scholarly journals Considering Health Literacy in Cardiovascular Disease Management: A Qualitative Study on Healthcare Professionals’ and Patients' Perspectives

2021 ◽  
Author(s):  
Adèle PERRIN ◽  
Eléonore Damiolini ◽  
Anne-Marie Schott ◽  
Jéremy Zermati ◽  
Estelle Bravant ◽  
...  
Keyword(s):  
Health Literacy ◽  
Healthcare Professionals ◽  
Implementation Strategies ◽  
Structured Interviews ◽  
Face To Face ◽  
Implementing Change ◽  
Fishbone Diagram ◽  
Patient Health ◽  
Health Action

Abstract Background: Implementing practices adapted to patient health literacy (HL) is a promising avenue for improving their outcomes in the context of cardiovascular diseases (CVD). The health communication skills of healthcare professionals (HCPs) and the quality of information provided are essential for low-HL patients. We aimed to explore HCPs knowledge about HL, patients and HCPs views on current practices regarding low-HL patients, and facilitators and barriers to adapting communication to patients’ HL level, in order to prepare the implementation of a complex intervention dedicated to improve CVD management for low-HL patients.Methods: We conducted face-to-face semi-structured interviews with HCPs practicing in cardiology units and patients hospitalized for CVD. Study design and analysis were based on the Theory of Planned Behavior for HCPs and the framework of Health Literacy and Health Action for patients. Deductive and inductive thematic analysis were used. Barriers and facilitators were structured into an Ishikawa fishbone diagram and implementation strategies were selected to address resulting themes from the Expert Recommendations for Implementing Change (ERIC).Results: Fifteen patients and 14 HCPs were interviewed. HCPs had partial knowledge of HL dimensions. Perceptions of HCPs and patients were not congruent regarding HCP-patient interactions and information provided by hospital and community HCPs. HCPs perceived they lacked validated tools and skills, and declared they adapted spontaneously their communication when interacting with low-HL patients. Patients expressed unmet needs regarding communication during hospital discharge and at return to home. Conclusion: To implement HL-tailored practices in this setting, our results suggest that several implementation strategies will be valuable at individual (engaging patients and their family), interactional (educating and training of HCPs about HL) and organizational levels (creating a multidisciplinary HCPs interest group dedicated to HL). Trial registration: The study was registered on Clinical Trials: NCT03949309.

scholarly journals PARE0023 ORAL HEALTH IN RHEUMATOID ARTHRITIS: LISTENING TO PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1297.2-1297
Author(s):  
J. Protudjer ◽  
C. Billedeau ◽  
C. Stavropoulou ◽  
A. Cholakis ◽  
R. Schroth ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Oral Health ◽  
Periodontal Disease ◽  
Oral Care ◽  
Structured Interviews ◽  
Face To Face ◽  
Oral Health Education ◽  
To Receive ◽  
Latent Content

Background:Rates of periodontal disease and tooth loss are increased in rheumatoid arthritis (RA). Periodontal disease may exacerbate RA inflammation and complicate RA care. Understanding factors that contribute to the increased burden of periodontal disease in RA is critical to improving oral health and possibly arthritis outcomes. People with RA may have unique needs and/or barriers to maintain oral health.Objectives:To determine from people with RA what are their experiences and perceptions about their oral health, their most important questions relating to oral health, and how they wish to receive oral health information.Methods:Semi-structured interviews were conducted with RA patients. Recorded interview transcripts underwent iterative content analysis. Transcripts were initially reviewed to develop a coding guide. Latent content, or larger themes, were then applied to the transcripts. Constructs were considered saturated when no new themes were identified with subsequent interviews. We report identified themes with representative quotes.Results:Interviews with 11 RA (10[91%] female; all on RA medication) averaged 19 minutes (range 8-31 minutes) and were mostly conducted face-to-face. Many believed RA medication contributed to dry mouth. Most participants had not previously considered other links between oral health and RA. Themes identified included the need for complicated oral health routines, barriers of cost and access to dental care, and shame relating to oral health (Table 1). Participants preferred to receive oral health education from their rheumatologists or dentists over printed or online resources.Conclusion:RA patients have unique needs relating to oral health and report poor oral quality of life. Strategies to optimize oral health in RA may include educational tools for optimizing oral self-care appropriate for RA, and improved access to oral care professionals who are aware of the needs of arthritis patients.Disclosure of Interests:Jennifer Protudjer: None declared, Corrie Billedeau: None declared, Chrysi Stavropoulou: None declared, Anastasia Cholakis: None declared, Robert Schroth: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada

scholarly journals Evaluation of two strategies to implement physical cancer rehabilitation guidelines for survivors of abdominopelvic cavity tumors: a controlled before-and-after study

