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1.
Patient Education & Counseling ; 109:N.PAG-N.PAG, 2023.
Article in English | Academic Search Complete | ID: covidwho-2257903

ABSTRACT

Although debates about vaccination resurfaced with the COVID-19 pandemic, they date back to the invention of the first vaccines, and have been especially active in recent years, often resulting in outbreaks such as the 2017 measles outbreak in the UK. Anti-vaccination and vaccine hesitancy has been acknowledged by WHO as one of the most urgent threats to global health. Social media and especially online forums are particularly important mediums in this regard as misinformation may easily take place and spread uncontrollably. Considering that healthcare professionals play a key role in building public trust regarding vaccinations, this study aims to examine how healthcare professionals communicate about childhood vaccines and how other users' information attributed to healthcare professionals was shaped in the most popular UK parenting website, Mumsnet. All posts about vaccinations in 2019 were manually extracted from the Mumsnet forum using the keywords jab(s), vaccin*, jag(s), injection(s), immuni*, vax*. This resulted in 10,995 total posts. A stratified random sample by month of around 15% (n = 1,563) was subsequently extracted and coded through content analysis. Of the overall sample only a small percentage (1%, n = 16) of the posts were authored by a healthcare professional. However, these posts deserve attention due to their potential for impact in this environment. Early childhood vaccines were the most mentioned vaccines by healthcare professionals, and they mostly communicated directly to the posters (88%), and the most dominant topic was the share of experience/thought and side/adverse effects. In this study, which reveals healthcare professional-patient communication regarding vaccinations is not limited to physical, and the emergence of social media should be taken into care. Especially mediums that allow more personalised communication for patients pursuing an answer for their questions such as web forums play a key role in terms of public health. [ FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

2.
The Journal for Nurse Practitioners ; 19(1), 2023.
Article in English | ProQuest Central | ID: covidwho-2247326

ABSTRACT

Telehealth demand increased precipitously among all populations, particularly Medicare beneficiaries with complex care needs, during the coronavirus disease 2019 pandemic. Current nurse practitioner (NP) graduates require practice readiness in telehealth when transitioning to advanced practice. Competency-based education models integrate progressive, multimodal evaluation of core practice competencies, including telehealth. Self-reflection supports student acquisition of new competencies. Thematic analysis of guided reflections after a pilot gerontologic robot-enabled telehealth simulation identified curricular opportunities in a primary care NP program. NP students' perceived challenges in communication and adaptation to virtual patient presence were considered in building integrated telehealth curricula in clinical courses applying the 4Ps of Telehealth Education (Planning, Preparing;Providing;and Performance Improvement) framework.

3.
Med Decis Making ; 42(6): 741-754, 2022 08.
Article in English | MEDLINE | ID: covidwho-2278202

ABSTRACT

HIGHLIGHTS: Fuzzy-trace theory (FTT) supports practical approaches to improving health and medicine.FTT differs in important respects from other theories of decision making, which has implications for how to help patients, providers, and health communicators.Gist mental representations emphasize categorical distinctions, reflect understanding in context, and help cue values relevant to health and patient care.Understanding the science behind theory is crucial for evidence-based medicine.


Subject(s)
Decision Making , Problem Solving , Clinical Decision-Making , Humans
4.
Patient Educ Couns ; 106: 107-112, 2023 01.
Article in English | MEDLINE | ID: covidwho-2259262

ABSTRACT

OBJECTIVE: To test the impact of varied physician recommendations on COVID-19 vaccine hesitancy. METHODS: We conducted a vignette-based experimental survey on Prolific, an online research platform. COVID-19 vaccine hesitant, adult panel members were assigned to one of five messages that varied by recommendation style (participatory vs explicit) and strategy (acknowledgement of concerns; comparison to the flu shot; statement that millions of people have already received it; emphasis on protecting others). Vaccine hesitancy was re-assessed with the question, "Would you get vaccinated at this visit?". RESULTS: Of the 752 participants, 60.1% were female, 43.4% Black, 23.6% Latino, and 33.0% White; mean age was 35.6 years. Overall, 33.1% of the initially "not sure" and 13.1% of the initially "no" participants became less hesitant following any recommendation. Among the "not sure" participants, 20.3% of those who received a participatory recommendation became less hesitant compared with 34.3%- 39.5% for the explicit recommendations. The "protect others" message was most effective among initially "no" participants; 19.8% become less hesitant, compared to 8.7% for the participatory recommendation. CONCLUSION: A physician recommendation may reduce COVID-19 vaccine hesitancy. PRACTICE IMPLICATIONS: An explicit recommendation and "protect others" message appear to be important elements of a physician recommendation for COVID-19 vaccination.


