Patient Activation in Dialysis

Background: During the rapid onset of the pandemic, clinicians transitioned from traditional outpatient practice to virtual modalities for providing routine care to patient panels. Like training programs nationwide, telemedicine training and assessment had not been systematically incorporated into our residency. In response, a scheduled Internal Medicine (IM) Objective Structured Clinical Examination (OSCE) was adapted to a remote modality to become virtual care-focused learning experience for trainees and to provide valuable feedback to educators. Methods: Standardized Patients (SPs) rated residents on their communication (including information gathering, relationship development and patient education), patient activation and satisfaction, and telemedicine skills. Analyses included a comparison of domain scores for residents who participated in both the 2020 remote and 2019 in-person OSCEs, and a review of written resident comments about the virtual OSCE. Results: During 2020’s video visit OSCE (VOSCE), residents (n = 23) excelled at nonverbal communication but struggled with virtual physical exams and information gathering. In debrief, residents expressed substantial interest in more opportunity to practice virtual visit skills going forward. In comparing scores of the virtual care (2020) OSCE with the in-person (2019) version, the small subset of residents who participated in both assessments (n = 9) performed similarly on communication skills, patient satisfaction and activation. Patient education scores were significantly lower during the virtual care OSCE ( P = .008). Conclusion: Our reformulated OSCE accomplished 3 goals including; (1) physically distancing residents from SPs per COVID regulations, (2) providing residents with the opportunity to practice critical virtual visit skills, and (3) alerting our educators to curricular improvement areas. Our methods are useful for other institutions and have applications to the larger medical education community.

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Telephone follow-up of oncology patients: the contribution of the nurse specialist for a Service-Dominant Logic in hospital

BMC Health Services Research ◽

10.1186/s12913-021-06552-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Corinne Rochette ◽

Anne Sophie Michallet ◽

Stéphanie Malartre-Sapienza ◽

Sophie Rodier

Keyword(s):

Patient Activation ◽

Central Element ◽

Cancer Control ◽

Control Unit ◽

Active Phase ◽

Nurse Specialist ◽

Structured Interviews ◽

Service Dominant Logic ◽

Dominant Logic

Abstract Background The French healthcare system is characterised by a shift towards outpatient care and the desire to develop telemedicine affirmed in the collective commitment “Ma santé 2022” presented by President Macron in 2018. In France, remote patient follow up has recently been developed in the active phase of cancer treatment inspired by the patient navigation approach used in other countries. According to Service-Dominant Logic (S-D L), patients become more active. Their role in co-production of services is strengthened and their behaviours changed. Telephone follow-ups can contribute to modifying the relationship between the patient and the nurse navigators in charge of it, moving logically from a passive attitude from the patient to a more active one. Methods This study was carried out at Léon Bérard, a cancer control unit, in France. It concerned patients treated in an oncohaematology department, who benefited from telephone follow-ups carried out by nurse specialists during the active phase of their treatment. The multidisciplinary research team including social science researchers, physicians and carers developed a research protocol to study this pilot case. Essentially based on a qualitative approach, it was validated by the centre’s management to study this follow-up on patients’ behaviours. The 1st phase of the research, based on 24 semi-structured interviews with patients undergoing treatment undertaken from November 2018 to September 2019, is presented. Results The Telephone follow-up was a positive experience for all patients. The action of the nurse specialist helped to develop certain dimensions of in-role and extra-role behaviour that created value. The patients’ discourse has reported a positive follow-up in its clinical dimensions, its psychological dimensions and an enhanced quality of life. We detected a patient activation through their roles but it remained limited. The telephone follow-up also created a patient dependency. Conclusions The telephone follow-up is a relevant tool for patients undergoing treatment and it deserves to be more widely deployed. It brings comfort and creates a relationship based on trust but at the same time it limits the emancipation of the patient, which is a central element of the S-D logic and its empowerment.

