Perceptions of shared decision-making among patients and dental professionals.

As an important part of surgery, breast surgery not only involves knowledge of related disciplines, but also involves a variety of disciplines such as psychology, pharmacology and physiology. This study aims to compare the effect of traditional teaching and sandwich joint teaching in the clinical teaching of granulomatous mastitis. A total of 80 breast surgery interns from January 2023 to January 2024 were selected according to different teaching methods, and 40 of them were selected as the control group using the traditional teaching method. The other 40 cases were taken as the experimental group and were taught by the sandwich joint case teaching method. The differences of assessment scores, mini-clinical evaluation exercise scores and stress were compared between the 2 groups after teaching. The scores of test group in theory, practice and comprehensive assessment were higher than those of control group, and the difference was statistically significant (P < .05). In terms of mini-clinical evaluation exercise scores, the experimental group was significantly higher than the control group in clinical judgment, medical reading, communication skills, humanistic care, organizational effectiveness, overall performance and teacher satisfaction, with statistical significance (P < .05). In terms of Beck stress score, the study and interpersonal stress in the experimental group were significantly higher than those in the control group, and the difference was statistically significant (P < .05). The combined sandwich case teaching method can improve students’ grades, problem-solving ability, interaction and communication skills, and reduce learning and interpersonal pressure.

Patients newly diagnosed with acute leukemia or lymphoma face an immediate life-threatening condition and the need for rapidly initiated intensive therapy within specialized hematology settings. These circumstances can trigger significant psychological distress and post-traumatic stress symptoms (PTSS), which may influence treatment adherence, patient–clinician communication, and early clinical outcomes. A total of 68 patients with newly diagnosed acute leukemia or lymphoma completed validated questionnaires assessing PTSS and psychosocial risk factors at the time of diagnosis. PTSS were common, with 33% of participants reporting moderate-to-severe PTSS. Regression analyses identified practical difficulties (transportation, childcare, work/school, financial issues) and recent bereavements as risk factors for PTSS beyond age, gender, and diagnosis. These findings highlight the importance of early detection and management of PTSS for psychological care and may have direct clinical implications for overall hematologic care outcomes. Implementing systematic psychological screening at diagnosis could therefore improve patient-centered hematology care.

Enhancing clinical communication skills through podcast-based scenario dialogues and shadow play: A mixed-methods study in multilingual nursing education.

Are answers obtained from artificial intelligence models for information purposes repeatable?

Medical Apps for Physicians: Leveraging MHealth to Enhance Healthcare.

Effects of a "credit bank" intervention on the professional identity and public stigma among nursing students: A randomized controlled trial.

Contextualizing Clinical Communication Models for Ethical Practice: A Comprehensive Narrative Review with Implications for Health Professions Education

HLA typing challenges in organ donation after transplant.

Objectives: This study qualitatively explored the learning experiences of dental hygiene students who participated in an international clinical training program based on guided biofilm therapy (GBT), focusing on their perceptions of clinical communication, self-efficacy, professional identity, global competence, and a prevention-centered approach to dental care. Methods: Ten undergraduate dental hygiene students from a university in Korea participated in an international clinical training program conducted from August 16 to 30, 2025. Data were collected through post-program in-depth interviews and daily reflective learning journals. Qualitative content analysis and thematic analysis were performed, and trustworthiness was ensured through member checking, peer debriefing, and data triangulation. Results: Five overarching themes emerged: confidence in clinical communication, enhanced self-efficacy, expanded professional identity awareness, the development of global communication competence, and a shift toward a prevention-centered clinical perspective. Structured GBT stages and practicebased learning supported the understanding of the clinical communication flow and reduced the psychological burden during patient interactions. Multicultural clinical experiences also promoted cultural openness and awareness of global competence. Conclusions: These findings provide foundational evidence for the incorporation of prevention-centered, practice-based, and internationalized educational approaches into dental hygiene curricula.

