Insights into medication adherence among Jordanian patients with dyslipidemia: evaluating health literacy, well-being, and doctor-patient communication.

Background: This study aimed to assess medication adherence among Jordanian patients with dyslipidemia and evaluate the impact of health literacy, well-being, and doctor-patient communication on adherence in this population. Dyslipidemia is a prevalent condition that significantly increases the risk of cardiovascular diseases, and understanding the factors influencing medication adherence is crucial for improving patient outcomes. Methods: An observational cross-sectional study was conducted from March to July 2023. A convenience sample of adult Jordanians diagnosed with dyslipidemia was surveyed in a tertiary hospital using validated scales: the Lebanese Medication Adherence Scale-14 (LMAS-14), the Doctor-Patient Communication Scale (DPC), the WHO well-being index, and the health literacy scale. Bivariate analysis and linear regression models were employed to analyze associations. Results: Among 410 participants (mean age 58.62 ± 12.11 years), the mean scores were LMAS-14 (35.10), DPC (55.77), WHO well-being (47.53), and health literacy (38.96). Higher medication adherence was associated with older age (B = 0.093, p = 0.049), university education (B = 2.872, p = 0.017), prior surgery (B = 2.317, p = 0.021), medium income level (B = 3.605, p = 0.006), and better doctor-patient communication (B = 0.166, p = 0.003). Conversely, cigarette smoking (B = -3.854, p = 0.001) and health insurance (B = -2.146, p = 0.039) were linked to lower adherence. Conclusion: The findings underscore the substantial interplay of socio-demographic and clinical factors affecting medication adherence. Enhanced public health interventions focusing on improving health literacy, communication quality, and addressing socio-economic conditions are vital for better adherence and patient outcomes in Jordan.

Medical Students' Readiness for Prescription Communication Skills Training: A Needs Assessment Study.

Background and objectives The quality of doctor-patient communication plays a crucial role in determining positive medical outcomes. Medical educators may be able to develop effective programs to orient the students toward learning communication skills with the aid of assessment of the attitude of medical students toward such learning. Recently, the National Medical Commission's updated syllabus strongly emphasized on the value of training in prescription communication skills (PCS), in pharmacology. Our study utilizes the Communication Skills Attitude Scale (CSAS) to explore medical students' attitudes toward learning PCS in a private medical college, aiming to address the dearth of data in the Indian context. Methodology This cross-sectional study assessed the attitudes of 131 second-year medical students at Adichunchanagiri Institute of Medical Sciences toward PCS training. Validated, 26-item CSAS was used to measure their attitudes which include 13 items of Positive Attitude Scale (PAS) and 13 items of Negative Attitude Scale (NAS), and data analysis was conducted using independent t-tests to explore potential associations based on socio-demographic factors. Results The study scale showed an acceptable internal consistency of 0.71 (Cronbach's alpha) with 0.92 and 0.76 for PAS and NAS, respectively. The overall mean PAS score and NAS score were 54.2±6.9 and 34.7±6.3, respectively, indicating that the majority of students recognized the significance of communication skills for their future medical practice. Male students had significantly lower PAS scores (52.1±7.4) compared to female students (55±6.6) (p=0.02). Students with a rural background had significantly higher PAS scores (56.2±6.1) (p=0.01) compared to those with an urban background (53.2±9.8). No significant association was seen with demographic parameters like schooling background, presence of doctors in the family, and mother tongue they spoke. Conclusion The study revealed that second-year medical students had a strong inclination toward learning PCS. Therefore, greater emphasis should be placed on providing adequate training in PCS to the students to ensure effective doctor-patient interactions.

[Digital health apps : How to achieve the successful integration into healthcare]. / Digitale Gesundheits-Apps : Wie gelingt die Integration in die medizinische Versorgung.

Digital health applications (apps) have been available on prescription since 2019 and offer a multitude of functions in health monitoring, symptom recognition, follow-up monitoring and patient care. The Digital Care Act from 2023 strives for a comprehensive integration of apps into medical care. The utilization of artificial intelligence (AI) in health apps promises an earlier diagnosis, sensitive symptom monitoring, optimization of courses of treatment, more effective doctor-patient communication and saving of resources. The integration of health apps and AI can enable a stronger personalized high-value care.

