Aloud Method Research Articles

Exploring accessibility, user experience and engagement of digital media among older patients with depression: a pilot and observational screening study protocol of the DiGA4Aged study

IntroductionThe prevalence of mental health problems is increasing worldwide, particularly in the vulnerable group of older people. The limited availability of therapists, long wait periods and increasing shortage of healthcare...

Usability Evaluation in a Remote Access Scenario.

We present an approach to use the think aloud method for formative usability evaluation for medical software in a remote access scenario which combines researchers in two different locations and test persons distributed across five Swiss hospitals into one study using MS-Teams. We could show that a) these tests can be performed remote in a tight time schedule and b) that results valuable for the formative development of the examined mockup solution could be achieved. Two sessions had to be rescheduled for technical problems but all test persons could complete the think aloud study in 30 minutes at their usual working environment. This offers the opportunity to software providers to develop medical software with better usability in close cooperation with future users.

With sensitive eyes: ECEC teachers’ visual gaze and related reflections on pedagogical actions in toddler groups using eye-tracking glasses

This study explored early childhood education and care (ECEC) teachers’ visual gaze and related reflections on pedagogical actions during pedagogical activities in groups of children under three years of age in Finland. The data were collected from play and teacher-guided activities using mobile eye-tracking glasses, the retrospective thinking aloud (RTA) method, and semi-structured interviews. The results showed that even though the teachers were surprised about some aspects of the visual gaze metrics, they reflected on and gave reasons for their visual gazes on children. When observing gaze data from play, teachers explained the high amount of gaze by citing children’s particular needs. When observing gaze data from guided activities, teachers reflected on children’s unpredictable behavior and noted that the children’s need for support in concentration was linked to more gazes by the teacher. The findings showed that both during play and guided activities, children seeking a gaze and the position of children in the classroom influenced the number of teachers’ gazes. In the teachers’ explanations of their visual gaze and related pedagogical actions, five categories were identified: protection; physical and emotional availability, teaching and learning; facilitation; and initiatives. This explorative study showed that teachers utilize their knowledge concerning children’s individuality, development, and learning when they explain their decisions concerning their visual gaze and pedagogical activities with toddlers. The use of mobile eye-tracking technology is relatively new; therefore, its applications to ECEC are pioneering for the development of the field in relation to the practices and research of toddlers’ groups and groups with older children in ECEC

Exploring seafood choices at the point of purchase among a sample of Swedish consumers

PurposeSeafood consumption in Sweden is below the national recommendations and limited to very few species. This study aims to explore the factors shaping seafood choices at the point of purchase among a sample of current consumers in Sweden, and examines their attitudes regarding seafood consumption more broadly.Design/methodology/approachConvenience sampling was used to recruit consumers planning to purchase seafood at a supermarket in Sweden. Participants’ shopping trip was recorded using wearable eye tracking glasses and, upon completion, semi-structured interviews were conducted using a cued retrospective think aloud method. This exploratory study integrates qualitative data (N = 39) with eye tracking data (N = 34), to explore how seafood choices unfold when consumers purchase at the point of purchase.FindingsPurchases were mostly restricted to familiar seafood species. Four interlinked main themes were identified from thematic analysis of the interview data: Ambivalence, Nice and Necessary, Proficiency with Seafood and External Influences. Sustainability information (e.g. certifications) faced strong competition from other visual elements at the point of purchase, receiving less attention than product imagery and pricing information.Originality/valueThis study is the first to explore the factors shaping seafood choices of current consumers at the point of purchase. The unique approach, combining explicit and implicit measures, enriches understanding of the factors influencing seafood choices and how these may interrelate. The results are valuable for the industry and contribute to the literature by identifying possible routes to improve seafood sustainability communication.

Designing immersive narratives of Jugra heritage site for cultural edutainment using mixed reality

