- Improving Provider-Patient Communication about Routine HIV Testing in VA
This study sought to understand patient and provider perspectives on the adoption of routine HIV testing within the VA healthcare system. Findings show that Veterans and providers agreed that the implementation of routine HIV testing, treating HIV like other chronic diseases, and removing requirements for written informed consent and pre-test counseling would benefit both Veterans and public health. Veterans wished to have HIV testing routinely offered by providers so that they could decide whether or not to be tested; they also believed that routine testing would help de-stigmatize HIV. Six steps for providers to use in communicating about routine testing also were identified, such as raising the topic of HIV testing, reassuring the Veteran that he/she is not showing clinical signs of the disease, and responding to Veteran questions about HIV.
Date: October 1, 2009
- New Concept Regarding Patient Autonomy When Coping with Multiple Chronic Conditions
The clinical benchmark for evaluating patient autonomy in the acute care setting is patients’ capacity to participate in the informed consent process. However, this one-component concept of patient autonomy may be problematic in the context of multiple chronic conditions that require the patient to participate in their treatment plan beyond providing consent. Authors in this article call for a new two-component concept that includes both autonomous decision-making and the execution of the agreed upon treatment plan.
Date: February 1, 2009
- Conveying Risk Information Presented During the Informed Consent Process
Whether numeric or word formats lead to better decisions about participation in research is largely unknown. A few small studies indicate that using numbers rather than words to communicate the likelihood of adverse outcomes can make a difference, and suggest that many people prefer the chances of adverse effects be expressed in numerical terms. The author recommends minimizing probabilistic words (e.g., rarely, possible) and encourages the use of simple frequencies with common denominators (e.g., one out of 100 people).
Date: July 1, 2008
- Appreciation of Research Information in Patients with Bipolar Disorder
Patients with bipolar disorder were able to weigh risk levels associated with various studies, and to appreciate that their participation was voluntary. However, patients demonstrated two misconceptions: their appreciation of research goals was flawed (a substantial proportion had difficulty distinguishing clinical research from clinical care), and they incorrectly applied concepts of 'double-blind' and 'randomization.' In addition, more than half believed that their primary mental health provider could convince them to participate in a study even if they did not want to.
Date: July 1, 2008