Health Care Provider Communication Research Articles

Patient-caregiver dyad concordance of transition readiness assessment for adolescent with cancer: A network analysis.

The concordance of adolescents with cancer and caregivers was examined, and the core elements of transition readiness were identified. In this cross-sectional study, 196 adolescent-caregiver dyads completed the Chinese version of Self-Management and Transition to Adulthood with Rx = Treatment Questionnaire and its parent version between March 2023 and August 2023. Intraclass correlation coefficients, paired t-tests and network analysis were used for data analysis. Caregivers reported slightly lower scores for transition readiness than adolescents (3.28 vs. 3.32). Healthcare engagement and provider communication were core elements in transition readiness networks. At the dyad level, agreement between adolescents' and caregivers' transition readiness ranged from poor to fair (intraclass correlation coefficients 0.103-0.486), and a significant difference in structure was found between the two networks. Caregivers tended to underestimate adolescents' transition readiness. Attaining better concordance between adolescents and family caregivers is critical to aligning roles and responsibilities in the transition process. This study extends the evidence on the variation in adolescents' transition readiness, clarifying the complex associative relationships among the elements of transition readiness, which can be potential pathways for improving transition readiness. Second, this study is the first to assess transition readiness from a dyad's perspective. The findings highlighted the patient-caregiver incongruence in rating patients' transition readiness, suggesting that targeted dyadic interventions should be developed and implemented to improve patient-caregiver transition readiness concordance, facilitate effective communication and mutuality between patients and caregivers, and contribute to their collaboration during the transition of adolescents and optimization of outcomes. WHAT PROBLEM DID THE STUDY ADDRESS?: Increased long-term survival rates of survivors of paediatric cancer highlighted the significant need for care continuity. Transitional readiness is an important predictor of adolescent survivor's ability to adapt to a long-term survival period. Assessments of adolescents' transition readiness are limited and overlook the synergies between family caregivers and adolescents in the transition period. WHAT WERE THE MAIN FINDINGS?: The levels of agreement on rating transition readiness varied from poor to fair among adolescent-caregiver dyads, and caregivers tended to underestimate adolescents' transition readiness. The findings highlighted the patient-caregiver incongruence in rating patients' transition readiness. Targeted dyadic interventions should be developed and implemented to improve patient-caregiver's transition readiness concordance, and facilitate effective communication and mutuality between patients and caregivers. Study methods and results reported in adherence to the STROBE checklist. No patients or members of the public were involved in the study. The main findings introduce pathways for improving transition readiness, which can enhance healthcare transition among other medical populations.

Consequences of COVID-19 Vaccine Hesitancy Among Healthcare Providers During the First 10 Months of Vaccine Availability: Scoping Review.

Throughout the COVID-19 pandemic, healthcare providers (HCPs)-including nurses-have played important roles in the vaccination effort. It is expected that COVID-19 vaccine hesitancy among HCPs has numerous consequences; however, the scope of these consequences and their impacts on providers, patients, and the broader healthcare system remained unclear. To identify existing and emerging evidence to understand the state of knowledge of the consequences of COVID-19 vaccine hesitancy among HCPs. A scoping review was completed based upon the JBI scoping review methodology. The databases searched included OVID Medline, EBSCOhost CINAHL, ProQuest Nursing and Allied Health Source, ProQuest APA PsycInfo, and ProQuest Dissertations and Theses. The final literature search was completed on June 2, 2022. Studies were screened and retrieved based on predefined inclusion and exclusion criteria using Covidence reference management software. Data extraction followed criteria recommended in the JBI scoping review framework with additional relevant variables identified by the authors. A total of 33 sources were included in the review. Consequences of HCP COVID-19 vaccine hesitancy were grouped under three themes and seven subthemes. Consequences affecting HCPs included health-related, psychosocial, and employment-related consequences. Consequences affecting patients pertained to COVID-19 vaccination communication and COVID-19 vaccination practices of HCPs. Consequences to the healthcare system involved consequences to coworkers and employment/attendance/staffing-related consequences. Healthcare provider COVID-19 vaccine hesitancy was found to have numerous consequences. By understanding the scope and extent of these consequences, healthcare leaders, researchers, and HCPs can work together to protect providers, patients, and healthcare systems.

