Giuseppe Deledda

A standardized approach to qualitative content analysis of focus group discussions from different countries

OBJECTIVE To describe the methodological procedures of a multi-centre focus group research for obtaining content categories also suitable for categorical statistical analyses. METHODS Inductive content analyses were performed on a subsample of 27 focus groups conducted in three different countries, the Netherlands (Utrecht), the UK (Liverpool) and Italy (Verona). The analyses of the subsample of focus group discussions were performed in five steps: (1) independent development of content categories in each of the participating centres, (2) obtaining consensus categories, (3) creation of a manual with coding rules and defining criteria for categories and subcategories, (4) assessment of inter-rater reliability to identify unreliable categories to be revised, and (5) repetition of inter-rater reliability assessment. RESULTS The resulting coding system considers five areas: non verbal communication, process oriented expression, task oriented or problem focused expressions, affective or emotional expressions, and physicians personal characteristics. It contains 12 categories of acceptable inter-rater reliability and 41 subcategories. CONCLUSION The coding procedures show how focus group data, obtained in an international multi-centre study can be analysed in a systematic way combining scientific rigour with the richness of data obtainable from qualitative methodologies. PRACTICE IMPLICATION The applied procedures may be helpful for multi-centre focus group research on other topics.

What do people appreciate in physicians' communication? An international study with focus groups using videotaped medical consultations

The literature shows that the quality of communication is usually determined from a professional perspective. Patients or lay people are seldom involved in the development of quality indicators or communication.

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. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? There are only a few examples of decision aids designed for patients according to SDM concepts. A critical point is the lack of specific tools for the evaluation of SDM processes. Exceptions include the Italian versions of the OPTION scale and the SDM-Q, used at the micro-level for the evaluation of SDM. What about professional interest and real implementation? Health professionals recognise that doctor-patient communication is an important area. Italian research in SDM has grown and improved. It is very promising, but still limited. Undergraduate and postgraduate courses of some medical schools include specific programs on doctor-patient communication skills, focusing also on promotion of patient participation. WHAT DOES THE FUTURE LOOK LIKE? In conclusion, there is room for improving the Italian efforts to implement SDM into practice at both the individual and public level.

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. The aims of the present study are to (1) assess the effects of a preconsultation intervention to increase the involvement of breast cancer patients during the consultation, and (2) explore the role of the attending companions in the information exchange during consultation. Methods and analysis All female patients with breast cancer who attend the Oncology Out-patient Services for the first time will provide an informed consent to participate in the study. They are randomly assigned to the intervention or to the control group. The intervention consists of the presentation of a list of relevant illness-related questions, called a question prompt sheet. The primary outcome measure of the efficacy of the intervention is the number of questions asked by patients during the consultation. Secondary outcomes are the involvement of the patient by the oncologist; the patients perceived achievement of her information needs; the patients satisfaction and ability to cope; the quality of the doctor–patient relationship in terms of patient-centeredness; and the number of questions asked by the patients companions and their involvement during the consultation. All outcome measures are supposed to significantly increase in the intervention group. Ethics and dissemination The study was approved by the local Ethics Committee of the Hospital Trust of Verona. Study findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration ClinicalTrials.gov identifier: NCT01510964

Effect of Acceptance and Commitment Therapy (ACT) on Weight Loss and the Acceptance of Body Image in Breast Cancer Patients. In: Abstracts of the IPOS 15th World Congress of Psycho-Oncology. November 4-8, 2013. Rotterdam, The Netherlands

Nadine Köhle 1, Constance Drossaert2, Cornelia van Uden-Kraan3, Irma Verdonck -de Leeuw4, Ernst Bohlmeijer5 1University of Twente, Enschede, Overijssel, The Netherlands, 2University of Twente, Enschede, Overijssel, The Netherlands, 3VU University, Amsterdam, Noord-Holland, The Netherlands, 4VU University, Amsterdam, Noord-Holland, The Netherlands, 5University of Twente, Enschede, Overijssel, The NetherlandsFrom Vision to Action - Innovation and Implementation of an Integrated Cancer Rehabilitation Within Clinical Practice

Il coinvolgimento del paziente nel processo clinico decisionale

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.