Subject(s)
COVID-19 , Physicians , Adult , Female , Humans , Male , COVID-19 Vaccines , COVID-19/prevention & control , Intention , Vaccination
5.
Int J Environ Res Public Health ; 20(1)2022 12 25.
Article in English | MEDLINE | ID: covidwho-2246213

ABSTRACT

The purpose of this study is to evaluate patient complaints using the Healthcare Complaints Analysis Tool (HCAT) during the COVID-19 pandemic in 2021 in Taiwan. Additionally, the study examines the distribution and type of patient complaints before and during the COVID-19 pandemic to provide a better clinical procedure, hospital management and patient relationship. This study utilizes a cross-sectional design. We collected patient complaints from January 2021 to December 2021 at a medical center in Southern Taiwan. Using the Healthcare Complaints Analysis Tool (HCAT), the patient complaints are classified and coded into three major domains (clinical, management and relationship), and seven problem categories (quality, safety, environment, institutional process, respect and patient rights, listening and communication). We further compared and categorized the complaints based on whether they were COVID-19-related or not and whether it was before or during the COVID-19 pandemic to understand the differences in patient complaints. In total, we collected 584 events of patient complaints. Based on the HCAT domains, the complaints about management were the highest, at 52.9%, followed by complaints about relationship, about 37.7%. According to the types of problem, the complaints about the environment were the highest, about 32.5% (190/584), followed by communication at about 29.6% (173/584), and institutional process at about 20.4% (119/584). There were 178 COVID-19-related complaints and they were made more frequently during Q3 and Q4 (from mid-June to December) which was the pandemic period in 2021 in Taiwan. Among the COVID-19-related complaints, the most frequent were in the environment domain with 114 cases (about 65.7% of COVID-19-related complaints). The domains of patient complaints were statistically different between COVID-19-related and non-related (p < 0.001). During the COVID-19 pandemic, the proportion of COVID-19-related complaints increased 1.67 times (117/312 vs. 61/272, p < 0.001). Both prior to and during the COVID-19 pandemic, management-related complaints represented the highest domain. During the COVID-19 pandemic, the implementation of infectious disease prevention and control policies and actions may have developed some inconvenience and difficulty in seeking medical practice and process. These characteristics (complaints) are more prominent, and timely and patient-first consideration is required immediately to build up better clinical procedures, the healthcare environment and comprehensive communication. Using the HCAT can allow health centers or health practitioners to understand the needs and demands of patients through complaints, provide friendly medical and health services, avoid unequal information transmission, build trust in doctor−patient relationships and improve patients' safety.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Taiwan/epidemiology , Cross-Sectional Studies , Hospitals , Patient Satisfaction
6.
Patient Experience Journal ; 7(2):27-30, 2020.
Article in English | Scopus | ID: covidwho-2235663

ABSTRACT

This narrative presents a series of stories (interactions) lived by a palliative care nurse during the time of COVID-19, a time when we tirelessly prepare to help the services that need us, but we have little preparation of ourselves for the changes that we will have to face in the care of our patients and families. It shares the lived experiences, difficulties, emotions lived by me but shared by so many around the world. It also tries to show that despite the scarcity of physical presence, creativity and commitment to patients and families make us go beyond ourselves and continue to make a difference by saying we are here!. © The Author(s), 2020.

