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1.
Semin Speech Lang ; 45(3): 171-193, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38950566

RESUMO

Researchers implemented a short-term cascading coaching model focusing on naturalistic developmental behavioral intervention with three participant triads. Triads consisted of a graduate student clinician, a minimally verbal child with autism spectrum disorder, and the child's parent. Coaching and intervention occurred during an interprofessional summer clinic that included graduate student clinicians from special education and speech and hearing sciences departments. The efficacy of short-term instruction, researcher coaching for student clinicians, and student clinician coaching of parents was evaluated using a multiple baseline across participants' design. The dependent variables were student clinician's and parent's use of elicitation techniques (creating communication temptations, waiting, and prompting) and response techniques (naturally reinforcing children's communication and providing spoken language models). Following coaching, parents and student clinicians from all triads increased their use of elicitation and response techniques, with very large effect sizes across all variables. Visual analysis findings suggest individualized differences and variability across triads. Implications for graduate education and parent coaching programs are discussed.


Assuntos
Transtorno do Espectro Autista , Comunicação , Tutoria , Humanos , Transtorno do Espectro Autista/terapia , Tutoria/métodos , Masculino , Feminino , Educação de Pós-Graduação/métodos , Pré-Escolar , Pais/educação , Criança , Patologia da Fala e Linguagem/educação
2.
JAMA Netw Open ; 7(7): e2418639, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38949813

RESUMO

Importance: Serious illness conversations (SICs) that elicit patients' values, goals, and care preferences reduce anxiety and depression and improve quality of life, but occur infrequently for patients with cancer. Behavioral economic implementation strategies (nudges) directed at clinicians and/or patients may increase SIC completion. Objective: To test the independent and combined effects of clinician and patient nudges on SIC completion. Design, Setting, and Participants: A 2 × 2 factorial, cluster randomized trial was conducted from September 7, 2021, to March 11, 2022, at oncology clinics across 4 hospitals and 6 community sites within a large academic health system in Pennsylvania and New Jersey among 163 medical and gynecologic oncology clinicians and 4450 patients with cancer at high risk of mortality (≥10% risk of 180-day mortality). Interventions: Clinician clusters and patients were independently randomized to receive usual care vs nudges, resulting in 4 arms: (1) active control, operating for 2 years prior to trial start, consisting of clinician text message reminders to complete SICs for patients at high mortality risk; (2) clinician nudge only, consisting of active control plus weekly peer comparisons of clinician-level SIC completion rates; (3) patient nudge only, consisting of active control plus a preclinic electronic communication designed to prime patients for SICs; and (4) combined clinician and patient nudges. Main Outcomes and Measures: The primary outcome was a documented SIC in the electronic health record within 6 months of a participant's first clinic visit after randomization. Analysis was performed on an intent-to-treat basis at the patient level. Results: The study accrued 4450 patients (median age, 67 years [IQR, 59-75 years]; 2352 women [52.9%]) seen by 163 clinicians, randomized to active control (n = 1004), clinician nudge (n = 1179), patient nudge (n = 997), or combined nudges (n = 1270). Overall patient-level rates of 6-month SIC completion were 11.2% for the active control arm (112 of 1004), 11.5% for the clinician nudge arm (136 of 1179), 11.5% for the patient nudge arm (115 of 997), and 14.1% for the combined nudge arm (179 of 1270). Compared with active control, the combined nudges were associated with an increase in SIC rates (ratio of hazard ratios [rHR], 1.55 [95% CI, 1.00-2.40]; P = .049), whereas the clinician nudge (HR, 0.95 [95% CI, 0.64-1.41; P = .79) and patient nudge (HR, 0.99 [95% CI, 0.73-1.33]; P = .93) were not. Conclusions and Relevance: In this cluster randomized trial, nudges combining clinician peer comparisons with patient priming questionnaires were associated with a marginal increase in documented SICs compared with an active control. Combining clinician- and patient-directed nudges may help to promote SICs in routine cancer care. Trial Registration: ClinicalTrials.gov Identifier: NCT04867850.


