The relation between patient education, patient empowerment and patient satisfaction: A cross-sectional-comparison study

Investigating the capabilities of advanced large language models in generating patient instructions and patient educational material

OBJECTIVES

Large language models (LLMs) with advanced language generation capabilities have the potential to enhance patient interactions. This study evaluates the effectiveness of ChatGPT 4.0 and Gemini 1.0 Pro in providing patient instructions and creating patient educational material (PEM).

METHODS

A cross-sectional study employed ChatGPT 4.0 and Gemini 1.0 Pro across six medical scenarios using simple and detailed prompts. The Patient Education Materials Assessment Tool for Print materials (PEMAT-P) evaluated the understandability, actionability, and readability of the outputs.

RESULTS

LLMs provided consistent responses, especially regarding drug information, therapeutic goals, administration, common side effects, and interactions. However, they lacked guidance on expiration dates and proper medication disposal. Detailed prompts yielded comprehensible outputs for the average adult. ChatGPT 4.0 had mean understandability and actionability scores of 80% and 60%, respectively, compared with 67% and 60% for Gemini 1.0 Pro. ChatGPT 4.0 produced longer outputs, achieving 85% readability with detailed prompts, while Gemini 1.0 Pro maintained consistent readability. Simple prompts resulted in ChatGPT 4.0 outputs at a 10th-grade reading level, while Gemini 1.0 Pro outputs were at a 7th-grade level. Both LLMs produced outputs at a 6th-grade level with detailed prompts.

CONCLUSION

LLMs show promise in generating patient instructions and PEM. However, healthcare professional oversight and patient education on LLM use are essential for effective implementation.

Swedish translation and content evaluation of the Empowerment Audiology Questionnaire (EmpAQ-15)

OBJECTIVE

Translating the newly developed Empowerment Audiology Questionnaire, EmpAQ-15 to Swedish, and performing content validation on the Swedish version.

DESIGN

Best-practice principles using forward and back translations which were revised by a committee prior to field testing. Field testing was conducted by cognitive interviews with hearing-aid users talking through and rating the items in the translated questionnaire. Content validation was assessed by examining equivalence, accessibility, acceptability, comprehensiveness, and relevance of interview data. Questionnaire introduction and scoring instructions were evaluated by Swedish audiologists.

STUDY SAMPLE

Ten adult native speaking Swedish hearing aid users, recruited with purposive sampling. Maximum variation based on age, gender, hearing aid usage, and degree of hearing loss. Seven Swedish audiologists assessing instructions for result calculations.

RESULTS

The conceptual equivalence between the Swedish translation and the English original questionnaire was judged to be high overall. The instructions and majority of items were experienced as accessible, acceptable, comprehensive, and relevant. The audiologists showed that they could follow scoring instructions and reason about the results.

CONCLUSIONS

This content validity study was the first step towards a Swedish version of a self- report measure of Empowerment for people with hearing loss.

Beyond health: exploring women's socio-cultural motivations for HPV vaccination

PURPOSE

Autonomous motivation is critical to motivating individuals to adopt healthy behaviours. While many studies have explored the medical factors that influence women's autonomous motivation to receive HPV vaccination, sociocultural factors have received less attention. Therefore, this study analyses women's autonomous motivation for HPV vaccination from a sociocultural perspective to gain insight into the generation of women's health decisions.

METHODS

This study conducted in-depth interviews with 19 women at their peak age of infection who had been vaccinated against HPV to examine the socio-cultural factors that drove them to receive HPV vaccination. It used NVivo12 to analyse qualitative data obtained from interviews.

RESULTS

The results showed that (1) Demonstrating Personal Independence, (2) Asserting Reproductive Autonomy, (3) Acknowledging Sexual Needs, and (4) Showcasing Health Literacy, Economic Power, and Social Connections were autonomous motivations for women to receive HPV vaccination.

CONCLUSIONS

Based on these motivations, future vaccine promotion programmes should demonstrate the role of the HPV vaccine for women to become autonomous individuals, as well as clear up misconceptions between the HPV vaccine and sexual shame and reduce the monetary burden of the vaccine to build a friendly and egalitarian vaccination environment.

Forecasting the future of smart hospitals: findings from a real-time delphi study

BACKGROUND

In concert with other digital technologies, artificial intelligence (AI) is shaping the vision of smart hospitals. The transformation into smart hospitals, however, is all but trivial due to the lack of financial and human resources, digital skills, and supporting policies. Thus, the extent to which the vision of smart hospitals will eventually become reality is uncertain. In this context, our study provides a multidimensional conceptualization of the immediate future of smart hospitals to 2042.

METHODS

This study employs an iterative mixed-methods approach, including expert workshops and a Delphi study. We conducted a real-time Delphi study to forecast the evolution of smart hospitals in 5-year steps from 2027 to 2042. A total of 39 experts in healthcare, artificial intelligence, and management participated.

RESULTS

Our understanding of a technology-enabled smart hospital in this study includes four dimensions: artificial intelligence (AI), sustainability, ecosystems, and human-centeredness. Our findings underscore the critical need to address the shortage of hospital staff and general practitioners that models predict will peak by 2032. Additionally, our results show a significant shift to individualized medicine and home care. This shift indicates that smart hospitals are expected to leverage AI and digital technologies to tailor care to each patient. Furthermore, the roles and responsibilities of hospital staff will undergo significant changes. Healthcare personnel will have to adapt to new technologies that facilitate more efficient workflows and improve patient engagement in evolving healthcare environments. The results of our study suggest a shift in care to individualized medicine and home care, with corresponding changes in the roles and responsibilities of hospital staff who will employ new technologies.

CONCLUSIONS

The findings from our real-time Delphi study suggest that the vision of smart hospitals is gradually becoming reality over the next 20 years. Advancements in artificial intelligence should enhance operational efficiency and patient-centric care, while facilitating the integration of sustainability practices and fostering collaborative ecosystems. However, addressing challenges such as staff shortages, ethical considerations, and the need for robust digital skills will be essential. A deep pool of expert healthcare practitioners, clear ethical guidelines, and robust digital skills are essential to fully realize this vision and ensure that smart hospitals can meet the evolving needs of healthcare delivery.

Level of empowerment of hospitalized patient in Taiwan clinical practice

PURPOSE

In the health-care system within hospitals, Taiwanese patients usually play the role of passively cooperating with health-care professionals. Therefore, patients rarely make their own treatment decisions. This study evaluated the level of patient education and patient satisfaction in relation to empowerment level in Taiwan.

METHODS

A cross-sectional survey by a self-administered structured questionnaire was carried out with 618 inpatients from the four hospitals. Statistical analyses were then conducted. Analysis of covariance and post-hoc comparison was used to compare differences between the level of patient empowerment, age, and education as covariates in the model.

RESULTS

This study found that 21.2% and 35.6% of participants were highly empowered and well empowered, respectively. Years of education is a significant covariate in the counselling domain of patient education. Even after controlling for age and education level, the counselling, answer question and justifying action, providing information scores remain significant for all levels after adjusting for the effects of degree of patient empowerment. Patients with higher empowerment also having more-sufficient patient education, indicating a tendency toward higher patient satisfaction. Patient education and counselling practices in Taiwan's clinical practice could be improved to enhance patient empowerment and ensure health-care systems are person-centred.

CONCLUSION

To move more toward highly patient empowerment, we suggest that health-care professionals advocate a patient-empowerment approach and to provide more counselling related to patients' illnesses and possible treatments.

Patient perspectives on health care models in cardiac surgery: a qualitative evaluation

BACKGROUND

The implementation of ERAS represents a promising solution to improve treatment efficiency and facilitate patient involvement. This innovative care model aims to optimize recovery processes following surgeries by adopting a holistic, interprofessional approach. At our hospital, ERAS was implemented in minimally invasive heart valve surgery, offering two distinct ERAS models. Additionally, there is also the standard of care without ERAS. The objective of the study is to gain insight into patient satisfaction and perceived differences across these various care models.

