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van Vliet, L. M., Leeuwenburgh, M. L., Westendorp, J., van Dulmen, S., de Jong, P. C. & Stouthard, J. M. (2024). Good versus bad news consultations in advanced breast cancer: the role of empathy in information recall – an observational study. BMJ Supportive & Palliative Care, 14, e528-e532
Open this publication in new window or tab >>Good versus bad news consultations in advanced breast cancer: the role of empathy in information recall – an observational study
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2024 (English)In: BMJ Supportive & Palliative Care, ISSN 2045-435X, E-ISSN 2045-4368, Vol. 14, p. e528-e532Article in journal (Refereed) Published
Abstract [en]

Objective 

We explored, in advanced breast cancer, whether: (1) patients recall less information following bad versus good news consultations; (2) empathy has a greater effect on recalled information following bad versus good news consultations.

Methods 

Observational study using audio-recorded consultations. Participants’ recall of provided information about treatment options, aims/positive effects and side-effects was assessed. Clinician-expressed empathy and consultation type were determined. Regression analyses assessed associations between consultation type and recall, exploring moderating influences of clinician-expressed empathy.

Results

For 41 consultations (18 bad news, 23 good news), recall data were completed; total recall (47% vs 73%, p=0.03) and recall about treatment options (67% vs 85%, p=0.08, trend) were significantly worse following bad news compared with good news consultations. Recall about treatment aims/positive effects (53% vs 70%, p=0.30) and side-effects (28% vs 49%, p=0.20) was not significantly worse following bad news. Empathy moderated the relationship between consultation type and total recall (p<0.01), recall about treatment options (p=0.03) and about aims/positive effects (p<0.01) but not about side-effects (p=0.10). Only following good news consultations empathy influenced recall favourably.

Conclusions 

This explorative study suggests that in advanced cancer, information recall is especially impaired following bad news consultations, for which empathy does not improve remembered information.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31590 (URN)10.1136/spcare-2022-003938 (DOI)
Note

Funding:

Netherlands Institute for Advanced Study in the Humanities and Social Sciences 10.13039/501100001719KWF Kankerbestrijding 10.13039/501100004622

Available from: 2024-02-20 Created: 2024-02-20 Last updated: 2024-05-15Bibliographically approved
van Oorschot, F., Brouwers, M., Muris, J., Veen, M., Timmerman, A. & van Dulmen, S. (2024). How does guided group reflection work to support professional identity formation in postgraduate medical education: A scoping review. Medical teacher, 1-11
Open this publication in new window or tab >>How does guided group reflection work to support professional identity formation in postgraduate medical education: A scoping review
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2024 (English)In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, p. 1-11Article, review/survey (Refereed) Published
Abstract [en]

Purpose

In postgraduate medical education, guided group reflection is often applied to support professional identity formation. However, little is known about how guided group reflection is shaped and how it works. Our scoping review synthesizes existing evidence about various approaches for guided group reflection, their aims, components and potential working mechanisms.

 

Methods

We conducted a scoping review using JBI (Joanna Briggs Institute) guidelines for conducting scoping reviews. We searched PubMed, PsycINFO, EMBASE and ERIC databases for all research articles published in English or Dutch in an iterative team approach. The articles were extracted and summarized quantitatively and qualitatively.

 

Results

We included 71 papers (45 primary research papers and 26 non-empirical papers including program descriptions, theoretical concepts and personal experiences). We identified a diversity of approaches for guided group reflection (e.g. Balint groups, supervised collaborative reflection and exchange of experiences), applied in a variety of didactic formats and aims. We distilled potential working mechanisms relating to engagement in reflection, group learning and the supervisor’s role.

 

Conclusions

There are significant knowledge gaps about the aims and underlying mechanisms of guided group reflection. Future systematic research on these topics is needed to understand the effectiveness of educational methods, that can help facilitate learning conditions to best shape professional identity formation (PIF) in educational curricula.

