National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Arthritis (2)
- Behavioral Health (2)
- Blood Thinners (1)
- Cancer (8)
- Cancer: Breast Cancer (5)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (1)
- Caregiving (8)
- Children/Adolescents (7)
- Chronic Conditions (5)
- Clinical Decision Support (CDS) (2)
- (-) Clinician-Patient Communication (62)
- Communication (29)
- Comparative Effectiveness (1)
- COVID-19 (1)
- Cultural Competence (1)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Dialysis (1)
- Digestive Disease and Health (2)
- Disparities (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (4)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (6)
- Evidence-Based Practice (2)
- Genetics (1)
- Guidelines (2)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (4)
- Health Literacy (4)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Hospitals (1)
- Infectious Diseases (2)
- Inpatient Care (1)
- Kidney Disease and Health (2)
- Medication (2)
- Newborns/Infants (3)
- Patient-Centered Healthcare (17)
- Patient-Centered Outcomes Research (4)
- Patient and Family Engagement (29)
- Patient Experience (9)
- Prevention (1)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Provider (2)
- Provider: Physician (3)
- Quality of Care (3)
- Racial and Ethnic Minorities (4)
- Risk (1)
- (-) Shared Decision Making (62)
- Sleep Problems (1)
- Social Stigma (1)
- Stroke (1)
- Substance Abuse (1)
- Surgery (4)
- Training (1)
- Transplantation (1)
- Vaccination (2)
- Web-Based (1)
- Women (3)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 62 Research Studies DisplayedBuchanan CL, Morris MA, Matlock D
Parental experience and understanding of parent-provider discussions of treatment for infants with ureteropelvic junction obstruction.
The objective of this study was to understand what families perceive as necessary information to guide decisionmaking in the treatment of children with ureteropelvic junction obstruction (UPJO). The authors conducted semi-structured interviews with parents of children with UPJO. Their findings were organized into three major themes: barriers to meaningful participation in decisionmaking, logistical aspects, and psychosocial aspects. They concluded that these results highlighted the importance of caregivers needing clear and accurate information to engage in meaningful discussions related to surgical decisionmaking regarding UPJO treatment. They recommended patient education and enhanced psychosocial support for more meaningful parental engagement in the surgical decisionmaking process.
AHRQ-funded; HS024597.
Citation: Buchanan CL, Morris MA, Matlock D .
Parental experience and understanding of parent-provider discussions of treatment for infants with ureteropelvic junction obstruction.
PEC Innov 2023 Dec; 2:100142. doi: 10.1016/j.pecinn.2023.100142..
Keywords: Newborns/Infants, Patient Experience, Shared Decision Making, Patient and Family Engagement, Clinician-Patient Communication
Zisman-Ilani Y, Thompson KD, Siegel LS
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
The purpose of this multi-site cluster randomised controlled trial was to test the impact of standard Crohn's disease care and compare with the impact of shared decision making (SDM) on the provider’s choice of therapy, quality of decisions, and provider trust. A total of 158 adult patients with Crohn's disease within 15 years of their diagnosis, with no prior Crohn's disease complications, and who were candidates to receive immunomodulators or biologics, from 14 diverse gastroenterology practices in the US, participated in the study. 99 of those participants received the intervention and 59 received standard care. The study found that participants in the intervention group chose combination therapy more frequently, had a significantly lower decisional conflict, and had greater trust in their provider.
AHRQ-funded; HS021747.
Citation: Zisman-Ilani Y, Thompson KD, Siegel LS .
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
Aliment Pharmacol Ther 2023 Jan;57(2):205-14. doi: 10.1111/apt.17286..
Keywords: Digestive Disease and Health, Chronic Conditions, Shared Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication
Rao BR, Jung EH, Dickert NW
Getting cost discussions right: nudging patients to avoid cognitive pitfalls.