METHODS

Patients were interviewed using semi-structured interviews approximately two to three months after undergoing surgery. The data were analysed using qualitative content analysis in accordance with the methodology proposed by Kuckartz. Four main categories were established: Preoperative care, postoperative care and communication, patient participation and involvement, and rehabilitation and post-clinical course.

RESULTS

Comprehensive preoperative education and seamless communication throughout the perioperative care journey were identified as fundamental to patient satisfaction and optimal care processes. Patients in the ERAS + model reported higher overall satisfaction with their care compared to patients in the standard of care and ERAS groups.

CONCLUSION

Preoperative education establishes the foundation for patients' subsequent behaviours and expectations regarding their treatment. Physical activity, nutrition, and mental health are significant aspects. The active involvement and participation of patients and their families in the treatment process facilitated superior postoperative care, intensive physiotherapy, mental support, and faster recovery. A functional flow of information throughout the entire care process is vital. Moreover, having a dedicated point of contact had a beneficial impact on patients´ well-being. The integration of innovative ERAS concepts, which encompass interprofessional preoperative patient education and psychosomatic support, represents a promising approach from a patient perspective, offering benefits to a broad spectrum of cardiac surgical patients.

Diabetes specialist nurses' knowledge, skills, and personal attributes for providing competent health education practice, and its influencing factors: A cross-sectional survey

BACKGROUND

The number of diabetes specialist nurse as well as their knowledge and skills have increased in Gansu Province since 2017. However, China has not fully addressed how to improve their professional skills to deliver effective health education.

AIMS

To investigate the knowledge, skills, and personal attributes of competent health education practices among diabetes specialist nurses in Gansu Province, western China, and the potential influencing factors.

DESIGN

Cross-sectional study.

METHODS

In total, 178 diabetes specialist nurses from 45 hospitals participated in this study. Data were collected between December 2022 and April 2023 using the Nurse Health Education Competence Instrument (I-CepSE) and a self-report questionnaire. Descriptive and inferential statistics, including univariate and multiple linear regression analyses, were used to analyze data.

RESULTS

The mean scores of overall I-CepSE, knowledge, skills, and personal attributes were 218.77 ± 31.65, 77.80 ± 18.27, 103.95 ± 13.75 and 37.02 ± 4.73, respectively. A shortage of nursing staff and heavy workload (81.4 %), lack of cooperation from patients (56.5 %), lack of access to educational resources during work placement (54.2 %), and nurses' lack of knowledge/skills in health education (53.1 %) were common barriers to health education implementation. The regression models for the overall health education competence domain were significant (P < 0.001) with R2 values ranging from 31.9 % to 50.5 %. Education level and years of experience in diabetes-related care were found to be significant on all knowledge, skills, and personal attitude scales (P < 0.05), and age was associated with diabetes specialist nurses' skills and personal attitude scores (P < 0.05).

CONCLUSION

Diabetes specialist nurses demonstrated moderate to high levels of health education knowledge, skills, and attitudes. However, they lacked knowledge of pedagogical techniques and resources, with inadequate educational skills. This study suggests that reasonable nursing human resource allocation and continuous education and training are crucial for improving health education competence.

Emphasizing the Importance of Naproxen Prophylaxis May Decrease the Rate of Heterotopic Ossification After Hip Arthroscopy

Purpose

To investigate the incidence of heterotopic ossification (HO) in patients prescribed prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs), both before and after the introduction of a standardized education protocol.

Methods

A retrospective review was conducted using a database of hip arthroscopy patients treated by a single surgeon at an academic hospital from 2015 to 2023. The inclusion criteria were (1) primary hip arthroscopy for the treatment of femoroacetabular impingement, (2) completion of a 2-week course of prophylactic postoperative NSAIDs (500 mg of naproxen twice daily), and (3) availability of follow-up radiographs at the 6-month postoperative visit. The control cohort was merely prescribed the postoperative prophylactic NSAIDs, whereas the intervention cohort also received dedicated in-person education, emphasizing the importance of NSAID adherence. The presence of HO was determined through review of follow-up radiographs. Standard descriptive statistics were used to describe the findings.

Results

Both the control and intervention groups consisted of 200 continuous hip arthroscopy patients, with the control group treated from 2015 to 2017 and the intervention group treated from 2020 to 2023. Within the control group, 10 cases of HO (5%) were detected. Within the intervention group, 2 cases of HO (1%) were found. The Pearson χ2 test with Yates continuity correction produced a value of 4.21, with a P value of .04.

Conclusions

In this study, we found a significantly lower incidence rate of HO in patients who received standardized education on the importance of NSAID compliance versus those who did not. This finding suggests that patient education may play a contributory role in reducing the incidence of HO after hip arthroscopy.

Level of Evidence

Level III, comparative cohort study.

The effect of patients' empowerment on satisfaction of diabetic patients attending primary care clinics

BACKGROUND

Different approaches, especially the patient-centered approach with emphasis on the patient's empowerment, were used with diabetic patients to ensure a better quality of life. The study aimed to evaluate the effects of patient empowerment versus traditional health education models on the satisfaction of diabetic patients.

MATERIALS AND METHODS

A randomized clinical trial was conducted on 130 patients, aged 40-65 years, diagnosed with type 2 diabetes mellitus, and attending a family medicine outpatient clinic. Patients were blinded and randomly allocated into one of the two Groups (A and B) for a health education session with trained family physicians using the empowerment model and the traditional model, respectively. Patient satisfaction was assessed using the consultation satisfaction questionnaire (CSQ). The relations between different qualitative variables were assessed by Chi-square test; differences in various quantitative variables were determined by t-test and ANOVA. Pearson correlation assessed the correlation between age and different domains as well as the total questionnaire scores of both groups.

RESULTS

A highly statistically significant difference was found between Group A (n = 65) and Group B (n = 65) for the general satisfaction scale, professional care analysis, depth, and length of consultation (P < 0.001). In Group A, 61.5% were highly satisfied and 35.4% were moderately satisfied, while in Group B, 41.5% were moderately satisfied and 43.1% were neutral. Regarding physicians' perceptions of the communication process with patients during the health education sessions, 83% in Group A perceived it as good, while 69.2% in Group B perceived it as average.

CONCLUSION

The patient empowerment model of health education was linked to higher rates of patient satisfaction and a better physician perception of the communication process during the consultation. The study was self-funded, and no harm was done to the patients.

Development and Psychometric Test of the Inpatients Experiences Measurement Scale (IEMS)

Purpose

In South Korea, hospitalized patients' experiences significantly impact satisfaction and treatment outcomes. This study developed and evaluated the Inpatients Experience Measurement Scale (IEMS) for its psychometric properties.

Patients and Methods

Participants from three hospitals were recruited using convenience sampling. Scale item generation involved patient interviews and a Delphi survey with experts. Psychometric testing used Exploratory Factor Analysis (EFA) with 150 participants and Confirmatory Factor Analysis (CFA) with 151 participants.

Results

A total of 301 patients participated, resulting in a 20-item scale across four factors: "Care Quality and Information Provision", "Patient Safety and Dietary Services", "Facility and Comfort Infrastructure", and "Comprehensive Patient Support Services". Rated on a 5-point Likert scale, the scale showed a high Content Validity Index (CVI) over 0.80. EFA explained 61.43% of the variance. The four-factor model was validated using CFA with favorable fit indices. The IEMS demonstrated strong convergent validity, supported by high composite reliability (CR) and average variance extracted (AVE) values. Significant correlations with the Patient Satisfaction Scale reinforced its convergent validity. Discriminant validity was confirmed, and all reliability measures exceeded the minimum threshold of 0.80.

Conclusion

The IEMS effectively captures inpatients' experiences, demonstrating robust reliability and validity. This scale is a valuable tool for assessing patient experiences, facilitating enhancements in patient care and satisfaction within hospital settings.