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The relationships of health literacy, preferred involvement, and patient activation with perceived involvement in care among Mongolian patients with breast and cervical cancer

Patient Education and Counseling ◽

10.1016/j.pec.2021.05.010 ◽

2021 ◽

Author(s):

Dulmaa Munkhtogoo ◽

Erdenekhuu Nansalmaa ◽

Kuo-Piao Chung

Keyword(s):

Cervical Cancer ◽

Health Literacy ◽

Patient Activation ◽

Breast And Cervical Cancer ◽

Perceived Involvement

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The Impact of the COVID-19 Pandemic on Self-Reported Management of Chronic Conditions

Journal of Patient Experience ◽

10.1177/23743735211007693 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110076

Author(s):

Hyllore Imeri ◽

Erin Holmes ◽

Shane Desselle ◽

Meagen Rosenthal ◽

Marie Barnard

Keyword(s):

Locus Of Control ◽

Chronic Conditions ◽

Online Survey ◽

Health Locus Of Control ◽

Patient Activation ◽

Survey Study ◽

Chronic Obstructive ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

The Impact

Chronic conditions (CCs) management during the COVID-19 pandemic and the impact of the pandemic on patient activation (PA) and health locus of control (HLOC) remain unknown. This cross-sectional online survey study examined the role of COVID-19 pandemic-related worry or fear in PA and HLOC among patients with CCs. Individuals with CCs (n = 300) were recruited through MTurk Amazon. The questionnaire included sociodemographic questions, the Patient Activation Measure, and the Multidimensional Health Locus of Control–Form B. Out of the 300 participants, 9.7% were diagnosed with COVID-19, and 7.3% were hospitalized. Patients with cancer, chronic kidney disease, chronic obstructive pulmonary disease, drug abuse/substance abuse, and stroke reported significant difficulties in managing their CCs due to worry or fear because of COVID-19. More than half of the sample (45.7%) reported COVID-19-related worry or fear about managing their CCs, and these patients had lower PA and lower external HLOC compared to patients not affected by COVID-19-related worry or fear. Health professionals should provide more support for patients facing difficulties in managing their CCs during the COVID-19 pandemic.

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Patient Activation, Depressive Symptoms, and Self-Rated Health: Care Management Intervention Effects among High-Need, Medically Complex Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115690 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5690

Author(s):

Cynthia F. Corbett ◽

Kenn B. Daratha ◽

Sterling McPherson ◽

Crystal L. Smith ◽

Michael S. Wiser ◽

...

Keyword(s):

Depressive Symptoms ◽

Care Management ◽

Controlled Trial ◽

Patient Activation ◽

Study Groups ◽

Telephone Intervention ◽

Management Intervention ◽

Self Rated Health ◽

Randomized Controlled ◽

Complex Population

The purpose of this randomized controlled trial (n = 268) at a Federally Qualified Health Center was to evaluate the outcomes of a care management intervention versus an attention control telephone intervention on changes in patient activation, depressive symptoms and self-rated health among a population of high-need, medically complex adults. Both groups had similar, statistically significant improvements in patient activation and self-rated health. Both groups had significant reductions in depressive symptoms over time; however, the group who received the care management intervention had greater reductions in depressive symptoms. Participants in both study groups who had more depressive symptoms had lower activation at baseline and throughout the 12 month study. Findings suggest that patients in the high-need, medically complex population can realize improvements in patient activation, depressive symptoms, and health status perceptions even with a brief telephone intervention. The importance of treating depressive symptoms in patients with complex health conditions is highlighted.

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Estimating Measurement Error of the Patient Activation Measure for Respondents with Partially Missing Data

BioMed Research International ◽

10.1155/2015/270168 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Ariel Linden

Keyword(s):

Missing Data ◽

Measurement Error ◽

Controlled Trial ◽

Patient Activation ◽

Percentage Error ◽

Missing Responses ◽

Improve Measurement ◽

Patient Activation Measure ◽

Minimum Score ◽

Missing Items

The patient activation measure (PAM) is an increasingly popular instrument used as the basis for interventions to improve patient engagement and as an outcome measure to assess intervention effect. However, a PAM score may be calculated when there are missing responses, which could lead to substantial measurement error. In this paper, measurement error is systematically estimated across the full possible range of missing items (one to twelve), using simulation in which populated items were randomly replaced with missing data for each of 1,138 complete surveys obtained in a randomized controlled trial. The PAM score was then calculated, followed by comparisons of overall simulated average mean, minimum, and maximum PAM scores to the true PAM score in order to assess the absolute percentage error (APE) for each comparison. With only one missing item, the average APE was 2.5% comparing the true PAM score to the simulated minimum score and 4.3% compared to the simulated maximum score. APEs increased with additional missing items, such that surveys with 12 missing items had average APEs of 29.7% (minimum) and 44.4% (maximum). Several suggestions and alternative approaches are offered that could be pursued to improve measurement accuracy when responses are missing.

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