Patient Narratives Research Articles

Encore des mots, toujours des maux, les mêmes maux ?

ContextThe hospital is in crisis, with many ills and difficulties experienced by caregivers and patients alike. These difficulties are due to the de-subjectivization of caregivers and patients, conveyed by the language of a techno-scientific new management. ObjectivesTo show how metapsychology and psychoanalysis can help caregivers and their patients rediscover in their language a space of subjectivity in which to express themselves and bear witness to their realities. MethodExploration of the effects of the new managerial and techno-scientific language used and experienced in care by caregivers and their patients. ResultsThe language of new hospital management can be seen as a socio-psycho-linguistic virus, weakening caregivers and forcing them to act rather than reflect, because of a lack of words and of space in which to express themselves. Techno-scientific language reifies patients and detaches them from their unique experiences. Caregivers and patients therefore find it difficult to relate to each other in any way other than through their illness. Psychoanalysis and metapsychology create the conditions for deepening and redeploying the caregiver-patient relationship, and through attention to narrativity, they enable us to give importance to the patient's narrative. Systems inspired by institutional psychotherapy give caregivers the space to develop their subjectivity and reduce the suffering associated with caring for patients. ConclusionThe struggle of languages to which patients and caregivers are subjected is partly responsible for the malaise in hospital culture. It seems to us that working on the language of caregivers and patients, and maintaining spaces for everyone to put themselves into words, could contribute to the development of a culture of care that prevents the actors and subjects of care from talking to each other only about their ills.

Coping self-efficacy and personal growth in the situation of the COVID-19 threat

IntroductionIn studies of the socio-psychological consequences of the COVID-19 pandemic, models focused on the negative aspects of stressors, dysfunctions, anxiety We present the attempt to expand the context and include in the field positive personal resources for psychological well-being and even post traumatic personality growth after disasters. Sometimes separation from family and friends, lack of medicines and medical resources, loss of income, social isolation to humanity, do not automatically assume that a person is capable and responsible for effectively coping with life difficulties.Objectives397 (students and patients of clinic average age 26, 2/3 are femaleMethodsPeritraumatic Distress Index (CPDI) (Feng, 2020); Impact of Event Scale (Horowitz, 1979), Coping Self-efficacy Scale (Chespeu et al, 2006); Posttraumatic Growth Inventory (Tedeschi& Calhoun, 1996), MMI (Nuttin, 1986) – adapted by M. Magomed-Eminov.ResultsSignificant negative correlation between coping self-efficacy and intensity of the impact of stressful events (IES) (rS = - 0,140, p < 0,05) was predictable.CPDI and PTG showed significant correlation (Pearson’s r= 0.23, p<0.01) between Peritraumatic Distress Index and Post-Traumatic Growth indicators only in the group of respondents who have had COVID-19. The data is confirmed by the content analysis of incomplete sentences of the subjects of COVID group. The correlation between these indicators in the Non-Covid group was insignificant.Moreover additional information we got from narratives of infected patients: the data has been split into 3 groups of narratives in the context of cultural-historical activity theory which shows the triadic outcome of survivor after trauma : a) suffering, b) adaptation, coping, resilience, c) personal growth.ConclusionsTo interpret the data the authors propose the meaning-activity approach and personality work with negative life experience (Magomed-Eminov, 1998, 2007, 2009, 2021). Authors suggest that further research on the positive consequences of stressful events beside coping styles and mechanisms that would expand the repertoire of tools predicted the ability of a modern person to cope with adversity and use experience for deeper involvement of human resources with the help of personality work with personal experience.Disclosure of InterestNone Declared

Teaching Intersectionality in Instructional Librarianship: Asynchronous Information Literacy Instruction in the Health Sciences

This article explores the topic of intersectionality and its applications in teaching graduate students at a health sciences university. The case study examined the creation of an asynchronous information literacy module that centered intersectionality in the research process. Summative assessment data indicated that students were able to critically reflect on gaps in their knowledge to address health inequities, learn the narratives of multiply-marginalized patients, and make connections between research and intersectional justice. The study also revealed areas for improvement such as restructuring the assessment component of the module to better evaluate student success, strengthening the module as a socially engaging learning space for students, and integrating other metrics to measure the student experience. Findings from this study demonstrate how instructional librarians can create equitable and engaging learning spaces through an asynchronous instruction model as well as teaching intersectionality in STEMM-specific disciplines.

