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Elkefi S. Supporting patients' workload through wearable devices and mobile health applications, a systematic literature review. ERGONOMICS 2024; 67:954-970. [PMID: 37830977 DOI: 10.1080/00140139.2023.2270780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 08/25/2023] [Indexed: 10/14/2023]
Abstract
Patients face a challenging workload in their course of care. In this study, we investigate the impact of using mobile health technologies in supporting this workload and identify the system challenges of its application through a systematic review of the literature published in the last two decades following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Reviews and Meta-Analysis guidelines PRISMA guidelines. Twenty-two studies that satisfied the inclusion criteria were included. The review revealed various mobile health and wearable devices used to support mental demand, physical demand, frustration, and performance. Better outcomes were related to mobile health use in healthcare for patients in different settings. There were no applications of health that supported the temporal demand of patients. Some populations, such as cancer patients, need more than only physical demand. Mhealth devices are important in supporting the patients' workload in their daily activities and clinical settings.Practitioner summary: This review study shows the importance of mHealth and wearables in supporting patients' workload (physical, mental, emotional) but not the temporal load.
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Affiliation(s)
- Safa Elkefi
- Nursing School, Columbia University, New York, NY, USA
- HPHACTORS Lab, NYC, USA
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2
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Karschuck P, Müller L, Groeben C, Aksoy C, Flegar L, Zacharis A, Baunacke M, Wülfing C, Huber J. [Patient events in German urology: trend towards hybrid formats?]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:75-82. [PMID: 37566223 DOI: 10.1007/s00120-023-02162-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Patient events are an important tool to respond to the increasing need of the public for health information. Through the "patient forum", the German Society of Urology (DGU) is committed to patient information and public relations at its annual congresses. The goal of the study was to evaluate the events from 2017-2019 and to compare them with the first digital patient forum in 2020. MATERIALS AND METHODS Using a two-page standardized questionnaire, we surveyed the visitors of the presence patient forums (presence group = P) of the three annual congresses of the DGU 2017-2019 as well as the users of the digital event 2020 (online group = O). RESULTS We obtained 71 records for 2017-2019 and 18 for 2020. The median age of visitors was 64 years (range 30-89). Males were 66% (P) vs. 83% (O) of participants (p = 0.005). The offer was rated overall as good to very good by both groups, i.e., 1.6 (P) vs. 1.6 (O; p = 0.7) on a scale from 1 to 6 with 1 being the highest rating. In line with the lower interaction in the digital format, the possibility to ask questions was rated worse with 1.5 (P) vs. 2.8 (O; p = 0.003). When asked about the desired future event format, two-thirds of the users of the digital patient forum were in favor of a hybrid event on-site and online. CONCLUSION Patient events are suitable means of communication for the public and are rated well by visitors. In particular, interaction with experts is highly valued. Face-to-face formats are associated with a high logistical effort and high costs, and their reach is limited. In the future, hybrid formats could be a reasonable alternative, as they combine the advantages of online and face-to-face formats.
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Affiliation(s)
- Philipp Karschuck
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland.
| | - Laura Müller
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Christer Groeben
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Cem Aksoy
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Luka Flegar
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Aristeidis Zacharis
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Martin Baunacke
- Klinik und Poliklinik für Urologie, Technische Universität Dresden, Dresden, Deutschland
| | | | - Johannes Huber
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
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Beales D, Ho YK, Lewin J, Loh BWQ, Yusof AB, Grieve S, Ranelli S, Holthouse D, Mitchell T, Slater H. Participatory design of an infographic to help support the care of people living with complex regional pain syndrome. Br J Pain 2023; 17:519-531. [PMID: 37969133 PMCID: PMC10642498 DOI: 10.1177/20494637231190587] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
Background Complex regional pain syndrome (CRPS) can be a debilitating pain condition with enduring physical, psychological and social impacts. CRPS is often poorly understood by healthcare professionals and management needs to be tailored to each individual's presentation. People with lived experience express difficulty in accessing reliable and meaningful information about the condition. This study aimed to co-create a trustworthy infographic to share information about the lived experience of CRPS. Methods We adopted a seven-phase, iterative, participatory methodology to co-create the infographic. Potential infographic content was obtained from qualitative work investigating the lived experience of CRPS. Online consumer engagement (people with doctor diagnosed CRPS/their family, n=20) was used to prioritise content to be included in the infographic and then potential designs were sourced. The research team narrowed the selections down to two designs which were presented to consumers online for final selection (n=25) and refinement (n=34). Results An infographic for understanding the lived experience of CRPS was completed using participatory design, providing a resource aligned to the needs of people with this condition. Using the Patient Education Materials Assessment Tool, the final infographic rated highly for understandability (92%) and participants indicated significant willingness to share this infographic with others (93%). Conclusion A process of participatory design was an effective and efficient process for translation of evidence gathered from qualitative research into a trustworthy resource for people with CRPS and their support people.
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Affiliation(s)
- Darren Beales
- Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Yi Ki Ho
- Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - James Lewin
- Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Bianca Wen-Qi Loh
- Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Amirah Binte Yusof
- Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Sharon Grieve
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
| | - Sonia Ranelli
- Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | | | | | - Helen Slater
- Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA, Australia
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Pienkowska A, Ang CS, Mammadova M, Mahadzir MDA, Car J. A Diabetes Education App for People Living With Type 2 Diabetes: Co-Design Study. JMIR Form Res 2023; 7:e45490. [PMID: 37721799 PMCID: PMC10546275 DOI: 10.2196/45490] [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: 01/04/2023] [Revised: 06/30/2023] [Accepted: 07/19/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is a growing global health concern, including in Singapore. Diabetes education programs have been shown to be effective in improving health outcomes and diabetes self-management skills. Mobile health apps have emerged as useful tools for diabetes education; however, their use and acceptance by the target population remain inconsistent. Therefore, end-user participation in the design and development of a mobile health app is crucial for designing an acceptable app that can improve outcomes for populations with a chronic disease. OBJECTIVE The objective of this study was to apply an end-user participatory approach to co-design a diabetes education app prototype for people living with T2D by exploring their perceptions, acceptance, and usability of an app prototype, as well as their diabetes experience and perspectives on digital diabetes education. METHODS A total of 8 people with T2D, who were recruited from diabetes management Facebook groups, participated in 4 web-based surveys via Qualtrics and 2 structured interviews via Zoom (Zoom Video Communications, Inc) between August 20, 2021, and January 28, 2022. Descriptive statistics and thematic analyses of the discussion and iterative feedback on the app prototype were used to assess the participants' perceptions of living with T2D, attitudes toward digital diabetes education, and acceptance of the prototype. RESULTS Analyses of the surveys and interview data revealed 3 themes: challenges of living with T2D; validation, acceptability, and usability of the diabetes education app prototype; and perspectives on digital diabetes education. In the first theme, participants highlighted the importance of solitary accountability, translating knowledge into practice, and developing pragmatic self-consciousness. The second theme indicated that the diabetes education app prototype was acceptable, with information and appearance being key; revealed ambivalent and polarized opinions toward the chatbot; and confirmed potential impact of the app on diabetes self-management skills and practice. The third theme comprised the necessity of using a variety of information-seeking strategies and recommendations for desired content and app qualities, including accessibility, adaptability, autonomy, evidence-based design and content, gamification, guidance, integration, personalization, and up-to-date content. The findings were used to reiterate the app design. CONCLUSIONS Despite a small sample size, the study demonstrated the feasibility of engaging and empowering people living with T2D to consider digital therapeutics for diabetes self-management skills and practice. Participants gave rather positive feedback on the design and content of the app prototype, with some recommendations for improvements. The findings suggest that incorporating end-user feedback into app design can lead to the creation of feasible and acceptable tools for diabetes education, potentially improving outcomes for populations with a chronic disease. Further research is needed to test the impact of the refined diabetes education app prototype on diabetes self-management skills and practice and quality of life.
