Does being accompanied make a difference in communication during breast cancer consultations? Results from a multi-centered randomized controlled trial.

Objectives: This study is based on a multi-centered RCT conducted on breast cancer patients during their first consultation with an oncologist. The main aim was to evaluate whether the introduction of a communication tool (i.e.

Employment status and information needs of patients with breast cancer: a multicentre cross-sectional study of first oncology consultations.

Objectives: To investigate the early information needs of women with a recent diagnosis of breast cancer (BC) according to their employment status.

Design: Cross-sectional.

Setting: Secondary-care patients attending three outpatient oncology clinics in northern Italy.

Factors related to the expression of emotions by early-stage breast cancer patients.

Objective: (1) To report the number and type of emotional expressions (cues/concerns) raised by breast cancer patients; (2) to identify the influence of setting, patient characteristics, and doctor-patient interaction on emotional expression.

Methods: 308 Italian-speaking female patients were recruited at their first breast cancer consultation. The visits were audio-recorded and analysed for number and type of emotional expressions (VR-CoDES).

Effects of a Question Prompt Sheet on the Oncologist-Patient Relationship: a Multi-centred Randomised Controlled Trial in Breast Cancer.

This study assessed the effect of a question prompt sheet (QPS) on the oncologist-patient relationship as compared with a question listing (QL). In particular, the differences in difficulties perceived by the oncologist during the consultation and in the patient's experience of the therapeutic aspects of the relationship were assessed. A total of 324 patients with a recent diagnosis of early stage breast cancer were involved in the study.

Counseling in urogynecology: A difficult task, or simply good surgeon-patient communication?

Surgical treatments for pelvic organ prolapse (POP) and urinary incontinence (UI) have greatly changed in recent years. Prompted by increases in reports of adverse outcomes in relation to such treatments, several scientific societies and researchers have emphasized providing patients with thorough counseling before treating them. Patient-centered communication has become the gold standard for excellence in clinical care.

The involvement of early stage breast cancer patients during oncology consultations in Italy: a multi-centred, randomized controlled trial of a question prompt sheet versus question listing.

Objectives: To investigate, prior to an oncology consultation, the use of a pre-prepared list of evidence based questions, Question Prompt Sheet (QPS), compared with a Question List (QL), a patient self-generated list of questions.

Design: Multi-centred, randomised controlled trial.

Setting: Secondary-care patients attending three outpatient oncology clinics in Northern Italy.

Shared decision making in Italy: An updated revision of the current situation.

The aim of this paper is to update the previous review on the state of patient and public participation in healthcare in Italy. Policymakers consider patient involvement an important aspect in health care decisions and encourage patients to actively participate in the clinical interaction. Nevertheless, the term shared decision making (SDM) is still not clearly defined.

Information needs of female Italian breast cancer patients during their first oncological consultation.

Purpose: Questions asked by patients during consultations reflect their most immediate information needs. The aim of this study is to observe the frequency and type of questions asked by Italian breast cancer patients and to explore associated factors.

Methods: Breast cancer patients at their first meeting with the oncologist were asked to complete five questionnaires (STAI-X1, PHQ-9, GHQ-12, CPS and DSES) before the consultation and three other questionnaires (PEI, SDM-Q, SWD) after.

How psychiatrist's communication skills and patient's diagnosis affect emotions disclosure during first diagnostic consultations.

Objective: To describe how emotions are disclosed during psychiatric diagnostic consultations and the contribution of the psychiatrists in facilitating their expression.

Methods: Descriptive naturalistic study. Sixteen psychiatrists recorded their first consultations with 104 patients.

INvolvement of breast CAncer patients during oncological consultations: a multicentre randomised controlled trial--the INCA study protocol.

Introduction: Studies on patient involvement show that physicians make few attempts to involve their patients who ask few questions if not facilitated. On the other hand, the patients who participate in the decision-making process show greater treatment adherence and have better health outcomes. Different methods to encourage the active participation during oncological consultation have been described; however, similar studies in Italy are lacking.

Decision-making in multiple sclerosis consultations in Italy: third observer and patient assessments.

Objective: To assess decision-making in multiple sclerosis (MS) from third observer and patient perspectives.

Method: Audio recordings of first-ever consultations with a participating physician (88 outpatients, 10 physicians) at four tertiary MS care clinics in Italy, were rated by a third observer using the Observing Patient Involvement in Shared Decision Making (OPTION) and by patients using the Perceived Involvement in Care Scale (PICS).

Results: Mean patient age was 37.

The perception of shared medical decision making of expert and lay people: effects of observing a movie clip depicting a medical consultation.

Objective: To test for differences between experts and lay people in assessment of the degree to which a doctor engaged in a shared decision making (SDM) with a patient using the OPTION scale and a movie clip as stimulus material.

Methods: A segment of the movie 'Wit', depicting the communication of the diagnosis and the therapy proposed of a cancer, was shown to (a) university students with no knowledge about doctor-patient communication; (b) nurses working in medicine departments; (c) advanced medical students; (d) hospital physicians. The participants were asked to complete the OPTION scale which measures the extent to which physicians involve patients in medical decisions.