"Numbers call for action, personalized narratives provide support and recognition": a qualitative assessment of cancer patients' perspectives on patient-reported outcome measures (PROMs) feedback with narratives.

PURPOSE: Patient-reported outcome measures (PROMs) are questionnaires completed by patients to gain insight in their health-related quality of life. However, patients often find the interpretation of PROMS challenging. A personalized narrative, i.e., a story with patients' experiences tailored to the reader, could help explain PROMs and might be appreciated alongside numerical outcomes. We studied how cancer patients perceive PROMs feedback presented in a regular numerical and a novel narrative format. METHODS: Cancer patients who completed PROMs in routine clinical practice were recruited. All participants received numerical feedback and a personalized narrative. Semi-structured interviews were conducted to uncover perceptions of both formats. Interviews were analyzed with an inductive reflexive approach to thematic analysis. RESULTS: Twenty-nine patients with breast cancer, melanoma, and bladder cancer participated. Thematic analysis identified six themes: "Understanding: I get the gist of it!"; "Usefulness: Tell me why I should complete PROMs"; "Format preferences: Numbers are cold, narratives are warm"; "Taking action: Can I do something about my score?"; "Personal relevance: Personalized narratives show me what life has in store for me"; and "Personal relevance: That's (not) me!" Numbers seemed to help participants act, whereas narratives may provide emotional support and recognition. Participants identified with the content of the narrative yet differed in how they related to the main character. CONCLUSION: Personalized narratives could be a useful addition to PROMs feedback. The studied formats seem to serve different purposes; numbers help to facilitate action, personalized narratives provide recognition. IMPLICATIONS FOR CANCER SURVIVORS: Personalized narratives may be a useful new way to communicate about quality of life to cancer survivors and help them to envision what the impact of cancer can be.

Why don't patients with dentine hypersensitivity discuss the condition with their dentist?

OBJECTIVES: This qualitative study aimed to develop an understanding of patients' barriers and facilitators of conversations about dentine hypersensitivity (DH) with their dentist. METHODS: The Theoretical Domains Framework shaped the topic guide for 26 participants who were troubled (High H) or not particularly troubled (Low L) by DH. Inductive thematic analysis of anonymised, transcribed, online focus group conversations was undertaken to identify reasons for non-discussion of DH during dental consultations. RESULTS: Participants reported that dentists did not routinely discuss DH, nor did participants feel they could bring it up. There was a perception among participants that DH was not a 'proper' condition and DH pain was not worthy of dentists' attention. Participants reported dealing with DH through lifestyle changes, and had little faith that dentists could offer more than 'just toothpaste' and voiced a need for a 'miracle cure'. Dental anxiety was a reported barrier to conversations. A positive attitude to DH by a dental team that normalised the condition and acknowledged its impacts on patients was voiced as a potential facilitator to DH discussions. CONCLUSIONS: DH conversations do not routinely take place in dental practice because patients believe DH is not serious, DH pain is not legitimate and there is no credible solution dentists can offer. Patients and dental teams need to be supported through behavioural science tools to change these perceptions for DH conversations to take place more routinely. CLINICAL SIGNIFICANCE: As DH cannot be diagnosed by visual inspection of teeth, patients cannot be managed unless they raise the issue of their DH with their dentist. The paper helps clinicians manage patients who are reticent to discuss DH with them and suggests how dentists may intervene to help.

Challenges and recommendations in the implementation of audiovisual telemedicine communication: a systematic review.