2021 ◽  
Author(s):  
Charlotte IJsbrandy ◽  
Petronella B. Ottevanger ◽  
Winald R. Gerritsen ◽  
Wim H. van Harten ◽  
Rosella P. M. G. Hermens
Keyword(s):  
Primary Outcome ◽  
Healthcare Professionals ◽  
Patient Empowerment ◽  
Implementation Strategies ◽  
Primary Outcome Measure ◽  
Cancer Rehabilitation ◽  
Systematic Screening ◽  
Before And After ◽  
Before And After Study

Abstract Purpose This study evaluates the effectiveness and feasibility of two strategies to implement physical cancer rehabilitation (PCR) guidelines for patients who have survived abdominopelvic cavity malignancies. Methods We tested and compared two tailored strategies to implement PCR guidelines for survivors of gastrointestinal, female organ and urogenital organ malignancies, in a clustered controlled before-and-after study. A patient-directed (PD) strategy was tested in five cancer centers, aiming to empower survivors. A multifaceted (MF) strategy was tested in four cancer centers, aiming additionally to influence healthcare professionals and the healthcare organization. Data were collected from existing registration systems, patient questionnaires and professional questionnaires. We measured both implementation- and client outcomes. For insight into the effectiveness we measured indicators related to PCR guidelines: (1) screening with the Distress Thermometer (DT) (=primary outcome measure), (2) information provision concerning physical activity (PA) and physical cancer rehabilitation programs (PCRPs), (3) advice to take part in PA and PCRPs, (4) referral to PCRPs, (5) participation in PCRPs, (6) PA uptake (PAU); and patient reported outcomes (PROs) such as (7) quality of life, (8) fatigue, and (9) empowerment. Furthermore, survivor and center determinants were assessed as possible confounders. Multilevel analyses were performed to compare the scores of the indicators of the PD and MF strategies, as well as the differences between the characteristics of these groups. The use of and experiences with both strategies were measured using questionnaires and Google Analytics to assess feasibility. Results In total, 1326 survivors participated in the study, 673 in the before- and 653 in the after-measurement. Regarding our primary outcome measure, we found a significant improvement of screening with the DT between the before- and after-measurement for both strategies, respectively from 34.2 to 43.1% (delta=8.9%; odds ratio (OR)=1.6706; p=0.0072) for the PD strategy and from 41.5 to 56.1% (delta=14.6%; OR=1.7098; p=0.0028) for the MF strategy. For both the primary and secondary outcomes, no statistically significant effect of the MF strategy compared to the PD strategy was observed. We found good use of and positive experiences with both strategies. Conclusion Implementation strategies containing tools enhancing patient empowerment seem to be effective in increasing the systematic screening with the DT for survivors of abdominopelvic cavity malignancies. Further research is needed to assess the additional effectiveness of strategies that stimulate compliance among healthcare professionals and healthcare organizations. Implications for Cancer Survivors Using implementation strategies containing tools enhancing patient empowerment seem to be effective in increasing the systematic screening with the DT and might improve the quality of care of patients who have survived abdominopelvic cavity malignancies.

Importance of Medication Reconciliation as a Strategy for Health Literacy

2022 ◽  
pp. 224-237
Author(s):  
José Manuel Feliz ◽  
Marta Barroca
Keyword(s):  
Health Literacy ◽  
Communication Skills ◽  
Health Professionals ◽  
Medication Reconciliation ◽  
Drug Regimen ◽  
Communication Model ◽  
Professional Relationship ◽  
Patient Health ◽  
Model Technique

Health literacy depends on communication skills of health professionals. Assertiveness, clarity, and positivity (ACP) are a communication model/technique very useful to improve the patient-health professional relationship, adherence to treatment, health literacy, and quality of life. This model can be used in medication reconciliation (MR) – the identification of the most precise list of medication that a patient has been taking and should take, which requires a multidisciplinary participation and a better communication between health professionals and between them and the patient. When the guidance from healthcare professionals is clear and effective, patients and caregivers are more compliant to the recommended drug regimen, resulting in better health outcomes.

