Implementation Seminar: Health information and decision aids by the Institute for Quality and Efficiency in Health Care (IQWiG)

Topic:

The Institute for Quality and Efficiency in Health Care (IQWiG) provides health information for the general public via a bilingual website (gesundheitsinformation.de/informedhealth.org). It also has developed a number of decision aids for screening and treatment decisions. Core elements of the process are a systematic literature search / evidence assessment, involvement of stakeholders and user testing of the drafts. Results of user testing show good acceptance. Usage of the website has been steadily growing. The decision aids are implemented in health care processes, for example as part of the organized cancer screening program in Germany.

Speaker:

Dennis Fechtelpeter works as a medical writer in the Health Information Department of IQWiG (Institute for Quality and Efficiency in Health Care). He is a trained nurse and has degrees in health communication and nursing science. IQWiG is a professionally independent, scientific institute that assesses the advantages and disadvantages of medical procedures for decision-making bodies of the German health care system.

Implementation Seminar: The Patient University to enhance Health Literacy and Empowerment

Topic:

The Patient University at Hannover Medical School, founded in 2005, aims to improve empowerment and health literacy of patients and citizens. We provide knowledge about health and health care, patients’ rights, navigation in the health care system, or evidence-based patient information. We will discuss the concept, the acceptance, the outreach and future developments, i.e. in digital health. 

Speaker:

Prof. Dr. Marie-Luise Dierks
Educational scientist, since 2004 Professor of Public Health at the Hannover Medical School (MHH), co-initiator and head of the Patient University at the MHH, head of the research unit “Patient orientation and Health Education”

Research topics: Empowerment and health literacy, patient satisfaction, quality of patient information and advice, empowerment, strengthening of self-management skills and digital competence in people with chronic diseases, effects of patient participation in support groups

Virtual research seminar on “Researching Patient-centered care
in Latin America”

Topic:

Researchers from three different Latin American countries will give us insights into their research and experiences. Please find out more about the speakers below.

Speaker:

Paula Riganti (Argentina), Is a family Physician in Buenos Aires, Argentina. Holds a master’s in medical education from Cardiff University. She is part of the research group on Shared Decision Making of the Italian Hospital of Buenos Aires.

Germán Málaga (Peru)
Is a Senior Professor at the Universidad Peruana Cayetano Heredia, Lima, Peru and an internist with more than 25 years of experience. His research interests are chronic diseases, research implementation and the search for inclusive and democratic health systems. An important part of his work has been to promote the participation of patients in health care, thus improving adherence to treatment and seeking to reform the health system from the community level.

Paulina Bravo (Chile)
Is an Associate Professor at the School of Nursing of the Pontificia Universidad Católica de Chile. Her background is in mental health nursing and completed her postdoctoral training at the School of Social Sciences and Medicine at Cardiff University. Paulina leads the research team for patient-centered care and shared decisionmaking. She is the Director of Patient Involvement at the Cancer Center Fundación Arturo López Pérez in Santiago.

Virtual research seminar on the “Benefits and risks of patient participation in multidisciplinary tumor conferences – findings of the mixed methods PINTU study” with Prof. Dr. Lena Ansmann¹

Background: Previous research in breast cancer centers throughout Germany revealed that between 5 to 7% of patients have participated in MTCs during their own case discussion (e.g. Ansmann et al. 2014). Research on this phenomenon and its benefits and risks is rare. The PINTU study (Heuser et al. 2019) aimed to fill this gap by answering the following research questions: A) How do the providers perceive participation of patients in MTCs with regard to feasibility and quality of decision-making? B) How do MTCs with and without patient participation differ with regard to organisation, interaction and patient orientation? C) How do patients experience the participation and what direct cognitive and emotional effects can be observed?

Method: This is an exploratory, observational, prospective multicenter study using mixed methods. MTCs with and without patient participation in 6 breast and gynaecological cancer centres in Germany were examined. Data collection included: (1) interviews with providers, (2) videotaped or audiotaped participatory observations in MTCs, (3) patient surveys.