Purpose: This study aimed to develop and validate a multidimensional role transition scale for new graduate nurses (RTS-NGN) that captures both the theoretical perspectives and contextual characteristics of Korean clinical settings.Methods: An initial item pool was generated through an extensive literature review and then refined through expert content validation and pilot testing. Psychometric evaluation was performed using two separate samples. Exploratory factor analysis identified the underlying structure, while confirmatory factor analysis verified construct validity. Convergent validity was examined using the average variance extracted (AVE) and composite reliability (CR), and discriminant validity was confirmed by comparing the square root of AVE with inter-factor correlations. Concurrent validity was assessed using a Transition Shock scale. The reliability was assessed using Cronbach’s alpha and CR.Results: A six-factor structure comprising the following 35 items was finalized: clinical competence, communication competence, professionalism, self-efficacy, stress management, and organizational adaptation. The model demonstrated a good fit (comparative fit index &gt;.90, Tucker–Lewis index &gt;.90, root mean square error of approximation &lt;.08). The AVE and CR supported convergent validity, and discriminant validity was confirmed for all factors. A moderate negative correlation with the Transition Shock scale provided evidence of concurrent validity. The internal consistency reliability was excellent across all subscales.Conclusion: The RTS-NGN is a psychometrically sound instrument that captures the positive and multifaceted aspects of role transition among new graduate nurses. It can be used to assess transition readiness, evaluate educational and residency programs, and guide organizational strategies to support early career nurses.

To explore men's assisted reproductive technology (ART) experiences, awareness and concerns about fertility-associated health outcomes, and perceptions of using administrative health records in the United Kingdom (UK) without consent to investigate these outcomes. Over a 2-year period, all adult men were eligible to complete an anonymous online survey distributed via a UK-based fertility charity's social media. Free-text responses underwent thematic analysis, and categorical responses were analysed with descriptive statistics and Fisher's exact test. Among 80 participants, most were aged ≥ 40 (66.7%), completed university (70.2%), White (77.2%), and UK residents (83.0%). Older (p = 0.004) and White (p = 0.001) men more likely underwent ART. Most ART users received treatment privately (60%) within the past three years (71.4%). Only one-fifth of the 15 men with identified fertility problems received discussion on fertility-associated health outcomes in clinic. Regarding perceptions, most were unaware of but concerned about these outcomes across biopsychosocial aspects, with participant quotes reflecting uncertainty and vulnerability. Recency of ART was associated with awareness (p = 0.015) and concerns (p = 0.001). Overall, 90.3% supported using administrative health records to investigate long-term health of fertility-challenged men, and 84.2% had no concerns about doing so without individual consent under established legal frameworks. Others raised concerns about the reliability of data anonymisation. Quotes suggested participants' desire to understand the wider health implications of male fertility amidst a perceived gender imbalance in fertility research. Gaps in participant knowledge, clinician communication, and research in male fertility-associated outcomes support the need for universal education and further investigations in these outcomes.

Serious illness communication (SIC) is a series of complex, iterative conversations between patients, their caregivers, and clinicians in which a patient's understanding of their illness, preferences, values, and medical decisions are addressed. An essential part of SIC for patients with chronic lung disease is communication about lung disease progression. How patients interpret clinician communication about lung disease progression is unknown. This study sought to understand how patients experience communication about the future of lung disease and how this influences a patient's understanding of their disease. Semi-structured interviews. Transcripts were analyzed using content analysis. Participants were veterans and had chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and/or pulmonary hypertension. Twenty-two patients were approached and completed interviews. Participants were a mean age of 71 years; female, 9%; white, 64%; and non-Hispanic, 86%. Four themes emerged. (1) Gaps in understanding of lung disease: Participants did not know about future exacerbations of lung disease. (2) Burden: Participants did not want to burden family members, which motivated a desire for information about how to manage their lung disease and plan for future care needs. (3) Mistrust: Participants were mistrustful about a potential link between military exposures and lung disease. (4) Information needs: Participants wanted information about daily life, causes of lung disease, test results, and time remaining. There are information needs among veterans with chronic lung disease regarding exposures, causes of lung disease, and managing lung disease. Future work should explore how to address veterans' unmet SIC needs.