Health care providers' communication with pediatric patients and carers: a best practice implementation project.

Health care providers need a high level of communication skills in dealing with pediatric patients and their carers. The objective of this project was to evaluate current practice and implement best practices promoting health care provider communication with pediatric patients and carers in a children's hospital in Tabriz, Iran. This project used the JBI Model of Evidence-Based Healthcare, which guided the conceptualization of evidence implementation, context analysis, project implementation, and evaluation of outcomes using evidence-based quality indicators. An audit and feedback strategy was adopted to measure baseline compliance with best practices, develop strategies to address areas of non-compliance, and conduct a final audit to measure any changes in compliance. Four criteria were developed for the baseline and follow-up audits. Criteria 1 and 2 were evaluated using a sample of 30 health care providers, while Criteria 3 and 4 were evaluated using a sample of 80 pediatric patients and carers. All four criteria improved at the end of the project. Criterion 1 (health care staff receive communication skills training) had the highest mean score at baseline and follow-up (63% and 83%, respectively). Criterion 2 (implementation of local strategies by health care organizations) increased from 45% to 55%. However, this rate of improvement was the lowest of all the criteria. Criterion 3 (pediatric patients receive relevant education) improved from low to moderate, rising from 18% to 49%. A more significant improvement was noted for Criterion 4 (parents receive relevant education), which rose from 19% to 56%. The strategies implemented in this project successfully improved health care provider communication with pediatric patients and their carers. To ensure project sustainability, repeat audits will be conducted after 3, 6, and 12 months. http://links.lww.com/IJEBH/A199.

Entrustable professional activities-based objective structured clinical examinations in a pharmacy curriculum

Entrustable professional activities-based objective structured clinical examinations in a pharmacy curriculum

Facilitating coordination between medical and educational systems to improve access to pediatric therapies for preschool children with developmental delays and disabilities.

A large portion of preschool-age children with developmental delays and disabilities (PCw/DD) do not receive recommended therapeutic services, including legally mandated school-based therapies. This study examines the feasibility of a community-clinical linkage using virtual patient navigation and a medical-educational care plan called Preschool and Me (PreM) to connect clinical settings serving historically marginalized communities with early childhood special education (ECSE) services. Parents of PCw/DD attending an urban pediatric clinic from January to March 2022 were enrolled to receive PreM which included navigation support for ECSE, overcoming barriers accessing ECSE, and health care provider communication. Families completed measures of demographics and indicators of feasibility at baseline and 4-month follow-up. Of the 34 families referred, 30 were eligible and enrolled. Most parents identified as mothers (97%). Most participant children (70% male, 60% Black, 30% Hispanic) were enrolled in public health insurance (93%) and were not receiving any clinic-based therapies (93%). Parents overwhelmingly found PreM acceptable with the majority stating it would be a strong reason to continue care at the clinic. Among families who received PreM, 26 (96%) completed an individualized education plan (IEP) evaluation (96%). Of these, 24 (92%) children were eligible for an IEP. Nineteen children enrolled in an ECSE program; two families awaited school assignments and three families did not consent to the assigned school placement due to neighborhood safety concerns. Our findings suggest PreM was feasible, acceptable, and demonstrated promise in supporting families to navigate the ECSE process. Future studies examining effectiveness are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Healthcare provider Communication and Data-Informed Message Strategies for Encouraging Older Adults to Stay up to Date on COVID-19 Vaccination.

Older adults are a high in risk of severe COVID-19 disease outcomes and experience "vaccine hesitancy." Guided by health communication models such as the Reasoned Action Approach and the Extended Parallel Process Model, online surveys designed to inform statewide public health communication efforts were administered in West Virginia, a primarily rural and fully Appalachian state, in Winter 2021 (n = 272) and Fall 2022 (n = 248). Adults ages 50+ years (N = 520) reported attitudes, intentions, and behaviors regarding COVID-19 vaccination and their related patient-provider communication. Vaccine usefulness/safety, perceived effectiveness, and subjective norms predicted behavior while perceived severity, efficacy, and usefulness/safety predicted intention to get a booster, specifically the updated Fall 2022 Omicron (bivalent) booster. As patient-provider communication (which a minority reported receiving) was a strong predictor of behavioral outcomes, characteristics of effective healthcare provider communication and considerations for public message construction are discussed.

