Papers by Barbara Schouten
Background: Older migrant patients with cancer face many language-and culture-related barriers to... more Background: Older migrant patients with cancer face many language-and culture-related barriers to patient participation during medical consultations. To bridge these barriers, an eHealth tool called Health Communicator was developed in the Netherlands. Essentially used as a digital translator that can collect medical history information from patients, the Health Communicator did not include an oncological module so far, despite the fact that the prevalence of Dutch migrant patients with cancer is rising. Objective: This study aims to systematically develop, implement, and conduct a pilot evaluation of an oncological module that can be integrated into the Health Communicator to stimulate patient participation among older Turkish-Dutch and Moroccan-Dutch patients with cancer. The Spiral Technology Action Research model, which incorporates 5 cycles that engage key stakeholders in intervention development, was used as a framework. The listen phase consisted of a needs assessment. The plan phase consisted of developing the content of the oncological module, namely the question prompt lists (QPLs) and scripts for patient education videos. On the basis of pretests in the do phase, 6 audiovisual QPLs on patient rights, treatment, psychosocial support, lifestyle and access to health care services, patient preferences, and clinical trials were created. Additionally, 5 patient education videos were created about patient rights, psychosocial support, clinical trials, and patient-professional communication. In the study phase, the oncological module was pilot-tested among 27 older Turkish-Dutch and Moroccan-Dutch patients with cancer during their consultations. In the act phase, the oncological model was disseminated to practice. The patient rights QPL was chosen most often during the pilot testing in the study phase. Patients and health care professionals perceived the QPLs as easy to understand and useful. There was a negative correlation between the tool's ease of use and patient age. Patients reported that using the module impacted the consultations positively and thought they were more active compared with previous consultations. Health care professionals also found patients to be more active than usual. Health care professionals asked significantly more questions than patients during consultations. Patients requested to see the patients' rights video most often. Patients rated the videos as easy to understand, useful, and informative. Most of the patients wanted to use the tool in the future. Older migrant patients with cancer, survivors, and health care professionals found the oncological module to be a useful tool and have shown intentions to incorporate it into future consultation sessions. Both QPLs and videos were evaluated positively, the latter indicating that the use of narratives to inform older, low-literate migrant patients with cancer about health-related
Health Communication, Jul 24, 2018
Previous research has shown that ethnic minority patients participate less during medical encount... more Previous research has shown that ethnic minority patients participate less during medical encounters than patients from majority populations. Given the positive outcomes of active patient participation, such as higher understanding of information and better treatment adherence, interventions are required to enhance ethnic minority patients' participation levels. However, little is known about what patients perceive as barriers hindering their participation. This study therefore aimed to explore differences in perceptions of barriers to patient participation among ethnic minority and ethnic majority patients in general practice. Eight focus-groups with Turkish-Dutch and indigenous Dutch participants were performed. A semi-structured topic-list concerning patients' enabling and predisposing factors to participate, and physicians' responses guided the interviews. Interviews were recorded, transcribed verbatim, and transcripts were analyzed using the constant comparison method described in Grounded Theory. Regarding Turkish-Dutch patients' enabling factors to participate, two perceptions of barriers were identified: (i) low Dutch language proficiency; (ii) a preference for an indirect communication style. Three perceptions of barriers to Turkish-Dutch patients' predisposition to participate were identified: (i) collectivistic values; (ii) power distance; (iii) uncertainty avoidance. Regarding doctors' responses, discrimination was identified among Turkish-Dutch patients as a perception of barrier to their patients' participation. None of these perceptions of barriers emerged among indigenous Dutch patients. This study contributes to our understanding of which perceptions of barriers might impede ethnic minority patients' level of patient participation. To enhance their participation, a combined intervention is needed, tackling the language barrier, raising awareness about cultural differences in values, and increasing doctors' cultural competencies to communicate adequately with ethnic minority patients.
BMC Cancer, Jan 25, 2022
Background: Older cancer patients may search for health information online to prepare for their c... more Background: Older cancer patients may search for health information online to prepare for their consultations. However, seeking information online can have negative effects, for instance increased anxiety due to finding incorrect or unclear information. In addition, existing online cancer information is not necessarily adapted to the needs of older patients, even though cancer is a disease often found in older individuals. The aim of this study was to systematically develop, implement and evaluate an online health information tool for older cancer patients, the Patient Navigator, providing information that complements the consultation with healthcare providers. For the development and evaluation of the Patient Navigator, the four phases of the MRC framework were used. In the first and second phase the Patient Navigator was developed and pilot tested based on previous research and sub-studies. During the third phase the Patient Navigator was implemented in four Dutch hospitals. In the last phase, a pilot RCT was conducted to evaluate the Patient Navigator in terms of usage (observational tracking data), user experience (self-reported satisfaction, involvement, cognitive load, active control, perceived relevance of the tool), patient participation (observational data during consultation), and patient outcomes related to the consultation (questionnaire data regarding anxiety, satisfaction, and information recall). Recently diagnosed colorectal cancer patients (N = 45) were randomly assigned to the control condition (usual care) or the experimental condition (usual care + Patient Navigator). The Patient Navigator was well used and evaluated positively. Patients who received the Patient Navigator contributed less during the consultation by using less words than patients in the control condition and experienced less anxiety two days after the consultation than patients in the control condition.