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Affiliation(s)
- Anita Pienkowska
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Chin-Siang Ang
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Maleyka Mammadova
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Muhammad Daniel Azlan Mahadzir
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Stewart TA, Perrin EM, Yin HS. Addressing Health Literacy in Pediatric Practice: A Health Equity Lens. Pediatr Clin North Am 2023; 70:745-760. [PMID: 37422312 DOI: 10.1016/j.pcl.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
Low health literacy has been linked to worse child health-related knowledge, behaviors, and outcomes across multiple health domains. As low health literacy is highly prevalent and an important mediator of income- and race/ethnicity-associated disparities, provider adoption of health literacy best practices advances health equity. A multidisciplinary effort involving all providers engaged in communication with families should include a universal precautions approach, with clear communication strategies employed with all patients, and advocacy for health system change.
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Affiliation(s)
- Tiffany A Stewart
- Department of Pediatrics, New York University Grossman School of Medicine / Bellevue Hospital Center, 550 First Avenue, NBV 8S4-11, New York, NY 10016, USA
| | - Eliana M Perrin
- Department of Pediatrics, Johns Hopkins School of Medicine / School of Nursing, 200 North Wolfe Street, Rubenstein Building 2071, Baltimore, MD 21287, USA
| | - Hsiang Shonna Yin
- Department of Pediatrics, New York University Grossman School of Medicine / Bellevue Hospital Center, 550 First Avenue, NBV 8S4-11, New York, NY 10016, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
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Lawrie K, Giannopoulos E, Papadakos T, Addiss F, Christensen S, Cunningham L, Foster J, Mulato L, Siegel R, Sullivan C, Tanha J, Papadakos J. Impact of the COVID-19 Pandemic on Cancer Patient Educators. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:545-551. [PMID: 35233754 PMCID: PMC8888025 DOI: 10.1007/s13187-022-02151-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 05/20/2023]
Abstract
Patient education (PE) is vital in reducing anxiety, increasing satisfaction with treatment, helping with self-management, and creating a sense of control for cancer patients. Patients access much of their material from health care providers through in-person visits, patient libraries, and in-person classes. Due to reductions in in-person visits throughout the pandemic, we sought to understand how PE programs responded under varying levels of COVID-19 restrictions to meet the information needs of patients and families. A cross-sectional survey was distributed to members of the Cancer Patient Education Network (CPEN) and the Health Care Education Association (HCEA) via the respective listservs. The survey consisted of five sections that included closed and opened questions. Participants were asked questions to describe their PE programs and how their duties were affected during the pandemic. Forty-two CPEN members completed the survey (N = 42, 66%) with a 35% response rate and a 55% completion rate, and 19 HCEA members completed the survey (N = 19, 30%) with a 5% response rate and 16% completion rate. The majority of staff surveyed were not furloughed (N = 57/64, 89%). Just under half reported a change in daily PE program activities (N = 23/52, 44%) and most reported a change in developing PE materials (e.g., pamphlets) (N = 10/26, 63%), finding information for patients/families (N = 11/19, 58%), and delivering classes (N = 12/21, 57%). COVID-19 has ushered in a new era in the delivery of PE with the rapid deployment of digital cancer patient education. Results can inform future directions for the delivery of PE post-pandemic.
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Affiliation(s)
- Karen Lawrie
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Eleni Giannopoulos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Tina Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Patient Education, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Faith Addiss
- Roswell Park Cancer Center, Patient Education, Buffalo, NY, USA
| | - Sarah Christensen
- Patient Education Department, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Jackie Foster
- National Marrow Donor Program/Be The Match, Patient Services, Minneapolis, MN, USA
| | | | | | | | - Jila Tanha
- Patient Education Department, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
- Patient Education, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Rau NM, Mcintosh JJ, Flynn KE, Szabo A, Ahamed SI, Asan O, Hasan MK, Basir MA. Multimedia tablet or paper handout to supplement counseling during preterm birth hospitalization. Am J Obstet Gynecol MFM 2023; 5:100875. [PMID: 36708966 DOI: 10.1016/j.ajogmf.2023.100875] [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: 11/07/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND Parents of premature infants engage in shared decision-making regarding the care of their infant. The process of prenatal counseling typically involves a verbal conversation with a neonatal provider during hospitalization. Support people may not be available, and the pregnant person's memory is impaired by medications, pain, and stress. The American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development have called for improvements to this process, including the development of educational aids. OBJECTIVE This study aimed to investigate whether a multimedia tablet would be more effective than a paper handout in supplementing verbal clinician counseling during preterm birth hospitalization. STUDY DESIGN This was a randomized controlled trial including English-speaking pregnant people aged ≥18 years and hospitalized at 22 to 33 weeks' gestation for preterm birth. Exclusion criteria were known fetal or chromosomal anomaly and delivery before study completion. Pregnant people received either a multimedia tablet or a paper handout before verbal clinician counseling. Preintervention assessment included demographics and State-Trait Anxiety Inventory, and postintervention assessment included the Parent Knowledge of Premature Birth Questionnaire and State-Trait Anxiety Inventory. Continuous variables were analyzed by t-test and categorical variables by Fisher exact test. RESULTS A total of 122 pregnant people referred for counseling were screened; 76 were randomized, and 59 completed the study. Demographics were similar between groups, except that pregnant people in the handout group were older (mean 32 vs 29 years; P=.03). The multimedia tablet group (n=32) was less likely to report reviewing all the educational material than the paper handout group (n=27) (41% vs 72%; P=.037). Both groups correctly answered a similar number of knowledge items (P=.088). Postintervention state anxiety decreased in both groups (P<.0001), with no difference between groups. Computerized tracking showed that the multimedia group spent a median of 37 minutes reviewing the tablet. CONCLUSION Contrary to our hypothesis, a paper handout and multimedia tablet were equally effective in the labor unit for supplementing verbal preterm birth counseling, and both decreased parental anxiety.
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Affiliation(s)
- Nicole M Rau
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI (Drs Rau and Basir)
| | - Jennifer J Mcintosh
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI (Dr Mcintosh)
| | - Kathryn E Flynn
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI (Drs Flynn and Asan)
| | - Aniko Szabo
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Dr Szabo)
| | - Sheikh Iqbal Ahamed
- Department of Computer Science, Marquette University, Milwaukee, WI (Drs Ahamed and Hasan)
| | - Onur Asan
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI (Drs Flynn and Asan)
| | - Md Kamrul Hasan
- Department of Computer Science, Marquette University, Milwaukee, WI (Drs Ahamed and Hasan)
| | - Mir A Basir
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI (Drs Rau and Basir).
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Szeto SG, Wan H, Alavinia M, Dukelow S, MacNeill H. Effect of mobile application types on stroke rehabilitation: a systematic review. J Neuroeng Rehabil 2023; 20:12. [PMID: 36694257 PMCID: PMC9872745 DOI: 10.1186/s12984-023-01124-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 01/07/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Stroke is a significant contributor of worldwide disability and morbidity with substantial economic consequences. Rehabilitation is a vital component of stroke recovery, but inpatient stroke rehabilitation programs can struggle to meet the recommended hours of therapy per day outlined by the Canadian Stroke Best Practices and American Heart Association. Mobile applications (apps) are an emerging technology which may help bridge this deficit, however this area is understudied. The purpose of this study is to review the effect of mobile apps for stroke rehabilitation on stroke impairments and functional outcomes. Specifically, this paper will delve into the impact of varying mobile app types on stroke rehabilitation. METHODS This systematic review included 29 studies: 11 randomized control trials and 18 quasi-experimental studies. Data extrapolation mapped 5 mobile app types (therapy apps, education apps, rehab videos, reminders, and a combination of rehab videos with reminders) to stroke deficits (motor paresis, aphasia, neglect), adherence to exercise, activities of daily living (ADLs), quality of life, secondary stroke prevention, and depression and anxiety. RESULTS There were multiple studies supporting the use of therapy apps for motor paresis or aphasia, rehab videos for exercise adherence, and reminders for exercise adherence. For permutations involving other app types with stroke deficits or functional outcomes (adherence to exercise, ADLs, quality of life, secondary stroke prevention, depression and anxiety), the results were either non-significant or limited by a paucity of studies. CONCLUSION Mobile apps demonstrate potential to assist with stroke recovery and augment face to face rehabilitation, however, development of a mobile app should be carefully planned when targeting specific stroke deficits or functional outcomes. This study found that mobile app types which mimicked principles of effective face-to-face therapy (massed practice, task-specific practice, goal-oriented practice, multisensory stimulation, rhythmic cueing, feedback, social interaction, and constraint-induced therapy) and education (interactivity, feedback, repetition, practice exercises, social learning) had the greatest benefits. Protocol registration PROPSERO (ID CRD42021186534). Registered 21 February 2021.
