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1.
J Food Sci ; 2024 Aug 04.
Artículo en Inglés | MEDLINE | ID: mdl-39098815

RESUMEN

Despite the growing interest in innovative nonanimal protein-prepared foods, knowledge about consumer demand for these newly prepared foods and their potential scope in the market could be improved. This study reports the results of a discrete choice experiment on consumers' (n = 1245) willingness to pay (WTP) for prepared plant-based meat (PPBM) in the context of Chinese food culture. Consumers were randomly assigned to a treated group with additional environmental information about PPBM. The estimation results of the random parameter logit model showed that when environmental information was provided, consumer preferences and WTP for frozen meatballs with mixed meat (beef-based and soy protein-based meat) and PBM (pure soy protein-based meat) significantly increased. However, their preference and WTP for food quality and safety attributes of meatballs decreased. Simultaneously, the availability of information reveals the heterogeneity of preferences. This study found that positive WTP for PPBM was limited to consumers with a low degree of food technology neophobia (FTN) and that consumers with a high degree of FTN may avoid purchasing meatballs made from PBM. In contrast, consumers with a higher time preference (i.e., impatient consumers) were likelier to pay for PPBM meatballs. PRACTICAL APPLICATION: PPBM is especially valuable in developing innovative nonanimal protein-prepared foods, and China has the potential to become the largest PPBM food market. Understanding consumers' preference for PPBM products and the impact of information provision on their WTP will assist food companies in devising suitable strategies for the development of new PPBM products. The findings of this study provide targeted market insights for the food industry to help guide the development of plant-based meat products more effectively.

2.
Behav Ther ; 55(5): 1026-1042, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39174263

RESUMEN

Parents and children who have recently immigrated from the Chinese mainland to Hong Kong face various challenges, including psychological and sociocultural adaptation difficulties. In collaboration with community partners, our research team has developed and implemented culturally sensitive and preventive parent-child parallel interventions to enhance positive adaptation among immigrant parents and children. Two interventions were conducted in this randomized controlled trial: an emotion regulation (ER) arm, which addressed psychological adaptation by reducing parent-child conflicts and improving emotions, and an information provision (IP) arm targeting sociocultural adaptation by increasing participants' knowledge about Hong Kong. The study randomly assigned 113 and 73 parent-child pairs (allocation ratio 3:2) into the ER and IP arms, respectively. Parents and children attended four two-hour weekly sessions of their assigned intervention and completed assessments before, immediately after, and one month following the intervention. The results showed that in the ER arm, parents showed improved positive affect, and children reported decreases in parent-child conflicts more than their counterparts in the IP arm. In the IP arm, parents and children increased their knowledge, and parents decreased sociocultural adaptation difficulties more than their counterparts in the ER arm. In addition, the moderation analyses showed that in both interventions, parents and children with elevated baseline depressive symptoms obtained greater benefits relative to their counterparts with fewer symptoms. Such marked improvements were seen among parents in negative affect and adaptation difficulties and among children in parent-child conflict, positive and negative affect in the ER arm. More improvements were noted among parents in negative affect and sociocultural adaptation difficulties and among children in negative affect in the IP arm. Future studies are suggested to develop and provide parent-child parallel interventions targeting both psychological and sociocultural adaptations to parents and children with heightened baseline depressive symptoms to facilitate their positive adaptation in Hong Kong.


Asunto(s)
Adaptación Psicológica , Depresión , Emigrantes e Inmigrantes , Relaciones Padres-Hijo , Humanos , Hong Kong , Masculino , Femenino , Depresión/psicología , Depresión/terapia , Niño , Adulto , Emigrantes e Inmigrantes/psicología , Padres/psicología , Regulación Emocional , Persona de Mediana Edad
3.
PEC Innov ; 4: 100297, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38962499

RESUMEN

Objective: To identify parents' information needs about impending very preterm birth and compare these needs to current information practices in the Netherlands. Methods: Step 1: We surveyed N = 203 parents of preterm infants to assess their information needs. Data were analyzed using inductive thematic analysis. Step 2a: We collected information resources from hospitals (N = 9 NICUs) and via an online search. These materials were analyzed using deductive thematic analysis. Step 2b: We compared findings from Steps 1-2a. Results: We identified four themes pertaining to parents' information needs: (1) participation in care, (2) emotional wellbeing, (3) experience/success stories, and (4) practical information about prematurity. Clinicians' communicative skills and time were considered prerequisites for optimal information-provision. Notably, hospital resources provided mainly medical information about prematurity with some emphasis on participation in care, while parent associations mainly focused on emotional wellbeing and experience/success stories. Conclusion: While parents demonstrate clear information needs about impending very preterm birth, current information resources satisfy these partially. Innovation: Our multidisciplinary research team included both scholars and veteran NICU parents. As such, we identified parents' information needs bottom-up. These parent-driven insights will be used to design an innovative, tailored information platform for parents about impending very preterm birth.

