Care Communication Research Articles

Individuals' Desire for Social Needs Sharing Among Healthcare Providers: Findings from the 2022 Health Information National Trends Survey.

Increasingly, health systems are collecting and using social needs data, yet there is limited information about individuals' preferences for how social needs information is shared among providers for treatment purposes. To explore the connection between experiencing social needs and concerns about healthcare providers sharing social needs information. A nationally representative, cross-sectional study of 6252 US community-dwelling adults (≥ 18 years of age) who responded to the Health Information National Trends Survey (HINTS 6) (response rate 28.1%) from March to November 2022. Core measures include experiencing social needs in the past year (food, transportation, housing issues), and comfort with providers sharing social needs information with each other for treatment purposes. Other key independent variables included patient-centered communication, discrimination, trust, and quality of care. Odds of reporting experiencing a social need varied by age, race, education, and income, yet those 75 years or older (compared to ages 18-34) had higher odds of reporting feeling comfortable with providers sharing information about social needs. Those who reported having experienced discrimination in healthcare had lower odds of reporting comfort with providers sharing information about food (adjusted odds ratio [aOR], 0.63; 95% confidence interval [CI], 0.41-0.98) and transportation (aOR, 0.64; 95%CI, 0.44-0.94) needs. Those who trusted the healthcare system had higher odds of being comfortable with providers sharing information about unmet needs for food (aOR, 1.33; 95%CI, 1.07-1.65). Also, those who report better patient-centered communication and quality of care had higher odds of being comfortable with providers sharing information on unmet social needs. Individuals' preferences regarding social needs information sharing for treatment purposes, as well as experience of discrimination, trust in healthcare, quality of care, and patient-provider communication, should be considered in health system efforts to capture social needs information.

Patient and Health Professional's Perspectives of Periprosthetic Joint Infection: A Systematic Review and Meta-Ethnography.

Background: Periprosthetic joint infection (PJI) is a major challenge for surgical teams and patients following an orthopedic surgical procedure. There is limited understanding on patient and health professional's perception of PJI. The aim of this study was to examine the literature to better understand the perspectives of patients, and those who manage PJI. Methods: Published and unpublished literature databases were systematically searched from inception to June 21, 2024. Qualitative studies reporting the perspectives of living with and managing PJI were included. Data were synthesized using a meta-ethnography approach and the GRADE-CERQual tool. Results: Of the 584 citations identified, 10 studies (n = 91 patients; n = 70 health professionals) met the eligibility criteria and were included. Three themes, all moderate-certainty evidence, were identified from the health professional data, including the following: (1) importance of PJI; (2) impact on health professionals; and (3) support for change. From the patient data, six themes on the basis of moderate-certainty evidence were identified: (1) psychological and social impact; (2) physical impacts; (3) relationship with health professionals; (4) relationship with others; (5) uncertainty over the future; and (6) support for change. A novel line of argument was developed offering third-order constructs, on the basis of first- and second-order themes. Conclusion: PJIs are perceived as devastating by both patients and health professionals. They impact on all aspects of a patient's physical, social and psychological health, each interacting on one another over the course of infection and management. Strategies to improve communication, multidisciplinary management, and personalization of care are advocated by both patients and health professionals to promote better outcomes.

Considerations and expectations for the administration of dispersible arpraziquantel to young children: a landscape analysis.

Schistosomiasis is a serious public health problem in many African countries and beyond. Preventive chemotherapy with praziquantel is a successful public health intervention that is recommended for all communities at risk, commonly reached through large-scale mass drug administration campaigns. However, preschool-age children are currently not routinely targeted for treatment due to operational challenges related to dosing and administration with the standard drug formulation. In response to the need for a suitable, child-friendly treatment, the multistakeholder Pediatric Praziquantel Consortium has developed a novel dispersible tablet with improved taste and smaller size. To prepare the introduction and inform future uptake of the novel paediatric formulation in endemic countries, we conducted a landscape analysis to explore perspectives, opinions and experiences of key stakeholders on operational and practical issues in relation to drug dosing and administration. Our findings confirm that child-friendly drug formulations mitigate several operational constraints related to the dosing and administration in young children. The introduction of this novel child health intervention into routine platforms and programs requires solid training and careful communication by engaging with communities, caregivers, healthcare workers and decision-makers to ensure acceptance and future uptake of treatment.