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Affiliation(s)
- Stephen G. Szeto
- grid.17063.330000 0001 2157 2938Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada ,grid.231844.80000 0004 0474 0428UHN Toronto Rehab Institute, 550 University Avenue, Toronto, ON M5G 2A2 Canada
| | - Hoyee Wan
- grid.17063.330000 0001 2157 2938Division of Plastic, Reconstructive, and Aesthetic Surgery, University of Toronto, Toronto, Canada
| | - Mohammad Alavinia
- grid.17063.330000 0001 2157 2938Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada
| | - Sean Dukelow
- grid.22072.350000 0004 1936 7697Division of Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Heather MacNeill
- grid.17063.330000 0001 2157 2938Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada ,grid.492573.e0000 0004 6477 6457Physical Medicine & Rehabilitation, Hennick Bridgepoint Hospital, Sinai Health System, Toronto, Canada
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Nwanaji-Enwerem JC, Smith-Wilkerson M, Gordon B, Okpere H, Jones T, Gizaw R, Husain I. Universal Precautions Plus: Physician-Directed Strategies for Improving Patient Health Literacy in the Emergency Department. West J Emerg Med 2023; 24:110-113. [PMID: 36602487 PMCID: PMC9897242 DOI: 10.5811/westjem.2022.10.57697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/07/2022] [Indexed: 01/06/2023] Open
Abstract
Working on the frontlines with safety-net populations, emergency physicians are uniquely positioned to take on a greater role in addressing the current health literacy crisis and specific barriers that may exist. Here, we review the concept of universal health literacy precautions and explore the application of these universal precautions in conjunction with other patient-centered strategies. More specifically, to improve patient understanding and outcomes, emergency physicians can pair universal health literacy precautions with strategies including multiple learning techniques, dual-code theory, empowerment counseling, family buy-in, and hands-on practice. We provide two examples of emergency department encounters where this combined approach was used differently yet successfully and efficiently. Ultimately, we aim to highlight the value of emergency physicians being equipped with basic skills in health literacy educational strategies.
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Affiliation(s)
- Jamaji C. Nwanaji-Enwerem
- Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia,Emory Rollins School of Public Health, Gangarosa Department of Environmental Health, Atlanta, Georgia
| | | | - Brittney Gordon
- Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia
| | - Helene Okpere
- Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia
| | - Terrell Jones
- Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia
| | - Rahel Gizaw
- Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia
| | - Irfan Husain
- Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia
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Padival R, Harris KB, Garber A, El-Khider F, Kichler A, Vargo J, Baggott BB. Video Consent for Colonoscopy Improves Knowledge Retention and Patient Satisfaction: A Randomized Controlled Study. J Clin Gastroenterol 2022; 56:433-437. [PMID: 34319948 DOI: 10.1097/mcg.0000000000001589] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/11/2021] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND AIM Informed consent for endoscopy is variable across institutions and remains understudied in gastrointestinal endoscopy. This study aims to standardize informed consent for screening and diagnostic colonoscopies with a supplemental video tool that includes the key components of informed consent. METHODS A video tool was developed that incorporated the key components of informed consent for colonoscopy. In addition, a 7-question survey was developed to query patients on core aspects of informed consent and satisfaction with the informed consent process. Patients undergoing elective outpatient colonoscopy with conscious sedation were randomized to traditional consent or consent with the addition of a video tool. A pilot study determined the sample size. Traditional consent was standard of practice before the procedure. Patients in the video tool group watched the video tool in the preprocedure area followed by traditional consent. Both groups had the opportunity to address questions with the attending physician before the procedure. All patients were contacted 1 to 2 days following the colonoscopy to answer the question survey. RESULTS A total of 110 patients were eligible for participation, and 91 were included in the final data analysis. Subjects in the video tool group demonstrated significantly higher recall of key aspects of informed consent and higher satisfaction with the informed consent process versus the traditional consent group. The history of prior colonoscopy was similar between both groups. Mean endoscopy operation metrics were not negatively impacted by the inclusion of the video tool. CONCLUSION Patients undergoing screening and diagnostic colonoscopies who received informed consent supplemented by a video tool had a higher recall of core aspects of informed consent and higher satisfaction with the process, with no impact on procedural times.
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Affiliation(s)
- Ruthvik Padival
- Department of Gastroenterology, Hepatology, and Nutrition, Digestive Diseases and Surgery Institute
| | - Kevin B Harris
- Department of Internal Medicine, Community Care Institute, Cleveland Clinic, Cleveland, OH
| | - Ari Garber
- Department of Gastroenterology, Hepatology, and Nutrition, Digestive Diseases and Surgery Institute
| | - Faris El-Khider
- Department of Gastroenterology, Hepatology, and Nutrition, Digestive Diseases and Surgery Institute
| | - Adam Kichler
- Department of Gastroenterology, Hepatology, and Nutrition, Digestive Diseases and Surgery Institute
| | - John Vargo
- Department of Gastroenterology, Hepatology, and Nutrition, Digestive Diseases and Surgery Institute
| | - Brian B Baggott
- Department of Gastroenterology, Hepatology, and Nutrition, Digestive Diseases and Surgery Institute
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Bershteyn A, Kim HY, Scott Braithwaite R. Real-Time Infectious Disease Modeling to Inform Emergency Public Health Decision Making. Annu Rev Public Health 2022; 43:397-418. [DOI: 10.1146/annurev-publhealth-052220-093319] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Infectious disease transmission is a nonlinear process with complex, sometimes unintuitive dynamics. Modeling can transform information about a disease process and its parameters into quantitative projections that help decision makers compare public health response options. However, modelers face methodologic challenges, data challenges, and communication challenges, which are exacerbated under the time constraints of a public health emergency. We review methods, applications, challenges and opportunities for real-time infectious disease modeling during public health emergencies, with examples drawn from the two deadliest pandemics in recent history: HIV/AIDS and coronavirus disease 2019 (COVID-19). Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Anna Bershteyn
- New York University Grossman School of Medicine, New York, NY, USA
| | - Hae-Young Kim
- New York University Grossman School of Medicine, New York, NY, USA
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12
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Yin HS, Neuspiel DR, Paul IM, Franklin W, Tieder JS, Adirim T, Alvarez F, Brown JM, Bundy DG, Ferguson LE, Gleeson SP, Leu M, Mueller BU, Connor Phillips S, Quinonez RA, Rea C, Rinke ML, Shaikh U, Shiffman RN, Vickers Saarel E, Spencer Cockerham SP, Mack Walsh K, Jones B, Adler AC, Foster JH, Green TP, Houck CS, Laughon MM, Neville K, Reigart JR, Shenoi R, Sullivan JE, Van Den Anker JN, Verhoef PA. Preventing Home Medication Administration Errors. Pediatrics 2021; 148:183379. [PMID: 34851406 DOI: 10.1542/peds.2021-054666] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Medication administration errors that take place in the home are common, especially when liquid preparations are used and complex medication schedules with multiple medications are involved; children with chronic conditions are disproportionately affected. Parents and other caregivers with low health literacy and/or limited English proficiency are at higher risk for making errors in administering medications to children in their care. Recommended strategies to reduce home medication errors relate to provider prescribing practices; health literacy-informed verbal counseling strategies (eg, teachback and showback) and written patient education materials (eg, pictographic information) for patients and/or caregivers across settings (inpatient, outpatient, emergency care, pharmacy); dosing-tool provision for liquid medication measurement; review of medication lists with patients and/or caregivers (medication reconciliation) that includes prescription and over-the-counter medications, as well as vitamins and supplements; leveraging the medical home; engaging adolescents and their adult caregivers; training of providers; safe disposal of medications; regulations related to medication dosing tools, labeling, packaging, and informational materials; use of electronic health records and other technologies; and research to identify novel ways to support safe home medication administration.