Refinement and Validation of the Empowerment Audiology Questionnaire: Rasch Analysis and Traditional Psychometric Evaluation

OBJECTIVES

Empowerment is the process through which individuals with hearing-related challenges acquire and use knowledge, skills and strategies, and increase self-efficacy, participation, and control of their hearing health care, hearing solutions, and everyday lives. The aim was to refine and validate the Empowerment Audiology Questionnaire (EmpAQ), a hearing-specific measure of empowerment. This was achieved through (1) refinement via Rasch analysis (study 1), and (2) traditional psychometric analysis of the final survey structure (study 2).

DESIGN

In study 1, 307 adult hearing aid owners completed the initial empowerment measure (33 items) online. To inform an intended item reduction, Rasch analysis was used to assess a range of psychometric properties for individual items. The psychometric properties included analysis of individual items (e.g., response dependency, fit to the polytomous Rasch model, threshold ordering) and the whole EmpAQ (e.g., dimensionality). Item reduction resulted in a 15-item version (EmpAQ-15) and a short-form 5-item version (EmpAQ-5), validated using modern (Rasch), and traditional (Classical Test Theory) psychometric analysis (study 2). In study 2, 178 adult hearing aid owners completed the EmpAQ-15 and EmpAQ-5, alongside 5 questionnaires to measure related constructs. These included two hearing-specific questionnaires (Social Participation Restrictions Questionnaire and Self-Assessment of Communication), two general health-related questionnaires (Patient Activation Measure and World Health Organization Disability Assessment Schedule 2.0), and a general empowerment questionnaire (Health Care Empowerment Questionnaire). Modern (Rasch) and traditional psychometric analysis techniques (internal consistency, construct validity, and criterion validity) were used to assess the psychometric properties of the EmpAQ-15 and EmpAQ-5.

RESULTS

Rasch analysis of the initial 33-item measure of empowerment identified 18 items with high response dependency, poor fit to the Rasch model, and threshold disordering, which were removed, resulting in a long-form (EmpAQ-15) hearing-specific measure of empowerment. A short-form (EmpAQ-5) version was developed for use in the clinic setting. Validation of the two EmpAQ measures using Rasch analysis showed good item fit to the Rasch model, appropriate threshold targeting, and the existence of unidimensionality. Traditional psychometric evaluation showed that both questionnaires had high internal consistency and positive correlations with the hearing-specific questionnaires. However, in contrast with our hypotheses, correlations with general health questionnaires were stronger than with hearing-specific questionnaires; all questionnaires were correlated with the EmpAQ and in the direction hypothesized. Taken together, these findings support the construct validity of the EmpAQ-15 and EmpAQ-5.

CONCLUSIONS

The EmpAQ-15 and EmpAQ-5 are the first self-report measures to be developed specifically for the measurement of empowerment. The EmpAQ-15 and EmpAQ-5 were found to meet the Rasch model criteria for interval-level measurements. Traditional psychometric evaluation supports the construct validity of both measures. The EmpAQ measures have the potential to be used in both research and clinical practice to evaluate empowerment along the hearing journey. The next stage of this research will be to further validate these measures by assessing their responsiveness, minimal clinically important difference, and clinical interpretability in a clinical population.

Bridging the gaps in patient education through aesthetic-based education: A concept analysis study

BACKGROUND

Aesthetics is a branch of philosophy that has been entered into the philosophy of education for a long time. Reviewing the concept of aesthetics in education, we can see the components that can cover a number of challenges in the field of patient education. Focusing on the conceptual dimensions obtained from the analysis of this concept, the aim is matching the resulting conceptual categories with the gaps in the field of patient education.

MATERIALS AND METHODS

Using a scoping review, we reviewed the literature dealt with different dimensions of aesthetic-based education. Walker and Avant's concept analysis approach was used to inductively analyze the content obtained from the review of literature. The data were divided into three general groups of antecedents, attributes, and consequences of the aesthetic-based education concept, and the final conceptual model was defined. Interdisciplinary comparisons between educational and medical sciences were made to match the concept of aesthetic education with the field of patient education to cover its issues. During the scope review process of the texts, after screening the articles, 17 articles selected to enter the concept analysis stage.

RESULT

Concept analysis phase showed that the main conceptual categories of antecedents of aesthetic-based education are aesthetic-based intrapersonal competencies and aesthetic capacities of educational setting. The attributes include aesthetic-based educational content and teaching methods including unity in diversity, combination with art and being based on empathy. The consequences include subliminal learning and constraint-free learning. These conceptual dimensions can cover four important issues in patient education including patient satisfaction, pedagogical competences of health educators, patient centeredness, and empathetic relationship.

CONCLUSION

Applying aesthetic concept in the patient education process can bridge part of the gaps in this process. So, this study can be an introduction to future innovative models based on aesthetic paradigm in the field of patient education.

Association between abusive supervision and nurses' withholding voice about patient safety: the roles of impression management motivation and speak up-related climate

BACKGROUND

Abusive supervision by the nurse manager significantly influences nurses' withholding voice about patient safety. The role of impression management motivation and speak up-related climate is crucial in understanding their connection. This study aimed to explore the relationship between abusive supervision, impression management motivation, speak up-related climate, and withholding voice about patient safety.

METHODS

This cross-sectional study employed a convenience sampling method to recruit 419 clinical nurses from Taizhou Hospital, Zhejiang Province, China, between 1 November 2022 and 31 January 2023. The study adhered to the STROBE checklist. Abusive supervision and impression management motivation were assessed using the Chinese versions of the Abusive Supervision Scale and the Impression Management Motivation Scale, respectively. Withholding voice about patient safety and speak up-related climate were identified using the Chinese version of the Speaking Up about Patient Safety Questionnaire.

RESULTS

Nurse leaders' abusive supervision (β=0.40, p<0.01) and nurses' impression management motivation (β=0.10, p<0.01) significantly and positively influenced nurses' withholding voice about patient safety. We introduced impression management motivation as a mediating variable, and the effect of abusive supervision on nurses' withholding voice decreased (β from 0.40 to 0.38, p< 0.01). Nurses' speak up-related climate played a moderating role between abusive supervision and impression management motivation (β= 0.24, p<0.05).

CONCLUSIONS

Abusive supervision by nursing leaders can result in nurses withholding voice about patient safety out of self-protective impression management motives. This phenomenon inhibits nurses' subjective initiative and undermines their proactive involvement in improving patient safety, and hinders the cultivation of a culture encouraging full participation in patient safety, which should warrant significant attention.

Multi-professional development of a competency framework for patients with a Port-a-Cath (PAC)

PURPOSE

In France, 40,000 Port-a-Cath (PAC) are inserted each year. These medical devices are prone to complications during their insertion or use. The education of patients wearing these devices could be a lever to reduce the risk of complications. The objective of this work was to develop, in a multi-professional and consensual manner, a unique and specific skills reference framework for patients with PAC and to propose it as a reference tool for health professionals.

METHODS

A multidisciplinary working group was set up to draw up this reference framework of skills. The first stage of the work consisted of a reflection leading to an exhaustive list of competencies necessary for the patient. These skills were then classified according to three different fields of knowledge (theoretical, know-how and attitudes). Finally, the working group identified priority competencies and established a grid that can be used to evaluate the level of acquisition of these competencies.

RESULTS

Fifteen competencies were identified: five relating to theoretical knowledge, six relating to know-how and four relating to attitudes. These competencies were broken down into sub-competences. Seven competencies or sub-competencies were selected to constitute the list of priority competencies.

DISCUSSION

This competency framework provides a reference framework for the education of patients with PAC and will help to harmonise practices within the different teams that care for patients with PAC.

Empowerment of the older adults in the context of Chinese culture: an evolutionary concept analysis

Background

With the increasing focus on addressing the challenges of aging, researchers have begun to recognize the potential impact of empowering older individuals in addressing retirement issues. However, within different cultural contexts, there still needs to be a more precise analysis regarding the definition of empowering older individuals.

Objective

To define and analyze the concept of empowering older individuals within the cultural context of China.