PALLM: Evaluating and Enhancing PALL iative Care Conversations with L arge L anguage M odels

Effective patient-provider communication is crucial in clinical care, directly impacting patient outcomes and quality of life. Traditional evaluation methods, such as human ratings, patient feedback, and provider self-assessments, are often limited by high costs and scalability issues. Although existing natural language processing (NLP) techniques show promise, they struggle with the nuances of clinical communication and require sensitive clinical data for training, reducing their effectiveness in real-world applications. Emerging large language models (LLMs) offer a new approach to assessing complex communication metrics, with the potential to advance the field through integration into passive sensing and just-in-time intervention systems. This study explores LLMs as evaluators of palliative care communication quality, leveraging their linguistic, in-context learning, and reasoning capabilities. Specifically, using simulated scripts crafted and labeled by healthcare professionals, we test proprietary models (e.g., GPT-4) and fine-tune open-source LLMs (e.g., LLaMA2) with a synthetic dataset generated by GPT-4 to evaluate clinical conversations, to identify key metrics such as ‘understanding’ and ‘empathy’. Our findings demonstrated LLMs’ superior performance in evaluating clinical communication, providing actionable feedback with reasoning, and demonstrating the feasibility and practical viability of developing in-house LLMs. This research highlights LLMs’ potential to enhance patient-provider interactions and lays the groundwork for downstream steps in developing LLM-empowered clinical health systems.

End-of-life issues in the ITU - 10 important points to remember.

End-of-life (EOL) issues have become increasingly common in intensive therapy units (ITUs), largely due to advances in critical care that enable patients to be kept alive for extended periods. Death in the ITU now generally follows an EOL decision, which can pose ethical, emotional, and practical challenges. Our approach to such issues should be based on adherence to the four bioethical principles -autonomy, beneficence, nonmaleficence, and distributive justice- as well as the concept of proportionate care, and requires careful and effective communication with the whole ITU team, including the patient and their family. In this article, we discuss 10 key considerations related to EOL care in the ITU, in an attempt to highlight some critical aspects of EOL decision-making for intensivists navigating this sensitive and multifaceted area of practice.

Adapting to the emotional complexity of palliative care communication: Palliative care clinicians' experiences.

Communication is essential to medical care and is key in improving patient outcomes. We aimed to understand clinicians' emotions when communicating with patients in palliative care (PC) and the evolution of their communication skills. Between October and November 2021, 231 Swiss PC clinicians participated in an online cross-sectional survey (65% nurses, 35% physicians). Three questions invited participants to reflect on the development of their communication skills and on their emotions when communicating with patients in PC. Answers to these questions were analyzed thematically. Constantly adapting to complex emotions in communication was the overarching theme. Three main themes further allowed for an understanding of different communication challenges: emotions as a dynamic compass, not always under control, and evolving comfort and competence through personal and professional growth. In evolving comfort and competence, 6 strategies helped clinicians overcome fears and improve their confidence in communication: learning by doing and formal training, integrating life experiences and gaining insight from private life, taking time, collaborating and connecting with peers, acknowledging individuality, and connecting with one's own and patients' emotions. Participants described powerful emotional experiences when communicating with patients in PC, underscoring the emotional labor involved in PC communication. Our study highlights the need to re-conceptualize emotions as a valuable resource rather than a hindrance in clinical practice. The interplay between personal and professional identities in shaping communication skills, emphasizes the importance of emotional competence as a core professional skill. As clinicians often develop these skills individually, our findings suggest a need for earlier integration of emotional competence training in medical education, along with ongoing support through collaboration, and improved allocation of time resources, to enhance clinician well-being and patient care.

Enhancing Communication and Empathy Skills in Geriatric Care: Nurses' Reflections on Simulation-Based Training for Patient Interaction and Education.