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Affiliation(s)
- H Shonna Yin
- Departments of Pediatrics and Population Health, Grossman School of Medicine, New York University, New York, New York
| | | | - Ian M Paul
- Departments of Pediatrics and Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania
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13
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Kennedy MBB, Parish AL. Educational Theory and Cognitive Science: Practical Principles to Improve Patient Education. Nurs Clin North Am 2021; 56:401-412. [PMID: 34366160 DOI: 10.1016/j.cnur.2021.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There can be multiple barriers to implementation of patient education, yet there are also multiple modalities and opportunities for engaging patients. Using frameworks and evidence from multiple disciplines can inform nursing design of patient education approaches. This article provides an introduction to educational theory and cognitive science principles such as constructivism, metacognition, deliberate practice, and cognitive load for consideration in improving the effectiveness and outcomes of patient education.
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Affiliation(s)
| | - Abby Luck Parish
- Vanderbilt University School of Nursing, 274 SON, 461 21st Avenue South, Nashville, TN 37240, USA
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14
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Simonsmeier BA, Flaig M, Simacek T, Schneider M. What sixty years of research says about the effectiveness of patient education on health: a second order meta-analysis. Health Psychol Rev 2021; 16:450-474. [PMID: 34384337 DOI: 10.1080/17437199.2021.1967184] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although meta-analyses have examined the association between patient education and health, the validity and quality of this evidence have not been comprehensively assessed. This second order meta-analysis combined previous meta-analyses that examined the effectiveness of patient education on health outcomes as an overall weighted grand mean d¯¯. Further, measures of methodological quality, meaningful variability across first order meta-analyses, and evidence for publication bias were examined. Forty meta-analyses were identified, investigating 156 associations between patient education and health summarizing data from over 776 studies including more than 74.947 patients. Quantitative analyses showed that patient education positively affects health outcomes with d¯¯ = 0.316 (95% CI [0.304, 0.329]). Summarizing data exclusively from randomized controlled trials indicated a causal effect. Patient education was effective for patients with neoplasms, diabetes, mental and behavioral disorders, diseases of the circulatory system, the respiratory system, and the musculoskeletal system. Patient education was effective in the reduction of medication use, pain, and visits to medical facilities, and significantly improved physiological, physical, psychological outcomes, and patients' general function. Overall, the findings reveal firm evidence for the effectiveness of patient education on health outcomes. However, theory-based interventions are lacking and need to be implemented to enable a successful transfer from theory to practice.
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Affiliation(s)
| | - Maja Flaig
- University of Tübingen, Tübingen, Germany
| | - Thomas Simacek
- Department of Educational Psychology, University of Trier, Trier, Germany
| | - Michael Schneider
- Department of Educational Psychology, University of Trier, Trier, Germany
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15
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A Randomized Controlled Trial of a Multimedia Patient Education Tool for Stress Versus Urgency Urinary Incontinence. Female Pelvic Med Reconstr Surg 2021; 27:403-408. [PMID: 32925421 DOI: 10.1097/spv.0000000000000946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether there was a difference in patient education when comparing traditional conversation-based patient counseling with multimedia-based patient counseling about stress and urgency urinary incontinence. METHODS Patients seeking treatment for urinary incontinence were randomized to traditional, conversation-based counseling from a physician regarding stress and urgency urinary incontinence (control group) or view a video (multimedia) as their counseling (treatment group). A vignette-based assessment of the patient's knowledge of stress and urgency urinary incontinence was administered as a pretest, immediate posttest, and 6- to 8-week delayed posttest. The Incontinence Impact Questionnaire, short form, was used to assess quality of life and was administered at the initial visit and at the 6- to 8-week follow-up call. Patient satisfaction was recorded at the end of the initial visit using a continuous visual analog scale, and health literacy was evaluated using the Rapid Estimate of Adult Literacy in Medicine-Short Form or Short Assessment of Health Literacy-Spanish. RESULTS In the 98 participants, immediate posttest scores trended toward significance between the control and treatment groups (P = 0.086). This trend was lost at the delayed posttest (P = 0.122). Both methods of education showed a significant difference between pretest, immediate posttest, and delayed posttest (P < 0.001). There were no demographic differences between groups. CONCLUSIONS Multimedia-based patient education represents an effective method of providing patient education regarding urinary incontinence because those who received video education showed comparable comprehension of this topic when compared with standard physician counseling. Video education can feasibly be used as an alternative to, or in conjunction with, current patient education practices in a urogynecology setting.
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16
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Turkdogan S, Schnitman G, Wang T, Gotlieb R, How J, Gotlieb WH. Development of a Digital Patient Education Tool for Patients With Cancer During the COVID-19 Pandemic. JMIR Cancer 2021; 7:e23637. [PMID: 34101611 PMCID: PMC8218900 DOI: 10.2196/23637] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/24/2021] [Accepted: 06/02/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Due to the COVID-19 pandemic, a large portion of oncology consultations have been conducted remotely. The maladaptation or compromise of care could negatively impact oncology patients and their disease management. OBJECTIVE We aimed to describe the development and implementation process of a web-based, animated patient education tool that supports oncology patients remotely in the context of fewer in-person interactions with health care providers. METHODS The platform created presents multilingual oncology care instructions. Animations concerning cancer care and mental health during the COVID-19 pandemic as well as immunotherapy and chemotherapy guides were the major areas of focus and represented 6 final produced video guides. RESULTS The videos were watched 1244 times in a period of 6 months. The most watched animation was the COVID-19 & Oncology guide (viewed 565 times), followed by the video concerning general treatment orientations (viewed 249 times) and the video titled "Chemotherapy" (viewed 205 times). Although viewers were equally distributed among the age groups, most were aged 25 to 34 years (342/1244, 27.5%) and were females (745/1244, 59.9%). CONCLUSIONS The implementation of a patient education platform can be designed to prepare patients and their caregivers for their treatment and thus improve outcomes and satisfaction by using a methodical and collaborative approach. Multimedia tools allow a portion of a patient's care to occur in a home setting, thereby freeing them from the need for hospital resources.
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Affiliation(s)
- Sena Turkdogan
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - Gabriel Schnitman
- Department of Experimental Surgery, McGill University, Montreal, QC, Canada
| | - Tianci Wang
- Department of Physiology, McGill University, Montreal, QC, Canada
| | | | - Jeffrey How
- Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, TX, United States
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17
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Hensley CP, Lenihan EM, Pratt K, Shah A, O'Donnell E, Nee PC, Lee J, Yang A, Chang AH. Patterns of video-based motion analysis use among sports physical therapists. Phys Ther Sport 2021; 50:159-165. [PMID: 34029988 DOI: 10.1016/j.ptsp.2021.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Examine video-based motion analysis (VBMA) use among sports physical therapists. DESIGN Cross-sectional observation. SETTING Survey, online-platform. PARTICIPANTS American Academy of Sports Physical Therapy members (n = 261). MAIN OUTCOME MEASURES VBMA use frequency, reasons for use, facilitators/barriers, tools used, factors associated with use. RESULTS 194 (74.3%) used VBMA but 163 (84%) use it for ≤ 25% of their caseload. Most (57.7%) used their personal device to capture VBMA. Commonly cited reasons for use were movement analysis (93.8%) and patient education (87.6%). Barriers to use included time (30.7%), unfamiliarity with device/equipment (19.2%), and lack of device/equipment (18.4%). Younger age, advanced training, and greater time spent with return patients were each associated with use. For every 5-year increase of age, there was a 12% reduced likelihood of VBMA use (OR = 0.88; 95% CI = 0.77-1.00). Board-certified sports clinical specialists were more likely to use vs. those without additional certifications/degrees (OR = 3.27; 95% CI = 1.33-8.02). Spending 30-59 (vs. <30) minutes with return patients increased the odds of use (ORs range: 2.71 to 3.85). CONCLUSION Most respondents used VBMA, albeit infrequently. Those younger, with advanced training, and spending ≥30 min with return patients were more likely to use VBMA. Future research should investigate whether VBMA use enhances patient outcomes.