4.
Breast ; 77: 103764, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38970983

RESUMEN

BACKGROUND: Ductal carcinoma in situ (DCIS) can progress to invasive breast cancer (IBC), but often never will. As we cannot predict accurately which DCIS-lesions will or will not progress to IBC, almost all women with DCIS undergo breast-conserving surgery supplemented with radiotherapy, or even mastectomy. In some countries, endocrine treatment is prescribed as well. This implies many women with non-progressive DCIS undergo overtreatment. To reduce this, the LORD patient preference trial (LORD-PPT) tests whether mammographic active surveillance (AS) is safe by giving women with low-risk DCIS a choice between treatment and AS. For this, sufficient knowledge about DCIS is crucial. Therefore, we assessed women's DCIS knowledge in association with socio-demographic and clinical characteristics. METHODS: LORD-PPT participants (N = 376) completed a questionnaire assessing socio-demographic and clinical characteristics, risk perception, treatment choice and DCIS knowledge after being informed about their diagnosis and treatment options. RESULTS: 66 % of participants had poor knowledge (i.e., answered ≤3 out of 7 knowledge items correctly). Most incorrect answers involved overestimating the safety of AS and misunderstanding of DCIS prognostic risks. Overall, women with higher DCIS knowledge score perceived their risk of developing IBC as being somewhat higher than women with poorer knowledge (p = 0.049). Women with better DCIS knowledge more often chose surgery whilst most women with poorer knowledge chose active surveillance (p = 0.049). DISCUSSION: Our findings show that there is room for improvement of information provision to patients. Decision support tools for patients and clinicians could help to stimulate effective shared decision-making about DCIS management.


Asunto(s)
Neoplasias de la Mama , Carcinoma Intraductal no Infiltrante , Conocimientos, Actitudes y Práctica en Salud , Espera Vigilante , Humanos , Femenino , Carcinoma Intraductal no Infiltrante/cirugía , Carcinoma Intraductal no Infiltrante/patología , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/psicología , Persona de Mediana Edad , Adulto , Encuestas y Cuestionarios , Mastectomía/psicología , Anciano , Prioridad del Paciente , Mamografía/estadística & datos numéricos , Mastectomía Segmentaria , Progresión de la Enfermedad , Conducta de Elección
5.
BMC Public Health ; 24(1): 1428, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38807103

RESUMEN

BACKGROUND: Antibiotics have been widely used in feed and drinking water for food animals to prevent them from getting sick. Such preventive use of antibiotics has become a contributor to increasing antibiotic resistance and thus poses threats to human health. However, consumers have little knowledge about this practice and the associated health risks of increasing transmission of antibiotic residues and antibiotic resistant bacteria. This study aimed to examine the effect of information provision on consumers' risk perceptions, support for a ban, and behavioral intention regarding the preventive use of antibiotics in food animals. Especially, the study sought to test two competing hypotheses which were informed by two theoretical perspectives of fear appeal theory - the linear model and the plateau effect model. The former suggested that providing information on the health risks of both antibiotic residues and antibiotic resistant bacteria would have a stronger effect compared to providing information on only one of them, while the latter posited that providing information on both risks might not have additional influence, as the effect of information on either risk could reach the plateau. METHODS: An experimental study with four conditions was conducted where participants read different information on the health risks associated with the preventive use first and then answered questions regarding consumers' risk perceptions, support for a ban, and behavioral intention regarding the preventive use. Condition 1 was the control condition, where basic information about antibiotics, antibiotic resistance, and the preventive use was provided. Condition 2 and Condition 3 further added information on the health risk of antibiotic residues (Condition 2) and antibiotic resistant bacteria (Condition 3) due to the preventive use, respectively. Condition 4 provided all information contained in the first three conditions. RESULTS: The results showed that compared to participants in the control condition, participants in Conditions 2-4 reported higher risk perceptions, stronger support for a ban on the preventive use, and a higher intention to buy meat produced without the preventive use of antibiotics. However, there were no significant differences in these factors between Conditions 2-4, indicating that providing information on the health risk of either antibiotic residues, or antibiotic resistant bacteria, or both, has similar effect on these variables. That is, the hypothesis based on the plateau effect model was supported. CONCLUSIONS: The findings suggested that informing the public with the health risk of either antibiotic residues or antibiotic resistant bacteria associated with the preventive use is effective enough to reach plateau effect in increasing risk perceptions, support for a ban, and behavioral intention, which has important implications for policymakers and livestock industries to develop effective communication strategies to promote responsible antibiotic use in food animals.