Assuntos
Neoplasias , Relações Médico-Paciente , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Neoplasias/psicologia , Neoplasias/terapia , Idoso , Comunicação , Adulto , Análise por Conglomerados , Pennsylvania
3.
BMC Med Educ ; 24(1): 707, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951784

RESUMO

BACKGROUND: The effects of many treatments in healthcare are determined by factors other than the treatment itself. Patients' expectations and the relationship with their healthcare provider can significantly affect treatment outcomes and thereby play a major role in eliciting placebo and nocebo effects. We aim to develop and evaluate an innovative communication training, consisting of an e-learning and virtual reality (VR) training, for healthcare providers across all disciplines, to optimize placebo and minimize nocebo effects through healthcare provider-patient communication. The current paper describes the development, mid-term evaluation, optimization, and final evaluation of the communication training, conducted in The Netherlands. METHODS: The development of both the e-learning and the VR training consisted of four phases: 1) content and technical development, 2) mid-term evaluation by healthcare providers and placebo/communication researchers, 3) optimization of the training, and 4) final evaluation by healthcare providers. To ensure the success, applicability, authenticity, and user-friendliness of the communication training, there was ongoing structural collaboration with healthcare providers as future end users, experts in the field of placebo/communication research, and educational experts in all phases. RESULTS: Placebo/communication researchers and healthcare providers evaluated the e-learning positively (overall 7.9 on 0-10 scale) and the content was perceived as useful, accessible, and interesting. The VR training was assessed with an overall 6.9 (0-10 scale) and was evaluated as user-friendly and a safe method for practicing communication skills. Although there were some concerns regarding the authenticity of the VR training (i.e. to what extent the virtual patient reacts like a real patient), placebo and communication researchers, as well as healthcare providers, recognized the significant potential of the VR training for the future. CONCLUSIONS: We have developed an innovative and user-friendly communication training, consisting of an e-learning and VR training (2D and 3D), that can be used to teach healthcare providers how to optimize placebo effects and minimize nocebo effects through healthcare provider-patient communication. Future studies can work on improved authenticity, translate the training into other languages and cultures, expand with additional VR cases, and measure the expected effects on providers communication skills and subsequently patient outcomes.


Assuntos
Comunicação , Efeito Nocebo , Efeito Placebo , Realidade Virtual , Humanos , Países Baixos , Pessoal de Saúde/educação , Relações Médico-Paciente , Instrução por Computador/métodos , Feminino
4.
MedEdPORTAL ; 20: 11411, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38957534

RESUMO

Introduction: Physicians can be unaware that many US adults have intermediate or lower health literacy. Avoiding medical jargon in patient communication can improve poor outcomes associated with lower health literacy, but physicians may struggle to do so as health literacy education is neither standardized nor universal at US allopathic medical schools. As with other skills-based proficiencies in medical education, repeat exposure and active learning help build competency. Medical students developed the Patient Communication Challenge (PCC), an adaptation of the Hasbro game Taboo, to facilitate practice of patient-centered communication skills among medical trainees. Methods: Hour-long workshops were held for groups of preclinical medical students. Students watched a communication exemplar video, played the PCC game, and completed a postworkshop survey. To play, two teams competed to earn points by identifying medical concepts as explained by a teammate who described the term without using medical jargon. Results: Evaluations indicated that the game was enjoyable and reinforced didactic concepts through active learning, with self-reported participant satisfaction and competency gain. Overall, 59% of participants (53 of 90) completed postworkshop surveys; 91% (48 of 53) agreed they felt more proficient in avoiding jargon, 94% (50 of 53) would recommend the workshop to a classmate, and 100% (53 of 53) would play again. Discussion: The PCC can help early medical trainees develop health communication skills through gamification with utilization of adult learning principles and adequate frequency for skill retention. Future applications include longitudinal assessment and expanding to later stages of medical training and other health professions.