The purpose of this article was to discuss the challenges of high out-of-pocket medication costs and their negative impact on healthcare, patient behavior, and access to quality care. The authors report that integrating cost information into medical decisions can be a useful tool for improving patient outcomes, but there are several cognitive biases that can skew patients' decisions in different directions. The article emphasizes the need for using nudge strategies as a focused counterweight to address out-of-pocket costs and other complex medical decisions. The authors explain that nudges involving manipulations in framing and choice architecture can be harnessed to impact decisions in a predictable way without restricting options or changing economic incentives. The article suggests several nudge strategies that clinicians can employ to help patients make better decisions and avoid cognitive pitfalls in shared decision-making discussions related to out-of-pocket costs.
AHRQ-funded; HS028558.
Citation: Rao BR, Jung EH, Dickert NW .
Getting cost discussions right: nudging patients to avoid cognitive pitfalls.
Circ Cardiovasc Qual Outcomes 2023 Jan; 16(1):e009447. doi: 10.1161/circoutcomes.122.009447..
Keywords: Healthcare Costs, Shared Decision Making, Clinician-Patient Communication, Communication
Wasp GT, Knutzen KE, Murray GF
Systemic therapy decision making in advanced cancer: a qualitative analysis of patient-oncologist encounters.
This study sought to characterize patient-oncologist communication and decision making about continuing or limiting systemic therapy in encounters after an initial consultation, with a particular focus on whether and how oncologists foster shared decision making (SDM). The authors performed content analysis of outpatient oncology encounters at two US National Cancer Institute-designated cancer centers audio recorded between November 2010 and September 2014. A multidisciplinary team used a hybrid approach of inductive and deductive coding and theme development with a combination of random and purposive sampling. Among 31 randomly sampled dyads with 3 encounters each (93 total), systematic therapy decision making was discussed in 90% encounters. Only 34 oncologists broached limiting therapy, which 27 framed as temporary; nine as completion of a standard regime; and five as permanent discontinuation. Thematic analysis found that that (1) patients and oncologists framed continuing therapy as the default, (2) deficiencies in the SDM process (facilitating choice awareness, discussing options, and incorporating patient preferences) contributed to this default, and (3) oncologists use persuasion rather than deliberation when broaching discontinuation.
AHRQ-funded; HS022242.
Citation: Wasp GT, Knutzen KE, Murray GF .
Systemic therapy decision making in advanced cancer: a qualitative analysis of patient-oncologist encounters.
JCO Oncol Pract 2022 Aug;18(8):e1357-e66. doi: 10.1200/op.21.00377..
Keywords: Shared Decision Making, Cancer, Clinician-Patient Communication
Rosenberg SM, Gierisch JM, Revette AC
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
This study investigated the impact of a ductal carcinoma in situ (DCIS) diagnosis by engaging self-identified patients regarding their experience. Findings showed that, in a large, national sample, participants with a history of DCIS reported confusion and concern about the diagnosis and treatment, which caused worry and significant uncertainty.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Gierisch JM, Revette AC .
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
Cancer 2022 Apr 15;128(8):1676-83. doi: 10.1002/cncr.34126..
Keywords: Cancer: Breast Cancer, Cancer, Shared Decision Making, Women, Patient-Centered Healthcare, Clinician-Patient Communication, Patient and Family Engagement, Communication
Kunneman M, Branda ME, Ridgeway JL
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
The purpose of this trial was to determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. Findings showed that using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence, or improved diabetes control in patients with type 2 diabetes.
AHRQ-funded; HS018339.
Citation: Kunneman M, Branda ME, Ridgeway JL .
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
Endocrine 2022 Feb;75(2):377-91. doi: 10.1007/s12020-021-02861-4..
