Introduction
Notifying the patients of their laboratory results is an important aspect of patient care. Not only will this greatly help in motivating patients to follow the health regimen given to them, but this will also make it easier for physicians to keep track of the developments in their patients’ health. Although there is no specific law that requires doctors to provide all the results found in the test, patients should be given at least the abnormal findings detected in the test so as proper treatment can be administered. The specific practice or mean of notifying the patients of these results is yet to be defined; for now, it is up to the physicians’ discretion on how patients will be informed of their test results.
Telephone notification is the most common method used for this purpose; though this method is considered as costly and time-consuming, this method is the easiest way to notify the patients. In addition, if immediate action or notification is necessary, the use of the telephone is the most practical instrument to use. For cases where immediate action is not really required, patient notification is done through mails. In some instances, postcards bearing predetermined symbols are used to inform the patients of their patients rather than textual presentation of the findings; this helps in protecting the patients’ privacy.
At times, patients are the ones who will contact their doctors or medical staff regarding their test results. This method however, can be frustrating especially for patients who incessantly calls the office before the arrival of their results or when the person in charge for the release of the results in not available. With the help of communication technology, this process is also made easier. One available alternative is through a telephone system where medical staff can record the test results of patients in voicemail boxes; the patients on the other hand, can access their results through a private identification number. Another method is through online access where patients can obtain their lab test results by logging in with their personal passwords.
There are indeed a number of methods on how patients can be informed of their laboratory results. However, it has been considered that personal or face to face notification of the lab results is the most efficient way that physicians should apply. In general, this strategy is claimed to be effective as it will help patients get a clearer understanding of the results; this will also ensure that the confidential results will be directly disclosed to the patients only, thus, ensuring privacy and confidentiality. This proposed study will then be conducted in order to obtain the view of the patients regarding the efficacy of personal notification. This will help in determining whether physicians should do this method of notification in actual practice.
Background
Several previous studies had been conducted in order to identify the different methods used by physicians and medical staff in notifying patients of their laboratory test results. In a study done by Devroey, Van Casteren, and Sasse (2002), the researchers aimed to investigate how patients are notified of their HIV test results. Using records from 1996 to 1999, a total of 4,807 requests for HIV tests were used for the analysis. The results of the analysis showed that 41.9% of the HIV test results were given to patients by phone. Those tested and considered at risk were notified more frequently through a planned follow-up. In addition, a total of 61.2% of the test results had been communicated a week after the test had been conducted. In some instances, results of the tests are given immediately for anxious patients. The researchers concluded that the use of telephone notification for laboratory results helped in reducing delays; nonetheless, notifying patients of the results is not enough, especially those who were identified as at risk. It is imperative that follow-up appointments should be done along with the notification; moreover, at risk patients should be informed or counseled personally by the physicians to ensure that the patients fully understand their condition (Devroey, Van Casteren & Sasse, 2002).
In the study of Meza and Webster (2000), the researchers also believed that notifying the patients of their test results is important especially in encouraging behavior changes for better health conditions. This research was focused on identifying the preferences of the patients with regards to how they will receive their test results. The research process was done through a telephone survey; a total of 49 patients with hypercholesterolemia who had taken a lipoprotein profile six months ago were used as the study’s participants. The survey basically inquired whether the patients were informed of their test results, how they were informed and how satisfied were they with the notification process. Their preferred notification method was also asked. The results indicated that 94% or majority of the patients surveyed preferred to be notified of the full results of their laboratory tests, including abnormal findings. Moreover, they preferred to receive health management procedures from their physicians along with the notification. Fifty-nine percent of the participants wanted to be notified by mail, while others would want to receive them by phone (16%), office visit (12%) or by other means (6%).
The finding on which notification method is preferred by the patients appears to be inconclusive and is significantly dependent on the status of the results. In the research conducted by Lind, Kopans and Good (1992) for instance, a survey was done in order to identify the notification preferences of women who had undergone traditional mammography. Using a questionnaire, the researchers asked about the feeling patients have on various notification procedures used for disclosing mammogram results as well as the method used to notify them on both previous and current mammogram results. The interviewed patients stated that if no abnormal results were detected in the tests, they would rather be informed through a telephone call; however, patients prefer to be informed of any abnormal findings by personally visiting the office of their physicians.
The patients wish to be notified of the results, including both normal and abnormal findings; thus, receiving no feedback at all for normal results is the least preferred method. Moreover, the patients are not interested on receiving their results from the staff who had conducted the test. The feelings of the patients towards the notification procedure used vary as well. For example, patients who had gone through mammogram for diagnostic reasons only, were not as comfortable when they were personally informed by their physician. In general, the patients are open to any type of notification method for good news of findings. On the other hand, the patients would prefer to be informed of any abnormal results through face to face notification by their physicians (Lind, Kopans & Good, 1992).
While other studies had concentrated on determining which notification method is most appropriate for the patients, the research done by Schofield and associates (1994) emphasized more on utilizing better notification methods to enhance the knowledge of the patients of their condition and promote compliance to follow up recommendations. In this research, the objective is to determine the knowledge accuracy of women regarding their Pap test findings, identify the current notification methods used for disclosing Pap test results and the satisfaction of the women on methods used. For this research, a total of 315 women who had recently taken a Pap test result went through a telephone survey. The process revealed that 61% of the participants with normal results and 93% of those with abnormal results had been notified. A total of 7% with abnormal results were not notified and 11% of women who had abnormal results were not aware that their test results were abnormal. This indicated that 18% of the participants did not receive an adequate explanation of their Pap results.