This systematic review aims to identify the elements of doctor-patient communication in telemedicine, emerging challenges, and proposed recommendations. Four databases, including Science Direct, PubMed, Cochrane, and ProQuest, were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria consisted of original research papers, availability of free full text, and publications during the past 10 years. A total of 13 articles completed the selection process and satisfied the established criteria. The issues and recommendations of telemedicine communication were categorized into three distinct groups: pre-consultation, during-consultation, and post-consultation. Preparation encompasses the arranging of visual elements, safeguarding patient privacy and confidentiality, and addressing any technical challenges that may arise. The consultation encompasses nonverbal behavior, empathy, the doctor-patient connection, and a physical examination. Post-telemedicine consultations refer to medical appointments that occur after a telemedicine session, typically involving follow-up medical interactions. Telemedicine presents unique challenges in doctor-patient consultations that differ from face-to-face interactions. Therefore, clinicians must acquire communication skills specific to telemedicine to ensure effective consultations and achieve optimal health results.

Physician Communication Behaviors on Patient Satisfaction in Primary Care Medical Settings in Bangladesh.

OBJECTIVES: This study aims at exploring the effects of physicians' communication behaviors on patients' satisfaction in primary care medical consultations in Chattogram, Bangladesh. The study used a quantitative research approach designed with a cross-sectional survey. METHODS: Data were collected using post-consultation and facilitator administered questionnaire from the patients who visited the physician for medical consultation in different hospitals and clinics in Chattogram city. Seven hundred patients were included as the study participants. A hierarchical linear regression analysis was performed to examine the factors contributing to the outcome variables. RESULTS: A statistically significant difference (P < .001) appeared regarding patients' perception of adequate consultation, physicians' nonverbal behavior, inhibiting behavior and patients' participating behavior in private and public settings. However, R2 value shows that physicians' patient-centered behaviors appeared as the stronger predictors of patient satisfaction toward medical interviews, followed by socioeconomic variables of patients and physicians and patients' participation during the consultation. Presence of a third person with patients during consultation (ß = -.05, P = .040), physicians' private setting of consultation (ß = .16, P < .001), physicians' seniority (ß = .05, P = .042), patients' participating behavior during consultation (ß = .20, P < .001), physicians' nonverbal behavior (ß = .10, P < .001), physicians' inhibiting behavior (ß = -.39, P < .001), and physicians' facilitating behavior with patients (ß = .32, P < .001) were reported as the influencing factors of patients' satisfaction with medical consultation. CONCLUSION: This study suggests the profound impact of physicians' patient-centered communication behaviors on patient satisfaction in primary care settings, overshadowing even socioeconomic factors and patient participation.

Access to the internet and mobile applications in a mixed population emergency department: A repeated cross-sectional survey.

Objective: This study aimed to assess patients' interest in education content delivered through electronic modalities and identify trends in internet access and use among emergency department patients of various socioeconomic statuses. Methods: A prospective, cross-sectional survey with 50 questions was completed by 241 English and Spanish-speaking patients in 2014 and repeated with 253 participants in 2019 at the University of California, Irvine Medical Center's Emergency Department (UCIMCED). Results: Internet access increased from 83.8 % in 2014 to 88.1 % in 2019. Most internet-using patients owned smartphones (80.1 % in 2014, 89.7 % in 2019). Patients used electronic devices, such as fit bits and activity trackers, to obtain health information. Email was the preferred method for receiving discharge instructions. Conclusions: As of 2019, 88.1 % of UCIMCED patients have access to the internet or email, making electronic media a reasonable venue for patient education. Given that we have a predominantly low-income patient population-61 % and 32 % of respondents in 2014 and 2019, respectively, reporting an income of less than $25,000-these results are provide new avenues to reach patients of all socioeconomic statuses. Innovation: The implications of this study can be used to develop electronic resources tailored to educate emergency department patients about their healthcare beyond the confines of a hospital.

Large language model triaging of simulated nephrology patient inbox messages.