7.
Iberica ; 2022(44):239-262, 2022.
Article in English | Scopus | ID: covidwho-2204356

ABSTRACT

Doctor-patient interpersonality strategies have evolved considerably in recent years, mainly due to the increase in telephone and online consultations generated by the Covid-19 pandemic. In such interactions, the control and expression of emotions have a crucial influence on the adequacy and effectiveness of communication. Remote interaction makes this affective exchange even more complex than in face-to-face consultations. This study aims to configure a comprehensive model for analysing the affective domain in virtual medical consultations, useful for English and Spanish patients and learners. With this aim, the most recognised theories on professional interpersonality are reviewed and applied to a corpus of doctor-patient interactions in Peninsular Spanish and British English, extracted from representative forums on the Internet. The analysis highlights how specific stance and register variation mechanisms positively and negatively influence the emotional domain in these communicative exchanges. The proposed model allows significant contrastive findings on the occurrence and intensity of sentiment markers in both languages. The results illustrate how doctors in Spanish favour a more cautious, detached and predictable encounter, while doctors in English use a greater number and variety of attitudinal strategies to achieve engagement, empathy and emotional comfort. © 2022, AELFE. All rights reserved.

8.
Cancers (Basel) ; 14(10)2022 May 23.
Article in English | MEDLINE | ID: covidwho-2115344

ABSTRACT

Patients with cancer are concerned about the effects of the COVID-19 vaccination. We conducted an online survey on the COVID-19 vaccination status and side effects among patients with cancer in Japan between 8 and 14 August 2021. We included 1182 female patients with cancer aged 20-70 years and registered on an online patient website. Of the patients, 944 had breast cancer, 216 had gynecological cancer, 798 were undergoing drug/radiation therapy, and 370 were in follow-up. At the time of the survey, 885 patients had already received at least one dose. Of these, 580 had also received their second dose. The incidence rate of side effects was equivalent to previous reports. In patients with breast cancer, problems such as the onset or worsening of lymphedema or axillary lymphadenopathy metastasis requiring differential diagnosis were encountered following vaccination. A total of 768 patients were concerned about the vaccine at some point, and 726 consulted with their attending physicians about the timing or side effects of the vaccination. Of the 110 patients undergoing chemotherapy or radiation therapy, 75 adjusted the timing of the vaccination based on their therapy. The cross-analysis revealed that 81% of those who consulted their physician had received at least one dose of the COVID-19 vaccination compared with 65% of those who had not consulted their physician. Consulting with a physician about the COVID-19 vaccination was found to alleviate the concerns of patients with cancer and encourage them to get vaccinated.

9.
Int J Med Inform ; 168: 104898, 2022 12.
Article in English | MEDLINE | ID: covidwho-2069138

ABSTRACT

BACKGROUND: Chronic kidney disease (CKD) has a strong negative impact on patients. Finding ways to improve CKD patients' conditions by shared decision-making is receiving much attention. However, little attention has been paid to influencing antecedents and effects of shared decision-making. Meanwhile, as advanced technologies bring in new communication devices, effects of different types of communications used in shared decision-making need to be addressed. OBJECTIVE: This study proposes a research framework to determine the influencing antecedents of shared decision-making, and to evaluate the effects of shared decision-making on patient outcomes when they are computer-mediated and when the decision-makers communicate face-to-face. METHODS: A cross-section survey was conducted and a total of 48 valid samples were obtained. The participants were CKD Stage III, IV, or V patients who had received medical treatment in a hospital in Taiwan. The collected data were subjected to an independent t-test and partial least squares analysis to validate the research framework. RESULTS: Doctor-patient communication (DPC) and doctor-patient relationship (DPR) have no significant direct impact on patient outcomes. Nevertheless, both DPC and DPR significantly impact shared decision-making which in turn impacts patient outcomes. Moreover, patients who use computer-mediated communication were found to have significantly higher perceptions of shared decision-making than those who did not. CONCLUSIONS: The incidence and prevalence of end-stage renal disease in Taiwan are among the highest in the world. The results of this study can serve as a reference for hospitals to improve CKD patients' outcomes. Meanwhile, during the COVID-19 pandemic, this study suggested hospitals should encourage shared decision-making with computer-mediated communication to ensure that patients receive proper treatment and have the desired outcomes.