The COMFORT Model: Moving the Initiative Outside of the Academy

ABSTRACT Reflexive and prospective in nature, the creators of the COMFORT model describe experiences of moving this research outside of the academy. The COMFORT model represents the seven basic principles of healthcare provider communication: C – Connect, O – Options, M – Making Meaning, F – Family Caregivers, O – Openings, R – Relating, T – Team. The COMFORT initiative began as a call for change in healthcare communication education. Originally published as a final chapter in a volume on family and palliative care communication, it was the start of an extensive translational program of trainings and tools addressing healthcare provider communication.

Harris Poll Migraine Report Card: population-based examination of high-frequency headache/migraine and acute medication overuse

BackgroundMigraine is a disabling neurologic disease that can fluctuate over time in severity, frequency, and acute medication use. Harris Poll Migraine Report Card was a US population-based survey to ascertain quantifiable distinctions amongst individuals with current versus previous high-frequency headache/migraine and acute medication overuse (HFM+AMO). The objective of this report is to compare self-reported experiences in the migraine journey of adults with HFM+AMO to those who previously experienced HFM+AMO but currently have a sustained reduction in headache/migraine frequency and acute medication use.MethodsAn online survey was available to a general population panel of adults (≥18 years) with migraine per the ID Migraine™ screener. Respondents were classified into “current HFM+AMO” (within the last few months had ≥8 headache days/month and ≥10 days/month of acute medication use; n=440) or “previous HFM+AMO” (previously had HFM+AMO, but within the last few months had ≤7 headache days/month and ≤9 days/month of acute medication use; n=110). Survey questions pertained to demographics, diagnosis, living with migraine, healthcare provider (HCP) communication, and treatment.ResultsParticipants in the current HFM+AMO group had 15.2 monthly headache days and 17.4 days of monthly acute medication use in last few months compared to 4.2 and 4.1 days for the previous HFM+AMO group, respectively. Overall, current preventive pharmacologic treatment use was low (15-16%; P>0.1 for current vs previous) in both groups. Previous HFM+AMO respondents reported better current acute treatment optimization. More respondents with current (80%) than previous HFM+AMO (66%) expressed concern with their current health (P<0.05). More than one-third of both groups wished their HCP better understood their mental/emotional health (current 37%, previous 35%; P>0.1 for current vs previous) and 47% (current) to 54% (previous) of respondents worried about asking their HCP too many questions (P>0.1 for current vs previous).ConclusionApart from optimization of acute medication, medical interventions did not significantly differentiate between the current and previous HFM+AMO groups. Use of preventive pharmacological medication was low in both groups. Adults with current HFM+AMO more often had health concerns, yet both groups expressed concerns of disease burden. Optimization of acute and preventive medication and addressing mental/emotional health concerns of patients are areas where migraine care may impact outcomes regardless of their disease burden.Graphical

Barriers and Facilitators to Screening for Kidney Disease Among Older Adults with Hypertension and Diabetes in Mbarara Southwestern Uganda: Healthcare Providers' Perspective.

Screening for kidney disease (KD) among high-risk patients (patients with hypertension or diabetes) allows early diagnosis, intervention and delayed progression of the disease. In low- and middle-income countries (LMIC), KD screening is still sub-optimal. This study explored the healthcare providers' perceived barriers and facilitators to KD screening among older adults with hypertension and diabetes in Mbarara southwestern Uganda. This was a descriptive qualitative study among healthcare providers caring for older adults with diabetes mellitus and hypertension at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed to develop themes of barriers and facilitators. We conducted 30 in-depth interviews among healthcare providers. Barriers to screening for kidney disease included patient related factors according to healthcare providers (financial hardships, poor health seeking behavior, limited knowledge and awareness), healthcare factors (work overload, ineffective patient healthcare provider communication) and system/policy related factors (lack of laboratory supplies, lack of guidelines and poor medical record keeping and documentation). With respect to facilitators, we found formation of peer support groups, effective team, and continuous medical education (CME). Healthcare providers encounter substantial but modifiable barriers in screening older adults for KD. The identification of barriers and facilitators in timely KD detection gives us an outlook of the problem in Uganda and leads for proposals of action. Interventions that address these barriers and promote facilitators may improve the healthcare provider's effectiveness and capacity to care including screening for patients at risk of KD.