Results: The main findings of the study will be summarized: (1) The way patient participation is implemented varies strongly by center. (2) Feasibility in routine care is limited. (3) Most patients experienced patient participation in MTC as positive, whereas some patients reported negative experiences. (4) Providers experienced and expected a mix of benefits and risks of patient participation. (5) The implementation of shared decision making in MTCs seemed difficult under the current circumstances. (6) The development of patient-reported experiences and outcomes over time did not show substantial differences between patients with or without patient participation.

Implications: The way patient participation is implemented seems to vary greatly. The results show a mixed picture of positive and negative experiences of providers and patients, but also clear limitations regarding shared decision making in MTCs. The prospective study further revealed that patient participation seems to neither improve nor worsen patient-reported experiences or outcomes. The next urgent questions to be answered before recommendations for or against patient participation in MTCs can be made are: Which patients could benefit from participation in MTCs? How can MTC participation be arranged for the patient’s benefit?

References

1. Ansmann L et al. (2014). Patient participation in multidisciplinary tumor conferences. Breast 23 (6):865-869.
2. Heuser C, et al. (2019). Patient participation in multidisciplinary tumour conferences in breast cancer care (PINTU): a mixed-methods study protocol. BMJ open 9 (4): e024621.

¹Carl von Ossietzky Universität Oldenburg

Virtual research seminar on the “Guideline for Good Practice in Risk Communication During a Health Crisis” with Paulina Bravo, Ph.D.¹ & Alejandra Martínez, Ph.D.¹.

Background: The COVID-19 pandemic has brought a high volume of technical and complex information to the population. In Chile, the pandemic has shown a lack of preparation of health teams and the health authority on how to communicate the risk associated with COVID-19.

Aim: To develop a “Guideline for Good Practice in Risk Communication during a health crisis health” for the Chilean context.

Method: A mixed methods study was conducted. We carried out a systematic review and semi-structured interviews with international experts to identify effective practices on risk communication. This informed a preliminary version of the Guideline. This Guideline was assessed and modified through a Delphi study with national experts. Finally, cognitive interviews with citizens were conducted to assess, and construct validity of a checklist proposed in the Guideline.

Results: The Guideline provides recommendations for developing a timely and effective risk communication strategy during health crises. These recommendations are divided into designing the message and communicating the message. When designing the message, it is essential to define what and why we want to communicate, with whom we wish to share it, and how it will be communicated. When communicating the message special attention must be given to the communication channels, the messenger (level of preparation, and criteria for his/her selection), and the frequency of the information. The Guideline also provides a checklist for evaluating health messages during crises. It is expected that this checklist will help to establish improvement plans and identify critical points that should be considered to increase the effectiveness of a communication strategy.

¹School of Nursing, Pontificia Universidad Católica de Chile

Virtual research seminar on the “Development and refinement of the integrative model for patient-centeredness” with PD Dr. Isabelle Scholl¹ and Dr. Pola Hahlweg¹.

The research seminar will provide an insight into the aims and activities of PCC NET, and an overview of the development of the integrative model of patient-centeredness (Scholl et al., 2014). During the first part of the event, we will welcome new  members to the network. In small groups, there will be time for personal exchange. During the second part of the event, Isabelle Scholl and Pola Hahlweg will present the integrative model of patient-centeredness and related completed and ongoing research projects  (Zeh et al., 2019, 2021; Zill et al. 2015). Questions and thoughts on the presentation will be discussed in the plenum.

