A Systematic Review of Communication Quality Improvement Interventions for Patients with Advanced and Serious Illness

Fawole, Oluwakemi A; Dy, Sydney M.; Wilson, Renée F; Lau, Brandyn; Martinez, Kathryn A.; Apostol, Colleen C.; Vollenweider, Daniela; Bass, Eric B.; Aslakson, Rebecca

doi:10.1007/s11606-012-2204-4

Cited by 74 publications

(70 citation statements)

References 28 publications

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“…7,32,[46][47][48][49][50] Much intervention research is focused on improving patient experiences and communication, [51][52][53][54][55] and the frequency of responses indicating dislike of both physicians and the health care system confirms that this intervention focus is well-deserved. However, we also observed a variety of other reasons, such as avoiding specific recommendations or procedures, which could also be addressed through interventions aimed at changing negative perceptions about specific aspects of medical care.…”

Section: Discussionmentioning

confidence: 99%

Why do People Avoid Medical Care? A Qualitative Study Using National Data

2014

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BACKGROUND: Many studies have examined barriers to health care utilization, with the majority conducted in the context of specific populations and diseases. Less research has focused on why people avoid seeking medical care, even when they suspect they should go. OBJECTIVE: The purpose of the study was to present a comprehensive description and conceptual categorization of reasons people avoid medical care. DESIGN: Data were collected as part of the 2008 Health Information National Trends Survey, a cross-sectional national survey. PARTICIPANTS: Participant-generated reasons for avoiding medical care were provided by 1,369 participants (40% male; M age =48.9; 75.1% non-Hispanic white, 7.4% non-Hispanic black, 8.5% Hispanic or Latino/ a). MAIN MEASURES: Participants first indicated their level of agreement with three specific reasons for avoiding medical care; these data are reported elsewhere. We report responses to a follow-up question in which participants identified other reasons they avoid seeking medical care. Reasons were coded using a general inductive approach. KEY RESULTS: Three main categories of reasons for avoiding medical care were identified. First, over one-third of participants (33.3% of 1,369) reported unfavorable evaluations of seeking medical care, such as factors related to physicians, health care organizations, and affective concerns. Second, a subset of participants reported low perceived need to seek medical care (12.2%), often because they expected their illness or symptoms to improve over time (4.0%). Third, many participants reported traditional barriers to medical care (58.4%), such as high cost (24.1%), no health insurance (8.3%), and time constraints (15.6%). We developed a conceptual model of medical care avoidance based on these results. CONCLUSIONS: Reasons for avoiding medical care were nuanced and highly varied. Understanding why people do not make it through the clinic door is critical to extending the reach and effectiveness of patient care, and these data point to new directions for research and strategies to reduce avoidance.

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Section: Discussionmentioning

confidence: 99%

Why do People Avoid Medical Care? A Qualitative Study Using National Data

2014

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“…Although further research is needed, there is evidence that interventions designed to improve communication and decision making can be effective in improving patient-centered outcomes. 27 Our study has several strengths. First, we used an explicit literature search to inform the initial selection of items for the scoring system.…”

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confidence: 96%

Improving End-of-Life Communication and Decision Making: The Development of a Conceptual Framework and Quality Indicators

Sinuff

Dodek

You

et al. 2015

Journal of Pain and Symptom Management

187

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“…A growing body of research, mostly in the setting of intensive care, demonstrates the effectiveness of communication and decision-making interventions, such as structured family meetings, for decreasing potentially inappropriate health care utilization at the end of life. 3 However, these previous studies used provider-oriented interventions based on verbal communication. Decision support tools, including written, video and interactive options, are increasingly being developed and show promise for improving patients' knowledge, outcomes such as decision satisfaction, and the appropriateness of patient decisions.…”

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confidence: 99%