Approaches towards optimizing individualized, high‐quality, evidence‐informed care

Healthcare professionals and service providers are constantly striving to find the best ways of delivering highquality, individualized, evidenceinformed care. Critical to the process is shared decisionmaking, exchange of information and patient and public engagement at all levels from the clinical encounter to policy development. Other essential characteristics are communication, partnership working, therapeutic relationships, respect for dignity, cultural sensitivity and team working. Manuscripts in this edition draw attention to patient information and the importance of codesign, experiences of immigrant woman, parental involvement, the sexual needs of care home residents, discharge protocols and the contribution of technology. There is consensus that information leaflets are helpful for patients. Information is available through other sources such as the Internet, which some patients cautiously access Zizzo et al., but others prefer written information. Xie et al., illustrate that with respect to the sources of health information used by Chinese patients with cancer and their family caregivers. The systematic review reported by Sustersic et al. describes the impact of patient information leaflets (PILs) on patients’ knowledge, satisfaction and shared decisionmaking. It raises a note of caution that PILs have the potential (depending on context) to increase anxiety and impact on a patient’s sense of selfefficacy. However, what appears to be missing from the review is any consideration of the importance of codesign,1,2 now considered essential in the production of highquality patient information. Engaging patients in the design and production of information materials helps ensure that the material is relevant and presented in an accessible format to facilitate uptake and usage. Codesign is reinforced in work of Learmonth et al. when exploring the needs of those suffering from multiple sclerosis and the low uptake of exercise. These authors report that patients were dissatisfied with the level of exercise promotion stating that “effort is required to develop a proactive partnership and structured exercise communication between patients with MS and healthcare providers.” This statement suggests a realization of the importance of codesign without it being explicit. When addressing delicate care issues within specific populations where relevance and cultural sensitivity are paramount, codesign is a key. The studies of Partin et al. and Quaife et al. draw attention to this with respect to screening. In relation to patient perceptions about prostate cancer screening benefits, harms and recommendations, Partin et al. compared perceptions across race, age and other variables to inform educational materials and conclude that information targeted by race, age or prostatespecific antigen level may not be necessary, but information addressing the misperceptions about benefits and lack of awareness of potential harms is required. Misconceptions and mixed views were also the findings from the work of Quaife et al. when exploring attitudes towards lung cancer screening in socioeconomically deprived and heavy smoking communities. The findings from the studies of Partin et al. and Quaife et al. suggest the need for a codesign approach when developing future educational materials to ensure relevance and usability. Reporting a study on colorectal cancer screening, Barnett et al. highlight the need for patient engagement and codesign of any information materials to ensure that patients understand the intended message; how a negative faecal occult blood test may influence symptom recognition and future helpseeking behaviour is also reported. Successful patient participation in interprofessional team meetings is the focus of the paper by Jacques van Dongen et al. especially when treating those with complex healthcare needs. The authors state that patient participation during team meetings was appreciated by both patients and professionals and offer some suggestions as to how such meetings could be conducted. The need for a tailored approach is stressed, with attention paid to patients’ willingness and ability to participate. The importance of team working is also highlighted in the paper by Meaney et al. when considering the impact of stillbirth on parents. Using interpretative phenomenological analysis (IPA), the authors report that in the days following stillbirth, while both parents expressed fear, mothers were driven to plan a future pregnancy while fathers were reluctant to consider any pregnancies. The authors suggest that to meet the complex needs of the mother and father, a multidimensional, multiprofessional team approach is required to include both healthand social care professionals during future care. Three papers focus on older people. Zizzo et al., in their study looking at the participation preferences of patients with Parkinson’s disease, note the complexities of decisionmaking processes with some patients expressing a preference to take a final decision; others wanted it to be shared (patient/professional) and others that the doctor takes the decision but that they consent to it. Acknowledging selfmanagement as a contributing factor to independence, Veldman et al. designed a tool to evaluate the selfmanagement behaviour of older people within a Dutch context—Partners in Health scale for older adults. Using the original Partners in Health scale (PIA), the