Background: Efficient triage of patient communications is crucial for timely medical attention and improved care. This study evaluates ChatGPT's accuracy in categorizing nephrology patient inbox messages, assessing its potential in outpatient settings. Methods: One hundred and fifty simulated patient inbox messages were created based on cases typically encountered in everyday practice at a nephrology outpatient clinic. These messages were triaged as non-urgent, urgent, and emergent by two nephrologists. The messages were then submitted to ChatGPT-4 for independent triage into the same categories. The inquiry process was performed twice with a two-week period in between. ChatGPT responses were graded as correct (agreement with physicians), overestimation (higher priority), or underestimation (lower priority). Results: In the first trial, ChatGPT correctly triaged 140 (93%) messages, overestimated the priority of 4 messages (3%), and underestimated the priority of 6 messages (4%). In the second trial, it correctly triaged 140 (93%) messages, overestimated the priority of 9 (6%), and underestimated the priority of 1 (1%). The accuracy did not depend on the urgency level of the message (p = 0.19). The internal agreement of ChatGPT responses was 92% with an intra-rater Kappa score of 0.88. Conclusion: ChatGPT-4 demonstrated high accuracy in triaging nephrology patient messages, highlighting the potential for AI-driven triage systems to enhance operational efficiency and improve patient care in outpatient clinics.

Patient Experiences and Perceptions with Infections Due to Multidrug-Resistant Organisms: A Systematic Review.

Infections by multidrug-resistant organisms (MDROs) pose significant public health challenges, including increased mortality rates, healthcare costs, and significant impacts on the quality of life for patients. Utilizing a systematic review methodology adhering to PRISMA guidelines, we performed a comprehensive search across three databases, identifying 20 relevant studies that investigated the psychological effects of infections due to MDROs on hospitalized adults. The primary outcomes examined included depression, anxiety, and other psychosocial impacts, while secondary outcomes included patient and caregiver understanding of the infection. Findings revealed consistent associations between contact isolation due to MDRO infections and heightened levels of depression and anxiety among patients, although evidence regarding the impact on anger was mixed. Other psychological aspects, such as feelings of stigmatization and reduced healthcare provider interactions, were also recorded. The current systematic review highlights the importance of addressing these psychological effects through holistic, patient-centered care approaches, emphasizing the need for better communication and comprehensive education for both patients and healthcare providers. Our findings suggest that mitigating the psychological burden of MDROs can enhance overall patient care and outcomes and call for further research to optimize care strategies for patients hospitalized for infections due to MDROs.

A Bedside Electronic Whiteboard System for Patient Care in Isolation Rooms: A Scenario-Based Preliminary Study.

AIM: To assess a commercially available electronic whiteboard's usability and acceptability in isolation rooms, focusing on improving nurse-patient communication and supporting data input. DESIGN: A cross-sectional study with quantitative and qualitative mixed methods. METHODS: We evaluated the usability and acceptability of electronic whiteboards among nurses using scenarios in a virtual isolation room environment. RESULTS: Nurses recognised the electronic whiteboard as a valuable tool for communication and error reductions in record-keeping but noted a learning curve for less tech-savvy users. Positive correlations were found between perceived usefulness, ease of use and adoption intent. Despite challenges, electronic whiteboards show promise for enhancing patient care, requiring comprehensive training and management systems. Time allocation in patient wards and nurse-patient interactions are crucial considerations. CONCLUSION: Electronic whiteboards have usability and acceptability as a tool to improve nurse-patient communication. However, considering technical issues and staff resistance, a management system and user training are necessary. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses perceive electronic whiteboards as user-friendly and as facilitating data input. REPORTING METHOD: TREND (Nonrandomised evaluations of behavioural and public health interventions). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Exploring Patient Preferences for Information About CT Radiation Exposure: Bridging the Gap Between Patient Preference and Physician Practice.