Assuntos
Comunicação , Estudantes de Medicina , Humanos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Jogos de Vídeo , Educação de Graduação em Medicina/métodos , Relações Médico-Paciente , Aprendizagem Baseada em Problemas/métodos
5.
PLoS One ; 19(7): e0304127, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38968253

RESUMO

BACKGROUND: Digital transformation (DT) involves integrating digital technologies into organizations to improve productivity, efficiency, and quality. Investing in the workforce's skillsets is essential for successful DT. However, it remains unclear which skillsets are essential. OBJECTIVES: This study aims to identify and define the essential skillsets needed for exploiting the full potential of DT, and to consolidate the identified skills into a comprehensive framework of DT skills. METHOD: A systematic literature review was conducted using the PRISMA approach for selecting studies. This led to the selection of 36 articles that were examined using thematic analysis for identifying and consolidating skills into a framework. RESULTS: The Digital Transformation Skills Framework (DTSF) was developed, which contains six overarching skillsets and 44 underlying skills. The framework covers key skillsets in the areas of digital work, entrepreneurship, evidence-based work, collaboration, communication, and adaptation. CONCLUSION AND DISCUSSION: The DTSF offers a comprehensive understanding of essential skills for today's evolving organizations, addressing a critical gap in existing literature. It is valuable for organizations and HR professionals, serving as a foundation for re- and upskilling initiatives. Ongoing research should expand the framework to include domain-specific DT skills and emerging digital technologies.


Assuntos
Tecnologia Digital , Humanos , Empreendedorismo , Comunicação
7.
J Dermatolog Treat ; 35(1): 2376268, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38981618

RESUMO

Purpose: Patients with atopic dermatitis (AD) require both skills and support to effectively manage life with the disease. Here, we developed an agenda-setting tool for consultations with patients with AD to establish a collaborative agenda that enhances patient involvement and prioritizes on self-management support.Materials and methods: Using the design thinking process, we included 64 end-users (patients and healthcare professionals (HCPs)) across the different phases of design thinking. We identified seven overall categories that patients find important to discuss during consultations, which informed the development of a tool for co-creating a consultation agenda (conversation cards, CCs).Results: Through iterative user testing of the CCs, patients perceived the cards as both inspiring and an invitation from HCPs to openly discuss their needs during consultations. Healthcare professionals have found the CCs easy to use, despite the disruption to the typical consultation process.Conclusion: In summary, the CCs provide a first-of-its-kind agenda-setting tool for patients with AD. They offer a simple and practical method to establishing a shared agenda that focuses on the patients' needs and are applicable within real-world clinical settings.


Assuntos
Dermatite Atópica , Encaminhamento e Consulta , Humanos , Dermatite Atópica/terapia , Dermatite Atópica/diagnóstico , Feminino , Participação do Paciente , Masculino , Adulto , Relações Médico-Paciente , Comunicação , Pessoa de Meia-Idade , Autogestão
8.
JASA Express Lett ; 4(7)2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38984970

RESUMO

This article presents a different experiment examining the impact of feedback timing on its perception. Dialog sequences, featuring a main speaker's utterance followed by a listener's feedback, were extracted from spontaneous conversations. The original feedback instances were manipulated to be produced earlier, up to 1.5 s in advance, or to be delayed, up to 2 s later. Participants evaluated the feedback acceptability and engagement level of the listener. The findings reveal that 76% of the time feedback remains acceptable regardless of the delay. However, engagement decreases after a 1-s delay while no consistent effect is observed for feedback anticipation.