Keywords: Diabetes, Medication, Shared Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication, Chronic Conditions
Dossett LA, Mott NM, Bredbeck BC
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
The purpose of this study was to examine the role that an individual’s maximizing-minimizing trait, an inherent preference for more or less medical care, may influence the preference for low-value care in the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women 70 years of age or higher with early-stage, hormone-receptor positive invasive breast cancer. The researchers recruited women 70 years of age or higher (n=1600) who were maximizers (515), minimizers (550), or neutral (535), and presented them with a hypothetical breast cancer diagnosis and then randomized exposure to one of three follow-up messages. Messages included: 1) maximizer-tailored, 2) minimizer-tailored, or 3) neutral. The study reported that higher maximizing tendency correlated positively with electing both SLNB and radiotherapy on logistic regression. Any maximizer- or minimizer-tailoring decreased preference for SLNB in maximizing and neutral women but had no effect in minimizing women. Tailoring had no impact on radiotherapy decision, except for an increased probability of minimizers electing radiotherapy when presented with maximizer-tailored messaging. The study concluded that among women facing a hypothetical breast cancer diagnosis, tendencies for maximizing-minimizing are correlated with preferences for treatment.
AHRQ-funded; HS026030.
Citation: Dossett LA, Mott NM, Bredbeck BC .
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
J Surg Res 2022 Feb;270:503-12. doi: 10.1016/j.jss.2021.10.005..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Shared Decision Making, Clinician-Patient Communication, Communication
Aronson PL, Schaeffer P, Niccolai LM
Parents' perspectives on communication and shared decision making for febrile infants ≤60 days old.
This study examined parents’ perceptions of receiving and understanding information in the emergency department (ED) and their perspectives on shared decision making (SDM) in the management of febrile infants 60 days of age or less. The authors conducted semistructured interviews with 23 parents of febrile infants ≤60 days old evaluated in the pediatric ED at an urban, academic medical center. Themes for parents’ perspectives on SDM included: 1) giving parents the opportunity to express their opinions and concerns builds confidence in the decision making process, 2) parents’ preferences for participation in decision making vary considerably, and 3) different perceptions about risk influence parents’ preferences about having their infant undergo a lumbar puncture (LP). Parents valued risk and benefits of having their infant undergo an LP differently, which influences their preferences.
AHRQ-funded; HS026006.
Citation: Aronson PL, Schaeffer P, Niccolai LM .
Parents' perspectives on communication and shared decision making for febrile infants ≤60 days old.
Pediatr Emerg Care 2021 Dec;37(12):e1213-e19. doi: 10.1097/pec.0000000000001977..
Keywords: Newborns/Infants, Clinician-Patient Communication, Communication, Shared Decision Making, Emergency Department
Links AR, Callon W, Wasserman C
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
A deeper understanding of the dialogue clinicians use to relay treatment recommendations is needed to fully understand their influence on patient decisions about surgery. In this study, the authors characterize how otolaryngologists provide treatment recommendations and suggest a classification framework. The investigators concluded that clinicians provide treatment recommendations in a variety of ways that may introduce more or less certainty and choice to parental treatment decisions.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
Patient Educ Couns 2021 Jun;104(6):1371-79. doi: 10.1016/j.pec.2020.11.015..
Keywords: Children/Adolescents, Surgery, Caregiving, Shared Decision Making, Clinician-Patient Communication, Communication, Provider: Physician, Provider
Kostick KM, Blumenthal-Barby JS
Avoiding "toxic knowledge": the importance of framing personalized risk information in clinical decision-making.
In this article, the authors discuss personalized risk information in clinical decision making, concluding that the framing of this information’s intended purpose at the patient level should be tailored to the decision-making context as a patient perceives it, which may vary from patient to patient.
AHRQ-funded; HS027784.
Citation: Kostick KM, Blumenthal-Barby JS .
Avoiding "toxic knowledge": the importance of framing personalized risk information in clinical decision-making.
Per Med 2021 Mar;18(2):91-95. doi: 10.2217/pme-2020-0174..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Risk, Clinician-Patient Communication, Communication
Nair D, Malhotra S, Lupu D
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
This paper uses case vignettes to highlight challenges in communication, prognostication, and medical decision-making that have been exacerbated by the COVD-19 pandemic for patients with kidney disease. The authors include best practice recommendations to mitigate those issues and conclude with implications for interdisciplinary models of care in crisis settings. Concerns about certain biomarkers, demographics, and medical comorbidities that can predict an increased risk for mortality among patients with COVID-19 and kidney disease are discussed, because there may be communication barriers related to physical exposure and conservation of personal protective equipment with those at-risk patients.
