1
|
Wu D, Jin B, Li J, Chen T, Gu T. The impact of whole-process visualization collaborative nursing discussions education on perioperative symptoms and emotional well-being in radical prostatectomy patients. Int Urol Nephrol 2024; 56:3259-3268. [PMID: 38776055 DOI: 10.1007/s11255-024-04088-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/16/2024] [Indexed: 09/18/2024]
Abstract
OBJECTIVE Prostate cancer is one of the most common malignant neoplasms in elderly males, with radical prostatectomy being the established therapeutic approach for localized disease. Patients undergoing this surgical procedure frequently experience increased negative emotions and symptomatology during the perioperative period, likely due to concerns about the illness and its treatment. The present study aims to investigate the effects of a novel educational approach involving a whole-process visualization and collaborative nursing discussions on perioperative symptoms and emotional well-being in radical prostatectomy patients. METHODS Data were prospectively collected from 310 patients admitted to the hospital between June 2021 and December 2023, all of whom were scheduled to undergo radical prostatectomy. These patients were randomly assigned to either the intervention group (receiving new model education) or the control group (receiving conventional education), with 155 patients in each group. The study compared basic demographic information, anxiety and depression scores, fear of disease progression scores, quality-of-life scores, main symptom scores, and changes in perioperative vital signs between the two groups. RESULTS No statistically significant differences were observed between the two groups in terms of age, comorbidities, insurance type, education level, income, and tumor history (P > 0.05). Similarly, there were no significant differences in anxiety and depression scores, proportion of patients with anxiety and depression, vital signs, and fear of disease progression scores between the two groups at Time 1 stage (P > 0.05). During stages Time 2 and Time 3, the intervention group exhibited lower anxiety and depression scores, a lower proportion of anxious and depressed patients, as well as significantly reduced blood pressure and heart rate fluctuations compared to the control group (P < 0.05). Following radical prostatectomy, the main symptoms of patients, such as pain, nausea, and fatigue, were assessed using the MADIS Symptom Assessment Scale on days 1-3 post-surgery. The intervention group exhibited significantly lower scores for three symptoms compared to the control group (P < 0.05); at Time 4 stage, the patients in the intervention group also demonstrated significantly improved quality-of-life scores compared to the control group (P < 0.05). Additionally, blood pressure and heart rate of patients returned to baseline levels at Time 4 stage, with no significant difference between the two groups (P > 0.05). Nevertheless, the anxiety and depression scores in the intervention group at the Time 4 stage remained significantly lower than those in the control group (P < 0.05). Additionally, the fear of disease progression scores in both groups were lower than those at the Time 1 stage, with a more pronounced improvement observed in the intervention group compared to the control group (P < 0.05). CONCLUSION Patients diagnosed with malignant tumors often experience fear and anxiety regarding the progression of their disease and upcoming surgery, as well as uncertainty surrounding their treatment and prognosis. This heightened emotional distress can contribute to a greater symptom burden during the perioperative period. Utilizing a whole-process visualization and collaborative nursing discussion approach, as compared to traditional communication methods, has been shown to alleviate patients' fears, reduce anxiety and depression, and ultimately lessen the symptom burden experienced during the perioperative phase. Ultimately, this approach can enhance the overall quality of life for patients facing malignant tumors.
Collapse
Affiliation(s)
- Dan Wu
- Department of Urology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Lishui, 323000, China
| | - Bixia Jin
- Department of Urology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Lishui, 323000, China
| | - Jie Li
- Department of Urology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Lishui, 323000, China
| | - Ting Chen
- Department of Urology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Lishui, 323000, China
| | - Tengfei Gu
- Department of Urology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Lishui, 323000, China.
| |
Collapse
|
2
|
Makary MS, Jacob CC, Boggs Z, Brankovic R, Paradiso M, Regalado L. Impact of Educational Videos on Patient Understanding of Interventional Radiology Procedures. Acad Radiol 2024:S1076-6332(24)00583-X. [PMID: 39198139 DOI: 10.1016/j.acra.2024.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 07/30/2024] [Accepted: 08/08/2024] [Indexed: 09/01/2024]
Abstract
RATIONALE AND OBJECTIVES Under-awareness of Interventional Radiology (IR) care by the public has been reported. The aim of this study is to evaluate the impact of educational videos to facilitate better patient understanding during the informed consent process. MATERIALS AND METHODS Educational videos for six common IR procedures including chemoembolization, radioembolization, ablation, tunneled central venous catheter placement, port placement, and port removal were developed for educating patients in the pre-procedural setting. One hundred and eighty patients referred to a tertiary academic institution were randomly selected to participate, including 30 patients per procedure type. Anonymous seven question, five-point Likert-scale assessments were administered to the participants before and after engaging with the videos. The survey evaluated patients' perceived understanding of IR procedures and satisfaction with the videos as educational tools. RESULTS One hundred and eighty patients completed the survey. Comparing post-video to pre-video ratings, there was an increase in patients' understanding of the involved anatomy (4.5 vs 3.3; p < 0.01), understanding of procedure benefits (4.6 vs 3.7; p < 0.01), understanding of procedural risks (4.5 vs 3.3; p < 0.01), understanding of procedural alternatives (3.4 vs 2.7; p < 0.01), and overall procedural understanding (4.7 vs 3.4; p < 0.01). Additionally, patients had a positive impression of the videos with a mean overall satisfaction rating of the video-assisted explanation of 4.80. CONCLUSIONS A patient-centric video-assisted informed consent for IR procedures enhances patients' understanding and results in high patient satisfaction.
