Nudging and Relationship Building With Frequent Contact
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 入组人数
- 142
- 试验地点
- 2
- 主要终点
- Guttman Satisfaction scale
研究概览
简要总结
This study aims to test in what way a care strategy incorporating frequent contact can benefit patients with musculoskeletal condition that necessitates some adaptation and resiliency to symptoms and limitations that are expected to be either long-lasting or permanent.
Patients will be randomized into either group A, where they will receive the standard amount of contact with their clinician, or group B, in which they will have contact with their clinican more frequently.
The communication strategy may utilize text, email, portal, phone, video or other options as agreed on. The frequency will be at least once a week. All patients will complete a set of questionnaires at the end of the visit.
详细描述
Irregular and uncomfortable bodily symptoms are common. Most are well adapted in a healthy life. People seek care when a symptom becomes a concern. Even the effort to attend a routine healthy check-up is usually based on not wanting to miss anything, which is accompanied by at least a slight concern that a problem might be found. People that are seeking care are unsettled to some degree.
This unsettled feeling is often rooted in or worsened by unhelpful thoughts (less effective cognitive coping strategies). An example of a less effective cognitive coping strategy is rumination on worst-case thoughts (catastrophic thinking). The unsettled feeling is worse when thoughts are perceived as facts (cognitive fusion). Cognitive fusion is greater when people are under greater stress or distress.
Clinicians can help people feel better and do more by gently correcting these misconceptions. And when correction of misconceptions is to some degree at odds with a person's experience of reality, expert advice may seem impersonal, dismissive, and uncaring.
Adherence to medical expertise is enhanced by a trusting relationship with one's clinicians. There are several methods for nurturing a clinician-patient relationship. One is to make small agreements or compromises such as ordering a test that is not likely to yield useful information, has a small risk of harm, and uses resources and doing so in the context of efforts to move towards more effective cognitive coping strategies and greater self-efficacy. Another is to use educational tools such as decision aids to depersonalize the transfer of expertise. A third approach is use more frequent contact to deepen the relationship.
This study posits that establishing a frequent-contact plan with a patient that might benefit from a healthier inner narrative can improve health using few resources other than clinician time, with a good patient experience compared to the typical single or infrequent in person specialist office visits.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 89 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patient
- •New or return visit
- •English or Spanish speaker
- •A musculoskeletal condition that necessitates some adaptation and resiliency to symptoms and limitations that are expected to be either long-lasting or permanent
排除标准
- •Cognitive dysfunction
- •Language other than English or Spanish
研究组 & 干预措施
Standard care
Patients in this arm will receive the standard amount of contact with their clinician.
High-contact communication strategy
Patients will have contact with their clinician more frequently. The communication strategy may utilize text, email, portal, phone, video or other options as agreed on. The frequency will be at least once a week. All patients will complete a set of questionnaires at the end of the visit.
干预措施: High-contact communication strategy (Behavioral)
结局指标
主要结局
Guttman Satisfaction scale
时间窗: 1 month after enrollment
The Guttman Satisfaction Scale is a unidimensional questionnaire designed to measure the degree of patient satisfaction with the care they received. It consists of a series of hierarchically ordered yes/no items, with each successive item indicating a higher level of satisfaction. Total scores range from 0 to 7, with higher scores reflecting greater satisfaction, representing a better outcome.
次要结局
- PROMIS Physical Function CAT(1 month after enrollment)
- Negative Pain Thoughts Questionnaire (NPTQ-4)(1 month after enrollment)
- PROMIS Depression CAT(1 month after enrollment)
- Jefferson Scale of Patient's Perceptions of Physician Empathy (JSPPE)(1 month after enrollment)
- Communication effectiveness(1 month after enrollment)
研究者
David Ring
Professor, Dean associate of surgery department
University of Texas at Austin