scholarly journals Perceived facilitating and limiting factors for healthcare professionals to adopting a patient decision aid for breast cancer aftercare: A cross-sectional study

2020 ◽  
Vol 103 (1) ◽  
pp. 145-151
Author(s):  
Linda A. Klaassen ◽  
Jolanda H.H.M. Friesen-Storms ◽  
Gerrie J.J.W. Bours ◽  
Carmen D. Dirksen ◽  
Liesbeth J. Boersma ◽  
...  

2011 ◽  
Vol 27 (4) ◽  
pp. 363-368 ◽  
Author(s):  
Fátima Izquierdo ◽  
Javier Gracia ◽  
Mercedes Guerra ◽  
Juan Antonio Blasco ◽  
Elena Andradas

Objectives: The aim of this study was to develop a breast cancer Patient Decision Aid (PDA), using a Health Technology Assessment (HTA) process, to assist patients in their choice of therapeutic options, and to promote shared decision making among patients, healthcare professionals, and other interested parties.Methods: A systematic review (SR) was conducted of existing breast cancer patient Decision Aids encountered in the main scientific journal databases and on institutional Web sites that create PDAs, together with a Qualitative Research (QR) study, using semi-structured interviews and focus group with stakeholders (patients, family members, and health professionals), with the aim of developing a PDA for breast cancer.Results: The SR shows that PDAs in breast cancer not only increase patient knowledge of the illness, leading to more realistic expectations of treatment outcomes, but also reduce passivity in the decision-making process and facilitate the appropriate choice of treatment options in accordance with patient medical and personal preferences. The analysis of QR shows that both breast cancer patients and healthcare professionals agree that surgery, adjuvant treatments, and breast reconstruction represent the most important decisions to be made. Worry, anxiety, optimism, and trust in healthcare professionals were determined as factors that most affected patients subjective experiences of the illness. This HTA was used as the basis for developing a PDA software program.Conclusions: The SR and QR used in the development of this PDA for breast cancer allowed patients to access information, gain additional knowledge of their illness, make shared treatment decisions, and gave healthcare professionals a deeper insight into patient experiences of the disease.



2020 ◽  
Author(s):  
Guillaume Sacco ◽  
Pauline Carliez ◽  
Frédéric Noublanche ◽  
Romain Simon ◽  
Anne Renaudin ◽  
...  

BACKGROUND Usability is the keystone in the evolution of tablet technology in healthcare. The Ardoiz® tablet has been designed with a simplified interface for older adults. OBJECTIVE To assess the perceived usability and satisfaction of the Ardoiz® tablet. METHODS We conducted a mixed methods with cross-sectional study using System Usability Scale (SUS), satisfaction score and workshops, including geriatric patients, healthcare professional and caregivers. RESULTS Between September 25, 2019 and March 11, 2020, 58 participants were included in a cross-sectional study (including 38 patients, mean ±SD 85±6 years, 66% women), 26 in workshops (including 5 patients, mean ±SD 86.4±2.9, 40% women). The SUS was 74±12/100, the satisfaction score was 2.8±0.9/4, with 59% of satisfied participants with the use of Ardoiz® pads. The intent to acquire remained low with 18% (n=6) of participants who would be interested in acquiring the tablet. This tablet computer seemed to be difficult to use by geriatric patients and healthcare professionals, mainly because of its complex homepage. Nevertheless, former caregivers and healthcare professionals thought that the tablet could be of great interest to hospitals for leisure and medical use. The main feedback in order to improve the tablet is to simplify the home page with fewer and more static icons (without switching). CONCLUSIONS Notwithstanding the usability of the tablet, the intent to acquire of Ardoiz® tablet remained low. The interface should be simplified for older adults in order to improve usability and adherence. CLINICALTRIAL NCT04091152



Breast Care ◽  
2020 ◽  
pp. 1-7
Author(s):  
Elna Kuehnle ◽  
Wulf Siggelkow ◽  
Kristina Luebbe ◽  
Iris Schrader ◽  
Karl-Heinz Noeding ◽  
...  