Collapse
Affiliation(s)
- Mina S Makary
- Department of Radiology, The Ohio State Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210
| | - Connor C Jacob
- Department of Radiology, The Ohio State Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210.
| | - Zac Boggs
- Department of Radiology, The Ohio State Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210
| | - Ryan Brankovic
- Department of Radiology, The Ohio State Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210
| | - Michela Paradiso
- Department of Radiology, The Ohio State Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210
| | - Luis Regalado
- Department of Radiology, The Ohio State Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210
| |
Collapse
|
3
|
Mansell H, Rosaasen N, Wichart J, West-Thielke P, Blackburn D, Liu J, Mainra R, Shoker A, Groot B, Wen K, Wong A, Bateni B, Luo C, Trivedi P. Video Education and Behavior Contract to Improve Outcomes After Renal Transplantation (VECTOR): A Randomized Controlled Trial. Patient Prefer Adherence 2024; 18:1589-1602. [PMID: 39100428 PMCID: PMC11298174 DOI: 10.2147/ppa.s467142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/24/2024] [Indexed: 08/06/2024] Open
Abstract
Sub-optimal adherence to immunosuppressant medications reduces graft survival for kidney transplant recipients and adherence-enhancing interventions are resource and time intensive. We performed a multi-center randomized controlled trial to investigate the impact of an electronically delivered intervention on adherence. Of 203 adult kidney transplant recipients who received a de novo kidney transplant n = 173 agreed to participate (intent-to-treat population) and were randomized to the intervention (video education plus behavior contract n = 91) or the control (standard education, n = 82). No significant differences were found between the groups for medication adherence measured by the Basel Assessment of Adherence to Immunosuppressive Medications Scale, intrapatient variability in tacrolimus levels, time in therapeutic range for any immunosuppressant, knowledge, self-efficacy, QOL, or hospitalizations. Among a subgroup of 64 participants randomized to the intervention group who completed a post-intervention questionnaire, two-thirds (67%, n = 43) reported watching at least 80% of the videos and 58% (n = 37) completed the electronic goal setting exercise and adherence contract. An autonomous goal setting exercise and electronic behavioural contract added to standard of care did not improve any outcomes. Our findings reiterate that nonadherence in transplantation is a difficult multifactorial problem that simple solutions will not solve. Trial registration number NCT03540121.
Collapse
Affiliation(s)
- Holly Mansell
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nicola Rosaasen
- Saskatchewan Transplant Program, Saskatchewan Health Authority, Saskatoon, SK, Canada
| | - Jenny Wichart
- Department of Pharmacy, Alberta Health Services, Calgary, AB, Canada
| | | | - David Blackburn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Juxin Liu
- Department of Mathematics and Statistics, College of Arts and Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - Rahul Mainra
- Saskatchewan Transplant Program; Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ahmed Shoker
- Saskatchewan Transplant Program; Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Brianna Groot
- Canadian Hub for Applied and Social Research, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kevin Wen
- Division of Nephrology and Transplant Immunology, Department of Medicine University of Alberta, Edmonton, AB, Canada
| | - Anita Wong
- Department of Pharmacy, University of Alberta Hospital, Edmonton, AB, Canada
| | - Bita Bateni
- St. Paul’s Hospital, and University of British Columbia, Vancouver, BC, Canada
| | - Cindy Luo
- Vancouver General Hospital; Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC, Canada
| | - Paraag Trivedi
- Transplant Recipient/Patient Advisor, Regina, SK, Canada
| |
Collapse
|
4
|
Andrade LRDS, dos Anjos LD, Aguiar APF, de Lima EA, Abuchaim EDSV, Lopes JDL, Lopes CT, Santos VB. Sexual counseling for people with acute coronary syndrome: educational video development. Rev Bras Enferm 2024; 77:e20230416. [PMID: 39082545 PMCID: PMC11290733 DOI: 10.1590/0034-7167-2023-0416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/12/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE to assess validity evidence of an educational video on safe sexual activity after acute coronary syndrome. METHOD study in three phases: video development; content validity analysis by 11 experts; and analysis of validity based on response processes by seven people with coronary disease. The content validity ratio (CVR) was calculated with critical values for the second phase of 0.63 and for the third of 1.0. RESULTS the video addressed the importance of resuming sexual activity and positions that consume less energy, clinical warning signs, the importance of adhering to treatment and a welcoming environment for sexual practice. A CVR above the critical value was obtained with a total of 4 minutes and 41 seconds. CONCLUSION the educational video brings together adequate content validity evidence and can be used as a tool for patients after acute coronary syndrome.
