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ASHA Research in the Spotlight

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ASHA’s Research and Health Communications Division conducts numerous research projects on STI-related topics. Read on for news on some of our most recent projects.

HSV: What do patients really want to know?

According to several surveys, patients are not satisfied with the information and counseling they receive from healthcare providers regarding the herpes simplex virus. What better way to find out what patients need their healthcare providers to address, than to analyze what patients are asking? ASHA did such an analysis. Transcripts from ASHA’s anonymous chat room-that was available several weekday hours and moderated by a health communication specialist-were content analyzed. These transcripts covered chat conversations from fall 2001 to spring 2006. Results of the analysis were recently published in the journal Herpes.  

ASHA Research in the SpotlightAnalyzing the transcripts, ASHA researchers were able to identify common themes and sub-themes associated with the questions and/or myths chatters presented. Twelve themes and fifty sub-themes emerged. Themes were transmission, symptoms, diagnosis, natural history, psychosocial impact, treatment, seeking referral, miscellaneous, research issues, pregnancy issues, rates (incidence/prevalence), and legal issues. The first six of the aforementioned themes made up 90% of the concerns.  Transmission was the most frequent theme and included questions regarding the risks from exposure, transmission without symptoms and transmission without symptoms just to name a few.  Surprisingly, legal issues were the least frequent theme and weren’t considered for this paper’s analysis, given that the focus was on the most common themes. However, researchers at ASHA do plan to consider the uncommon themes in a future analysis.

This analysis brought to light many concerns that are being addressed inadequately or not being addressed at all for those concerned with herpes.  Clearly not every person will have the same set of questions, however observing the frequency of concerns presented, will most likely be of benefit to healthcare providers. It gives them a rubric of what questions and/or concerns they need to address with patients initially.  Also, it may inform written materials that patients receive regarding herpes as well.  Hopefully, this is the first of many analyses of this nature.

Gilbert, L, Omisore, F: Common Questions about Herpes: Analysis of Chat-room Transcripts. Herpes 2009,15(3):57-61.

Just The Facts, Please: One-page Herpes FAQ Aids in Patient Counseling

Counseling newly diagnosed genital herpes patients isn’t easy. With so many topics to cover–treatment, symptoms, risk reduction, partner communication, not to mention the patient’s own emotional needs–harried healthcare providers in busy practices can be excused if they feel overwhelmed. Patients, too, are often too embarrassed or shell-shocked upon learning they have herpes to know what questions to ask.

With this in mind, ASHA’s Division of Research and Health Communications developed and tested a one-page herpes FAQ fact sheet for providers to use with newly diagnosed patients. Designed to make patient/provider discussions easier and more efficient, the FAQ covers counseling messages recommended by the Centers for Disease Control and Prevention (CDC) on topics such as HSV prevalence, transmission, risk reduction, treatment, pregnancy, and psychosocial issues.

The FAQ was distributed to physicians and nurse practitioners that routinely diagnose herpes in their practice, and feedback was received from 26 health care providers and 147 patients. Data were analyzed with regard to length of initial diagnostic visit, patient satisfaction with topics covered, topics covered by providers, and resources and referrals offered to patients.  When comparing pre- and post-test data, the investigators found:

  • Providers using the fact sheet were much more likely to cover a number of topics, including the use of suppressive therapy to reduce outbreaks and prevent transmission, psychosocial coping, disclosing herpes to a partner, and managing HSV during pregnancy. They also reported offering more referrals/resources (such as websites, chat groups, booklets, and support groups).
  • Diagnostic visit length was not greatly reduced when using the intervention, though, perhaps due to more topics being covered and ensuing discussions.
  • Overall, patient satisfaction improved: Patients who were given “standard of care: counseling without the fact sheet were twice as likely to report dissatisfaction when compared to those with whom the FAQ was used.

The authors conclude the one-page fact sheet has promise in facilitating effective patient counseling, and recommend evaluating an updated version of the intervention with a larger provider/patient sample.

Noting, too, the body of research that shows awareness of HSV status is associated with activities that reduce the likelihood of transmission to partners, they ponder if a smoother counseling process might play a role in risk reduction by spurring more providers to test for herpes.

Gilbert, L, Wyand, F: Genital Herpes Education and Counseling: Testing a One-page “FAQ” Intervention. Herpes 2009, 15 (3): 51-56.

 

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