To explore the impact of simulation-based training on communication and empathy skills among nurses working with elderly patients in the Abha region of Saudi Arabia. The study also aimed to identify the barriers and facilitators to applying these skills in real-world clinical practice. A qualitative study. Semi-structured interviews were conducted between June and July 2024 with 17 nurses from urban and rural healthcare settings in the Abha region. Data were analysed using both deductive framework analysis, guided by social support theory, and inductive thematic analysis to identify key themes related to communication, empathy, and the application of simulation-based skills in practice. We adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The study involved 17 participants aged 22-50 years, with diverse educational backgrounds and work experience. The findings indicated that simulation-based training significantly improved nurses' confidence in delivering difficult news and their ability to empathise with elderly patients. Nurses working in urban settings with regular access to simulation training reported better outcomes compared to those in rural settings with less frequent training opportunities. Simulation-based training has a positive impact on enhancing communication and empathy skills among nurses, but challenges in real-world application remain. Efforts should be made to improve the accessibility of simulation training and address the barriers preventing its effective implementation in clinical practice. Healthcare practitioners and policymakers should prioritise simulation-based training in nursing education and professional development to improve the quality of care for elderly patients. The Consolidated Criteria for Reporting Qualitative Research (COREQ). The engagement and interview data from nursing participants provided valuable insights into the impact of simulation-based training on communication and empathy in elderly care.

An Overview of Dentist-Patient Communication in Quality Dental Care.

Dentist-patient communication is at the core of providing quality dental care. This study aims to review the importance, challenges, strategies, and training of dentist-patient communication. The World Dental Federation (FDI) emphasizes the importance of effective communication between oral healthcare providers and patients as a critical component of high-quality care. Effective dentist-patient communication allows dentists to accurately and effectively pass on essential medical information to patients. It improves the dentist's efficiency, boosts self-confidence, reduces occupational stress, and minimizes the risks of complaint or litigation. Moreover, it alleviates dental anxiety and fear, helps build trust between dentists and patients, addresses patients' needs and preferences, increases patients' adherence to improved treatment outcomes, and ultimately leads to enhanced patient satisfaction. Nonetheless, it has been widely acknowledged that dentists universally encounter the repercussions arising from suboptimal communication strategies. Time constraints, difficulties in establishing rapport, the oral-health illiteracy of the patients, the poor communication skills of the dentists, dentists' perceptions, and language barriers often hinder dentist-patient communication. Dentists should take the patient-centered approach as a premise and acquire verbal and non-verbal communication skills to overcome these communication barriers. The patient-centered approach comprises the understanding of patients' illness, shared decision-making, and intervention with mindfulness of the patient's own pace. Simple, succinct, and jargon-free language should be used in verbal communication. Proper body postures and gestures are fundamental for showing positive attitudes towards patients. Communication training for dental students should involve a structured pedagogical approach that includes didactic instruction, role-playing exercises, patient interviewing, and ongoing assessments. Key components of effective communication skills training in dental education include motivational interviewing, open-ended questioning, affirmations, reflective listening, and summaries to enhance patient engagement and adherence to treatment plans.

Nurses’ experiences of text-based digital triage at primary healthcare centres in Sweden: a qualitative interview study

BackgroundTelehealth services are becoming increasingly popular at primary healthcare centres. Some examples include text-based digital triage and health guidance using chats, emails, images and pre-filled forms. Telephone-based communication has until recent years been the predominant means for triage and health guidance, but now includes written communication via computer or smartphone. Hence conditions to perform triage and health guidance have changed, which may affect the quality of nurses’ work and patient safety. This motivates an in-depth exploration of the consequences of such changes for nurses working with telehealth. The study aimed to explore nurses’ experiences of digital triage and health guidance at primary healthcare centres in Sweden.MethodsA qualitative inductive design was chosen for the current study. Four registered nurses and two public health nurses, working at primary healthcare centres in southern Sweden, contributed with information about text-based digital triage and health guidance. Semi-structured interviews were conducted to collect data. Data were analysed using qualitative content analysis.FindingsOne main theme, “Adapting to a new professional toolbox to triage and give health guidance” was constructed based on three categories which describe the altered professional tools. They were: “Using one’s senses differently to collect information”, “Change of communication mode to convey messages” and “Change of timeframe and the use of time”. Six subcategories describe how the new toolbox was experienced by the nurses. They were: “Loss of clinical ear”, “Gain of viewing images”, “Difficulties in written communication of care and emotions”,“Seeing oneself as a writer or talker”, “Tardy asynchronous communication” and“Available time”. ConclusionThe findings tell of a substantial change in nurses’ professional toolbox that demanded other skills than they were used to working with. Due to limitations in communication and communication skills, digital triage alone may lead to an impaired workflow, quality of care, and patient safety as well as maintain the digital divide. However, digital triage may also enhance nurses’ work with the addition of attached images, convenient communication for those who are comfortable with writing, and a gain of time for consultation and reflection. The current study contributes insights regarding new competencies that nurses and patients must have or gain to be able to benefit from the possibilities of digitisation of primary healthcare.