We sought to investigate the current state of education to support person- and whānau-centred care (PWCC) in our setting and to inform a new approach to teaching and learning. Additionally, we investigated the potential use case of an artificial intelligence (AI) tool to enable clinical communication skill development. A mixed-method co-design approach was used, combining data from a consumer group, an anonymous staff survey (n=312) and a clinician focus group. The project captured lived experiences of communication in clinical care, enablers and barriers to effective training, and perspectives on future educational innovations including AI. Consumers emphasised the importance of individualised, culturally safe communication and clear, jargon-free language. Findings confirmed that while clinicians generally gain confidence with experience, existing training in communication and PWCC is inconsistent and often inaccessible. Clinicians identified a need for more frequent feedback and practical opportunities for skill development. This feedback should be from a person and whānau perspective. Notably, 90% of clinicians expressed openness to using an AI-based tool for improving communication skills. Traditional workplace education models are insufficient to meet the growing need for effective PWCC, including culturally safe communication in healthcare. An AI-enabled, feedback-driven tool may present a viable complementary solution to current offerings, provided it is co-designed with consumers and clinicians, is culturally grounded and is integrated into existing systems. Further investigation into the development and validation of a tool is warranted.

In 2023, the National Comprehensive Cancer Network® (NCCN®) updated its guidelines for managing breast cancer risk in patients with a CHEK2 p.I157T variant, recommending de-escalation of enhanced screening based on this variant alone. This shift reflects evidence that some missense variants carry a lower cancer risk than CHEK2 loss-of-function variants. A reduced cancer risk is particularly well established for the CHEK2 p.I157T variant, prompting the updated guidelines. This study examines healthcare providers' understanding of these updated guidelines and explores how providers communicate these changes to patients affected by hereditary cancer risks. We conducted a survey targeting healthcare providers involved in hereditary cancer management, capturing their perceptions of the clinical implications of CHEK2 p.I157T and the approaches used to communicate de-escalated management recommendations. Additionally, a retrospective records review was performed to approximate the percentage of patients impacted by these de-escalation recommendations. This research aims to evaluate factors shaping provider recommendations and communication following guideline changes in hereditary cancer care. Results may inform best practice considerations for patient-provider communication in hereditary cancer care, particularly when new evidence leads to modified screening or management recommendations.

PurposeHospice care is a patient- and family-centered approach to end-of-life care that prioritizes comfort, symptom management, and psychosocial support while foregoing curative treatment. Hospice care improves quality of life and care at the end of life. Despite its benefits, hospice remains underutilized by racially and ethnically diverse people, sexual and gender minorities, and socioeconomically marginalized populations.FindingsGuided by the Social Ecological Model, the objectives of this narrative review are to (a) discuss disparities in hospice care use, (b) explore multidimensional levels and factors contributing to such disparities, and (c) outline implications and imperatives for improving access to and use of hospice care. This review revealed that hospice care disparities are shaped by interacting factors across societal, structural, healthcare system, interpersonal, and individual levels. Historical context, policy design, geographic and socioeconomic constraints, clinician communication, and cultural beliefs collectively influence patterns of access, timing, and utilization of hospice care. System-level solutions include integrating hospice referrals into routine care workflows, improving hospice-related policies, strengthening partnerships with community organizations, and transitional care research. Clinicians are uniquely positioned to identify care preferences, advocate for timely referrals and support the hospice transition, and build trust with patients and families at the end of life.ConclusionsEfforts across clinical settings, policy, and research are critical to improving hospice care use, and ensuring that all seriously ill individuals benefit from goal-concordant, high-quality hospice care. Reducing hospice care disparities will require coordinated, multilevel interventions that address policy and healthcare system factors while strengthening hospice-related communication and care.

Hyperkinetic movement disorders, characterized by complex and overlapping motor patterns, present significant challenges in classification and treatment. The inconsistency in definitions and descriptors complicates both research and clinical communication. This study aims to provide an overview of current terminology and definitions related to spasticity and other hyperkinetic movement disorders associated with central nervous system lesions. We propose a unified terminology and classification system for spastic movement disorders (SMD). In this scoping review, definitions of spasticity, dystonia, tremor, chorea, hemiballismus, athetosis, myoclonus, and dyssynergia were reviewed, with emphasis on overlaps and diagnostic challenges among these disorders. The goal was to develop a consensus expert opinion on a phenomenological approach to SMD. The proposed classification system for spasticity includes clinical characteristics (Axis 1) and etiology (Axis 2). Axis 1 includes: age at onset, body distribution, disease course, phenomenological description, and impact on body function, activity, and participation. The phenomenological description allows sub-classification of SMD into: phasic reflex overactivity, stimulus-induced muscle overactivity, constant muscle overactivity, and lack of muscle selectivity. These categories clarify disabling phenotypes such as clonus, dysregulated co-contraction, muscle spasms, activity-induced muscle hypertonia, associated reactions, and persistent muscle hypertonia. This framework for classification of SMD aims to establish a common language for describing clinical phenotypes. By adopting a phenomenological approach, we underscore the importance of consistent descriptors and propose a systematic classification method for movement disorders, particularly spasticity. We hope this unified terminology will enhance clinical practice, research, and ultimately, patient care.