Asunto(s)
Antibacterianos , Conocimientos, Actitudes y Práctica en Salud , Intención , Humanos , Masculino , Femenino , Animales , Adulto , Adulto Joven , Persona de Mediana Edad , Medición de Riesgo , Comportamiento del Consumidor , Encuestas y Cuestionarios , Adolescente
6.
Behav Ther ; 55(3): 485-498, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38670663

RESUMEN

Daily cross-boundary schooling between Shenzhen and Hong Kong constitutes a constant challenge for Chinese cross-boundary families in terms of parenting burden. To address their most urgent parenting needs, we adapted and evaluated two intervention approaches-improving emotional regulation and providing knowledge about Hong Kong. A cluster randomized controlled trial with repeated assessments (pre-, post-intervention, and one-month follow-up) was adopted to evaluate the intervention effects on the increases of parental resilience resources and reduction of children's problem behaviors. We further conducted moderation analyses to investigate whether parents with more increases in parental resilience resources would report a greater reduction in children's problem behaviors. A total of 214 mothers of cross-boundary families were randomly assigned to the emotional regulation arm (ER, n = 120) or the information provision arm (IP, n = 94). Both intervention arms showed positive effects on emotional regulation strategies, and the IP arm outperformed the ER arm in knowledge acquisition. Both arms showed significant and comparable improvements in parental self-efficacy and children's problem behaviors. Moreover, participants in the IP arm who reported more improvements in parental resilience resources showed a greater reduction in children's problem behaviors. By adapting two interventions to a new population of cross-boundary families, this trial extended the benefits from parents to children and demonstrated that the improvement of parental resilience resources makes a difference in reducing children's problem behaviors in the IP arm. Future studies are suggested to focus on parental resilience resources and maximize the benefits on children's outcomes.


Asunto(s)
Responsabilidad Parental , Problema de Conducta , Resiliencia Psicológica , Humanos , Femenino , Responsabilidad Parental/psicología , Masculino , Adulto , Niño , Problema de Conducta/psicología , Hong Kong , Padres/psicología , Padres/educación , Regulación Emocional , Autoeficacia , China , Preescolar , Madres/psicología , Pueblos del Este de Asia
7.
Surv Ophthalmol ; 69(4): 646-660, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38499047

RESUMEN

Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment among people aged 50 years and older. Earlier research has indicated that the communication process between patients and healthcare professionals (HCPs) leaves considerable room for improvement in AMD care. Effective communication is essential to enhance trust in the professional and understanding of the diagnosis and treatment, and decrease anxiety and stress related to illness. We review patients' experiences, needs and preferences regarding information provision, communication style of the HCP and shared decision-making. We conducted a systematic search in PubMed, Embase, PsycINFO, CINAHL and Web of Science. Study quality was assessed using standard checklists of quality measures. Our search returned 31 eligible articles. Findings indicated current deficits in information provision for people with AMD. Patients were often ill-informed regarding the chronic character of the condition, treatment duration, nutrition, and visual aids and low vision rehabilitation. Many patients were not actively involved during the decision-making process. Altogether, patients with AMD are faced with challenges in terms of patient-HCP communication. Methods of providing information and discussing possible options for care need to be further investigated and improved for this patient group.


Asunto(s)
Degeneración Macular , Humanos , Degeneración Macular/terapia , Degeneración Macular/psicología , Relaciones Médico-Paciente , Comunicación
8.
MDM Policy Pract ; 9(1): 23814683241232935, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38445047

