Increase Patient Understanding Research Articles

Systematic review of rural interventions addressing barriers and facilitators in recruitment and adherence of oncology clinical trials.

e13675 Background: Rural patients are significantly underrepresented in cancer clinical trials leading to an inequitable distribution of research funding and excluding rural patients from innovative care. Properly understanding the barriers and facilitators to rural patient participation in cancer clinical trials is essential to lessen this disparity in representation. Methods: EBSCO Medline, Embase, Cinahl, Cochrane and PsycInfo were systematically searched for articles related to the primary research objective. The search strategies focused on a combination of keywords pertaining to “rural populations”, “cancer”, and “clinical trials”. Additional search terms included the presence of “barriers” or “facilitators” within the articles. Articles were removed from the study if they were not written in English, were conducted outside the U.S., focused on pediatric populations, or lacked original data. Results: A systematic review of the literature reveals that barriers and facilitators to cancer clinical trial participation by rural populations are present at the patient, physician, and healthcare system levels. Notable barriers found in this review include the burden of travel, lack of patient knowledge about clinical trial participation, insufficient provider communication and awareness of current trials, and strict eligibility criteria. Promising facilitators include caregiver support, close physician support and contact, and programs to increase patient understanding of clinical trials. Potential future interventions include telemedicine, expanding monetary support for clinical trial transportation, utilizing RUCA codes to document disparities and elucidate further interventions, and cultivating stronger partnerships between industry and rural medical facilities, as well as between the NCI, academic institutions, and rural medical facilities. Conclusions: There is a significant and urgent need to strengthen this body of literature as is underscored by the apparent lack of cancer clinical trials in rural counties, specifically in the state of Texas (CPRIT). It is evident that barriers need to be further elucidated to ascertain why rural patients have less participation in clinical trials, and facilitators need to be further explored in order to sufficiently illustrate and thus effectively harness the power of facilitators in the pursuit of lessening disparities and improving cancer outcomes for rural patients.

Effectiveness of Educational Videos on Reducing Anxiety in Pre-Anesthesian Patients

Surgery and anesthesia are actions that can cause problems for someone who will undergo them, one of the problems that is often found is anxiety. Several research results report that anxiety can affect 60-80% of patients undergoing surgery. Objective: To determine the effectiveness of health education using video media in reducing preoperative patient anxiety. Method:This research uses a pre-experimental method with one group pretest and posttest design. This research was conducted in March-April 2023 at Buleleng Regional Hospital. The sample in this study involved 42 patients undergoing elective surgery. The research instrument was a questionnaire sheet which was then analyzed using the Kolmogorov – Smirnov statistical test. Results:Providing complete anesthesia education was 42 (100.0%) respondentsn. The results of the pre-education research on gold were 23 (54.8%) respondents who were seriously anxious, 16 (38.1%) respondents were moderately anxious, 2 (4.8%) respondents were very anxious, 1 (2.4%) respondent was mildly anxious. The results of the post-education research were 25 (59.5%) respondents who were seriously anxious, 14 (33.3%) respondents were moderately anxious, 2 (4.8%) respondents were very anxious, and 1 (2.4%) respondent was mildly anxious. Conclusion:Effectiveness of educational videosanesthesia is able to increase patient understanding and knowledge so that it can reduce the anxiety level of pre-anesthesia patients at Buleleng Regional Hospital.

Evaluation of a novel augmented reality educational tool and its effects on patient experience: A randomized controlled trial.