The psychological burden of NMOSD - a mixed method study of patients and caregivers.

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved ones, so as to inform a specialized intervention. 31 adults living with NMOSD and 22 caregivers of people with NMOSD in the United States and Canada, recruited from NMOSD patient advocacy groups, social media groups, and through word of mouth from other participants, completed a battery of standardized self-report measures of anxiety, depression, trauma, cognitive fusion, valued living, and coping styles. Semi-structured focus group sessions were conducted via HIPAA-compliant Zoom with 31 patients, and separate focus groups were conducted with 22 caregivers. A subset of these samples, comprised of 16 patients and 11 caregivers, participated in individual semi-structured interviews, prioritizing inclusion of diverse perspectives. Descriptive statistics and bivariate correlations were run on quantitative self-report data using SPSS [Version 28.0.1]; data were stored in REDCap. Reflexive thematic analysis was employed regarding qualitative individual interview data. The majority of patients reported experiencing anxiety, depression, cognitive fusion, over-controlled coping, and lack of values-based living. Caregivers also reported heightened anxiety, cognitive fusion, and over-controlled coping, although they did not endorse clinically significant depression. Patient and caregiver degree of anxiety and of overcontrolled coping were both strongly positively correlated, likely affecting how both parties manage NMOSD-related stressors, both individually and as a dyad. Patients reported more anxiety, depression, psychological inflexibility, and lack of values-based living, compared with caregivers. Patient and caregiver narrative themes included mistrust of medical professionals, lack of support immediately following diagnosis, changes in relationships, deviation from values-based living, internalization of feelings, and avoidant coping strategies to manage the psychological burden of NMOSD. A novel mental health intervention targeting the specific psychological burden of life with NMOSD is proposed.

Novel Integration of a Health Equity Immersion Curriculum in Medical Training.

Health disparities education is an integral and required part of medical professional training, and yet existing curricula often fail to effectively denaturalize injustice or empower learners to advocate for change. We discuss a novel collaborative intervention that weds the health humanities to the field of health equity. We draw from the health humanities an intentional focus retraining provider imaginations by centering patient narratives; from the field of health equity, we draw the linkage between stigmatized social identities and health disparities. We describe a longitudinal health equity curriculum for the Hospice and Palliative Medicine fellowship in Memphis, Tennessee, to give trainees exposure to the concept of structural violence and how it affects clinical care. The curriculum was developed in partnership with humanities and social sciences faculty who staff a Health Equity academic program at a small liberal arts college in Memphis. This curriculum has been implemented for the past four years in support of 22 hospice and palliative medicine fellows. Group debriefs and a mixed methods survey have revealed widespread and lasting impact towards understanding health equity concepts, enhanced communication and treatment of patients, and empowerment to address the broader needs and policies affecting patients and the communities in which they live. Ultimately, we model an educational initiative that integrates equity across the full scope of healthcare practice and equips learners with skills for sustaining compassionate practices, focusing on equity-oriented, person-centered care across the full scope of healthcare practice.

Advanced Applications of Artificial Intelligence in Pharmacovigilance: Current Trends and Future Perspectives

The primary goal of pharmacovigilance, the cornerstone of public health, is to track and evaluate adverse drug reactions in order to guarantee patient safety. Conventional approaches suffer from biases in human error, inefficiency, and scalability problems. A new era in pharmacovigilance is being ushered in by the introduction of artificial intelligence (AI), which holds the promise of vast data analysis, automated procedures, and enhanced safety signal detection. Artificial intelligence technologies improve adverse event detection and signal identification by providing unparalleled speed, accuracy, and scalability. They are adept at applying sophisticated algorithms, machine learning models, and natural language processing to glean insights from unstructured data sources like clinical notes, patient narratives, and regulatory reports. This capacity makes it possible to implement risk management plans that are more thorough and proactive. However, using artificial intelligence in pharmacovigilance necessitates large expenditures for processing power, infrastructure, and regulatory compliance. For artificial intelligence-driven systems to be accurate, dependable, and applicable, ongoing validation, monitoring, and improvement efforts are essential. The ethical and legal implications of patient privacy, data security, and regulatory compliance underscore the necessity of cautious artificial intelligence deployment in order to maintain public trust and protect patient rights. Regulatory agencies, healthcare professionals, and artificial intelligence developers must work together efficiently to implement explainable artificial intelligence frameworks, adaptive surveillance techniques, and improved signal validation processes in order to fully realize the potential of artificial intelligence in pharmacovigilance. This will usher in a new era of proactive risk assessment and improved public health outcomes. Keywords Pharmacovigilance, Artificial Intelligence, Signal Detection, Regulatory Affairs, Patient Safety, Public Health

Cultural pathways to psychosis care: Patient and caregiver narratives from Puebla, Mexico.