RESUMEN

Introduction. This study aimed to understand the impact of alternative modes of information provision on the stated preferences of a sample of the public for attributes of newborn bloodspot screening (NBS) in the United Kingdom. Methods. An online discrete choice experiment survey was designed using 4 attributes to describe NBS (effect of treatment on the condition, time to receive results, whether the bloodspot is stored, false-positive rate). Survey respondents were randomized to 1 of 2 survey versions presenting the background training materials using text from a leaflet (leaflet version) or an animation (animation version). Heteroskedastic conditional logistic regression was used to estimate the effect of mode of information provision on error variance. Results. The survey was completed by 1,000 respondents (leaflet = 525; animation = 475). Preferences for the attributes in the DCE were the same in both groups, but the group receiving the animation version had 9% less error variance in their responses. Respondents completing the animation version gave higher ratings compared with the leaflet version in terms of ease of perceived understanding. Subgroup analysis suggested that the animation was particularly effective at reducing error variance for women (20%), people with previous children (16.5%), and people between the ages of 35 and 45 y (11.8%). Limitations. This study used simple DCE with 4 attributes, and the results may vary for more complex choice questions. Conclusion. This study provides evidence that that supplementing the information package offered to parents choosing to take part in NBS with an animation may aid them their decision making. Further research would be needed to test the animation in the health system. Implications. Researchers designing DCE should carefully consider the design of their training materials to improve the quality of data collected. Highlights: Prior to completing a discrete choice experiment about newborn bloodspot screening, respondents were shown information using either a leaflet-based or animated format.Respondents receiving information using an animation version reported that the information was slightly easier to understand and exhibited 9% less error variance in expressing their preferences for a newborn screening program.Using the animation version to present information appeared to have a larger impact in reducing the error variance of responses for specific respondents including women, individuals with children, individuals between the ages of 35 and 45 y, and individuals educated to degree level.

9.
J Adolesc Young Adult Oncol ; 13(3): 534-540, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38237110

RESUMEN

Purpose: To investigate factors that obstruct and facilitate the use of the foster parent and special adoption systems (i.e., foster systems) by cancer survivors, and examine how to effectively provide information. Methods: This was a cross-sectional study that compared the results of a questionnaire survey of foster parents and adoptive parents (i.e., foster parents) who were and were not cancer survivors belonging to foster parent associations in 33 locations in Japan. This study was supported by a 2022 Ministry of Health, Labor, and Welfare Grant-in-Aid for Scientific Research (Grant No. 20EA1004). Results: "Lack of information," an obstructive factor and "Sympathetic understanding and cooperation from my partner and family," a facilitative factor were the highest score in both groups. Significant differences between the two groups were found in "Support from government agencies and others for foster parents," a facilitative factor, which was lower in the cancer survivors' group. There were no other significant differences between both the groups. Conclusion: This study found that when considering the use of the foster systems, a lack of information was the biggest obstructive factor and family understanding was the most helpful for both cancer survivors and noncancer groups. It was thought that stronger government support for cancer survivors might encourage cancer survivors to consider becoming foster parents. It would be effective for cancer treatment facilities, reproductive medical facilities, the government, and foster parent associations to work together to provide information carefully to cancer survivors.


Asunto(s)
Adopción , Supervivientes de Cáncer , Humanos , Estudios Transversales , Supervivientes de Cáncer/psicología , Masculino , Femenino , Japón , Adulto , Persona de Mediana Edad , Adopción/psicología , Encuestas y Cuestionarios , Neoplasias/psicología , Adulto Joven , Cuidados en el Hogar de Adopción/psicología
10.
Patient Educ Couns ; 119: 108092, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38056218

RESUMEN

Although medical information is essential for all patients, information needs and information processing capacities vary between individual patients and over time and context, within patients. Therefore, it is often recommended to "tailor" medical information to individual patients during clinic visits. However, there is a lack of consensus on what "tailoring" in clinical interactions represents since the definitions provided in the literature thus far generally regard tailoring of written text, rather than in dialogue during face-to-face interactions. To provide clinicians with guidance on how to tailor information to individual patients and to allow researchers to assess the effectiveness thereof, clarity is urgently needed regarding what "tailoring" actually means and what it entails in practice. In this paper we outline the current challenges of applying the concept of "tailoring" to the clinical setting and present existing definitions. Importantly, we introduce a new working definition of the concept that encompasses essential informational and dialogic components. We believe this provisional definition promotes much-needed conceptual precision in how communication researchers and educators define and assess tailored information provision in clinical consultations.


Asunto(s)
Comunicación , Derivación y Consulta , Humanos
11.
Disabil Rehabil ; : 1-9, 2023 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-37950406

RESUMEN

PURPOSE: This focus group study aimed to explore experiences and perceptions on post-stroke fatigue guidance in Dutch rehabilitation and follow-up care among people/patients with stroke and health professionals. METHODS: Ten persons with stroke and twelve health professionals with different professions within stroke rehabilitation or follow-up care in the Netherlands were purposively sampled and included. Eight online focus group interviews were conducted. We analysed the data using reflexive thematic analysis. RESULTS: Three themes were identified. Guidance in fatigue management did not always match the needs of people/patients with stroke. Professionals were positive about the provided fatigue guidance (e.g. advice on activity pacing), but found it could be better tailored to the situation of people/patients with stroke. Professionals believe the right time for post-stroke fatigue guidance is when people/patients with stroke are motivated to change physical activity behaviour to manage fatigue - mostly several months after stroke - while people/patients with stroke preferred information on post-stroke fatigue well before discharge. Follow-up care and suggestions for improvement described that follow-up support after rehabilitation by a stroke coach is not implemented nationwide, while people/patients with stroke and professionals expressed a need for it. CONCLUSIONS: The study findings will help guide improvement of fatigue guidance in stroke rehabilitation programmes and stroke follow-up care aiming to improve physical activity, functioning, participation, and health.