<b><i>Background:</i></b> Although immigrant health is an important issue in national health policy, there is a serious shortage of data in many countries. Most studies lack information on educational status, which is a major limitation. This prospective cross-sectional study analyzed a real-world breast cancer population on the influence of immigration background and educational status on participation in breast cancer early detection programs in the federal state of Lower Saxony, Germany. <b><i>Methods:</i></b> Data collection was conducted from 2012 to 2016 in six certified breast cancer centers using a standardized questionnaire for patients’ interview and tumor-specific data from the patients’ medical records. <b><i>Results:</i></b> 2,145/3,047 primary breast cancer cases were analyzed. 17.5% of our patients had a history of immigration, including <i>n</i> = 202 first-generation immigrants and <i>n</i> = 168 second-generation immigrants. Most of them were citizens of EU27 member states. No significant difference was seen in age, tumor stage, histology, grading, Ki-67, Her2/neu-status, and hormone receptor status compared to the native cohort. 100% participation rate in the breast cancer early detection programs were seen in patients with no school graduation. With regards to the national mammography screening program, participation decreased significantly with educational status (<i>p</i> = 0.0003). <b><i>Conclusions:</i></b> No tumor biological differences were seen between immigrants and German natives. In first-generation immigrants, early detection programs were well accepted despite sociocultural and language differences. Participation rate decreased significantly with higher education levels irrespective of country of origin. Immigration background does not have a negative effect on the participation in breast cancer screening. This mainly relates to immigrants from EU27 member states.



Author(s):  
Serena Barello ◽  
Rosario Caruso ◽  
Lorenzo Palamenghi ◽  
Tiziana Nania ◽  
Federica Dellafiore ◽  
...  

Abstract Purpose The purpose of the present cross-sectional study is to investigate the role of perceived COVID-19-related organizational demands and threats in predicting emotional exhaustion, and the role of organizational support in reducing the negative influence of perceived COVID-19 work-related stressors on burnout. Moreover, the present study aims to add to the understanding of the role of personal resources in the Job Demands-Resources model (JD-R) by examining whether personal resources—such as the professionals’ orientation towards patient engagement—may also strengthen the impact of job resources and mitigate the impact of job demands. Methods This cross-sectional study involved 532 healthcare professionals working during the COVID-19 pandemic in Italy. It adopted the Job-Demands-Resource Model to study the determinants of professional’s burnout. An integrative model describing how increasing job demands experienced by this specific population are related to burnout and in particular to emotional exhaustion symptoms was developed. Results The results of the logistic regression models provided strong support for the proposed model, as both Job Demands and Resources are significant predictors (OR = 2.359 and 0.563 respectively, with p < 0.001). Moreover, healthcare professionals’ orientation towards patient engagement appears as a significant moderator of this relationship, as it reduces Demands’ effect (OR = 1.188) and increases Resources’ effect (OR = 0.501). Conclusions These findings integrate previous findings on the JD-R Model and suggest the relevance of personal resources and of relational factors in affecting professionals’ experience of burnout.



Author(s):  
Raquel Adjafre da Costa Matos ◽  
Rita de Cassia Coelho de Almeida Akutsu ◽  
Renata Puppin Zandonadi ◽  
Raquel Braz Assunção Botelho

Dietitians as healthcare professionals could decrease their quality of life during the SARS-COV-2 pandemic period; therefore, this study aimed to compare Brazilian dietitians’ perceptions of quality of life before and during the pandemic. This nationwide cross-sectional research aimed to evaluate Brazilian dietitians’ quality of life before and in the course of the COVID-19 pandemic, using a previously validated self-administered instrument WHO-QOL-BREF in Brazilian-Portuguese. The questionnaire was composed of 26 items (four domains) to evaluate life quality (physical, psychological, social relationship, and environment). The questionnaire also presented some sociodemographic variables and three questions about the COVID-19 pandemic. It was applied using GoogleForms® platform (Google LLC, Mountain View, CA, USA). For the statistical analysis of data, Paired T-test, Chi-squared test, and Analysis of Variance were used. A total of 1290 Brazilian dietitians replied to the instrument. Comparing quality of life (QoL) before SARS-COV-2 (3.83 ± 0.59) and during the pandemic (3.36 ± 0.66), data was statistically different. Comparing prior and in the course of the COVID-19 pandemic, all variables and domains presented statistical differences (better before the pandemic period). Among Brazilian dietitians, the psychological health domain was the most affected. The Sars-Cov-2 pandemic negatively impacted the QoL of Brazilian dietitians since health professionals face changes in their lives because of work.