Keywords
guided group reflection, medical speciality training, postgraduate medical education, professional identity formation, scoping review
National Category
Pedagogy Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31796 (URN)10.1080/0142159x.2024.2339409 (DOI)001203816200001 ()
Available from: 2024-05-03 Created: 2024-05-03 Last updated: 2024-05-03
McGhie-Fraser, B., McLoughlin, C., Lucassen, P., Ballering, A., van Dulmen, S., Brouwers, E., . . . Olde Hartman, T. (2024). Measuring persistent somatic symptom related stigmatisation: Development of the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP). Journal of Psychosomatic Research, Article ID 111689.
Open this publication in new window or tab >>Measuring persistent somatic symptom related stigmatisation: Development of the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP)
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2024 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, article id 111689Article in journal (Refereed) Published
Abstract [en]

Objective: Persistent somatic symptoms (PSS) describe recurrent or continuously occurring symptoms such as fatigue, dizziness, or pain that have persisted for at least several months. These include single symptoms such as chronic pain, combinations of symptoms, or functional disorders such as fibromyalgia or irritable bowel syndrome. While stigmatisation by healthcare professionals is regularly reported, there are limited measurement instruments demonstrating content validity. This study develops a new instrument to measure stigmatisation by healthcare professionals, the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP). Methods: Development was an iterative process consisting of research team review, item generation and cognitive interviewing. We generated a longlist of 60 items from previous reviews and qualitative research. We conducted 18 cognitive interviews with healthcare professionals in the United Kingdom (UK). We analysed the relevance, comprehensibility and comprehensiveness of items, including the potential for social desirability bias. Results: After research team consensus and initial feedback, we retained 40 items for cognitive interviewing. After our first round of interviews (n = 11), we removed 20 items, added three items and amended five items. After our second round of interviews (n = 7), we removed four items and amended three items. No major problems with relevance, comprehensibility, comprehensiveness or social desirability were found in remaining items. Conclusions: The provisional version of the PSSS-HCP contains 19 items across three domains (stereotypes, prejudice, discrimination), demonstrating sufficient content validity. Our next step will be to perform a validation study to finalise item selection and explore the structure of the PSSS-HCP. 

Keywords
discrimination, functional disorders, healthcare professionals, measurement instrument, persistent somatic symptoms, prejudice, scale, stereotype, stigma
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31817 (URN)10.1016/j.jpsychores.2024.111689 (DOI)
Funder
EU, Horizon Europe, 956673
Available from: 2024-05-13 Created: 2024-05-13 Last updated: 2024-05-13
van den Bosch, S. C., van Dalen, D., Meinders, M., van Goor, H., Bergé, S., Stommel, M. & van Dulmen, S. (2024). Outpatient Video Visits During the COVID-19 Pandemic: Cross-Sectional Survey Study of Patients’ Experiences and Characteristics. Journal of Medical Internet Research, 26, Article ID e49058.
Open this publication in new window or tab >>Outpatient Video Visits During the COVID-19 Pandemic: Cross-Sectional Survey Study of Patients’ Experiences and Characteristics
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2024 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 26, article id e49058Article in journal (Refereed) Published
Abstract [en]

Background: During the first lockdown of the COVID-19 pandemic, an exponential increase in video consultations replacing in-person outpatient visits was observed in hospitals. Insight into patients’ experiences with this type of consultation is helpful for a broad, sustainable, and patient-centered implementation of video consultation.

Objective: This study aims to examine patients’ experiences with video consultation during the COVID-19 pandemic and identify discriminative patient and consultation characteristics to determine when video consultation is most feasible.

Methods: A cross-sectional survey study was conducted. Patients aged ≥18 years and scheduled for a video consultation at the outpatient clinic of a Dutch university medical center from August 2020 to December 2020 for all medical specialties were eligible. Patients’ experiences were explored through a study-specific survey using descriptive quantitative statistics. Open-ended questions were qualitatively analyzed and thematically categorized into appreciated aspects and aspects for improvement. Discriminative patient and consultation characteristics were identified using 3 distinctive survey items. Characteristics of patients who scored and those who did not score all 3 items positively were analyzed using binary logistic regression.