The study also found out that the most common method for notification was by women calling the receptionist or their physicians. This suggests that the patients were not given clear instruction as to how and when they will be notified of the results. The participants strongly preferred that their doctors are the ones who will initiate the notification either by a telephone call, written record or consultation. With these findings, the researchers suggested that better notifications methods should be used for disclosing Pap test results; this will greatly help in improving the patients’ knowledge and satisfaction with regards to their test results. Moreover, patients with abnormal findings will likely comply more strictly to follow up recommendations of their doctors (Schofield et al., 1994).
Statement of the Problem
Although there had been a number of researches done to determine the different notification methods for lab results as well as those that identify the patients’ preferred notification procedure, the studies concentrating on the patients’ view on face to face notification are limited. Considering that the cited studies stressed on the importance of employing the most effective means of notifying laboratory results, it is then essential to test whether methods like personal or face to face notification are indeed effective. This study will then attempt to answer the following questions:
Significance of the Study
Receiving a clear and full notification of the test results is an important matter for the patients and the physicians. By receiving a clear explanation of the test results, patients will be able to understand their condition. Moreover, this will make them more adherent to the suggestion or recommendations of their physicians. Doctors on the other hand, will be able to benefit with this process as it will fulfill their responsibilities and role to the patients; notifying them of their condition through test results will make behavior modification easier. If these can be achieved through face to face notification, testing its efficacy by means of obtaining the views of the patients will then be of great benefit.
Methodology
Research Design
This study will be conducted in order to determine the view of the patients towards face to face notification of laboratory test results for diabetes. Specifically, the efficacy of using this notification method will be determined based on the patients’ perspectives or views. In this proposed study, the descriptive method will be utilized, using a sample of 50 patients. According to Creswell (2005), the descriptive method of research is appropriate for gathering information about the present existing condition. Thus, the descriptive approach for this research will be most appropriate.
Two types of data will be used for this study: the primary and the secondary data. The primary data will be derived from the answers respondents will give in the interview process. The secondary data on the other hand, will be derived from the findings stated in literatures related to the research problem. This study will utilize the qualitative method of research as this will be suited in gathering the opinions, beliefs and individual insights of the interviewed respondents.
Participants
A total of 50 patients who had gone through a glycated HB test for diabetes will be selected as participants for this research. The participants will be derived from the records of one health institution. In order for the respondents to answer the interview with pertinent information, the researcher opted to employ an age range of 20 and above; gender limits however, will not be used as this factor do not have any direct relevance to the objectives of the research. Patients for the study should have taken the blood test for diabetes for the past 3 to 6 months; this criterion is employed so that participants can provide pertinent data regarding personal notification method. As this research aims to identify the efficacy of using face to face notification method, it is imperative that the selected sample had already gone through this process. Once the inclusion criteria had been used on the population, random sampling will be used to form the sample.
In determining the size of the sample, a formula (Pagoso et al., 1981) will be used:
n = N
———–
1+Ne2
Where:
n = the size of the sample
N = the size of the population
e = the margin of error
In this case, the researcher will have to identify the number of confined ICU patients in the university hospital. Inclusion criteria will then be used to select the patients who will constitute the population. The formula above will then be used to compute the sample size.
Data Collection
As this study will need to obtain the views of the patients towards the use of personal or face to face notification for their test results, the personal interview method is the most appropriate instrument for data-gathering. An interview schedule will then be used to facilitate the process. Through this data-gathering tool, specific information that will help in achieving the cited objectives will be acquired. The entire interview process will be audio taped for purposes of documentation and analysis.
In order to test the validity of the interview schedule which will be used for this study, the researcher will initially submit a sample of the interview questionnaire. After obtaining an approval, the researcher will test the questionnaire to five respondents. These respondents as well as their answers are not part of the actual study process and will only be used for testing purposes. After the questions have been answered, the researcher will ask the respondents for any suggestions or any necessary corrections to ensure further improvement and validity of the instrument. The researcher will then revise the interview schedule based on the suggestion of the respondents. The researcher will basically exclude irrelevant questions and change vague or difficult terminologies into simpler ones in order to ensure comprehension. In order to analyze the data gathered from the interview procedure, thematic analysis will be used.
References:
Creswell, JW 2005, Educational Research: Planning, Conducting, and Evaluating Quantitative and Qualitative research, Pearson/Merrill, Upper Saddle River, New Jersey.
Devroey, D, Van Casteren, V & Sasse A 2002, ‘How are patients informed about their HIV test results?’, Family Practice, vol. 19, no. 2, pp. 125–127.
Lind SE, Kopans D & Good MJ 1992, ‘Patients’ preferences for learning the results of mammographic examinations’, Breast Cancer Research and Treatment, vol. 23, no. 3, pp. 223-32.
Meza JP & Webster DS 2000, ‘Patient preferences for laboratory test results notification’, American Journal of Managed Care, vol. 6, no. 12, pp. 1297-300.
Pagoso, C et al 1981, Fundamental Statistics for College Students, 3rd edn, Sinagtala Publishers, Manila.
Schofield, MJ, Sanson-Fisher, R, Halpin, S & Redman S 1994, ‘Notification and follow-up of Pap test results: current practice and women’s preferences’, Preventive Medicine, vol. 23, no. 3, pp. 276-83.
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