Method

Using Rodgers' concept analysis approach, a search was conducted in five databases (PubMed, Web of Science, China National Knowledge Infrastructure, Wan fang Data, and VIP Chinese Journal Platform) for studies on empowering older individuals from the time the databases were established until February 2023. The main disciplines involved in the search included nursing, medicine, and public health.

Results

Out of the 7,028 studies, 50 articles met the inclusion criteria. The identified attributes are as follows: support system, belief change, and behavioral autonomy. The antecedents were grouped into four categories: physical obstacles, psychological concerns, personal needs and external challenges. The consequences were determined to be improved quality of life, reduced burden of old-age care, gain respect, and self-actualization.

Conclusion

Empowering older individuals is a dynamic and evolving concept that involves aligning personal aspirations with appropriate external resources and expressing a certain degree of belief and behavioral change. This study deepens our understanding of empowering older individuals through comprehensive concept analysis, and the identified attributes, antecedents, and consequences of empowering older individuals can be utilized in practice, education, and research.

Identifying Factors that Support the Delivery of Exceptional Care in General Practice and Development of the IDEAL Framework: A Qualitative Study

The positive deviance approach seeks to identify and learn from those that perform exceptionally well. Positive deviance as an approach to quality improvement is gaining traction in general practice. This study aimed to explore and compare stakeholders' perceptions of the factors that support the delivery of exceptional care in general practice and to refine a previously developed theoretical framework of factors associated with positively deviant care in general practice: the Identifying and Disseminating the Exceptional to Achieve Learning (IDEAL) framework. Semi-structured interviews were conducted with 33 purposively sampled patients, general practitioners, practice nurses, and practice managers in Irish general practice. Subsequently, a directed content analysis approach was employed to deductively analyse interview data using the IDEAL framework, and newly emerging factors were inductively analysed and abstracted into the framework. Several distinct strategies (e.g. patient activation and team collaboration), structures (e.g. facilities and staffing), and contextual factors (e.g. communication and rapport, and culture) were found to support the delivery of exceptional care, and differences in perceptions, values, and expectations emerged between patients and practice staff. Interview data largely supported the pre-determined factors posited by the IDEAL framework, and new factors were abstracted into the framework (e.g. facilities and infrastructure). Stakeholder engagement regarding the factors supporting exceptional care in general practice supported and extended the IDEAL framework, contributing to a more comprehensive understanding of how exceptional care is delivered in general practice. The refined framework will support researchers, policymakers, and teams looking to support, measure, and achieve exceptionally good patient care in general practice.

A Protection Motivation Theory-Based Empowerment Intervention for Promoting Health Behaviors in Women With Human Papillomavirus: An Experimental Study

ABSTRACT

This experimental study on 70 women with human papillomavirus, referred to the specialized obstetrics and gynecology clinics of public hospitals in Iran in 2021, revealed that implementing the protection motivation theory-based empowerment intervention could promote their health behaviors.

Predicting and Empowering Health for Generation Z by Comparing Health Information Seeking and Digital Health Literacy: Cross-Sectional Questionnaire Study

BACKGROUND

Generation Z (born 1995-2010) members are digital residents who use technology and the internet more frequently than any previous generation to learn about their health. They are increasingly moving away from conventional methods of seeking health information as technology advances quickly and becomes more widely available, resulting in a more digitalized health care system. Similar to all groups, Generation Z has specific health care requirements and preferences, and their use of technology influences how they look for health information. However, they have often been overlooked in scholarly research.

OBJECTIVE

First, we aimed to identify the information-seeking preferences of older individuals and Generation Z (those between the ages of 18 and 26 years); second, we aimed to predict the effects of digital health literacy and health empowerment in both groups. We also aimed to identify factors that impact how both groups engage in digital health and remain in control of their own health.

METHODS

The Health Information National Trends Survey was adopted for further use in 2022. We analyzed 1862 valid data points by conducting a survey among Chinese respondents to address the research gap. A descriptive analysis, 2-tailed t test, and multiple linear regression were applied to the results.

RESULTS

When compared with previous generations, Generation Z respondents (995/1862, 53.44%) were more likely to use the internet to find out about health-related topics, whereas earlier generations relied more on traditional media and interpersonal contact. Web-based information-seeking behavior is predicted by digital health literacy (Generation Z: β=.192, P<.001; older population: β=.337, P<.001). While this was happening, only seeking health information from physicians positively predicted health empowerment (Generation Z: β=.070, P=.002; older population: β=.089, P<.001). Despite more frequent use of the internet to learn about their health, Generation Z showed lower levels of health empowerment and less desire to look for health information, overall.

CONCLUSIONS

This study examined and compared the health information-seeking behaviors of Generation Z and older individuals to improve their digital health literacy and health empowerment. The 2 groups demonstrated distinct preferences regarding their choice of information sources. Health empowerment and digital health literacy were both significantly related to information-seeking behaviors.

[Design, implementation and evaluation of an educational approach for patients with PICC line and midline]

OBJECTIVES

Design the competency framework and an interview guide for patients with PICC line or midline. Develop a patient satisfaction evaluation questionnaire.

METHODS

A multidisciplinary team has developed a reference system for the skills of patients with PICC line or midline. The skills are classified in three categories: knowledge, know-how and attitudes. An interview guide was written in order to transmit the priority skills, determined beforehand, to the patient. A second multidisciplinary team designed a questionnaire to evaluate patient satisfaction.

RESULTS

The competency framework includes nine competencies: four, knowledge-based; three, know-how-based and two, attitude-based. Among these competencies, five were considered to be priorities. The interview guide is a tool that allows care professionals to transmit the priority skills to patients. The satisfaction questionnaire explores the information received by the patient, the passage through the interventional technical platform, the end of the management before the return home, and the overall satisfaction of the patients with the course of the device placement. Over a 6-month period, 276 patients responded with a high satisfaction rate.

CONCLUSIONS

The PICC line or midline patient's competency framework has made it possible to list all the skills that patients should acquire. The interview guide serves as a support for the care teams in the patient education process. This work could be used by other establishments to develop the educational process around these vascular access devices.

The Influence of Medicine Approaches on Patient Trust, Satisfaction, and Loyalty

The increase in traditional and complementary medicine (TCM) methods has revealed the necessity of determining relevant behavioral tendencies among healthcare users. In our study, the evaluation of TCM approaches of healthcare users living in North Cyprus in terms of treatment effectiveness, patient trust and patient satisfaction, and the effects of these variables on patient loyalty, were investigated. Data were collected utilizing the scale approach as well as the survey technique in order to measure the variables in the study. A total of 452 participants completed the survey. TCM has a positive effect on treatment effectiveness, patient trust and patient satisfaction. Patient trust and patient satisfaction have a positive effect on patient loyalty, whereas treatment effectiveness did not have a significant effect on patient loyalty. There is a significant and positive mediating effect of patient trust and patient satisfaction between TCM and patient loyalty. However, the mediating effect of treatment effectiveness is not significant between TCM and patient loyalty. This study will help researchers and practitioners understand the importance of attitude, trust, effectiveness, satisfaction and loyalty in relation to TCM. It is suggested that studies that measure the behaviors of patients should increase in order to obtain better health outcomes.