The current study used the McGill Illness Narrative Interview (MINI) to explore patients' (n = 6) and caregivers' (n = 3) narratives about how they identified and sought care for psychosis. Participants were recruited from an outpatient clinic at the Hospital Psiquiátrico Dr. Rafael Serrano, a public psychiatric hospital in Puebla, Mexico. All participants consented to complete semi-structured interviews in Spanish. Thematic analyses were used to inductively identify common themes in participants' narratives. The results indicated that during the initial symptom onset, most participants noticed the presence of hallucinations but did not seek help for this hallmark symptom. Participants described seeking care only when they or their ill relative exhibited escalating aggressive behaviors or physical symptoms that were interpreted as common medical problems. As participants became connected to specialty mental health services, they began to develop a conceptualization of psychosis as a disorder of aggression. For some participants, this conceptualization of psychosis as an illness of aggression contributed to their ambivalence about the diagnosis. These results can be understood using a cultural scripts framework, which suggests that cultural norms are influenced by collective understandings of normalcy and valorization of behaviors. Implications for community campaigns are discussed.

Narrative Forewarnings: A Qualitative Analysis of the Themes Preceding Disorganized Speech in Schizophrenia.

Disorganized speech is a critical barrier to recovery in schizophrenia, with profound negative impacts on one's ability to engage with the world. Despite the limited efficacy of existing treatments in addressing disorganization, a qualitative analysis of what leads to disorganization in patient narratives has been lacking. This study addresses this gap through inductive thematic analysis of 30 narrative interviews with individuals with schizophrenia, matched based on whether Formal Thought Disorder (FTD) is present. Through this analysis, we identified four core themes (alienation, interpersonal tension, personal benchmarks, and adverse experiences) and eight subthemes. Our findings suggest that disorganization may serve as a protective mechanism against psychological distress and highlight how the severity of FTD influences these themes. Alienation, particularly due to illness-related stigma, emerged more prominently in those with FTD. The themes of personal benchmarks and interpersonal tension pointed towards a heightened sensitivity to social interactions and self-perception among those with schizophrenia. Adverse experiences, encompassing past challenges, suggest a potential link between trauma and symptom exacerbation. Our qualitative analysis of what themes precede disorganized speech has implications for tailoring psychotherapy. By considering an individual's specific triggers and level of disorganization, therapy may be more effectively targeted to improve recovery-based outcomes. By identifying themes within patient narratives, this study advances our understanding of the qualitative aspects preceding disorganized speech in schizophrenia, paving the way for more personalized and effective recovery-focused interventions.

Evaluating the impact of interprofessional training wards on patient satisfaction and clinical outcomes: a mixed-methods analysis.

Interprofessional teamwork is pivotal in modern healthcare, prompting the establishment of interprofessional training wards since 1996. While these wards serve as hubs for optimizing healthcare professional collaboration and communication, research into patient outcomes remains notably sparse and geographically limited, predominantly examining patient satisfaction and sparingly exploring other metrics like mortality or self-discharge rates. This study seeks to bridge this gap, comparing patient outcomes in interprofessional training wards and conventional wards under the hypothesis that the former offers no disadvantage to patient outcomes. We explored patient outcomes within an interprofessional student ward called A-STAR at a University Hospital from October 2019 to December 2022. Engaging with patients discharged between May 2021 and April 2022, we utilized digital and paper-based anonymous questionnaires, catering to patient preference, to gather pertinent data. Analysis of outcomes for 1,482 A-STAR (interprofessional student ward) and 5,752 conventional ward patients revealed noteworthy findings. A-STAR patients tended to be younger (59 vs. 61 years, p < 0.01) and more frequently male (73.5% vs. 70.4%, p = 0.025). Vital clinical outcomes, such as discharges against medical advice, complication-driven readmissions, and ICU transfers, were statistically similar between groups, as were mortality rates (1.2% vs. 1.3%, p = 0.468). A-STAR demonstrated high patient satisfaction, underscored by positive reflections on team competence, ward atmosphere, and responsiveness to concerns, emphasizing the value placed on interprofessional collaboration. Patient narratives commended team kindness, lucid explanations, and proactive involvement. This data collectively underscores the safety and reliability of patient care within training wards, affirming that patients can trust the care provided in these settings. Patients on the interprofessional ward demonstrated high satisfaction levels: 96.7% appreciated the atmosphere and conduct of ward rounds. In comparison, 98.3% were satisfied with the discussion and information about their treatment during their hospital stay.