Background: CT scan utilizes ionizing radiation poses a danger to the patient's health. Thus, telling the patient about ionizing radiation would be critical in promoting shared decision-making and improving patient-doctor communication. However, few studies have examined this topic broadly. Objective: The study was conducted to identify the frequency of physicians informing patients about the radiation risk before ordering a CT scan, as well as to examine the association between patients' demographic characteristics and their awareness of the radiation risks associated with CT scans. Methods: A cross-sectional study was conducted among 387 patients who had undergone CT scans at a tertiary hospital in Riyadh, Saudi Arabia. Data were collected via phone interviews using a structured questionnaire. Chi-squared tests were employed to assess associations between patients' demographic characteristics and their awareness of CT scan radiation risks. Results: When examining knowledge, 58% of patients knew that CT involves harmful radiation. This knowledge was significantly associated with higher education level and previous experience with CT scans. Regarding doctors' practice of providing information to patients about the scan, 344 (88.9%) patients indicated that their doctor had explained to them why they needed the scan. Only 28 (7.2%) patients stated that their doctor had mentioned the amount of radiation, and 74 (19.1%) patients indicated that doctors mentioned the risks associated with the radiation of the scan. Almost all patients (96.9%) preferred to be told about why they needed a CT scan. Conclusion: The vast majority of patients who underwent CT scans did not receive enough information about the harm of the scans. However, most of them preferred to know about this harm.

[Vaccine hesitancy in postpandemic times-A guide for physicians]. / Impfmüdigkeit in postpandemischen Zeiten ­ ein Wegweiser für Ärzt*innen.

The coronavirus disease 2019 (COVID-19) pandemic emphasized the importance of vaccinations for the prevention of life-threatening diseases and for avoiding the overburdening of the healthcare system. Despite the clear advantage of vaccinations, increasing vaccine hesitancy has been observed worldwide, especially among young people who are potential future parents. Vaccine hesitancy describes the delayed or lack of willingness to utilize recommended vaccinations and represents a substantial challenge for public health. This article analyzes the causes of vaccine hesitancy in the postpandemic period and discusses factors that could make communication successful. The role of artificial intelligence and structured evidence-based discussion techniques, such as the empathetic refutation interview, are emphasized. The aim is to provide practice-oriented recommendations to be able to provide physicians with tools that can help in the education counselling with insecure patients and can promote the acceptance of vaccinations.

Family strategies for managing childhood cancer: Using traditional and complementary medicine in Southern Egypt.

BACKGROUND AND PURPOSE: The use of traditional and complementary medicine (T&CM) is common in children with cancer globally. We aimed to assess the prevalence, types, reasons, perceived effectiveness, and disclosure rate of T&CM use among children with cancer in Southern Egypt. We also investigated whether T&CM use contributed to delays in initial presentation and treatment. MATERIALS AND METHODS: A cross-sectional design was utilized. Data were collected via an interviewer-administered questionnaire. Eligible children and their caregivers at the South Egypt Cancer Institute were invited to participate. RESULTS: Eighty-six children completed the study (response rate = 86%). T&CM use was reported by 52 (60.5%) patients, with six (11.5%) experienced delayed presentation. The reasons for T&CM use were complementary for 37 (71%) and alternative for 15 (29%) of the participants. The types of T&CM used included herbal (63%), nutritional (33%), witchcraft (29%), and religious (19%) therapies. Approximately 48% of users employed multiple T&CM types. Family members recommended T&CM for 60% of the users. Most patients (65%) perceived T&CM as effective, with 71% initiating its use during the early phases of treatment. Almost all participants (98%) reported that healthcare providers did not inquire about T&CM use. T&CM usage was more prevalent among wealthier families (p = .023). There was no significant relationship between T&CM use and patient gender, diagnosis, residence, or paternal educational level. CONCLUSIONS: The significant utilization of T&CM among children with cancer highlights the need for healthcare providers to engage in open and early discussions with families regarding T&CM use.

Physician's prosodic behavior and the regulation of patient anxiety: A quantitative study within the communication accommodation theory framework.

OBJECTIVES: Patients commonly experience anxiety when visiting a medical provider. While regulating its level, the physician may adjust their own prosodic behavior to express different levels of affective empathy and shape the emotional outcome. The primary aim was to examine the impact of convergence and divergence with the patient's prosodic emotional cues on the patient-perceived physician's affective empathy and the emotion regulation process. METHODS: Analog patients (n = 132) made assessments after the exposure to an audio vignette of a physician - patient conversation in the prosodic convergence or divergence condition. RESULTS: Convergence with the prosodic cues of anxiety was associated with the physician experiencing the same as or a similar emotional state to the patient. The former type of emotional reaction was related to lower odds of anxiety alleviation. Prosodic convergence had a negative effect on anxiety alleviation through the mediation of experiencing the same emotional state as the patient. CONCLUSIONS: Divergence from the prosodic cues of anxiety and, therefore, a low patient-perceived level of this emotion may facilitate the anxiety regulation process. PRACTICE IMPLICATIONS: A careful use of convergence and divergence with prosodic emotional cues and adequate control of prosody in general are strongly recommended for practitioners.