Parents’ Knowledge regarding the Significance of Immunization for Children: A Systematic Review

Background: Parents often lack specific knowledge about vaccines schedules, lesser-known diseases, and vaccines safety. Enhancing parents’ knowledge about immunization is essential for informed decision-making and promoting vaccine acceptance. Objective: This systematic review aimed to identify the parents’ knowledge about immunization, including their understanding of immunization concepts, knowledge gaps, and misconceptions. The review explored the factors influencing parents’ knowledge, such as socio-demographic factors, cultural and religious beliefs, sources of information, healthcare provider communication, and vaccine hesitancy. Methods: A literature search was conducted by viewing relevant studies via computerized searching through PubMed, Scopus, and Embrace. Results: The number of reviewed studies was 137, all in English and none in Arabic. Only 47 of them were selected based on inclusion criteria. Misconceptions, such as concerns about vaccine ingredients or false associations with adverse events, contribute to vaccine hesitancy. Socio-demographic factors influence parents’ knowledge, including age, education, and income. Cultural and religious beliefs shape their understanding, and sources of information, such as healthcare providers and media, play a significant role. Conclusion: Addressing knowledge gaps and misconceptions requires strengthening healthcare provider communication, targeted educational interventions, regulation of online information, collaboration with community stakeholders, and longitudinal research.

Neighbourhood Care Teams: Integrating Health Care and Social Services for Seniors in Toronto Community Housing

Toronto Seniors Housing Corporation (TSHC), owned by the City of Toronto, provides housing for 15,000 low-income seniors in 83 seniors-designated buildings across Toronto. The North Toronto Ontario Health Team (including primary care, hospital, community and home-care) partnered with one of the TSHC buildings in North Toronto to develop and implement a Neighbourhood Care Team (NCT) model to support TSHC’s Integrated Service Model to address tenants' health and social needs, co-designed with the tenants. The goal of the NCT is to provide an integrated model of care that is accountable to meeting the needs of people living within a specific neighbourhood so that people experience one system that provides simple access to service, and care that is coordinated with streamlined communication of health care providers.&#x0D; The NCT objectives include:&#x0D; &#x0D; Increasing primary care provider connections&#x0D; Increasing mental health &amp; addictions care access and support options&#x0D; Increase Digital Health access and literacy to support primary care and specialist access, reduce social isolation and increase wellness&#x0D; Reduce avoidable ED and hospital use.&#x0D; &#x0D; The service design is guided by a co-design process with the tenants as follows:&#x0D; &#x0D; Door to door survey to engage tenants in identifying their barriers and the services and supports most meaningful to them&#x0D; Eliciting and voting on key education and support initiatives at an influenza vaccination clinic&#x0D; Communication back to tenants regarding the results of the survey and how the strategies/activities planned for the building have been prioritized based on their feedback.&#x0D; Multi-organization Education Fair focusing on the top issues addressed during the vaccination clinic survey which was well attended&#x0D; Regular educational sessions in response to tenant interest, combined with a self-screening component to help link the information to a concrete service/intervention to promote better health.&#x0D; Providing translation support to enable access and engagement by tenants from a variety of cultural backgrounds.&#x0D; Ongoing commitment to continue and co-design services and elicit tenants’ feedback.&#x0D; &#x0D; The team has worked to design structures to strengthen coordination and collaboration among the various delivery partners:&#x0D; &#x0D; Multi-organizational bi-weekly huddles to discuss residents identified with unmet needs (with consent or anonymized without consent) and identify options for improving their access to health care/social services and respond to their needs in a timely manner&#x0D; Designed pathways for ensuring attachment to primary care, access to primary care and specialist support, access to home care services and assistance with social determinants of health&#x0D; Established mechanisms to obtain informed consent and enable information sharing between delivery partners.&#x0D; &#x0D; Multi-modality tenant engagement to tailor services and supports to a TSHC building has led to increased involvement by tenants and a growing interest by tenants in strategies to improve their health and social inclusion. Cross-sector collaboration is an efficient and effective way to establish needs-based integration of health and social care services in this setting. Strong leadership as well as co-developed processes, frequent building meetings and cross-sector huddles were effective ways of sharing innovative ways of meeting needs with limited resources.&#x0D; &#x0D; &#x0D; &#x0D;

