversais , Alemanha , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
6.
Prax Kinderpsychol Kinderpsychiatr ; 69(8): 700-719, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33245036

RESUMO

Patient Participation in Child and Adolescent Psychiatry - A Scoping Review The present study deals with the concept of participation in inpatient child- and adolescent mental health care. Aim is to analyse theoretical constructs in the light of a literature review on participation as an important method to implement patient autonomy in the specific context. The potential for conflict of patient autonomy as a greater principle and the absence of literature reviews on the topic make this study essential. The method is a scoping-review. 978 texts from three central databases have been screened for title and abstract, 27 have been included. The results show arguments, barriers and methods of participation. Most of the arguments are utilitarian: positive effects on patients, therapists and the hospital. On the other hand, there are multiple barriers of implementation: willingness of physicians, reticence of patients and systemic barriers. Structures of cooperation, key figures and interactive information brochures have already been used as methods of participation. In conclusion, a contextual concept of participation is proposed: Shared Care Planning. It is meant to be independent from the capacity to give informed consent and underlines the importance of day-to-day issues. It calls for the consideration of the mentioned barriers and a high flexibility of participation methods.


Assuntos
Psiquiatria do Adolescente , Psiquiatria Infantil , Participação do Paciente , Adolescente , Criança , Humanos
7.
BMC Fam Pract ; 20(1): 33, 2019 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-30803433

RESUMO

BACKGROUND: Back pain is one of the most frequent causes of health-related work absence. In Germany, more than 70% of adults suffer from at least one back pain episode per annum. It has strong impact on health care costs and patients' quality of life. Patients increasingly seek health information on the internet. However, judging its trustworthiness is difficult. In addition, physicians who are being confronted with this type of information often experience it to complicate the physician-patient interaction. The GAP trial aims to develop, implement and evaluate an evidence-based, easy-to-understand and trustworthy internet information portal on lower back pain to be used by general practitioners and patients during and after the consultation. Effectiveness of GAP portal use compared to routine consultation on improving communication and informedness of both physicians and patients will be assessed. In addition, effects on health care costs and patients' days of sick leave will be evaluated. METHODS: We will conduct a prospective multi-centre, cluster-randomized parallel group trial including 1500 patients and 150 recruiting general practitioners. The intervention group will have access to the GAP portal. The portal will contain brief guides for patients and physicians on how to improve the consultation as well as information on epidemiology, aetiology, symptoms, benefits and harms of treatment options for acute, sub-acute and chronic lower back pain. The GAP portal will be designed to be user-friendly and present information on back pain tailored for either patients or physicians in form of brief fact sheets, educative videos, info-graphics, animations and glossaries. Physicians and patients will assess their informedness and the physician-patient communication in consultations at baseline and at two time points after the consultations under investigation. Days of sick leave and health care costs related to back pain will be compared between control and intervention group using routine data of company health insurance funds. DISCUSSION: The GAP-trial intends to improve the communication between physicians and their patients and the informedness of both groups. If proven beneficial, the evidence-based and user-friendly portal will be made accessible for all patients and health professionals in back pain care. Inclusion of further indications might be implemented and evaluated in the long term. TRIAL REGISTRATION: German Clinical Trials Register DRKS00014279 (registered 27th of April 2018).


Assuntos
Comunicação , Clínicos Gerais , Internet , Dor Lombar , Relações Médico-Paciente , Informação de Saúde ao Consumidor , Gerenciamento Clínico , Custos de Cuidados de Saúde , Humanos , Portais do Paciente , Licença Médica
9.
Clin Rehabil ; 31(7): 926-935, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27587330

RESUMO

OBJECTIVE: Structural analysis of the German translation of the "Client-Centered Rehabilitation Questionnaire" (CCRQ). DESIGN: Cross-sectional multicenter study. SETTING: Ten inpatient rehabilitation centers in Germany. SUBJECTS: The CCRQ was completed by patients in the ten rehabilitation centers. MAIN MEASURES: The psychometric analysis of the CCRQ was conducted using exploratory and confirmatory factor analysis. RESULTS: The CCRQ was completed by 496 patients (average age: 59 years; 59.7% women). The CCRQ's 7-factor structure could not be confirmed. Factor analysis showed that the three latent constructs "decision-making/communication", "self-management/empowerment", and "psychosocial well-being" (60.73% variance explained) adequately represent patient-centeredness in medical rehabilitation assessed by the CCRQ. The scales possess good reliability (Cronbach's α = .83 to .87) and convergent criterion validity (r = 0.48 to 0.68). The three-factorial model exhibited good local and global data fit (RMSEA: 0.063, CFI 0.962, TLI 0.954) and proved to have a better data fit than concurring models (e.g. a model assuming an underlying factor). CONCLUSIONS: A validated short form of the Client-Centered Rehabilitation Questionnaire, CCRQ-15, could be identified. Three scales based on 15 items allow assessing the key aspects of patient-centeredness in German medical rehabilitation.