Results: A total of 1054 patients were included in the analysis. Most patients (964/1054, 91.46%) were satisfied with their video consultation, with a mean overall grade of 8.6 (SD 1.3) of 10. In the qualitative analyses, 70.02% (738/1054) of the patients cited aspects they appreciated and 44.97% (474/1054) mentioned aspects for improvement during their consultation. Patients with better self-rated health reported a positive evaluation significantly more often (P=.001), which also held true for other medical specialties (vs surgical and nonsurgical specialties; P<.001).

Conclusions: Video consultation was perceived as highly satisfactory by patients during the COVID-19 pandemic, with the best experience reported by healthy participants and those undergoing their first consultation. Appreciated aspects are mainly at the individual professional level, organizational level, and innovation level itself. The aspects that were mentioned for improvement can be changed for the better.

Keywords
telemedicine, video visit, remote consultation, eHealth, patient-centered care, Covid-19, mobile phone
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31748 (URN)10.2196/49058 (DOI)001198427800001 ()38536236 (PubMedID)2-s2.0-85189264782 (Scopus ID)
Available from: 2024-04-09 Created: 2024-04-09 Last updated: 2024-04-29
Makoul, G., Noble, L., Gulbrandsen, P. & van Dulmen, S. (2024). Reinforcing the humanity in healthcare: The Glasgow Consensus Statement on effective communication in clinical encounters. Patient Education and Counseling, 122, Article ID 108158.
Open this publication in new window or tab >>Reinforcing the humanity in healthcare: The Glasgow Consensus Statement on effective communication in clinical encounters
2024 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 122, article id 108158Article in journal, Editorial material (Refereed) Published
Abstract [en]

Contemporary healthcare is characterized by multidisciplinary teamwork across a vast array of primary, secondary and tertiary services, augmented by progressively more technology and data. While these developments aim to improve care, they have also created obstacles and new challenges for both patients and health professionals. Indeed, the increasingly fragmented and transactional nature of clinical encounters can dehumanize the care experience across disciplines and specialties. Effective communication plays a pivotal role in reinforcing the humanity of healthcare through the delivery of person-centered care – compassionate, collaborative care that focuses on the needs of each patient as a whole person. After convening at the International Conference on Communication in Healthcare (Glasgow, 2022), an interdisciplinary group of researchers, educators and health professionals worked together to develop a framework for effective communication that both acknowledges critical challenges in contemporary health services and reinforces the humanity of healthcare. The Glasgow Consensus Statement is intended to function as a useful international touchstone for the training and practice of health professionals, fully recognizing and respecting that different countries are at different stages when it comes to teaching, assessment and policy. It also provides a vocabulary for monitoring the impact of system-level challenges. While effective communication may not change the structure of healthcare, it can improve the process if health professionals are supported in infusing the system with their own innate humanity and applying the framework offered within this consensus statement to reinforce the humanity in everyday practice.

Keywords
Communication, Clinician-patient, Person-centered care, Human-centered care
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31546 (URN)10.1016/j.pec.2024.108158 (DOI)
Available from: 2024-02-09 Created: 2024-02-09 Last updated: 2024-04-22Bibliographically approved
Noordam, D., Noordman, J., van den Braak, G., Visee, H., Bakker, A., Batenburg, R., . . . van Dulmen, S. (2024). Shared decision-making in undergraduate nursing and medical education: An explorative dual-method study. Patient Education and Counseling, Article ID 108246.
Open this publication in new window or tab >>Shared decision-making in undergraduate nursing and medical education: An explorative dual-method study
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2024 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, article id 108246Article in journal (Refereed) Published
Abstract [en]

Objective: This study explores how shared decision-making (SDM) is integrated in undergraduate nursing and medical education.