Beyond the Scalpel: Addressing Communication and Distress in ENT Cancer.

Background and Objectives: Effective communication in oncology is crucial, but challenging due to the complex information and emotional burden associated with a cancer diagnosis. This cross-sectional study investigated the communication preferences of 155 Romanian adults diagnosed with ENT cancers and explored the relationship between these preferences, their levels of psychological distress, and sociodemographic factors. Materials and Methods: Participants completed the KOPRA questionnaire, assessing communication preferences, and the Hospital Anxiety and Depression Scale (HADS) to measure psychological distress. Results: The results revealed that patients strongly prioritized active involvement in their care (Patient Participation and Patient Orientation-PPO) and open communication with healthcare providers (Effective and Open Communication-EOC). While emotional support was valued, it was considered less critical than PPO and EOC. Notably, communication about personal matters was deemed the least important aspect of communication. A high prevalence of psychological distress was observed, particularly among widowed individuals and females. No direct correlation was found between communication preferences and distress. Conclusions: These findings underscore the importance of shared decision-making, clear information exchange, and a patient-centered approach in the context of ENT cancer care, while also highlighting the need for routine screening and appropriate support for psychological well-being in this patient population.

Lived Experiences of Patients Hospitalized With Acute Decompensated Heart Failure and Kidney Dysfunction

For patients hospitalized with acute decompensated heart failure (ADHF), the presence of kidney dysfunction can substantially shape prognosis and treatment options. Yet little is known about the lived experiences of these medically vulnerable patients. To elicit accounts of the illness and care experiences of patients currently or recently hospitalized with ADHF and kidney dysfunction in order to identify potential opportunities to improve care. This qualitative study of patients with ADHF and kidney dysfunction was conducted at 3 hospitals within an academic health system serving the Greater Seattle area between February 2022 and February 2023. Patients were recruited from those enrolled in a parent study of patients hospitalized with ADHF. A sample of patients who had either acute kidney injury and/or chronic kidney disease were invited to participate in 1 or more qualitative interviews during hospitalization or approximately 3 months postdischarge. Transcribed interviews were analyzed using inductive thematic analysis. A total of 40 interviews were conducted among 28 participants. The mean (SD) participant age was 67 (12) years, and 8 (28%) identified as female, 4 as Black [14%], and 20 as White [71.4%]. Qualitative analysis resulted in 4 dominant themes: (1) pervasive impact of functional limitation, (2) adapting goals and changing expectations, (3) struggling to interpret clinical information, and (4) decisional roles and relationships with clinicians. Participants described how their illness had shaped their day-to-day function, life space, and sense of self. They did not always speak in explicit terms about prognosis but most recognized limits on longevity and life options and had started to rethink their priorities. Most participants were engaged in a process of trying to understand the medical aspects of their illness and care, often drawing on their own embodied experience of illness. They had particular difficulty grasping the significance of kidney dysfunction and connecting this to the symptoms they were experiencing. Participants did not always feel equipped or empowered to engage in clinical decision-making, tending to trust the clinicians caring for them. Interviews with adults currently or recently hospitalized with ADHF and kidney dysfunction highlight the importance of improving education, communication, and engagement in care among members of this medically vulnerable group.

The Impact of HIRAID Implementation on the Accuracy of Emergency Nurse Documentation in Australian Rural Emergency Departments: A Multicenter Quasi-Experimental Study.