Healthcare professionals’ use of communication strategies in language discordant consultations
Patient Education and Counseling
Journal of Geriatric Oncology
Onomázein Revista de lingüística filología y traducción, Dec 31, 2023
The aim of this article is to illustrate the goals, process and results of the first stage of a E... more The aim of this article is to illustrate the goals, process and results of the first stage of a European project: MentalHealth4All. Partners from 9 different European countries have worked together to design a multilingual validated repository targeted at third-country nationals with limited language proficiency (LLP TCNs) and healthcare providers, which contains resources to improve this population's knowledge and understanding of how to access interlinguistic support in mental healthcare services in the main languages of the countries involved in the project. The present article provides a detailed overview of the assessment process of resources and its main results.
Patient Education and Counseling, Jun 1, 2018
The aim of this observational study was twofold. First, we examined how often and which roles inf... more The aim of this observational study was twofold. First, we examined how often and which roles informal interpreters performed during consultations between Turkish-Dutch migrant patients and general practitioners (GPs). Second, relations between these roles and patients' and GPs' perceived control, trust in informal interpreters and satisfaction with the consultation were assessed. Methods: A coding instrument was developed to quantitatively code informal interpreters' roles from transcripts of 84 audio-recorded interpreter-mediated consultations in general practice. Patients' and GPs' perceived control, trust and satisfaction were assessed in a post consultation questionnaire. Results: Informal interpreters most often performed the conduit role (almost 25% of all coded utterances), and also frequently acted as replacers and excluders of patients and GPs by asking and answering questions on their own behalf, and by ignoring and omitting patients' and GPs' utterances. The role of information source was negatively related to patients' trust and the role of GP excluder was negatively related to patients' perceived control. Conclusion: Patients and GPs are possibly insufficiently aware of the performed roles of informal interpreters, as these were barely related to patients' and GPs' perceived trust, control and satisfaction. Practice implications: Patients and GPs should be educated about the possible negative consequences of informal interpreting.
Dental check-up frequency: preferences of Dutch patients
PubMed, Sep 1, 2006
Objective: In 1995, the requirement to visit the dentist for a check-up every six months in The N... more Objective: In 1995, the requirement to visit the dentist for a check-up every six months in The Netherlands was replaced by the obligation to get a routine examination no more than once a year. The aim of this study was to determine patients' opinions about this change in policy, and to assess their preferences regarding frequency and content of regular dental check-up visits. Possible associations between patients' preferences for regular dental check-ups and a number of antecedent variables, such as dental attitudes, were examined as well. Basic research design: Patients' preferences for regular dental check-ups were assessed by means of a questionnaire, containing a 19-item Likert-type scale, twelve visual analogue scales and seven forced choice items. Items assessing various background variables and a selection of items of the Dental Attitude Questionnaire were also added. This questionnaire was administered to patients of seven dental practices. A total of 428 patients completed the questionnaire. Results: Results indicated that patients prefer to have regular dental check-ups. Patients' evaluation of six-monthly dental check-up visits was significantly more positive than their evaluation of flexible, individualized, check-up frequencies. Factors positively associated with a higher preference for regular dental check-up visits were female gender, being more satisfied with one's teeth, less cynicism toward dental health care professionals and more intrinsic motivation to maintain one's oral health. Conclusions: Patients seem to prefer to attend their dentist regularly, at fixed intervals of about six months. This fact should be taken into account when deciding about the most appropriate interval between dental examinations.
Dutch dental patients on informed consent: knowledge, attitudes, self-efficacy and behaviour
Patient Education and Counseling, 2002
In The Netherlands, the legal doctrine of informed consent is established in the &amp... more In The Netherlands, the legal doctrine of informed consent is established in the 'Medical Treatment Contract Act', which was introduced in 1995. This study assessed dental patients' knowledge, attitudes and self-efficacy, as well as their self-reported behaviour concerning informed consent. One hundred and twenty-eight patients (response rate: 91.4%) filled out a questionnaire on these topics, right after their treatment or consultation. Results show that only a minority of the patients is acquainted with the 'Medical Treatment Contract Act'. However, their specific rights concerning informed consent are better known. On the other hand, patients' attitudes and self-efficacy were less positive. Dental patients' self-reported behaviour, did not reflect their attitudes and self-efficacy though. Contrary to social-psychological theory, almost no significant relations were found between the four measured variables, and self-reported behaviour could hardly be predicted by patients' knowledge, attitudes and self-efficacy. In light of these findings, it is concluded that other factors, which take into account more of a consumerist perspective on the dentist-patient relationship, probably play a more important role in predicting to what extent patients assert their rights in dental practice.