We recommend fatigue guidance, including peer support, to be accessible to all people after stroke and for health professionals to pay attention to acceptance of the stroke.To improve fatigue guidance, we suggest providing information on post-stroke fatigue to people after stroke and their relatives well before discharge from stroke rehabilitation.Tailored advice on activity pacing during and after stroke rehabilitation is important to fill the current unmet need of people after stroke to manage fatigue and to gradually improve participation, physical activity behaviour and health.We recommend to health professionals working in stroke rehabilitation to tailor the rehabilitation schedule to their patients' energy level and perception of fatigue levels.

12.
Pan Afr Med J ; 45: 189, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38020351

RESUMEN

Introduction: patient satisfaction is an attitude resulting from a person's general orientation towards the total experience of health care. The study was done with the aim of evaluating post-operative patient satisfaction level with the quality of service provided at the surgical wards; determining how much factors related to physicians, nursing, laboratory, and information provision service influence satisfaction level; and determining factors impacting patient satisfaction level. Methods: a hospital-based quantitative cross-sectional study design was conducted in six Addis Ababa City Government tertiary hospitals from November 4th to December 13th, 2022. Patients who had major operations done at the government hospitals from November 21st to December 5th, 2022, were included in the study population. A pre-tested, structured, and Amharic-version questionnaire was used to interview patients. A bivariate and multivariate logistic regression model was used to identify the variables that had an association with the dependent variable. P-values less than 0.05 were considered statistically significant. Results: a total of 287 patients participated in the research, providing a response rate of 95%. Of the total participants, 144 were males (50.8%) and 143 were females (49.5%). The overall patient satisfaction level with surgical ward service is 96.2%. The level of patient satisfaction with nursing services is 94.8%, with physician's services it is 98.6%, with the facility it is 92.3%, and with the provision of information about post-operative complications it is 69.7%. Those who have above-first-degree educational status are less satisfied (66.7%) than patients with other levels of educational status. Only the patients' residency showed a small level of association (r= 0.145, p=0.014) with overall patient satisfaction with surgical ward service among the demographic components. The two variables that are strongly correlated with patient satisfaction are the adequacy of the time ward nurses spent with patients during evaluation and treatment (r = 0.503, p = 0.000) and adequate nurses' response to patients' calls (r = 0.498, p = 0.000). Post-operative patient satisfaction with surgical ward nursing service, physician service, hospital facilities, and the provision of information about post-op complications explain about 40.9 percent of the variation in the overall patient satisfaction with post-op care provided at the surgical ward. Patient satisfaction with nursing service has more significant effect with overall patient satisfaction than the other variables (ß = 0.266, p =0.0002). Conclusion: post-operative patients at Addis Ababa City Government Tertiary Hospitals expressed a very high degree of satisfaction with the care they received in the surgical wards. The study also found that patients were generally less satisfied with the information they were given on drugs, side effects, and available treatment options. Another factor identified in the study that caused unhappiness was the unavailability of some pharmacy and laboratory services.


Asunto(s)
Gobierno Local , Satisfacción del Paciente , Masculino , Femenino , Humanos , Estudios Transversales , Centros de Atención Terciaria , Etiopía
13.
Acta Oncol ; 62(12): 1616-1624, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37856077

RESUMEN

BACKGROUND: There are two main coping styles regarding information seeking under medical threat; monitoring (information-seeking) and blunting (information-avoiding). The aim of this study is to (1) determine factors associated with a monitoring or blunting coping style in gastro-intestinal stromal tumour (GIST) patients and (2) investigate its association with psychological distress, cancer-related concerns, health-related quality of life and satisfaction with healthcare. METHODS: In a cross-sectional study, Dutch GIST patients completed the shortened version of the Threatening Medical Situations Inventory to determine their coping style, the Hospital Anxiety and Depression Scale, Cancer Worry Scale, EORTC QLQ-C30 and part of the EORTC QLQ-INFO25. RESULTS: A total of 307 patients were classified as blunters (n = 175, 57%) or monitors (n = 132, 43%). Coping style was not associated with tumour or treatment variables, but being a female (OR 2.5; 95%CI 1.5-4.1; p= <.001) and higher educated (OR 5.5; 95%CI 2.5-11.9, p= <.001) were associated with higher odds of being a monitor. Monitors scored significantly lower on emotional functioning (mean = 86.8 vs mean = 90.9, p=.044), which is considered a trivial difference, more often experienced severe fear of cancer recurrence or progression (53.0% vs 37.7%, p=.007), and had more concerns about dying from GIST in the future (60.6% vs 47.4%, p=.025). Compared to blunters, monitors were less satisfied with the received healthcare and information, and would have liked to receive more information. CONCLUSION: GIST patients with a monitoring coping style experience a higher emotional burden. Additionally, monitors exhibit a greater need for information. Although this need for information could potentially result in fears and concerns, recognising it may also create an opening for tailored communication and information.