AHRQ-funded; HS026395.
Citation: Nair D, Malhotra S, Lupu D .
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
Curr Opin Nephrol Hypertens 2021 Mar 1;30(2):190-97. doi: 10.1097/mnh.0000000000000689..
Keywords: COVID-19, Dialysis, Kidney Disease and Health, Shared Decision Making, Clinician-Patient Communication, Communication, Chronic Conditions
Aronson PL, Politi MC, Schaeffer P
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
This study’s aim was to develop and test a tool to engage parents of febrile infants 60 days or less of age evaluated in the emergency department (ED). The tool was designed to improve communication between parents and healthcare providers and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age. The authors conducted a multi-phase development and testing process including individual, semi-structured interviews with parents and clinicians; design of a “storyboard” of the tool with design impression testing; development of a software application prototype called e-Care; and usability testing of e-Care using qualitative assessment and the System Usability Scale (SUS). The authors interviewed 27 parents and 23 clinicians. After the interviews, they developed separate versions of e-Care for infants aged 28 days or less and 29 to 60 days of age in both English and Spanish. e-Care is divided into 4 sections: 1) homepage; 2) why testing is done; 3) what tests are done; and 4) what happens after testing. The mean SUS score given by parents and clinicians was 90.3 representing “excellent” usability.
AHRQ-funded; HS026006.
Citation: Aronson PL, Politi MC, Schaeffer P .
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
Acad Emerg Med 2021 Jan;28(1):46-59. doi: 10.1111/acem.14082..
Keywords: Clinician-Patient Communication, Communication, Newborns/Infants, Caregiving, Shared Decision Making, Patient and Family Engagement, Emergency Department, Health Information Technology (HIT)
Rogith D, Satterly T, Singh H
Application of human factors methods to understand missed follow-up of abnormal test results.
This study demonstrated application of human factors methods for understanding causes for lack of timely follow-up of abnormal test results ("missed results") in outpatient settings. The investigators identified 30 cases of missed test results by querying electronic health record data, developed a critical decision method based interview guide to understand decision-making processes, and interviewed physicians who ordered these tests. They analyzed transcribed responses, developed a CI-based flow model, and conducted a fault tree analysis to identify hierarchical relationships between factors that delayed action.
AHRQ-funded; HS022087; HS022901.
Citation: Rogith D, Satterly T, Singh H .
Application of human factors methods to understand missed follow-up of abnormal test results.
Appl Clin Inform 2020 Oct;11(5):692-98. doi: 10.1055/s-0040-1716537..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Shared Decision Making, Diagnostic Safety and Quality, Communication, Clinician-Patient Communication
Greenhawt M
Shared decision-making in the care of a patient with food allergy.
The purpose of this study was to determine the value of shared decision-making in the care of patients with food allergy. Data was compiled via a narrative review of the shared decision-making and food allergy outcomes literature for the past 20 years. Findings showed that shared decision-making was an approach that could greatly enhance food allergy care and improve patient-reported outcomes.
AHRQ-funded; HS024599.
Citation: Greenhawt M .
Shared decision-making in the care of a patient with food allergy.
Ann Allergy Asthma Immunol 2020 Sep;125(3):262-67. doi: 10.1016/j.anai.2020.05.031..
Keywords: Shared Decision Making, Clinician-Patient Communication, Patient and Family Engagement
Brand-McCarthy SR, Delaney RK, Noseworthy PA
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
This paper discusses the need for shared decision making (SDM) in atrial fibrillation (AF) patients not just at the beginning of treatment but throughout during ongoing care. Use of SDM can help with patient adherence to recommended anticoagulation treatment regimens and lifestyle changes. It can help build a strong partnership between clinician and patient.
AHRQ-funded; HS026379.
Citation: Brand-McCarthy SR, Delaney RK, Noseworthy PA .
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
Circ Cardiovasc Qual Outcomes 2020 Mar;13(3):e006080. doi: 10.1161/circoutcomes.119.006080..