Language shapes scientific interpretation, clinical decision-making, and public understanding of autism. Although much attention has focused on identity-first versus person-first terminology, little is known about how researchers describe behaviors targeted for reduction (e.g., aggression, self-injury). We examined how the terminology used to label such behaviors in autism intervention single-case research has changed over the past three decades, quantifying shifts across journals and years to evaluate the extent to which the field has moved away from consistent, standardized terminology. A bibliometric prevalence analysis was conducted across six journals with a history of publishing single-case experimental design (SCED) research related to autism or problem behavior. All articles published in 1994, 2004, 2014, and 2024 were reviewed (n = 2326). Articles were included if they measured a behavior targeted for reduction using an SCED and used one of 12 predetermined behavior-related terms. Interrater agreement was 100%. Frequency data were analyzed descriptively and using Kruskal-Wallis tests. Across 189 included articles, terminology diversity increased by 22% from 1994 to 2024. Use of problem behavior declined sharply in 2024, while challenging behavior increased markedly. Disruptive behavior and target behavior remained stable. Significant differences were observed across both year (H = 38.07, p < .001) and journal (H = 14.42, p = .0132). Behavior-related terminology in autism research has become increasingly heterogeneous, with a notable shift away from the term problem behavior. These changes likely reflect evolving editorial practices and sociocultural influences rather than empirical evidence. Greater transparency, consistency, and stakeholder input are needed to ensure that language choices advance, rather than obscure, scientific and clinical communication.

ABSTRACT As telehealth becomes increasingly central to cancer care, many patients still report low confidence navigating digital communication with providers. Grounded in self-determination theory, this study investigates how patient-centered communication (PCC) in clinical settings can foster patient activation, thereby enhancing patients’ efficacy in using telehealth tools. Using a sample of 495 Chinese cancer patients with telehealth experience, we conducted path analysis to examine how six PCC functions relate to four progressive stages of patient activation (role importance, confidence, action, and endurance), and how these, in turn, predict telehealth efficacy. PCC functions such as shared decision-making and support for self-management significantly predicted higher levels of patient activation. Activation stages, particularly role importance and action, were associated with stronger telehealth efficacy. PCC effects on efficacy were fully mediated by activation stages, suggesting an internalization pathway where clinical communication transforms into patients’ self-confidence and competence in telehealth contexts. By linking PCC to telehealth efficacy through motivation dynamics, this study advances both theoretical and practical understandings of telehealth care. To support confident use of telehealth among cancer patients, providers should adapt communication strategies that go beyond information delivery to build patients’ autonomy and competence, especially among vulnerable populations with low digital confidence.

This study investigates how linguistic structures and metaphorical frameworks in patient narratives shape coping strategies, emotional resilience and agency among people living with cancer. Semistructured interviews with 10 participants were analysed thematically, revealing four key patterns: rejection of militaristic metaphors in favour of journey-based narratives, narrative coherence and identity reconstruction, cognitive reframing and meaning-making, and the role of social support in emotional regulation. Illustrative participant quotes demonstrate how individuals actively reshape their illness stories to assert agency, integrate emotional experiences and maintain psychological stability. Findings highlight the influence of language and metaphor on patient well-being, showing that narrative framing and emotional agency are closely intertwined with relational and clinical communication outcomes. These insights provide actionable guidance for clinicians, suggesting that adopting narrative-sensitive and metaphor-sensitive approaches can enhance patient engagement, emotional adaptation and culturally sensitive care. This study underscores the value of integrating qualitative narrative analysis into oncology practice, offering an empirically grounded framework for interventions that support patient empowerment and holistic care.