Methods: A dual-method design was applied. The integration of SDM in medicine and nursing education programs (i.e. SDM on paper) was explored through document analyses; the integration of SDM in curricula (i.e. SDM in class) through interviews with teachers and curriculum coordinators (N = 19).

Results: A majority of the education programs featured SDM, mostly non-explicit. In curricula SDM was generally implicitly featured in compulsory courses across all study years. SDM was often integrated into preexisting theories and models and taught through various methods and materials. Generally, teachers and supervisors were not trained in SDM themselves. They assessed students’ competence in SDM in a summative manner.

Conclusion: Overall, SDM was featured in undergraduate nursing and medical education, however, very implicitly. 

Keywords
Shared decision-making, Undergraduate education, Curricula, Education programs, Medical doctors, Nursing education
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31697 (URN)10.1016/j.pec.2024.108246 (DOI)001223684700001 ()
Available from: 2024-03-18 Created: 2024-03-18 Last updated: 2024-05-28Bibliographically approved
Engelen, M. M., Franken, M.-C. J. P., Stipdonk, L. W., Horton, S. E., Jackson, V. E., Reilly, S., . . . Eising, E. (2024). The Association Between Stuttering Burden and Psychosocial Aspects of Life in Adults. Journal of Speech, Language and Hearing Research, 67(5), 1385-1399
Open this publication in new window or tab >>The Association Between Stuttering Burden and Psychosocial Aspects of Life in Adults
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2024 (English)In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 67, no 5, p. 1385-1399Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Stuttering is a speech condition that can have a major impact on a person's quality of life. This descriptive study aimed to identify subgroups of people who stutter (PWS) based on stuttering burden and to investigate differences between these subgroups on psychosocial aspects of life. METHOD: The study included 618 adult participants who stutter. They completed a detailed survey examining stuttering symptomatology, impact of stuttering on anxiety, education and employment, experience of stuttering, and levels of depression, anxiety, and stress. A two-step cluster analytic procedure was performed to identify subgroups of PWS, based on self-report of stuttering frequency, severity, affect, and anxiety, four measures that together inform about stuttering burden. RESULTS: We identified a high- (n = 230) and a low-burden subgroup (n = 372). The high-burden subgroup reported a significantly higher impact of stuttering on education and employment, and higher levels of general depression, anxiety, stress, and overall impact of stuttering. These participants also reported that they trialed more different stuttering therapies than those with lower burden. CONCLUSIONS: Our results emphasize the need to be attentive to the diverse experiences and needs of PWS, rather than treating them as a homogeneous group. Our findings also stress the importance of personalized therapeutic strategies for individuals with stuttering, considering all aspects that could influence their stuttering burden. People with high-burden stuttering might, for example, have a higher need for psychological therapy to reduce stuttering-related anxiety. People with less emotional reactions but severe speech distortions may also have a moderate to high burden, but they may have a higher need for speech techniques to communicate with more ease. Future research should give more insights into the therapeutic needs of people highly burdened by their stuttering. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25582980.

National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31898 (URN)10.1044/2024_jslhr-23-00562 (DOI)2-s2.0-85192683587 (Scopus ID)
Available from: 2024-05-28 Created: 2024-05-28 Last updated: 2024-05-28
Scheffer, M., Menting, J., Boeije, H., van Nispen, R. & van Dulmen, S. (2024). Understanding healthcare communication in age-related macular degeneration care: A mixed-methods review of patients’ perspectives. Survey of ophthalmology
Open this publication in new window or tab >>Understanding healthcare communication in age-related macular degeneration care: A mixed-methods review of patients’ perspectives
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2024 (English)In: Survey of ophthalmology, ISSN 0039-6257, E-ISSN 1879-3304Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment among people aged 50 years and older. Earlier research has indicated that the communication process between patients and healthcare professionals (HCPs) leaves considerable room for improvement in AMD care. Effective communication is essential to enhance trust in the professional and understanding of the diagnosis and treatment, and decrease anxiety and stress related to illness. We review patients’ experiences, needs and preferences regarding information provision, communication style of the HCP and shared decision-making. We conducted a systematic search in PubMed, Embase, PsycINFO, CINAHL and Web of Science. Study quality was assessed using standard checklists of quality measures. Our search returned 31 eligible articles. Findings indicated current deficits in information provision for people with AMD. Patients were often ill-informed regarding the chronic character of the condition, treatment duration, nutrition, and visual aids and low vision rehabilitation. Many patients were not actively involved during the decision-making process. Altogether, patients with AMD are faced with challenges in terms of patient-HCP communication. Methods of providing information and discussing possible options for care need to be further investigated and improved for this patient group.