Information and Participation Preferences of Dental Patients
Journal of Dental Research, Dec 1, 2004
Dutch dentists have a moral and legal obligation to inform their patients and involve them in the... more Dutch dentists have a moral and legal obligation to inform their patients and involve them in the decision-making process. It is unclear, though, to what extent patients prefer information and involvement in decision-making. Therefore, the aim of this study was to determine levels of preference for information and participation in decision-making among emergency patients (n = 96) and regular patients (n = 245). It was hypothesized that female gender, higher education, younger age, and a monitoring coping style are positively associated with higher preferences for information and participation. The results demonstrated that emergency and regular patients have high preferences for information, but that their preferences for actual involvement are significantly lower. Only weak associations were found between the antecedent variables and patients’ preferences. It is concluded that, in the study of the etiology of patients’ preferences for information and participation, future research should incorporate factors such as dental anxiety and seriousness of the dental condition.
Dentists' and patients' communicative behaviour and their satisfaction with the dental encounter
PubMed, Mar 1, 2003
Objective: The aim of this study was to examine the relations between patients' and dentists' com... more Objective: The aim of this study was to examine the relations between patients' and dentists' communicative behaviour and their satisfaction with the dental encounter. Participant: The sample consisted of 90 patients receiving emergency care from 13 different dentists. Basic research design: Consultations were videotaped in order to assess dentists' and patients' communicative behaviour. Dentists' behaviour was coded by means of the Communication in Dental Setting Scale (CDSS), scores for patients' behaviour included among other things, the number of questions asked during the consultation. Main outcome measures: After treatment, patients filled out a questionnaire that assessed their satisfaction with their own and their dentist's communicative behaviour. Dentists also filled out a satisfaction questionnaire after each consultation. Results: Results showed that dentists' satisfaction could not be explained by patients' or dentists' communicative behaviour. Patients' satisfaction was mainly influenced by the communicative behaviour of the dentist. Conclusion: Not only is patients' satisfaction positively related to the communicative behaviour of dentists, but the principle of informed consent requires dentists also to inform their patients adequately enough for them to reach a well-informed decision about the treatment. Therefore, it remains important to train dentists in communicative skills.
Patient Education and Counseling, Feb 1, 2001
UvA-DARE is a service provided by the library of the University of Amsterdam () UvA-DARE (Digital... more UvA-DARE is a service provided by the library of the University of Amsterdam () UvA-DARE (Digital Academic Repository) On the autonomy of dental patients Schouten, B.C. Publication date 2002 Link to publication Citation for published version (APA): Schouten, B. C. (2002). On the autonomy of dental patients. General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website.
Dutch dentists’ views of informed consent: a replication study
Patient Education and Counseling, Feb 1, 2004
The aim of this study was to replicate a previous study on informed consent in dental practice, b... more The aim of this study was to replicate a previous study on informed consent in dental practice, because of the low response-rate of that study. The present study assessed Dutch dentists' knowledge, their attitudes and self-efficacy towards the principle of informed consent, by means of a strongly shortened version of the questionnaire used in the original study. This questionnaire was sent to 384 Dutch dental practitioners; 60.2% of them responded. The results obtained in this study are highly comparable with the results of the original study, thereby increasing the confidence in the outcomes. Results of both studies indicate that dentists still have problems with some aspects of informed consent. Specifically, dentists' fear for legal procedures and the difficulty they have with informing immigrant patients warrants further attention.
Community Dentistry and Oral Epidemiology, Sep 8, 2003
SDM in interpreter-mediated communication in general practice
Patient Education and Counseling
Language and cultural discordance between practitioners and refugees in mental healthcare consultations: Developing a promising European intervention to break down barriers
Patient Education and Counseling
PsycTESTS Dataset, 2013
Awareness of communication style allows us to respond more effectively to people because we are m... more Awareness of communication style allows us to respond more effectively to people because we are more attentive to their styles of communication. An essential part of communication is sending and receiving information. Unless we can send information to people in a style in which they understand readily, we may not complete the process at all. If you ever made or heard any of the statements listed above you were experiencing the frustration that comes with not understanding styles of communication. AUDITORY: People receive information best when they hear it -with their own ears and can repeat and hear it again for clarity. VISUAL: People receive information best when they can see it and review it again by looking at it. KINESTHETIC: People receive information best when they can feel it, be a part of it and/or experience it and understand how it works.
Bad News in Medicine, Communicating
The International Encyclopedia of Communication, 2008
Health Communication in Southern Africa: Engaging with social and cultural diversity
Luuk Lagerwerf, Henk Boer & Herman Wasserman (eds.) (2009)
Disclaimer/Complaints regulations If you believe that digital publication of certain material inf... more Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.
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Papers by Barbara Schouten