114 results match your criteria post-visit communications


Impact of an Educational Comic to Enhance Patient-Physician-Electronic Health Record Engagement: Prospective Observational Study.

JMIR Hum Factors 2021 Apr 28;8(2):e25054. Epub 2021 Apr 28.

Department of Medicine, University of Chicago, Chicago, IL, United States.

Background: Electronic health record (EHR) use can impede or augment patient-physician communication. However, little research explores the use of an educational comic to improve patient-physician-EHR interactions.

Objective: To evaluate the impact of an educational comic on patient EHR self-advocacy behaviors to promote patient engagement with the EHR during clinic visits. Read More

View Article and Full-Text PDF

Batman or Joker? A mixed-method approach to understanding children's perceptions of dentists.

Authors:
Burak Buldur

Eur J Oral Sci 2021 Apr 7:e12787. Epub 2021 Apr 7.

Department of Pediatric Dentistry, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey.

It is important to understand children's perceptions of dentists in order to improve child-dentist communication. The aim of this mixed-methods study was to develop and validate a conceptual model of individual determinants of children's perceptions of dentists. A total of 1014 children completed an oral health behaviour form, a metaphor form, the Children's Fear Survey Schedule-Dental Subscale, the Dental Trust Scale, and the Early Childhood Oral Health Impact Scale. Read More

View Article and Full-Text PDF

Impact of Pre-visit Contextual Data Collection on Patient-Physician Communication and Patient Activation: a Randomized Trial.

J Gen Intern Med 2021 Feb 9. Epub 2021 Feb 9.

Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.

Background: Patient contextual data (PCD) are often missing from electronic health records, limiting the opportunity to incorporate preferences and life circumstances into care. Engaging patients through tools that collect and summarize such data may improve communication and patient activation. However, differential tool adoption by race might widen health care disparities. Read More

View Article and Full-Text PDF
February 2021

Development and Pilot Testing of a Patient-Centered Web-Based Reproductive Decision Support Tool for Primary Care.

J Gen Intern Med 2021 Feb 4. Epub 2021 Feb 4.

Center for Health Equity, Research, and Promotion, VA Pittsburgh Health Care System, Pittsburgh, PA, USA.

Background: Patient-centered counseling to help women achieve their reproductive goals is an essential yet often absent component of primary care.

Objective: We developed and piloted MyPath, a novel web-based decision support tool integrating reproductive goals assessment, information about optimizing health before pregnancy, and contraceptive decision support, for use prior to primary care visits in the Veterans Administration (VA).

Design: We created MyPath using best practices for decision tool development, including a conceptual framework informed by theory and user-centered design with input from patients, providers, and scientific experts. Read More

View Article and Full-Text PDF
February 2021

Effect of provider recommendation style on the length of adolescent vaccine discussions.

Vaccine 2021 02 12;39(6):1018-1023. Epub 2021 Jan 12.

Department of Obstetrics and Gynecology, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA. Electronic address:

Objective: To determine whether providers' vaccine recommendation style affects length of the adolescent vaccine discussions.

Methods: We analyzed vaccine discussions using audio-recordings of clinical encounters where adolescents were eligible for HPV vaccines ± meningococcal vaccines. We measured length of vaccine discussions, the provider's use of an "indicated" (vaccination due at visit) or "elective" (vaccination is optional) recommendation style, and vaccine receipt. Read More

View Article and Full-Text PDF
February 2021

Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.

BMC Fam Pract 2021 01 4;22(1). Epub 2021 Jan 4.

Department of Internal Medicine, University of California Davis, 4150 V Street Suite 2400, Sacramento, CA, 95817, USA.

Background: Agenda setting is associated with more efficient care and better patient experience. This study develops a taxonomy of visit opening styles to assess use of agenda and non-agenda setting visit openings and their effects on participant experience.

Methods: This observational study analyzed 83 video recorded US primary care visits at a single academic medical center in California involving family medicine and internal medicine resident physicians (n = 49) and patients (n = 83) with chronic pain on opioids. Read More

View Article and Full-Text PDF
January 2021

Therapy Dogs' and Handlers' Behavior and Salivary Cortisol During Initial Visits in a Complex Medical Institution: A Pilot Study.

