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1.
G Ital Cardiol (Rome) ; 21(4): 309-314, 2020 Apr.
Artículo en Italiano | MEDLINE | ID: mdl-32202565

RESUMEN

BACKGROUND: The request for informed consent to join a clinical trial often creates mistrust and hesitation in the patient who should be enrolled. In our study, we evaluated the reasons for refusing to participate in a clinical trial. METHODS: In the last 10 years of cardiovascular clinical research, we asked an informed consent to 2586 patients for intervention studies. Overall, 59% agreed to join clinical trials, 40% refused. The 1% initially accepted and then withdrew the consent. Those who refused were more frequently women, relatively younger (mean age 62 ± 5 vs 74 ± 9 years) and had a higher level of education and income. We asked all these patients who refused to answer a brief questionnaire about the reasons for rejection. RESULTS: Of 1031 patients, 629 (61%), accepted to answer the interview; 176 (28%) answered they refused on relatives', friends' or other doctors' advices, or after Internet searches; 157 (25%) answered they did not agree about how the trials were carried out (double-blind control procedure, use of placebo); 126 (20%) did not trust official medicine; 63 (10%) could not guarantee their presence at the follow-up visits; 69 (11%) did not want to undergo additional medical examinations; 31 (5%) had previous bad research experiences (feeling like a guinea pig); 7 (about 1%) refused for other reasons. CONCLUSIONS: Recruitment into clinical research studies is still a major challenge. Patients, due to a prevailing humanistic culture, are not fully aware of the importance of participation in clinical research, which is sometimes considered as exclusive economic or prestige interest. In our experience, people who refused participation in the trials were younger, with a high level of education and income, more frequently women. The researcher's task is to motivate the patient by emphasizing that participating in a study means being the actors of a treatment choice and that one is a guinea pig when taking untested therapies.


Asunto(s)
Ensayos Clínicos como Asunto , Consentimiento Informado , Participación del Paciente , Adulto , Toma de Decisiones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Motivación , Participación del Paciente/psicología , Selección de Paciente , Sujetos de Investigación , Encuestas y Cuestionarios , Confianza
3.
Bull Cancer ; 107(3): 322-327, 2020 Mar.
Artículo en Francés | MEDLINE | ID: mdl-32061377

RESUMEN

Cervical cancer screening is considered one of the most significant public health interventions that can reduce not only the incidence, but also the mortality of the disease. One of the most important factors for screening effectiveness is coverage defined as the number of women tested within a recommended interval. In the first years of the cervical screening, the participation rate in National Screening Program in Romania was 14.2% with slight difference in different region of the country. In the northeastern part of the country, in the first four years of the program, the rate was 16.9% with an alarmingly continuous decrease. Thus, increasing the rate of uptake of cervical screening is essential. The policy-makers should take new measures to increase women's participation in this screening program. The objective of this paper was to review situation of the screening program and to identify gaps and needs in the system and to bring or suggest solution.


Asunto(s)
Detección Precóz del Cáncer/métodos , Tamizaje Masivo/métodos , Participación del Paciente/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Neoplasias del Cuello Uterino/diagnóstico , Detección Precóz del Cáncer/estadística & datos numéricos , Detección Precóz del Cáncer/tendencias , Femenino , Educación en Salud/métodos , Humanos , Difusión de la Información , Tamizaje Masivo/organización & administración , Tamizaje Masivo/estadística & datos numéricos , Tamizaje Masivo/tendencias , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Participación del Paciente/tendencias , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Rumanía/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/mortalidad , Neoplasias del Cuello Uterino/virología
5.
Bone Joint J ; 102-B(1): 42-47, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31888361