Assuntos
Comunicação , Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Retroalimentação , Fatores de Tempo , Percepção da Fala/fisiologia
9.
JAAPA ; 37(6): 42-44, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38985115

RESUMO

ABSTRACT: Communication errors during transfer of care from one clinician to another are a major cause of medical errors. In 2006, The Joint Commission made handoff communications a national patient safety goal. In 2014, the Association of American Medical Colleges included giving and receiving a report to transfer a patient's care as one of the 13 core entrustable professional activities required for entry into residency programs. Communication is the key to successful transfer of patient care from one clinician to another during shift change. A structured method of communication used by all clinicians in high-stakes healthcare settings can ensure all vital information about a patient is given to the receiving clinician.


Assuntos
Comunicação , Erros Médicos , Transferência da Responsabilidade pelo Paciente , Humanos , Transferência da Responsabilidade pelo Paciente/normas , Erros Médicos/prevenção & controle , Segurança do Paciente , Internato e Residência
10.
JMIR Res Protoc ; 13: e56608, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38990615

RESUMO

BACKGROUND: Social communication is a key factor in maintaining cognitive function and contributes to well-being in later life. OBJECTIVE: This study will examine the effects of "Photo-Integrated Conversation Moderated by Application version 2" (PICMOA-2), which is a web-based conversational intervention, on cognitive performance, frailty, and social and psychological indicators among community-dwelling older adults. METHODS: This study is a randomized controlled trial with an open-label, 2-parallel group trial and 1:1 allocation design. Community dwellers aged 65 years and older were enrolled in the trial and divided into the intervention and control groups. The intervention group receives the PICMOA-2 program, a web-based group conversation, once every 2 weeks for 6 months. The primary outcome is verbal fluency, including phonemic and semantic fluency. The secondary outcomes are other neuropsychiatric batteries, including the Mini-Mental State Examination, Logical Memory (immediate and delay), verbal paired associates, and comprehensive functional status evaluated by questionnaires, including frailty, social status, and well-being. The effect of the intervention will be examined using a mixed linear model. As a secondary aim, we will test whether the intervention effects vary with the covariates at baseline to examine the effective target attributes. RESULTS: Recruitment was completed in July 2023. A total of 66 participants were randomly allocated to intervention or control groups. As of January 1, 2024, the intervention is ongoing. Participants are expected to complete the intervention at the end of February 2024, and the postintervention evaluation will be conducted in March 2024. CONCLUSIONS: This protocol outlines the randomized controlled trial study design evaluating the effect of a 6-month intervention with PICMOA-2. This study will provide evidence on the effectiveness of social interventions on cognitive function and identify effective target images for remote social intervention. TRIAL REGISTRATION: UMIN Clinical Trials UMIN000050877; https://tinyurl.com/5eahsy66. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56608.


Assuntos
Cognição , Humanos , Idoso , Cognição/fisiologia , Feminino , Masculino , Intervenção Baseada em Internet , Japão , Estado Funcional , Idoso de 80 Anos ou mais , Vida Independente , Comunicação , População do Leste Asiático
11.
Psychooncology ; 33(7): e6374, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38977423

RESUMO

OBJECTIVE: To deliver and evaluate an educational intervention to equip health and social care professionals (professionals) on how best to support parents at end of life with cancer concerning their dependent children (<18). METHODS: An evidence-based and theory-driven face-to-face educational intervention was developed and evaluated using three levels of Kirkpatrick's Model of Evaluation. Pre-test, post-test surveys were completed immediately before-and-after the intervention using a validated self-efficacy scale and single-item questions evaluating perceived usefulness and relevance (levels one/two). Qualitative interviews ≥ 3-months post-intervention explored if, and how the intervention impacted professionals' practice (level three). Fourteen sessions were delivered at oncology settings to 347 professionals between 2021 and 2023. Two hundred seventy four professionals completed the pre-test survey, with 239 completing the post-test survey. Fourteen professionals were interviewed between three-and 19-months post-intervention. RESULTS: Quantitative findings demonstrated a statistically significant improvement in self-efficacy post-educational intervention (p < 0.001). Qualitative data highlighted professionals gained new approaches to progress end of life conversations with parents, despite some familial resistance to sharing the reality of the situation with children. Positive intervention content shaping clinical practice included the bereaved parent's lived experience, communication framework and roleplay videos. Some professionals considered a booster session and opportunities to practice conversations necessary to further consolidate learning into practice. CONCLUSIONS: Evidence and theory-driven education can positively impact professionals' provision of family-centred cancer care. Future studies should explore the impact of this educational intervention on familial outcomes. Alongside a sustainable delivery of this intervention, advanced communication skills programmes should incorporate parent-child end of life conversations.