Collapse
Affiliation(s)
| | - Lanay Dourado dos Anjos
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
- Hospital Sírio-Libanês. São Paulo, São Paulo, Brazil
| | - Ana Paula Freitas Aguiar
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
- Hospital Universitário São Paulo, Unidade de Cardiologia. São Paulo, São Paulo, Brazil
| | - Edvone Alves de Lima
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
- Hospital Israelita Albert Einstein. São Paulo, São Paulo, Brazil
| | | | | | | | | |
Collapse
|
5
|
Borges LADC, Almeida RGDS, Barboza ES, Arruda GOD. Simulation training of caregivers at hospital discharge of patients with chronic diseases: an integrative review. Rev Bras Enferm 2023; 76:e20230043. [PMID: 38055488 DOI: 10.1590/0034-7167-2023-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/11/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to identify evidence about the use and effects of clinical simulation for preparing caregivers for discharging patients with chronic conditions. METHODS an integrative peer review in the Scopus, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect and Virtual Health Library databases, from July to September 2022. RESULTS 3,218 studies were identified, with a final sample consisting of four national and two international articles. Using simulation as an educational technology contributed to caregiver preparation in home care. In most studies, using clinical simulation included using other strategies to complement training: expository dialogued class, conversation circle and audiovisual resources. FINAL CONSIDERATIONS simulation proved to be efficient for training caregivers, with the active participation of family members and nurses in health education actions.
Collapse
Affiliation(s)
| | | | - Elton Santo Barboza
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| | | |
Collapse
|
6
|
Zheng Y, Yan Q. Effect of application of short-form video health education on the health knowledge and satisfaction with nursing care of patients with lower extremity fractures. BMC Nurs 2023; 22:395. [PMID: 37858080 PMCID: PMC10588147 DOI: 10.1186/s12912-023-01530-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 09/25/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Video health education has been increasingly adopted in the clinic to expand patient guidance and improve perioperative outcomes. To date, however, it is unclear whether the use of short-form videos and web-based clinician-created forums actually improve the perioperative experience of patients. OBJECTIVE To evaluate the effect of application of short-form video health education on the health knowledge and satisfaction with nursing care of patients with lower extremity fractures. METHODS This study is a quasi experimental study, using convenient sampling method and grouping according to historical control., one hundred and twenty-two patients admitted with lower limb fractures to the orthopedic ward of a tertiary first-class general hospital in Fujian, China were enrolled in this study. Based on their admission order, patients admitted from September 2021 to November 2021 were enrolled into the control group (n = 61) and patients admitted from December 2021 to March 2022 were enrolled in the intervention group (n = 61). Both groups received identical admission-based patient education, perioperative care, and discharge rehabilitation instructions. The control group received the traditional education method while the intervention group received a short-form educational video in addition to the traditional education method. Patient perioperative health knowledge and patient satisfaction with nursing care during treatment of lower limb fractures were compared across the two groups. RESULTS Preoperative health knowledge in the intervention group was 95.1%, compared to 82.0% in the control group (χ2 = 3.954, P<0.05). The Newcastle satisfaction with nursing scales score in the intervention group was (80.902 ± 7.016) points, compared to (78.131 ± 8.213) points in the control group. These group differences were statistically significant (P < 0.05). CONCLUSION The application of a short-form educational video during the perioperative care of patients with lower limb fractures may improve patients' understanding of perioperative health and increase satisfaction with nursing care.
Collapse
Affiliation(s)
- Yuliu Zheng
- The Nursing Department of the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Lu, Taijiang District, RN, 350004, Fuzhou, China.