"Mixed Reality" in patient education prior to abdominal aortic aneurysm repair

Background: To investigate the usability of Mixed-Reality (MR) during patient education in patients scheduled for abdominal aortic aneurysm (AAA) repair. Patients and methods: Consecutive patients scheduled for elective AAA repair were block-randomized in either the Mixed-Reality group (MR group) or the conventional group (control group). Patients of both groups were educated about open and endovascular repair of their respective AAA. The MR group was educated using a head-mounted display (HMD) demonstrating a three-dimensional virtual reconstruction of the respective patient's vascular anatomy. The control group was educated using a conventional two-dimensional monitor to display the patient's vasculature. Outcomes were informational gain as well as patient satisfaction with the educational process. (DRKS-ID: DRKS00025174). Results: 50 patients were included with 25 patients in either group. Both groups demonstrated improvements in scores in the Informational Gain Questionnaire (IGQ) when comparing pre- and post-education scores. (MR group: 6.5 points (±1.8) versus 7.9 points (±1.5); Control group: 6.2 points (±1.8) versus 7.6 points (±1.6); p<0.01) There was no significant difference between the MR group and the control group either in informational gain (MR group: 1.4±1.8; Control group: 1.4±1.8; p=0.5) nor in patient satisfaction scores (MR group: mean 18.3 of maximum 21 points (±3.7); Control group: mean 17 of 21 points (±3.6); p=0.1) Multiple regression revealed no correlation between the use of MR and informational gain or patient satisfaction. Usability of the system was rated high, and patients' subjective assessment of MR was positive. Conclusions: The use of MR in patient education of AAA patients scheduled for elective repair is feasible. While patients reported positively on the use of MR in education, similar levels of informational gain and patient satisfaction can be achieved with MR and conventional methods.

Health education competence: An investigation of the health education knowledge, skills and attitudes of nurses in Kazakhstan

AIMS

This study assessed the nurses' knowledge of, skills on and attitudes toward health education among nurses working at the University Medical Center Corporate Fund (UMC) in Kazakhstan. The personal and professional factors influencing the nurses' knowledge of, skills on and attitudes toward health education were also investigated.

BACKGROUND

Health education is one of the nurses' fundamental responsibilities. Nurses' role in health education is critical in empowering patients and their families to live healthier lives, thus ensuring optimum health, well-being and quality of life. However, in Kazakhstan, where the nursing profession is still establishing its professional autonomy, data concerning the competence of Kazakh nurses in health education is unknown.

DESIGN

A quantitative study, specifically the cross-sectional, descriptive and correlational designs.

METHODS

The survey was performed at UMC in Astana, Kazakhstan. Using a convenience sampling technique, 312 nurses participated in the survey from March to August 2022. The "Nurse Health Education Competence Instrument" was used to collect data. The personal and professional characteristics of the nurses were also collected. Standard multiple regression analysis examined the personal and professional variables influencing the nurses' health education competence.

RESULTS

The respondents' average score in the "Cognitive domain," "Psychomotor domain," and "Affective-attitudinal domain" was 3.80 (SD = 0.66), 3.99 (SD = 0.58) and 4.04 (SD = 0.62), respectively. The nurses' category as a nurse, medical center, attendance to health education training/seminars in the last 12 months, provision of health education to a patient in the last week and perception of health education's significance in nursing practice were significant predictors of the nurses' health education competence contributing an approximately 24.4 %, 29.3 % and 27.1 % of the variance of the health education knowledge (R² = 0.273, Adjusted R² = 0.244), skills R² = 0.320, Adjusted R² = 0.293) and attitudes (R² = 0.299, Adjusted R² = 0.271).

CONCLUSIONS

The nurses reported high levels of health education competence (knowledge, attitudes and skills). The personal and professional factors influencing the nurses' competence in health education are essential to consider when developing interventions and healthcare policies to ensure nurses' competent provision of health education to patients.

Identifying best practices for disclosure of amyloid imaging results: A randomized controlled trial

INTRODUCTION

Empirical studies on effective communication for amyloid disclosure in mild cognitive impairment (MCI) are lacking. We aimed to study the impact of six communication strategies.

METHOD

We performed a randomized controlled trial with seven randomly assigned, video-vignette conditions: six emphasizing a communication strategy and one basic condition. All showed a scripted consultation of a neurologist disclosing positive amyloid positron emission tomography (PET) scan results to an MCI patient. Healthy individuals (N = 1017; mean age ± SD 64 ± 8, 808 (79%) female) were instructed to imagine themselves in the video, answered questionnaires assessing information recall, emotional state, and behavioral intentions, and evaluate the physician/information.

RESULTS

"Risk best practice" resulted in highest free recall compared to other strategies (P < .05), except "emotional support". Recall in "emotional support" was better compared to "basic-' and elaborate information"(P < .05). "Risk best practice" resulted in the highest uncertainty (P < .001). "Teach-back" and "emotional support" contributed to the highest evaluations (P -values < .01).

CONCLUSION

Risk communication best practices, attending to emotions, and teach-back techniques enhance information recall of amyloid-PET results, and could contribute to positive care evaluations.

Facilitators and barriers to empowerment in children and young people with cystic fibrosis: a meta-synthesis of the qualitative literature

PURPOSE

Patient empowerment may be particularly important in children and young people (CYP) with CF, due to high treatment burden and limited peer support opportunities. This review aimed to meta-synthesize the qualitative literature pertaining to empowerment in CYP with CF.

MATERIALS AND METHODS

This work was guided by the ENTREQ framework, with a search strategy based on the SPIDER framework. A systematic search of PsycInfo, Medline, CINAHL and ASSIA databases was conducted. Identified studies were quality assessed and data analysed using thematic synthesis. PROSPERO registration: CRD42019154014.

RESULTS

Seventeen studies met inclusion criteria, though none explicitly explored empowerment. Thematic synthesis identified six analytic themes: relational support, information and understanding and feeling heard and respected appeared to facilitate empowerment, while prejudices and assumptions were identified as potential barriers. Mastery and competence and Navigating being different appeared to be components of empowerment.

CONCLUSIONS

The findings provide an initial understanding of patient empowerment in CYP with CF. Potential clinical implications include the need for more CYP-friendly information, more shared decision making and more opportunities to experience mastery. The need for further research is highlighted, particularly relating to developmental influences and factors unique to CF, which are not adequately addressed in existing patient empowerment models.Implications for rehabilitationEmpowerment in children and young people with cystic fibrosis can be facilitated by supportive and respectful relationships with family, friends and clinical teams, that enable them to feel heard and understood.It can be further supported by providing developmentally appropriate information and opportunities for children and young people to experience mastery and competency in typical childhood activities.Prejudices and assumptions about the capabilities of children and young people with CF, even when based in good intentions, can act as a barrier to empowerment.Empowerment can shape (and be shaped by) the way the children and young people navigate differences associated with living with CF.

Quality of counselling assessed by patients after total knee arthroplasty: A cross-sectional study

Patient counselling is a key function in nursing. High-quality counselling promotes adherence to treatment and reduces complications. The purpose of the study was to describe the quality of counselling experienced by total knee arthroplasty patients following surgery. The study was a descriptive cross-sectional study. The data were collected from patients following total knee arthroplasty (N = 60) in 2016 with a modified Quality of Counselling Instrument, and analysed using statistical methods. Over half of the patients (58%) were women and the mean age was 68 years (range 49-84). Over a quarter of patients (28.9%) lived alone, and about two-thirds were overweight (42.1%), or obese (31.6%). After surgery, many patients (88%) experienced moderate pain. Half of patients (52.6%) received a good quality of counselling for the disease and its treatment, and counselling for recovery from treatment (81.6%) was good. Most patients (92.1%) received satisfactory counselling about physical activity. There was a correlation between the disease and its treatment counselling and quality of life (r = -0.553, p = 0.003) and pain (r = -0657, p = 0.000). Interaction during counselling was good (97.4%) and it was implemented in a patient-centred way (89.5%). High-quality counselling implemented in a patient-centred manner can play a part in reducing pain and increasing patients' quality of life.

Ideal Suggestions for Discharge Training and Telephone Counseling of Patients With Coronary Artery Bypass Graft Surgery: A Randomized Controlled and Experimental Study

BACKGROUND

In this context, discharge training and telephone counseling given to patients who underwent coronary artery bypass graft surgery increase the ability of patients to cope with and adapt to their self-care.

METHODS

This study was a randomized controlled, experimental design. Both experimental and control groups consisted of 35 individuals with G*power analysis (n = 70). Patients in the experimental group were given discharge training and telephone counseling for two months. At the end of the process, data collection forms were administered to both groups for the last time. Necessary ethical approvals were taken and consent was taken from the patients.