Concept mapping brainstorming results for improving care transitions for adults with hip fracture in Ontario, Canada

Introduction: Individuals who have experienced a hip fracture often undergo numerous transitions in care between providers and sectors. These transitions are a time of vulnerability with the potential for poor health outcomes and experiences, yet there are limited recommendations on how to improve this care journey for adults with hip fracture.&#x0D; Target Audience: The target audience for our study include decision-makers and providers with a hip fracture portfolio, as well as patients who have experienced a hip fracture and their unpaid caregivers. &#x0D; Who was involved: This study included patient and caregiver partners. They were involved in the grant application, study participant recruitment, data collection, and final data analysis. This study also included healthcare provider and decision-maker partners who supported participant recruitment and will be knowledge users. &#x0D; Aims and Methods: The aim of this study was to create a list of actionable recommendations to improve care transitions for individuals with hip fracture from the perspectives of patients, caregivers, providers, and decision-makers. We used a mixed methods concept mapping approach, to gather perspectives from these key stakeholders in Ontario, Canada. Here, we report on the results of the first phase of the concept mapping study. Participants created a list of statements that they felt would improve care transitions for individuals who had experienced a hip fracture. The statements were analyzed inductively and grouped thematically. &#x0D; Results: Thirty-two individuals participated in the brainstorming phase of this study (2 patients, 5 caregivers, 21 providers, 4 decision-makers). They created 887 statements that were condensed by the research team into 72 final statements. The final statements were grouped into seven main themes and were divided into four domains for care transition improvement. The first is the patient-related domain, which encompassed two themes: self-management and self-management-support, and rehabilitation therapy and activities. The second domain is provider-related and includes: healthcare provider skills and communication and trust. The third domain includes two system-related themes: continuity of care and health system efficiencies. The last domain relates to care processes with one theme: transition planning and follow up care. &#x0D; Learnings for the international audience: Previous literature on improving care transitions has had focused primarily on the transfer of information between care providers with little emphasis on the caregiver/patient role. Our results, however, highlight the importance of meaningful patient and caregiver engagement, with active involvement in all aspects of care including the transition process. Further, many statements created by our participants included policies, assessments, and care specific to individuals with hip fracture and cognitive impairment/delirium, emphasizing this as an important area for consideration when aiming to improve care transitions. &#x0D; Next Steps: The next phases of concept mapping will be conducted, which will include statement sorting and rating (importance and priority). A final concept mapping session will be held integrating the qualitative and quantitative data and an opportunity to reflect on the findings with key stakeholders. Statements that are rated highly importance and priority will inform actionable recommendations to improve care transitions for hip fracture.

Patient-Reported Outcome Measures to Improve the Care Continuum for Patients With Metastatic Breast Cancer: Opportunities and Implications for Nursing Practice

ObjectivesAlbeit treatable, metastatic breast cancer (MBC) remains incurable. To achieve remaining life years lived well, extended survival should be balanced with optimal health-related quality of life (HRQoL) and timely initiated supportive, palliative, and end-of-life care. The Advanced Breast Cancer (ABC) Global Alliance identified 10 urgent and actionable goals for the decade between 2015 and 2025 to achieve substantial improvement in the lives of patients living with ABC, including MBC. Enhancements are needed for HRQoL, research, quality of care, and survival. We explore the potential of patient-reported outcome measures (PROMs) in addressing these gaps and aim to describe opportunities and current initiatives for improving the MBC care continuum through PROMs. Data sourcesNarrative description of recent literature on MBC and PROMs. ConclusionWe believe PROMs can make valuable contributions to seven of the 10 goals described: 1) enhancing the understanding of MBC through high-quality data collection, 2) improving HRQoL and raising consideration of survival versus HRQoL, 2) prolonging survival, 4) increasing referral to nonclinical support services, 5) supporting patient–healthcare provider communication, 6) encouraging improvements in healthcare access, and 7) supporting meeting patients’ informational needs. Implications for Nursing PracticeMaximizing the benefits of PROMs requires effective implementation. Because nurses and nurse practitioners are at the forefront of care, they can offer a comprehensive understanding of patients’ needs and play a crucial role in facilitating the integration of PROMs into routine care for MBC patients and ultimately optimizing patients’ outcomes and life years and months left.