RESUMEN

AIMS: Patient engagement in adaptive health behaviours and interactions with their healthcare ecosystem can be measured using self-reported instruments, such as the Patient Activation Measure (PAM-13) and the Effective Consumer Scale (ECS-17). Few studies have investigated the influence of patient engagement on limitations (patient-reported outcome measures (PROMs)) and patient-reported experience measures (PREMs). First, we assessed whether patient engagement (PAM-13, ECS-17) within two to four weeks of an upper limb fracture was associated with limitations (the Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), and Patient-Reported Outcome Measurement Information System Upper Extremity Physical Function computer adaptive test (PROMIS UE PF) scores) measured six to nine months after fracture, accounting for demographic, clinical, and psychosocial factors. Secondly, we assessed the association between patient engagement and experience (numerical rating scale for satisfaction with care (NRS-C) and satisfaction with services (NRS-S) six to nine months after fracture. METHODS: A total of 744 adults with an isolated fracture of the proximal humerus, elbow, or distal radius completed PROMs. Due to multicollinearity of patient engagement and psychosocial variables, we generated a single variable combining measures of engagement and psychosocial factors using factor analysis. We then performed multivariable analysis with p < 0.10 on bivariate analysis. RESULTS: Patient engagement and psychosocial factors combined to form a single factor (factor 1) accounting for 20% (QuickDASH, semi-partial R2 = 0.20) and 14% (PROMIS UE PF, semi-partial R2 = 0.14) of the variation in limitations six to nine months after fracture. Factor 1 also accounted for 17% (NRS-C, semi-partial R2 = 0.17) of variation in satisfaction with care, and 21% (NRS-S, semi-partial R2 = 0.21) of variation in satisfaction with services. Demographic factors (age, sex, work status) and measures of greater pathophysiology (type of fracture, high-energy injury, post-surgical complications), accounted for much less variation. CONCLUSION: Patients who actively manage their health and demonstrate effective emotional and social functioning share a common underlying trait. They have fewer limitations and greater satisfaction with care during recovery from upper limb fractures. Future efforts should focus on evaluating initiatives that optimize patient engagement, such as patient education, coaching, and a communication strategy for healthcare professionals. Cite this article: Bone Joint J 2020;102-B(1):42-47.


Asunto(s)
Articulación del Codo/lesiones , Conductas Relacionadas con la Salud , Fracturas del Húmero/cirugía , Fracturas Intraarticulares/cirugía , Participación del Paciente , Fracturas del Radio/cirugía , Actividades Cotidianas , Adaptación Psicológica , Adulto , Anciano , Anciano de 80 o más Años , Articulación del Codo/cirugía , Femenino , Fracturas Óseas , Promoción de la Salud , Humanos , Fracturas del Húmero/psicología , Fracturas Intraarticulares/psicología , Masculino , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Satisfacción del Paciente , Estudios Prospectivos , Fracturas del Radio/psicología , Autoeficacia , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
8.
Artículo en Alemán | MEDLINE | ID: mdl-31938837

RESUMEN

There are dynamic interactions between (digital) technologies and society. Digital technologies have a (re-)structuring effect on social relationships and social innovations in a variety of ways. Because of these characteristics, technological innovations affect our individual lifestyles and living environments. In particular, the development and implementation of interventions with digital (health) technologies is attracting increasing national and international attention (e.g. telematics GP consultations and app-supported patient education programs).Digital health technologies enable new forms of interaction and knowledge-based reproduction in the field of health. The integration of potential users in the development process of digital health technologies and interventions requires the discussion of new research approaches. The interests, needs, and requirements of users may influence the nonuse of digital health technologies. It is above all the successful implementation, involving potential users, that can have an influence on acceptance and integrative use in the later course of care. The discourse on the participatory development and implementation of interventions with digital health technologies in the field of digital public health presents itself as a complex process characterized by various theoretical approaches and methodological procedures and requiring representation, evaluation, and classification.


Asunto(s)
Atención al Paciente , Telemedicina , Alemania , Humanos , Participación del Paciente
10.
BMC Health Serv Res ; 20(1): 25, 2020 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-31914994

RESUMEN

BACKGROUND: Limited attention has been paid to adolescents and young adults' (AYA's) experiences in the aftermath of a cancer diagnosis, despite this being a time when potentially life-changing decisions are made. We explored AYA's and caregivers' experiences of, and views about, making treatment and trial participation decisions following a cancer diagnosis, in order to understand, and help facilitate, informed treatment decision-making in this age group. METHODS: Interviews were undertaken with 18 AYA diagnosed, or re-diagnosed, with cancer when aged 16-24 years, and 15 parents/caregivers. Analysis focused on the identification and description of explanatory themes. RESULTS: Most AYA described being extremely unwell by the time of diagnosis and, consequently, experiencing difficulties processing the news. Distress and acceleration in clinical activity following diagnosis could further impede the absorption of treatment-relevant information. After referral to a specialist cancer unit, many AYA described quickly transitioning to a calm and pragmatic mind-set, and wanting to commence treatment at the earliest opportunity. Most reported seeing information about short-term side-effects of treatment as having limited relevance to their recovery-focused outlook at that time. AYA seldom indicated wanting to make choices about front-line treatment, with most preferring to defer decisions to health professionals. Even when charged with decisions about trial participation, AYA reported welcoming a strong health professional steer. Parents/caregivers attempted to compensate for AYA's limited engagement with treatment-relevant information. However, in seeking to ensure AYA received the best treatment, these individuals had conflicting priorities and information needs. CONCLUSION: Our study highlights the challenging context in which AYA are confronted with decisions about front-line treatment, and reveals how their responses make it hard to ensure their decisions are fully informed. It raises questions about the direct value, to AYA, of approaches that aim to promote decision-making by improving understanding and recall of information, though such approaches may be of value to caregivers. In seeking to improve information-giving and involvement in treatment-related decision-making at diagnosis, care should be taken not to delegitimize the preference of many AYA for a directive approach from trusted clinicians.