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Affiliation(s)
- Craig P Hensley
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Erin M Lenihan
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kyle Pratt
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Aayush Shah
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Erin O'Donnell
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Ping-Chen Nee
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jungwha Lee
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Amy Yang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Alison H Chang
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
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18
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Shickh S, Rafferty SA, Clausen M, Kodida R, Mighton C, Panchal S, Lorentz J, Ward T, Watkins N, Elser C, Eisen A, Carroll JC, Glogowski E, Schrader KA, Lerner-Ellis J, Kim RH, Chitayat D, Shuman C, Bombard Y. The role of digital tools in the delivery of genomic medicine: enhancing patient-centered care. Genet Med 2021; 23:1086-1094. [PMID: 33654192 DOI: 10.1038/s41436-021-01112-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Alternative models of genetic counseling are needed to meet the rising demand for genomic sequencing. Digital tools have been proposed as a method to augment traditional counseling and reduce burden on professionals; however, their role in delivery of genetic counseling is not established. This study explored the role of the Genomics ADvISER, a digital decision aid, in delivery of genomic counseling. METHODS We performed secondary analysis of 52 pretest genetic counseling sessions that were conducted over the course of a randomized controlled trial evaluating the effectiveness of the Genomics ADvISER. As part of the trial, participants were randomized to receive standard counseling or use the tool and then speak with a counselor. A qualitative interpretive description approach using thematic analysis and constant comparison was used for analysis. RESULTS In the delivery of genomic counseling, the Genomics ADvISER contributed to enhancing counseling by (1) promoting informed dialogue, (2) facilitating preference-sensitive deliberation, and (3) deepening personalization of decisions, all of which represent fundamental principles of patient-centered care: providing clear high-quality information, respecting patients' values, preferences, and expressed needs, and providing emotional support. CONCLUSION This study demonstrates that our digital tool contributed to enhancing patient-centered care in the delivery of genomic counseling.
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Affiliation(s)
- Salma Shickh
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Sara A Rafferty
- Hospital for Sick Children, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Marc Clausen
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Rita Kodida
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Chloe Mighton
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Seema Panchal
- Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
| | | | - Thomas Ward
- Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
| | | | - Christine Elser
- University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Andrea Eisen
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - June C Carroll
- Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Kasmintan A Schrader
- BC Cancer, Vancouver, BC, Canada.,Department of Medical Genetics, The University of British Columbia, Vancouver, BC, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada.,Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Raymond H Kim
- Hospital for Sick Children, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - David Chitayat
- Hospital for Sick Children, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.,Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada
| | - Cheryl Shuman
- Hospital for Sick Children, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Yvonne Bombard
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. .,St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
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19
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Wang Q, Xie L, Wang L, Li X, Xu L, Chen P. Readability in printed education materials for Chinese patients with systemic lupus erythematosus: a mixed-method design. BMJ Open 2020; 10:e038091. [PMID: 33055117 PMCID: PMC7559043 DOI: 10.1136/bmjopen-2020-038091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the readability of printed education materials (PEMs) for patients with systemic lupus erythematosus (SLE) and to explore the perceptions of patients with SLE with different health literacy regarding the readability of PEMs. DESIGN A mixed-methods study, including a cross-sectional survey and semistructured interviews. SETTING The SLE PEMs were collected from 13 hospitals in China. The interviews were conducted in the Department of Rheumatology of a hospital in Hefei, China. PARTICIPANTS In the cross-sectional survey, convenience sampling was used to select the Chinese SLE PEMs, with 20 PEMs included. In the qualitative study, the patients with SLE were divided into two groups based on their health literacy. Then, purposive sampling was used to select participants in each group, with 18 patients recruited. OUTCOME MEASURES The readability of PEMs was assessed by the language analysis technology and the Chinese version of the Suitability Assessment of Materials (SAM-C) instrument. RESULTS For text factors of readability, the mean Chinese language difficulty coefficient was 67.09±8.03, which indicates that the text of PEMs was difficult to read. For non-text factors, the mean SAM-C score was 45.62±9.51. Eight PEMs were rated not suitable, 12 were adequate and none were superior. In the interviews, eight categories were identified: information source, content, actionability, plain language, pictures, tables, numbers and layout. Patients with different health literacy had discrepant views on the detail of basic information, the necessity of question list, the location of functional pictures and the application of mathematical symbols. CONCLUSIONS The readability of Chinese SLE PEMs does not perform well, and it is necessary to reduce the difficulty of words, shorten the length of sentences and improve the picture design and actionability. To develop PEMs tailored to patients' level of health literacy, patients' unique view of readability should be integrated into the design of PEMs.
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Affiliation(s)
- Qiuyi Wang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Lunfang Xie
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Lei Wang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Xing Li
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Liangmei Xu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Peiling Chen
- Rheumatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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20
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Chu YM, Choi KS. Effectiveness of patient education in acute stroke: a comparison between a customised computer system and a pictorial information booklet. BMJ Health Care Inform 2020; 27:bmjhci-2020-100144. [PMID: 32816839 PMCID: PMC7430415 DOI: 10.1136/bmjhci-2020-100144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/03/2022] Open
Abstract
BackgroundPatients who develop acute stroke are at high risk for deterioration in the first 48–72 hours after admission. An effective educational intervention is needed.ObjectiveThis study aimed to examine the applicability of the customised interactive computer education system (CICS) in patients who had a stroke in the early acute phase in order to determine the efficacy of the education system in (1) information satisfaction and (2) physiological related management compliance.MethodsThe prospective non-blinded randomised controlled study was conducted in an acute stroke unit of a local hospital in Hong Kong from March to August 2019. Chinese participants were selected if they were at least 18 years of age, experienced a minor stroke within 3 days. The exclusion criteria were communication problem and comorbidity with another acute disease. On the first day of admission, participants were allocated to the CICS and booklet groups, with each group comprising 50 participants. On the third day, the primary outcome, Modified Information Satisfaction Questionnaire for Acute Stroke (MISQ-S), was assessed.ResultsThere was a significant difference in ‘the need to improve information measures’ of the MISQ-S (p=0.04) between the CICS and booklet groups. The management compliance of these two groups did not have difference, but the CICS group had better clinical outcome, though not significant (p=0.387).ConclusionPatient education was needed and feasible in the early acute phase, and the CICS was more efficacious than the booklet. The positive results provided insights into and give a direction to the use of information technology in patient education.
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Affiliation(s)
- Yin Man Chu
- Department of Medicine, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong
| | - Kup Sze Choi
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong
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21
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Rau NM, Hasan K, Ahamed SI, Asan O, Flynn KE, Basir MA. Designing a tablet-based prematurity education app for parents hospitalized for preterm birth. Int J Med Inform 2020; 141:104200. [PMID: 32563027 DOI: 10.1016/j.ijmedinf.2020.104200] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/10/2020] [Accepted: 05/24/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND As technology has advanced over the last decade, handheld Mobile Health (mHealth) applications have increased in popularity. Pregnancy is one area of mHealth that has rapidly expanded, however very few pregnancy apps are developed in collaboration with health professionals. This creates an environment where the pregnancy information women are accessing may be inaccurate or even dangerous. Additionally, there are relatively few medical apps devoted to prematurity or targeted to women at risk for premature birth. To address the gap in premature birth education, we assembled a multidisciplinary team, including health care professionals, and developed the Preemie Prep for Parents (P3) app. METHODS Our team previously conducted 5 focus group meetings to assess the information needs of our target audience. Based on this information we developed a low fidelity P3 prototype. Our software development team transferred the low fidelity prototype into a high fidelity prototype which was hosted on Test Flight (a beta testing platform). We performed heuristic evaluation as well as user testing to improve the P3 app. RESULTS User testing of the high fidelity P3 prototype was performed with 13 diverse participants. 6 participants were parents of currently admitted Neonatal Intensive Care Unit (NICU) babies and 7 participants were women who had been or were currently pregnant. The native language of participants included English, Spanish, and Hmong and their educational level varied between completing high school and graduate degree. Participants provided feedback on the content of the P3 app, as well as its organization and aesthetics. The feedback led to 83 iterations of the P3 app prior to its deployment. Overall, participants noted that the information was "informative" and "reliable". They also noted that the P3 app provided control over the information they could view and when they viewed it, stating "I could see info on my time". Overall, participants felt that the P3 app was a valuable tool for mothers in preterm labor and it would help them ask questions. CONCLUSIONS Development of a mHealth app provides unique challenges regarding content, reliability of information, organization, and aesthetics. Creation of the P3 app to address the educational needs of women at risk for premature birth required assembling a multidisciplinary team, which included target users, and implementing an iterative design process. The efficacy of this app in improving user knowledge and decreasing anxiety is currently being tested in a randomized controlled trial.
