Barriers to patient education and their relationship to nurses’ perceptions of patient education climate

A core component of patient-centered care is effective patient education. Although it is a part of professional nursing and has been found to promote high-quality healthcare, its implementation is often deficient. This study responds to the need for theory-based research on health communication and aims to provide a theoretical framework for understanding nurses’ barriers to patient education. Drawing on organizational climate theory, the study examines two possible predictors of barriers to effective patient education, namely nurses’ perceptions of patient education climate, and of their role as patient educators. The hypotheses were tested using a cross-sectional correlational design with a sample of 328 nurses from 26 units in one general hospital. Data were obtained by means of questionnaires. The results supported our hypotheses, as each predicting variable was significantly related to the relevant barriers to patient education: i.e. patient education climate perceptions predicted the barriers of overload, lack of policies, and low priority, whereas role perception predicted the barriers of difficulty in communication with patients, insufficient professional knowledge and skills, and the belief that educating patients was not the nurse’s responsibility. To conclude, this study attributes the concept of patient education to organizational climate theory and, thus, may offer a theoretical framework for understanding the reluctance of hospital nurses to provide their patients with effective education. Practical implications for reducing barriers to patient education are discussed.

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Healthcare Providers’ Attitudes, Knowledge, and Practice Behaviors for Educating Patients About Advance Directives: A National Survey

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118813720 ◽

2018 ◽

Vol 36 (5) ◽

pp. 387-395 ◽

Cited By ~ 5

Author(s):

Frances R. Nedjat-Haiem ◽

Tamara J. Cadet ◽

Anup Amatya ◽

Shiraz I. Mishra

Keyword(s):

Online Survey ◽

Survey Design ◽

Healthcare Providers ◽

Medical Decision ◽

Cross Sectional Survey ◽

Patient Centered ◽

Cross Sectional ◽

Practice Behaviors ◽

Centered Care ◽

Seriously Ill Patients

Background: Advance care planning for end-of-life care emerged in the mid-1970’s to address the need for tools, such as the advance directive (AD) legal document, to guide medical decision-making among seriously ill patients, their families, and healthcare providers. Objective: Study aims examine providers’ perspectives on AD education that involve examining (1) a range of attitudes about educating patients, (2) whether prior knowledge was associated with practice behaviors in educating patients, and (3) specific factors among healthcare providers such as characteristics of work setting, knowledge, attitudes, and behaviors that may influence AD education and documentation. Design: To examine providers’ views, we conducted a cross-sectional, online survey questionnaire of healthcare providers using social media outreach methods for recruitment. Methods: This study used a cross-sectional survey design to examine the proposed aims. Healthcare providers, recruited through a broad approach using snowball methods, were invited to participate in an online survey. Logistic regression analyses were used to examine providers’ views toward AD education. Results: Of 520 participants, findings indicate that most healthcare providers said that they were knowledgeable about AD education. They also viewed providing education as beneficial to their practice. These findings suggest that having a positive attitude toward AD education and experiencing less organizational barriers indicate a higher likelihood that providers will educate patients regarding ADs. Conclusion: Various disciplines are represented in this study, which indicates that attitudes and knowledge influence AD discussions. The importance of AD discussions initiated by healthcare providers is critical to providing optimal patient-centered care.

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Facilitating Team-Based Care Coordination and Collaboration in Myelofibrosis: Findings from a Quality Improvement Study in Three US Community Oncology Systems

Blood ◽

10.1182/blood-2020-136432 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 32-33

Author(s):

Srdan Verstovsek ◽

Anne Jacobson ◽

Jeffrey D Carter ◽

Tamar Sapir

Keyword(s):