Technology integration in the tourism industry has introduced new possibilities for enhancing visitor experiences and promoting cultural edutainment in heritage tourism. Mixed Reality (MxR) is a promising technology for achieving these goals. By leveraging MxR, cultural heritage sites can provide tourists with engaging and educational experiences, allowing them to delve into the rich history and cultural significance of these sites. However, the quality of content in MxR applications can significantly impact the overall experience and educational value. This research proposes best practices for MxR development in smart heritage tourism, ensuring the delivery of high-quality, culturally authentic, and educational experiences to visitors. A qualitative approach has been adopted to achieve this aim, utilizing the Speak Aloud method to collect data from participants who interacted with the MxR prototype. The study focuses on a case study of the Jugra heritage urban landscape, using it as a basis for developing an MxR prototype. The research encompasses two stages: the first is the design for prototype development, and the second is to test the application for user feedback. Through discussions on prototype design development and user experience testing, the research proposes a storyboard framework as a guideline for designing the MxR environment. This framework serves as a comprehensive blueprint, ensuring that each phase, from data analysis to the final Mixed Reality application, is meticulously designed and executed. Respondents tested the prototype to gather feedback on the prototype's outcomes, enabling refinement of the blueprint for subsequent levels of testing with heritage visitors. The results of this study contribute to the field of MxR development in smart heritage tourism. The research enables developers to create high-quality, culturally authentic, educational MxR experiences by offering guidelines and best practices. Therefore, the application of MxR in cultural heritage enhances the level of visitor engagement and facilitates a more profound comprehension of cultural heritage.

Improve Pre-Reading Skills of Children with Light Intellectual Impairment with Read Aloud Method

The pre-reading ability is a fundamental skill that must be mastered to improve reading skills. Learning to read requires an understanding of symbols and theoretical comprehension, thus requiring strong imagination and memory. The learning process can be challenging to be quickly grasped by mildly intellectually disabled children with learning disabilities. Although the cognitive abilities of mildly intellectually disabled children may be slow, they can still be gradually developed with an effective learning process, such as the read-aloud method, to make children comfortable with reading activities, thus facilitating the gradual acceptance of pre-reading learning. This research aims to determine the influence of the read-aloud method on pre-reading abilities in mildly intellectually disabled children at SLB-C Autis Pelita Hati Palembang. The research method used is experimental quantitative. Sample selection is done using purposive sampling technique, with a sample size of 6 mildly intellectually disabled students. Data collection methods include interviews, observations, questionnaires, and measurements using a modified pre-reading ability assessment test assessed using the Guttman scale. The design used in this research is a repeated treatment design with a one-group pretest-posttest design. The data analysis technique used is the paired sample t-test. The hypothesis testing results show t = -18.634 and p = 0.000, indicating that p < 0.05, which means the hypothesis is accepted. This indicates that there is a difference between the pre-test and post-test results after the read aloud treatment, meaning that reading aloud influences the pre-reading abilities of children with mild hearing impairments.Kemampuan pra-membaca merupakan hal dasar yang harus dikuasai untuk meningkatkan kemampuan membaca. Dalam pembelajaran membaca membutuhkan pemahaman simbol dan pemahaman secara teoritis, sehingga membutuhkan daya imajinasi dan daya ingat yang kuat. Proses pembelajaran tersebut sulit untuk cepat diterima bagi anak tungarahita ringan yang memiliki keterbatasan intelektual. Meskipun kemampuan dalam berpikir anak tunagrahita ringan lambat, namun masih dapat dikembangkan secara perlahan dengan proses pembelajaran yang efektif yaitu dengan metode read aloud agar anak nyaman dengan kegiatan membaca sehingga perlahan proses belajar pra-membaca dapat mudah diterima. Penelitian ini bertujuan untuk mengetahui pengaruh read aloud terhadap kemampuan pra-membaca pada anak tunagrahita ringan di SLB-C Autis Pelita Hati Palembang. Metode penelitian yang digunakan dalam penelitian ini yaitu metode kuantitatif eksperimental. Pengambilan sampel menggunakan teknik purposive sampling dengan jumlah sampel 6 siswa tunagrahita. Metode pengumpuan data melalui wawancara, observasi, angket dan alat ukur berupa modifikasi tes asesmen kemampuan pra-membaca dengan cara penilaian menggunakan skala guttman. Desain yang digunakan dalam penelitian ini adalah desain perlakukan ulang dengan one group pretest-posttest design. Teknik analisis data menggunakan uji paired sample t-test. Hasil pengujian hipotesis menunjukkan t = -18,634 dan p = 0,000 sehingga p< 0,05 yang berarti hipotesis diterima. Hal ini menunjukkan bahwa terdapat perbedaan hasil pre-test dan post-test setelah treatment read aloud yang artinya read loud memiliki pengaruh terhadap kemampuan pra-membaca pada anak tungarhita ringan.