Asunto(s)
Cuidadores/psicología , Toma de Decisiones , Neoplasias/terapia , Participación del Paciente/psicología , Sujetos de Investigación/psicología , Adolescente , Ensayos Clínicos como Asunto , Femenino , Humanos , Masculino , Neoplasias/diagnóstico , Investigación Cualitativa , Adulto Joven
11.
BMC Health Serv Res ; 20(1): 24, 2020 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-31914997

RESUMEN

BACKGROUND: Community Health Representatives (CHRs) overcome health disparities in Native communities by delivering home care, health education, and community health promotion. The Navajo CHR Program partners with the non-profit Community Outreach and Patient Empowerment (COPE), to provide home-based outreach to Navajo clients living with diabetes. COPE has created an intervention (COPE intervention) focusing on multiple levels of improved care including trainings for CHRs on Motivational Interviewing and providing CHRs with culturally-appropriate education materials. The objective of this research is to understand the participant perspective of the CHR-COPE collaborative outreach through exploring patient-reported outcomes (PROs) of clients who consent to receiving the COPE intervention (COPE clients) using a qualitative methods evaluation. METHODS: Seven COPE clients were selected to participate in semi-structured interviews one year after finishing COPE to explore their perspective and experiences. Qualitative interviews were recorded, transcribed, and coded to identify themes. RESULTS: Clients revealed that health education delivered by CHRs facilitated lifestyle changes by helping them understand key health indicators and setting achievable goals through the use of accessible material and encouragement. Clients felt comfortable with CHRs who respected traditional practices and made regular visits. Clients also appreciated when CHRs educated their family members, who in turn were better able to support the client in their health management. Finally, CHRs who implemented the COPE intervention helped patients who were unable to regularly see a primary care doctor for critical care and support in their disease management. CONCLUSION: The COPE-CHR collaboration facilitated trusting client-CHR relationships and allowed clients to better understand their diagnoses. Further investment in materials that respect traditional practices and aim to educate clients' families may foster these relationships and improve health outcomes. TRIAL REGISTRATION: clinicaltrials.gov: NCT03326206. Registered 9/26/2017 (retrospectively registered).


Asunto(s)
Nativos de Alaska/psicología , Actitud Frente a la Salud/etnología , Servicios de Salud Comunitaria/organización & administración , Diabetes Mellitus/etnología , Indios Norteamericanos/psicología , Nativos de Alaska/estadística & datos numéricos , Agentes Comunitarios de Salud/psicología , Relaciones Comunidad-Institución , Conducta Cooperativa , Diabetes Mellitus/terapia , Femenino , Humanos , Indios Norteamericanos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Organizaciones sin Fines de Lucro/organización & administración , Participación del Paciente , Relaciones Profesional-Paciente , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Estados Unidos
12.
Isr J Health Policy Res ; 9(1): 3, 2020 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-31952548

RESUMEN

Digital healthcare promises to achieve cost-efficiency gains, improve clinical effectiveness, support better public sector governance by enhancing transparency and accountability, and increase confidence in medical diagnoses, especially in the field of oncology. This article aims to discuss the benefits offered by digital technologies in tax-based European healthcare systems against the backdrop of structural bureaucratic rigidities and a slow pace of implementation.Artificial intelligence (AI) will transform the existing delivery of healthcare services, inducing a redesign of public accountability systems and the traditional relationships between professionals and patients. Despite legitimate ethical and accountability concerns, which call for clearer guidance and regulation, digital governance of healthcare is a powerful means of empowering patients and improving their medical treatment in terms of quality and effectiveness. On the path to better health, the use of digital technologies has moved beyond the back office of administrative processes and procedures, and is now being applied to clinical activities and direct patient engagement.