How to increase and maintain high immunization coverage: Vaccination Demand Resilience (VDR) framework

BackgroundResilience in vaccination demand is ever more critical as the COVID-19 pandemic has increased our understanding of the importance of vaccines on health and well-being. Yet timid demand for COVID-19 vaccines where available and reduced uptake of routine immunizations globally further raise the urgent need to build vaccination resilience. We demonstrate the complexity of vaccination demand and resilience in a framework where relevant dimensions are intertwined, fluid, and contextual. MethodsWe developed the Vaccination Demand Resilience (VDR) framework based on a literature review on vaccination demand and expert consultation. The matrix framework builds on three main axes: 1) vaccination attitudes and beliefs; 2) vaccination seeking behavior; and 3) vaccination status. The matrix generated eight quadrants, which can help explain people’s levels of vaccination demand and resilience. We selected four scenarios as examples to demonstrate different interventions that could move people across quadrants and build vaccination resilience. ResultsIncongruence between individuals’ attitudes and beliefs, vaccination behavior, and vaccination status can arise. For example, an individual can be vaccinated due to mandates but reject vaccination benefits and otherwise avoid seeking vaccination. Such incongruence could be altered by interventions to build resilience in vaccination demand. These interventions include information, education and communication to change individuals' vaccination attitudes and beliefs, incentive programs and reminder-recalls to facilitate vaccination seeking, or by strengthening healthcare provider communications to reduce missed opportunities. ConclusionsVaccination decision-making is complex. Individuals can be vaccinated without necessarily accepting the benefits of vaccination or seeking vaccination, threatening resilience in vaccination demand. The VDR framework can provide a useful lens for program managers and policy makers considering interventions and policies to improve vaccination resilience. This would help build and sustain confidence and demand for vaccinations, and help to continue to prevent disease, disability, and death from vaccine-preventable diseases.

'It depends on who is asking and why they will use it': Access to male condoms in Timor-Leste.

The uptake of male condoms remains markedly low in The Democratic Republic of Timor-Leste (Timor-Leste), an island nation in South-East Asia. To understand why, we conducted participatory and operational research about beliefs, understanding and access to male condoms from both a community and healthcare provider perspective. We held 14 participatory group discussions (PGDs) with 175 community participants (84 men, 91 women; aged 18-72) across seven municipalities (Ainaro, Baucau, Bobonaro, Dili, Lautem, Manufahi, and Oecusse) in 2019. We held individual in-depth interviews (IDIs) with 24 healthcare providers working in the same community catchment areas as the PGDs. Two counsellors, four doctors, fifteen midwives, and three nurses participated (16 women, 8 men; aged 25-56 years). Data were analysed using reflexive thematic analysis. PGD and IDI participant awareness, understanding and beliefs about male condoms were diverse. Male condoms were often discussed as something negative and taboo, and as something that is highly regulated and discouraged within society and the health system. However, many PGD and IDI participants also challenged this narrative by providing a more rights-based perspective about universal access to sexual and reproductive health information and services, including male condoms. Insights from our research have been used to inform programmatic decision-making in Timor-Leste, including health promotion and service delivery initiatives. Our findings can be further used to inform national health policy, healthcare provider training, and advocacy and communication work.

Geriatric Communication Skills Training Program for Oncology Healthcare Providers: a Secondary Analysis of Patient and Caregiver Outcomes.

Geriatric cancer patients and their caregivers have unique needs that make it difficult for their healthcare providers (HCPs) to effectively communicate with them. As ineffective communication can lead to negative health outcomes, it is important that oncology HCPs receive specialized training on communication with older adult patients and their caregivers. We conducted a small pilot study examining audio recordings of clinical encounters between HCPs and older adult cancer patients/caregivers and questionnaires completed by the patients and their caregivers before and after the HCPs participated in a geriatric communication skills training program. Eleven HCPs completed the 6-h Geriatric Comskil Training. Two clinic consultations with unique geriatric patients (n = 44) and their caregivers (n = 29) were recorded before and after training and coded for HCPs' use of communication skills. Patients and caregivers also completed surveys measuring their satisfaction with HCP communication and perceived empathy. Analysis of the audio recordings revealed that HCPs did not increase their use of communication skills after training. Although our sample was too small to detect statistical significance, measures of effect size showed trending improvements in patients' and caregivers' perceptions of HCPs' empathy and satisfaction with their communication after training. Our findings build on previous studies evaluating the feasibility and effectiveness of the Geriatric Comskil Training in real world setting and indicate that the training may have improved HCPs' communication with older adult patients and their caregivers even if their use of their observable communication skills did not change.