Assuntos
Pessoal de Saúde , Neoplasias , Pais , Assistência Terminal , Humanos , Neoplasias/psicologia , Neoplasias/terapia , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Pais/psicologia , Pais/educação , Assistência Terminal/psicologia , Masculino , Feminino , Criança , Adulto , Autoeficácia , Pesquisa Qualitativa , Inquéritos e Questionários , Comunicação , Relações Profissional-Família
13.
Pediatr Clin North Am ; 71(4): 707-727, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39003012

RESUMO

In the adolescent mental health crisis, negative narrative communication has unitended consequences. Supportive communication involves reframing communications to find a new narrative that does not evoke biases. This narrative must emphasize agency and highlight the strengths, potential, and common experiences of young people. It is clear that supporting positive development and well-being is an "us" endeavor. There is a place in this communication strategy for pediatric professionals to address young people, caregivers, other health care professionals, and the community. The science of framing helps us shape a more supportive and productive discourse.


Assuntos
Saúde Mental , Humanos , Adolescente , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Comunicação , Desenvolvimento do Adolescente , Saúde do Adolescente , Defesa do Paciente
14.
Glob Public Health ; 19(1): 2369100, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38987991

RESUMO

BACKGROUND: There is limited evidence on how to engage health workers as advocates in preventing female genital mutilation (FGM). This study assesses the feasibility, acceptability, appropriateness and impact of a person-centered communication (PCC) approach for FGM prevention among antenatal care (ANC) providers in Guinea, Kenya and Somalia. METHODS: Between August 2020 and September 2021, a cluster randomised trial was conducted in 180 ANC clinics in three countries testing an intervention on PCC for FGM prevention. A process evaluation was embedded, comprising in-depth interviews (IDIs) with 18 ANC providers and 18 ANC clients. A qualitative thematic analysis was conducted, guided by themes identified a priori and/or that emerged from the data. RESULTS: ANC providers and clients agreed that the ANC context was a feasible, acceptable and appropriate entry point for FGM prevention counselling. ANC clients were satisfied with how FGM-related information was communicated by providers and viewed them as trusted and effective communicators. Respondents suggested training reinforcement, targeting other cadres of health workers and applying this approach at different service delivery points in health facilities and in the community to increase sustainability and impact. CONCLUSION: These findings can inform the scale up this FGM prevention approach in high prevalence countries.


Assuntos
Circuncisão Feminina , Estudos de Viabilidade , Cuidado Pré-Natal , Humanos , Feminino , Somália , Quênia , Guiné , Adulto , Pesquisa Qualitativa , Gravidez , Entrevistas como Assunto , Comunicação , Adulto Jovem
15.
Am J Manag Care ; 30(7): e198-e202, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38995823