Documentation templates supported the implementation of HIRAID, a validated framework that supports nurses in assessing and managing patients in emergency departments in rural Australia using a strategy informed by behavior change theory. The study aimed to determine whether the implementation of HIRAID improved the accuracy of nurses' documentation across a large rural health district. A Quasi-experimental pre-post study design was conducted across 10 rural emergency departments between November 2020 and November 2021, with HIRAID implemented in February 2021. Retrospective audit of clinical documentation occurred 3 months pre-implementation and repeated at 6-months post. Based on power analysis and a sampling framework, records that met study inclusion were randomized for audit. Documentation accuracy was evaluated, using a modified D-catch instrument, assessing quality and quantity by an experienced research nurse. Data were analyzed with descriptive and inferential statistics. A review of 222 records (110 pre/112 post), demonstrated an improvement in initial ED nursing assessment documentation. Audit scores increased significantly for quantity of documentation across all areas, in particular history (P < .001) and red flags (P < .001), with a 27.1% increase in all red flags recorded. The quality of documentation also significantly improved across all areas, most notably in history (P < .001) and assessment (P < .001). Implementation of HIRAID demonstrated a sustained improvement in the quantity and quality of emergency nurse documentation. Improved documentation accuracy is key to informing and evaluating ongoing care and supporting communication and continuity of care, and is essential to patient safety.

Partial Language Concordance in Primary Care Communication: What is Lost, What is Gained, and How to Optimize

Partial Language Concordance in Primary Care Communication: What is Lost, What is Gained, and How to Optimize

EXPLORING AI FOR DEMENTIA CARE SUPPORT IN NORTHERN ONTARIO: A LITERATURE REVIEW

Abstract Dementia is the seventh leading cause of death globally, significantly impairs cognitive abilities and memory loss. Artificial intelligence (AI) has the potential to revolutionize dementia care by assisting healthcare professionals in diagnosing, managing, and treating dementia worldwide. We conducted literature review using Google Scholar, PubMed, and Laurentian libraries (OMNI), focusing on key terms such as “dementia,” “Alzheimer’s disease,” “artificial intelligence,” and “healthcare.” This review covered peer-reviewed publications from 2014 to 2023, aiming to fill gaps in this research area. The search yielded five relevant articles, identifying three core themes: AI’s impact on Alzheimer’s disease and related dementias (ADRD), early detection and diagnosis of ADRD, and AI’s role in supporting healthcare professionals, caregivers, and patients. Zhang et al. (2023) emphasized AI’s role in diagnosing Alzheimer’s disease using MRI, PET scans, biomarkers, and advanced machine learning applications. Hane et al. (2020) highlighted the use of machine learning models for assessing ADRD risk by analyzing clinical notes to prevent nursing home admissions and reduce care costs. Xie et al. (2020) explored the use of assistive AI devices by caregivers to manage ADRD, reducing patient dependence. Li et al. (2020) focused on voice-activated AI tools that help caregivers manage nutrition and reduce their workload. Gustavsson, Svanberg, and Mullersdorf (2015) examined the benefits of the interactive robotic “Justo Cat” in enhancing communication in dementia care. This review suggests conducting ethnographic participatory focused-groups with thematic analysis to inform policymakers in developing specialized educational programs, integrating advanced AI, expanding digital health and telemedicine, and launching community-driven initiatives.

Families of children with disabilities: specific problems and models of support

Studies show that families with one or more children with disabilities face a series of specific problems, in addition to those with typical children, as a result of special living situations, difficulties in coping with child care, material, medical problems, socialization and restricted communication with relatives or the community. The therapy addressed to children and adolescents with disabilities did not take into account from the beginning the need for support for their parents, who form their main support. The family can be part of the therapeutic recovery process, in addition to its primary role as parents, but for this, it is necessary that its condition and functioning and that of its members be optimal.