[Patient involvement in medical decision-making].

The increasing interest in the Shared Decision Making approach is linked to an improvement of the clinical outcomes. This paper proposes an update of the literature review on Shared Decision-Making in the clinical setting in Italy, describing the areas of application, the objectives, the instruments used and the main results.

Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials.

Background: Psychiatric patients have more physical health problems and much shorter life expectancies compared to the general population, due primarily to premature cardiovascular disease. A multi-causal model which includes a higher prevalence of risk factors has provided a valid explanation. It takes into consideration not only risks such as gender, age, and family history that are inherently non-modifiable, but also those such as obesity, smoking, diabetes, hypertension, and dyslipidemia that are modifiable through behavioural changes and improved care.

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial.

Background: Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services.

Methods/design: The Psychosis early Intervention and Assessment of Needs and Outcome (PIANO) trial is part of a larger research program (Genetics, Endophenotypes and Treatment: Understanding early Psychosis - GET UP) which aims to compare, at 9 months, the effectiveness of a multi-component psychosocial intervention versus treatment as usual (TAU) in a large epidemiologically based cohort of patients with FEP and their family members recruited from all public community mental health centers (CMHCs) located in two entire regions of Italy (Veneto and Emilia Romagna), and in the cities of Florence, Milan and Bolzano. The GET UP PIANO trial has a pragmatic cluster randomized controlled design.

How emotions emerge and are dealt with in first diagnostic consultations in psychiatry.

Objective: To illustrate how patients introduce cues and concerns during clinical consultations and how psychiatrists respond to them.

Method: Sixteen psychiatrists recorded 104 first diagnostic consultations, coded with the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Cues, concerns and responses were analyzed in relation to patient gender and ICD-10 diagnosis, and psychiatrists' age, gender, clinical experience and consultation process.

Interprofessional education about patient decision support in specialty care.

Specialty care involves services provided by health professionals who focus on treating diseases affecting one body system. In contrast to primary care - aimed at providing continuous, comprehensive care - specialty care often involves intermittent episodes of care focused around specific medical conditions. In addition, it typically includes multiple providers who have unique areas of expertise that are important in supporting patients' care.

Participation of patients and citizens in healthcare decisions in Italy.

WHAT ABOUT POLICY REGARDING SDM? The Italian National Health Plan and many regional and local health authorities explicitly recognise the importance of patient/citizen participation. These official documents rarely mention the specific concept of SDM, but they use terms such as patient involvement, participation, and empowerment. Patient associations are actively involved in promoting patient/citizen participation, but still play a marginal role in the health debate compared to health professionals, clinicians and healthcare managers.

Coding patient emotional cues and concerns in medical consultations: the Verona coding definitions of emotional sequences (VR-CoDES).

Objective: To present the Verona Coding Definitions of Emotional Sequences (VR-CoDES CC), a consensus based system for coding patient expressions of emotional distress in medical consultations, defined as Cues or Concerns.

Methods: The system was developed by an international group of communication researchers. First, consensus was reached in different steps.

Development of the Verona coding definitions of emotional sequences to code health providers' responses (VR-CoDES-P) to patient cues and concerns.

Objective: To present a method to classify health provider responses to patient cues and concerns according to the VR-CoDES-CC (Del Piccolo et al. (2009) [2] and Zimmermann et al. (submitted for publication) [3]).

Involving patients in decisions during psychiatric consultations.

Background: Patient involvement in the decision-making process is a key element for good clinical practice. Few data are available on patient involvement in psychiatry.

Aims: To assess in a psychiatric out-patient context how psychiatrists involve patients in therapeutic decisions and to determine the extent to which patient and psychiatrist characteristics contribute to patient involvement.

[How to involve patients in the decision making process].

In the last recent years the need to improve the doctor-patient communication rose the question on how to involve patients in the decision making process. Aim of this paper is to propose some practical abilities that can be used to improve patient involvement in the decision making process.

[The assessment of patient involvement across consultation. The Italian version of the OPTION scale].

Aim: To present the Italian version of the OPTION (observing patient involvement) rating scale, developed in UK by Elwyn et al. (2005), and its psychometric characteristics, together with some findings when applied on the consultations transcripts of a group of Italian General Practitioners.

Methods: The OPTION scale assesses the extent to which clinicians involve patients in decisions and consists of 12 items to be rated on a 5 point scale (from 0--behaviour not observed to 4--high standard).

Patient and citizen participation in health care decisions in Italy.

In recent years there has been a growing recognition in Western healthcare systems of the importance of considering preferences of patients and the public in tailoring health services and treatment plans. The active collaboration between doctor and patient has recently been encouraged through the shared decision-making model. Aim of the present contribution is to describe the current state of patient and public participation in healthcare in Italy.

Shared decision making: the reliability of the OPTION scale in Italy.

Objective: To provide psychometric characteristics of the Italian language version of the OPTION scale and descriptive statistics on patients' involvement. The OPTION scale assesses the extent to which clinicians involve patients in therapeutic decisions. The English language version has a Cohen's kappa score for individual items ranging from 0.