RESULTS

After the discharge training and telephone counseling given to the experimental group, the mean Exercise of Self-Care Agency Scale (ESCA) score of the patients increased by 13.94; the mean Coping and Adaptation Processing Scale (CAPS) increased by 13.6. The mean ESCA score of the control group increased by 7.86; the mean CAPS score increased by 9.14. The effect size that occurred for both groups was statistically significant (P < 0.05).

CONCLUSION

Positive results were achieved in the experimental group which received given discharge training and telephone counseling.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05104996.

The role and effectiveness of augmented reality in patient education: A systematic review of the literature

OBJECTIVES

To provide an overview of the existing research concerning the use and effects of AR in patient education.

METHODS

Following PRISMA guidelines four electronic databases were systematically searched.

INCLUSION CRITERIA

empirical studies using any type of AR intervention in patient education across all medical specialties. Quality assessment of the retrieved literature was carried out.

RESULTS

Ten papers, comprising 788 patients, were identified and included (Randomized controlled trial (RCT)(n = 3), non-randomized controlled trial (n = 3), before-and-after study (n = 3), and qualitative survey (n = 1)). Retrieved literature showed itself to be highly heterogeneous. The studied population included patients suffering from a diverse spectrum of chronic diseases (e.g., prostate cancer, diabetes mellitus, multiple sclerosis, epilepsy). Quantitative results indicated that the use of AR had a positive effect on knowledge retention and patient satisfaction. Qualitative findings suggested that patients liked the technology and felt comfortable with its use for educational purposes. The quality of the retrieved results was shown to be moderate to low.

CONCLUSION

The limited evidence of this topic suggests the possible potential of AR in patient education.

PRACTICE IMPLICATION

More research, using high-quality study designs and more evidence-based interventions, is needed to fully appreciate the value of AR on patient education.

Evaluation of patient satisfaction with nursing services before and after implementation of the Health System Transformation Plan in Iran: A cross-sectional study

Background and Aims

How healthcare service delivery is achieved after implementing the Health System Transformation Plan (HSTP) is investigated in the present study by assessing the patients' satisfaction with nursing care services compared to before HSTP.

Methods

This cross-sectional study was conducted in Iranian hospitals during two periods, that is, before (N = 300) and after (N = 279) HSTP, whereas the Patient Satisfaction Instrument was used to assess the satisfaction with nursing services.

Results

About 57.7% and 4.7% of the patients were dissatisfied with nursing care services, whereas 34% and 77.4% for moderate satisfaction, and 8.3% and 17.9% for total satisfaction, before and after HSTP, respectively. The mean score of overall satisfaction was 57.33 (±11.17) and 70.84 (±11.99) before and after HSTP, respectively (p < 0.001), which represents there is an improvement in healthcare services delivery after HSTP. Although none of the sociodemographic factors were significantly associated with satisfaction, higher satisfaction was found among the coronary care unit (CCU) hospitalized patients.

Conclusion

The patients' overall satisfaction with nursing care services after HSTP was increased, although higher satisfaction was observed in the patients of special wards such as CCU. Therefore, using more care facilities and equipment and engaging more skilled nursing staff in other wards is highly recommended.

Reliability and Validation of the Japanese Version of the Patient Empowerment Scale

Empowerment scales for inpatients have been developed worldwide, but their validity and reliability have not been adequately tested and applied to the health promotion and care among older adults during hospitalization. In this study, the Patient Empowerment Scale developed by Faulkner was translated into Japanese, and Japanese patients were surveyed to test its clinical applicability. To test its applicability, 151 patients in rehabilitation wards were surveyed in four municipalities. After considering ceiling/floor effects and validating the structure, the Patient Empowerment Scale—Japanese comprised 37 items and six factors: subject−staff interaction, environmental adjustment through collaboration, necessary information gathering and problem awareness, proactive behavioral practices, self-disclosure, and self-management of activities. Criteria-related validity assessment confirmed the scale’s correlation with the Health Locus of Control Scale, General Self-Efficacy Scale, 13-item Sense of Coherence Scale, Rosenberg Self-Esteem Scale, and Philadelphia Geriatric Center Morale Scale. Regarding internal consistency, the Cronbach’s alpha was 0.93 for all 37 items. The Cronbach’s alphas for the six factors were 0.93, 0.91, 0.92, 0.92, 0.91, and 0.75, respectively. In our test/re-test of reliability, Spearman’s rank correlation coefficient between the first and second total scores was ρ = 0.96, p < 0.01. These results confirm the scale’s validity and reliability, and its applicability to older hospitalized patients.

Exploring patient education unmet needs for rare and complex connective tissue and musculoskeletal diseases: A survey of health care providers' and patients' expectations in Europe

OBJECTIVE

The European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases involves health care providers (HCPs) from 8 European countries and 7 patients' representatives of European Patient Advocacy Groups. The objective was to evaluate current practice and unmet needs for patient education (PE) in Europe.

METHODS

A questionnaire was sent to HCP members asking about the PE practices and another, to enquire about their needs, was sent to patients' associations in the different countries.

RESULTS

The questionnaire was completed by 33 HCPs. Half had no specific staff members dedicated to PE. For HCPs with dedicated staff, 83.3% (n = 11) considered that care providers were insufficient to meet patients' needs. Most of HCPs would like to see the practice of PE standardized. Sixty eight percent (n = 1093) of patients suffering from connective tissue diseases completed the questionnaire had never heard about PE. Most of them were interested in taking part in a PE program.

DISCUSSION

Our survey revealed a strong interest in PE among patients and HCP and heterogeneity of practice. PE appeared important for both HCPs and patients. An online course for medical students in Europe will be developed in partnership with EULAR to respond to these unmet needs.

Nursing Telemedicine Educational Encounters: Improved Patient Satisfaction in Radiation Therapy Clinics

BACKGROUND

 Nurse-led education can improve patient satisfaction, and telemedicine has increased patient access during the COVID-19 pandemic.

OBJECTIVES

 The aim of this article was to investigate how nursing telemedicine educational visits influence patient satisfaction.

METHODS

 Patients receiving standard of care in-person education for breast cancer radiation therapy (RT) between January 2019 and June 2019 comprised the preintervention cohort. After July 2019, patients received the same information virtually and represented the postintervention cohort. Press Ganey surveys were used to evaluate patient satisfaction, t tests were performed to differentiate satisfaction scores, and f tests were calculated to determine differences in the variances of response.

FINDINGS

 Patient satisfaction increased in the postintervention cohort for what to expect during RT, how to manage side effects, and nurses' attentiveness to patient questions and worries. There was decreased variance in patient satisfaction in the postintervention group for quality of care received from nurses and caring manner of nurses.

Patient perspectives on chronic kidney disease and decision-making about treatment. Discourse of participants in the French CKD-REIN cohort study

Background

Little is known about psychological issues in patients with chronic kidney disease (CKD) facing transition to kidney failure and the involvement of their family in decision-making about kidney replacement therapy (KRT). This study investigated patients’ experience of their illness, their views on KRT choice and their perception of the influence of their relatives.

Methods

We conducted a qualitative study nested in the CKD-REIN prospective cohort study which included non-dialysis CKD patients from 40 nationally representative nephrology clinics. Among 1555 patients who returned a self-administered questionnaire, we used purposive sampling to select 50 participants who underwent semi-structured phone interviews with a psychologist.

Results

The patients' mean age was 62.2 ± 12 years, 42% were women, and 68% had CKD stage 4–5. The analysis yielded four lexical classes: “illness rhythm”, “considering dialysis”, “family and transplantation”, and “disease, treatment choice and introspection”. When experiencing few or mild symptoms, patients tended to avoid thinking about CKD, for the prospect of dialysis was the most stressful part of their experience. Surprisingly, the importance of family appeared when they talked about transplantation decision-making, but not about choice of dialysis modality.