Front Vet Sci 2020 13;7:564201. Epub 2020 Nov 13.

Division of General Internal Medicine, Section of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, United States.

Therapy dogs provide health benefits for individuals who suffer from illnesses, such as dementia, depression, loneliness, and aggression. Therapy dogs' impact on human health has been thoroughly studied; however, studies on dog welfare have been limited. Additionally, as dogs have evolved with humans, they have learned to read non-verbal social cues. Read More

View Article and Full-Text PDF
November 2020

Framing the Clinical Encounter: Shared Decision-Making, Mammography Screening, and Decision Satisfaction.

J Health Commun 2020 09 28;25(9):681-691. Epub 2020 Oct 28.

School of Journalism and Mass Communication, UW-Madison , Madison, WI, USA.

The study examines whether physicians' framing of clinical interactions is related to patient shared decision-making (SDM) satisfaction when using a clinical decision support tool (CDST) concerning mammographic screening. To answer this question, we combined (a) system log data from a CDST, (b) content coding of the physicians' message framing while using the CDST, and (c) a post-visit patient survey to assess SDM satisfaction concerning screening mammography. Results suggest that two types of message frames - consequence frames and numerical frames - moderated the relationship of the CDST on SDM satisfaction. Read More

View Article and Full-Text PDF
September 2020

Engagement and Affective Communication During Pediatric Nephrology Clinic Visits: Associations with Medication Adherence.

Patient Educ Couns 2021 03 5;104(3):578-584. Epub 2020 Sep 5.

Johns Hopkins University School of Medicine, Baltimore MD - 733 N Broadway, Baltimore, MD, 21205, USA. Electronic address:

Objective: To evaluate whether engagement and affective communication among adolescents and young adults (AYAs) with chronic kidney disease (CKD), caregivers, and pediatric nephrology providers during outpatient clinic visits predicts antihypertensive medication adherence.

Methods: AYAs (n = 60, M age = 15.4 years, SD = 2. Read More

View Article and Full-Text PDF

Clinical problem solving and social determinants of health: a descriptive study using unannounced standardized patients to directly observe how resident physicians respond to social determinants of health.

Diagnosis (Berl) 2020 08;7(3):313-324

Department of Medicine, Division of General Internal Medicine and Clinical Innovation, NYU School of Medicine, New York, NY, USA.

Objectives While the need to address patients' social determinants of health (SDoH) is widely recognized, less is known about physicians' actual clinical problem-solving when it comes to SDoH. Do physicians include SDoH in their assessment strategy? Are SDoH incorporated into their diagnostic thinking and if so, do they document as part of their clinical reasoning? And do physicians directly address SDoH in their "solution" (treatment plan)? Methods We used Unannounced Standardized Patients (USPs) to assess internal medicine residents' clinical problem solving in response to a patient with asthma exacerbation and concern that her moldy apartment is contributing to symptoms - a case designed to represent a clear and direct link between a social determinant and patient health. Residents' clinical practices were assessed through a post-visit checklist and systematic chart review. Read More

View Article and Full-Text PDF

A single, early aged care experience improves speech-language pathology students' attitudes towards older people, communication confidence, and career aspirations in aged care.

Int J Speech Lang Pathol 2020 Jul 14:1-11. Epub 2020 Jul 14.

School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.

Purpose: This study aimed to investigate if a single, early learning experience in an aged care setting could influence speech-language pathology students': (1) attitudes towards older people; (2) confidence in communicating with older people; and (3) career aspirations in aged care.

Method: Ninety first-year undergraduate speech-language pathology students participated in a single visit to an aged care community centre. Students participated in recreational activities alongside older people and engaged in conversation. Read More

View Article and Full-Text PDF

Communicating cardiovascular risk to high-risk cancer survivors: a mixed-methods pilot study of a statin risk communication tool.

J Cancer Surviv 2020 08 10;14(4):417-423. Epub 2020 Feb 10.

Department of Medicine, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2nd Floor, New York City, NY, 10017, USA.