Using community organizing to build a system of care: A mixed methods evaluation

AbstractThe purpose of this study was to utilize mixed methods to evaluate the initial implementation of a system of care (SOC) developed and implemented from a community organizing framework. Surveys were conducted with partners (navigators, community partners, parents) to examine changes pre‐ and post‐implementation of the SOC. Surveys assessed care coordination, effectiveness of communication across organizations, quality of services and relationships, barriers, health‐related stressors, and distrust. Surveys were conducted at baseline and follow‐up approximately 1 year later. At baseline, 160 parents and 40 community partners completed surveys. At follow‐up, 125 parents and 33 community partners participated. Qualitative interviews and focus groups were conducted with participating community‐based organization staff (n = 10), community navigators (n = 13), school staff (n = 10), and recipients of services (n = 13). Parent surveys suggested promising improvements in care coordination, communication, and quality of services. These results were supported by qualitative themes describing increased communication, care coordination, relationships, and access to services driven by community navigators. Despite these encouraging findings, surveys completed by community partners did not reveal significant changes. Findings must also be understood within the context of COVID‐19.

Providing ‘professionalism with compassion’; how the time for caring communication can improve experiences at the end-of-life at home, findings from a realist evaluation

BackgroundFor many patients and caregivers, attending to dying and death at home will be a new and fearful experience. This research brings new evidence on the central support of the Rapid Response Service (RRS), provided to those who chose to die at home. RRS’s are variable, although all seek to avoid unwanted hospital admissions and to respond flexibly to suit individual preferences for support. Staffed by specialist palliative and end-of-life care nurses, the RRS works alongside primary and acute care, but little is known on their impact.MethodsRealist evaluation is a theory driven approach which identifies patterns of generative causation; this approach ascertains what works, for who, why, and in what circumstances. In this study, initial theories were developed by the research team and subsequently tested through semi-structured realist interviews with patients, caregivers, RRS staff, and other health practitioners. Iterative rounds of data analysis were undertaken to tease out contexts, mechanisms and outcomes, testing and revising the theories, including the application of substantive theory. Finally, we produced refined programme theories (PTs) which provide the basis for wider application of findings.ResultsOverall, 36 participants contributed, and six areas of inquiry were developed. This paper sets out the data from one area, PT Skilled Communication. Several benefits arose from RRS staff having the time to talk to and with patients and caregivers: specifically, that this communication improved knowledge in a tailored and compassionate manner. These exchanges allayed fears and reduced uncertainty, improving confidence to care. This was particularly embedded in one RRS because of their holistic approach.ConclusionsSupporting death and dying at home is a novel and difficult experience for many; skilled communication, provided by specialist palliative care staff, can make a positive difference. Through their provision of compassionate support, RRS staff can help caregivers to recognise and respond to different symptoms and situations, reducing fear. By responding rapidly, only on request, they also meet individual preferences for contact. Together, this improves the opportunity for the last days and hours of life to be experienced, at home, in as affirmative a manner as possible.

How bereaved families conceptualise good care and communication in intensive care in South Australia

Since 2018, DonateLife South Australia and the Royal Adelaide Hospital (RAH) have collaborated to deliver routine family follow-up after bereavement in the intensive care unit (ICU). This follow-up includes a telephone interview that invites bereaved family members to comment on the quality of care and communication experienced in the ICU. To identify bereaved families’ experiences, including how they conceptualise good care and communication in intensive care, an analysis was conducted on all qualitative data collected during 118 interviews completed between 1 February 2018 and 30 May 2019. Reflexive thematic analysis was undertaken in an inductive and semantic way, with coding and theme generation being directed by the explicit content of the data, as conceptualised by Braun and Clarke. Initial codes were based on the interview questions, then additional codes were created during data analysis. Coding was informed by philosophical insights about concepts and the spirit of interpersonal engagement developed by Wittgenstein and Cordner, respectively. A concept map of the relationships observed between patterns of meaning in the data was created. Participants deeply appreciated staff providing them and their loved one with practical expressions of care and hospitality, however modest. These, along with staff sometimes crossing professional boundaries, expressed staff’s spirit of engagement, which in turn helped to maintain the patient’s dignity. Private space also helped to maintain the patient’s dignity, and it helped family to have enough time to say goodbye. Family not feeling rushed and being informed about their loved one dying also helped family to have enough time to say goodbye. Being informed depended on the quality of doctors’ communication. When family were not clearly informed, or had to wait long periods, they felt rushed and that they did not have enough time to say goodbye. Documents written to guide the assessment of intensive care comment on almost all of these matters, but the present study newly maps how they interact based on the extensive empirical evidence that it collected. Guidance documents should comment on giving staff scope to occasionally traverse a boundary, such as an institutional border or rule, to better support the patient and family, since families experience exceptionless practice insensitive to context as callous or disruptive of care.