Subject(s)
COVID-19 , Renal Insufficiency, Chronic , Humans , Decision Making, Shared , Physician-Patient Relations , Cross-Sectional Studies , Decision Making , Pandemics , Communication , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/therapy , Patient Participation
10.
BMC Med Educ ; 22(1): 681, 2022 Sep 16.
Article in English | MEDLINE | ID: covidwho-2038726

ABSTRACT

BACKGROUND: Peer-assisted learning represents a favoured method of teaching in universities. The COVID-19 pandemic has necessitated transferring medical education to digital formats, and subsequently, the question has arisen of whether online tutorials might be effective. This study, thus, investigated the efficacy of online tutorials in a communication course by assessing the interaction, verbal communication, and nonverbal communication of tutors and students. METHODS: Second-year medical students were invited to participate in this longitudinal quantitative study. Validated and self-developed questionnaires (e.g., Jefferson Empathy Scale) including 39 questions (rated on a 7- or 5-point Likert scale) were used to assess the different variables including interaction, verbal and nonverbal communication and students' learning success. RESULTS: Out of 165 medical students, 128 took part in the study. The students as well as tutors reported that they found each other likeable (Mstudents = 4.60±0.71; Mtutors = 4.38±0.53; p > .05). Learning success increased throughout the communication course (Cohen's d = 0.36-0.74). The nonverbal and verbal communication in the simulated patient (SP) encounter was also rated as high by all three groups (Mnonverbal = 3.90±0.83; Mverbal = 4.88±0.35). CONCLUSIONS: Interaction as well as nonverbal and verbal communication occurred in the online format, indicating that online tutorials can be effective. The implementation of SPs increases the efficiency of synchronous online learning as it enhances the simulation of a real patient-physician encounter. Thus, online tutorials are a valuable amendment to medical education.


Subject(s)
COVID-19 , Education, Medical , Students, Medical , COVID-19/epidemiology , Education, Medical/methods , Humans , Pandemics , Peer Group
11.
Narodna Umjetnost ; 58(1):65, 2021.
Article in English | ProQuest Central | ID: covidwho-1955108

ABSTRACT

Rad se bavi medijskom eksponiranošću medicinskih stručnjaka, a ujedno i osoba na rukovodećim funkcijama pojedinih državnih institucija – ministra zdravstva Vilija Beroša, ravnatelja Hrvatskog zavoda za javno zdravstvo Krunoslava Capaka i ravnateljice Klinike za infektivne bolesti "Dr. Fran Mihaljević" Alemke Markotić – tijekom epidemije bolesti COVID-19 u Hrvatskoj. U istraživačkom fokusu je prvih nekoliko mjeseci javnog djelovanja tih liječnika u okviru Nacionalnog stožera civilne zaštite i ispred zdravstvenog sustava, pri čemu se analizom medijskog narativa nastoji ispitati utjecaj njihove komunikacije s javnošću na stupanj povjerenja koje im građani poklanjaju u doba koronakrize. Na tragu Giddensova i Luhmannova promišljanja povjerenja u kasnoj/refleksivnoj modernosti te primjena njihovih teza u području istraživanja zdravstvene skrbi raspravljaju se utvrđene oscilacije povjerenja i komunikacijski izazovi. Pritom se, uz prepoznavanje međusobne povezanosti fenomena straha, rizika i povjerenja, upozorava na metaprocese medijatizacije i celebritizacije liječničke struke u specifičnim, kriznim društveno-političkim okolnostima.Alternate :This paper deals with the media exposure of medical experts in management positions in state institutions during the COVID-19 epidemic in Croatia – the Minister of Health, Vili Beroš, the director of the Croatian Public Health Institute Krunoslav Capak and the director of the Dr. Fran Mihaljević Clinic for Infectious Diseases, Alemka Markotić. The article focuses on the first several months of their work within the National Civil Protection Headquarters and as representatives of the healthcare system. The analysis of the media narrative is an attempt to investigate the influence of their public communication on the citizens' level of trust in them during the corona crisis. The article discusses oscillations in trust and communicative challenges identified in the analysis from the point of view of Giddens's and Luhmann's views of trust in late/reflexive modernity, by applying their ideas to the healthcare system. In addition to recognizing the interconnections between fear, risk and trust, the article points to the metaprocesses of mediatization and celebritization of doctors in sociopolitical crises.