Asunto(s)
Participación del Paciente , Programas de Gobierno , Humanos , Israel
13.
Curr Opin Anaesthesiol ; 33(2): 185-191, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31913145

RESUMEN

PURPOSE OF REVIEW: Patient decision aids are educational tools used to assist patients and clinicians in healthcare decisions. As healthcare moves toward patient-centered care, these tools can provide support to anesthesiologists by facilitating shared decision-making. RECENT FINDINGS: Recent research has shown that patient decision aids are beneficial in the clinical setting for patients and physicians. Studies have shown that patients feel better informed, have better knowledge, and have less anxiety, depression, and decisional conflict after using patient decision aids. In addition, a structured approach for the development of patient decision aids in the field of anesthesia has been established. SUMMARY: Patient decision aids can support patient-centered care delivery and shared decision-making, especially in the field of anesthesia. Current research involves implementing the use of patient decision aids in the discussion for monitored anesthesia care. Further development of quality metrics is needed to improve the decision aids and maximize decision quality.


Asunto(s)
Anestesia , Técnicas de Apoyo para la Decisión , Humanos , Participación del Paciente , Atención Dirigida al Paciente
14.
J Surg Res ; 246: 411-418, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31635834

RESUMEN

BACKGROUND: High-quality decision making is important in patient-centered care. Although patient involvement in decision making varies widely, most patients desire to share in decision making. The Press-Ganey Patient Satisfaction survey includes questions that measure patients' perceptions of their providers' efforts to involve them in decision making (PGDM). We hypothesized that higher PGDM scores would correlate with higher scores on a validated measure of patient centeredness. MATERIALS AND METHODS: Surgical providers at a university hospital who routinely receive Press-Ganey scores received a survey that included the Patient-Practitioner Orientation Scale (PPOS), a validated tool that measures the provider's orientation toward patient centeredness on a continuous six-point scale: score ≥5 = high, 4.57-5 = moderate, and <4.57 = low and includes nine-item "caring" or "sharing" subscales. We compared PPOS scores to PGDM scores, averaged from April 2015 to January 2016. RESULTS: Eighty-six of 112 (75%) of surgical providers responded to the survey. Fifty-two (46%) had PGDM scores available and 26% achieved a perfect score on the PGDM. The overall PPOS scores were low, with a mean of 4.2 (SD = 0.5). The PPOS was not correlated with the PGDM, correlation coefficient (rs) = -0.07 (CI: -0.34-0.21, P = 0.63). Similarly, the two subscales of the PPOS did not correlate with the PGDM with rs = -0.15 (CI: -0.41-0.13, P = 0.29) for "caring" and rs = -0.04 (CI: -0.31-0.23, P = 0.76) for "sharing". CONCLUSIONS: Although surgical providers scored low in patient centeredness using the PPOS, over one-quarter (26%) of them rank in the top 1% on the PGDM. No correlation was found between providers' patient centeredness and their patients' perceptions of efforts to include them in decision making.


Asunto(s)
Actitud del Personal de Salud , Toma de Decisiones , Planificación de Atención al Paciente , Satisfacción del Paciente , Cirujanos/psicología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Participación del Paciente , Cirujanos/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos
15.
Pflege ; 33(1): 3-12, 2020 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-31595828

RESUMEN

The congruence of nursing diagnoses, interventions, and outcomes between care observations, patient perceptions, and nursing records: a qualitative multiple case study Abstract. Background: Nurses with good decision-making competencies state more relevant and accurate nursing diagnoses, perform more effective nursing interventions, and achieve better nursing-sensitive patient outcomes. It was reported that the content of nursing records sometimes doesn't match with statements of patients and nurses. RESEARCH QUESTION: In what extent do the recorded nursing diagnoses, interventions, and outcomes match with observed care situations and patients' statements? METHODS: A multiple case study with structured observations, guided interviews, and document analyses was performed. The congruence of nursing diagnoses, interventions, and outcomes between the three data sources was investigated by within- and cross-case-analysis in a sample of 24 patients. RESULTS: In total, 114 nursing diagnoses were identified of which 66 were recorded, 37 were found by observations, and 11 by patient interviews. A high congruence between the three perspectives was determined in 59 % of the recorded nursing diagnoses, in 41 % of nursing interventions, and in 33 % of nursing-sensitive patient outcomes. Almost all documented nursing diagnoses (89 %) were supported by most codes from all three sources. CONCLUSIONS: To increase the congruence of the three perspectives, nurses' clinical decision-making competencies should be fostered, so that nurses choose more effective nursing interventions that lead to better nursing-sensitive patient outcomes. Patient participation should be fostered.