Keywords: Shared Decision Making, Stroke, Heart Disease and Health, Cardiovascular Conditions, Prevention, Guidelines, Blood Thinners, Medication, Clinician-Patient Communication, Communication
Hale KL, Wallace DD, Blanco-Duran D
Conversations between Latina mothers and their child's mental health provider: An observational study of shared decision-making regarding pediatric patient mental health needs.
The authors evaluated shared decision-making (SDM) and delineated SDM processes in audio-recorded conversations between language-congruent Spanish-/English-speaking clinicians and parents of pediatric mental health patients. They found that their present sample performed on par with other populations studied to date, and that it expanded the evaluation of observed SDM to include Latino patients and new clinician populations. The practical implications of their findings is that use of the Observer OPTION(5) instrument highlights that eliciting and integrating parent/patient preferences is a skill that requires attention when delivering culturally competent interventions.
AHRQ-funded; HS000032.
Citation: Hale KL, Wallace DD, Blanco-Duran D .
Conversations between Latina mothers and their child's mental health provider: An observational study of shared decision-making regarding pediatric patient mental health needs.
Patient Educ Couns 2020 Jan;103(1):96-102. doi: 10.1016/j.pec.2019.08.013..
Keywords: Children/Adolescents, Shared Decision Making, Cultural Competence, Racial and Ethnic Minorities, Clinician-Patient Communication, Communication, Caregiving, Behavioral Health
Schoenfeld EM, Probst MA, Quigley
Does shared decision making actually occur in the emergency department? Looking at it from the patients' perspective.
In this study the investigators sought to assess the frequency, content, and quality of shared decision making (SDM) in the emergency department (ED), from patients' perspectives. The investigators found that fewer than half of ED patients surveyed reported they were involved in SDM. The most common decision for which SDM was used was around ED disposition (admission vs. discharge). When SDM was employed, patients generally rated the discussion highly.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Probst MA, Quigley .
Does shared decision making actually occur in the emergency department? Looking at it from the patients' perspective.
Acad Emerg Med 2019 Dec;26(12):1369-78. doi: 10.1111/acem.13850..
Keywords: Shared Decision Making, Emergency Department, Clinician-Patient Communication, Patient and Family Engagement
Gressler LE, Natafgi NM, DeForge BR
What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.
The purpose of this study was to identify and define potential positive and negative factors in patient experiences and patient-provider interactions that are associated with the pursuit and maintenance of treatment by those suffering from substance use disorders (SUD). The investigators conducted two focus groups with patients in treatment for SUD and four in-depth interviews with healthcare providers involved in the treatment of patients with SUD.
AHRQ-funded; HS022135.
Citation: Gressler LE, Natafgi NM, DeForge BR .
What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.
J Subst Use 2019;24(6):587-99. doi: 10.1080/14659891.2019.1620891..
Keywords: Clinician-Patient Communication, Shared Decision Making, Healthcare Utilization, Patient-Centered Healthcare, Patient Experience, Patient and Family Engagement, Substance Abuse
Ronis SD, Kleinman LC, Stange KC
A learning loop model of collaborative decision-making in chronic illness.
In this article, the authors discuss their learning loop model, which posits the relationship between pediatric patients, their parents, and their clinicians as central to the collaborative decision-making process in the setting of chronic illness. The model incorporates the evolution of both context and developmental capacity over time. It suggests that "meta-learning" from the experience of and outcomes from iterative decision is a key factor that may influence relationships and thus continued engagement in collaboration by patients, their parents, and their clinicians.
AHRQ-funded; HS024433.
Citation: Ronis SD, Kleinman LC, Stange KC .
A learning loop model of collaborative decision-making in chronic illness.
Acad Pediatr 2019 Jul;19(5):497-503. doi: 10.1016/j.acap.2019.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Shared Decision Making, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Clinician-Patient Communication, Communication
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Shared Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery
Pavlo AJ, O'Connell M, Olsen S
Missing ingredients in shared decision-making?
This article discusses the practice of shared decision making (SDM) for clinicians when making decisions in health care. This widespread practice is considered the best approach for person-centered care, but for individuals diagnosed with serious mental illness there are still many barriers to effective collaboration. The authors suggest that more emphasis needs to be placed on the doctor-patient relationship itself conducting SDM.