Decision Making ◽

Quality Improvement ◽

Patient Education ◽

Care Coordination ◽

Research Funding ◽

Practice Patterns ◽

Patient Centered Care ◽

Patient Centered ◽

Community Oncology ◽

Centered Care

Background Care coordination can be especially challenging in the setting of rare malignancies such as myelofibrosis (MF), where hematology/oncology teams have limited experience working together to implement rapidly evolving standards of care. In this quality improvement (QI) initiative, we assessed barriers to patient-centered MF care in 3 community oncology systems and conducted team-based audit-feedback (AF) sessions within each system to facilitate improved care coordination. Methods Between 1/2020 and 3/2020, 31 hematology/oncology healthcare professionals (HCPs) completed surveys designed to characterize self-reported practice patterns, challenges, and barriers to collaborative MF care in 3 community oncology systems (Table 1). Building on findings from the team-based surveys, 39 HCPs from these centers participated in AF sessions to reflect on their own practice patterns and to prioritize areas for improved MF care delivery. Participants developed team-based action plans to overcome identified challenges, including barriers to effective risk stratification, care coordination, and shared decision-making (SDM) for patients with MF. Surveys conducted before and after the small-group AF sessions evaluated changes in participants' beliefs and confidence in delivering collaborative, patient-centered MF care. Results Team-Based Surveys: HCPs identified managing MF-associated anemia and other disease symptoms (42%), providing individualized care despite highly variable clinical presentations (29%), and developing institutional expertise despite low patient numbers (16%) as the most pressing challenges in MF care. For patients who are candidates for JAK inhibitor therapy, HCPs reported most commonly relying on current guidelines (71%) and clinical evidence (61%) to guide treatment selection. HCPs also considered drug safety/tolerability profiles (55%), personal or institutional experience (13%), and out-of-pocket costs for patients (13%); no participants (0%) reported incorporating patient preference into their decision-making. Teams were underutilizing SDM and patient-centered care resources; fewer than 50% reported providing tools to support adherence (48%), visual aids for patient education (47%), financial toxicity counseling (40%), resources for managing MF-related fatigue (36%), or counseling to reduce risk factors for CVD, bleeding, and thrombosis (26%). Small-Group AF Sessions: Across the 3 oncology centers, teams participating in the AF sessions (Table 1) shared a self-reported caseload of 97 patients with MF per month. HCPs reported a meaningful shift in beliefs regarding the importance of collaborative care: following the AF sessions, 100% of HCPs agreed or strongly agreed that collaboration across the extended oncology care team is essential for achieving MF treatment goals, an increase from 71% prior to the AF sessions (Figure 1). Participants also reported increased confidence in their ability to perform each of 6 aspects of evidence-based, collaborative, patient-centered care (Figure 2). In selecting which aspects of patient-centered care to address with their clinical teams, HCPs most commonly prioritized individualizing treatment decision-making based on patient- and disease-related factors (57%), followed by providing adequate patient education about treatment options and potential side effects (24%) and engaging patients in SDM (18%). To achieve these goals, 73% of HCPs committed to sharing their action plans with additional clinical team members; others committed to creating a quality task force to oversee action-plan implementation (15%) and securing buy-in from leadership and stakeholders (9%). Conclusions As a result of participating in this community-based QI initiative, hematology/oncology HCPs demonstrated increased confidence in their ability to deliver patient-centered MF care and improved commitment to team-based collaboration. Remaining practice gaps and challenges can inform future QI programs. Study Sponsor Statement The study reported in this abstract was funded by an independent educational grant from Incyte Corporation. The grantors had no role in the study design, execution, analysis, or reporting. Disclosures Verstovsek: ItalPharma: Research Funding; CTI Biopharma Corp: Research Funding; Promedior: Research Funding; Gilead: Research Funding; NS Pharma: Research Funding; Celgene: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Genentech: Research Funding; Sierra Oncology: Consultancy, Research Funding; PharmaEssentia: Research Funding; AstraZeneca: Research Funding; Incyte Corporation: Consultancy, Research Funding; Blueprint Medicines Corp: Research Funding; Protagonist Therapeutics: Research Funding; Roche: Research Funding.