RESUMO

OBJECTIVE: To analyze patient satisfaction with letter-based communication of lung cancer screening (LCS) pulmonary nodule results. STUDY DESIGN: Prospective randomized controlled trial of LCS between May and December 2019. METHODS: All participants came from a prospective randomized controlled study on pulmonary nodule results in LCS with low-dose CT (LDCT) to analyze patient satisfaction, perception of information received via letters, preferred methods of receiving results, and dissatisfaction-related characteristics. RESULTS: A total of 153 patients were detected to have pulmonary nodules among 600 recruited participants in the lung cancer high-risk group screened using LDCT. Most of the patients were satisfied with receiving pulmonary nodule results via letters (78.4%; n = 120) and agreed that the letters contained an appropriate amount of information (83.7%; n = 128). Univariate logistic regression analysis revealed that satisfaction was related to age (OR, 0.905; 95% CI, 0.832-0.985), education level (OR, 0.367; 95% CI, 0.041-3.250), no family history of cancer (OR, 0.100; 95% CI, 0.011-0.914), and the number of nodules (OR, 6.028; 95% CI, 1.641-22.141). Of the patients who reported dissatisfaction with letter-based communication (7.2%; n = 11), the most common reasons cited were that they contained insufficient patient education materials and that it was difficult to comprehend the medical terminology. The majority of participants (61.4%; n = 94) reported that they would prefer the letter-based communication. No correlation was identified between satisfaction and gender, smoking status, alcohol consumption, risk factors, nodule size, or nodule location. CONCLUSIONS: Patients were generally satisfied with receiving their LCS pulmonary nodule results via letters, reporting that the letters included adequate information about their diagnosis and follow-up steps. This may provide a basis for feasible result communication via letters for cancer screening programs in underdeveloped regions in China.


Assuntos
Neoplasias Pulmonares , Satisfação do Paciente , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Estudos Prospectivos , Idoso , Detecção Precoce de Câncer , Comunicação , Tomografia Computadorizada por Raios X , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/patologia , Correspondência como Assunto , China , Adulto
16.
J Prof Nurs ; 53: 71-79, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38997201

RESUMO

BACKGROUND: Simulation-based interventions for nursing students addressing challenging communication situations involving geriatric patients and end-of-life care are limited. PURPOSE: This study evaluated the effects of technology-based interactive communication simulations on nursing students' communication knowledge, self-efficacy, skills, compassion, and program satisfaction. METHOD: A randomized controlled repeated-measures design was used with third- and fourth-year nursing students enrolled in five nursing colleges located in five regions in Korea as participants. Participants were randomly assigned to either a technology-based interactive communication simulation or an attention control group. Changes in communication knowledge, self-efficacy, skills, compassion, and program satisfaction were assessed using three self-reported measures and communication skills were measured by the raters. Statistical analyses included descriptive analyses, chi-square tests, t-tests, and a generalized estimating equation model. RESULTS: Eighty students participated in one of the two programs, and 77 in the four-week follow-up test. The intervention group indicated significant improvements in communication knowledge, self-efficacy, skills, and compassion, as well as higher program satisfaction compared with the attention control group. Communication skills as assessed by raters also showed significant change at all assessment time points. CONCLUSION: The technology-based interactive communication simulation program is effective in improving communication skills among nursing students managing geriatric patients and end-of-life care.


Assuntos
Comunicação , Autoeficácia , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Feminino , República da Coreia , Masculino , Empatia , Bacharelado em Enfermagem , Treinamento por Simulação , Adulto , Adulto Jovem , Competência Clínica , Relações Enfermeiro-Paciente
17.
Cancer Med ; 13(14): e70010, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39001678

RESUMO

PURPOSE: High-quality communication is essential to patient-centered care. Existing communication models and research tends to focus on what is said verbally with little attention to nonverbal aspects of communication. In sensitive and emotionally intensive healthcare encounters, such as in cancer care, provider and patient nonverbal behavior may be particularly important for communicating with empathy. Therefore, the aim of this study was to develop a conceptual model of communication that accounts for nonverbal behavior. METHODS: We followed a systematic grounded theory design that involved semi-structured interviews with 23 providers, including nurse practitioners, physicians, surgeons, and physician's assistants. Using constant comparative analysis, we analyzed transcripts and developed a grounded theory model of communication accounting for nonverbal behavior. RESULTS: The major themes included building rapport, gauging how patients will take bad news, ensuring patients' understanding of their conditions, staying honest but hopeful, centering but guiding patient through cancer care, conveying empathy while managing heightened emotions, and ensuring patient understanding. Throughout the process, providers synthesize both verbal and nonverbal information and apply what they learn to future encounters. CONCLUSIONS: The results extend existing models of patient-centered communication and invite communication intervention and research that incorporates nonverbal behavior. The model contributes an understanding of the full process of communication in clinical encounters.


