Psychometric properties of the Shared Decision-Making Questionnaire (SDM-Q-9) in oncology practicePropiedades psicométricas del Questionnaire Shared Decision-Making (SDM-Q-9) en oncología

Background/Objective: This study sought to assess the psychometric properties of the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) in patients with resected, non-metastatic cancer and eligible for adjuvant chemotherapy. Method: A total of 568 patients were recruited from a multi-institutional, prospective, transversal study. Patients answered the SDM-Q-9 after visiting their medical oncologist who, in turn, completed the SDM-Q–Physician version. Reliability, factorial structures [exploratory factor analysis (EFA), confirmatory factor analysis (CFA)], and convergent validity of the SDM-Q-9 scores were explored. Results: SDM-Q-9 showed a clear factorial structure, compatible with a strong and replicable general factor and a secondary group factor, in patients with resected, non-metastatic cancer. Total sum scores derived from the general factor showed good reliability in terms of omega coefficient: .90. The association between patient and physician perception of SDM was weak and failed to reach statistical significance. Males and patients over 60 years of age displayed the greatest satisfaction with SDM. Conclusions: SDM-Q-9 can aid in evaluating SDM from the cancer patients’ perspective. SDM-Q-9 is helpful in studies examining patient perspectives of SDM and as an indicator of the degree of quality and satisfaction with health care and patient-physician relationship.     

Motivational Interviewing in Primary Care

Healthcare systems are in the process of reforming themselves to better meet the needs of people with, or at risk of developing, chronic diseases and long term conditions. One goal of these efforts is the coproduction of activated, informed, engaged and motivated patients and citizens. The clinical, public health and financial benefits of achieving such a goal may be dramatic. Motivational Interviewing (MI) is a proven and practical front-line approach which can help deliver this goal whilst also helping to deliver such policy objectives and intermediate outcomes as increased levels of patient centered care, participatory or shared decision making, evidence-based healthcare and improved clinician-patient relationships. Until now, MI has been passively diffusing through the system as a result of the innovation and early uptake by insightful individuals and organizations. If healthcare systems want to breakthrough to higher levels of performance, investment in the conscious and deliberate implementation of MI into front-line settings may prove helpful.     

Internet-based cognitive behavioral therapy for anxiety in an outpatient specialized care setting: A qualitative study of the patients’ experience of the therapy

Knowledge about user experiences of internet-based cognitive behavioral therapy (iCBT) has mostly been drawn from non-clinical groups or with iCBT offered via self-referral. The present study therefore focused on patients who had undergone iCBT with minimal support while actively awaiting outpatient psychological treatment in the form of face-to-face CBT. To seek out barriers to adherence the study also included patients who had withdrawn from the iCBT treatment before completion. The study was performed in an outpatient clinic for anxiety disorders where twelve participants with a primary diagnosis of either social anxiety disorder or panic disorder were recruited from an ongoing randomized control trial for semi-structured interviews. Statements from the interviews showed that the iCBT treatment was unfavorably compared to the usual face-to-face treatment at the clinic. Despite this, a majority of the interview participants still expressed to have experienced various benefits from the treatment. Some participants did however, experience difficulties putting the materials to practical use. Furthermore, a large majority of the participants expressed a need for additional support, with a strong tendency for non-completers specifically expressing a need for face-to-face contact with a clinician. Implications for future research and implementation of iCBT in clinical practice are discussed.     

Building Meaningful Community Advocacy for Ethnic-based Health Equity: The RoAd4Health Experience

The pervasive failure of policies aimed at overcoming health inequities suffered by European Roma reflects the oppressive and impoverished living conditions of many ethnic minorities in the Western world. The multiple social inequities that Roma experience and the cumulative effect on their health prove that the failure of health policies that impact Roma must be attributed to their ameliorative nature. These policies legitimize the mechanisms of oppression that sustain inequities, fueling fatalistic attitudes toward minorities, while these minorities internalize the stigma and attempt to survive on the margins of society. This paper presents the RoAd4Health project, a community initiative in which academic researchers partnered with Roma communities to overcome health inequities. We present the multiple methods utilized for building meaningful advocacy, such as photovoice and asset mapping led by Roma agents of change. These methods provided the capacity to develop a local narrative of disparities, build alliances to gain capacity to respond to injustices, and take actions to promote social change. The results of effectively involving all significant stakeholders (i.e., community agents of change, residents, health and social care providers, Roma community grassroots organizations, and institutional actors) are discussed along with lessons learned.     