Patient education is an essential element of the treatment pathway. Augmented reality (AR), with disease simulations and three-dimensional visuals, offers a developing approach to patient education. We aim to determine whether this tool can increase patient understanding of their disease and post-visit satisfaction in comparison to current standard of care (SOC) educational practices in a randomized control study. Our single-site study consisted of 100 patients with initial diagnoses of kidney masses or stones randomly enrolled in the AR or SOC arm. In the AR arm, a physician used AR software on a tablet to educate the patient. SOC patients were educated through traditional discussion, imaging, and hand-drawn illustrations. Participants completed pre- and post-physician encounter surveys adapted from the Press Ganey® patient questionnaire to assess understanding and satisfaction. Their responses were evaluated in the Readability Studio® and analyzed to quantify rates of improvement in self-reported understanding and satisfaction scores. There was no significant difference in participant education level (P = 0.828) or visit length (27.6 vs. 25.0 min, P = 0.065) between cohorts. Our data indicate that the rate of change in pre- to post-visit self-reported understanding was similar in each arm (P ≥ 0.106 for all responses). The AR arm, however, had significantly higher patient satisfaction scores concerning the educational effectiveness and understanding of images used during the consultation (P < 0.05). While AR did not significantly increase self-reported patient understanding of their disease compared to SOC, this study suggests AR as a potential avenue to increase patient satisfaction with educational tools used during consultations.

Thoracic Surgery Litigation: Analysis Using the Westlaw Legal Database

BackgroundIn the United States, medical malpractice bears a significant financial risk associated with surgery, particularly in the field of cardiothoracic surgery. Approximately 18.9% of cardiothoracic surgeons face litigation. We report an analysis of litigation in thoracic surgery. MethodsThe Westlaw legal database was used to identify thoracic surgery cases. Search terms were identified for various thoracic procedures. Case characteristics were analyzed. ResultsMedical malpractice in thoracic surgery results in a median payout of $1,183,000 million for plaintiff verdicts and a mean settlement award of $550,000. Outcomes of litigation are variable. Geographic location does not play a significant role in litigation. Thoracic surgeons in New York, California, Florida, and Illinois faced the most lawsuits. Intraoperative or procedural error and inadequate informed consent accounted for 52% of all cases. ConclusionsAttempts to increase patient understanding and education may be beneficial for reducing litigation. Analysis of why New York, California, and Illinois are highly litigious is warranted. Future analysis would also be useful to evaluate whether advances in techniques, such as robotic or thoracoscopic approaches, are associated with reduced incidence of litigation.

682 A single adult cystic fibrosis center initiative to increase patient understanding of lung transplantation processes

682 A single adult cystic fibrosis center initiative to increase patient understanding of lung transplantation processes

Using eConsent to improve patient comprehension and solving issues for introduction, with special attention to the COVID-19 pandemic: A questionnaire survey by the Japan Pharmaceutical Manufacturers Association

The environment surrounding clinical trials is evolving rapidly with the advancement of digital transformation (DX). Especially during the COVID-19 pandemic, digital methods are effective in promoting multiregional clinical trials (MRCT). eConsent is an electronic tool for obtaining informed consent that is expected as a key solution to improve patient understanding. According to the report by Pietrzykowski et al., patient understanding in clinical trials is surprisingly low, and this is a significant ethical problem. Despite the current situation, the use of eConsent has not significantly progressed at least in Japan. This study aimed to identify the current issues for eConsent and consider measures to solve them. In January 2022, an online questionnaire survey was sent to 69 member companies of the Japan Pharmaceutical Manufacturers Association (JPMA), and 52 companies (75.4%) responded. Thirteen companies (25.0%) conducted a trial using eConsent. Among the 13 companies, 17 trials were conducted by 8 companies after the COVID-19 pandemic (summer 2020), compared to 8 trials by 5 companies before the pandemic. We found that the biggest obstacles to the spread of eConsent are the lack of awareness of eConsent use and the development of provisions for treating electronic files as source records in medical institutions. In conclusion, we need to encourage medical institutions to update provisions for handling electronic source documents and to notify them of the importance of eConsent. Thus, further promotion of eConsent is needed to increase patient understanding and enable more efficient clinical trials.

Study of Patient and Physician Attitudes Toward Automated Prognostic Models for Patients With Metastatic Cancer.