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Affiliation(s)
- Nicole M Rau
- Medical College of Wisconsin, Department of Pediatrics, 999 N 92ndSt, Suite C410, PO Box 1997, Wauwatosa, WI, 53226, United States
| | - Kamrul Hasan
- Marquette University, Department of Computer Science, Katharine R. Cudahy Hall, Room 201 1313 W. Wisconsin Avenue, Milwaukee, WI, 53233, United States
| | - Sheikh Iqbal Ahamed
- Marquette University, Department of Computer Science, Katharine R. Cudahy Hall, Room 201 1313 W. Wisconsin Avenue, Milwaukee, WI, 53233, United States
| | - Onur Asan
- Medical College of Wisconsin, Department of Medicine, 9200 W. Wisconsin Ave, Suite C5500, Milwaukee, WI, 53226, United States
| | - Kathryn E Flynn
- Medical College of Wisconsin, Department of Medicine, 9200 W. Wisconsin Ave, Suite C5500, Milwaukee, WI, 53226, United States
| | - Mir A Basir
- Medical College of Wisconsin, Department of Pediatrics, 999 N 92ndSt, Suite C410, PO Box 1997, Wauwatosa, WI, 53226, United States.
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22
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Choudhury A, Crotty B, Asan O. Comparing the Impact of Double and Single Screen Electronic Health Records on Doctor-Patient Non-Verbal Communication. IISE Trans Occup Ergon Hum Factors 2020. [DOI: 10.1080/24725838.2020.1742251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Avishek Choudhury
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, USA
| | - Bradley Crotty
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, USA
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23
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Vikström P, Carlsson I, Rosén B, Björkman A. Patients' views on early sensory relearning following nerve repair-a Q-methodology study. J Hand Ther 2019; 31:443-450. [PMID: 28967458 DOI: 10.1016/j.jht.2017.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/12/2017] [Accepted: 07/09/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Descriptive study. INTRODUCTION Early sensory relearning where the dynamic capacity of the brain is used has been shown to improve sensory outcome after nerve repair. However, no previous studies have examined how patients experience early sensory relearning. PURPOSE OF THE STUDY To describe patient's views on early sensory relearning. METHODS Statements' scores were analyzed by factor analysis. RESULTS Thirty-seven consecutive adult patients with median and/or ulnar nerve repair who completed early sensory relearning were included. Three factors were identified, explaining 45% of the variance: (1) "Believe sensory relearning is meaningful, manage to get an illusion of touch and complete the sensory relearning"; (2) "Do not get an illusion of touch easily and need support in their sensory relearning" (3) "Are not motivated, manage to get an illusion of touch but do not complete sensory relearning". DISCUSSION Many patients succeed in implementing their sensory relearning. However, a substantial part of the patient population need more support, have difficulties to create illusion of touch, and lack motivation to complete the sensory relearning. To enhance motivation and meaningfulness by relating the training clearly to everyday occupations and to the patient's life situation is a suggested way to proceed. CONCLUSION The three unique factors indicate motivation and sense of meaningfulness as key components which should be taken into consideration in developing programs for person-centered early sensory relearning. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Pernilla Vikström
- Department of Translational Medicine-Hand Surgery, Skåne University Hospital and Lund University, Malmö, Sweden.
| | - Ingela Carlsson
- Department of Translational Medicine-Hand Surgery, Skåne University Hospital and Lund University, Malmö, Sweden
| | - Birgitta Rosén
- Department of Translational Medicine-Hand Surgery, Skåne University Hospital and Lund University, Malmö, Sweden
| | - Anders Björkman
- Department of Translational Medicine-Hand Surgery, Skåne University Hospital and Lund University, Malmö, Sweden
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24
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Hersche R, Weise A, Michel G, Kesselring J, Barbero M, Kool J. Development and Preliminary Evaluation of a 3-Week Inpatient Energy Management Education Program for People with Multiple Sclerosis-Related Fatigue. Int J MS Care 2019; 21:265-274. [PMID: 31889931 DOI: 10.7224/1537-2073.2018-058] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Energy conservation strategies and cognitive behavioral therapy techniques are valid parts of outpatient fatigue management education in people with multiple sclerosis (MS). In many European countries, multidisciplinary rehabilitation for people with MS is chiefly delivered in specialized rehabilitation centers, where they benefit from short intensive inpatient rehabilitation annually. However, no evidence-based and standardized fatigue management education program compatible with the inpatient setting is available. Methods Based on a literature search and the expertise of occupational therapists (OTs), a manualized group-based Inpatient Energy Management Education (IEME) program for use during 3-week inpatient rehabilitation that incorporates energy conservation and cognitive behavioral management approaches was developed. An IEME pilot program operated by trained OTs included 13 people with MS-related fatigue. The experiences of the IEME users and OTs were collected during focus groups to refine the program's materials and verify its feasibility in the inpatient setting. Results The program was feasible in an inpatient setting and met the needs of the people with MS. Targeted behaviors were taught to all participants in a clinical context. In-charge OTs were able to effect behavioral change through IEME. Conclusions Users evaluated the evidence-based IEME program positively. The topics, supporting materials, and self-training tasks are useful for the promotion and facilitation of behavioral change. The next step is a clinical trial to investigate the efficacy of IEME and to evaluate relevant changes in self-efficacy, fatigue impact, and quality of life after patients return home.
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Olivia Kim U, Barnekow K, Ahamed SI, Dreier S, Jones C, Taylor M, Hasan MK, Basir MA. Smartphone-based prenatal education for parents with preterm birth risk factors. PATIENT EDUCATION AND COUNSELING 2019; 102:701-708. [PMID: 30396713 PMCID: PMC6440855 DOI: 10.1016/j.pec.2018.10.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/20/2018] [Accepted: 10/26/2018] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To develop an educational mobile application (app) for expectant parents diagnosed with risk factors for premature birth. METHODS Parent and medical advisory panels delineated the vision for the app. The app helps prepare for preterm birth. For pilot testing, obstetricians offered the app between 18-22 weeks gestational age to English speaking parents with risk factors for preterm birth. After 4 weeks of use, each participant completed a questionnaire. The software tracked topics accessed and duration of use. RESULTS For pilot testing, 31 participants were recruited and 28 completed the questionnaire. After app utilization, participants reported heightened awareness of preterm birth (93%), more discussion of pregnancy or prematurity issues with partner (86%), increased questions at clinic visits (43%), and increased anxiety (21%). Participants reported receiving more prematurity information from the app than from their healthcare providers. The 15 participants for whom tracking data was available accessed the app for an average of 8 h. CONCLUSION Parents with increased risk for preterm birth may benefit from this mobile app educational program. PRACTICE IMPLICATIONS If the pregnancy results in preterm birth hospitalization, parents would have built a foundation of knowledge to make informed medical care choices.
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Affiliation(s)
| | - K Barnekow
- University of Wisconsin Milwaukee, Milwaukee, USA
| | | | - S Dreier
- Parent Advocate, Milwaukee, WI, USA
| | - C Jones
- Medical College of Wisconsin, Milwaukee, USA
| | - M Taylor
- Moreland Obstetrics and Gynecology, Waukesha, USA
| | | | - M A Basir
- Medical College of Wisconsin, Milwaukee, USA.