12.
Age and Ageing ; 51, 2022.
Article in English | ProQuest Central | ID: covidwho-1901096

ABSTRACT

Aim To improve communication on the medical ward round with patients with limited English through implementation of a medical communication chart. Introduction King’s College Hospital (KCH), London, is situated in Southwark in which 11% of households have no members that speak English as a first language, 4.1% of London’s population report they do not speak English well. Language barriers impair healthcare delivery including during daily ward rounds. This has been exacerbated by the need for PPE during the SARS-CoV2 pandemic. Effective communication between healthcare teams and patients is essential for high quality, patient-centred care. Communication tools commonly used include online, telephone and face-to-face translation services but these have limitations. Method Face-to-face patient questionnaires were conducted in the pre-QIP (baseline) group to assess communication on medical ward rounds. Medical communication charts were designed by adapting pre-existing aids commonly used by speech and language therapy. Charts were translated into commonly spoken languages among KCH inpatients. Patients with limited English were selected from both COVID-19 and non-Covid wards. Pre-intervention and post-intervention questionnaires were completed in three Plan–Do–Study–Act (PDSA) cycles. Results At baseline, patients agreed or strongly agreed that the ward round addressed physical symptoms (8/8), concerns or anxieties (7/8), ongoing needs (7/8). Only 2/8 doctors felt they could communicate effectively with patients. In PDSA 1, 4/5 patients reported high satisfaction in communicating physical symptoms, anxieties or concerns pre-intervention with 5/5 post-chart implementation. 5/5 patients reported high satisfaction in communicating ongoing needs pre-intervention but only 3/5 post-intervention. In PDSA 2, 2/5 patients reported increased satisfaction in communicating physical symptoms, concerns or anxieties with 4/4 doctors reporting improved satisfaction in communication in PDSA 2 and 2/3 doctors reporting higher satisfaction in communication in PDSA 3. Conclusion Medical communication charts can help in delivering high-quality, patient-centred care in multicultural and multilingual healthcare settings within the NHS.

13.
JMIR Form Res ; 6(6): e36289, 2022 Jun 14.
Article in English | MEDLINE | ID: covidwho-1875291

ABSTRACT

BACKGROUND: Uncertainties are omnipresent in health care, but little is known about general practitioners' (GPs) professional uncertainties concerning digital consultations. This is problematic, as many countries have undergone an extensive digital transformation. OBJECTIVE: The aim of this study was to explore the professional uncertainties that emerged among Danish GPs with the introduction of video consultations. METHODS: We conducted qualitative interviews with 15 Danish GPs during the beginning of the COVID-19 pandemic in 2020. The interviews were analyzed using an abductive approach. RESULTS: We identified 3 categories of uncertainty: integrity, setting, and interaction. Respectively, these 3 categories of uncertainty refer to (1) uncertainties related to how technology may impede the provision of health care; (2) uncertainties related to the potentials of video technology; and (3) uncertainties related to how the video consultation technology affects interactions with patients. CONCLUSIONS: The uncertainties experienced by Danish GPs appear to be a typical reaction to the introduction of new technology. Embedding video consultation technology into GPs' working routines will take time, and GPs do not necessarily feel intuitively capable of transferring their abilities, such as being good and socially present for video-mediated consultations. The heterogeneity of professional uncertainties experienced among the GPs suggests that they are the product of individual GP-technology relationships-not of the technology in itself. Consequently, we cannot expect that uncertainties can be remedied by changing or precluding new technology.

14.
Journal of Integrated Care ; 30(2):216-224, 2022.
Article in English | ProQuest Central | ID: covidwho-1784462

ABSTRACT

Purpose>This paper presents my experience of breast cancer care in which I describe my care as positive and integrated.Design/methodology/approach>I have applied an autoethnographical approach to my patient story to analyse my care in order to reflect and share insights. I have applied my knowledge and experience in integrated care through my research, management and practice.Findings>In my patient story I describe being empowered and feeling like “one of the team.” Vertical and horizontal integration was evident across staff services and agencies. This included integrated working across multi‐disciplinary teams, between primary and secondary care and also between the NHS and a voluntary agency. I identified features that were important to me in my care under the headings of: certainty, communication, contact, compassion, continuity, cohesive, care and collaboration.Practical implications>I consider the implications of sharing patient stories to inform quality improvement, influence education and training for staff and design support for patients. I consider how patients can be more involved in the evaluation of their care.Originality/value>This viewpoint has been written from my perspective as a patient and a professional, and was written in order to recognise good practice and share the learning for continual quality improvement. There is every sign that person-centred integrated care is starting to be embedded in some of our services and hopefully this will be recognised, celebrated and sustained.