Asunto(s)
Competencia Clínica , Diagnóstico de Enfermería , Registros de Enfermería , Participación del Paciente , Humanos , Investigación Cualitativa
16.
Int J Cancer ; 146(5): 1316-1323, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-31509608

RESUMEN

Due to the increasing incidence and prevalence of neuroendocrine tumors (NETs), there is a need to assess any gaps in awareness and care. A survey was undertaken in 2017 to identify perceived unmet needs from the perspectives of patients/families, patient advocates and health care professionals (HCPs). The survey consisted of 33-37 questions (depending on type of respondent) across four areas: information, care, treatments and research. In total, 443 participants from 26 countries responded: 338 patients/families, 35 advocates and 70 HCPs. Perceived unmet needs regarding provision of information at diagnosis differed between groups. While 59% of HCPs believed they provided sufficient information, informational needs were mostly/fully met for only 30% of patients and 18% of advocates. Additionally, 91% of patients and 97% of advocates felt that patients had to search for information themselves. Availability of Gallium-68-Dotatate PET/CT scan was limited for the majority of patients (patients: 73%; advocates: 85%; HCP: 86%), as was access to treatments, particularly peptide receptor radionuclide therapy (patients: 42%; advocates: 95%; HCPs: 77%). All groups felt that standards of care, including psychological needs and diagnosis of mental health, were not fully met. Although about two-thirds of patients were managed by a multidisciplinary team, 14% of patients reportedly did not have enough contact. All groups supported more patient involvement in research; patients and advocates prioritized improvement in diagnosis and HCPs focused on clinical trials. This survey revealed significant unmet needs but differing perceptions regarding these among the groups. There is a need for investigation and collaboration to improve standards of care for NET patients.


Asunto(s)
Salud Global , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Tumores Neuroendocrinos/terapia , Participación del Paciente/estadística & datos numéricos , Brechas de la Práctica Profesional/estadística & datos numéricos , Adolescente , Adulto , Carga Global de Enfermedades , Comunicación en Salud , Personal de Salud/estadística & datos numéricos , Humanos , Incidencia , Conducta en la Búsqueda de Información , Oncología Médica/organización & administración , Oncología Médica/estadística & datos numéricos , Persona de Mediana Edad , Tumores Neuroendocrinos/diagnóstico , Tumores Neuroendocrinos/epidemiología , Neuroendocrinología/organización & administración , Neuroendocrinología/estadística & datos numéricos , Defensa del Paciente/estadística & datos numéricos , Prevalencia , Relaciones Profesional-Paciente , Encuestas y Cuestionarios/estadística & datos numéricos , Adulto Joven
17.
Int J Cancer ; 146(5): 1230-1240, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-31107987

RESUMEN

Our study used a refined case-control cervical cancer Audit framework to investigate effectiveness of cervical screening, with measures of three screening failures: irregular-participation, cervical cancer developed after cytological abnormalities and after normal screening results. The register-based study included 4,254 cervical cancer cases diagnosed in Sweden during 2002-2011, and 30 population-based controls per case. We used conditional logistic regression models to examine relative risks of cervical cancer in relation to screening participation and screening results in the past two screening rounds from 6 months before cancer diagnosis. We found that women unscreened in past two screening rounds showed four times increased risk of cervical cancer compared to women screened in time (OR = 4.1, 95% CI = 3.8-4.5), and women unscreened in the previous round but screened in the most recent round also showed a statistically significantly elevated risk (OR = 1.6, 95% CI = 1.5-1.8). Women having abnormality in previous two rounds exhibited higher risk of cervical cancer compared to women screened with normal results, while having normal results in the subsequent round after the abnormality also yielded an increased risk (OR = 4.0, 95% CI = 3.2-5.1). Being screened with only normal results was associated with 89% risk reduction for squamous cell cancer, compared to women unscreened, but only 60% reduction for adenocarcinoma. Our findings emphasize the importance of routine participation in cervical screening and suggest that management of abnormalities, as well as sensitivity of the test, warrants improvement especially for preventing cervical adenocarcinoma. The Audit framework serves as routine evaluation model and the findings benchmark for future evaluation of changes in screening practice.