Assuntos
Assistência Centrada no Paciente/organização & administração , Psicometria/métodos , Centros de Reabilitação/organização & administração , Inquéritos e Questionários , Adulto , Idoso , Estudos Transversais , Análise Fatorial , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Prognóstico , Estudos de Amostragem , Resultado do Tratamento
10.
BMC Med Educ ; 17(1): 120, 2017 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-28705207

RESUMO

BACKGROUND: Interprofessional teamwork is considered to be a key component of patient-centred treatment in healthcare, and especially in the rehabilitation sector. To date, however, no interventions exist for improving teamwork in rehabilitation clinics in Germany. A team training programme was therefore designed that is individualised in content but standardised regarding methods and process. It is clinic specific, task related, solution focused and context oriented. The aim of the study was to implement and evaluate this training for interprofessional teams in rehabilitation clinics in Germany. METHODS: The measure consists of a training of a varying number of sessions with rehabilitation teams that consists of four distinct phases. Those are undergone chronologically, each with clinic-specific contents. It was implemented between 2013 and 2014 in five rehabilitation clinics in Germany and evaluated by the participants via questionnaire (n = 52). RESULTS: Staff in three clinics evaluated the programme as helpful, in particular rating moderation, discussions and communication during the training positively. Staff in the remaining two clinics rated it as not very or not helpful and mentioned long-term structural problems or a lack of need for team training as a reason for this. CONCLUSIONS: The team training is applicable and accepted by staff. It should, however, be tested in a greater sample and compared with a control group. Processes should be studied in more detail in order to determine what differentiates successful from non-successful interventions and the different requirements each of these might have.


Assuntos
Educação Médica Continuada , Equipe de Assistência ao Paciente/normas , Medicina Física e Reabilitação/educação , Avaliação de Programas e Projetos de Saúde , Atitude do Pessoal de Saúde , Comportamento Cooperativo , Estudos Transversais , Educação Médica Continuada/normas , Alemanha , Humanos , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente/organização & administração , Medicina Física e Reabilitação/normas , Projetos Piloto
11.
BMC Med Educ ; 16: 172, 2016 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-27400872

RESUMO

BACKGROUND: Patient safety (PS) is influenced by a set of factors on various levels of the healthcare system. Therefore, a systems-level approach and systems thinking is required to understand and improve PS. The use of e-learning may help to develop a systems thinking approach in medical students, as case studies featuring audiovisual media can be used to visualize systemic relationships in organizations. The goal of this quasi-experimental study was to determine if an e-learning can be utilized to improve systems thinking, knowledge, and attitudes towards PS. METHODS: A quasi-experimental, longitudinal within- subjects design was employed. Participants were 321 third-year medical students who received online surveys before and after they participated in an e-learning course on PS. Primary outcome measures where levels of systems thinking and attitudes towards PS. Secondary outcome measures were the improvement of PS specific knowledge through the e-learning course. RESULTS: Levels of systems thinking showed significant improvement (58.72 vs. 61.27; p < .001) after the e-learning. Student's attitudes towards patient safety improved in several dimensions: After the course, students rated the influence of fatigue on safety higher (6.23 vs. 6.42, p < .01), considered patient empowerment more important (5.16 vs. 5.93, p < .001) and realized more often that human error is inevitable (5.75 vs. 5.97, p < .05). Knowledge on PS improved from 36.27 % correct answers before to 76.45 % after the e-learning (p < .001). CONCLUSIONS: Our results suggest that e-learning can be used to teach PS. Attitudes towards PS improved on several dimensions. Furthermore, we were able to demonstrate that a specifically designed e-learning program can foster the development of conceptual frameworks such as systems thinking, which facilitates the understanding of complex socio-technical systems within healthcare organisations.