A qualitative study using semi-structured interviews of palliative care patients’ views on corneal donation and the timing of its discussion

2018 ◽  
Vol 32 (8) ◽  
pp. 1428-1437
Author(s):  
Lucy Walker ◽  
Karen Neoh ◽  
Hazel Gilkes ◽  
Clare Rayment
Keyword(s):  
Palliative Care ◽  
Sampling Method ◽  
Healthcare Professionals ◽  
Corneal Transplantation ◽  
Structured Interviews ◽  
Illness Trajectory ◽  
Face To Face ◽  
Donor Shortage ◽  
Corneal Donation ◽  
Sight Restoration

Background: Corneal transplantation can lead to sight restoration, but globally there is a donor shortage. Many palliative care patients can donate their corneas but think they are ineligible due to comorbidities. Healthcare professionals are reluctant to broach the topic, but studies have shown that relatives would be upset if they were not offered this chance. There is no existing research involving patients. Aim: To understand the views and feelings of patients in palliative care settings towards corneal donation and explore their opinions regarding the timing of its discussion. Design: This is an exploratory study based at one UK palliative care unit. A census sampling method was used. Nine participants took part in semi-structured interviews and thematic analysis was undertaken. Results: Themes found included altruistic motivation and the value of sight. Family views were important, but the influence on final decisions varied. The timing of discussion relative to the illness trajectory was important; patients want to be able to engage fully in conversations and had concerns about not being able to think clearly when closer to death. Participants also associated discussion of donation as an indication of a poor prognosis. Patients prefer face-to-face discussions with someone whom they had a close rapport. Many had misconceptions about eligibility. Conclusion: This is the first study to engage directly with palliative care patients and to establish their views on the timing of corneal donation discussions. Patients are willing to discuss donation, and further exploration of patient views in this area should be undertaken.

Delays in the diagnosis of pulmonary tuberculosis in critical and non-critical areas in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Leite ◽  
P Soares ◽  
J Santos ◽  
C Nunes
Keyword(s):  
Health Literacy ◽  
General Population ◽  
Pulmonary Tuberculosis ◽  
Healthcare Professionals ◽  
Cox Regression ◽  
Diagnosis Delay ◽  
Critical Areas ◽  
Patient Health ◽  
Tuberculosis Diagnosis ◽  
And Training

Abstract Background Delays in diagnosing tuberculosis lead to longer infectious periods, posing a challenge in tuberculosis control. This is particularly relevant in high incidence areas (critical). Thus, the objectives of this work were to characterize tuberculosis diagnosis delay and its components (patient delay and health delay) in incidence critical and non-critical areas in Portugal, as well as associated factors. Methods Notified cases of pulmonary tuberculosis diagnosed due to symptoms (passive screening) in the Portuguese Tuberculosis Surveillance System were analysed (2008-2017). Patient, health and overall delays were calculated. Factors associated with each delays' components were identified utilising Cox regression, while adjusting for sex, age and education level. Analyses were stratified by area type (critical and non-critical). Results Median (1st-3rd quartile - Q1-Q3) delays in patient, health and overall delay in critical areas were: 40 (Q1-Q3: 21-76), 8 (Q1-Q3:1-31), and 65 (Q1-Q3: 40-105) days, respectively; similar delays in non-critical areas were 32 (Q1-Q3:16-63); 9 (Q1-Q3: 1-34) and 58 (Q1-Q3: 35-98), respectively. More recent cases, adults younger than 65 years and alcoholic presented longer patient delays (both areas); healthcare professionals and patients with HIV infection presented shorter patient delays (only critical areas). Tuberculosis high-risk groups (males, alcohol dependency, homelessness, community residency) presented shorter health delays in both areas; drug use also presented shorter health delays but only in critical areas. Existing comorbidities was associated with longer health delays in both areas. Conclusions Patient delays increased between 2008 and 2017. Groups with longer/shorter delays differed between delay type and area type. Intervening in tuberculosis diagnosis delays requires different action for critical and non-critical areas, targeting health literacy from the general population and training of healthcare professionals. Key messages Delays in diagnosing in Portugal are mainly driven by delays in patient seeking care and are longer in areas of higher tuberculosis incidence. Intervening in tuberculosis diagnosis delays in Portugal requires different action in different areas, targeting health literacy in the general population and training of professionals.