For patients with cancer and their doctors, prognosis is important for choosing treatments and supportive care. Oncologists' life expectancy estimates are often inaccurate, and many patients are not aware of their general prognosis. Machine learning (ML) survival models could be useful in the clinic, but there are potential concerns involving accuracy, provider training, and patient involvement. We conducted a qualitative study to learn about patient and oncologist views on potentially using a ML model for patient care. Patients with metastatic cancer (n = 15) and their family members (n = 5), radiation oncologists (n = 5), and medical oncologists (n = 5) were recruited from a single academic health system. Participants were shown an anonymized report from a validated ML survival model for another patient, which included a predicted survival curve and a list of variables influencing predicted survival. Semistructured interviews were conducted using a script. Every physician and patient who completed their interview said that they would want the option for the model to be used in their practice or care. Physicians stated that they would use an AI prognosis model for patient triage and increasing patient understanding, but had concerns about accuracy and explainability. Patients generally said that they would trust model results completely if presented by their physician but wanted to know if the model was being used in their care. Some reacted negatively to being shown a median survival prediction. Patients and physicians were supportive of use of the model in the clinic, but had various concerns, which should be addressed as predictive models are increasingly deployed in practice.

743 Educate Before You Operate: Improving the Informed Consent Process

Abstract Introduction The informed consent process is a daily task for providers with a surgical patient population. In the burn population, informed consent is often presented by an intern or resident physician. Consent is comprised of surgical debridement with a multitude of options for coverage of their wounds. The current state of practice is a verbal overview of all the possible procedures that may be done to the patient’s wound(s). Patients often verbalize feeling overwhelmed with the amount of information on the consent and often have questions related to their procedure just before the brief of the operative case. Methods An educational video was developed that detailed the surgical procedure and the potential burn wound coverings. A 3-question survey was given to patients who have already been through the informed consent process. Survey metrics examined knowledge of consent when signed, the satisfaction of verbal explanation, and if a video would increase understanding. The video was given to the same patients to watch. After the video was viewed, those patients were then again surveyed. Providers were also given a 3-question survey before viewing the video. Survey metrics examined comfort of consent, knowledge of procedures, and if the video would increase patient understanding of consent topics. The providers were then surveyed after watching the video. Results Initial post-implementation data shows that patients and providers have increased comfort and knowledge in the informed consent process. Patients show an 80% increase in understanding of consent, a 72% increase in satisfaction with video vs verbal overview, and a 97% increase in satisfaction with material viewed. Provider data shows a 65% increase in the comfort of consent, a 64% increase in knowledge of procedures, and a 97% increase that the video will help patients understand their consent. This shows that this evidence-based project is an improvement from the current standard of practice. Conclusions The informed consent process is an opportunity for providers and patients to have a moment of discussion. It is a pivotal point in which a patient and a provider determine the next step of their care. The patient must have clear communication and education regarding the procedures to which they are consenting. It is also a discussion where a provider can provide education and support at what is an overwhelming time for patients in their hospital stay. Applicability of Research to Practice Implementation of a standardized audio/video teaching method for burn surgical patients is an effective way to increase patient and provider satisfaction regarding the informed consent process. Implementing this educational tool is a cost-effective and simple way to educate burn patients before their surgical procedures. There is an overall improvement in patient satisfaction and increased satisfaction in the providers who obtain the consent.

Veteran Perspectives on Population-Based Suicide Risk Screening in VHA Primary Care: Mixed-Methods Study.

In late 2018, VHA implemented a multi-stage suicide risk screening and evaluation initiative, Suicide Risk Identification Strategy, or "Risk ID," in primary care settings. The main objective of this study was to characterize VHA primary care patient perspectives regarding population-based suicide risk screening through the Risk ID program. Mixed methods; survey and qualitative interviews. Veterans screened for suicide risk using Risk ID in primary care (n = 868) participated in a survey of veteran attitudes about screening (45% response rate); thirty additionally participated in follow-up qualitative interviews. The quantitative survey consisted of three questions on attitudes about screening for suicidal thoughts in primary care. In qualitative interviews, veterans were asked about their experiences with the Risk ID processes and recommendations for improving Risk ID. Over 90% of veterans reported that it is appropriate for primary care providers or nurses/medical assistants to ask veterans about thoughts of suicide during primary care visits. Approximately half of veterans indicated that veterans should be asked about suicidal thoughts at every visit. Qualitative findings revealed that while most veterans were generally supportive and appreciated VHA screening for suicidal thoughts, they also expressed concern for the potential for inadvertent harm. Participants expressed conflicting preferences for how screening should be handled and delivered. Findings suggest that most veterans support the integration of standardized suicide risk assessment into routine primary care visits. However, findings also suggest that population-based suicide risk assessment should further consider patient experiences and preferences. Specifically, additional guidance or training for staff conducting suicide risk screening may be warranted to ensure patients feel heard (e.g., eye contact, expressing empathy) and increase patient understanding of the purpose of the screening and potential outcomes. These patient-centered approaches may improve patient experience and facilitate disclosure of suicidal thoughts.