Keywords
age-related macular degeneration, information provision, communication, shared, decision-making, systematic review
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31712 (URN)10.1016/j.survophthal.2024.03.002 (DOI)2-s2.0-85189946116 (Scopus ID)
Available from: 2024-03-22 Created: 2024-03-22 Last updated: 2024-04-29
Wegstapel, J., den Hartog, T., Sneekes, M., Staal, B., van der Scheer-Horst, E., van Dulmen, S. & Brinkkemper, S. (2023). Automated Identification of Yellow Flags and Their Signal Terms in Physiotherapeutic Consultation Transcripts. In: Federico Cabitza, Ana Fred and Hugo Gamboa (Ed.), Proceedings of the 16th International Joint Conference on Biomedical Engineering Systems and Technologies BIOSTEC - (Volume 5): . Paper presented at 16th International Conference on Health Informatics, Lisbon, Portugal, 16-18 February, 2023. (pp. 530-537). SciTePress, 5
Open this publication in new window or tab >>Automated Identification of Yellow Flags and Their Signal Terms in Physiotherapeutic Consultation Transcripts
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2023 (English)In: Proceedings of the 16th International Joint Conference on Biomedical Engineering Systems and Technologies BIOSTEC - (Volume 5) / [ed] Federico Cabitza, Ana Fred and Hugo Gamboa, SciTePress, 2023, Vol. 5, p. 530-537Conference paper, Published paper (Refereed)
Abstract [en]

This paper investigates the possibility of automating the process of identifying yellow flags and their signal terms in physiotherapeutic consultation transcripts from patients with low back pain, using Automated Text Identification. It is part of the Automated Medical Reporting research domain. In physiotherapy focused on low back pain, yellow flags are considered psycho-social predictors of poor recovery and risk factors for chronic disability development. This paper uses a 6-step mixed method approach. Consultation transcripts and yellow flag assessment guidelines were collected, an automated identification tool was built and the OSPRO assessment guideline was used to test the tool for accuracy. It was found that it is possible to identify Yellow Flags and their Signal Terms automatically with the tool developed in this experiment. However, this is just the beginning, and much more research must be done in the future to further enhance the tool, mainly to improve precision.

Place, publisher, year, edition, pages
SciTePress, 2023
Series
BIOSTEC, ISSN 2184-4305
Keywords
Physiotherapy, Yellow Flags, Signal Terms, Automated Medical Reporting, Automated Text Identification
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-29914 (URN)10.5220/0011793800003414 (DOI)978-989-758-631-6 (ISBN)
Conference
16th International Conference on Health Informatics, Lisbon, Portugal, 16-18 February, 2023.
Available from: 2023-06-16 Created: 2023-06-16 Last updated: 2023-06-21Bibliographically approved
van Dulmen, S., Eide, H. & Finset, A. (2023). Implementing lifestyle interventions in clinical practice: The importance of adherence. Patient Education and Counseling, 109, Article ID 107651.
Open this publication in new window or tab >>Implementing lifestyle interventions in clinical practice: The importance of adherence
2023 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 109, article id 107651Article in journal, Editorial material (Other academic) Published
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-29446 (URN)10.1016/j.pec.2023.107651 (DOI)000933529100001 ()2-s2.0-85147414635 (Scopus ID)
Available from: 2023-02-13 Created: 2023-02-13 Last updated: 2024-02-01Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1651-7544

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