Assuntos
Empatia , Teoria Fundamentada , Neoplasias , Comunicação não Verbal , Assistência Centrada no Paciente , Relações Médico-Paciente , Humanos , Neoplasias/psicologia , Neoplasias/terapia , Feminino , Masculino , Comunicação , Pessoa de Meia-Idade , Adulto
18.
Support Care Cancer ; 32(8): 516, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014258

RESUMO

PURPOSE: Dyadic communication positively affects marital relationships, good relationships help restore body image, and this study explores the relationship between dyadic communication and body image of breast cancer patients. METHODS: Cross-sectional correlation design with convenience sampling was used to recruit participants from two outpatient medical centers. Demographic information, medical records, and two questionnaires, dyadic communicative resilience scale (DCRS) and body image scale (BIS), were administered. Participants comprised women with breast cancer and their partners. Multiple regression analysis was performed to control related factors to understand the association between the DCRS of the women with breast cancer and their partners and the women's body image. Analysis of variance (ANOVA) was performed to analyze between three categories of couple's communication status (consistent and good, consistent and poor, and inconsistent) and body image of women with breast cancer. RESULTS: Data were obtained from 162 women with breast cancer and 90 partners. The study found (1) significant correlation between the women's perception of their communication and body image, (2) humor in partner's perception of their communication was significantly associated with women's body image, and (3) dyadic communication that both patients and partners were consistent and good in the domain of keeping pre-cancer routines and attractiveness was associated with women's body image. CONCLUSION: The correlation between dyadic communication and the body image of women with breast cancer is significant. Improving communication specific on keeping pre-cancer routines and attractiveness between women with breast cancer and their partners could enhance the women's body image.


Assuntos
Imagem Corporal , Neoplasias da Mama , Comunicação , Humanos , Feminino , Neoplasias da Mama/psicologia , Imagem Corporal/psicologia , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Inquéritos e Questionários , Cônjuges/psicologia , Relações Interpessoais , Masculino , Idoso , Análise de Regressão , Análise de Variância , Resiliência Psicológica
19.
JMIR Aging ; 7: e47565, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38963691

RESUMO

BACKGROUND: Persons living with dementia experience autonomy loss and require caregiver support on a daily basis. Dementia involves a gradual decline in communication skills, leading to fewer interactions and isolation for both people living with dementia and their caregivers, negatively impacting the quality of life for both members of the dyad. The resulting stress and burden on caregivers make them particularly susceptible to burnout. OBJECTIVE: This study aims to examine the efficacy of Communication Proches Aidants (COMPAs), an app designed following the principles of person-centered and emotional communication, which is intended to improve well-being in persons living with dementia and caregivers and reduce caregiver burden. METHODS: In this implementation study, volunteer caregivers in 2 long-term care facilities (n=17) were trained in using COMPAs and strategies to improve communication with persons living with dementia. Qualitative and quantitative analyses, semistructured interviews, and questionnaires were completed before and after 8 weeks of intervention with COMPAs. RESULTS: Semistructured interviews revealed that all caregivers perceived a positive impact following COMPAs interventions, namely, improved quality of communication and quality of life among persons living with dementia and caregivers. Improved quality of life was also supported by a statistically significant reduction in the General Health Questionnaire-12 scores (caregivers who improved: 9/17, 53%; z=2.537; P=.01). COMPAs interventions were also associated with a statistically significant increased feeling of personal accomplishment (caregivers improved: 11/17, 65%; t15=2.430; P=.03; d=0.61 [medium effect size]). CONCLUSIONS: COMPAs intervention improved well-being in persons living with dementia and their caregivers by developing person-centered communication within the dyad, increasing empathy, and reducing burden in caregivers although most caregivers were unfamiliar with technology. The results hold promise for COMPAs interventions in long-term care settings. Larger group-controlled studies with different populations, in different contexts, and at different stages of dementia will provide a clearer picture of the benefits of COMPAs interventions.