The Patient-Provider Gap: A Cross-sectional Survey to Understand Barriers and Motivating Factors for Home Blood Pressure Monitoring in a CKD Cohort

Blood pressure (BP) management can decrease morbidity and mortality in chronic kidney disease (CKD) patients. Evidence-based hypertension guidelines endorse home BP monitoring (HBPM), and the growing use of virtual health has highlighted the need for HBPM. A comprehensive understanding of HBPM adoption in our province is lacking. To identify the baseline practices, perspectives, barriers, and enablers in both providers and patients in our kidney care clinics regarding HBPM. Ultimately, this will inform the development of a provincial intervention that empowers providers to both increase patient understanding and equip them for accurate and reliable home BP measurement. Cross-sectional, descriptive study using online survey methodology. Kidney care clinic network in the province of British Columbia, Canada. Kidney care clinic staff and patients who perform HBPM. Data were collected using semi-structured online surveys, one for staff and one for patients and/or caregivers. These surveys were developed by an interdisciplinary working group that included patient partners and addressed some key components of the implementation of an HBPM program (including perceived barriers to uptake, education, and adoption of best practices). In all, 46 patients and 43 staff responded to the survey from 16 kidney care clinics. Of the patients 53% were women, and the most common age range was 60 to 69 years (25%); 93% of the staff respondents were women and 63% were nurses. We identified numerous areas of discordance between providers and patients and the need for improvement from the perspective of implementing best practices from hypertension guidelines, both in staff teaching and patient usage of HBPM. Blood pressure targets were not known to 18% of patients and 39% of patients had received a BP target from their kidney care clinic team; 89% of patients had not had their upper arm circumference measured for cuff size. Furthermore, 54% of patients knew what to do when their BP is off-target. All recognized the benefits of HBPM, providers were more likely to perceive anxiety as a barrier relative to patients, and patients were more likely to report expense as a barrier than providers. This study includes only a single provincial health care system limiting generalizability to other jurisdictions and sampled a small subset of patients and providers. The systematic evaluation of education, understanding, implementation of best practices, and barriers and motivating factors for HBPM from both patient and clinician perspectives is an important step in designing strategies to improve the use of HBPM. Given differences in staff and patient perspectives, targeted interventions based on these responses may lead to improved use of HBPM, and ultimately enhance hypertension self-management and BP control in our CKD patients.

19 Increasing patient understanding of the relationship between Human Papillomavirus and cervical dysplasia through standardized video education in an underserved patient population

19 Increasing patient understanding of the relationship between Human Papillomavirus and cervical dysplasia through standardized video education in an underserved patient population

Kepatuhan Penggunaan Masker dalam Upaya Pencegahan Penularan Covid-19 di Kota Samarinda

Cases in Indonesia are still showing an increase in the number of positive cases exposed to COVID-19, so the government has implemented various efforts to reduce the number of positive cases in Indonesia. One of them is the policy of using masks. The use of mask is part of a comprehensive series of prevention and control measures that can limit the spread of certain viral respiratory tract diseases, including COVID-19. Masks can be used to protect healthy people (used to protect themselves when in contact with infected people) or to control the source (used by an infected person to prevent further transmission). One of the methods to increase compliance with wearing masks is to increase patient understanding of the importance of preventing transmission of the corona virus by obediently wearing masks. The results showed that respondents with low knowledge in the use of mask were 51.7% with a total of 120 respondents and those with good knowledge were 48.3% with a total of 112 respondents. Respondents with poor compliance in using masks were 39.7% with a total of 92 respondents and those with good compliance in using masks were 60.3% with a total of 140 respondents. The results of the chi-square test showed that there was no relationship between public knowledge and compliance with the use of mask in Samarinda City with a p-value of 0.146 (p-value&gt;0.05).