Assuntos
Instrução por Computador , Educação de Graduação em Medicina/métodos , Conhecimentos, Atitudes e Prática em Saúde , Segurança do Paciente , Aprendizagem Baseada em Problemas , Treinamento por Simulação , Estudantes de Medicina , Adulto , Competência Clínica/normas , Educação de Graduação em Medicina/normas , Avaliação Educacional , Feminino , Humanos , Masculino , Erros Médicos/prevenção & controle , Ensino , Interface Usuário-Computador
12.
J Interprof Care ; 30(1): 15-28, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26709985

RESUMO

To identify key features of teamwork and interventions for enhancing interprofessional teamwork (IPT) in chronic care and to develop a framework for further research, we conducted a systematic literature review of IPT in chronic care for the years 2002-2014. Database searches yielded 3217 abstracts, 21 of which fulfilled inclusion criteria. We identified two more studies on the topic by scanning the reference lists of included articles, which resulted in a final total of 23 included studies. The key features identified in the articles (e.g., team member characteristics, common task, communication, cooperation, coordination, responsibility, participation, staff satisfaction, patient satisfaction, and efficiency) were structured in line with the input-process-output model, and evaluated interventions, such as tools, workshops, and changes in team structure, were added to the model. The most frequently evaluated team interventions were complex intervention programs. All but one of the 14 evaluation studies resulted in enhancement of teamwork and/or staff-related, patient-related, and organization-related outcome criteria. To date, there is no consensus about the main features of IPT and the most effective team interventions in chronic care. However, the findings may be used to standardize the implementation and evaluation of IPT and team interventions in practice and for further research.


Assuntos
Doença Crônica/terapia , Comportamento Cooperativo , Comunicação Interdisciplinar , Relações Interprofissionais , Equipe de Assistência ao Paciente/organização & administração , Gerenciamento Clínico , Humanos
13.
BMC Health Serv Res ; 15: 243, 2015 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-26099228

RESUMO

BACKGROUND: Team effectiveness is often explained on the basis of input-process-output (IPO) models. According to these models a relationship between organizational culture (input = I), interprofessional teamwork (process = P) and job satisfaction (output = O) is postulated. The aim of this study was to examine the relationship between these three aspects using structural analysis. METHODS: A multi-center cross-sectional study with a survey of 272 employees was conducted in fifteen rehabilitation clinics with different indication fields in Germany. Structural equation modeling (SEM) was carried out using AMOS software version 20.0 (maximum-likelihood method). RESULTS: Of 661 questionnaires sent out to members of the health care teams in the medical rehabilitation clinics, 275 were returned (41.6%). Three questionnaires were excluded (missing data greater than 30%), yielding a total of 272 employees that could be analyzed. The confirmatory models were supported by the data. The results showed that 35% of job satisfaction is predicted by a structural equation model that includes both organizational culture and teamwork. The comparison of this predictive IPO model (organizational culture (I), interprofessional teamwork (P), job satisfaction (O)) and the predictive IO model (organizational culture (I), job satisfaction (O)) showed that the effect of organizational culture is completely mediated by interprofessional teamwork. The global fit indices are a little better for the IO model (TLI: .967, CFI: .972, RMSEA .052) than for the IPO model (TLI: .934, CFI: .943, RMSEA: .61), but the prediction of job satisfaction is better in the IPO model (R(2) = 35%) than in the IO model (R(2) = 24%). CONCLUSIONS: Our study results underpin the importance of interprofessional teamwork in health care organizations. To enhance interprofessional teamwork, team interventions can be recommended and should be supported. Further studies investigating the organizational culture and its impact on interprofessional teamwork and team effectiveness in health care are important.


Assuntos
Comportamento Cooperativo , Satisfação no Emprego , Cultura Organizacional , Equipe de Assistência ao Paciente , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Alemanha , Humanos , Funções Verossimilhança , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/organização & administração , Inquéritos e Questionários , Adulto Jovem
14.
Healthcare (Basel) ; 12(7)2024 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-38610132

RESUMO

The majority of transgender and gender-nonconforming people (TGNC) report negative experiences with doctors in the healthcare system. As there is little knowledge about the communication behaviour of doctors towards TGNC, this survey aimed to assess the self-reported trans-inclusive communication of doctors and their willingness to communicate trans-inclusively, as well as their self-perceived barriers to it. A mixed-methods survey was applied for this. Firstly, we measured self-reported trans-inclusive communication behaviour based on the CommTrans questionnaire. Based on this, the overall willingness, as well as self-perceived barriers (qualitative) to communication, were assessed. In total, N = 57 doctors took part in the survey. Most participants reported not introducing themselves using pronouns (79.4%). Of these, 61.4% said that they would not be able to do this in the future either. Perceived barriers were classified into the following eight categories: necessity, sample-dependency, habit, structural barriers in practice, uncertainties in dealing with the topic, limits of patient-centredness, gender as a binary concept, and transphobia. In summary, doctors in Germany show different degrees of trans-inclusive communication. It is likely that this has a negative effect on TGNC, their health and access to the healthcare system.