Purpose: Childhood, adolescent, and young adult cancer survivors treated with radiation therapy (RT) may be unaware of their high cardiovascular disease (CVD) risk or how to mitigate it. Tools are needed to improve understanding. We developed and pilot-tested a risk communication tool for shared decision-making with survivors regarding CVD risk reduction with statin therapy. Read More

View Article and Full-Text PDF

Patient affect, physician liking for the patient, physician behavior, and patient reported outcomes: A modeling approach.

Patient Educ Couns 2020 06 11;103(6):1143-1149. Epub 2020 Jan 11.

Department of Psychology, Northeastern University, Boston, MA, USA.

Objective: To determine associations between patient affect and physician liking of the patient, and their associations with physician behavior and patient-reported outcomes.

Methods: Structural equation modeling based on coding of 497 videotaped hospital encounters, with questionnaires assessing pre-visit patient affect, post-visit patient affect and encounter evaluations, and physician liking of the patient, involving 71 physicians.

Results: In first visits, patient reported outcomes were strongly correlated with physician behavior and less so with physician liking, while in later visits, patient reported outcomes were directly related to physician liking and not mediated by physician behavior. Read More

View Article and Full-Text PDF

Patient-reported outcomes in RA care improve patient communication, decision-making, satisfaction and confidence: qualitative results.

Rheumatology (Oxford) 2020 07;59(7):1662-1670

Division of Rheumatology, Department of Medicine, Johns Hopkins University.

Objective: To evaluate the impact of integrating patient-reported outcomes (PROs) into routine clinics, from the perspective of patients with RA, clinicians and other staff.

Methods: We conducted a prospective cohort study using a mixed methods sequential explanatory design at an academic arthritis clinic. RA patients completed selected Patient-Reported Outcomes Measurement Information System measures on tablets in the waiting room. Read More

View Article and Full-Text PDF

Orthosis Comfort Score: Establishing initial evidence of reliability and validity in ankle foot orthosis users.

Prosthet Orthot Int 2019 Oct 5;43(5):478-484. Epub 2019 Aug 5.

University of Ottawa, Ottawa, ON, Canada.

Background: Comfort of an orthosis is an important characteristic that is likely to dictate use of and satisfaction with a device. However, instruments to assess only orthosis user comfort do not exist. The Prosthetic Socket Fit Comfort Score, developed previously for prosthesis users, may be adapted to serve this purpose. Read More

View Article and Full-Text PDF
October 2019

Patient-Defined Visit Priorities in Primary Care: Psychosocial Versus Medically-Related Concerns.

J Am Board Fam Med 2019 Jul-Aug;32(4):513-520

From the Department of Internal Medicine(ECS), Division of Research (MTV, CSU, RWG), Kaiser Permanente Northern California, Oakland, CA.

Background: Primary care providers (PCPs) are often challenged to address multiple patient concerns during time-limited visits. The need for PCPs to limit the number of issues addressed may have a negative impact on discussion of patient-defined visit priorities.

Methods: Using data from a recent clinical trial (Aligning Patients and Providers, ClinicalTrials. Read More

View Article and Full-Text PDF

Challenges to patient centredness - a comparison of patient and doctor experiences from primary care.

BMC Fam Pract 2019 06 15;20(1):83. Epub 2019 Jun 15.

Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.

Background: We designed this observational study to investigate the level of patients' and doctors' ratings of patient-centred aspects of the primary care consultation.

Methods: Questionnaire study with patients and doctors. Consecutive patients in a primary care setting and 16 doctors responding post visit. Read More

View Article and Full-Text PDF

Sharing in care: engaging care partners in the care and communication of breast cancer patients.

Breast Cancer Res Treat 2019 Aug 4;177(1):127-136. Epub 2019 Jun 4.

The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Purpose: Family is often overlooked in cancer care. We developed a patient-family agenda setting intervention to engage family in cancer care communication.

Methods: We conducted a pilot randomized controlled trial (NCT03283553) of patients on active treatment for breast cancer and their family "care partner. Read More

View Article and Full-Text PDF

Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: a Pragmatic Cluster Randomized Trial.

J Gen Intern Med 2019 06 11;34(6):831-838. Epub 2019 Feb 11.

Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.

Background: Most patients with diabetes do not meet all evidence-based goals of care, and many patients report poor communication and lack of involvement in decision-making during primary care visits.

Objective: To test the hypothesis that a "Pre-Visit Prioritization" secure email message could improve visit communication and glycemic control among patients with type 2 diabetes.