Implementasi metode read aloud dalam mengembangkan kosa kata anak di kelompok A TK Mentari Loa Janan

This research is motivated by the importance of developing children's vocabulary in their language skills. The choice of method for implementation is also no less important. It is hoped that choosing the read aloud method will provide a pleasant atmosphere and be able to facilitate children in acquiring vocabulary. This method is a means that can provide a wide variety of vocabulary to children. The aim of this research is to determine the implementation of the read aloud method in developing the vocabulary of children in group A. This research is field research with a qualitative approach. Data was collected through observation, interviews and documentation. The subjects in this research were the Principal and Teacher of Mentari Loa Janan Kindergarten. The validity of the data was tested through triangulation of sources, techniques and time. Data analysis refers to the work steps of Miles, Huberman, and Saldana involving data condensation, data presentation, and drawing conclusions. The results of this research relate to the implementation of the read aloud method applied by teachers in developing children's vocabulary. Planning consists of selecting books that suit the learning theme and pre-reading the books. The implementation consists of creating a pleasant atmosphere, showing and introducing the book cover, actively interacting with the children, asking questions to the children and discussing about 4-5 new vocabulary words in the book. Evaluation is carried out by asking children about the story they have just read, including the content, concepts and vocabulary. Assessment of vocabulary development itself is carried out by paying attention to children's conversations and language use. Although the research results provide an overview of the implementation of the read aloud method, further research is still needed to evaluate the long-term impact on children's vocabulary development. This can be a basis for developing more concrete recommendations to increase the effectiveness of using the read aloud method in the context of vocabulary development for children in group A.

Perancangan Dan Evaluasi Usability User Interface Aplikasi Cemilanpuas Berbasis Website

User-centered design methods are used to identify user needs, analyze usage contexts, and design interfaces that are intuitive and easy to use. In this study, data collection was carried out through interviews with Cemilanpuas stakeholders and prospective users. Based on the data obtained, the researcher formulates user requirements and creates a solution design in the final form of a prototype. After the design is complete, usability evaluation is carried out using the Think Aloud method. Evaluators are directed to complete a series of tasks that represent common activities in using the Cemilanpuas application. During the test, the constraints and difficulties encountered by the evaluator were recorded both verbally and non-verbally. The results of the usability evaluation contain the advantages and disadvantages of the user interface which are grouped based on the five usability points. Based on these findings, improvements were made with a minimum of two iterations. Measuring the value of user satisfaction has a grade B final result of 87.5. This research makes an important contribution in understanding user needs and improving the usability of the website-based Cemilanpuas application. The results of this study can be used as a guideline for the development and improvement of the user interface of similar applications in the future.

Pre-Service Teachers’ Perceptions on the Use of Heritage in Secondary Education and Their Reception of Educational Materials from the Heritage and Museum Sector: A Case Study in Flanders (Belgium)

There has been a growing policy interest in establishing connections between heritage and education. Nevertheless, there seems to be very little evaluation or critical reflection on what actually happens in practice, and it remains unclear how heritage education is employed in countries throughout Europe. The aim of this paper is to assess the current status of heritage education in Flanders (the Dutch-speaking northern part of Belgium) via a literature review and an exploratory case study. The perceptions and opinions of pre-service teachers (n = 17) were investigated using three instruments: a questionnaire, document analysis, and the think aloud method. The results show that the pre-service teachers had a traditional interpretation of heritage, mainly relying on well-known and monumental examples and following a rather historical–artistic conception. However, it was found that their opinions were positive towards the use of heritage as an educational resource, and their evaluations of educational materials from the heritage and museum sector provided detailed information concerning teachers’ desires and needs in this regard. The implications of this study should encourage initial teacher training in Flanders to further consider the epistemological and methodological challenges in the emerging field of heritage education.

Pengembangan Kemampuan Bahasa Ekspresif Anak Melalui Membaca Nyaring Buku Berbasis Nilai Agama dan Moral di TKIT Permata Bunda Merauke

The development of expressive language needs to be developed so that children can express their opinions and thoughts to other people. Children's expressive language development can be developed through the reading aloud method. This research aims to examine the development of children's expressive language skills through reading aloud at TKIT Permata Bunda. The research method used is descriptive qualitative. The subjects of this research were group A children aged 4-5 years and two teachers. Data collection techniques include interviews, documentation and direct observation. The results of the research show that developing children's expressive language skills can be done through the activity of reading aloud books based on religious and moral values. The implementation stage includes planning by selecting books according to the child's development level and containing religious and moral values. The next stage is implementation in the form of introducing the book, reading the story book aloud with the right intonation, holding a discussion and asking stimulating questions and motivating the child to retell the story. Next, the teacher carries out an assessment to determine the achievement of expressive language development.