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Optimizing patient education of oncology medications: A quantitative analysis of the patient perspective

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155219843675 ◽

2019 ◽

Vol 25 (6) ◽

pp. 1445-1455

Author(s):

Kristin Kaupp ◽

Samantha Scott ◽

Laura V Minard ◽

Tessa Lambourne

Keyword(s):

Nova Scotia ◽

Patient Education ◽

Formal Education ◽

Hospital Pharmacist ◽

Patient Centered ◽

Cancer Treatments ◽

Post Secondary ◽

Centered Care ◽

Descriptive Survey

Background With the ever-increasing complexity of cancer treatments, oncology medication patient education is becoming a progressively important component of cancer care. Despite this, cancer patients frequently report that they receive inadequate information and feel that their education needs have not been met. Objective To explore patients' perspectives of optimal oncology medication education across Nova Scotia. Methods This was a descriptive survey of adult medical, hematological and gynaecological oncology outpatients receiving intravenous chemotherapy within the Nova Scotia Health Authority between January 26 and April 30, 2018. Results One hundred forty-two responses were included; 41% and 47% of respondents reported being satisfied or very satisfied with their oncology medication education, respectively; 30% and 43% of respondents would like the opportunity to receive education or follow-up from a hospital pharmacist, respectively. Respondents with post-secondary education were found to have 2.82 higher odds of wanting to make an appointment for education with a hospital pharmacist. Conclusions Patients were generally satisfied with their oncology medication education despite the majority not receiving education from a hospital pharmacist. Patients with a higher level of formal education were more likely to want the opportunity to schedule an appointment for education with and/or receive follow-up from a hospital pharmacist. The oncology medication education participants received in the past appeared to align with their education preferences. Findings from this research can be used to optimize the limited time healthcare professionals have to provide meaningful and effective oncology medication patient education and improve patient-centered care.

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Patients’ and Families’ Satisfaction with Visiting Policies in Cardiac Intensive Care Units

Global Journal of Health Science ◽

10.5539/gjhs.v9n1p67 ◽

2016 ◽

Vol 9 (1) ◽

pp. 67 ◽

Cited By ~ 1

Author(s):

Shiva Khaleghparast ◽

Soodabeh Joolaee ◽

Majid Maleki ◽

Hamid Peyrovi ◽

Behrooz Ghanbari ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Simple Random Sampling ◽

Vital Role ◽

Patient Centered ◽

Cross Sectional ◽

The Family ◽

Centered Care ◽

Cardiac Intensive Care ◽

Cross Sectional Design

BACKGROUND: Families play a vital role in the recovery of patients admitted to Intensive Care Units. They can help patients to adapt themselves to the crisis and feel more satisfied.OBJECTIVE: In this study, we examined the patients’ and families’ satisfaction with the current visiting policies in Cardiac Intensive Care Units in the largest Cardiovascular Medical and Research Center of Iran.METHOD: This research used a cross-sectional design with a simple random sampling. To do so, 303 patients admitted to those Cardiac Intensive Care Units and their families responded to a two-part questionnaire between September 2014 and March 2015. The inclusion criteria for patients were aged between 18 and 85, acceptable general status to respond to the questions of the questionnaire, and having one of the cardiac diseases symptoms. Intention to attend was the only inclusion criterion for the family members.RESULTS: The results showed that 167(55.1%) of the participants were dissatisfied with the limited visiting policies of the Cardiac Intensive Care Units, while the satisfaction rate was 43(14.2%). The remaining participants (30.7%) were slightly satisfied with the visiting policies in Cardiac Intensive Care Units.CONCLUSIONS: Patient-centered care is an expectation among patients and their families in the Cardiac Intensive Care Units. It seems that a change in visiting policies is necessary.

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Formação de cuidadores de idosos institucionalizados

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v13i5a238934p1216-1222-2019 ◽

2019 ◽

Vol 13 (5) ◽

pp. 1216

Author(s):

Vitor Emanuel Sousa da Silva ◽

Kaiza Vilarinho da Luz ◽

Dalton Kaynnan de Prado Costa ◽

André Ricardo Ferreira da Silva Rocha ◽

Rosângela Nunes Almeida ◽

...