Asunto(s)
Tumores del Estroma Gastrointestinal , Distrés Psicológico , Humanos , Femenino , Calidad de Vida , Estudios Transversales , Satisfacción del Paciente , Recurrencia Local de Neoplasia , Adaptación Psicológica , Satisfacción Personal
14.
BMC Health Serv Res ; 23(1): 978, 2023 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-37697293

RESUMEN

BACKGROUND: Total knee arthroplasty (TKA) is an option for the treatment of knee osteoarthritis (OA). Patients have high expectations regarding the benefits of the actual operation. Patients can seek a second opinion on the indication for TKA. In a study, less than half of recommended TKAs were confirmed by the second opinion and conservative treatments are not fully utilized. Informed consent forms that are used in Germany usually do not meet the requirements to support informed decision-making. Our aim was to describe the process from the diagnosis of knee OA through the decision-making process to the informed consent process for TKA, and to understand when, how, and by whom decisions are made. Moreover, we wanted to describe patients' information needs and preferences about knee OA and its treatment, including TKA, and find out what information is provided. We also wanted to find out what information was important for decision-making and identify barriers and facilitators for the optimal use of evidence-based informed consent forms in practice. METHODS: We chose a qualitative approach and conducted semi-structured interviews with patients who were going to receive, have received, or have declined TKA, and with general practitioners (GP), office-based as well as orthopaedists and anaesthesiologists in clinics who obtain informed consent. The interviews were audio-recorded, transcribed and analysed using qualitative content analysis. RESULTS: We conducted interviews with 13 patients, three GPs, four office-based orthopaedists and seven doctors in clinics who had obtained informed consent. Information needs were modelled on subjective disease theory and information conveyed by the doctors. Patients in this sample predominantly made their decisions without having received sufficient information. Trust in doctors and experiences seemed to be more relevant in this sample than fact-based information. Office-based (GPs, orthopaedists) and orthopaedists in clinics had different understandings of their roles and expectations in terms of providing information. CONCLUSIONS: We were able to identify structural barriers and assumptions that hinder the implementation of evidence-based informed consent forms.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Médicos Generales , Osteoartritis de la Rodilla , Humanos , Consentimiento Informado , Investigación Cualitativa , Anestesiólogos , Osteoartritis de la Rodilla/cirugía
15.
Prev Med Rep ; 35: 102325, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37601828

RESUMEN

Prior faecal Hemoglobin (f-Hb) concentrations of a negative fecal immunochemical test (FIT) can be used for risk stratification in colorectal cancer (CRC) screening. Individuals with higher f-Hb concentrations may benefit from a shorter screening interval (1 year), whereas individuals with undetectable f-Hb concentrations could benefit from a longer screening interval (3 year). Individuals' views on personalised CRC screening and information needed to make a well-informed decision is unknown. We conducted three semi-structured focus groups among individuals eligible for CRC screening (i.e. men and women aged 55 to 75) in the Netherlands. Thematic analysis was used to analyse participants' information need on personalised CRC screening strategies. Fourteen individuals took part. The majority were positive about CRC screening and indicated that they would participate in personalised CRC screening. The rationale for a longer interval among those at lowest risk was, however, unclear for many. The preferred information on individual risk was variable: ranging from full information to only information on the personalised strategy without mentioning the risk. It was not possible to address everyone's need with a single approach. Additional communications, e.g. public media campaigns, billboards, videos on social media, were also suggested as necessary. This study showed that preferences on receiving information on individual CRC risk varied substantially and no consensus was reached. Introducing a personalised screening programme will require careful communication, particularly around the rationale for the strategy, and a layered approach to deliver information.