"Provider discretionary power practices to support implementation of patient-centered HIV care in Lusaka, Zambia".

Traditional patient-provider relationships privilege the providers, as they possess the formal authority and clinical knowledge applied to address illness, but providers also have discretion over how they exercise their power to influence patients' services, benefits, and sanctions. In this study, we assessed providers' exercise of discretionary power in implementing patient-centered care (PCC) practices in Lusaka, Zambia. HIV clinical encounters between patients on antiretroviral therapy (ART) and providers across 24 public health facilities in Lusaka Province were audio recorded and transcribed verbatim. Using qualitative content analysis, we identified practices of discretionary power (DP) employed in the implementation of PCC and instances of withholding DP. A codebook of DP practices was inductively and iteratively developed. We compared outcomes across provider cadres and within sites over time. We captured 194 patient-provider interactions at 24 study sites involving 11 Medical Officers, 58 Clinical Officers and 10 Nurses between August 2019 to May 2021. Median interaction length was 7.5 min. In a hierarchy where providers dominate patients and interactions are rapid, some providers invited patients to ask questions and responded at length with information that could increase patient understanding and agency. Others used inclusive language, welcomed patients, conducted introductions, and apologized for delayed services, narrowing the hierarchical distance between patient and provider, and facilitating recognition of the patient as a partner in care. Although less common, providers shared their decision-making powers, allowing patients to choose appointment dates and influence regimens. They also facilitated resource access, including access to services and providers outside of scheduled appointment times. Application of DP was not universal and missed opportunities were identified. Supporting providers to recognize their power and intentionally share it is both inherent to the practice of PCC (e.g., making a patient a partner), and a way to implement improved patient support. More research is needed to understand the application of DP practices in improving the patient-centeredness of care in non-ART settings.

PENGARUH SPIRITUAL EMOTIONAL FREEDOM TECHNIQUE (SEFT) TERHADAP KEPATUHAN TERAPI PENDERITA HIPERTENSI

Hypertension is a disease with long-term therapy even for life and is sustainable at home, especially with this pandemic condition, it is very necessary for patient compliance in carrying out hypertension therapy on a regular basis. Patient compliance in carrying out therapy can fluctuate. One of the main strategies that can be done to increase compliance is from the patient's perspective by increasing individual confidence. One way that can be used to control psychology is to use the Spiritual Emotional Freedom Technique. The purpose of this study was to determine the effect of SEFT on adherence to therapy in patients with hypertension. The research method used is a quasi-experimental approach with a pretest posttest with control group design. This study uses primary data with a population of 57 people in the working area of the Penimbung Public Health Center with a sample of each control and intervention group of 13 people.data were analyzed bivariately using the paired T-test. There is an effect of Spiritual Emotional Freedom Technique (SEFT) on therapy adherence in patients with hypertension (p = 0.000). The SEFT method can increase patient understanding and awareness in therapy adherence

The use of individualized 3D-printed models on trainee and patient education, and surgical planning for robotic partial nephrectomies.

3D printing is a growing tool in surgical education to visualize and teach complex procedures. Previous studies demonstrating the usefulness of 3D models as teaching tools for partial nephrectomy used highly detailed models costing between $250 and 1000. We aimed to create thorough, inexpensive 3D models to accelerate learning for trainees and increase health literacy in patients. Patient-specific, cost-effective ($30-50) 3D models of the affected urologic structures were created using pre-operative imaging of 40 patients undergoing partial nephrectomy at Thomas Jefferson University Hospital (TJUH) between July 2020 and May 2021. Patients undergoing surgery filled out a survey before and after seeing the model to assess patient understanding of their kidney, pathophysiology, surgical procedure, and risks of surgery. Three urological residents, one fellow, and six attendings filled out separate surveys to assess their surgical plan and confidence before and after seeing the model. In a third survey, they ranked how much the model helped their comprehension and confidence during surgery. Patient understanding of all four subjects significantly improved after seeing the 3D model (P < 0.001). The urology residents (P < 0.001) and fellow (P < 0.001) reported significantly increased self-confidence after interacting with the model. Attending surgeon confidence increased significantly after seeing the 3D model (P < 0.01) as well. Cost-effective 3D models are effective learning tools and assist with the evaluation of patients presenting with renal masses, and increase patient, resident, and fellow understanding in partial nephrectomies. Further research should continue to explore the utility of inexpensive models in other urologic procedures.