Religious and/or Spiritual Social Justice Advocacy: Guidance From the Multicultural and Social Justice Counseling Competencies

The Multicultural and Social Justice Counseling Competencies (MSJCC; Ratts, Singh, Nassar-McMillan, Butler, & McCullough, 2015) provide recommendations for social justice advocacy through a socioecological lens. The authors conceptualize and apply the MSJCC to inform counselor engagement in social justice advocacy for an often-neglected area of diversity: religion and/or spirituality. Practice and ethical examples, considerations, and recommendations related to religion and/or spirituality in MSJCC-compatible social justice advocacy are provided.     

The Future of Community Coalition Building

The future holds great promise for community coalitions as powerful interventions for community change. Community change is envisioned as: working with whole communities; increasing grassroots and civic engagement; promoting diversity, collaboration and, advocacy; increasing roles for professional technical assistance and evaluation; future changes in the role of government; and the building of healthy communities. Examples of these dimensions follow, as contributed by activists from a wide range of fields.     

Meeting the advocacy needs of people who have been abused by health and social care practitioners

The Prevention of Professional Abuse Network (POPAN) is the first national organization within the UK to address the problem of the abuse of clients and patients by health and social care providers. POPAN has a small staff group of eight people and a larger network of advisers, supporters and allies; its activities include campaigning, training, consultancy, and the provision of information, advice and advocacy. Jennie Williams is a clinical psychologist and trustee of POPAN, she has supported the development of the organization since the early 1990s; Jo Nash was the main person involved in the development and provision of the advocacy service between September 1997 to January 2000. This is the edited version of a taped and transcribed interview that took place in 1999. Jo Nash is uniquely placed to provide information of significance to anyone using or providing health and social care services. Her work as an advocate has given her a very particular insight into the challenges faced by those seeking redress for professional abuse, and she has first hand experience of providing advocacy to people who are vulnerable and reluctant to trust anyone offering help. In this interview Jo Nash directs attention to the considerable limitations in current complaints systems, practices and procedures, and offers comment on the implications for change. Her work with POPAN provides continual reminders of the importance of prevention, and she identifies a number of ways in which action can be taken to prevent health and social care practitioners abusing their patients and clients. Copyright © 2001 John Wiley & Sons, Ltd.     

The Master of Arts in Child Advocacy

Abstract

Recent heinous examples of child neglect and abuse in the State of New Jersey have called into question how public child welfare workers are trained. The author, in collaboration with the Division of Youth and Family Services (DYFS) and other experts in the field of child welfare, worked on the development of a new degree that would more appropriately educate these workers. This paper discusses the development of the Master of Arts of Child Advocacy and its optional Concentration in Public Child Welfare and offers its curriculum as an alternative to the Master of Arts of Social Work (MSW). Child Advocacy is also explored as a new and emerging discipline.     

24-Karat or fool’s gold? Consequences of real team and co-acting group membership in healthcare organizations

Although theory on team membership is emerging, limited empirical attention has been paid to the effects of different types of team membership on outcomes. We propose that an important but overlooked distinction is that between membership of real teams and membership of co-acting groups, with the former being characterized by members who report that their teams have shared objectives, and structural interdependence and engage in team reflexivity. We hypothesize that real team membership will be associated with more positive individual- and organizational-level outcomes. These predictions were tested in the English National Health Service, using data from 62,733 respondents from 147 acute hospitals. The results revealed that individuals reporting the characteristics of real team membership, in comparison with those reporting the characteristics of co-acting group membership, witnessed fewer errors and incidents, experienced fewer work related injuries and illness, were less likely to be victims of violence and harassment, and were less likely to intend to leave their current employment. At the organizational level, hospitals with higher proportions of staff reporting the characteristics of real team membership had lower levels of patient mortality and sickness absence. The results suggest the need to clearly delineate real team membership in order to advance scientific understanding of the processes and outcomes of organizational teamwork.     

Doing advocacy from a feminist standpoint

Abstract

Feminist Standpoint theory contends that all research is partial, located, and interested. It argues that research should start from the standpoint of the disadvantaged and work toward social change. Following a brief exploration of the perspective, this article explores some of the ways that feminists pursue advocacy. The article reviews two methodological approaches employed by Feminist Standpoint researchers: Community Action Research and Institutional Ethnography. Turning to examine the work of several feminist scholars who study religion, we see that there is no one way that they do advocacy. There is considerable variation in choice of subject (who feminists advocate for) and audience (who feminists advocate to), as well as in the forms that advocacy takes. Finally, the article suggests that for these scholars of religion, being an advocate is an important identity that they bring to their work.