| | - Qiuyan Yan
- Fujian Medical University School of Nursing, Fuzhou, 350004, China
| |
Collapse
|
7
|
McDonald IR, Blocker ES, Weyman EA, Smith N, Dwyer AA. What Are the Best Practices for Co-Creating Patient-Facing Educational Materials? A Scoping Review of the Literature. Healthcare (Basel) 2023; 11:2615. [PMID: 37830651 PMCID: PMC10572900 DOI: 10.3390/healthcare11192615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
Co-creating patient-facing educational materials (PEMs) can enhance person-centered care by responding to patient priorities and unmet needs. Little data exist on 'best practices' for co-creation. We followed the Arksey and O'Malley framework to conduct a systematic literature search of nine databases (MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, Joanna Briggs Institute, TRIP-April, 2022) to identify empirical studies published in English on PEM co-creation to distill 'best practices'. Following an independent dual review of articles, data were collated into tables, and thematic analysis was employed to synthesize 'best practices' that were validated by a patient experienced in co-creating PEMs. Bias was not assessed, given the study heterogeneity. Of 6998 retrieved articles, 44 were included for data extraction/synthesis. Studies utilized heterogeneous methods spanning a range of health conditions/populations. Only 5/45 (11%) studies defined co-creation, 14 (32%) used a guiding framework, and 18 (41%) used validated evaluation tools. Six 'best practices' were identified: (1) begin with a review of the literature, (2) utilize a framework to inform the process, (3) involve clinical and patient experts from the beginning, (4) engage diverse perspectives, (5) ensure patients have the final decision, and (6) employ validated evaluation tools. This scoping review highlights the need for clear definitions and validated evaluation measures to guide and assess the co-creation process. Identified 'best practices' are relevant for use with diverse patient populations and health issues to enhance person-centered care.
Collapse
Affiliation(s)
- Isabella R. McDonald
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA; (I.R.M.); (E.S.B.); (E.A.W.)
| | - Elizabeth S. Blocker
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA; (I.R.M.); (E.S.B.); (E.A.W.)
| | - Elizabeth A. Weyman
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA; (I.R.M.); (E.S.B.); (E.A.W.)
| | - Neil Smith
- “I Am HH” Patient Organization, Dallas, TX 75238, USA;
| | - Andrew A. Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA; (I.R.M.); (E.S.B.); (E.A.W.)
- Massachusetts General Hospital—Harvard Center for Reproductive Medicine, Boston, MA 02114, USA
| |
Collapse
|
8
|
Watters TK, Glass BD, Mallett AJ. Identifying the barriers to kidney transplantation for patients in rural and remote areas: a scoping review. J Nephrol 2023:10.1007/s40620-023-01755-0. [PMID: 37656389 DOI: 10.1007/s40620-023-01755-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Populations in rural and remote areas have higher rates of chronic kidney disease and kidney failure than those in urban or metropolitan areas, and mortality rates for chronic kidney disease are almost twice as high in remote areas compared to major cities. Despite this, patients residing in regional, rural, or remote areas are less likely to be wait-listed for or receive a kidney transplant. The objective of this scoping review is to identify specific barriers to kidney transplantation for adult patients residing in rural and remote areas from the perspectives of health professionals and patients/carers. METHODS Studies were identified through database (MEDLINE, CINAHL, Emcare, Scopus) searches and assessed against inclusion criteria to determine eligibility. A descriptive content analysis was undertaken to identify and describe barriers as key themes. RESULTS The 24 selected studies included both quantitative (n = 5) and qualitative (n = 19) methodologies. In studies conducted in health professional populations (n = 10) the most prevalent themes identified were perceived social and cultural issues (80%), burden of travel and distance from treatment (60%), and system-level factors as barriers (60%). In patient/carer populations (n = 14), the most prevalent themes were limited understanding of illness and treatment options (71%), dislocation from family and support network (71%), and physical and psychosocial effects of treatment (71%). CONCLUSIONS Patients in regional, rural, and remote areas face many additional barriers to kidney transplantation, which are predominantly associated with the need to travel or relocate to access required medical testing and transplantation facilities.
Collapse
Affiliation(s)
- Tara K Watters
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
- Department of Renal Medicine, Cairns Hospital, PO Box 902, Cairns, QLD, 4870, Australia.
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Andrew J Mallett
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Department of Renal Medicine, Townsville University Hospital, Townsville, QLD, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
9
|
Chong HJ, Kim HK. Adaptation Process After Kidney Transplantation in Older Adult Recipients: Applied Grounded Theory. Res Gerontol Nurs 2023; 16:183-193. [PMID: 37159389 DOI: 10.3928/19404921-20230503-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Despite the increase in older adults receiving kidney transplantation (KT), little is known about their experience and adaptation process after KT. The current study aimed to explore the process of adaptation after KT in older adult recipients using a qualitative design and grounded theory methodology. Sixteen recipients who had KT at age ≥60 years and received follow-up care were recruited at a university hospital in South Korea. Data were collected from July to December 2017 through in-depth interviews with individual participants. The core theme of the adaptation process after KT in older adult recipients was A Journey of Straining to Save the Last Lifeline. The adaptation process comprised three stages: confusion, depression, and compromise. Tailored interventions based on the in-depth understanding of the adaptation process found in the current study are needed to improve adaptation after KT in older adult recipients. [Research in Gerontological Nursing, 16(4), 183-193.].
