Effects of a Computerized System to Support Shared Decision Making in Symptom Management of Cancer Patients: Preliminary Results

Ruland, Cornelia M.; White, Thomas; Stevens, Marguerite; Fanciullo, Gilbert J.; Khilani, Samir M.

doi:10.1197/jamia.m1365

Cited by 87 publications

(116 citation statements)

References 17 publications

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“…Clinical support systems that include patient-specific information and help have produced positive patient outcomes (Ruland, White, Stevens, Fanciullo, & Khilani, 2003). Thus integrating and building on patients' health assets appears to be of significance.…”

Section: Implications For Theory and Clinical Practicementioning

confidence: 99%

Health assets: A concept analysis

Rotegård

Moore

Fagermoen

et al. 2010

International Journal of Nursing Studies

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Section: Implications For Theory and Clinical Practicementioning

confidence: 99%

Health assets: A concept analysis

Rotegård

Moore

Fagermoen

et al. 2010

International Journal of Nursing Studies

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“…Results can be used to assist care providers to better tailor symptom management and care individually to each patient and to support person-centered communication. Development of the Choice application for cancer patients [11,12], and a demonstration of its validity and reliability are presented in detail elsewhere [13].…”

Section: The Choice Applicationmentioning

confidence: 99%

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Børøsund

Ruland

Moore

et al. 2014

International Journal of Medical Informatics

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Please cite this article in press as: E. Børøsund, et al., Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation, Int. J. No. of Pages 12 i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s x x x ( 2 0 1 3 ) xxx-xxx j o u r n a l h o m e p a g e : w w w . i j m i j o u r n a l . c o m Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation Objective: To explore nurses' experiences of the benefits of and barriers to using an ITPA called Choice, in cancer care one year after its implementation. ARTICLE IN PRESSMethods: This investigation is a part of a larger study examining the use of Choice in cancer care. Four focus group interviews were conducted with 20 nurses experienced in using the Choice application. The data were analyzed using qualitative content analysis.Results: Three themes and nine sub-themes emerged: (1) "Choice as facilitator for shared understanding and engagement in patients' own care," with three sub-themes: preparing both patient and nurse for communication, shared engagement in care planning, and giving the patients a voice; (2) "enhancing the patients' strengths," with two sub-themes: releasing patient's internal strengths and confirming "normalcy" for the patient; and (3) "new challenges for the nurse," with four sub-themes: organizational challenges, interactions with technology, a need for training in communication skills, and new ethical challenges. Conclusions: Findings suggest that, from nurses' perspectives, integration of ITPAs suchas Choice in clinical practice offers many benefits that can contribute to patient-centered care. However, to reap these benefits, use of such tools must receive equal priority as other routines, and require sufficient time, space and competence. Choice also challenged nurses' professional roles and created dilemmas such as nurses' ambivalence regarding patients' levels of disclosure of sensitive issues and the nurses' ability to respond to

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“…tablet computers, smart phones, voice response systems, and secure Internet connections) also affords a level of privacy for sensitive topics as well as ensuring that patient concerns come to the attention of the health care provider and are not forgotten once the clinical encounter begins, thereby facilitating patient-physician communication. 40 Patients prefer electronic capture of PROs to paper and find the method easy and acceptable, 33,41 a conclusion confirmed by meta-analysis. 42 While the incorporation of PROs into a rapid learning system is gaining acceptance in the oncology community, widespread adoption in other subspecialties has not been as aggressive.…”

Section: Rapid Learning Health Carementioning

confidence: 93%

Improving the management of dyspnea in the community using rapid learning approaches

et al. 2012

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Patients with chronic pulmonary disease often suffer from breathlessness or dyspnea. Traditional evidence generation techniques to expand upon current treatment paradigms are limited by the significant delay between study initiation and clinical implementation of findings. Rapid learning health care is a novel approach to health care delivery that relies on intelligent and continuous integration of clinical and research data sets to deliver personalized medicine using the most current evidence available. Results of important studies in the management of chronic respiratory disease are presented in brief; however, the focus of this review is on evidence supporting the implementation of a rapid learning model for symptom management. Recent findings suggest that a rapid learning system is feasible and acceptable to patients with advanced illness, helps monitor symptoms overtime, facilitates study of the impact of novel interventions, and can identify unrecognized needs and concerns. A rapid learning model improves comprehensive assessment, timeliness of intervention, and accrual of contemporaneous data to support best practice that tailors care specific to the needs of patients as their disease and lifestyle change overtime. Using the rapid learning health care model, data collected in the process of routine care can simultaneously function both as clinical information and as a resource for research on patient-centered experiences and outcomes.

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Effects of a Computerized System to Support Shared Decision Making in Symptom Management of Cancer Patients: Preliminary Results

Abstract: This study provided beginning evidence that eliciting patients' symptoms and preferences and providing clinicians with this information prior to consultation can be an effective and feasible strategy to improve patient-centered care.

Cited by 87 publications

References 17 publications

Health assets: A concept analysis

Health assets: A concept analysis

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Improving the management of dyspnea in the community using rapid learning approaches

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