Raising patient voices in medical education: an assessment of patient perceived effect of social determinants of health conversations and the patient-physician relationship on quality of obstetric care, to inform the development of patient driven medical education curricula.

Conventional medical education lacks the lived experiences of patients which may authentically convey the social determinants of health (SDOH) and resulting health disparities. Videos of first-person patient narratives may prove a valuable education tool in this regard. The objective of this study is to investigate how patient demographics, satisfaction with care, and patient-physician relationships influence obstetric patient interest and willingness to contribute to a SDOH video curriculum by sharing their lived experiences through first-person narratives. Study design included an anonymous, cross-sectional survey and an optional semi-structured telephone interview. Participants were 18 years old with a live-birth delivery <8 weeks prior to recruitment and received care during their pregnancy at Los Angeles General Medical Center (LAGMC). Variables surveyed included demographics, satisfaction with care, aspects of the patient-physician relationship, perceived utility, and personal interest in contributing to an educational SDOH video. A bivariate analysis was conducted to compare participants' characteristics and responses on interest in contributing and perceived helpfulness of first-person patient SDOH videos. 72.43% of participants (N = 70) believed a patient's first-person video on SDOH would be "Helpful" in preparing physicians to provide competent medical care; however, 71.43% responded "No" to "Interest" in sharing with physicians their experiences with SDOH. English preference and being U.S. born were factors significantly associated with viewing first-person SDOH video as "Helpful" (P > 0.001). Major themes from telephone interviews reflected enthusiasm for first-person patient narratives and perceived benefits of using patient experiences to educate physicians on SDOH. However, participants cited barriers to disclosing SDOH including brief and strictly clinical interactions with physicians, lack of continuity of care, and fear of being judged by physicians. While most participants recognized the utility of addressing social needs in medical education and reported satisfaction with their obstetricians and care, these factors did not uniformly translate into willingness to contribute first-person patient narratives. To improve the representation of patients from racial, ethnic, gender, linguistic, and sexual minorities into medical curricula, further research and strategies are needed to overcome the barriers discouraging patient disclosure of social needs to physicians.

Text-Mining and Video Analytics of COVID-19 Narratives Shared by Patients on YouTube.

This study explores how individuals who have experienced COVID-19 share their stories on YouTube, focusing on the nature of information disclosure, public engagement, and emotional impact pertaining to consumer health. Using a dataset of 186 YouTube videos, we used text mining and video analytics techniques to analyze textual transcripts and visual frames to identify themes, emotions, and their relationship with viewer engagement metrics. Findings reveal eight key themes: infection origins, symptoms, treatment, mental well-being, isolation, prevention, government directives, and vaccination. While viewers engaged most with videos about infection origins, treatment, and vaccination, fear and sadness in the text consistently drove views, likes, and comments. Visuals primarily conveyed happiness and sadness, but their influence on engagement varied. This research highlights the crucial role YouTube plays in disseminating COVID-19 patient narratives and suggests its potential for improving health communication strategies. By understanding how emotions and content influence viewer engagement, healthcare professionals and public health officials can tailor their messaging to better connect with the public and address pandemic-related anxieties.

Care considerations in medical assistance in dying for persons with mental illness as the sole underlying medical condition: a qualitative study of patient and family perspectives