15.
Gerontologist ; 62(7): 956-963, 2022 08 12.
Article in English | MEDLINE | ID: covidwho-1774381

ABSTRACT

Alzheimer's disease and related dementias (ADRD) are progressive illnesses characterized by decline in cognitive function that impairs performing daily activities. People with ADRD are at an increased risk of suicide, especially those who have comorbid mental health conditions, have specific types of ADRD, or have been recently diagnosed. The coronavirus disease 2019 (COVID-19) pandemic has increased the distress of people with ADRD, a population also at increased risk of contracting the COVID-19 virus. In this article, we draw on a case study and use the Interpersonal Theory of Suicide to help describe the association between ADRD and suicide risk. Secondly, we call for new strategies to mitigate suicide risk in people living with ADRD during and beyond the current pandemic by using lessons learned from cancer care. Our goal is not to dictate solutions but rather to start the conversation by outlining a framework for future research aimed at preventing death by suicide in people with ADRD. Specifically, we draw on the updated Framework for Developing and Evaluating Complex Interventions to reflect on the complexity of the issue and to break it down into achievable parts to reduce the risk of suicidal behavior (ideation, plans, attempts) in those living with ADRD.


Subject(s)
Alzheimer Disease , COVID-19 , Dementia , Suicide Prevention , Alzheimer Disease/psychology , COVID-19/epidemiology , Dementia/epidemiology , Dementia/psychology , Humans , Pandemics
16.
11th IEEE International Conference on Consumer Electronics, ICCE-Berlin 2021 ; 2021-November, 2021.
Article in English | Scopus | ID: covidwho-1769602

ABSTRACT

Focusing on the clinical doctor-patient consultation setting, this paper outlines the methodology and presents the results from a series of observational studies between doctor and patients undertaken in September and October 2020 within a public hospital setting during the COVID-19 pandemic. Using a design thinking methodology, the authors gained empathy and insights into the challenges experienced from both doctor and patient perspectives, during this period. This paper also discusses emergent themes from this qualitative investigation and examines the role of empathy in helping define the extent of the challenges that arose. As the first phase in a planned set of research phases, this work is informing and helping to shape subsequent ideation and design of multimedia related interventions to see if these human-centred design interventions can assist in improving the complex doctor-patient communication process. © 2021 IEEE.

17.
MedieKultur ; 37(71):224-244, 2021.
Article in English | Scopus | ID: covidwho-1687371

ABSTRACT

This article proposes an extension to domestication theory by introducing the concept of collaborative domestication, which we define as the ongoing mutual influence and interdependence of technology users in specific interactional contexts. This concept arose from our investigation of how patients integrate healthcare-related video consultations into their daily lives. In Denmark, the Covid-19 pandemic has expedited the implementation of video consultations in general practice, yet little is known about their use in this context. To address this, we conducted 13 interviews with patients and analysed the interviews from the perspective of domestication theory. We find that the general practitioner plays a central role throughout patients’ domestication processes, and the doctor–patient relationship significantly influences how patients experience video consultations. We argue that there is a collaborative aspect to domesticating video consultations that needs to be considered in both future studies and the ongoing implementation of video consultations. © 2021 Society of Media Researchers In Denmark. All rights reserved.