Collapse
|
10
|
Qu Z, Oedingen C, Bartling T, Krauth C, Schrem H. Systematic review on the involvement and engagement of patients as advisers for the organisation of organ transplantation services. BMJ Open 2023; 13:e072091. [PMID: 37164468 PMCID: PMC10173988 DOI: 10.1136/bmjopen-2023-072091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVES This systematic review aims to derive practical lessons from publications on patient involvement and engagement in the organisation of organ transplantation services. DESIGN This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Inclusion criteria for the analysis of publications in English cited in the databases PubMed and Web of Science until 6 December 2022 required that patients participated as advisers in the organisation of organ transplantation services. Quality assessment was performed using the Guidance for Reporting Involvement of Patients and the Public (GRIPP) 2 small form and the Critical Appraisal Skills Programme (CASP) tool for the assessment of the risks of bias. RESULTS Deployed search strings identified 2263 records resulting in a total of 11 articles. The aims and strategies, deployed methods, observed effects, observed barriers and proposed improvements for the future varied vastly. All reported that well-developed programmes involving and engaging patients at an organisational level provide additional benefits for patients and foster patient-centred care. Lessons learnt include: (1) to empower patients, the information provided to them should be individualised to prioritise their needs; (2) financial as well as organisational resources are important to successfully implement patient involvement and engagement; (3) systematic feedback from patients in organisational structures to health providers is required to improve clinical workflows and (4) the consideration of ethical issues and the relationship between investigators and participating patients should be clarified and reported. CONCLUSIONS Actionable management recommendations could be derived. The quantitative impact on clinical outcome and economic clinical process improvements remains to be investigated. Study quality can be improved using the GRIPP 2 guidance and the CASP tool. PROSPERO REGISTRATION NUMBER CRD42022186467.
Collapse
Affiliation(s)
- Zhi Qu
- Transplant Center, Hannover Medical School, Hannover, Germany
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Carina Oedingen
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Tim Bartling
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Christian Krauth
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Harald Schrem
- General, Visceral and Transplant Surgery, Medical University Graz, Graz, Austria
- Transplant Center Graz, Medical University Graz, Graz, Austria
| |
Collapse
|
11
|
Silva MD, Charlo PB, Zulin A, Santos FGTD, Jaques AE, Haddad MDCFL, Radovanovic CAT. Construction and validation of clinical scenarios for training informal caregivers of dependent persons. Rev Bras Enferm 2022; 75:e20220140. [PMID: 36259877 DOI: 10.1590/0034-7167-2022-0140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/04/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE To construct and validate three clinical scenarios for training dependent persons' informal caregivers. METHODS Methodological study, conducted between January and August 2021, in a municipality in the northwest of the state of Paraná. It was developed in two stages: construction of scenarios; and content validation by experts (n = 12). To estimate the degree of agreement between the experts, the content validity index was used, and 80% was considered an acceptable rate of agreement. RESULTS The simulation scenarios proved appropriate, obtaining an average value of 91.6%. However, some adjustments were made in their organization pertaining clarity in the wording of guidelines, as suggested by the expert validators. CONCLUSIONS The construction and validation of the clinical scenarios proved to be adequate and relevant for use in the training of informal caregivers of dependent persons.
Collapse
Affiliation(s)
| | | | - Aline Zulin
- Universidade Estadual de Maringá. Maringá, Paraná, Brazil
| | | | | | | | | |
Collapse
|
12
|
Mansell H, Fenton ME, Tam JS, Rosaasen N, Cardinal L, Nelson N. A Mixed Methods Assessment of Home-Based Video Pretransplant Lung Education. Prog Transplant 2022; 32:261-265. [PMID: 35686353 PMCID: PMC9297341 DOI: 10.1177/15269248221107048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction: Patients awaiting lung transplantation must learn new information to successfully navigate the transplant process. A supplemental video series was piloted to patients at home during the Covid-19 pandemic to improve pre-transplant education. Methods: A mixed methods study was undertaken to assess patient experiences with this method of education, confirm the ideal timing of the education, and identify gaps that require further attention. Semi-structured interviews were conducted with 17 one-on-one or dyadic (patients and caregivers) who viewed the video series at home. A third-party researcher (not involved in creation of the educational materials) conducted the interviews by phone, which were audio recorded and then transcribed verbatim. NVivo 12 Pro for Windows software was used to code the data and identify emerging themes. Results: Participants indicated that home-based videos were applicable, and informative and helpful (4.7 on 5-point Likert scale) and appreciated the advice and experiences of real patients. They were satisfied with their transplant education (4.2/5). While there were few aspects that the participants disliked about the videos, the interviews elicited outstanding questions about the transplant process (eg, logistical aspects of travel) and transplant concerns (eg, medications, expenses, and precautions in daily life). Conclusion: Patients being assessed or listed for lung transplant valued the novel electronic video education, and we will implement the home-based process into standard of care after the patient's initial visit with the transplant respirologist. Pre-transplant education will be tailored to help address the outstanding gaps identified in this program evaluation.