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Liu HYT, Chia RM, Setiawan IMA, Crytzer TM, Ding D. Development of "My Wheelchair Guide" app: a qualitative study. Disabil Rehabil Assist Technol 2018; 14:839-848. [PMID: 30451540 DOI: 10.1080/17483107.2018.1499140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The smartphone app "My Wheelchair Guide" is designed to provide essential information about wheelchair use and service delivery for new wheelchair users. It aims to empower wheelchair users in taking ownership in acquiring appropriate wheelchairs, and guiding them to use their wheelchairs in a safe and effective manner.Objective: This paper describes the development of the "My Wheelchair Guide" app and the usability evaluation of one of the app sections "Use a Wheelchair".Method: Ten manual wheelchair users and four seating/mobility professionals completed a survey on the ease of use and perceived usefulness of the app, and a semi-structured interview. Wheelchair users used checklists in the app to self-assess their wheelchairs' fit and set-up, and their wheelchair skills. Two investigators independently conducted content analysis of the interview transcripts and identified salient themes.Results: All participants perceived the app to be easy to use. Both wheelchair users and wheelchair seating professionals recognized that the "Use a Wheelchair" section would be very beneficial for new wheelchair users. Self-assessment checklists facilitated participants to review their wheelchair set-up and skills. Participants also provided several suggestions and recommendations to revise and refine the app section.Conclusion: The app section was perceived to be a useful and easy-to-use educational tool by most of the study participants. Participants' feedback will be used to guide the app revision for a better user experience. Further studies could be conducted to assess the app effectiveness on improving wheelchair users' knowledge and facilitating self-advocacy for appropriate wheelchairs.Implications for rehabilitationSmartphone apps designed to support patient education and self-management regarding wheelchair use are perceived beneficial by both wheelchair users and clinical professionals.Smartphone apps support multimedia information presentation and user interaction, and can potentially create an effective learning environment for wheelchair users and their families to learn about their everyday devices.Users of educational apps prefer reduced text-based content and care about app aesthetics.
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Affiliation(s)
- Hsin-Yi Tanya Liu
- Department of Rehabilitation Sciences and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rui-Min Chia
- Department of Rehabilitation Sciences and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - I Made Agus Setiawan
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA, USA
| | - Theresa Marie Crytzer
- Department of Rehabilitation Sciences and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dan Ding
- Department of Rehabilitation Sciences and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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Amherdt S, Kim UO, Basir MA. Effectiveness of Digital Multimedia Educational Aids Produced by Intensive Care Unit Providers. J Pediatr Intensive Care 2018; 7:182-187. [PMID: 31073492 DOI: 10.1055/s-0038-1637747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 02/13/2018] [Indexed: 10/17/2022] Open
Abstract
Multimedia improves understanding of information. Professionally developed digital multimedia educational modules are expensive. We tested educational modules developed by a medical student without extensive multimedia production training. The modules were developed with neonatologist collaboration, uploaded to YouTube, and presented via iPad to neonatal intensive care unit family members who were ≥ 18 years, English literate, and unexposed to topic they were reviewing. Thirty-six participants viewed the modules once and then answered topic-specific key questions. Thirty of 36 (83%) of the participants answered 4/4 (100%) of questions correctly and 6/36 (17%) answered three-fourths (75%) correctly, demonstrating success of the educational modules. Health care workers can economically create effective digital multimedia educational materials without extensive training.
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Affiliation(s)
- Sarah Amherdt
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - U Olivia Kim
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Mir A Basir
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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Chhabra R, Chisolm DJ, Bayldon B, Quadri M, Sharif I, Velazquez JJ, Encalada K, Rivera A, Harris M, Levites-Agababa E, Yin HS. Evaluation of Pediatric Human Papillomavirus Vaccination Provider Counseling Written Materials: A Health Literacy Perspective. Acad Pediatr 2018; 18:S28-S36. [PMID: 29502634 DOI: 10.1016/j.acap.2017.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 07/19/2017] [Accepted: 08/05/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite recommendations supporting human papillomavirus (HPV) vaccination, pediatric vaccination rates remain suboptimal in the United States; lack of tools to support provider counseling is one barrier. We sought to evaluate HPV-related counseling materials for readability, suitability, and content, and assess parent perceptions of materials, using a health literacy perspective. METHODS A systematic search was conducted for written materials developed for HPV vaccination counseling by examining state Department of Health Web sites and associated links to local and national organizations. Materials were assessed for the following: 1) readability (Flesch Reading Ease, Flesch-Kincaid, Gunning Fog, Simple Measure of Gobbledygook, Fry), 2) suitability (understandability and actionability) (Suitability Assessment of Materials; Patient Education Materials Assessment Tool for Printable Materials), and 3) coverage of 8 key content areas (recommended by Centers for Disease Control and Prevention). Semistructured interviews were conducted with English-speaking parents or caregivers of children 9 to 17 years of age from 3 pediatric clinics (New York, Ohio, Illinois) serving predominantly low-income families to assess perceptions and usefulness of 4 handouts selected for review. RESULTS Thirty-eight documents were assessed. Mean ± standard deviation (SD) reading grade level was 9.4 ± 2; 10.5% (n = 4) had a reading level of 6th grade or below; 68.4% (n = 26) were considered not suitable. Mean understandability was 41.7% and mean actionability was 20.7%. Only 5.3% (n = 2) addressed all 8 content areas mean ± SD (number of areas = 6.7 ± 1.2). Brochure comprehensiveness and inclusion of a personal story were cited as factors that would be helpful in influencing parents to vaccinate against HPV. CONCLUSIONS Few written materials for HPV vaccination counseling were optimal from a health literacy best practices perspective. Content comprehensiveness was important for informed decision making.
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Affiliation(s)
- Rosy Chhabra
- Department of Pediatrics, Albert Einstein College of Medicine/Montefiore, Bronx, NY.
| | - Deena J Chisolm
- The Ohio State University Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Barbara Bayldon
- Northwestern University Feinberg School of Medicine, Department of Pediatrics, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Maheen Quadri
- Northwestern University Feinberg School of Medicine, Department of Pediatrics, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Iman Sharif
- Department of Pediatrics, Sunset Park Family Health Center, NYU Langone, Brooklyn, NY
| | - Jessica J Velazquez
- Department of Pediatrics, NYU School of Medicine-Bellevue Hospital, New York, NY
| | - Karen Encalada
- Department of Pediatrics, NYU School of Medicine-Bellevue Hospital, New York, NY
| | - Angelic Rivera
- Department of Pediatrics, Albert Einstein College of Medicine/Montefiore, Bronx, NY
| | - Millie Harris
- The Ohio State University Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | | | - H Shonna Yin
- Department of Pediatrics, NYU School of Medicine-Bellevue Hospital, New York, NY; Department of Population Health, NYU School of Medicine, New York, NY
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Schnock KO, Ravindran SS, Fladger A, Leone K, Williams DM, Dwyer CL, Vu TG, Thornton K, Gazarian P. Identifying Information Resources for Patients in the Intensive Care Unit and Their Families. Crit Care Nurse 2017; 37:e10-e16. [DOI: 10.4037/ccn2017961] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND
Providing information to patients in intensive care units and their families is challenging. Patients often are admitted unexpectedly and experience stress and uncertainty. One source of stress has been identified as unclear, uncoordinated, or inconsistent communication and information. Despite the need for information, no centrally located, easily accessible, standardized intensive care unit education content exists.
OBJECTIVE
To identify educational content for patients in the intensive care unit and their families across 4 different hospitals, develop a general content database, and organize the general content into a framework for education of patients and their families.
METHODS
Educational content for patients in the intensive care units of 4 participating hospitals was collected and a gap analysis was performed.
RESULTS
Key content format and categories were identified. Educational content was organized into an information pathway divided into 3 phases: intensive care unit arrival; understanding the intensive care unit and partnering in care; and intensive care unit transitions. The gap analysis revealed substantial variation in content format and categories.
CONCLUSIONS
Structuring a digital learning center using different stages of the patient’s stay in the intensive care unit and placing resources in the context of an information pathway can help coordinate education for these patients and their families, and creates a consistent communication guide for clinicians as well. The optimal digital format should be considered in designing the learning center.