Conclusions

Cognitive avoidance seems common in patients with advanced CKD. Transplantation and dialysis decision-making appear to be two distinct processes, with different levels of family involvement. More research is needed to better understand the frequency and impact of cognitive avoidance on patients’ well-being and decision-making.

Graphic abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s40620-022-01345-6.

Patients' perspectives of a pharmacist-provided clinical pharmacogenomics service

Aim: To assess the perspectives and experiences of patients who participated in a pharmacist-provided clinical pharmacogenomics (PGx) service. Methods: We conducted individual semistructured interviews with 16 patients who received a pharmacist-provided PGx service. Qualitative data were analyzed to identify pertinent themes. Results: The major themes identified were: heterogeneity of patient PGx experiences and preferences, pharmacists as appropriate providers of PGx services, considerations regarding the use of PGx results in routine healthcare, and perceived applications of PGx testing. Theme-derived considerations included the need to establish appropriate pre-genotyping expectations, individualize patient education, facilitate collaboration with patients' providers and sustainably update patients' PGx information over time. Conclusion: Patient-specific perspectives such as these are important to consider when providing clinical PGx services, with intention of optimizing patient experiences.

Self-Efficacy of Saudi Patients with Autoimmune Diseases in Managing Hydroxychloroquine-Induced Ocular Complications: A Cross-Sectional Survey

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are common autoimmune diseases (AD) that affect joints and have multi-organ involvement that results in disability, morbidity, and increased mortality. Both conditions are known to cause a wide range of ocular manifestations. Antimalarial drugs, mainly hydroxychloroquine (HCQ), are among the treatment options for AD that is uniquely characterized by retinopathy as a main side effect. This study examines self-efficacy levels in autoimmune disease patients who were or are currently treated with HCQ and related factors such as patient education, communication with the physician, self-education, and ability to cope with the disease.

Temporal Changes of Metabolic Indicators and Quality of Life by a Two-Day Patient Education Program for Metabolic Syndrome Patients

Metabolic syndrome (MetS) is a disease with a high prevalence that threatens the health of modern people. Patient education is essential to control MetS. This prospective study aimed to evaluate 6-month changes in health indicators following a two-day education program for patients with MetS aged 45 or older. Education about MetS, lifestyle modification, nutrition, and physical activity was provided. At 3 and 6 months after the program, participants visited for follow-up. Twenty-two patients completed the 6-month study. Waist circumference was reduced, and life quality and depression index improved in 3 and 6 months compared to pre-education. Blood pressure decreased, and anxiety index improved at three months. Nutritional knowledge was well maintained for 3 and 6 months. High-density lipoprotein-cholesterol levels increased at six months. Three out of twenty-two patients did not satisfy MetS criteria at the end of the study due to improved indicators. A two-day multidisciplinary education program positively affected health indicators in MetS patients. Participation in the program also help with life satisfaction and positive emotional condition. However, some indicators improved in 3 months, but the effect disappeared 6 months after the program.

Social Media and Social Support: A Framework for Patient Satisfaction in Healthcare

Social media has been a powerful source of social support for health consumers. In the healthcare sector, social media has thrived, building on various dynamic platforms supporting the connection between social relationships, health, and wellbeing. While prior research has shown that social support exerts a positive impact on health outcomes, there is scant literature examining the implications of social support for patient satisfaction, which suggests that there is a profound gap in the extant literature. The objective of this study is to develop and test a theoretical model for understanding the relationship between different dimensions of social support and patient empowerment. The study further investigates the debated relationship between patient empowerment and patient satisfaction. The measurement model indicated an acceptable fit (χ2 = 260.226; df, 107, χ2/df = 2.432, RMSEA = 0.07, GFI = 0.90, IFI = 0.95, TLI = 0.94, and CFI = 0.95). Findings indicate that emotional support (p < 0.001), information support (p < 0.05), and network support (p < 0.001) positively influence the notion of patient empowerment. In turn, patient empowerment positively influences patient satisfaction (p < 0.001). The proposed framework contributes to the health communication literature by introducing a novel framework for patient satisfaction in the social media context, which provides important inputs for healthcare service providers in developing patient empowerment strategies.

Willingness to receive a booster dose of inactivated coronavirus disease 2019 vaccine in Taizhou, China

PURPOSE

This population-based study aimed to determine the willingness to receive a booster dose of vaccine against coronavirus disease (COVID-19) in Taizhou, China.

METHODS

An online questionnaire investigation addressing participants' willingness to receive a booster dose of the COVID-19 vaccine was organized in Taizhou, China. Of the 2318 interviewees who received the invitation, 1576 finished a qualifying questionnaire, corresponding to a response rate of 68.0%.

RESULTS

The majority of respondents (n = 1435 [91.1%]) were willing to accept a booster vaccination against COVID-19. History of allergic reaction to other vaccines (OR = 0.30), confidence in the safety of the COVID-19 vaccines (OR = 3.20), confidence in the effectiveness of the COVID-19 vaccines against SARS-CoV-2 (OR = 2.25) and its variants (useful versus [vs.] useless, OR = 2.33), and vaccine recipients (OR = 3.09) remained significantly associated with willingness to accept a booster dose of COVID-19 vaccines.

CONCLUSION

A moderate proportion of the participants who responded were willing to receive a booster dose of the COVID-19 vaccine. These results are valuable for starting health education and interventions to accelerate vaccine uptake and improve public health outcomes during the COVID-19 pandemic in China.

The impact of a digital platform on migraine patient-centered outcome research. Evaluation of midolordecabeza.org, a headache website in Spanish

OBJECTIVE

This internet survey aimed to analyze the activity of midolordecabeza.org, a specialized website for headache stakeholders.

BACKGROUND

eHealth tools, such as websites, can be educational for stakeholders of a specific disease, such as patients. This is particularly helpful in chronic disorders such as migraine. eHealth also enhances patient-centered outcome research. The website midolordecabeza.org has the stated aim of organizing key information on headache making it accessible and useful for all stakeholders, and, eventually promoting patient participation.

METHODS

We analyzed Google Analytics (GA) data to study the web's activity, traffic source, geographical distribution of access, registered-user behavior, electronic device performance, and temporary references with greater web activity.

RESULTS

From January 2015 until December 2020, the website registered 1,121,585 visitors, 1,775,953 sessions, and a total of 3,833,144 views with an average time per session of nearly 2 min. Higher data traffic has been registered in Spanish-speaking countries such as Spain (33.3%; 591,256/1,775,953), where Spain's regions with higher views were statistically significantly correlated with the nationwide migraine prevalence (ρ = 0.505; p = 0.039). In regard to social behavior, returning users were statistically significantly associated with being a woman (84.0%; 5696/6781), and they predominantly acceded from organic searches (50.6%; 3434/6781). When answering available open surveys, 72.5% (1827/2520) described their migraine as a disabling disease with high impact on their daily tasks and 64.4% (14,016/21,764) were unaware of what their headache diagnosis is.

CONCLUSIONS

Spanish-speaking patients with migraine around the world increasingly visited the headache-specialized website midolordecabeza.org using different electronic devices, showing great interest in their disease. This website allowed them to get updated information on their disease, share clinical data with physicians, and finally express their concerns.

What sixty years of research says about the effectiveness of patient education on health: a second order meta-analysis

Although meta-analyses have examined the association between patient education and health, the validity and quality of this evidence have not been comprehensively assessed. This second order meta-analysis combined previous meta-analyses that examined the effectiveness of patient education on health outcomes as an overall weighted grand mean d¯¯. Further, measures of methodological quality, meaningful variability across first order meta-analyses, and evidence for publication bias were examined. Forty meta-analyses were identified, investigating 156 associations between patient education and health summarizing data from over 776 studies including more than 74.947 patients. Quantitative analyses showed that patient education positively affects health outcomes with d¯¯ = 0.316 (95% CI [0.304, 0.329]). Summarizing data exclusively from randomized controlled trials indicated a causal effect. Patient education was effective for patients with neoplasms, diabetes, mental and behavioral disorders, diseases of the circulatory system, the respiratory system, and the musculoskeletal system. Patient education was effective in the reduction of medication use, pain, and visits to medical facilities, and significantly improved physiological, physical, psychological outcomes, and patients' general function. Overall, the findings reveal firm evidence for the effectiveness of patient education on health outcomes. However, theory-based interventions are lacking and need to be implemented to enable a successful transfer from theory to practice.