Keyword(s):

The Elderly ◽

Cross Sectional Study ◽

Health Care Education ◽

Patient Centered ◽

Cross Sectional ◽

Calidad De Vida ◽

Caregiver Quality ◽

Centered Care ◽

Qualitative Descriptive ◽

Elderly Caregivers

RESUMOObjetivo: analisar a formação dos cuidadores de idosos institucionalizados. Método: trata-se de um estudo qualitativo, descritivo e transversal. Realizou-se com dez cuidadores de instituição de longa permanência (ILP), utilizando-se um instrumento semiestruturado. Submeteram-se os dados coletados à Análise de Discurso. Resultados: registra-se que predominaram as cuidadoras do gênero feminino, casadas, com idade média de 42 anos, e que o período médio de atuação na área foi de 7,1 anos. Sabe-se que 90% tinham formação em cuidador de idoso e elencaram, como dificuldades, colocar a fralda, dar banho, a comunicação e as estratégias para interagir com a teimosia dos idosos, bem como as demandas dos idosos e a sobrecarga de peso e de trabalho. Conclusão: concluiu-se que há a necessidade de se qualificar bem e atualizar a formação do cuidador profissional para que este possa executar a sua práxis com segurança, efetividade, eficiência e atenção centrada no paciente. Descritores: Saúde do Idoso; Cuidador; Qualidade de Vida; Atenção Primária à Saúde; Educação; Ensino.ABSTRACT Objective: to analyze the training of institutionalized elderly caregivers. Method: this is a qualitative, descriptive and cross-sectional study. It was carried out with ten caregivers of long-term institution (LTI), using a semi-structured instrument. The collected data were submitted to Speech Analysis. Results: it is recorded that the female carers, married, with a mean age of 42 years, predominated, and that the average period of performance in the area was 7.1 years. It is known that 90% had training in elderly caregivers and listed, as difficulties, putting diapers, bathing, communication and strategies to interact with the stubbornness of the elderly, as well as the demands of the elderly and the overload of weight and of work. Conclusion: it was concluded that there is a need to qualify well and update the training of the professional caregiver so that they can perform their praxis with safety, effectiveness, efficiency and patient-centered care. Descriptors: Elderly Health; Caregiver; Quality of life; Primary Health Care; Education; Teaching.RESUMEN Objetivo: analizar la formación de los cuidadores de ancianos institucionalizados. Método: se trata de un estudio cualitativo, descriptivo y transversal. Se realizó con diez cuidadores de institución de larga permanencia (ILP), utilizando un instrumento semiestructurado. Se sometieron los datos recogidos al Análisis de Discurso. Resultados: se registra que predominaron las cuidadoras del género femenino, casadas, con edad promedio de 42 años, y que el período promedio de actuación en el área fue de 7,1 años. Se sabe que el 90% tenía formación en cuidador de anciano y enumeró, como dificultades, colocar el pañal, bañar, la comunicación y las estrategias para interactuar con la terquedad de los ancianos, así como las demandas de los ancianos y la sobrecarga de peso y de trabajo. Conclusión: se concluyó que hay la necesidad de calificar bien y actualizar la formación del cuidador profesional para que éste pueda ejecutar su praxis con seguridad, efectividad, eficiencia y atención centrada en el paciente. Descritores: Salud del Anciano; Cuidadores; Calidad de Vida; Atención Primaria de Salud; Educación; Enseñanza.

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Adoption of a Personal Health Record in the Digital Age: Cross-Sectional Study

Journal of Medical Internet Research ◽

10.2196/22913 ◽

2020 ◽

Vol 22 (10) ◽

pp. e22913

Author(s):

Consuela Cheriece Yousef ◽

Abin Thomas ◽

Ahmed O Alenazi ◽

Sumaya Elgadi ◽

Laila Carolina Abu Esba ◽

...