Comprehensive training in psychodermatology: the diploma course of the European Society for Dermatology and Psychiatry

Psychodermatological conditions play an important role in dermatological practice. The biopsychosocial disease model is of central significance. Psychodermatological knowledge is underrepresented in specialist training and medical care. There is aneed for continuing education offers for primary psychodermatological disorders as well as for skin diseases related to psychological stress. The work comprises adescription of the structure, organization, and content of the diploma course offered by the European Society for Dermatology and Psychiatry (ESDaP), along with apersonal conclusion after completing the course. Continuing education in the diagnosis and treatment of psychodermatological disorders should be an integral part of dermatology training. The ESDaP diploma course conveys knowledge regarding psychosomatic dermatology and dermatopsychiatry. The target audience includes dermatologists, psychologists, psychiatrists, and psychotherapists in training and practice. The two-level course offers foundational knowledge for those working with psychodermatological patients in level1, while level2 allows for advanced specialization. Additional requirements for obtaining the diploma include case presentations, lectures, and multiple-choice examinations. Psychological factors are common in dermatological patients and require effective and holistic management. The ESDaP diploma course provides in-depth knowledge and fosters skills in patient care and physician-patient communication.

Fostering Adherence to Evidence-Based Care in the Management of Musculoskeletal Shoulder Pain: A Mixed Methods Study.

The objective was to identify the priorities of individuals with musculoskeletal shoulder pain and their health care providers (HCPs) that are perceived to foster multi-stakeholder adherence to evidence-based recommendations. The study used a mixed methods design, informed by concept mapping. Patients with shoulder pain (ie, ≥6weeks) and HCPs involved in their care (recruited via social media, email, etc.) were invited to complete an initial survey to identify perceived priorities to foster adherence to evidence-based recommendations. Preliminary data sorting resulted in a final priority list, with a subset (n= 20) of respondents rating their importance using a Likert scale. A public and patient involvement (PPI) panel (N= 8) assisted in this rating phase, further sorting of priorities based on thematic similarities (ie, into categories and then domains), analysis, interpretation, and developing a concept map illustrating relationships between them. One hundred and fifty-four participants (HCPs = 133; Patients = 21) responded to the initial survey, generating 77 priorities, grouped into 13 categories, and then into 3 domains; 1) Education, 2) Patient-centred care, and 3) Health care communication. Patients prioritized categories relating to the provision of a specific diagnosis, the establishment of a strong therapeutic relationship, and the need for education on progress and recovery timelines, as well as treatment options. HCPs prioritized these same educational categories, also prioritizing the need for tailoring exercise therapy and providing a unified message on best management. PPI panelists identified education on treatment options coupled with a strong therapeutic alliance and a unified message on best management to be of pivotal importance in fostering adherence. Panelists also stressed that future knowledge translation resources must provide tailored education. HCPs and patients agree on the need to prioritize education related to progress and recovery timelines as well as treatment options, with a strong therapeutic alliance and a unified message on best management also considered of pivotal importance for adherence to evidence-based recommendations. To the knowledge of the authors, this is the first study, including a broad range of stakeholder groups spanning across 11 different countries, to explore the priorities that stakeholders perceived to support stricter adherence to evidence-based recommendations for musculoskeletal shoulder pain, with the relationship between these priorities visually illustrated using a concept map. Patients and HCPs were united in their prioritization of education relating to expected progress and recovery timelines, as well as treatment options and supporting evidence. Stakeholders also identified the need for greater emphasis to be placed on establishing a therapeutic relationship and on integrating shared decision-making into clinical practice to further facilitate adherence. Education relating to treatment options and supporting evidence, a strong therapeutic relationship, and a unified message on best management were perceived by the PPI panel as being pivotal in facilitating adherence to evidence-based treatment. The findings of this study highlight the need for improved tailoring of educational resources for shoulder pain, as well as more cohesive messaging from health care providers, both assisting in supporting first-line treatments, such as exercise therapy, for musculoskeletal shoulder pain.