How to break the news in amyotrophic lateral sclerosis/motor neuron disease: practical guidelines from experts.

In amyotrophic lateral sclerosis/motor neuron disease (ALS/MND), it is necessary to communicate difficult news during the initial diagnosis and throughout the disease trajectory as the condition progresses. However, delivering difficult news to people with ALS/MND is an emotionally demanding task for healthcare and allied health professionals-one for which many feel ill-prepared because of limited training in this area. Ineffective communication of difficult news damages the patient-provider relationship and negatively impacts patient quality of life (QoL). To address this issue, we developed the A-L S-PIKES protocol based on available literature and our extensive clinical experience. It provides easy-to-follow, stepwise guidelines to effectively deliver difficult news to people with ALS/MND (PALS) that includes: Advance Preparation (preparing for the discussion logistically and emotionally); Location & Setting (creating a comfortable setting that fosters rapport); Patient's Perceptions (assessing PALS' understanding and perception of their condition); Invitation (seeking PALS' permission to share information); Knowledge (sharing information in a clear, understandable manner); Emotion/Empathy (addressing emotions with empathy and providing emotional support); and Strategy & Summary (summarizing the discussion and collaboratively developing a plan of action). A-L S-PIKES provides practical guidelines on how to prepare for and conduct these challenging conversations. It emphasizes effective communication tailored to the individual needs of PALS and their families, empathy, sensitivity, and support for PALS' emotional well-being and autonomy. The aim of A-L S-PIKES is to both enhance skills and confidence in delivering difficult news and to improve the QoL of PALS and their families. Future studies should systematically evaluate the feasibility and effectiveness of A-L S-PIKES to establish its utility in clinical practice.

Health Care Discrimination Affects Patient Activation, Communication Self-Efficacy, and Pain for Black Americans.

This study examines whether a key psychosocial factor-perceiving racial discrimination in health care-is associated with worse patient activation, communication self-efficacy, and physical health outcomes for Black veterans with chronic pain. Moreover, we explore the role of physician-patient working alliance as a moderator that may alleviate the potential consequences of perceiving racial discrimination. This work is a secondary analysis of baseline data from a clinical trial with 250 U.S. Black veterans with chronic musculoskeletal pain. Participants were recruited from primary care clinics at a Midwestern VA hospital between 2018 and 2021. Perceiving racial discrimination in health care was associated with lower patient activation, lower self-efficacy in communicating with one's physician, higher pain intensity, and lower pain management self-efficacy (ps < .049) but was unrelated to reports of pain interference or use of pain coping strategies (ps > .157). Although the relationship between perceived discrimination and patient activation was moderated by working alliance (P = .014), having a stronger working alliance improved patient activation to varying degrees across levels of perceived discrimination (rather than buffering against negative outcomes when perceiving higher levels of discrimination). Moderation was not significant on any other measures. This study deepens our understanding of the broad range of health outcomes that are (not) associated with perceiving racial discrimination in health care. Contrary to prior theorizing, this work also indicates that having a strong working alliance does not attenuate the consequences of perceiving discrimination among Black individuals living with pain. These results highlight the need for system-level interventions to address perceptions of racial mistreatment in health care. PERSPECTIVE: This work has important public health implications by identifying the broad range of outcomes associated with perceived discrimination in health care among Black Americans. Importantly, a strong physician-patient relationship did not buffer Black individuals from the consequences of perceiving discrimination. These findings inform intervention targets to mitigate racial health disparities.

Older women's perspectives on the ethics of persuasion in doctor-patient communication.