16.
JMIR Form Res ; 7: e47121, 2023 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-37477975

RESUMEN

BACKGROUND: Nearly 1 in 3 clinical trials end prematurely due to underenrollment. Strategies to enhance recruitment are often implemented without scientific rigor to evaluate efficacy. Evidence-based, cost-effective behavioral economic strategies designed to influence decision-making may be useful to promote clinical trial enrollment. OBJECTIVE: This study evaluated 2 behavioral economic strategies to improve enrollment and retention rates across 4 clinical trials: information provision (IP) and contingency management (CM; ie, lottery). IP targets descriptive and injunctive norms about participating in research and CM provides participants incentives to reinforce a target behavior. METHODS: A sample of 212 participants was enrolled across 4 clinical trials focused on tobacco use: 2 focused on HIV and 2 focused on neuroimaging. The CM condition included a lottery: for each study visit completed, participants received 5 "draws" from a bowl containing 500 "chips" valued at US $0, US $1, US $5, or US $100. In the IP condition, text messages that targeted injunctive norms about research (eg, "Many find it a rewarding way to advance science and be part of a community") were sent through the Way to Health platform before all study visits. Participants were randomized to 1 of 4 conditions: IP, CM, IP+CM, or standard recruitment (SR). We performed logistic regression, controlling for sex and study, with condition as a between-subject predictor. Outcomes were the percentage of participants who attended a final eligibility visit (primary), met intent-to-treat (ITT) criteria (secondary), and completed the study (secondary). Recruitment was evaluated by the percentage of participants who attended a final eligibility visit, enrollment by ITT status, and retention by the percentage of participants who completed the study. RESULTS: Rates of attending the eligibility visit and meeting ITT status were 58.9% (33/56) and 33.9% (19/56) for IP+CM; 45.5% (25/55) and 18.2% (10/55) for IP only; 41.5% (22/53) and 18.9% (10/53) for CM only; and 37.5% (18/48) and 12.5% (6/48) for SR, respectively. In the logistic regression, females were more likely to meet ITT status than males (odds ratio [OR] 2.7, 95% CI 1.2-5.7; P=.01). The IP+CM group was twice as likely to attend the final eligibility visit than the SR group (OR 2.4, 95% CI 1.1-5.2; P=.04). The IP+CM group was also significantly more likely to reach ITT status than the SR condition (OR 3.9, 95% CI 1.3-11.1; P=.01). Those who received any active intervention (IP, CM, or IP+CM) had a higher study completion rate (33/53, 63.5%) compared to those who received SR (5/12, 41.7%), but this difference was not significant (P=.26). CONCLUSIONS: Combining IP and CM strategies may motivate participants to participate in research and improve recruitment and retention rates. Evidence from this study provides preliminary support for the utility of behavioral economics strategies to improve enrollment and reduce attrition in clinical trials.

17.
GM Crops Food ; 14(1): 1-14, 2023 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-37523332

RESUMEN

The Japanese Health Ministry recently granted permission for the market distribution of genome-edited (GE) foods, yet there remains a lack of full understanding among consumers regarding this technology. In this study, we conducted a survey to assess the acceptability of GE foods among Japanese consumers and examined the impact of providing information about GE foods on their acceptability. We conducted a web-based survey among 3,408 consumers aged 20-69 years, focusing on three aspects: (1) the commercial availability of GE foods, (2) the consumption of GE foods by others, and (3) your own consumption of GE foods. The survey findings revealed that participants were most accepting of the consumption of GE foods by others, followed by their acceptance of GE foods being commercially available. Notably, participants' acceptance of GE foods increased in all three aspects after they viewed an informative video. The video had a particularly strong impact on participants who fully or partially understood its content, compared to those who did not. Furthermore, regression analyses showed that participants' understanding of two key areas, namely "Why are GE foods important" and "What procedures are in place to ensure the safety of GE foods," played a crucial role in increasing acceptability. Overall, these results indicate that providing information about GE foods to Japanese consumers can effectively enhance their acceptance of such foods. The findings highlight the importance of understanding the benefits and safety measures associated with GE foods in influencing consumer attitudes.