18.
JMIR Form Res ; 6(1): e29647, 2022 Jan 27.
Article in English | MEDLINE | ID: covidwho-1662504

ABSTRACT

BACKGROUND: Patient portals allow communication with clinicians, access to test results, appointments, etc, and generally requires another set of log-ins and passwords, which can become cumbersome, as patients often have records at multiple institutions. Social credentials (eg, Google and Facebook) are increasingly used as a federated identity to allow access and reduce the password burden. Single Federated Identity Log-in for Electronic health records (Single-FILE) is a real-world test of the feasibility and acceptability of federated social credentials for patients to access their electronic health records (EHRs) at multiple organizations with a single sign-on (SSO). OBJECTIVE: This study aims to deploy a federated identity system for health care in a real-world environment so patients can safely use a social identity to access their EHR data at multiple organizations. This will help identify barriers and inform guidance for the deployment of such systems. METHODS: Single-FILE allowed patients to pick a social identity (such as Google or Facebook) as a federated identity for multisite EHR patient portal access with an SSO. Binding the identity to the patient's EHR records was performed by confirming that the patient had a valid portal log-in and sending a one-time passcode to a telephone (SMS text message or voice) number retrieved from the EHR. This reduced the risk of stolen EHR portal credentials. For a real-world test, we recruited 8 patients and (or) their caregivers who had EHR data at 2 independent health care facilities, enrolled them into Single-FILE, and allowed them to use their social identity credentials to access their patient records. We used a short qualitative interview to assess their interest and use of a federated identity for SSO. Single-FILE was implemented as a web-based patient portal, although the concept can be readily implemented on a variety of mobile platforms. RESULTS: We interviewed the patients and their caregivers to assess their comfort levels with using a social identity for access. Patients noted that they appreciated only having to remember 1 log-in as part of Single-FILE and being able to sign up through Facebook. CONCLUSIONS: Our results indicate that from a technical perspective, a social identity can be used as a federated identity that is bound to a patient's EHR data. The one-time passcode sent to the patient's EHR phone number provided assurance that the binding is valid. The patients indicated that they were comfortable with using their social credentials instead of having to remember the log-in credentials for their EHR portal. Our experience will help inform the implementation of federated identity systems in health care in the United States.

19.
Patient Educ Couns ; 105(2): 277-283, 2022 02.
Article in English | MEDLINE | ID: covidwho-1415708

ABSTRACT

OBJECTIVE: This study aims to investigate factors influencing COVID-19 vaccination intention in the United States. METHODS: A cross-sectional survey was conducted with 800 respondents recruited from an online panel managed by a survey company. Path analysis was employed to examine the relationships between the study variables. RESULTS: First, perceived susceptibility to COVID-19 vaccine side effects was negatively associated with vaccination intention whereas perceived severity did not show any significant impact. Second, vaccine-related knowledge was not directly related to vaccination intention, but it had an indirect and positive effect on vaccination intention via decreasing perceived susceptibility. Third, doctor-patient communication strengthened the negative effect of vaccine knowledge on perceived susceptibility and severity. CONCLUSION: The results of this study offer insights on how to increase people's vaccination intention and reduce their psychological concerns when making COVID-19 vaccine-related decisions. PRACTICE IMPLICATIONS: Government agencies should actively promote the effectiveness and importance of vaccination, while addressing concerns about vaccine safety in the public; Health initiatives also need to enhance the level of knowledge about COVID-19 vaccines through various media channels; Doctors can start the conversations about COVID-19 vaccination with their patients at the point of care and/or via online communication platforms.


Subject(s)
COVID-19 , Vaccines , COVID-19 Vaccines , Communication , Cross-Sectional Studies , Humans , Intention , Perception , SARS-CoV-2 , United States , Vaccination , Vaccines/adverse effects
20.
J Patient Exp ; 8: 23743735211034620, 2021.
Article in English | MEDLINE | ID: covidwho-1346188

ABSTRACT

Hospital visitor restriction policies prompted by Coronavirus Disease 2019 (COVID-19) may lead to a less comfortable or informed inpatient experience for oncology patients admitted for non-COVID-19 conditions. We surveyed oncology inpatients before (n = 47) and after (n = 65) implementation of a no-visitor policy using a validated questionnaire to measure patient experience. Results revealed no significant difference in the percentage of patients reporting "no problems" (P < .05) in all questions. Patient experience was not adversely impacted by visitor restrictions enacted in response to COVID-19 on an oncology service, as measured by a questionnaire capturing common concerns among inpatients.

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