Elements of patient–health-care provider communication related to cardiovascular rehabilitation referral

Pourhabib, Sanam; Chessex, Caroline; Murray, Judy; Grace, Sherry L.

doi:10.1177/1359105314529319

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…[26] A study suggesting that patients' attitude towards downward referral was influenced by patient-doctor communication. [27] And, due to the asymmetric information between patients and doctors, patients' choice of referral depends largely on doctors' advice, which was also confirmed in this study.…”

Section: Interpretation Within the Context Of The Wider Literaturesupporting

confidence: 76%

The downward referral experiences of stroke caregivers in the regional medical alliance in China: A phenomenological study

et al. 2022

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The downward referral platform in the regional medical alliance has provided more possibilities to follow-up rehabilitation and transitional care for increasing stroke survivors, which also has the most contributions in the rational use of resources and health promotion of stroke survivors. However the downward referral rate is low compared to upward referral. At present, no scholars have explored the downward referral experiences of medical demanders from the perspective of qualitative study, and these experiences may also most truly reflect the influencing factors of their unwillingness to downward referral. Therefore, this study explored the subjective experiences of stroke caregivers who had experienced the downward referral, because stroke attacks often lead to lack of autonomy of patients themselves, making it difficult to complete interviews with them. A descriptive phenomenological study was adopted. A purposive sampling strategy was used to recruit 13 stroke caregivers. Interviews were guided by a semi-structured interview-guide encouraging interviewees to reflect on their experiences with downward referral. Coliazzi’s data analysis process was applied. The analysis of the data revealed 4 themes: coping challenges; disrupted information; gaps in medical and nursing transition, and potential enabling factors. The results of this study showed that the lack of knowledge of medical alliance, non-sharing of medical information and non-homogeneousness of medical quality were identified to be impeding positive attitude towards downward referral and be factors of bad experiences. Of course, the interviewees had positive experiences such as smooth referral and comfortable environment. These may be potential enabling factors to their attitude towards downward referral. The challenges and needs of medical demanders after downward referral are worthy of attention, and these should be solved by corresponding measures to improve the downward referral rate and referral experiences.

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Section: Interpretation Within the Context Of The Wider Literaturesupporting

confidence: 76%

The downward referral experiences of stroke caregivers in the regional medical alliance in China: A phenomenological study

et al. 2022

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“…Statistics suggest that 48.6% of doctors refused to make downward referrals, because of patients' unwillingness, while 53.6% of patients refused downward referral, because they did not sufficiently understand the referral system. 35 Patients' attitudes towards downward referral is also influenced by their medical preference, 4 28 31 36 37 medical information, 23 patient-doctor communication, 38 quality of referral services, 39 course of diseases, 39 and sociodemographic characteristics (eg, age, residence). 40 41 Considering the characteristics of policymaking and long-term development process of CHSs, it is impossible to thoroughly conduct the community first treatment system and downward referral system, and improve the development of CHSs in the short term.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Nong

et al. 2017

BMJ Open

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ObjectivesIn China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics.MethodsDoctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling. The questionnaire surveyed their sociodemographic characteristics, attitudes towards CHSs and hospitals, understanding of downward referral, recognition of the community first treatment system, and downward referral practices and willingness. Descriptive statistics, χ2 test and stepwise logistic regression analysis were employed for statistical analysis.ResultsOnly 20.8% (161/773) of doctors were willing to accept downward referrals, although this proportion was higher among patients (37.6%, 326/866). Doctors' willingness was influenced by education, understanding of downward referral, and perception of health resources in hospitals. Patients' willingness was influenced by marital status, economic factors and recognition of the community first treatment system. Well-educated doctors who do not consider downward referral would increase their workloads and those with a more comprehensive understanding of hospitals and downward referral process were more likely to make a downward referral decision. Single-injury patients fully recognising the community first treatment system were more willing to accept downward referral. Patients' willingness was significantly increased if downward referral was cost-saving. A better medical insurance system was another key factor for patients to accept downward referral decisions, especially for the floating population.ConclusionsTo increase the rate of downward referral, the Chinese government should optimise the current referral system and conduct universal publicity for downward referral. Doctors and patients should promote understandings of downward referral. Hospitals should realise the necessity of downward referral, effectively reduce workloads and provide continuing education for doctors. Increasing monetary reimbursement is urgent, as is improving the medical insurance system.

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“…Modifications may occur and are fair, potentially being a result of unexpected changes in study’s circumstances. Whenever happening, it is crucial that care provider expertise should be ensured to keep the study’s internal validity, and therefore tobe replicated/implemented [32]. However, only 30% of the interventions studied in our sample described it adequately, still putting interventions at a high risk to not be implemented.…”

Section: Discussionmentioning

confidence: 99%

Assessing the completeness of reporting of exercise-based interventions in cardiovascular trials

Freccia

Santos²,

Lucca³

et al. 2022

Preprint

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Study Objective: In cardiology, the reporting of interventions is insufficiently detailed to elicit replication. Specifically for cardiovascular rehabilitation (CVR) trials, the quality of the description of its exercise-based interventions (EBI) is poorly known. Our primary objective is to estimate the adherence of EBI of CVR trials to TIDieR reporting guideline. Secondarily, we tested whether the CVR setting would be associated with a better reporting, also exploring whether transparency and methodological characteristics could be related. Design and Setting: This cross-sectional study analyzed 96 trials with EBI published within CVR literature. For our primary objective, TIDieR reporting guideline was accounted as a reference to assess overall adherence of eligible RCTs. For our secondary objectives we used generalized estimating equations to point out (a) if intervention setting (eg, home-based vs. centre-based) was associated with intervention reporting, and (b) if trials transparency and methodological characteristics would be associated with intervention reporting. Results: On average, arms adequately reported 4.8/12 (SD=2.4) TIDieR items. 65.07% of our EBI arms failed to adequately report ≥ 6 TIDieR items. Three of 146 (2.05%) arms adhered to all 12 TIDieR items. Additionally, intervention setting was not associated with a better description. Conclusions: We concluded that EBIs in CVR lack to report fundamental aspects of the interventions to be replicated by third parties based on their reports.

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Elements of patient–health-care provider communication related to cardiovascular rehabilitation referral

Cited by 5 publications

References 33 publications

The downward referral experiences of stroke caregivers in the regional medical alliance in China: A phenomenological study

The downward referral experiences of stroke caregivers in the regional medical alliance in China: A phenomenological study

Practices and attitudes of doctors and patients to downward referral in Shanghai, China

Assessing the completeness of reporting of exercise-based interventions in cardiovascular trials

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