We explored the relationship between family members and healthcare professionals (HCPs), specifically how family members can influence the course and outcome of patient care for youth. Exploring this ...under-researched area provided an opportunity to understand the tripartite relationship between the family, the youth experiencing mental health problems or substance use concerns and their HCP.
A qualitative research design was used to gain a full understanding of how family members experience relationships with HCPs. We interviewed 21 family members using semi-structure questions to explore the type of relationships formed between HCPs and family members throughout a patient's course of care, the family member's perceived role in the care of their youth accessing mental health or addiction services and the family member's awareness of formalized structures (i.e., hospital rules, policies) and resources that support family involvement.
Within a relationship-centred framework, four themes, with various sub-themes emerged from the interviews: 1) The family member-HCP relationship regarding creating a positive impression, being an extension of the patient and the discovery of "pink flags"; 2) The family member-youth-HCP relationship regarding the receptivity of youth to family involvement and a youth's individual right to privacy; 3)The family member's relationship to self with regard to the situation being a family illness; and 4) The family member's relationship with friends, family and peers regarding the feelings of loneliness, stigma and shame and the lack of understanding about mental health problems and substance use.
Our study provided in-depth information about the importance of family involvement in the care and health outcomes of youth who are accessing mental health and addiction services. Family members experienced and conceptualized their relationships with HCPs, their youth, themselves and their friends and peers as active interactions that influenced the course and outcomes of care. Future studies are needed to collect the multiple perspectives of youth and HCPs alongside with the family perspectives.
Compassion is a vital component to the achievement of positive health outcomes, particularly in mental health care. The rise of digital technologies may influence the delivery of compassionate care, ...and thus this relationship between compassion and digital health care needs to be better understood.
This scoping review aimed to identify existing digital technologies being used by patients and health professionals in the delivery of mental health care, understand how digital technologies are being used in the delivery of compassionate mental health care, and determine the facilitators of and barriers to digital technology use among patients and health professionals in the delivery of compassionate mental health care.
We conducted this scoping review through a search of Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online (MEDLINE), MEDLINE In-Process and EPub Ahead of Print, PsycINFO, and Web of Science for articles published from 1990 to 2019.
Of the 4472 articles screened, 37 articles were included for data extraction. Telemedicine was the most widely used technology by mental health professionals. Digital technologies were described as facilitating compassionate care and were classified using a conceptual model to identify each digital intersection with compassionate care. Facilitators of and barriers to providing compassionate care through digital technology were identified, including increased safety for providers, health care professional perceptions and abilities, and the use of picture-in-picture feedback to evaluate social cues.
Implementing digital technology into mental health care can improve the current delivery of compassionate care and create novel ways to provide compassion. However, as this is a new area of study, mental health professionals and organizations alike should be mindful that compassionate human-centered care is maintained in the delivery of digital health care. Future research could develop tools to facilitate and evaluate the enactment of compassion within digital health care.
Background: Interprofessional education (IPE) is thought to be important in fostering interprofessional practice (IPP) and in optimizing patient care, but formal evaluation is lacking.
Aim: To ...identify, through review of IPE evaluation instruments in the context of Barr/Kirkpatrick's hierarchy of IPE learner outcomes, the comprehensiveness of current evaluation strategies and gaps needing to be addressed.
Methods: MEDLINE and CINAHL were searched for work relating to IPE/IPP evaluation published between 1999 and September 2010 that contained evaluation tools. Tool items were stratified by learner outcome. Trends and gaps in tool use and scope were evaluated.
Results: One hundred and sixty three articles were reviewed and 33 relevant tools collected. Twenty-six (78.8%) were used in only one paper each. Five hundred and thirty eight relevant items were identified, with 68.0% assessing changes in perceptions of IPE/IPP. Fewer items were found to assess learner reactions (20.6%), changes in behaviour (9.7%), changes in knowledge (1.3%) and organizational practice (0.004%). No items addressed benefits to patients; most were subjective and could not be used to assess such higher level outcomes.
Conclusions: No gold-standard tool has been agreed upon in the literature, and none fully addresses all IPE learner outcomes. Objective measures of higher level outcomes are necessary to ensure comprehensive evaluation of IPE/IPP.
IntroductionThe notion of compassion and compassionate care is playing an increasingly important role in health professional education and in the delivery of high-quality healthcare. Digital ...contexts, however, are not considered in the conceptualisation of compassionate care, nor is there guidance on how compassionate care is to be exercised while using digital health technologies. The widespread diffusion of digital health technologies provides new contexts for compassionate care, with both opportunities for new forms and instantiations of compassion as well as new challenges. How compassion is both understood and enacted within this evolving, digital realm has not been synthesised.Methods and analysisThis scoping review protocol follows Arksey and O’Malley’s methodology to examine dimensions of compassionate professional practice when digital technologies are integrated into clinical care. Relevant peer-reviewed literature will be identified using a search strategy developed by medical librarians, which applies to six databases of medical, computer and information systems disciplines. Eligibility of articles will be determined using the two-stage screening process consisting of (1) title and abstract scan, and (2) full-text review. Screening, abstracting and charting will be conducted by two independent reviewers, with a third reviewer available for resolution when consensus is not achieved. In order to look at the range of current research in this area, extracted data will be thematically analysed and validated by content experts. Descriptive statistics will be calculated where necessary.Ethics and disseminationResearch ethics approval and consent to participate is not required for this scoping review. The results of the review will inform resource development and strategy for Associated Medical Services (AMS) Healthcare, a Canadian charitable organisation at the forefront of advancing research and leadership development in health and humanities, as part of the AMS Phoenix Project: A Call to Caring, particularly for digital professionalism frameworks so that they are inclusive of a compassion competency.