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Affiliation(s)
- Kumiko O. Schnock
- Kumiko O. Schnock is a research associate, Division of General Internal Medicine and Primary Care at Brigham and Women’s Hospital, Boston, Massachusetts
| | - Sucheta S. Ravindran
- Sucheta S. Ravindran is a medical student at Rush Medical College, Chicago, Illinois
| | - Anne Fladger
- Anne Fladger is a director, Medical Library at Brigham and Women’s Hospital
| | - Kathleen Leone
- Kathleen Leone is an adjunct faculty at Simmons College, Boston, Massachusetts
| | - Donna M. Williams
- Donna M. Williams is a nurse specialist cardiology at Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Cynthia L. Dwyer
- Cynthia L. Dwyer is a clinical quality and innovation coach at the Armstrong Institute for Patient Safety and Quality, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Thanh-Giang Vu
- Thanh-Giang Vu is a resident physician, Department of Anesthesia, University of California, San Francisco, California
| | - Kevin Thornton
- Kevin Thornton is associate clinical professor in the Department of Anesthesia and Perioperative Care, University of California, San Francisco
| | - Priscilla Gazarian
- Priscilla Gazarian is the nursing program director and a nurse scientist at Brigham and Women’s Hospital and an associate professor of nursing at School of Nursing and Health Sciences, University of Massachusetts, Boston, Massachusetts
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Shonna Yin H. Health Literacy and Child Health Outcomes: Parental Health Literacy and Medication Errors. SPRINGERBRIEFS IN PUBLIC HEALTH 2017. [DOI: 10.1007/978-3-319-50799-6_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Liquid Medication Dosing Errors by Hispanic Parents: Role of Health Literacy and English Proficiency. Acad Pediatr 2017; 17:403-410. [PMID: 28477800 PMCID: PMC5424611 DOI: 10.1016/j.acap.2016.10.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 09/26/2016] [Accepted: 10/03/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Hispanic parents in the United States are disproportionately affected by low health literacy and limited English proficiency (LEP). We examined associations between health literacy, LEP, and liquid medication dosing errors in Hispanic parents. METHODS Cross-sectional analysis of data from a multisite randomized controlled experiment to identify best practices for the labeling/dosing of pediatric liquid medications (SAFE Rx for Kids study); 3 urban pediatric clinics. Analyses were limited to Hispanic parents of children aged ≤8 years with health literacy and LEP data (n = 1126). Parents were randomized to 1 of 5 groups that varied by pairing of units of measurement on the label/dosing tool. Each parent measured 9 doses (3 amounts [2.5, 5, 7.5 mL] using 3 tools [2 syringes in 0.2 or 0.5 mL increments, and 1 cup]) in random order. Dependent variable was a dosing error of >20% dose deviation. Predictor variables included health literacy (Newest Vital Sign) (limited = 0-3; adequate = 4-6) and LEP (speaks English less than "very well"). RESULTS A total of 83.1% made dosing errors (mean [SD] errors per parent = 2.2 [1.9]). Parents with limited health literacy and LEP had the greatest odds of making a dosing error compared to parents with adequate health literacy who were English proficient (trials with errors per parent = 28.8 vs 12.9%; adjusted odds ratio = 2.2 [95% confidence interval 1.7-2.8]). Parents with limited health literacy who were English proficient were also more likely to make errors (trials with errors per parent = 18.8%; adjusted odds ratio = 1.4 [95% confidence interval 1.1-1.9]). CONCLUSIONS Dosing errors are common among Hispanic parents; those with both LEP and limited health literacy are at particular risk. Further study is needed to examine how the redesign of medication labels and dosing tools could reduce literacy- and language-associated disparities in dosing errors.
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Lin LY, Wang RH. Patient Education Competence Scale for Registered Nurses in Taiwan: Scale development and psychometric validation. Jpn J Nurs Sci 2016; 14:117-125. [DOI: 10.1111/jjns.12141] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 05/05/2016] [Accepted: 05/13/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Li-Ying Lin
- Department of Nursing, Kaohsiung Veterans General Hospital College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
- College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Ruey-Hsia Wang
- College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
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Yin HS, Gupta RS, Tomopoulos S, Mendelsohn AL, Egan M, van Schaick L, Wolf MS, Sanchez DC, Warren C, Encalada K, Dreyer BP. A Low-Literacy Asthma Action Plan to Improve Provider Asthma Counseling: A Randomized Study. Pediatrics 2016; 137:peds.2015-0468. [PMID: 26634774 DOI: 10.1542/peds.2015-0468] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The use of written asthma action plans (WAAPs) has been associated with reduced asthma-related morbidity, but there are concerns about their complexity. We developed a health literacy-informed, pictogram- and photograph-based WAAP and examined whether providers who used it, with no training, would have better asthma counseling quality compared with those who used a standard plan. METHODS Physicians at 2 academic centers randomized to use a low-literacy or standard action plan (American Academy of Allergy, Asthma and Immunology) to counsel the hypothetical parent of child with moderate persistent asthma (regimen: Flovent 110 μg 2 puffs twice daily, Singulair 5 mg daily, Albuterol 2 puffs every 4 hours as needed). Two blinded raters independently reviewed counseling transcriptions. PRIMARY OUTCOME MEASURES medication instructions presented with times of day (eg, morning and night vs number of times per day) and inhaler color; spacer use recommended; need for everyday medications, even when sick, addressed; and explicit symptoms used. RESULTS 119 providers were randomly assigned (61 low literacy, 58 standard). Providers who used the low-literacy plan were more likely to use times of day (eg, Flovent morning and night, 96.7% vs 51.7%, P < .001; odds ratio [OR] = 27.5; 95% confidence interval [CI], 6.1-123.4), recommend spacer use (eg, Albuterol, 83.6% vs 43.1%, P < .001; OR = 6.7; 95% CI, 2.9-15.8), address need for daily medications when sick (93.4% vs 34.5%, P < .001; OR = 27.1; 95% CI, 8.6-85.4), use explicit symptoms (eg, "ribs show when breathing," 54.1% vs 3.4%, P < .001; OR = 33.0; 95% CI, 7.4-147.5). Few mentioned inhaler color. Mean (SD) counseling time was similar (3.9 [2.5] vs 3.8 [2.6] minutes, P = .8). CONCLUSIONS Use of a low-literacy WAAP improves the quality of asthma counseling by helping providers target key issues by using recommended clear communication principles.
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Affiliation(s)
- H Shonna Yin
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York; Department of Population Health, New York University School of Medicine, New York, New York;
| | - Ruchi S Gupta
- Center for Community Health, and Smith Child Health Research Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; and
| | - Suzy Tomopoulos
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York
| | - Alan L Mendelsohn
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York; Department of Population Health, New York University School of Medicine, New York, New York
| | - Maureen Egan
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Linda van Schaick
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York
| | - Michael S Wolf
- Health Literacy and Learning Program, Center for Communication in Healthcare, Division of General Internal Medicine, and Institute for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Dayana C Sanchez
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York
| | | | - Karen Encalada
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York
| | - Benard P Dreyer
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York
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Siu JM, Rotenberg BW, Franklin JH, Sowerby LJ. Multimedia in the informed consent process for endoscopic sinus surgery: A randomized control trial. Laryngoscope 2015; 126:1273-8. [PMID: 26615812 DOI: 10.1002/lary.25793] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine patient recall of specific risks associated with endoscopic sinus surgery and whether an adjunct multimedia education module is an effective patient tool in enhancing the standard informed consent process. STUDY DESIGN Prospective, randomized, controlled trial. METHODS Fifty consecutive adult patients scheduled for endoscopic sinus surgery at a rhinology clinic of a tertiary care hospital were recruited for this study. Informed consent was studied by comparing the number of risks recalled when patients had a verbal discussion in conjunction with a 6-minute interactive module or the verbal discussion alone. Early recall was measured immediately following the informed consent process, and delayed recall was measured 3 to 4 weeks after patient preference details were also collected. RESULTS Early risk recall in the multimedia group was significantly higher than the control group (P = .0036); however, there was no difference between the groups in delayed risk recall. Seventy-six percent of participants expressed interest in viewing the multimedia module if available online between the preoperative and procedural day. Sixty-eight percent of patients preferred having the multimedia module as an adjunct to the informed consent process as opposed to the multimedia consent process alone. CONCLUSIONS There is an early improvement in overall risk recall in patients who complete an interactive multimedia module, with a clear patient preference for this method. Here we emphasize the well-known challenges of patient education and demonstrate the effectiveness of integrating technology into clinical practice in order to enhance the informed consent process. LEVEL OF EVIDENCE 1b Laryngoscope, 126:1273-1278, 2016.
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Affiliation(s)
- Jennifer M Siu
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Brian W Rotenberg
- Department of Otolaryngology-Head & Neck Surgery, Western University, London, Ontario, Canada
| | - Jason H Franklin
- Department of Otolaryngology-Head & Neck Surgery, Queen's University, Kingston, Ontario, Canada
| | - Leigh J Sowerby
- Department of Otolaryngology-Head & Neck Surgery, Western University, London, Ontario, Canada
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