Efforts to Improve the Ability to Read Aloud Using Picture Story Media in Indonesian Language Subjects at SD Negeri 095 North Bengkulu

Indonesian students' reading skills at SD Negeri 095 North Bengkulu Province will be improved through the use of picture story media. Located in Bengkulu. Classroom action research which includes two cycles is the core of this research. Ten second grade students at SD Negeri 095 North Bengkulu Province, Bengkulu, took part in the research in the 2023–2024 school year. This research data comes from a combination of tests, observations and documentation. We used descriptive statistics to average the quantitative data and data from observation notes to assess the qualitative data. Based on the research results, a reading aloud method using picture story media has been developed for class II students at SD Negeri 095, North Bengkulu Province. Bengkulu academic year 2023–2024. Students' ability to read aloud increases due to exposure to interesting visual story media. Student learning outcomes in the pre-cycle show this; Their average was 64.1, but by the end of the first cycle, they had improved to 66.6. Meanwhile, the average score in cycle II was 78.3, an increase from cycle I. Completed 20%, 40% and 80% of the pre-cycle, cycle I and cycle II respectively.

Improving English Pronunciation with AI Speech-Recognition Technology

This study explores the use of AI technology in the Google Read Along application as a tool to improve English pronunciation, particularly for students who struggle with English pronunciation. Therefore, the purpose of this study is to evaluate the Google Read Along app's effectiveness in improving English pronunciation, analyze the students' responses to using Google Read Along, and discover the factors that help students succeed in improving their pronunciation. Read Aloud is used in conjunction with AI technology to help children learn by listening to and precisely repeating new words and phrases. A quasi-experimental method was used to collect data, with 35 students in the experimental group and 35 in the control group. A questionnaire was presented to the experimental group regarding how they responded to Google Read Along, and interviews were conducted as further information to identify the factors affecting their pronunciation improvement. The results of the N-Gain test show that the Google Read Along is efficient in helping students improve their English pronunciation when used in combined with the Read Aloud approach by an average of 65.73 percent. As a result, a teaching strategy that combines the Read Aloud method and AI Google Read Along can be an effective alternative. Additionally, the instant feedback offered by this application gives students a chance to recognize their errors directly, and the convenience of using the application for learning anytime anywhere has a significant impact on their success in improving their pronunciation.

Exploring the cognitive processes of both Arabic and English‐speaking patients when completing the brief pain inventory: A qualitative study

AbstractBackgroundBrief Pain Inventory (BPI) is one of the most commonly used self‐initiated questionnaire for people with chronic pain. Although the questionnaire has been translated into multiple different languages and tested for its inter‐tester reliability, no study has currently explored the differences in interpretation of this questionnaire between non‐English speakers as compared to English‐speakers.PurposeUsing the Arabic‐language group as the comparator, this study explored the interpretation of the English and Arabic language Brief Pain Inventory (BPI) among participants living with chronic neuromusculoskeletal pain from Arabic‐ and English‐speaking backgrounds.MethodsThis qualitative study utilises the Think Aloud method to explore the differences in the interpretation of the BPI between two language groups. Consecutive consenting adults attending a tertiary pain clinic for management of a chronic neuromusculoskeletal pain condition and self‐identifying with a native English‐speaking (n = 15) or Arabic‐speaking (n = 15) background were included. Structured interviews using the think‐aloud method were conducted, audio‐recorded and analysed using coding and thematic analysis.ResultsInterpretation errors across three or more questions were recorded for all Arabic‐speaking participants and two English‐speaking participants. Three themes characterised appraisals of pain and interpretation of the BPI across the two cohorts: 1) pain constancy vs. variability, 2) the ability‐disability spectrum and 3) variance in expression of pain.ConclusionCross‐cultural differences in the appraisal of pain influenced participants' interpretation of the BPI. The cultural influences on conceptualisation of pain need to be considered when using the BPI across different cultures.

Development of a patient-centered transition program for stroke survivors and their informal caregivers, combining case-management and access to an online information platform: A user-centered design approach.