scholarly journals Communication with patients using negative wound pressure therapy and their adherence to treatment

2019 ◽  
Vol 28 (11) ◽  
pp. 738-756
Author(s):  
Christine J. Moffatt ◽  
Susie Murray ◽  
Aimee Aubeeluck ◽  
Isabelle Quere
Keyword(s):  
Health Professionals ◽  
Patient Adherence ◽  
Study Data ◽  
Adherence To Treatment ◽  
Structured Interviews ◽  
Pressure Therapy ◽  
Face To Face ◽  
Patient Health ◽  
Data Saturation ◽  
Ongoing Support

Objective: The purpose of this study was to explore the challenges of communication between patients and health professionals, and patient adherence to treatment for hard-to-heal wounds when using negative wound pressure therapy (NPWT). Methods: Face-to-face, semi-structured interviews were conducted with patients undergoing NPWT. Specific features of the NPWT device were the priority for discussion although other factors central to communication and adherence were also explored. Results: A total of 24 patients took part in the study. Data saturation was achieved during the analysis. Patients required ongoing support to understand complex and often protracted treatment and this was particularly important when specialist technology was used. A distinction was highlighted between those who decided not to adhere with therapy and those who did so unintentionally. Participants faced difficulties in their communications with health professionals and in ensuring their needs were listened to and addressed. Conclusion: Further research is needed to achieve a better understanding of this distinction and to evaluate interventions which can sustain adherence behaviours. Further exploration of how to establish concordant patient/health professional communications is warranted.

scholarly journals Subjective Commentary of Health Literacy through Social Networks for Civil Servants’ Pension Fund Beneficiaries: A Qualitative Study

2021 ◽  
Vol 12 (2) ◽  
pp. 178-186
Author(s):  
Atefeh Noorizadeh Ghasri ◽  
Seyyed Aliakbar Famil Rouhany ◽  
Nasrolah Erfani
Keyword(s):  
Quality Of Life ◽  
Social Networks ◽  
Health Literacy ◽  
Health Information ◽  
Pension Fund ◽  
Phenomenological Study ◽  
Structured Interviews ◽  
Access To Health ◽  
State Pension

Background and Objectives: Elderly people need to pay more attention to promoting health promotion and improving quality of life in comparison with other people. On the other hand, the interest and desire to work with the Internet and social networks of internet plays an indelible role in improving the health literacy of the community. This study was carried out with the aim of evaluation the subjective explanation of health literacy through social networks for retired of fund beneficiaries. Material and Methods: The present study is a phenomenological study with emphasis on Van Mennen's perspective to discover the experiences of retirees from the phenomenon of health literacy through social networks. The data were collected through a deep interview. Semi-structured interviews were conducted with 15 retirees of the State Pension Fund in Tehran in 2020 using purposive sampling. All interviews were recorded and implemented and the theme analysis method was used to analyze the interviews. Results: Data analysis resulted in the extraction of 71 primary codes and 33 sub-themes, which was classified in four main themes of experience in the field of "access to health information", experience in the field of "understanding health information" "Experience in the field of" health information evaluation ", experience in the field of" application of health information ". Conclusion: Retirees, who make a large part of the country's elderly population, are embedded in social networks, and all organizations that play a role in the health and education of retirees can create rich educational content and using Simple, understandable multimedia content by social networks as well as the introduction of networks with reliable information for retirees, to improve the level of health literacy and increase useful health information for them, which is an effective factor in maintaining health and increasing the quality of life.

scholarly journals Talking about smoking cessation with postnatal women: exploring midwives' experiences

2019 ◽  
Vol 27 (12) ◽  
pp. 760-766
Author(s):  
Rhona Reardon ◽  
Sarah Grogan
Keyword(s):  
Smoking Cessation ◽  
Thematic Analysis ◽  
Healthcare Professionals ◽  
Structured Interviews ◽  
Face To Face ◽  
Family Approach ◽  
Stop Smoking ◽  
Postnatal Women ◽  
The Uk