1. References
   Scholl I, Zill JM, Härter M, Dirmaier J. An integrative model of patient-centeredness – a systematic review and concept analysis. PloS one. 2014;9(9):e107828.
2. Zeh S, Christalle E, Hahlweg P, Härter M, Scholl I. Assessing the relevance and implementation of patient-centredness from the patients’ perspective in Germany: results of a Delphi study. BMJ open. 2019 Dec 1;9(12):e031741.
3. Zill JM, Scholl I, Härter M, Dirmaier J. Which dimensions of patient-centeredness matter?-Results of a web-based expert delphi survey. PloS one. 2015 Nov 5;10(11):e0141978. “ (bearbeitet) 

¹University Medical Center Hamburg-Eppendorf (UKE), Germany

Virtual research seminar “Development, evaluation and implementation of patient-centered communication skills training for nurses” with Prof. Dr. Dr. Martin Härter¹ and PD Dr. Isabelle Scholl¹

Abstract: There is a high demand for better implementation of communication skills trainings for nursing professionals that are needs-based and thoroughly evaluated. Yet, there is currently a lack of such trainings in continuing education in Germany.
Aim: Therefore, the aim of this study is to develop, evaluate and implement a needs-based communication skills training for nursing professionals.
Methods: This study will be performed using a mixed-methods approach. In the first phase, qualitative interviews and focus groups with relevant stakeholders will be conducted in order to assess the specific needs regarding communication skills trainings for nursing professionals. A content analysis of the qualitative data will be performed. In the second phase the training developed according to the needs of the relevant stakeholders will be carried out and evaluated. Multivariate analysis methods and descriptive statistics will be used to evaluate the data. During the third phase, expert workshops will be conducted and recommendations for further implementation of the developed communication skills training will be derived.
Expected results: From the first phase we expect to obtain information on the needs of the relevant stakeholders. We assume that the training conducted in the second phase will improve perceived self-efficacy and communication skills of the nursing professionals. We expect to be able to derive recommendations for further implementation of the communication skills training at the end of the third phase.

¹University Medical Center Hamburg-Eppendorf (UKE), Germany

Virtual research seminar with Dr. Paulina Bravo¹ and Alejandra Martínez¹ introducing their research on risk communication during health crisis.

Abstract: International experts views on best practices for health risk communication.
Background: The COVID-19 pandemic has meant a high volume of technical and complex information to be communicated to the population. In Chile, the lack of preparation of the teams and the health authority on how to communicate the risk associated with COVID-19 could explain the increasing number of disease cases.
Aim: This presentation aims to identify best practices for health risk communication.
Methods: This study used a qualitative design based on interviews with international experts with experience in crisis management or risk communication. A content analysis was performed.
Results: Four men and six women took part of the study (three from Europe, two from Latin America, two from North America, one from Asia, two from Oceania). International experts highlighted key components of the message during a health crisis (credibility, timing, and transparency) and the need to innovate when a crisis continues overtime so the audience fatigue is prevented. These findings could inform guidelines to best equip countries for a clear communication strategy for future crises.

¹School of Nursing, Pontificia Universidad Católica de Chile

Virtual kick-off event of PCC NET with presentations on the following topics:

• Introduction to the Chilean health care system by Dr. Paulina Bravo¹ and Alejandra Martínez¹
• Introduction to the German health care system by Prof. Dr. Dr. Marin Härter² and Dr. Isabelle Scholl²
• Presentations on current, past, or planned projects of the Chilean and German research teams:
  • Promoting Patient Participation in Care: Transferring knowledge on patient-centered research, education, and clinical practice (PRO-PACT) by Alejandra Martínez¹ and Anne Klimesch²
  • Assessment of Patient-Centeredness from the Patients‘ Perspective (ASPIRED) by Stefan Zeh²
  • Evaluation of a Program for Routine Implementation of Shared Decision-Making in Cancer Care: A Stepped Wedge Cluster Randomized Trial (PREPARED) by Dr. Pola Halweg²
  • CarePreg: Person-centeredness in healthcare and support services for women with unwanted pregnancy by Dr. Jördis Zill² and Lara Reck²
  • Development, dissemination and evaluation of patient information material to reduce misuse and dependence of Benzodiazepines and z-drugs by Dr. Christina Lindemann² and Johanna Heeg²

¹School of Nursing, Pontificia Universidad Católica de Chile

²University Medical Center Hamburg-Eppendorf (UKE), Germany