BackgroundPersons with mental illness as their sole underlying medical condition are eligible to access medical assistance in dying (MAiD) in a small number of countries, including Belgium, the Netherlands, Luxemburg and Switzerland. In Canada, it is anticipated that people experiencing mental illness as their sole underlying medical condition (MI-SUMC) will be eligible to request MAiD as of March 17th 2024. To date, few studies have addressed patient and family perspectives on MAiD MI-SUMC care processes. This study aimed to address this gap and qualitatively explore the perspectives of persons with lived experience of mental illness and family members on care considerations during MI-SUMC implementation.MethodsThirty adults with lived experience of mental illness and 25 adult family members residing in Ontario participated in this study. To facilitate participant engagement, the semi-structured interview used a persona-scenario exercise to discuss perspectives on MAiD MI-SUMC acceptability and care considerations. Framework analysis was used to inductively analyze data using NVivo 12 Pro. Steps, processes, or other care considerations suggested by the participants were charted in a framework matrix after familiarization with the narratives. Key themes were further identified. A lived-experience advisory group participated in every aspect of this study.ResultsSix themes were developed from the patient and family narratives: (1) Raising MAiD MI-SUMC awareness; (2) Sensitive Introduction of MAiD MI-SUMC in goals of care discussions; (3) Asking for MAiD MI-SUMC: a person-focused response; (4) A comprehensive circle of MAiD MI-SUMC care; (5) A holistic, person-centered assessment process; and (6) Need for support in the aftermath of the decision. These themes highlighted a congruence of views between patient and family members and described key desired process ingredients, including a person-centred non-judgmental stance by care providers, inter-professional holistic care, shared decision making, and the primacy of patient autonomy in healthcare decision making.ConclusionsFamily and patient perspectives on the implementation of MAiD MI-SUMC offer important considerations for service planning that could complement existing and emerging professional practice standards. These stakeholders’ perspectives will continue to be essential in MAiD MI-SUMC implementation efforts, to better address the needs of diverse communities and inform improvement efforts.

"Illness Calls for Stories": Care, Communication, and Community in the COVID-19 Patient Narrative.

This creative-critical piece reflects on the practices of recording, communicating, and caring that took place on social media and in digital spaces during the COVID-19 pandemic. Using my own experience of contracting COVID-19 as a starting point, the piece looks at the ways in which epidemics have often been recorded in collaborative ways, with the personal, professional, and familial converging in historical texts that could be used as sources of medical authority. COVID-19 has similarly been immortalized across a variety of forms and by different communities. The piece particularly explores the ways in which collective epidemic experience has been represented online through autopathographical Tweets, TikTok cures, and group chat messages and the future purposes that such collaborative patient narratives can serve.

'Staying cool, calm and positive': A dialogical narrative analysis of emotional reactions in narratives about operable lung cancer.

Patients with lung cancer suffer from physical, psychosocial and particularly emotional challenges. Twenty-five percent of patients with lung cancer are offered surgery as a potential cure. Nevertheless, 40% of surgically treated patients will experience recurrence. Paradoxically, research shows a dominant narrative of operable lung cancer patients 'being lucky', which silences other narratives about suffering, worries and emotional challenges. To explore narratives about operable lung cancer, particularly emotional reactions to illness and suffering in these narratives. A qualitative design was applied. Six women and four men diagnosed with operable lung cancer were included from one university hospital in Denmark and interviewed 1 month after surgery using active interviews. The interviews were subject to dialogical narrative analysis. The theoretical foundation is social constructivism, with socio-narratological inspiration. A typology of three emotional narratives emerged: 'staying cool', 'staying calm' and 'staying positive'. All three types of narrative are characterised by managing emotional reactions. Staying cool is characterised by not showing emotional reactions; staying calm narratives acknowledge emotional reactions, but that they need to be managed so that they do not burden relatives; and the last, staying positive, is characterised by managing emotional reactions in a positive direction. Together this typology of three emotional narratives revealed that operable lung cancer patients are under normative pressure from these socially preferred narratives of ideal emotional reactions to lung cancer. A typology of three emotional narratives were identified and can be called 'feeling rules' that guide patients after lung cancer surgery to manage their emotions. Consequently, if patients do not live up to these three emotional narratives of staying cool, calm and positive, they may be socially isolated and restricted from access to support.

A Mixed-Method Approach to Explore Successful Recruitment and Treatment of Minority Patients on Therapeutic Cancer Clinical Trials at a Tertiary Referral Center Using Photo-Elicitation Interviews.