Collapse
Affiliation(s)
- Holly Mansell
- College of Pharmacy and Nutrition, 70398University of Saskatchewan, Saskatoon, SK, Canada
| | - Mark E Fenton
- Division of Respirology, Critical Care, and Sleep Medicine, 12371College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Julian S Tam
- Division of Respirology, Critical Care, and Sleep Medicine, 12371College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nicola Rosaasen
- Saskatchewan Transplant Program, 7234Saskatchewan Health Authority, Saskatoon, SK, Canada
| | - Louise Cardinal
- Saskatchewan Transplant Program, 7234Saskatchewan Health Authority, Saskatoon, SK, Canada
| | | |
Collapse
|
13
|
Hamid M, Rogers E, Chawla G, Gill J, Macanovic S, Mucsi I. Pretransplant Patient Education in Solid-organ Transplant: A Narrative Review. Transplantation 2022; 106:722-733. [PMID: 34260472 DOI: 10.1097/tp.0000000000003893] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Education for pretransplant, solid-organ recipient candidates aims to improve knowledge and understanding about the transplant process, outcomes, and potential complications to support informed, shared decision-making to reduce fears and anxieties about transplant, inform expectations, and facilitate adjustment to posttransplant life. In this review, we summarize novel pretransplant initiatives and approaches to educate solid-organ transplant recipient candidates. First, we review approaches that may be common to all solid-organ transplants, then we summarize interventions specific to kidney, liver, lung, and heart transplant. We describe evidence that emphasizes the need for multidisciplinary approaches to transplant education. We also summarize initiatives that consider online (eHealth) and mobile (mHealth) solutions. Finally, we highlight education initiatives that support racialized or otherwise marginalized communities to improve equitable access to solid-organ transplant. A considerable amount of work has been done in solid-organ transplant since the early 2000s with promising results. However, many studies on education for pretransplant recipient candidates involve relatively small samples and nonrandomized designs and focus on short-term surrogate outcomes. Overall, many of these studies have a high risk of bias. Frequently, interventions assessed are not well characterized or they are combined with administrative and data-driven initiatives into multifaceted interventions, which makes it difficult to assess the impact of the education component on outcomes. In the future, well-designed studies rigorously assessing well-defined surrogate and clinical outcomes will be needed to evaluate the impact of many promising initiatives.
Collapse
Affiliation(s)
- Marzan Hamid
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada
| | | | | | | | | | | |
Collapse
|
14
|
Silva MD, Charlo PB, Zulin A, Santos FGTD, Jaques AE, Haddad MDCFL, Radovanovic CAT. Construção e validação de cenários clínicos para capacitação de cuidadores informais de pessoas dependentes. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2022-0140pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
RESUMO Objetivo: Construir e validar três cenários clínicos para capacitação de cuidadores informais de pessoas dependentes. Métodos: Estudo metodológico, realizado entre janeiro e agosto de 2021, em um município no noroeste do estado do Paraná. Foi desenvolvido em duas etapas: construção dos cenários; e validação do conteúdo por experts (n = 12). Para estimar o grau de concordância entre os juízes, utilizou-se o índice de validade de conteúdo, e considerou-se o valor de 80% como uma taxa aceitável de concordância. Resultados: Os cenários de simulação mostraram-se apropriados, obtendo valor médio de 91,6%. No entanto, foram feitos alguns ajustes em sua organização no que tange à clareza na redação das orientações, conforme sugestão dos juízes. Conclusões: A construção e validação dos cenários clínicos mostraram-se adequadas e relevantes, de modo que eles podem ser utilizados na capacitação de cuidadores informais de pessoas dependentes.
Collapse
|
15
|
A Randomized Controlled Trial of a Pretransplant Educational Intervention in Kidney Patients. Transplant Direct 2021; 7:e753. [PMID: 34514108 PMCID: PMC8425830 DOI: 10.1097/txd.0000000000001202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 12/18/2022] Open
Abstract
Supplemental Digital Content is available in the text. Poor patient knowledge about transplantation is a significant problem following kidney transplant. A video-based educational intervention was developed to supplement standard education provided by transplant teams.
Collapse
|
16
|
Ziade N, Arayssi T, Elzorkany B, Daher A, Karam GA, Jbara MA, Aiko A, Alam E, Emadi SA, Mashaleh MA, Badsha H, Kibbi LE, Halabi H, Harifi G, Khan B, Masri AF, Menassa J, Merashli M, Merheb G, Messaykeh J, Mroue' K, Saad S, Salloum N, Uthman I, Masri B. Development of an Educational Video for Self-Assessment of Patients with RA: Steps, Challenges, and Responses. Mediterr J Rheumatol 2021; 32:66-73. [PMID: 34386703 PMCID: PMC8314883 DOI: 10.31138/mjr.32.1.66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/06/2020] [Accepted: 10/15/2020] [Indexed: 01/05/2023] Open
Abstract
Objectives: The primary objective was to develop an educational video to teach patients with rheumatoid arthritis (RA) self-assessment of their disease activity. Secondary objectives were to validate the video, identify the challenges in producing it, and the responses to these challenges. Methods: Rheumatologists from 7 Middle Eastern Arab countries (MEAC) discussed unmet needs in the education of patients with RA. They reviewed pre-existing educational audiovisual material and drafted the script for a new video in Arabic. The video was produced in collaboration with a technical team, then validated by patients using a standardized interview. At each step of production, challenges were identified. Results: Twenty-three rheumatologists from MEAC identified unmet needs in patients’ education. A video was produced, explaining the concepts of treat-to-target and showing a patient performing self-assessment using DAS-28. Sixty-two patients were interviewed for validation and found the video to be useful and easy to understand, albeit not replacing the physician’s visit. Most common challenges encountered included acceptance of patient empowerment, agreement on DAS-28 as composite measure, production of a comprehensible written Arabic text, and addressing the population cultural mix. Conclusion: Despite challenges, the video was well accepted among patients and can be used for clinical and research purposes. It is particularly useful in pandemic periods where social distancing is recommended.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Humeira Badsha
- Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates
| | | | | | - Ghita Harifi
- Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates
| | - Bhavna Khan
- Mediclinic City Hospital, Dubai, United Arab Emirates
| | | | | | | | | | | | | | - Sahar Saad
- Assiut University, Egypt & King Hamad University Hospital, Bahrain
| | | | - Imad Uthman
- American University of Beirut, Beirut, Lebanon
| | | |
Collapse
|
17
|
Abstract
Medication nonadherence (MNA) after solid organ transplantation is highly prevalent and associated with (late) (sub)clinical acute rejection, graft dysfunction and graft loss, development of donor-specific anti-HLA antibodies, and antibody-mediated rejection. MNA is predominantly unintentional and originates from barriers to adherence that are often multifactorial and complex. Tools to establish an early diagnosis of MNA include incorporation of MNA as a vital sign in daily clinical practice, self-reporting using validated questionnaires, calculating intrapatient variability in drug exposure and applying electronic monitoring, and recent audio and video technologies such as in home telemonitoring. MNA is a modifiable risk factor after organ transplantation, and treatment is most effective if a multimodal approach is used. Management of MNA comprises education (cognitive) and counseling (behavioral) that require the involvement of a trained multidisciplinary team [ideally physician, nurse (specialist), social worker, transplant coordinator, psychologist, clinical pharmacist], electronic reminder and support systems (eg, Medication Event Monitoring System, smartphone), and different types of novel mobile health applications as well as simplification of the medication dosing regimen. Future studies that evaluate novel therapeutic approaches for MNA should assure the use of reliable MNA measures, focus on multimodal individualized therapy for enriched nonadherent target populations (eg, adolescents), and incorporate clinically relevant endpoints. Costs, time, and personnel investments should be taken into account when assessing scalability and cost-effectiveness of novel therapeutic strategies. This review provides suggestions how different types of transplant centers can set up a dedicated MNA program according to available resources to define and achieve realistic clinical goals in managing MNA.
Collapse
|
18
|
Finderup J, Crowley A, Søndergaard H, Lomborg K. Involvement of patients with chronic kidney disease in research: A case study. J Ren Care 2020; 47:73-86. [PMID: 32869408 DOI: 10.1111/jorc.12346] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/09/2020] [Accepted: 08/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Knowledge about best practices of patient involvement in research among patients with chronic kidney disease is sparse, with little information about barriers to and facilitators of this process. The purpose of this study is to evaluate the process and outcomes of patient involvement in a particular chronic kidney disease research project. OBJECTIVES To describe how patients with chronic kidney disease were involved in the research; to explain what occurred when patients with chronic kidney disease were involved; to identify facilitators of and barriers to patient involvement in research. PARTICIPANTS Two patients with chronic kidney disease who have both been involved in a previous research project. MEASUREMENTS A retrospective embedded case study of patient involvement in research with the shared decision-making and dialysis choice project inspired by Yin (2012, Case Study Methods), using document analysis and semistructured individual interviews. Data were analysed with specific research questions in mind. RESULTS Two patients participated in four research meetings covering all substudies of a research project and all six phases of the research process. Eight facilitators and barriers were identified. CONCLUSIONS Patients with chronic kidney disease were involved in all the six phases of the research process but were more highly involved in some phases than others. Important facilitators of patient involvement in chronic kidney disease research include working as a team, being a part of the process, and being prepared for the work. Important barriers to patient involvement include patient vulnerability and uremic symptoms, both of which must be taken into account.
Collapse
Affiliation(s)
- Jeanette Finderup
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,ResCenPI - Research Centre for Patient Involvement, Aarhus University & the Central Denmark Region, Aarhus, Denmark
| | | | | | - Kirsten Lomborg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Steno Diabetes Center, Copenhagen, Denmark
| |
Collapse
|
19
|
Mansell H, Rosaasen N, West-Thielke P, Wichart J, Daley C, Mainra R, Shoker A, Liu J, Blackburn D. Randomised controlled trial of a video intervention and behaviour contract to improve medication adherence after renal transplantation: the VECTOR study protocol. BMJ Open 2019; 9:e025495. [PMID: 30872550 PMCID: PMC6429879 DOI: 10.1136/bmjopen-2018-025495] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Non-adherence after kidney transplantation contributes to increased rejections, hospitalisations and healthcare expenditures. Although effective adherence interventions are sorely needed, increasing education and support to transplant recipients demands greater use of care providers' time and resources in a healthcare system that is stretched. The objective of this clinical trial is to determine the effectiveness of an electronically delivered video series and adherence behaviour contract on improving medication adherence to immunosuppressant medications. METHODS AND ANALYSIS A multicentre, parallel arm, randomised controlled trial will be conducted with four sites across North America (Saskatoon, Calgary, Halifax, Chicago). Adult patients will be randomised (1:1) to either the intervention (ie, home-based video education +behaviour contract plus usual care) or usual care alone. De novo transplant recipients will be enrolled prior to their hospital discharge and will be provided with electronic access to the video intervention (immediately) and adherence contract (1 month post-transplant). Follow-up electronic surveys will be provided at 3 and 12 months postenrolment. The primary outcome will be adherence at 12 months post-transplant, as measured by self-report Basel Assessment of Adherence to Immunosuppressive medications and immunosuppressant levels. Secondary outcomes include the difference in knowledge score between the intervention and control in groups (measured by the Kidney Transplant Understanding Tool); differences in self-efficacy (Generalised Self-efficacy Scale), Beliefs of Medicine Questionnaire (BMQ), quality of life (Short Form-12), patient satisfaction and cost utilisation. The study aims to recruit at least 200 participants across participating sites. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Saskatchewan Behavioural Ethics Committee (Beh 18-63), and all patients provide informed consent prior to participating. This educational intervention aims to improve information retention and self-efficacy, leading to improved medication adherence after kidney transplantation, at low cost, with little impact to existing healthcare personnel. If proven beneficial, delivery can be easily implemented into standard of care. TRIAL REGISTRATION NUMBER NCT03540121; Pre-results.
Collapse
Affiliation(s)
- Holly Mansell
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nicola Rosaasen
- Saskatchewan Transplant Program, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
| | - Patricia West-Thielke
- Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USA
| | - Jenny Wichart
- Southern Alberta Transplant Program, Alberta Health Services, Calgary, Alberta, Canada
| | - Christopher Daley
- Multi-organ Transplant Program of Atlantic Canada, Halifax, Nova Scotia, Canada
| | - Rahul Mainra
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ahmed Shoker
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Juxin Liu
- College of Arts and Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - David Blackburn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
20
|
Chisholm-Burns MA, Spivey CA, Pickett LR. Health literacy in solid-organ transplantation: a model to improve understanding. Patient Prefer Adherence 2018; 12:2325-2338. [PMID: 30464420 PMCID: PMC6229143 DOI: 10.2147/ppa.s183092] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Optimizing wellness and health are the most critical goals for patients post solid-organ transplantation. Low health literacy has important implications for wellness and health, increasing patient risk for negative health outcomes. More than 30% of the general US patient population has low health literacy, and solid-organ transplant recipients (SOTRs) may be especially vulnerable to low health literacy and its adverse impact on health outcomes. A comprehensive literature review was conducted and a model was adapted to better depict factors associated with low health literacy. Based on the Paasche-Orlow and Wolf model of health literacy, the Health Literacy Model in Transplantation (HeaL-T) provides a foundation to visually demonstrate the relationships among variables associated with low health literacy and to develop evidence-based strategies to improve care. The model depicts a number of patient and healthcare level factors associated with health literacy, several of which have bi-directional or reciprocal relationships, including access and utilization of healthcare, provider-patient interaction, and self-management/adherence. The impact of these factors and their relationships to SOTR outcomes are reviewed. The HeaL-T represents an important step in developing holistic understanding of the complexity of health literacy in SOTRs and offers clinicians a base from which to design strategies to mitigate adverse health effects including increased hospitalizations, graft failure, and mortality.
Collapse
Affiliation(s)
| | - Christina A Spivey
- University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, Memphis, TN, USA
| | - Logan R Pickett
- University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA,
| |
Collapse
|