BACKGROUND: Public health campaigns have often used persuasive techniques to promote healthy behaviors but the use of persuasion by doctors is controversial. We sought to examine older women's perspectives. METHODS: We conducted semi-structured interviews with 20 community-dwelling older women from the Baltimore metropolitan area. We asked whether participants thought it was ethically appropriate for doctors to try to persuade patients and explored their rationales. We probed about commonly used persuasive techniques and two example decisional contexts-stopping mammograms and moving out of one's house after multiple falls. We used qualitative thematic analysis to code the transcripts and summarized results into major themes. RESULTS: We found mixed views on the ethical appropriateness of persuasion (theme 1); supporters of persuasion were motivated by the potential benefit to patients' health, whereas opponents thought patients should be the ultimate decision-makers. Perspectives depended on the persuasive technique (theme 2), where emotional appeals elicited the most negative reactions while use of facts and patient stories were viewed more positively. Perspectives also varied by the decisional context (theme 3), where higher severity and certainty of harm influenced participants to be more accepting of persuasion. Participants suggested alternative communication approaches to persuasion (theme 4) that emphasized respect for patients. CONCLUSIONS: Our findings suggest that the type of persuasive technique and the decisional context are important considerations in the ethical debate around the use of persuasion. Limiting the use of persuasion to high-stakes decisions and using facts and patient stories rather than emotional appeals are likely more acceptable.

Experiences of families post treatment for childhood brain tumours during medical clinic consultations regarding health-related quality of life, unmet needs and communication barriers: A qualitative exploration.

BACKGROUND: Many studies highlight poor health-related quality of life (HRQoL) in children treated for brain tumours and their parents. However, little is known about the extent to which their informational, healthcare and communication needs regarding HRQoL are met during medical outpatient consultations. AIM: To explore the experiences of families regarding communication with physicians about HRQoL issues during consultations after treatment for childhood brain tumours. METHODS: Interviews were conducted with 18 families of children and adolescents aged 8-17 years after completion of brain tumour treatment. Participants had completed treatment within the last 5 years and were receiving regular outpatient follow-up care. Thematic analysis was undertaken using the Framework Method. RESULTS: Five main themes were identified: (i) unmet emotional and mental health needs; (ii) double protection; (iii) unmet information needs; (iv) communication barriers within consultations; and (v) finding a new normal. CONCLUSION: There was a need to improve communication between clinicians and these families, improve information provision, and overcome barriers to conversing with children within these outpatient consultations. Children and their parents should be supported to voice their current needs and concerns regarding their HRQoL. These findings will inform further development of the UK version of the 'KLIK' patient- and parent-reported outcome (PROM) portal.

Decision-making conflicts regarding hematopoietic stem cell transplantation in patients with hematological neoplasms: A descriptive qualitative study.

PURPOSE: To explore and understand the conflict in decision-making of hematopoietic stem cell transplantation in patients with hematological neoplasms. METHODS: A descriptive qualitative study of 16 patients with hematologic neoplasms in the hematology department was conducted between February 2022 and May 2022. Purposive sampling was used to select participants. Face-to-face in-depth personal interviews were performed. Interviews were recorded, transcribed, and coded. This descriptive qualitative study adhered to the COREQ checklist. RESULTS: All patients indicated difficulties in making decisions regarding hematopoietic stem cell transplantation. Five themes were identified: (1) weighing the pros and cons of HSCT, (2) financial burden versus desire for rebirth, (3) treatment urgency versus being unprepared, (4) saving oneself versus damaging loved ones, and (5) family companionship versus emotional isolation. These themes reflect the contradictions, entanglements, and realistic conflicts in decision-making regarding hematopoietic stem cell transplantation for patients with hematological neoplasms. CONCLUSIONS: This study identified multiple conflicts of decision-making in patients with hematologic neoplasms regarding decisions on hematopoietic stem cell transplantations. Healthcare workers should provide patients with disease knowledge, doctor-patient and intra-family communication, and access to financial support in order to resolve their conflicts and ultimately help them make the decision that is most optimum for them.