15.
J Homosex ; : 1-16, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38421283

RESUMO

Patient-doctor communication is an important component of patient-centered care and should be adapted to the target group. Adapting communication to transgender and gender-diverse individuals is particularly difficult, as little is known about the preferences of this group. Thus, the aim of the study was to develop a questionnaire to assess the communication preferences of the target group. Based on a qualitative study, an item pool was created, which was tested in a survey in September 2022. An item analysis was conducted and items with unacceptable characteristics were removed. The remaining item pool was examined with an explorative factor analysis. The sample consisted of N = 264 individuals. Of the initial k = 43 items, k = 9 items remained in the final factor analysis. The final two factor solution explained 60.7% of the variance. The factors describe the emotional resonance in communication (Cronbach's α = .74; e.g. "My medical doctors should be happy for me when my treatment progresses positively.") as well as gender-related communication (Cronbach's α = .85; e.g. "My medical doctors should introduce themselves with pronouns."). Overall, the questionnaire captures the communication preferences of transgender and gender-diverse individuals in medical conversations. It covers two important topics for the target group, but further validation is necessary.

16.
BMC Health Serv Res ; 13: 374, 2013 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-24083632

RESUMO

BACKGROUND: Effective patient-centred health care requires internal participation, which is defined as interprofessional patient-centred teamwork. Many scales are designed for measuring teamwork from the perspective of one type of health care professional (e.g. physician or nurse), rather than for the use for all health care professionals as well as patients. Hence, this paper's purpose is to develop a scale for measuring internal participation from all relevant perspectives and to check its psychometric properties. METHODS: In a multicentre cross-sectional study, a 6-item Internal Participation Scale (IPS) was developed and administered to 661 health care professionals (staff) and 1419 patients in 15 rehabilitation clinics to test item characteristics, acceptance, reliability (internal consistency) and construct validity. Additionally, we performed an exploratory factor analysis (EFA) to determine the factorial structure and explained variance. Confirmatory factor analysis (CFA) was used to verify the theoretically assumed one-dimensional factorial structure. RESULTS: A total of 275 health care professionals and 662 patients participated, and the complete data sets of 272 staff members and 536 patients were included in the final analysis. The discrimination index was above .4 for all items in both samples. Internal consistency was very good, with Cronbach's alpha equalling .87 for the staff and .88 for the patient sample. EFA supported a one-dimensional structure of the instrument (explained variance: 61.1% (staff) and 62.3% (patients)). CFA verified the factorial structure, with the factor loadings exceeding .4 for five of six items in both samples. Global goodness-of-fit indices indicated a good model fit, with a Tucker-Lewis index (TLI) of .974 (staff) and .976 (patients) and a comparative fit index (CFI) of .988 (staff) and .989 (patients). The root mean square error of approximation (RMSEA) amounted to .068 for the patient sample and .069 for the staff sample. There is evidence of construct validity for both populations. CONCLUSIONS: The analysis of the scale's psychometric properties resulted in good values. The scale is a promising instrument to assess internal participation from the perspective of both patients and staff. Further research should investigate the scale's psychometric properties in other interprofessional health care settings to examine its generalizability as well as its sensitivity to change.


Assuntos
Participação do Paciente/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comportamento Cooperativo , Estudos Transversais , Tomada de Decisões , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Participação do Paciente/estatística & dados numéricos , Assistência Centrada no Paciente , Relações Médico-Paciente , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
17.
J Interprof Care ; 27(2): 146-54, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23151149

RESUMO

For implementation of patient-centered treatment in interprofessional health care units, such as rehabilitation teams, external participation (interaction between patient and health care professionals) and internal participation (communication, coordination and cooperation in the interprofessional team) need to be considered. The aim of this study is to identify the preferences of patients and health care professionals concerning internal and external participation in rehabilitation clinics, in order to develop an interprofessional shared decision-making (SDM) training program for health care professionals to enhance both types of participation. Therefore, a cross-sectional mixed-methods study was implemented in four rehabilitation clinics. The study consists of two parts: focus groups with patients and a survey of experts (senior health care professionals from medicine, psychotherapy, physical therapy and nursing). More time, more respect from the health care professionals and the desire for more participation in decision-making processes were mentioned most frequently by patients (n = 36) in the focus groups. The health care professionals (n = 32) saw most deficits in internal participation, e.g. management of feedback, talking with difficult team members and moderate conflict discussion. The results of both assessments have been used to develop an interprofessional SDM training program for implementing internal and external participation in interprofessional teams in medical rehabilitation.