Keyword(s):

Health Care ◽

National Guard ◽

Personal Health Record ◽

Patient Centered Care ◽

Personal Health ◽

Health Record ◽

Objective Data ◽

Patient Centered ◽

Cross Sectional ◽

Centered Care

Background As health care organizations strive to improve health care access, quality, and costs, they have implemented patient-facing eHealth technologies such as personal health records to better engage patients in the management of their health. In the Kingdom of Saudi Arabia, eHealth is also growing in accordance with Vision 2030 and its National Transformation Program framework, creating a roadmap for increased quality and efficiency of the health care system and supporting the goal of patient-centered care. Objective The aim of this study was to investigate the adoption of the personal health record of the Ministry of National Guard Health Affairs (MNGHA Care). Methods A cross-sectional survey was conducted in adults visiting outpatient clinics in hospitals at the Ministry of National Guard Health Affairs hospitals in Riyadh, Jeddah, Dammam, Madinah, and Al Ahsa, and primary health care clinics in Riyadh and Qassim. The main outcome measure was self-reported use of MNGHA Care. Results In the sample of 546 adult patients, 383 (70.1%) reported being users of MNGHA Care. MNGHA Care users were more likely to be younger (P<.001), high school or university educated (P<.001), employed (P<.001), have a chronic condition (P=.046), use the internet to search for health-related information (P<.001), and use health apps on their mobile phones (P<.001). Conclusions The results of this study show that there is substantial interest for the use of MNGHA Care personal health record with 70% of participants self-reporting use. To confirm these findings, objective data from the portal usage logs are needed. Maximizing the potential of MNGHA Care supports patient engagement and is aligned with the national eHealth initiative to encourage the use of technology for high-quality, accessible patient-centered care. Future research should include health care provider perspectives, incorporate objective data, employ a mixed-methods approach, and use a theoretical framework.

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Attitudes of medical students in Pakistan toward the doctor-patient relationship

10.7287/peerj.preprints.606 ◽

2014 ◽

Author(s):

Waqas Ahmad ◽

Edward Krupat ◽

Yumna Asmaa ◽

Noor-E- Fatima ◽

Rayan Attique ◽

...

Keyword(s):

Medical Students ◽

Patient Centered Care ◽

Cross Sectional Study ◽

Individual Characteristics ◽

Patient Relationship ◽

Doctor Patient Relationship ◽

Patient Centered ◽

Cross Sectional ◽

Centered Care ◽

Academic Year

Background. We initiated this study with the aim to assess the leaning of medical students towards either a doctor-centered or a patient-centered care and explore the effects of personal attributes on it like gender, academic year etc. of the students. Methods. A cross-sectional study was conducted between July-Sep 2013. The study population consisted of 1274 medical students in years 1-5 from two medical colleges. English version of PPOS was used to assess attitudes of medical students towards doctor-patient relationship. The relationship between PPOS scores and individual characteristics like gender, academic year etc. were examined by using Independent t-test and one way ANOVA. Results. A total of 792 students formed the final sample. Characteristics associated with most patient-centered attitudes were being in 4th academic year, married, being a foreigner and belonging to a Private college (p<0.05). Characteristics associated with most doctor-centered attitudes were being in 2nd academic year, divorced, having a local origin and belonging to a Govt. college (p<0.05). Gender and having doctor parents had no bearing, statistically, on the attitudes. Conclusion. Despite ongoing debate and emphasis on a patient-centered curriculum, our study suggests that current curriculum and its teachings are not producing the results they are designed to achieve. Students should be adequately exposed to the patients from the beginning of their medical education in clinical settings which are more sympathetic to a patient-centered care.

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Trends in Patient-Centered Care in South West Nigeria: A Holistic Assessment of the Nurses Perception of Primary Healthcare Practice

Global Journal of Health Science ◽

10.5539/gjhs.v12n6p73 ◽

2020 ◽

Vol 12 (6) ◽

pp. 73

Author(s):

Adepeju M. Lateef ◽

Euphemia M. Mhlongo

Keyword(s):