Abstract
Background
Given the increasing integration of digital health technologies in team-based primary care, this review aimed at understanding the impact of eHealth on patient-provider and ...provider-provider relationships.
Methods
A review of reviews was conducted on three databases to identify papers published in English from 2008 onwards. The impact of different types of eHealth on relationships and trust and the factors influencing the impact were thematically analyzed.
Results
A total of 79 reviews were included. Patient-provider relationships were discussed more frequently as compared to provider-provider relationships. Communication systems like telemedicine were the most discussed type of technology. eHealth was found to have both positive and negative impacts on relationships and/or trust. This impact was influenced by a range of patient-related, provider-related, technology-related, and organizational factors, such as patient sociodemographics, provider communication skills, technology design, and organizational technology implementation, respectively.
Conclusions
Recommendations are provided for effective and equitable technology selection, application, and training to optimize the impact of eHealth on relationships and trust. The review findings can inform providers’ and policymakers’ decision-making around the use of eHealth in primary care delivery to facilitate relationship-building.
Recent media attention about radiation has led to heightened public awareness and concern about radiation therapy (RT). An understanding of concerns and their potential role in patient ...decision-making can inform education efforts. A multiphase needs assessment survey was designed to ascertain broad public perceptions of radiation (phase I) and the more in-depth cancer patient perceptions of RT (phase II). One hundred forty-six phase I and 111 phase II surveys were completed. Data suggested a prevalence of negative connotations of the word “radiation,” often associated with information from the media or secondhand experience. Side effects during and after RT were reported as concerns, including misperceptions about becoming radioactive and impact on fertility. Rankings of quality and safety perceptions suggested confidence in staff training and equipment, though concerns regarding overdoses and protection of healthy tissue were higher amongst those who refused RT. In deciding whether or not to undergo RT, high value was placed on the reputation of the cancer centre and the expected effectiveness of RT. The importance of understanding RT was more highly regarded by those who underwent RT than those who refused it. Perceptions of RT should thus be addressed amongst those in a position to consider RT, to maximize RT utilization where appropriate.
Mentoring and coaching practices have supported the career and skill development of healthcare professionals (HCPs); however, their role in digital technology adoption and implementation for HCPs is ...unknown. The objective of this scoping review was to summarize information on healthcare education programs that have integrated mentoring or coaching as a key component.
The search strategy and keyword searches were developed by the project team and a research librarian. A two-stage screening process consisting of a title/abstract scan and a full-text review was conducted by two independent reviewers to determine study eligibility. Articles were included if they: (1) discussed the mentoring and/or coaching of HCPs on digital technology, including artificial intelligence, (2) described a population of HCPs at any stage of their career, and (3) were published in English.
A total of 9473 unique citations were screened, identifying 19 eligible articles. 11 articles described mentoring and/or coaching programs for digital technology adoption, while eigth described mentoring and/or coaching for digital technology implementation. Program participants represented a diverse range of industries (i.e., clinical, academic, education, business, and information technology). Digital technologies taught within programs included electronic health records (EHRs), ultrasound imaging, digital health informatics, and computer skills.
This review provided a summary of the role of mentoring and/or coaching practices within digital technology education for HCPs. Future training initiatives for HCPs should consider appropriate resources, program design, mentor-learner relationship, security concerns and setting clear expectations for program participants. Future research could explore mentor/coach characteristics that would facilitate successful skill transfer.
Suicide and risk management protocols in mental health research aim to ensure patient safety, provide vital information on how to assess suicidal ideation, manage risk, and respond to unexpected and ...expected situations. However, there is a lack of literature that identifies specific components and strategies to include in suicide and risk management protocols (SRMPs) for mental health research. The goal of this scoping review was to review academic and grey literature to determine core components and associated strategies, which can be used to inform SRMPs in mental health research.
The methodological framework outlined by Arksey and O'Malley was used for this scoping review. The search strategy, conducted by a medical librarian, was multidisciplinary and included seven databases. Two reviewers independently assessed eligibility criteria in each document and used a standardized charting form to extract relevant data. The extracted data were then examined using qualitative content analysis. Specifically, summative content analysis was used to identify the core components and strategies used in SRMPs. The data synthesis process was iterative.
This review included 36 documents, specifically 22 peer-reviewed articles and 14 documents from the grey literature. Five core components of SRMPs emerged from the reviewed literature including: training; educational resources for research staff; educational resources for research participants; risk assessment and management strategies; and clinical and research oversight. Potentials strategies for risk mitigation within each of the core components are outlined.
The five core components and associated strategies for inclusion in SRMPs will assist mental health researchers in conducting research safely and rigorously. Findings can inform the development of SRMPs and how to tailor them across various research contexts.
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