This study explores midwives' experiences of talking to postnatal women about smoking cessation. Face-to-face, semi-structured interviews were held with seven midwives based in the UK. Thematic analysis identified themes which provided understanding as to factors determining discussion of smoking cessation. Six themes were identified, namely postnatal women factors, midwife factors, providing information, involving others, priorities, and whole family approach. Implications for midwives working with postnatal women are discussed, including the need to increase the involvement of other healthcare professionals in supporting postnatal women to stop smoking.

scholarly journals WHO Action Network on Measuring Health Literacy: the Italian pilot for the Survey 2019 Title

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Palmieri ◽  
A Rosano ◽  
C Cadeddu ◽  
C Donfrancesco ◽  
D Galeone ◽  
...  
Keyword(s):  
Health Literacy ◽  
Adult Population ◽  
Smoking Habit ◽  
Organizational Health ◽  
High Educational Level ◽  
Health Examination ◽  
Face To Face ◽  
Sum Score ◽  
Action Network

Abstract Background Health Literacy-HL is an important determinant to improve and maintain health and quality of life during life course. HL implies people’s knowledge, motivation, competencies to access, understand, appraise, apply information to make judgements and decisions in everyday life concerning healthcare, disease prevention, health promotion. Thanks to Ministry of Health funds, Italy joined the WHO Action Network on Measuring Population and Organizational Health Literacy-M-POHL for collecting comparable data on HL in order to measure and promote citizens’ HL among MS. Objective: The HLS-EU-Q16 questionnaire was administered to a sample of adult population during the Health Examination Survey-HES of the CUORE Project started in 2018, to verify and evaluate the feasibility of the HL survey. Methods One hundred people aged 35-74 years, resident in Reggio Calabria (South of Italy), were interviewed (face-to-face) following consecutive access to the HES. According to the HLS-EU-Q16 sum score, three levels of HL were defined: inadequate, problematic, and sufficient. HL mean score and standard deviation-SD were elaborated together with prevalence of the three HL levels. Socio-demographics conditions, lifestyles, risk factors were measured during the HES. Results HL mean score of 98 completed questionnaires (47 men, 51 women) was 13.0 (SD = 3.5), with no sex difference; prevalence of persons with inadequate HL was 11.2%, problematic 26.5%, sufficient 62.3%. Sufficient HL level presents the highest prevalence (72%) of high educational level. Smoking habit decreases as HL level increases. Conclusions The HLS-EU-Q16 questionnaire represents a standardised tool applicable in the general population. Preliminary results from the Italian pilot of the HLS-EU-Q16 suggest that the survey is feasible within the HES of the CUORE Project, with the opportunity to link HL data with HES measured data. More than one third of interviewed adult population have inadequate/problematic HL.

scholarly journals Midwives' evaluation of their role in crowdsourcing activities to improve the maternity experience: part 2

2019 ◽  
Vol 27 (7) ◽  
pp. 420-426
Author(s):  
Sam Frewin ◽  
Sarah Church
Keyword(s):  
Quality Improvement ◽  
Maternity Care ◽  
Service Evaluation ◽  
Qualitative Approach ◽  
Structured Interviews ◽  
Shared Learning ◽  
Face To Face ◽  
Agents Of Change ◽  
Generic Qualitative

BackgroundAlthough all members of staff can be involved in improving the quality of maternity services, midwives can identify areas in need of improvement through their relationships with women and their families, and can influence care through activities such as crowdsourcing.AimsA service evaluation was undertaken to explore how midwives who attended the workshop viewed their involvement in crowdsourcing, and to examine whether midwives who attended the workshop considered themselves as agents of change for quality improvement in maternity care.MethodsA generic qualitative approach was selected. Data were collected using face-to-face, semi-structured interviews with six midwives who attended the workshop.FindingsFour key themes emerged from analysing the data: improving communication, experiencing different perspectives, shared learning, and positivity.ConclusionsInvolving stakeholders as a ‘crowd’ to find solutions to problems in care is successful and highly rewarding. Midwife participants took pride in sharing their ideas for improvement.

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