Patient–healthcare provider communication and age-related hearing loss: a qualitative study of patients’ perspectives

BackgroundThe prevalence of age-related hearing loss (ARHL) significantly increases in people aged 60 and older. Medical errors are frequently reported because of communication breakdown, especially for patients with ARHL.AimsThis qualitative study focuses on identifying the communication challenges faced by people aged over 65 with ARHL and potential ameliorative strategies based on the participants’ personal experiences.MethodsThirteen participants, attending a support service for older adults with hearing loss in the South of Ireland, were recruited using convenience sampling. Semi-structured interviews were conducted with participants. Interviews were audio-recorded and transcribed using NVivo 12 software. Braun and Clarke’s thematic analysis methodology was used to identify themes arising from two main study domains: difficulties faced during the most recent healthcare interaction and suggestions for improving overall healthcare communication.ResultsOlder adults with hearing loss identified general mishearing, lack of awareness and use of medical terminology to be the cause of ineffective communication. Raising awareness of the impact of presbycusis on clinical interaction among healthcare professionals was cited as being of crucial importance. Other helpful strategies include repeat and rephrase, use of written information, providing context, minimizing ambient noise, continuity of care, longer consultation length and good body language.ConclusionEffective clinical communication can be achieved through a clear understanding of the patient’s perspective. Healthcare providers should be made aware of the hearing issues and associated communication difficulties posed, within the context of the development of patient-centred strategies to improve patient safety.

Health Care Use, Coverage, and Experiences During the Year Prior to Pregnancy in a Primarily Hispanic Population with Low Income: A Descriptive Qualitative Study.

A qualitative picture of the health care experiences prior to pregnancy can inform patient-centered strategies to optimize preconception health. This study describes health care utilization and experiences and how health care costs were covered in the year prior to pregnancy in a population of primarily Hispanic women with low income. Pregnant participants were recruited from 5 Federally Qualified Health Center clinics. Semistructured interviews included questions about health care in the year prior to pregnancy. Transcripts were analyzed using a thematic approach that integrated deductive and inductive analysis. Most participants self-identified as Hispanic. Just under half were US citizens. All but one were Medicaid or Children's Health Insurance Program Perinatal coverage insurance during pregnancy and relied on a variety of strategies to cover prepregnancy health care costs. Almost all received health care during the year prior to pregnancy. Fewer than half reported an annual preventive visit. Health care needs that led to care-seeking included a prior pregnancy, chronic depression, contraception, workplace injury, a persistent rash, screening and treatment for sexually transmitted infection, breast pain, stomach pain (leading to gallbladder removal), and kidney infection. The ways in which study participants covered the costs of health care ranged in terms of sources and complexity. Although some participants described stable health care coverage, most reported changes throughout the year as they pieced together various health care coverage programs and out-of-pocket payments. When participants did seek health care prior to their current pregnancy, most described the experience in positive terms and focused on health care provider communication quality. Respect of patient autonomy was highly valued. Women with pregnancy-related health care coverage accessed care for a wide range of health care needs prior to pregnancy. Health care providers may consider strategies to respectfully introduce preconception care into any visit by an individual who could become pregnant.

Interpersonal Communication of Healthcare Providers in Family Planning Services for Couples of Reproductive Age during the COVID-19 Pandemic at Banda City Health Center

Interpersonal Communication of Healthcare Providers in Family Planning Services for Couples of Reproductive Age during the COVID-19 Pandemic at Banda City Health Center

Health concerns and treatment perspectives among US adults with current versus previous high-frequency headache/migraine and acute medication overuse: The Harris Poll Migraine Report Card Survey (P14-12.007)

Health concerns and treatment perspectives among US adults with current versus previous high-frequency headache/migraine and acute medication overuse: The Harris Poll Migraine Report Card Survey (P14-12.007)