During the hospital-to-home transition, stroke survivors and their caregivers face a significant lack of support and information which impacts their psychosocial recovery. We aimed to co-design a program combining individual support by a trained case-manager (dedicated professional providing individual support) and an online information platform to address needs of stroke survivors and caregivers. A two-step methodology was used. The first step followed a "user-centered design" approach during four workshops with stroke survivors, caregivers, and healthcare professionals to develop the platform and define the case-manager profile. The second step was a usability test of the platform following a Think Aloud method with patients and caregivers. The workshops and interviews were analyzed following a qualitative thematic analysis. The analysis of Think Aloud interviews was based on User Experience Honeycomb framework by Morville. Eight participants attended the workshops: two patients, two caregivers, three nurses, and a general practitioner. Activities, training, and skills of the case-manager were defined according to stroke survivors and caregivers needs. Name, graphics, navigation, and content of the platform were developed with the participants, a developer and a graphic designer. The usability of the platform was tested with 5 patients and 5 caregivers. The Think Aloud confirmed satisfaction with graphics and content but a need for improvement regarding the navigability. An update of the platform was conducted in order to answer the needs expressed by participants. We developed, with a participatory approach, a patient-centered transition program, which will be evaluated in a randomized controlled trial.

The Malnutrition Awareness Scale for community-dwelling older adults: Development and psychometric properties

Background & AimsQualitative studies suggest that malnutrition awareness is poor in older adults. The aim of this study was to develop a questionnaire to quantitatively assess malnutrition awareness in community-dwelling older adults aged 60+ years. MethodsThe Malnutrition Awareness Scale (MAS) was developed based on the awareness phase of the Integrated-Change model, and included four domains: knowledge, perceived cues, risk perceptions, and cognizance. Twenty-six scale items were developed using results from mainly qualitative research and the expertise of the authors. Items were piloted in 10 Dutch older adults using the Thinking Aloud method to optimize wording. In a feasibility study, annoyance, difficulty and time to complete the MAS and its comprehensibility were tested. After final revisions, the MAS was applied to a large sample to test its psychometric properties (i.e., inter-item correlations, Cronbach’s alpha, score distribution) and relevance of the items was rated on a 5-point scale by 12 experts to determine content validity. ResultsThe feasibility study (n=42, 55% women, 19% 80+ y) showed that the MAS took 12±6 min to complete. Most participants found it not (at all) annoying (81%) and not (at all) difficult (79%) to complete the MAS, and found it (very) comprehensible (83%). Psychometric analyses (n=216, 63% women, 28% 80+ y) showed no redundant items, but two items correlated negatively with other items, and one correlated very low. After removal, the final MAS consists of 23 items with a min-max scoring range from 0 to 22 (with higher scores indicating higher awareness) and an overall Cronbach’s alpha of 0.67. The mean MAS score in our sample (n=216) was 14.8±3.2. The lowest obtained score was 6 (n=3) and the highest 22 (n=1), indicating no floor or ceiling effects. Based on the relevance rating, the overall median across all 22 items was 4.0 with IQR 4.0-5.0. ConclusionThe Malnutrition Awareness Scale is a novel, feasible and reliable tool with good content validity to quantitively assess malnutrition awareness in community-dwelling older adults. The scale is now ready to identify groups with poor malnutrition awareness, as a basis to start interventions to increase malnutrition knowledge and awareness.

Creative Subprocess Frequencies and Their Relation to Personal Characteristics and Product Creativity: Insights from a Drawing Task Think Aloud Study

ABSTRACTMost research on the creative process has focused on idea generation, and the prevalence and influence of many other creative subprocesses remain poorly understood. To clarify different subprocesses' respective roles in creative work, this study investigated their frequencies and associations with creativity‐related personal characteristics and product creativity. Undergraduate students (n = 266) articulated their creative thought processes via the think aloud method while completing an open‐ended drawing task and completed questionnaires assessing creativity‐relevant personal characteristics. Drawings were rated for creativity by quasi‐expert judges. Transcripts were coded using an a priori coding scheme informed by models of the creative process, including generation (14%), elaboration (26%), association (9%), selection (4%), evaluation (13%), anchoring (13%), metacognition (7%), and filler (14%). Subprocess frequencies correlated minimally with measures of personal characteristics, although several significant, albeit weak, relationships emerged. A hierarchical regression analysis indicated that the best predictors of drawing creativity were aesthetic fluency, the frequency of anchoring, time spent on task, and, marginally, the frequency of generation. Together, these results provide insight into how relevant personal characteristics and subprocess engagement contribute to drawing creativity and highlight the particular importance of anchoring, which involves monitoring and refining task‐related goals and constraints, throughout the creative process.