Video Radiology Reports: A Valuable Tool to Improve Patient-Centered Radiology.

BACKGROUND. Improved communication between radiologists and patients is a key component of patient-centered radiology. OBJECTIVE. The purpose of this study was to create patient-centered video radiology reports using simple-to-understand language and annotated images and to assess the effect of these reports on patients' experience and understanding of their imaging results. METHODS. During a 4-month study period, faculty radiologists created video radiology reports using a tool integrated within the diagnostic viewer that allows both image and voice capture. To aid patients' understanding of cross-sectional images, cinematically rendered images were automatically created and made immediately available to radiologists at the workstation, allowing their incorporation into video radiology reports. Video radiology reports were made available to patients via the institutional health portal along with the written radiology report and the examination images. Patient views of the video report were recorded, and descriptive analyses were performed on radiologist and examination characteristics as well as patient demographics. A survey was sent to patients to obtain feedback on their experience. RESULTS. During the study period, 105 of 227 faculty radiologists created 3763 video radiology reports (mean number of reports per radiologist, 36 ± 27 [SD] reports). Mean time to create a video report was 238 ± 141 seconds. Patients viewed 864 unique video reports. The mean overall video radiology report experience rating based on 101 patient surveys was 4.7 of 5. The mean rating for how well the video report helped patients understand their findings was also 4.7 of 5. Of the patients who responded to the survey, 91% preferred having both written and video reports together over having written reports alone. CONCLUSION. Patient-centered video radiology reports are a useful tool to help improve patient understanding of imaging results. The mechanism of creating the video reports and delivering them to patients can be integrated into existing informatics infrastructure. CLINICAL IMPACT. Video radiology reports can play an important role in patient-centered radiology, increasing patient understanding of imaging results, and they may improve the visibility of radiologists to patients and highlight the radiologist's important role in patient care.

Precision patient education using a "flipped classroom" approach.

ObjectivesTo improve patient education delivered over telemedicine by using a “flipped classroom”‐inspired approach.MethodsA “flipped classroom” is an education strategy used to engage active learning by sending students home with lecture material and reserving classroom time for collaborative learning. To adapt this approach for use in radiation oncology patient education, three pieces of written education material were created: introduction to radiation oncology, treatment planning scan, and treatment delivery. An automated system was created to deliver precisely timed emails at three time points ahead of appointments. Appointment time was then used for collaborative learning with our staff. As a primary endpoint, email engagement metrics were tracked via the automated system. Secondarily, enrolled patients were surveyed to assess level of understanding (before vs. after intervention), anxiety (before vs. after intervention), and satisfaction. Additionally, email delivery timing, clarity, relevance, and patient support were evaluated. Data analyses test the impact of active learning against our existing education approaches.ResultsOverall, 77.1% of the emails were opened, and of those, patients accessed 72.2% of the education material. Patients re‐read the education material 4.6 times on average. Active learning increased patient understanding regarding the purpose of the treatment planning scan (p = 0.031) and increased patient understanding of what to expect during daily radiation treatments (p = 0.0078). Patients reported reduced anxiety (p = 0.031) and high scores for satisfaction, timing, clarity, relevance, and overall support.ConclusionsPatient engagement with the education material was high, and they continued to access it many times. Active learning enhances patient comprehension of complex treatment information leading to decreased anxiety. Furthermore, this technique can be incorporated into existing telemedicine with basic technology.