Determinants of parental hesitancy to vaccinate their children against COVID-19 in China

Vaccine hesitancy seriously hinders herd immunity. We explored the determinants of parental hesitancy to vaccinate children against Coronavirus Disease 2019 (COVID-19) in China.A population-based self-administered online questionnaire evaluating parental hesitancy in vaccinating their children against COVID-19 was conducted in Taizhou, China. Of the 2463 parents who received the invitation, 1788 (72.6%) responded to the survey.Of the repondents, 52.5% were hesitant. Mothers exhibited a greater proportion of vaccine hesitancy than fathers did (57.5% vs. 41.7%, P < 0.001). Multiple logistic regression analysis indicated that parents with children under 18 years of age (OR = 0.94, 95%CI: 0.90-0.99), lower knowledge scores about COVID-19 vaccination (Q1: OR = 1.92, 95%CI: 1.37-2.69; Q2: OR = 1.51, 95%CI: 1.10-2.08), lower awareness of the permission of vaccinating children (OR = 1.74, 95%CI: 1.36-2.23) and hesitancy to inoculate themselves (OR = 8.18, 95%CI: 6.48-10.33) were associated with parental hesitancy to inoculate their children. Results also revealed the disparity between fathers and mothers regarding associated factors.This study found that a substantial proportion of parents reported being hesitant to vaccinate children against COVID-19, implying the necessity of comprehensive assessment and health education programs for vaccination systems in China.

Thriving alongside cystic fibrosis: Developing a grounded theory of empowerment in children and young people with cystic fibrosis during key life transitions

BACKGROUND

Although the importance of patient empowerment is increasingly recognized, little is known about empowerment in children and young people (CYP) with long-term conditions. Empowerment may be particularly important in CYP with cystic fibrosis (CF) due to high treatment burden and limited opportunities for peer support.

METHODS

A Grounded Theory method was employed to develop a preliminary theory of empowerment in CYP with CF. Seven CYP with CF, five parents and four professionals were interviewed.

RESULTS AND CONCLUSIONS

The emerging model suggests that 'thriving alongside CF' may be supported by interactions between 'having a team' and 'taking charge and having a voice', leading to 'being able to just be a child', that 'concealing self' may get in the way of 'thriving alongside CF' and that these processes occur within wider medical and developmental contexts. Study limitations, clinical and research implications are discussed.

Understanding Women's Cardiovascular Health Using MyStrengths+MyHealth: A Patient-Generated Data Visualization Study of Strengths, Challenges, and Needs Differences

PURPOSE

The purpose of this data visualization study was to identify patterns in patient-generated health data (PGHD) of women with and without Circulation signs or symptoms. Specific aims were to (a) visualize and interpret relationships among strengths, challenges, and needs of women with and without Circulation signs or symptoms; (b) generate hypotheses based on these patterns; and (c) test hypotheses generated in Aim 2.

DESIGN

The design of this visualization study was retrospective, observational, case controlled, and exploratory.

METHODS

We used existing de-identified PGHD from a mobile health application, MyStrengths+MyHealth (N = 383). From the data, women identified with Circulation signs or symptoms (n = 80) were matched to an equal number of women without Circulation signs or symptoms. Data were analyzed using data visualization techniques and descriptive and inferential statistics.

FINDINGS

Based on the patterns, we generated nine hypotheses, of which four were supported. Visualization and interpretation of relationships revealed that women without Circulation signs or symptoms compared to women with Circulation signs or symptoms had more strengths, challenges, and needs-specifically, strengths in connecting; challenges in emotions, vision, and health care; and needs related to info and guidance.

CONCLUSIONS

This study suggests that visualization of whole-person health including strengths, challenges, and needs enabled detection and testing of new health patterns. Some findings were unexpected, and perspectives of the patient would not have been detected without PGHD, which should be valued and sought. Such data may support improved clinical interactions as well as policies for standardization of PGHD as sharable and comparable data across clinical and community settings.

CLINICAL RELEVANCE

Standardization of patient-generated whole-person health data enabled clinically relevant research that included the patients' perspective.

Health Investment Management and Healthcare Quality in the Public System: A Gender Perspective

The aim of this empirical research was to provide useful information for health system managers on the costs and investments involved in improving the quality of the National Health Service (NHS) based on patient assessments and from a gender perspective, i.e., without assuming that the perceived experience is identical for men and women. A cross-sectional study of 31 variables was applied using partial least squares structural equation modeling (PLS-SEM) as a research tool. The data were obtained from the Spanish Ministry of Health, Consumption, and Social Welfare for the entire Spanish territory between 2005 and 2018. The influence of expenditure, resource allocation, and mortality was hypothesized with regard to patient satisfaction according to disconfirmation theory. Patient satisfaction reflects clinical effectiveness, and therefore is a measure of health system quality. The results show that women are more sensitive to public investment in health than men, i.e., an increase in the level of spending and resources increases satisfaction more in women. In both sexes, the level of expenditure has a direct influence on patient satisfaction, and therefore on the quality of the healthcare system. It is important to increase spending on primary care, especially on specialized medical care and diagnostic equipment. However, reducing the use of drugs in favor of alternative treatments or therapies is considered to be positive. Likewise, spending has an impact on available resources, and these, in turn, have a positive influence on the level of use and a negative impact on mortality. Resources, especially healthcare staff, nuclear magnetic resonance equipment, and the number of posts in day hospitals, increase patients’ positive perception of the NHS.

Information Recall in Pre-Operative Consultation for Glioma Surgery Using Actual Size Three-Dimensional Models

Three-dimensional (3D) technologies are being used for patient education. For glioma, a personalized 3D model can show the patient specific tumor and eloquent areas. We aim to compare the amount of information that is understood and can be recalled after a pre-operative consult using a 3D model (physically printed or in Augmented Reality (AR)) versus two-dimensional (2D) MR images. In this explorative study, healthy individuals were eligible to participate. Sixty-one participants were enrolled and assigned to either the 2D (MRI/fMRI), 3D (physical 3D model) or AR groups. After undergoing a mock pre-operative consultation for low-grade glioma surgery, participants completed two assessments (one week apart) testing information recall using a standardized questionnaire. The 3D group obtained the highest recall scores on both assessments (Cohen’s d = 1.76 and Cohen’s d = 0.94, respectively, compared to 2D), followed by AR and 2D, respectively. Thus, real-size 3D models appear to improve information recall as compared to MR images in a pre-operative consultation for glioma cases. Future clinical studies should measure the efficacy of using real-size 3D models in actual neurosurgery patients.

Using simulated patients as a learning strategy to support undergraduate nurses to develop patient-teaching skills

BACKGROUND

An increase in the number of patients with long-term conditions has required a greater focus on nurse-led educational interventions to enable patients to develop self-management strategies. However, patient education is frequently taken for granted, and nurses sometimes consider that their undergraduate training does not prepare them to participate in effective patient teaching.

AIM

The study aimed to formatively evaluate a simulated role-play scenario facilitated with third-year nursing students to support the development of patient-teaching skills.

METHOD

The study combined two approaches to simulation, using high-fidelity and mid-fidelity simulation scenarios sequentially. This enabled students (n=20) to apply the communication strategies learnt to both a skills-based procedural situation and a patient-teaching simulation. A five-item pro forma with four open questions and one closed question was used for formative evaluation.

FINDINGS

The results indicated that using a simulated patient to practise patient-teaching skills was perceived by the students to be a valuable method of learning that they could transfer to clinical practice.

CONCLUSION

The findings suggested that facilitating learning with a simulated patient is useful in replicating authentic verbal and practical interactions with a patient in practice.