Design: We conducted a pragmatic, provider-randomized, multi-site clinical trial from March 2015 to October 2016 across 30 primary care practices within Kaiser Permanente Northern California (KPNC), a large integrated care delivery system. Read More

View Article and Full-Text PDF

The association between patients' expectations and experiences of task-, affect- and therapy-oriented communication and their anxiety in medically unexplained symptoms consultations.

Health Expect 2019 06 30;22(3):338-347. Epub 2018 Dec 30.

Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.

Background: It is unknown whether patients with medically unexplained symptoms (MUS) differ from patients with medically explained symptoms (MES) regarding their expectations and experiences on task-oriented communication (ie, communication in which the primary focus is on exchanging medical content), affect-oriented communication (ie, communication in which the primary focus is on the emotional aspects of the interaction) and therapy-oriented communication (ie, communication in which the primary focus is on therapeutic aspects) of the consultation and the extent to which GPs meet their expectations.

Objective: This study aims to explore (a) differences in patients' expectations and experiences in consultations with MUS patients and patients with MES and (b) the influence of patients' experiences in these consultations on their post-visit anxiety level.

Study Design: Prospective cohort. Read More

View Article and Full-Text PDF

Measuring shared decision-making in the pediatric outpatient setting: Psychometric performance of the SDM-Q-9 and CollaboRATE among English and Spanish speaking parents in the US Midwest.

Patient Educ Couns 2019 04 23;102(4):742-748. Epub 2018 Oct 23.

Health Services and Outcomes Research, Children's Mercy Hospitals and Clinics, Kansas City, USA; University of Missouri - Kansas City School of Medicine, Kansas City, USA; University of Missouri - Kansas City School of Pharmacy, Kansas City, USA.

Objective: Shared decision-making (SDM) measures have never been assessed for validity and feasibility in pediatric outpatient settings. We compared psychometric performance of parent adaptations of a well-established measure (SDM-Q-9) to a newer measure focusing on provider effort in facilitating SDM (CollaboRATE) in two clinics.

Methods: English (n = 955) and Spanish (n = 58) speaking parents of children ages 1-5 years with symptoms of acute respiratory tract infections (ARTI) completed post-visit SDM-Q-9, CollaboRATE, satisfaction items (visit, provider communication, and study participation), and qualitative feedback. Read More

View Article and Full-Text PDF

Pill, patch or ring? A mixed methods analysis of provider counseling about combined hormonal contraception.

Contraception 2019 02 15;99(2):104-110. Epub 2018 Sep 15.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California; Department of Family and Community Medicine, University of California San Francisco, San Francisco, California; Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, California.

Objective: In this study we aimed to investigate the content and process of contraceptive counseling surrounding combined hormonal contraceptive (CHC) methods (combined oral contraceptives, the ring, and the patch).

Study Design: We performed a mixed methods analysis of data collected as part of the Patient-Provider Communication about Contraception study, in which reproductive age women and their providers were recruited at several San Francisco Bay Area clinics from 2009-2012. Participants completed pre- and post-visit surveys, and had their visits audio recorded and transcribed. Read More

View Article and Full-Text PDF
February 2019

Clinical Evaluation of an Individualized Risk Prediction Tool for Men on Active Surveillance for Prostate Cancer.

Urology 2018 Nov 30;121:118-124. Epub 2018 Aug 30.

Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Electronic address:

Objective: To determine whether providing individualized predictions of health outcomes to men on active surveillance (AS) alleviates cancer-related anxiety and improves risk understanding.

Materials And Methods: We consecutively recruited men from our large, institutional AS program before (n = 36) and after (n = 31) implementation of a risk prediction tool. Men in both groups were surveyed before and after their regular visits to assess their perceived cancer control, biopsy-specific anxiety, and burden from cancer-related information. Read More

View Article and Full-Text PDF
November 2018

A pilot study of observed physician-parent-child communication and child satisfaction in a gastroenterology clinic.

Patient Prefer Adherence 2018 26;12:1327-1335. Epub 2018 Jul 26.

Division of Adolescent Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,

Background: Child participation in pediatric medical visits is low. In this pilot study, we sought to better understand relationships between observed communication and child-reported perceptions of communication in a clinical setting.