Health Care ◽

Primary Health Care ◽

Research Study ◽

Patient Centered Care ◽

Participatory Action ◽

Patient Centered ◽

Quality Healthcare ◽

Primary Health ◽

South West ◽

Centered Care

BACKGROUND: A key dimension of a quality healthcare to patients is patient-centered care approach which is increasingly gaining recognition worldwide. However, this concept is not fully implemented in practice. AIM: The aim of this study is to provide outcomes from assessment of nurses’ perceptions about patient-centered care and the current trends in Primary Health Care system in South West Nigeria. METHODS: This study employed a qualitative participatory action research study approach and conducted a semi-structured individual interview with thirty-five nurses and four focus group discussions in Osun State South West Nigeria Primary Health Care centres. RESULTS: Primary Health Care (PHC) nurses perceived and described patient-centered care (PCC) as a global approach to improve and enhance nursing care to foster patient participation. The narratives were categorised into two: positive and negative perception. Ten main themes emerged: (I) Attitude of the nurses (ii) Lack of enforcement and implementation, (iii) Experience of the nurses, (iv) Quality-Caring, (v) Effective communication with patient, (vi) Motivated and Proactive healthcare, (vii) Sharpen the form of care, (viii) Outcome and after-effect driven healthcare, (ix) Approved support, and (x) Guarantor of service and motivation. CONCLUSION: Our participatory action research study on the assessment of nurses’ perception on the utilization of PCC at the PHC for effective and quality healthcare service revealed the importance of nurses’ role, acceptability of PCC and current nursing care practice at the Primary Health Care (PHC) rural community setting. Nurses as healthcare providers expressed PCC as a common and global approach that would enhance patient experiences and improves the quality of nursing healthcare delivery through integration of PCC and healthcare service at the PHC healthcare system.

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A multilevel study of patient-centered care perceptions in mental health teams

10.21203/rs.3.rs-48898/v2 ◽

2020 ◽

Author(s):

Francois Durand ◽

Marie-Josée Fleury

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Mental Health Professionals ◽

Interprofessional Collaboration ◽

Patient Centered Care ◽

Multidisciplinary Teams ◽

Patient Centered ◽

Cross Sectional ◽

Centered Care

Abstract Background: The successful combination of interprofessional collaboration in multidisciplinary teams with patient-centered care is necessary when it comes to delivering complex mental health services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines correlates of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration and informational role self-efficacy in multidisciplinary mental health teams.Method: A cross-sectional multilevel survey design was used, based on self-administered bilingual validated questionnaires. Participants (N=314) were mental health professionals and managers working in public primary care or specialized mental health services, in inpatient or outpatient settings. Results: This study showed that belief in interprofessional collaboration’s relationship with patient-centered perceptions is increased in teams with high collaboration. Collaboration is also found as a mediator, representing a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: Our results were in line with recent studies on team processes establishing that collaboration is a key component in multilevel examinations of predictors of patient-centered care. In terms of practice, our study showed that multidisciplinary teams should know that working hard on collaboration is an answer to the complexity of patient-centered care. Collaboration is related to the teams’ ability to respond to its challenges. It is also related to individuals’ beliefs central to the delivery of interprofessional care.

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A Multilevel Study of Patient-Centered Care Perceptions In Mental Health Teams

10.21203/rs.3.rs-48898/v1 ◽

2020 ◽

Author(s):

Francois Durand ◽

Marie-Josée Fleury

Keyword(s):

Mental Health ◽

Interprofessional Collaboration ◽

Patient Centered Care ◽

Multidisciplinary Teams ◽

Patient Centered ◽

Cross Sectional ◽

Team Processes ◽

Interprofessional Care ◽

Centered Care ◽

The Impact

Abstract Background: The combination of interprofessional collaboration in teams and patient-centered care is a necessary amalgamation when it comes to delivering complex mental healthy care and services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines the impact of predictors of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration, informal role self-efficacy in multidisciplinary mental health teams.Method: Cross-sectional multilevel design using self-administered bilingual validated questionnaires.Results: This study showed that belief in interprofessional collaboration’s impact on patient-centered perceptions is increased in teams with high collaboration. We also showed that collaboration is a mediator; that is, a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: In terms of research our results are in line with recent theorising on team processes and specifically established collaboration as key in a multilevel examination of predictors of patient-centered care perceptions. In terms of practice, we showed that multidisciplinary teams should know that working hard on collaboration as an answer to the complexity of patient-centered care impacts the teams’ ability to respond to its challenges but also impacts individuals’ beliefs central to the delivery of interprofessional care.

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