Asunto(s)
Detección Precóz del Cáncer/estadística & datos numéricos , Tamizaje Masivo/organización & administración , Auditoría Médica/estadística & datos numéricos , Participación del Paciente/estadística & datos numéricos , Neoplasias del Cuello Uterino/epidemiología , Adulto , Anciano , Benchmarking/estadística & datos numéricos , Estudios de Casos y Controles , Cuello del Útero/patología , Femenino , Humanos , Tamizaje Masivo/estadística & datos numéricos , Persona de Mediana Edad , Prueba de Papanicolaou/estadística & datos numéricos , Embarazo , Evaluación de Programas y Proyectos de Salud , Sistema de Registros/estadística & datos numéricos , Medición de Riesgo , Suecia/epidemiología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología , Adulto Joven
18.
Psychiatr Prax ; 47(1): 39-42, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31412368

RESUMEN

OBJECTIVE: Assessment of patients' preferences regarding depression treatment using a ranking approach. METHODS: 641 primary care patients (mean age 43.9 years) ranked their primary preference for depression treatment out of 9 options. Logistic Regression analyses were used to determine factors associated with the most prioritized treatment options. RESULTS: The most frequently prioritized treatment options were psychotherapy (30 %), combination treatment of psychotherapy and drug treatment (18.4 %) and sole drug treatment (15.4 %). 12.3 % of women prioritized alternative therapy options. CONCLUSION: Patients with depression report individually different treatment preferences. These findings underline the importance of elucidating patients' preferences within a shared decision making process as recommended by treatment guidelines. There is a need of evidence-based information on the role of alternative therapies in the context of depression treatment.


Asunto(s)
Depresión/terapia , Prioridad del Paciente , Atención Primaria de Salud , Psicoterapia/métodos , Adulto , Toma de Decisiones , Femenino , Alemania , Humanos , Masculino , Participación del Paciente
19.
Nursing ; 50(1): 1-3, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31855997

RESUMEN

This article discusses the potential drivers and barriers to clinical nurse research participation. Here, the author describes a research exemplar that highlights how understanding the link between research and practice can influence participation.


Asunto(s)
Investigación en Enfermería Clínica/organización & administración , Participación del Paciente/estadística & datos numéricos , Humanos , Selección de Paciente
20.
Br J Radiol ; 93(1105): 20190240, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31651188

RESUMEN

OBJECTIVE: To compare the participation rate between CT colonography (CTC) and colonoscopy in screening population in randomized controlled trials (RCTs). METHODS: A search was performed using the PubMed, Web of Science, and Cochrane databases. RCTs that included screening populations and reported participation number were assessed. Cochrane risk of bias tool was used to assess the bias and quality. Risk ratio (RR) was used to present the results. The non-participation rate was analyzed to verify the results of participation rate. RESULTS: Five of 760 studies, with a total of 15,974 invitees, were included. The participation rate was higher at CTC (28.8%) than colonoscopy (20.8%), although the difference did not reach statistical significance (RR = 1.26; p = 0.070; I2 = 90.3%). The non-participation rate at CTC was significantly lower than colonoscopy (RR = 0.92; p = 0.012; I2 = 86.7%). Subgroup analysis suggested both the participation and non-participation rate were with significant difference between reduced/no cathartic preparation CTC and colonoscopy. Cumulative meta-analysis showed both the participation rate and non-participation rate exhibited a trend over time and sample size. CONCLUSION: The participation rate was higher at CTC than colonoscopy, although the difference did not reach statistical significance. But the non-participation rate was with statistical difference. Screening population seemed more likely to participate the reduced/no cathartic preparation CTC. Statistical evidence was provided for more large RCTs are needed in the future. ADVANCES IN KNOWLEDGE: The screening populations seem more likely to participate in the CTC, especially the reduced/no cathartic preparation CTC. The statistical evidence was provided for more large RCTs are needed in the future.


Asunto(s)
Colonografía Tomográfica Computarizada/estadística & datos numéricos , Colonoscopía/estadística & datos numéricos , Neoplasias Colorrectales/diagnóstico por imagen , Tamizaje Masivo/métodos , Participación del Paciente/estadística & datos numéricos , Detección Precóz del Cáncer , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
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