Assuntos
Cuidadores , Comunicação , Demência , Assistência de Longa Duração , Aplicativos Móveis , Qualidade de Vida , Humanos , Demência/psicologia , Demência/enfermagem , Cuidadores/psicologia , Feminino , Masculino , Qualidade de Vida/psicologia , Idoso , Pessoa de Meia-Idade , Inquéritos e Questionários , Idoso de 80 Anos ou mais
20.
JAMA Netw Open ; 7(7): e2422399, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-39012633

RESUMO

Importance: Virtual patient-physician communications have increased since 2020 and negatively impacted primary care physician (PCP) well-being. Generative artificial intelligence (GenAI) drafts of patient messages could potentially reduce health care professional (HCP) workload and improve communication quality, but only if the drafts are considered useful. Objectives: To assess PCPs' perceptions of GenAI drafts and to examine linguistic characteristics associated with equity and perceived empathy. Design, Setting, and Participants: This cross-sectional quality improvement study tested the hypothesis that PCPs' ratings of GenAI drafts (created using the electronic health record [EHR] standard prompts) would be equivalent to HCP-generated responses on 3 dimensions. The study was conducted at NYU Langone Health using private patient-HCP communications at 3 internal medicine practices piloting GenAI. Exposures: Randomly assigned patient messages coupled with either an HCP message or the draft GenAI response. Main Outcomes and Measures: PCPs rated responses' information content quality (eg, relevance), using a Likert scale, communication quality (eg, verbosity), using a Likert scale, and whether they would use the draft or start anew (usable vs unusable). Branching logic further probed for empathy, personalization, and professionalism of responses. Computational linguistics methods assessed content differences in HCP vs GenAI responses, focusing on equity and empathy. Results: A total of 16 PCPs (8 [50.0%] female) reviewed 344 messages (175 GenAI drafted; 169 HCP drafted). Both GenAI and HCP responses were rated favorably. GenAI responses were rated higher for communication style than HCP responses (mean [SD], 3.70 [1.15] vs 3.38 [1.20]; P = .01, U = 12 568.5) but were similar to HCPs on information content (mean [SD], 3.53 [1.26] vs 3.41 [1.27]; P = .37; U = 13 981.0) and usable draft proportion (mean [SD], 0.69 [0.48] vs 0.65 [0.47], P = .49, t = -0.6842). Usable GenAI responses were considered more empathetic than usable HCP responses (32 of 86 [37.2%] vs 13 of 79 [16.5%]; difference, 125.5%), possibly attributable to more subjective (mean [SD], 0.54 [0.16] vs 0.31 [0.23]; P < .001; difference, 74.2%) and positive (mean [SD] polarity, 0.21 [0.14] vs 0.13 [0.25]; P = .02; difference, 61.5%) language; they were also numerically longer (mean [SD] word count, 90.5 [32.0] vs 65.4 [62.6]; difference, 38.4%), but the difference was not statistically significant (P = .07) and more linguistically complex (mean [SD] score, 125.2 [47.8] vs 95.4 [58.8]; P = .002; difference, 31.2%). Conclusions: In this cross-sectional study of PCP perceptions of an EHR-integrated GenAI chatbot, GenAI was found to communicate information better and with more empathy than HCPs, highlighting its potential to enhance patient-HCP communication. However, GenAI drafts were less readable than HCPs', a significant concern for patients with low health or English literacy.


Assuntos
Relações Médico-Paciente , Humanos , Estudos Transversais , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Comunicação , Melhoria de Qualidade , Inteligência Artificial , Médicos de Atenção Primária/psicologia , Registros Eletrônicos de Saúde , Idioma , Empatia , Atitude do Pessoal de Saúde
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