Asunto(s)
Comportamiento del Consumidor , Suplementos Dietéticos , Japón , Encuestas y Cuestionarios
18.
BMC Med Inform Decis Mak ; 23(1): 119, 2023 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-37442993

RESUMEN

BACKGROUND: Kampo medicine is widely used in Japan; however, most physicians and pharmacists have insufficient knowledge and experience in it. Although a chatbot-style system using machine learning and natural language processing has been used in some clinical settings and proven useful, the system developed specifically for the Japanese language using this method has not been validated by research. The purpose of this study is to develop a novel drug information provision system for Kampo medicines using a natural language classifier® (NLC®) based on IBM Watson. METHODS: The target Kampo formulas were 33 formulas listed in the 17th revision of the Japanese Pharmacopoeia. The information included in the system comes from the package inserts of Kampo medicines, Manuals for Management of Individual Serious Adverse Drug Reactions, and data on off-label usage. The system developed in this study classifies questions about the drug information of Kampo formulas input by natural language into preset questions and outputs preset answers for the questions. The system uses morphological analysis, synonym conversion by thesaurus, and NLC®. We fine-tuned the information registered into NLC® and increased the thesaurus. To validate the system, 900 validation questions were provided by six pharmacists who were classified into high or low levels of knowledge and experience of Kampo medicines and three pharmacy students. RESULTS: The precision, recall, and F-measure of the system performance were 0.986, 0.915, and 0.949, respectively. The results were stable even with differences in the amount of expertise of the question authors. CONCLUSIONS: We developed a system using natural language classification that can give appropriate answers to most of the validation questions.


Asunto(s)
Medicina Kampo , Médicos , Humanos , Procesamiento de Lenguaje Natural , Farmacéuticos , Tecnología , Japón
19.
J Cancer Res Clin Oncol ; 149(12): 10399-10422, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37273104

RESUMEN

PURPOSE: One-to-one peer supporters called isPO onco-guides (isPO OGs) are an integral part of the new German psycho-oncological form of care 'integrated, cross-sectoral Psycho-Oncology' (isPO), additionally to professional care. The isPO OGs are cancer survivors with experiential knowledge, offering information on local support services and answering questions 'all around cancer' to newly diagnosed cancer patients. We aimed to evaluate the isPO OG service from three perspectives: patients, isPO OGs, and professional service providers. METHODS: A mixed-methods approach was pursued. We conducted interviews and focus groups with the three person groups, and applied qualitative content analysis on the reported resources, processes and outcomes regarding the isPO OG service. Relations with patients' utilisation and isPO OGs' work satisfaction were identified with regression and correlation analyses of questionnaire and isPO care data. We compared isPO care networks (CN) with X2-tests or ANOVA. Qualitative and quantitative results were integrated during interpretation phase. RESULTS: Qualitatively, the three person groups agreed on the benefits of the isPO OG service. The implementation's maturity differed between the CN concerning established processes and resource availability. Attitudes of professional service providers appeared to be crucial for patients' utilisation of the isPO OG service. Quantitative results emphasised the differences between the CN. CONCLUSION: Beyond differences in the CN, the isPO OG service has two psychosocial benefits: providing relevant, reliable, and understandable information; and offering the encouraging example that surviving and living with cancer is possible. TRIAL REGISTRATION: The study was registered in the German Clinical Trials Register (No. DRKS00015326) on 30.10.2018.


Asunto(s)
Consejo , Psicooncología , Humanos , Alemania , Pacientes/psicología , Encuestas y Cuestionarios
20.
Explor Res Clin Soc Pharm ; 9: 100259, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37091628

RESUMEN

Background: During conversations about medication switches, pharmacy staff often deliver a message to patients that may lead to negative emotions. In these situations, clear and patient-centered communication is important. Aim: To gain insight into pharmacy technician-patient experiences regarding the communication during medication switching encounters, and in specific to map the needs and preferences of patients and whether pharmacy technicians (PTs) meet these. Method: PTs were invited to fill in a questionnaire via the Dutch Panel on practical research for Pharmacy Employees. Online questionnaires were distributed to adult chronic mediation users in two patient panels. Questionnaires contained questions on how PTs and patients experience the medication switch conversations at the moment (i.e. type of information patients need/receive, timing of information, channel, communication style), and whether the needs and preferences of patients are met. Results: In total, 138 PTs and 4679 patients responded. PTs indicated that they regularly struggle with these conversations due to emotional or negative responses of patients. Most patients expressed the need for information about why the medication switch took place (68%) and about the (same) effect of the medication (61%), while fewer patients currently receive this information (21% and 39%, respectively). Patients also indicated they need verbal information during pick-up/delivery (45%), written information beforehand (29%) and during pick-up/delivery (25%), while patients more often receive verbal information during pick-up (58%), and less frequently receive written information beforehand (6%) and during pick-up/delivery (18%). Conclusion: Communication during medication switch conversations generally goes well. However, there is a difference between what PTs claim they do and what patients experience, e.g. space for questions and patients' satisfaction about this aspect. Dealing with patient emotions is also difficult for PTs. Patients emphasize they need more information than they currently receive, preferably before switching. Matching these needs and preferences can improve patient-centered communication.

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