Self-Repair Practices in Pharmacist-Patient Interaction and their Role in Preventing Misunderstanding and Maintaining Medication Safety

Effective communication between pharmacists and patients can prevent medication errors as it enhances patients’ understanding of their medication and increases their adherence. As misunderstanding may occur in any type of interaction and lead to communication breakdown, repair practices that speakers adopt to enhance understanding in interaction are an especially important area of research in Conversation Analysis (CA). As such, this study aims to identify and explain the self-repair practices used by pharmacists to increase patient understanding in spoken interaction. The study was conducted at the University of Malaya Medical Centre from November to December 2014. Four pharmacists and 27 patients were recruited to participate in an intervention study. A detailed sequential analysis of interaction data revealed the pharmacists’ use of replacement, clarification, verbatim repeat, and repetition with an elaboration designed to increase the clarity and accuracy of the intended message and improve patient understanding. Self-repair practices may have an essential role in increasing medication safety in the healthcare setting.

Reflex BRCA1 and BRCA2 tumour genetic testing for high-grade serous ovarian cancer: streamlined for clinicians but what do patients think?

BackgroundReflex (automatic) BRCA1 and BRCA2 (BRCA1/2) genetic testing of tumour tissue is being completed for all newly diagnosed high-grade serous ovarian cancer (HGSOC) in the province of Ontario, Canada. The objective of this study was to measure the psychological impact of tumour genetic testing among individuals with a new diagnosis of HGSOC.MethodsParticipants had a new diagnosis of HGSOC and received reflex BRCA1/2 tumour genetic testing as a component of their care. Eligible individuals were recruited from two oncology centres in Toronto, Canada. One week after disclosure of tumour genetic test results, consenting participants were asked to complete a questionnaire that measured cancer-related distress, dispositional optimism, knowledge of hereditary breast/ovarian cancer, recall of tumour genetic test results, satisfaction, and the psychological impact of receiving tumour genetic test results. The Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire was used to measure the psychological impact of tumour genetic testing.Results76 individuals completed the study survey; 13 said they did not receive their tumour test results. Of the remaining 63 participants, the average MICRA score was 26.8 (SD = 16.3). Higher total MICRA scores were seen among those with children (p = 0.02), who received treatment with primary surgery (p = 0.02), and had higher reported cancer-related distress (p < 0.001). Higher dispositional optimism (p < 0.001) and increasing age (p = 0.03) were associated with lower total MICRA scores. Most (83.5%) participants reported being satisfied/highly satisfied with having tumour testing completed; however, 40.8% could not accurately recall their tumor test results.ConclusionsThis study is the first to assess psychological outcomes following reflex BRCA1/2 tumour genetic testing in women newly diagnosed with HGSOC. Increased dispositional optimism provided a protective effect, while increased cancer-related distress increased the psychological impact of tumour genetic testing. Educational resources are needed to help increase patient understanding and recall of tumour results, particularly when tumour genetic testing includes analysis of genes that may have implications for hereditary cancer risk. Additional research is required to better understand the patient experience of reflex tumour genetic testing.

Implementation of Health Belief Models (HBM) Education for Tuberculosis patients at the Tamansari Primary Health Care, Tasikmalaya City

Tuberculosis (TB) is an infectious disease that continues to increase not only nationally but also globally. Tuberculosis is a problem for sufferers both physically and psychologically, it can even cause negative stigma from themselves and society, so the disease affects the quality of life of the sufferer. Tuberculosis treatment that is long enough and requires compliance can cause susceptible to drop out (DO), finally will increase the risk of cases of Multi Drug Resistance (MDR). The role of nurses is needed in ensuring tuberculosis patient adherence in treatment. Patient will be understand that tuberculosis is important in the treatment process. Education is a strategy in increasing patient understanding to change positive behavior for tuberculosis sufferers. The aim of this community service is to implement Health Belief Models (HBM) Education in Tuberculosis patients. This method used lectures, interviews and practice. The results found that the implementation of HBM on 19 patients who visited Tamansari primary health care for 3 months showed a significant result in behavior and quality of life. HBM education can change the quality of life of tuberculosis sufferers by changing perceptions of the disease which includes perceptions of vulnerability, perception of severity, perceived benefits, perceptions of barriers and a person's belief in healthy behavior. It is recommended that HBM education should continue to be implemented for tuberculosis sufferers so that they can maintain their survival.