Assuntos
Tomada de Decisões , Ocupações em Saúde/educação , Estudos Interdisciplinares , Relações Interprofissionais , Desenvolvimento de Programas , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Grupos Focais , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Assistência Centrada no Paciente , Enfermagem em Reabilitação/educação , Adulto Jovem
18.
PLoS One ; 18(8): e0284959, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37611052

RESUMO

BACKGROUND: Trans and gender-diverse individuals experience adverse health outcomes that might be due, in addition to other factors, to stigma and discrimination in the health care sector. At the same time, the concept of person-centred care acknowledges the role of patient-physician communication in health care outcomes. This study aims to explore patient-physician communication preferences in trans and gender-diverse individuals. METHOD: A qualitative interview study was conducted, including N = 10 participants between February and March 2022. Participants were interviewed using a semi-structured interview guideline, based on previous knowledge in person-centred care and sample specific communication. Participants were asked about their experiences and wishes in patient-physician centeredness. Analyses were conducting using a qualitative content analysis strategy. RESULTS: Mean age was 29.3 years; n = 6 participants identified themselves within the binary gender concept, while n = 4 identified themselves with a non-binary gender. Communication preferences for patient-physician communication were categorised into four themes: general communication aspects (e.g. active listening); the role of gender during appointments (e.g. appropriate/inappropriate addressing); gender-neutral language (e.g. experiences use of gender neutral language by physicians); own communication style (e.g. early outing and justification). Furthermore, possible contextual factors of patient-physician communication where found (e.g. trusting relationship). CONCLUSION: Adding knowledge to communication preferences of trans and gender-diverse individuals, this study was able to identify preferences that are specific to the sample as well as preferences that differ from the cis-gendered population. However, it remains unclear how the patient-physician communication preferences affects health care utilization and outcomes. TRIAL REGISTRATION: German Clinical Trial Register (DRKS00026249).


Assuntos
Comunicação , Médicos , Adulto , Humanos , Idioma , Relações Médico-Paciente , Pesquisa Qualitativa , Masculino , Feminino
19.
Front Psychol ; 14: 1186303, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38022945

RESUMO

Introduction: Interprofessional healthcare teams are important actors in improving patient safety. To train these teams, an interprofessional training program (IPTP) with two interventions (eLearning and blended learning) was developed to cover key areas of patient safety using innovative adult learning methods. The aims of this study were to pilot test IPTP regarding its effectiveness and feasibility. The trial was registered with DRKS-ID: DRKS00012818. Methods: The design of our study included both a pilot investigation of the effectiveness of the two interventions (eLearning and blended learning) and testing their feasibility (effectiveness-implementation hybrid design). For testing the effectiveness, a multi-center cluster-randomized controlled study with a three-arm design [intervention group 1 (IG1): eLearning vs. intervention group 2 (IG2)]: blended learning (eLearning plus interprofessional in-person training) vs. waiting control group (WCG) and three data collection periods (pre-intervention, 12 weeks post-intervention, and 24 weeks follow-up) was conducted in 39 hospital wards. Linear mixed models were used for the data analysis. The feasibility of IPTP was examined in 10 hospital wards (IG1) and in nine hospital wards (IG2) using questionnaires (formative evaluation) and problem-focused interviews with 10% of the participants in the two intervention groups. The collected data were analyzed in a descriptive exploratory manner. Results: Pilot testing of the effectiveness of the two interventions (eLearning and blended learning) showed no consistent differences between groups or a clear pattern in the different outcomes (safety-related behaviors in the fields of teamwork, error management, patient involvement, and subjectively perceived patient safety). Feasibility checks of the interventions showed that participants used eLearning for knowledge activation and self-reflection. However, there were many barriers to participating in eLearning, for example, lack of time or access to computers at the ward. With regard to in-person training, participants stated that the training content sensitized them to patient-safety-related issues in their everyday work, and that awareness of patient safety increased. Discussion: Although the interventions were judged to be feasible, no consistent effects were observed. A possible explanation is that the duration of training and the recurrence rate may have been insufficient. Another conceivable explanation would be that participants became more sensitive to patient safety-critical situations due to their knowledge acquired through the IPTP; therefore, their assessment post-intervention was more critical than before. In addition, the participants reported high pre-measurement outcomes. Future studies should examine the evidence of the intervention within a confirmatory study after adapting it based on the results obtained.

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