Under-represented minority patients (URM) enroll in cancer clinical trials (CCT) at low rates. To gain insight into barriers and facilitators to CCT enrollment, we conducted a mixed method study of URM patients who were successfully treated on a therapeutic CCT from 2018-2021 at all institutional sites. A retrospective chart review of 270 minority patients was conducted to identify patient demographics and characteristics. All living URM patients were requested to participate in a survey and qualitative interview using a photo elicitation technique. Most patients who participated in a CCT were patients with solid tumors, metastatic disease, and did not live in a rural area. Survey data showed that the two most significant drivers of CCT enrollment were potential of benefit to self and to others (altruism). Direct recommendation from a healthcare provider to participate in CCT was critical. URM patients enrolled on a CCT experience a significant burden of symptoms and financial distress. Key themes identified from the interviews that motivated patients to participate included chance for cure, staying positive, altruism and advancement of science, and having diverse representation in research. Patient-level facilitators to participation included social support, cost coverage, and limited treatment options. Sytematic facilitators identified included minimizing logistical barriers, decentralizing cancer clinical trials, increasing awareness via patient narratives, diversifying research staff, minimizing cost, and being clear on puropose and benefit of the trial. Success stories of minority recruitment can provide useful information to enhance minority accrual. Photo elicitation interviews provide rich narratives of patient experience.

Examining One-Star Reviews in Orthopaedic Hand Surgeons in Large U.S. Cities

Abstract Introduction Physician-review websites are a commonly used resource by patients when choosing a surgeon. While data exist regarding some surgical specialties, no study has examined negative one-star reviews for orthopaedic-trained hand surgeons. The goal of this study was to investigate one-star reviews regarding orthopaedic-trained hand and upper extremity surgeons in the 10 largest cities in the United States to determine the associated factors behind unsatisfied patients to improve patient care. Methods Patient reviews and narratives of orthopaedic-trained hand surgeons were collected from the 10 largest cities in the United States using Vitals.com. One-star reviews (out of a five-star maximum) with comments were identified and classified as operative or nonoperative. These reviews were further subclassified based on the nature of the comment. Results A total of 830 one-star reviews with 1,662 complaints were included in this study. Of these complaints, 557 (33.5%) were from patients who received operative care and 1,105 (66.5%) were from nonoperative care patients. Nonoperative patient one-star reviews had a significantly higher proportion of complaints related to bedside manners (37.6 to 19.6%, p &lt; 0.001), not enough time spent with the provider (18.1 to 4.5%, p &lt; 0.001), and wait time (13.3 to 3.2%, p &lt; 0.001) as compared with operative patient one-star reviews. Operative patient one-star reviews had a higher proportion of complaints related to disagreement with the physician's decision or plan (15.6 to 10.2%, p = 0.002); uncontrolled pain (14.4 to 7.9%, p &lt; 0.001); and medical staff or institution (17.2 to 12.9%, p = 0.018) as compared with nonoperative patients. Discussion Most one-star reviews regarding orthopaedic-trained hand surgeons referenced nonclinical components—bedside manner was the most common complaint. It was determined that surgical patients were less likely to leave a one-star review; however, if they did, the most common complaint was in reference to a disagreement with the physician's decision or uncontrolled pain postoperatively. Type of Study Outcomes 2c.

Detection of Adverse Event Signals with Severity Grade Classification from Cancer Patient Narrative.

Adverse event (AE) management is crucial to improve anti-cancer treatment outcomes, but it is reported that some AE signals can be missed in clinical visits. Thus, monitoring AE signals seamlessly, including events outside hospitals, would be helpful for early intervention. Here we investigated how to detect AE signals from texts written by cancer patients themselves by developing deep-learning (DL) models to classify posts mentioning AEs according to severity grade, in order to focus on those that might need immediate treatment interventions. Using patient blogs written in Japanese by cancer patients as a data source, we built DL models based on three approaches, BERT, ELECTRA, and T5. Among these models, T5 showed the best F1 scores for both Grade ≥ 1 and ≥ 2 article classification tasks (0.85 and 0.53, respectively). This model might benefit patients by enabling earlier AE signal detection, thereby improving quality of life.

Perceived outcomes of periacetabular osteotomy.

Social media is a popular resource for patients seeking medical information and sharing experiences. periacetabular osteotomy (PAO) is the gold-standard treatment for symptomatic acetabular dysplasia with good long-term outcomes. However, little is known regarding the perceived outcomes of PAO on social media. The aims of this study were to describe the perceived outcomes following PAO using three social media platforms: Facebook, Instagram, and X (formerly known as Twitter). Facebook, Instagram, and X posts were retrospectively collected from 1 February 2023. Facebook posts were collected from the two most populated interest groups: "periacetabular osteotomy" and "PAO Australia." Instagram and X posts were queried using the most popular hashtags: #PAOwarrior, #periacetabularosteotomy, #periacetabularosteotomyrecovery, #PAOsurgery, and #PAOrecovery. Posts were assessed for demographic data (sex, race, location), perspective (patient, physician, professional organization, industry), timing (preoperative vs postoperative), and perceived outcome (positive, negative, neutral). A total of 1,054 Facebook posts, 1,003 Instagram posts, and 502 X posts were consecutively assessed from 887 unique authors. The majority (63.3%) of these posts were from patients in the postoperative period, with a median of 84 days postoperatively (interquartile range 20 to 275). The longest follow-up timeframe postoperatively was 20 years. Regarding perceived outcomes, 52.8% expressed satisfaction, 39.7% held neutral opinions, and 7.5% were dissatisfied. Most dissatisfied patients (50.9%) reported pain (chronic or uncontrolled acute) as an attributing factor. Most PAO-perceived surgical outcomes on social media had a positive tone. Findings also indicate that a small percentage of patients reported negative perceived outcomes. However, dissatisfaction with PAO primarily stemmed from postoperative pain. Social media posts from other sources (physicians, hospitals, professional organizations, etc.) trend towards neutrality. Healthcare providers must consider the social media narratives of patients following PAO, as they may reveal additional outcome expectations and help improve patient-centred care, create informed decision-making, and optimize treatment outcomes.

Effects of an empathy enhancement program using patient stories on attitudes and stigma toward mental illness among nursing students.

This study aims to explore the impact of an empathy intervention through patients' stories and investigate its impact on attitudes and stigma toward mental illness among nursing students prone to hold prejudices against this condition. Using a quasi-experimental pretest-posttest design, this study focused on nursing students and examined the effects of an empathy enhancement program targeting individuals with mental illnesses on communication, social distance, and prejudice. Ninety third-year nursing students from S and C cities and H and C universities enrolled in psychiatric nursing courses participated in the study. The intervention lasted 4 weeks and used the patient's story to facilitate a participatory approach to understanding the patient's life and encouraging mutual growth and expansion of consciousness in the therapeutic relationship. Age was treated as a covariate and analyzed using a two-way repeated-measure analysis of covariance. The Empathy Enhancement Program Using Patient Stories (EEP-PS) group and the clinical practicum group showed no significant differences in communication, social distance, and empathy scores between the two groups or across different time points. However, variations were observed when examining specific subdomains within each group and across time points. Informative communication (F = 10.34, p = 0.002) and affiliative communication (F = 21.60, p < 0.001), which are subcategories of communication, increased significantly in the posttest compared to the pretest. Among social distances, interpersonal-physical distance decreased significantly in the posttest compared to the pretest (F = 31.02, p < 0.001). Prejudice of incompetence (F = 6.52, p = 0.012) and prejudice of risk (F = 14.37, p < 0.001) were significantly lower in the posttest than in the pretest. Both the EEP-PS and clinical practicum groups experienced improvements in communication, social distance, and prejudice toward individuals with mental illness. This study suggests that direct patient interactions and the use of patient narratives as indirect methods are effective approaches for enhancing attitudes and reducing stigma toward mental illness among nursing students.

Improving motivation and treatment uptake behaviors of patients with eating disorders using patient narrative videos: study protocol of a pilot randomized controlled trial

BackgroundPatients with eating disorders (ED) typically report delays between the onset of symptoms and engagement with treatment services. Personal barriers including stigma, shame, and guilt, as well as the availability of social support may influence patients’ decisions to engage with treatment services. Patient narratives are personalized stories discussing the illness and recovery of previously affected persons. Such narratives can reduce self-stigma and provide current patients with hope for their own recovery.MethodThis pilot study will examine the effects of patient narrative videos on the treatment motivation and uptake of treatment services for patients with ED. Three narrative videos were developed from the perspectives of (a) a former patient with an ED, (b) an ED specialist, and (c) the same former patient discussing a somatic condition unrelated to ED. Patients will be randomized into three video viewing and one treatment-as-usual group. Effects on treatment motivation will be assessed using the University of Rhode Island Change Assessment Scale (URICA-S) immediately after viewing the videos, as well as one-week and three-month follow-ups. Treatment uptake will be assessed during follow-up using a questionnaire listing possible treatment interactions. A post-intervention questionnaire and semi-structured interviews will be used to assess the feasibility and acceptability of patient narrative videos for this population.DiscussionThere is an urgent need to encourage patients with ED to engage with specialized treatments as soon as possible. Patient narratives may be a pivotal approach to implementing cost effective and easy to disseminate early intervention programs to future patients with ED.