Materials And Methods: For this cross-sectional observational study, pediatric gastroenterology appointments (n=39) were videotaped and coded to quantify various adult affective (eg, chit-chat, empathy) and facilitative (eg, asking questions, encouraging responses) behaviors toward the child, interference with child participation (eg, interrupting or ignoring child), and child verbal participation. Read More

View Article and Full-Text PDF

Preceptor Perceptions of Virtual Quality Assurance Experiential Site Visits.

Am J Pharm Educ 2018 May;82(4):6438

CVS Pharmacy, Des Moines, Iowa.

To determine preceptor perceptions of the value of experiential quality assurance site visits between virtual and onsite visits, and to gauge preceptor opinions of the optimal method of site visits based on the type of visit received. Site visits (12 virtual and 17 onsite) were conducted with 29 APPE sites located at least 200 miles from campus. Participating preceptors were invited to complete an online post-visit survey adapted from a previously validated and published survey tool measuring preceptor perceptions of the value of traditional onsite visits. Read More

View Article and Full-Text PDF

Indicated or elective? The association of providers' words with HPV vaccine receipt.

Hum Vaccin Immunother 2018 28;14(10):2503-2509. Epub 2018 Jun 28.

b Boston Medical Center , Boston , MA , USA.

Background: Appropriate provider recommendation is crucial to raising HPV vaccination uptake, yet scant research has explored actual conversations between providers and parents, the effect of parental pre-visit vaccine intention on vaccination, or the effect of conversation style on parental satisfaction with that conversation.

Methods: We analyzed 146 audio-recorded clinical encounters between providers, parents/guardians, and HPV vaccine-eligible adolescents, from May 2015 to March 2017, at eight practices in Northeastern U.S. Read More

View Article and Full-Text PDF

After-visit summaries in primary care: mixed methods results from a literature review and stakeholder interviews.

Fam Pract 2019 03;36(2):206-213

Division of General Internal Medicine, University of California, San Francisco, CA, USA.

Background: After-visit summary (AVS) documents presenting key information from each medical encounter have become standard in the USA due to federal health care reform. Little is known about how they are used or whether they improve patient care.

Methods: First, we completed a literature review and described the totality of the literature on AVS by article type and major outcome measures. Read More

View Article and Full-Text PDF

Impact of Medical Scribes on Physician and Patient Satisfaction in Primary Care.

J Gen Intern Med 2018 07 26;33(7):1109-1115. Epub 2018 Apr 26.

Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA.

Background: Use of electronic health records (EHRs) is associated with physician stress and burnout. While emergency departments and subspecialists have used scribes to address this issue, little is known about the impact of scribes in academic primary care.

Objective: Assess the impact of a scribe on physician and patient satisfaction at an academic general internal medicine (GIM) clinic. Read More

View Article and Full-Text PDF

Provider Information Provision and Breast Cancer Patient Well-Being.

Health Commun 2019 08 27;34(9):1032-1042. Epub 2018 Mar 27.

d Division of Surgical Oncology , Rutgers Cancer Institute of New Jersey.

Research continues to delineate and clarify specific communication behaviors associated with improved patient outcomes. In the context of breast cancer surgery, this exploratory study examined the effect of breast surgeon information provision on the immediate post-visit outcomes of patients' anxious preoccupation, intention to adhere to treatment recommendations, and treatment plan satisfaction. Participants included 51 newly diagnosed breast cancer patients receiving care from one breast surgeon at a National Cancer Institute-designated cancer center in the northeastern United States. Read More

View Article and Full-Text PDF

The ecology of patient and caregiver participation in consultations involving advanced cancer.

Psychooncology 2018 06 16;27(6):1642-1649. Epub 2018 Apr 16.

University of Rochester, Rochester, NY, USA.

Objective: To identify predictors of participation of patients with advanced cancer in clinical encounters with oncologists and to assess the impact of patient and caregiver participation on perceptions of physician support.

Methods: This is a secondary data analysis from the Values and Options in Cancer Care study, a cluster randomized clinical trial of a patient-centered communication intervention. Patients and caregivers completed pre-visit and post-visit health and communication measures. Read More

View Article and Full-Text PDF