PENERAPAN METODE MEMBACA NYARING UNTUK MENINGKATKAN KEMAMPUAN MEMBACA SISWA KELAS 1 SD NEGERI PURWAKARTA I

Abstract
 Reading ability is a child's ability to recognize letters and words, then connect them with sounds, and understand the meaning of the writing they read, which begins with the ability to hear the letters correctly and precisely. The reading aloud method or reading aloud is an activity carried out to improve reading and listening skills. Because with this method all students in the class will pay attention to the reading material and it can be a stimulant for students. This study used descriptive qualitative method. The qualitative descriptive method is a form of research aimed at describing or illustrating existing phenomena, both natural phenomena and human engineering. The data collection techniques used were interviews, observation and documentation, with the subjects being class I students at SD Negeri Purwakarta I, totaling 33 students. The results of this research show that applying the reading aloud method can effectively improve students' reading abilities.
 Keywords: Reading Ability, Reading Aloud Method

Inpatient nurses' preferences and decisions with risk information visualization.

We examined the influence of 4 different risk information formats on inpatient nurses' preferences and decisions with an acute clinical deterioration decision-support system. We conducted a comparative usability evaluation in which participants provided responses to multiple user interface options in a simulated setting. We collected qualitative data using think aloud methods. We collected quantitative data by asking participants which action they would perform after each time point in 3 different patient scenarios. More participants (n = 6) preferred the probability format over relative risk ratios (n = 2), absolute differences (n = 2), and number of persons out of 100 (n = 0). Participants liked average lines, having a trend graph to supplement the risk estimate, and consistent colors between trend graphs and possible actions. Participants did not like too much text information or the presence of confidence intervals. From a decision-making perspective, use of the probability format was associated with greater concordance in actions taken by participants compared to the other 3 risk information formats. By focusing on nurses' preferences and decisions with several risk information display formats and collecting both qualitative and quantitative data, we have provided meaningful insights for the design of clinical decision-support systems containing complex quantitative information. This study adds to our knowledge of presenting risk information to nurses within clinical decision-support systems. We encourage those developing risk-based systems for inpatient nurses to consider expressing risk in a probability format and include a graph (with average line) to display the patient's recent trends.

Adaptation of the Digital Health Literacy Instrument and testing with German school-aged children

Abstract Background Children and adolescents in particular navigate in the digital space intensively and use the Internet, social media, and apps to seek health related information. From a public health perspective, the increasing amount of online-based information requires them to possess the abilities to find, understand, evaluate, and apply health information, making digital health literacy more and more important. The Digital Health Literacy Instruments (DHLI) is a psychometrically tested instrument for assessing digital health literacy in adults, which has been adapted for children and adolescents in the United States, using cognitive interviews. However, this version has not yet been adapted for Germany. Hence, the aim of this study is to adapt and test a German version of DHLI for secondary schoolchildren. Methods The pretest tool was translated into German by three native speakers. To test the translated version of the DHLI adapted for secondary schoolchildren, cognitive pretests were conducted with N = 12 children and adolescents aged 10-17 years. The thinking aloud method and probing questions were used during the pretests. The aim of the evaluation was to maximize usability and comprehensibility of the adapted version for schoolchildren in Germany. Results In order to adapt the instrument for a German target group, preferred synonyms were identified during the pretests, as well as a preferred word collocation for health information, namely ‘information about health,’ which was used consistently for all items. Furthermore, two explanations were added in one instruction and one item. Conclusions Based on the results of the pretest analysis, a German version of the DHLI for children and adolescents is now available. Psychometric properties and the methodological quality of the schoolchildren's version of the DHLI have been analyzed in a representative quantitative study, shown in the subsequent presentation.

Tailoring of exercise and dietary interventions to adverse effects and existing comorbidities in patients with ovarian cancer receiving chemotherapy: a clinical vignettes study among expert physical therapists and dietitians

Purpose This study aims to capture the complex clinical reasoning process during tailoring of exercise and dietary interventions to adverse effects and comorbidities of patients with ovarian cancer receiving chemotherapy. Methods Clinical vignettes were presented to expert physical therapists (n = 4) and dietitians (n = 3). Using the think aloud method, these experts were asked to verbalize their clinical reasoning on how they would tailor the intervention to adverse effects of ovarian cancer and its treatment and comorbidities. Clinical reasoning steps were categorized in questions raised to obtain additional information; anticipated answers; and actions to be taken. Questions and actions were labeled according to the evidence-based practice model. Results Questions to obtain additional information were frequently related to the patients’ capacities, safety or the etiology of health issues. Various hypothetical answers were proposed which led to different actions. Suggested actions by the experts included extensive monitoring of symptoms and parameters, specific adaptations to the exercise protocol and dietary-related patient education. Conclusions Our study obtained insight into the complex process of clinical reasoning, in which a variety of patient-related variables are used to tailor interventions. This insight can be useful for description and fidelity assessment of interventions and training of healthcare professionals.