AHRQ-funded; HS023000.
Citation: Pavlo AJ, O'Connell M, Olsen S .
Missing ingredients in shared decision-making?
Psychiatr Q 2019 Jun;90(2):333-38. doi: 10.1007/s11126-019-9624-9..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Shared Decision Making, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Links AR, Callon W, Wasserman C
Surgeon use of medical jargon with parents in the outpatient setting.
This study analyzed the use of unexplained medical jargon with parents whose children have sleep-disordered breathing and their consultations with otolaryngologists in a pediatric surgical setting. Participants (64 parents and 8 otolaryngologists) completed questionnaires that evaluated demographics, clinical features and parental role in decision-making. Unexplained medical jargon was commonly used by physicians (mean total utterances per visit = 28.9) while parents used jargon a mean of 4.3 times. Clinicians used more jargon when they felt that parents had greater involvement in decision-making or when parents used more jargon themselves. These results will be incorporated into communication training for clinicians.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Surgeon use of medical jargon with parents in the outpatient setting.
Patient Educ Couns 2019 Jun;102(6):1111-18. doi: 10.1016/j.pec.2019.02.002..
Keywords: Ambulatory Care and Surgery, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Shared Decision Making, Education: Patient and Caregiver, Provider, Provider: Physician
Ashcraft LE, Asato M, Houtrow AJ
Parent empowerment in pediatric healthcare settings: a systematic review of observational studies.
The objective of this systematic review was to synthesize potential antecedents and consequences of parent empowerment in healthcare settings. The authors identified six themes within consequences of empowerment: increased parent involvement in daily care, improved symptom management, enhanced informational needs and tools, increased involvement in care decisions, increased advocacy for child, and engagement in empowering others. Six themes summarizing antecedents of empowerment also emerged: parent-provider relationships.
AHRQ-funded; HS022989.
Citation: Ashcraft LE, Asato M, Houtrow AJ .
Parent empowerment in pediatric healthcare settings: a systematic review of observational studies.
Patient 2019 Apr;12(2):199-212. doi: 10.1007/s40271-018-0336-2..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Shared Decision Making, Patient and Family Engagement
Shah PD, Calo WA, Gikey MB
Questions and concerns about HPV vaccine: a communication experiment.
The purpose of this study was to identify effective responses to parents' questions and concerns about human papillomavirus (HPV) vaccine, using a surveyed national sample of 1196 parents of children aged 9 - 17. Brief videos of a pediatrician providing messages that addressed seven HPV vaccination topics were recorded and parents viewed four videos on one randomly assigned topic, in random order, and evaluated the messages. The authors conclude that the most important principles for increasing message effectiveness are to include information on the benefits of vaccination, including cancer prevention, and to avoid expressing urgency to vaccinate when addressing parents' questions or concerns. The authors also recommend that providers need to be prepared to have longer conversations with parents who express concerns about the HPV vaccine.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Gikey MB .
Questions and concerns about HPV vaccine: a communication experiment.
Pediatrics 2019 Feb;143(2):pii: e20181872. doi: 10.1542/peds.2018-1872..
Keywords: Clinician-Patient Communication, Communication, Shared Decision Making, Infectious Diseases, Vaccination
Fisher KA, Tan ASL, Matlock DD
Keeping the patient in the center: common challenges in the practice of shared decision making.
This study examines the practice of shared-decision making (SDM) to achieve patient-centered decisions. It was determined that not all circumstances make it possible for that to happen and there have to be some basic elements present. Those elements include the patients’ health literacy, their emotional state, their relationship with the clinician and the nature of the decision.
AHRQ-funded; HS024596.
Citation: Fisher KA, Tan ASL, Matlock DD .
Keeping the patient in the center: common challenges in the practice of shared decision making.
Patient Educ Couns 2018 Dec;101(12):2195-201. doi: 10.1016/j.pec.2018.08.007..
Keywords: Clinician-Patient Communication, Shared Decision Making, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement