Patient education in Europe: united differences

[The role of complex patient education program in heart failure care]

Bevezetés: Az Európai Kardiológus Társaság 2021-es Szívelégtelenség Irányelvének tükrében a szívelégtelenségben szenvedő betegek gondozásának kulcsfontosságú része a betegoktatás, többek között az öngondoskodás elemeinek megtanítása, a sürgősségi állapotok felismerésével kapcsolatos ismeretek oktatása. Célkitűzés: Az Intézetünkben zajló komplex szívelégtelenség-betegoktatási program hatásának felmérése a szívelégtelenséggel, öngondoskodással kapcsolatos ismeretekre, illetve azok tartós fennmaradására. Módszer: Az Intézetünk Szívelégtelenség Részlegén szívelégtelenség-tünetegyüttes miatt 2023. 06. 01-jétől hospitalizált betegek körében strukturált betegoktatási programot folytattunk. A betegek és hozzátartozóik egy interaktív előadáson vettek részt azzal a céllal, hogy elsajátítsák a szívelégtelenség fő jellemzőivel, az öngondoskodással, a sürgősségi állapotok felismerésével kapcsolatos ismereteket. Az oktatást megelőzően, közvetlenül az oktatás után, illetve 3 és 6 hónap múlva 11 kérdésből álló, egyszerű választásos kérdőívvel mértük fel a betegek ismereteit. Továbbá vizsgáltuk az öngondoskodással kapcsolatos napi teendők gyakorlásának változását. Eredmények: Vizsgálatunkban a betegoktatási programban részt vevő első 87, szívelégtelenség-tünetegyüttes miatt hospitalizált, konszekutív beteg adatait elemeztük. 76%-uk férfi, mediánéletkoruk 56 (45–64) év volt. Szívelégtelenség miatt korábban 45%-ukat hospitalizálták. Az oktatás hatására a betegek ismeretei szignifikánsan javultak a kérdőíven elért összpontszám alapján (9 [8–10] vs. 11 [11-11] pont, p<0,001; oktatás előtt vs. után). Az ismeretek tartósan, stabilan fennmaradtak (p<0,001) a 3 (9 [8–10] vs. 11 [10–11] pont; oktatás előtt vs. után 3 hónappal) és a 6 hónapos (9 [8–10] vs. 11 [10–11] pont; oktatás előtt vs. után 6 hónappal) utánkövetés során. Az öngondoskodással kapcsolatos napi teendők (vérnyomás-, pulzus-, testsúlymérés, a folyadékbevitelre való odafigyelés) gyakorlása az önbevallás alapján a betegoktatási program hatására szignifikánsan (p<0,001) javult. Következtetés: Eredményeink alapján a szívelégtelenséggel foglalkozó nővér bevonásával végzett strukturált betegoktatási program javítja a betegek szívelégtelenséggel, öngondoskodással kapcsolatos ismereteit, melyek felmérésünk alapján tartósan megmaradtak. Továbbá a betegoktatási program hatására az öngondoskodással kapcsolatos napi teendők gyakorlása jelentősen javult. Mindezek a szívelégtelenség miatti hospitalizáció során végzett betegoktatás jelentőségére hívják fel a figyelmet. Orv Hetil. 2024; 165(37): 1461–1471.

Effects of mind mapping based on standardized patient program in patient education among postgraduate nursing students in clinical setting

BACKGROUND

Patient education as an important process of postgraduate nursing education, however in previous studies there was limited study focus on the improvement of nursing students' patient education in clinical practice.This study examined the effects of a mind mapping based on standardized patient program in the patient education knowledge and communication competence of postgraduate nursing students in clinical setting.

METHODS

The present quasi-experimental study was performed in 2022 on 74 postgraduate nursing students who had taken clinical practice courses at affiliated hospital of Zunyi Medical University. Students were underwent two weeks of mind mapping based on standardized patient program. The outcome measures were patient education knowledge and communication competence evaluated were by the self-designed questionnaire consisting of 6 questions based on the Likert scale and nurse-patient communication competency rating scale respectively, self-efficacy was evaluated by the general self-efficacy scale, and patients' satisfaction were measured using a self-designed question. Data collection was conducted before and after intervention. Data analysis was performed using SPSS 19.0 software, and descriptive statistics and inferential statistics were performed.

RESULTS

Significant improvements in patient education knowledge, patient education communication competence, and self-efficacy (all P = 0.000)were observed after intervention. Improvements were also seen in measures of patients' satisfaction; 12/74 (16.22%) patients reported satisfied at baseline but only 53/74 (71.62%) at the end of intervention.

CONCLUSIONS

A web-based mind maps integrated with standardized patient program could improve patient education knowledge, communication competence,and self-efficacy of postgraduate nursing students in clinical setting.

Integrating Self-Management Education and Support in Routine Care of People With Type 2 Diabetes Mellitus: A Conceptional Model Based on Critical Interpretive Synthesis and A Consensus-Building Participatory Consultation

The integration of self-management education and support into the routine diabetes care is essential in preventing complications. Currently, however, there is no consensus on how to conceptualise integration in relation to self-management education and support. Therefore, this synthesis presents a framework conceptualising integration and self-management.

Methods

Seven electronic databases (Medline, HMIC, PsycINFO, CINAHL, ERIC, Scopus and Web of Science) were searched. Twenty-one articles met the inclusion criteria. Data were synthesised using principles of critical interpretive synthesis to build the conceptual framework. The framework was presented to 49 diabetes specialist nurses working at different levels of care during a multilingual workshop.

Results

A conceptual framework is proposed in which integration is influenced by five interacting components: the programme ethos of the diabetes self-management education and support intervention (content and delivery), care system organisation (the framework in which such interventions are delivered), adapting to context (the aspects of the people receiving and delivering the interventions), interpersonal relationship (the interactions between the deliverer and receiver of the intervention), and shared learning (what deliverer and receiver gain from the interactions). The critical inputs from the workshop participants related to the different priorities given to the components according to their sociolinguistic and educational experiences, Overall, they agreed with the conceptualisation of the components and their content specific to diabetes self-management education and support.

Discussion

Integration was conceptualised in terms of the relational, ethical, learning, contextual adapting, and systemic organisational aspects of the intervention. It remains uncertain which prioritised interactions of components and to what extent these may moderate the integration of self-management education and support into routine care; in turn, the level of integration observed in each of the components may moderate the impact of these interventions, which may also apply to the impact of the professional training.

Conclusion

This synthesis provides a theoretical framework that conceptualises integration in the context of diabetes self-management education and support in routine care. More research is required to evaluate how the components identified in the framework can be addressed in clinical practice to assess whether improvements in self-management education and support can be effectively realised in this population.

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.

Disseminating and assessing implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with patients' perspectives

OBJECTIVES

To explore patients' agreement and reasons for agreement or disagreement with the EULAR recommendations for patient education (PE) for people with inflammatory arthritis (IA).

METHODS

This mixed-method survey collected data using snowball sampling. The survey had been translated into 20 languages by local healthcare professionals, researchers and patient research partners. It explored the degree to which patients with IA agreed with each recommendation for PE (0=do not agree at all and 10=agree completely) and their rationale for their agreement level in free text questions. Descriptive statistics summarised participants' demographics and agreement levels. Qualitative content analysis was used to analyse the free text data. Sixteen subcategories were developed, describing the reasons for agreement or disagreement with the recommendations, which constituted the categories.

RESULTS

The sample comprised 2779 participants (79% female), with a mean (SD) age 55.1 (13.1) years and disease duration 17.1 (13.3) years. Participants strongly agreed with most recommendations (median 10 (IQR: 9-10) for most recommendations). Reasons for agreement with the recommendations included the benefit of using PE to facilitate collaborative care and shared decision making, the value of flexible and tailored PE, and the value of gaining support from other patients. Reasons for disagreement included lack of resources for PE, not wanting information to be tailored by healthcare professionals and a reluctance to use telephone-based PE.

CONCLUSION

The EULAR recommendations for PE have been disseminated among patients with IA. Overall, agreement levels were very high, suggesting that they reflect patients' preferences for engaging in collaborative clinical care and using PE to facilitate and supplement their own understanding of IA. Reasons for not completely agreeing with the recommendations can inform implementation strategies and education of healthcare professionals.

Effectiveness of patient education training on health professional student performance: A systematic review

BACKGROUND

Despite the fundamental role of patient education, concerns have been raised by health professionals, students, and professional bodies regarding student preparation for this area of practice.

OBJECTIVE

To evaluate the effectiveness of patient education training on health professional student performance.

METHOD

A systematic search was performed across PubMed, Cinahl, Embase, and Cochrane Library. Reference and forward citation searches of included articles were conducted. Inclusion criteria were published journal articles from 2010 to 2020 regarding patient education training for health professional students with measures relating to patient education performance. Quality appraisal of individual studies was conducted using Cochrane risk-of-bias v2 or ROBINS-I; overall appraisal was also determined. Sixteen articles met eligibility criteria. Independent data extraction was undertaken.

RESULTS

Fourteen studies reported improvements in student performance following patient education training; two studies reported no significant improvements. Of different modalities examined, simulation-based learning appeared to be most effective.

CONCLUSION

Patient education training enhances health professional students' performance of patient education. Future research is needed to evaluate effectiveness of pedagogically informed interventions across health professions using objective approaches to assess student performance in clinically relevant settings.

PRACTICAL VALUE

This review supports the use of specific training approaches to improve student performance of patient education.

Skills and Practices of European Orthopedic Nurses in Empowering Patient Education

Purpose: This study provides an overview of the self-defined skills and practices of European orthopedic nurses in empowering patient education. Nurses themselves have highlighted the necessity to enhance their own skills, but possibilities for further education have been limited. Methods: The data (n = 317 nurses) from a structured survey were collected during the years 2009–2012 in seven European countries with an EPNURSE—questionnaire (Empowering Patient Education from the point of view of Nurses). Results: Nurses considered patient education as an important part of their work and evaluated their own skills as good. However, their patient education practices were based more on practices on their ward and their own experience than on further education or evidence-based knowledge. On the other hand, lack of time for patient education and experienced overload were the major barriers experienced by nurses. Implications for Practice: Further education of orthopedic nurses in empowering evidence-based patient education is highly needed. Nurse leaders need to acknowledge the strong need for supporting nurses within clinical practice, improve their evidence-based knowledge and support practices that prioritize patient education within the hospital environment. Further international collaboration in nursing research and health-care organizations is desirable to reach these patient educational goals in clinical nursing practice.

Knowledge expectations of orthopaedic patients

AIM

To describe and compare knowledge expectations and received knowledge in elective orthopaedic surgery patients.

BACKGROUND

Population aging, increasing incidence of osteoarthritis, the growing number of surgical procedures, and reduced clinical stays underline the need for a new approach to patient education.

DESIGN

This study has a descriptive, comparative design.

METHODS

Data were collected from 263 patients who had total hip and knee replacement elective surgery during 3 years (2009-2012) in 5 public hospitals in Spain. The Knowledge Expectation of Hospital Patients and the Received Knowledge of Hospital Patients Scales were used to collect data. The questionnaires were filled before hospital admission, at discharge and at follow-up 6 to 7 months later.

RESULTS

Surgical patients received less knowledge than they expected. Patients' expectations were only met in the functional dimension. At follow-up, patients reported that they perceived having acquired more knowledge during their hospital stay than they reported at the time of discharge. Knowledge expectations and knowledge received were related to employment status, gender, and previous contact experience with the hospital.

CONCLUSION

Knowledge expectations were not met, and results showed the need to improve education for orthopaedic patients throughout the perioperative process, not only during hospitalization.

Patients' learning and understanding during their breast cancer trajectory

OBJECTIVE

To explore how women learn and understand their disease, treatment, care, and life-situation during a breast cancer trajectory.

METHOD

Semi-structured individual interviews were performed with 16 women suffering from breast cancer. Qualitative content analysis of data was performed.

RESULTS

Three themes describe the women's learning; Interacting with a diversity of information: women interact with a vast amount of information, including perceptions of bodily sensations and events. Concealed and expressed understandings: women interpret information that results in understanding which is either concealed or expressed. Struggling to understand and manage the new life situation: pre-understanding, driving forces to learn, contemplation and dialogue with healthcare staff influence the women's learning.

CONCLUSIONS

General theories of learning are applicable to learning during a breast cancer trajectory. Significant features of learning during a life-threatening illness are strong personal drivers to understand and deal with all that occurs. Vulnerability remains a challenge in developing understanding as a cancer diagnosis infers uncertainty.

PRACTICAL IMPLICATIONS

Patients need time to assimilate and process complex bodies of information in dialogue with health care staff. Patients' understanding needs to be assessed and pedagogical competence in the interprofessional team is assumed to facilitate patients' learning and participation in treatment and care.

Patients with heart failure as co-designers of an educational website: implications for medical education

OBJECTIVES

To identify the learning needs of patients with heart failure between outpatients follow-up visits from their perspective and to ascertain what they emphasize as being important in the design of an educational website for them.

METHODS

We conducted a two-step qualitative study at Aarhus University Hospital, Denmark. Twenty patients with heart failure participated either in focus group interviews, diary writing, or video-recorded design sessions. Data on learning needs were collected in step 1 and analyses, therefore, helped develop the preliminary prototypes of a website. In step 2, patients worked on the prototypes in video-recorded design sessions, employing a think-aloud method. The interviews were transcribed and a content analysis was performed on the text and video data.

RESULTS

Patients' learning needs were multifaceted, driven by anxiety, arising from, and often influenced by, such daily situations and contexts as the medical condition, medication, challenges in daily life, and where to get support and how to manage their self-care. They emphasized different ways of adapting the design to the patient group to enable interaction with peers and professionals and specific interface issues.

CONCLUSIONS

This study provided insights into the different learning needs of patients with heart failure, how managing daily situations is the starting point for these needs and how emotions play a part in patients' learning. Moreover, it showed how patient co-designers proved to be useful for understanding how to design a website that supports patients' learning: insights, which may become important in designing online learning tools for patients.

Educating Nurses and Patients to Manage Heart Failure

Patient education is an important component in the management of patients with heart failure and nurses are increasingly involved in this area. This paper reviews the literature on education to patients with heart failure and the education and training for heart failure nurses. Patients with heart failure need education in order to adapt to their chronic syndrome and perform self-care. The education process often starts during the hospital admission, but must continue in the outpatient setting. Nurses need to be skilled in assessing the requirements and level of the education given to the individual. Computer-based education has been found to be a preferred and effective compliment to the education provided by health care professionals. The effect of new materials and methods needs to be evaluated in order to improve the overall effectiveness of the education provided. The patient with heart failure should have an active role in this development and evaluation. The heart failure nurse needs to be experienced in cardiac care, have an ability to work independently in order to be delegated responsibilities such as drug titration and patient assessment. This requires optimal experience, training and education for advanced practice. In order to develop and evaluate the education of patients with heart failure and the overall effectiveness of heart failure nurses in this regard, national and international collaborations are needed.

Improving Diabetes Knowledge and Self-Care Practices

BACKGROUND

This study sought to identify the nature and extent of diabetes-related knowledge and self-care practices in people living with type 2 diabetes who attend primary-care clinics and to determine whether a correlation between the two exists.

METHODS

In a nonexperimental prospective study, the Diabetes Knowledge Questionnaire and the Summary of Diabetes Self-care Activities were used to assess knowledge and self-management in 50 patients.

RESULTS

The mean diabetes knowledge score was 14.40 out of a total of 24 and the mean self-care activities score was 2.89 out of a total of 7, indicating a deficit in a number of key areas in the management of diabetes. There was no statistically significant correlation between diabetes knowledge score and diabetes self-care activities (r = 0.190, P = 0.187). On analysis of the individual subscales, a significant relationship resulted between diabetes knowledge score and diet (r = 0.324, P = 0.022) but physical activity (r = 0.179, P = 0.214), blood sugar testing (r = 0.231, P = 0.107) and footcare (r = 0.189, P = 0.189) gave no significant results. On further analysis, education level was significantly correlated to diabetes knowledge score (r = 0.374, P = 0.007) and self-care activities score (r = 0.317, P = 0.025) while age was significantly correlated to diabetes knowledge score (P = 0.008) and self-care activities score (P = 0.035).

CONCLUSIONS

Integrating theories of behavior change into educational interventions at the primary-care level may translate to improved care, reduced long-term complications, and better quality of life.

Patient education among nurses: bringing evidence into clinical applicability in Iran

OBJECTIVE

The aim of this study was to present a comprehensive review of the literatures describing barriers and facilitators of patient education (PE) perceived by Iranian nurses in order to explain clinical applicability of patient education.

METHODS

Review of the literature was undertaken using the international databases including PubMed/Medline, Scopus, ScienceDirect, as well as Google Scholar. Also, Persian electronic databases such as Magiran, SID and IranMedex were searched. Electronic databases were searched up from conception to September 2014 using search terms: "patient education", " patients education", "patient teaching", "patient training", "nurse", " nurses", " nursing", " and "Iran". Only studies were included that were related to barriers and facilitators of PE among Iranian nurses.

RESULTS

Twenty-seven studies were included. The main influential barriers were categorized into three major areas: 1) Nurse-related factors: nursing shortage 2) Administration-related factors: unsupportive organizational culture, and 3) Patient-related factors: low compliance. The most perceived facilitators were recognized as "increasing, selecting and training special nurses for providing PE" and "providing PE courses for nurses and appropriate facilities for PE".

CONCLUSION

Iranian nurses encounter barriers in PE, and the most frequently encountered barriers were related to administration factors. These findings have implications for administrators and managers in health settings. In order to promote PE among nurses, administrators should create a supportive environment and use effective strategies to smooth the progress of PE by nurses in their practice in order to ensure optimal outcomes for patients.

Chronically ill patients’ expectations of therapeutic education and their health locus of control

<b>Background</b><br /> Beliefs as cognitive components of personality indicate what we consider as true or false and help us to answer questions concerning others, the world surrounding us and situations that we encounter. Beliefs about the health locus of control and their relations with expectations pertaining to therapeutic education seem to be of vital importance in the case of occurrence of a chronic illness.<br /> The aim of this paper is to verify whether expectations concerning therapeutic education in chronically ill patients demonstrate a relation with beliefs about the health locus of control and whether they vary according to gender, age and health, and to present the results of research that applies the Polish OE-15 scale for the evaluation of therapeutic education expectations depending on the health condition.<br /> <br /> <b>Participants and procedure</b><br /> Two hundred and ninety-one persons were examined, including 180 patients and 111 healthy controls (the control group), 187 women and 104 men. The average age of subjects was 45.71 (SD = 13.51) years, ranging from 21 to 80 years.<br /> The OE-15 Therapeutic Education Expectations Scale and the Multidimensional Health Locus of Control Scale in versions relevant for patients and healthy controls as well as demographics were used.<br /> <br /> <b>Results</b><br /> Age, gender and beliefs about the health locus of control are related to expectations of therapeutic education.<br /> <br /> <b>Conclusions</b><br /> When providing therapeutic education for chronically ill patients, one should assess their expectations and pay attention to patients’ beliefs about the health locus of control.

Experiences of registered nurses with regard to accessing health information at the point-of-care via mobile computing devices

Background

The volume of health information necessary to provide competent health care today has become overwhelming. Mobile computing devices are fast becoming an essential clinical tool for accessing health information at the point-of-care of patients.

Objectives

This study explored and described how registered nurses experienced accessing information at the point-of-care via mobile computing devices (MCDs).

Method

A qualitative, exploratory, descriptive and contextual design was used. Ten in–depth interviews were conducted with purposively sampled registered nurses employed by a state hospital in the Nelson Mandela Bay Municipality (NMBM). Interviews were recorded, transcribed verbatim and analysed using Tesch's data analysis technique. Ethical principles were adhered to throughout the study. Guba's model of trustworthiness was used to confirm integrity of the study.

Results

Four themes emerged which revealed that the registered nurses benefited from the training they received by enabling them to develop, and improve, their computer literacy levels. Emphasis was placed on the benefits that the accessed information had for educational purposes for patients and the public, for colleagues and students. Furthermore the ability to access information at the point-of-care was considered by registered nurses as valuable to improve patient care because of the wide range of accurate and readily accessible information available via the mobile computing device.

Conclusion

The registered nurses in this study felt that being able to access information at the point-of-care increased their confidence and facilitated the provision of quality care because it assisted them in being accurate and sure of what they were doing.

Babies' portal website hearing aid section: assessment by audiologists

Introduction The family has ultimate responsibility for decisions about the use and care during the daily routine and problem solving in the manipulation of hearing aids (HA) in infants and children.

Objective The purpose of the study was to assess technical and content quality of Babies' Portal website Hearing Aid section by audiologists.

Methods Letters and e-mails were sent inviting professionals to surf the website and anonymously fill out an online form with 58 questions covering demographic data as well as the website's technical (Emory questionnaire with the subscales of accuracy, authorship, updates, public, navigation, links, and structure) and content quality.

Results A total of 109 professionals (tree men and 106 women) with mean age of 31.6 years participated in the study. Emory percentage scores ranged from 90.1 to 96.7%. The Hearing Aid section contents were considered good or very good.

Conclusion The website was deemed to have good technical and content quality, being suitable to supplement informational counseling to parents of hearing-impaired children fitted with hearing aids.

EULAR recommendations for patient education for people with inflammatory arthritis

Objectives

The task force aimed to: (1) develop evidence-based recommendations for patient education (PE) for people with inflammatory arthritis, (2) identify the need for further research on PE and (3) determine health professionals’ educational needs in order to provide evidence-based PE.

Methods

A multidisciplinary task force, representing 10 European countries, formulated a definition for PE and 10 research questions that guided a systematic literature review (SLR). The results from the SLR were discussed and used as a basis for developing the recommendations, a research agenda and an educational agenda. The recommendations were categorised according to level and strength of evidence graded from A (highest) to D (lowest). Task force members rated their agreement with each recommendation from 0 (total disagreement) to 10 (total agreement).

Results

Based on the SLR and expert opinions, eight recommendations were developed, four with strength A evidence. The recommendations addressed when and by whom PE should be offered, modes and methods of delivery, theoretical framework, outcomes and evaluation. A high level of agreement was achieved for all recommendations (mean range 9.4–9.8). The task force proposed a research agenda and an educational agenda.

Conclusions

The eight evidence-based and expert opinion-based recommendations for PE for people with inflammatory arthritis are intended to provide a core framework for the delivery of PE and training for health professionals in delivering PE across Europe.

Iranian nurses and nursing students' attitudes on barriers and facilitators to patient education: a survey study

The aim of this study is to describe the attitudes of Iranian nurses and students on barriers and facilitators to patient education. In this descriptive quantitative study, 103 nurses and 84 nursing students in two teaching hospitals in an urban area of Iran responded to a questionnaire investigating their attitudes on patient education. Results showed that all nurses and the majority (87.3%) of the students mentioned that they performed patient education. Moreover, 95% and 63.3% of the nurses and students respectively accepted that patient education was one of their roles. The nurses stated that heavy workload, inadequate time and lack of educational facilities were main barriers to patient education. The students believed that lack of knowledge, lack of communication skills and heavy workload were main barriers to patient education from their perspectives. While Iranian nurses and nursing students had positive attitudes towards patient education, it could not guarantee the implementation of patient education. Therefore, the clarification of patient education activities and development of a patient education team with the support of healthcare settings' administrators can facilitate the process of patient education in the Iranian healthcare settings.

Knowledge expectations of surgical orthopaedic patients: a European survey

Ageing population entails a growing international problem of osteoarthritis. Best practices for education of these patients are lacking. This study focused on empowering education in Northern (Finland, Iceland, Lithuania and Sweden) and Southern Europe (Cyprus, Greece and Spain). The aim was to analyse associations between expected knowledge and background factors. The data were collected from European arthroplasty patients with the Knowledge Expectations of hospital patients- scale, (KE(hp) - scale), including bio-physiological, functional, experiential, ethical, social and financial dimensions. Patients had essential bio-physiological and functional knowledge expectations. Women expected more than men, employed less than retired, unemployed or who worked at home. Generally, patients in Northern countries expected more than in Southern countries. However, highest expectations were found in Sweden and Greece, lowest in Spain and Cyprus. There are differences in knowledge expectations based on patients' backgrounds. Development of common standards in European patient education needs further research.

Importance of therapeutic patient education in ichthyosis: results of a prospective single reference center study

BACKGROUND

Ichthyoses are a heterogeneous group of rare genodermatoses. Patients and their families face difficulties related to daily care and management that may be aggravated by social isolation.

OBJECTIVES

To evaluate the impact of therapeutic educational programs in improving the knowledge of ichthyosis patients, and their relatives, about their disease.

PATIENTS AND METHODS

We organized a two sessions-program of "know-how" dedicated to the overall management of ichthyoses. These sessions were conducted based on a tool specifically designed for the study, which addressed our various areas of expertise through a collective game. The participants (patients and their parents and siblings) were divided into groups, and the questions were tailored according to the participants' age. The program was conceived as a knowledge reinforcement program that took place during a weekend of education and rest, organized away from healthcare structures. Our aim was to facilitate the program in a neutral place to encourage respite care and to ensure the availability of a multidisciplinary healthcare team.

RESULTS

After the reinforcement session, children aged from 6 to 12 years and their families acquired the targeted know-how and social skills.

CONCLUSION

Benefits of TPE in the management of ichthyoses are the following: (1) the trust between patients their families and the caregivers was strengthened; (2) the context of the program encouraged self-expression, answered questions and provided mutual aid; and (3) the more self-sufficient families could better manage emergencies.

A history of patient education by health professionals in Europe and North America: from authority to shared decision making education

OBJECTIVE

This paper describes the development of patient education from the 1960s until now and identifies future challenges to improve patient education.

RESULTS

Patient education developed from the health care professional deciding what the patient needed to know to a shared decision making design where physician and patient are equally influential on the decision making process. The development of patient education is described for primary and secondary health care, as well as the impact of biomedical advances, an ageing population and cultural diversity on patient education. Some of the challenges for future patient education are identified: training health professionals as well as patients, involvement of the patient's social environment and application of e-Health techniques to patient education.

CONCLUSION

Patient education has made several developmental changes, has spread to different settings in health care and has now finally established itself as a valuable part of health care for patients. Nevertheless, both patients and health professionals still need to be provided with skills to optimize patient education. A good science-practice fit for future interventions to facilitate patient education is paramount.

PRACTICE IMPLICATION

Lessons from the past of patient education are important for the growth and future development of patient education.

Type 2 diabetic patients' experiences of two different educational approaches--a qualitative study

OBJECTIVE

The aim of the current study was to explore patients' experiences of participating in an empowerment group education programme or receiving individual counselling.

METHOD

In total, 28 patients from seven primary care centres were interviewed. Of these, 14 had received individual counselling and the remaining 14 had also participated in 4-5 empowerment group sessions. The semi-structured interviews were tape-recorded, transcribed verbatim and analysed using qualitative content analysis.

FINDINGS

Three main categories crystallized from the interviews: (I) relationships, (II) learning and (III) controlling the disease. The relationships in the individual counselling seemed vertical, characterized by one-way communication with care providers acting as superiors and patients as subordinates. The relationships in the empowerment group appeared to be horizontal, characterized by trust and mutual communication. Those who had received individual counselling talked about learning by compliance--care providers acted as superiors, giving advice they expected the patients to follow. In the empowerment groups the patients talked more about participatory learning, whereby the facilitators and patients shared their knowledge and experiences. Controlling the disease could be labelled external in individual counselling, which made it difficult for patients to take responsibility for and control of their diabetes self-care. On the contrary, the patients in the empowerment group achieved the insight that diabetes is a serious disease but can be influenced, which contributed to their experience of self-control.

CONCLUSIONS

The current study indicates that vertical relationships, learning by compliance and external control seem to limit patients' ability to take responsibility for their disease, while horizontal relationships, participatory learning and self-control may contribute to strengthening patients' ability to influence and be actively involved in their own care.

Self-monitoring of blood glucose--psychological aspects relevant to changes in HbA1c in type 2 diabetic patients treated with diet or diet plus oral antidiabetic medication

OBJECTIVE

To investigate the influence of psychological aspects on glycemic control in type 2 diabetic patients treated with diet alone or diet plus oral antidiabetic medication using meal-related self-monitoring of blood glucose (SMBG). These psychological aspects refer to the process of self-management including the tendency to structure situations and activate resources (self-perception), to accept options for action (self-reflection) and to believe in self-efficacy (self-regulation).

METHODS

In a randomized controlled 6-month group comparison study, one group (n = 113; mean age 58.7 years) used a blood glucose monitoring device, kept a blood glucose/eating diary and received standardized counseling focusing on self-perception, self-reflection and self-regulation. A control group (n = 110; mean age 60.5 years) received non-standardized counseling on diet and lifestyle.

RESULTS

Statistically significant endpoint differences between the SMBG and the control group were seen in glycemic control (p = 0.0086) and the well-being item 'depression' (p = 0.032). All aspects of counseling were influenced by SMBG with the extent of self-perception and self-reflection gradually increasing over time. Three HbA1c response types were identified among SMBG patients: continuous-achievers, late-achievers and non-achievers.

CONCLUSION

This study identified processes (structuring the situation and activating resources, accepting options for action and believing in self-efficacy) which lead to a change in the metabolic profile. SMBG coupled with structured counseling provided patients with a tool for taking on more self-control and resulted in an improved outlook on life.

PRACTICE IMPLICATIONS

This short-term intervention involved a structured counseling algorithm which requires 5-10 min of physician-patient contact and a structured documentation of metabolic control by the patient and can be taught by a diabetes training team within 4 h. The identification of the different response types might be of importance in clinical practice as it enables the physician to determine the right counseling option.

The crucial role of patient education in heart failure

BACKGROUND

Deterioration of heart failure causes and complicates many hospital admissions in people aged over 65 years. Frequent readmissions cause an immense burden on the individual, the family and the health care system. Heart failure management programmes, in which patient education is an important component, have been shown to be effective in improving self-care and reducing readmissions.

AIM

This paper reviews the literature on the education of patients with heart failure. The paper addresses the level of knowledge in patients with heart failure, barriers to learning, learning needs, educational methods, goals and how the effects of patient education can be evaluated.

CONCLUSION

Many patients had low levels of knowledge and lacked a clear understanding of heart failure and self-care. Educational interventions need to be designed specifically for elderly patients and need to target barriers to learning such as functional and cognitive limitations, misconceptions, low motivation and self-esteem. Health care professionals need to be skilled in assessing the requirements and level of education given to the individual. New technologies such as computer-based education and telemonitoring can be used as tools to improve the education. Patient education is an important component of heart failure care and should be provided through effective and well-evaluated strategies.

Patient education in nursing-Polish literature condition

The aim of the review is to present the results of an analysis and evaluation of the state of research on patient education based on the Polish nursing literature. A review and analysis of 139 research works was carried out, which during the years of 1990-2001 appeared in Polish nursing journals as well as in post-conference and convention proceedings and reports. The collected material was evaluated according to the following criteria: defining the research problem, defining and operationalising the variables studied, the research tool applied, the research method used, the size and selection of the research sample, the results achieved. The analysis of research works carried out in the area of patient education became the basis of the objective knowledge of the current state of research and its relation to the nursing practice in this area.