2021 ◽  
Vol 34 (2) ◽  
pp. 114-122
Author(s):  
Nilüfer Demirsoy ◽  
Hülya Öztürk ◽  
Nurdan Ergün Acar

Confidentiality is fundamental in building trust between patients and healthcare professionals. This research aims at presenting healthcare professionals’ opinions on patient privacy, using a 5-point Likert-type scale titled “Opinion of the Healthcare Professionals on Patient Privacy,” and 262 physicians’ and 231 nurses’ opinions were evaluated. Results showed that nurses and doctors working at emergency services got higher mean scores than those working at other units. Results revealed that doctors had the highest mean score for the item “ It is important that the patient’s body is not seen by other patients and professionals during the treatment,” while nurses had the highest mean score for the item “ I approach with due care to protect privacy in the work environment.” Results of this work highlight that patient’s right to privacy constitutes one of the most significant issues to be noted by healthcare professionals.





Author(s):  
Desirée Mena-Tudela ◽  
Susana Iglesias-Casás ◽  
Víctor Manuel González-Chordá ◽  
María Jesús Valero-Chillerón ◽  
Laura Andreu-Pejó ◽  
...  

Background: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. Methods: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. Results: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and “other” professionals repeatedly appeared. Conclusions: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System’s structure and management but also on healthcare professionals’ training.



2021 ◽  
Vol 21 (1) ◽  
Author(s):  
I. E. H. Kremer ◽  
P. J. Jongen ◽  
S. M. A. A. Evers ◽  
E. L. J. Hoogervorst ◽  
W. I. M. Verhagen ◽  
...  

Abstract Background Since decision making about treatment with disease-modifying drugs (DMDs) for multiple sclerosis (MS) is preference sensitive, shared decision making between patient and healthcare professional should take place. Patient decision aids could support this shared decision making process by providing information about the disease and the treatment options, to elicit the patient’s preference and to support patients and healthcare professionals in discussing these preferences and matching them with a treatment. Therefore, a prototype of a patient decision aid for MS patients in the Netherlands—based on the principles of multi-criteria decision analysis (MCDA) —was developed, following the recommendations of the International Patient Decision Aid Standards. MCDA was chosen as it might reduce cognitive burden of considering treatment options and matching patient preferences with the treatment options. Results After determining the scope to include DMDs labelled for relapsing-remitting MS and clinically isolated syndrome, users’ informational needs were assessed using focus groups (N = 19 patients) and best-worst scaling surveys with patients (N = 185), neurologists and nurses (N = 60) to determine which information about DMDs should be included in the patient decision aid. Next, an online format and computer-based delivery of the patient decision aid was chosen to enable embedding of MCDA. A literature review was conducting to collect evidence on the effectiveness and burden of use of the DMDs. A prototype was developed next, and alpha testing to evaluate its comprehensibility and usability with in total thirteen patients and four healthcare professionals identified several issues regarding content and framing, methods for weighting importance of criteria in the MCDA structure, and the presentation of the conclusions of the patient decision aid ranking the treatment options according to the patient’s preferences. Adaptations were made accordingly, but verification of the rankings provided, validation of the patient decision aid, evaluation of the feasibility of implementation and assessing its value for supporting shared decision making should be addressed in further development of the patient decision aid. Conclusion This paper aimed to provide more transparency regarding the developmental process of an MCDA-based patient decision aid for treatment decisions for MS and the challenges faced during this process. Issues identified in the prototype were resolved as much as possible, though some issues remain. Further development is needed to overcome these issues before beta pilot testing with patients and healthcare professionals at the point of clinical decision-making can take place to ultimately enable making conclusions about the value of the MCDA-based patient decision aid for MS patients, healthcare professionals and the quality of care.



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