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Di Pietro S, Ferrari I, Bulgari G, Muiesan ML, Falaschi F, De Silvestri A, Scudeller L, Musella V, Saglio S, Re B, Mattiuzzo E, Cherubini F, Perlini S. Video clips for patient comprehension of atrial fibrillation and deep vein thrombosis in emergency care. A randomised clinical trial. NPJ Digit Med 2024; 7:107. [PMID: 38688958 PMCID: PMC11061292 DOI: 10.1038/s41746-024-01107-7] [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: 08/21/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
Integrating video clips in the discharge process may enhance patients' understanding and awareness of their condition. To determine the effect of video clip-integrated discharge discussion on patient comprehension of atrial fibrillation (AF) and deep vein thrombosis (DVT), and their main complications (stroke and pulmonary embolism), we designed a multicentre, pragmatic, parallel groups, randomised clinical trial, that was conducted at two Emergency Units in Italy. A convenience sample of 144 adult patients (or their caregivers) discharged home with either AF or DVT were randomised to receive standard verbal instructions (control) or video clip-integrated doctor-patient discharge discussion. Participants were guided by the discharging physician through the clip. Mean score for primary outcome (knowledge of the diagnosis and its potential complication) (range 0-18) was 5.87 (95% CI, 5.02-6.72] in the control group and 8.28 (95% CI, 7.27-9.31) in the intervention group (mean difference, -2.41; 95% CI, -3.73 to -1.09; p < 0.001). Among secondary outcomes, mean score for knowledge of the prescribed therapy (range 0-6) was 2.98 (95% CI, 2.57-3.39) in the control group and 3.20 (95% CI, 2.73-3.67) in the study group (mean difference, -0.22; 95% CI, -0.84 to 0.39). Mean score for satisfaction (range 0-12) was 7.34 (95% CI, 6.45-8.23) in the control arm and 7.97 (95% CI, 7.15-8.78) in the intervention arm (mean difference, -0.625; 95% CI -1.82 to 0.57). Initiation rate of newly prescribed anticoagulants was 80% (36/45) in the control group and 90.2% (46/51) in the intervention group. Among 109 patients reached at a median follow up of 21 (IQR 16-28) months, 5.55% (3/54) in the control arm and 1.82% (1/55) in the intervention arm had developed stroke or pulmonary embolism. In this trial, video clip-integrated doctor-patient discharge discussion, improved participants comprehension of AF and DVT and their main complications. Physicians should consider integrating these inexpensive tools during the discharge process of patients with AF or DVT.Trial Registration: ClinicalTrials.gov Identifier "NCT03734406".
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Affiliation(s)
- Santi Di Pietro
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine, University of Pavia, Pavia, Italy.
- PhD Program in Experimental Medicine, University of Pavia, Pavia, Italy.
| | - Ilaria Ferrari
- Emergency Department, Humanitas University Hospital, Rozzano, Italy
| | | | - Maria Lorenza Muiesan
- Dipartimento di Scienza Cliniche e Sperimentali, Università di Brescia, Direttore 2° Medicina Generale ASST Spedali Civili, Brescia, Italy
| | - Francesco Falaschi
- Assistance Publique Hôpitaux de Paris, Hôpital Antoine Béclère, GHU Paris-Saclay, Unité Polyvalente Aiguë de Court Séjour, Clamart, France
| | - Annalisa De Silvestri
- Unit of Clinical Epidemiology and Biostatistics, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Luigia Scudeller
- Research and Innovation Unit, IRCCS Bologna University Hospital, Bologna, Italy
| | - Valeria Musella
- Unit of Clinical Epidemiology and Biostatistics, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Simone Saglio
- Internal Medicine Residency Programme, University of Pavia, Pavia, Italy
| | - Beatrice Re
- Respiratory Medicine Residency Programme, University of Milan, Milan, Italy
| | - Elena Mattiuzzo
- Emergency Physician, Pavia Poison Centre, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy
| | - Fabio Cherubini
- Internal Medicine Residency Programme, University of Brescia, Brescia, Italy
| | - Stefano Perlini
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine, University of Pavia, Pavia, Italy
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Kim MJ, Kim JR, Jo JH, Kim JS, Park JW. Temporomandibular disorders-related videos on YouTube are unreliable sources of medical information: A cross-sectional analysis of quality and content. Digit Health 2023; 9:20552076231154377. [PMID: 36762021 PMCID: PMC9903026 DOI: 10.1177/20552076231154377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
Objective The amount of online medical information available is rapidly growing and YouTube is considered as the most popular source of healthcare information nowadays. However, no study has been conducted to comprehensively evaluate YouTube videos related to temporomandibular disorders (TMD). So this study aimed to evaluate the content and quality of YouTube videos as a source of medical information on TMD. Method A total of 237 YouTube videos that were systematically searched using five keywords (temporomandibular disorders, tmd, temporomandibular joint, tmj, and jaw joint) were included. Included videos were categorized by purpose and source for analysis. The quality (DISCERN, Health on the Net (HON), Ensuring Quality Information for Patients (EQIP), and Global Quality Scale (GQS)) and scientific accuracy of video contents were evaluated. Results Total content, DISCERN, HON, EQIP, and GQS scores were 7.5%, 38.9%, 35.2%, 53.0%, and 48.6% of the maximum possible score, respectively. Only 69 videos (29.1%) were considered as "useful" for patients. News media, physician, and medical source videos showed higher evaluation scores than others. Quality evaluation scores were not significantly correlated or negatively correlated with public preference indices. In the ROC curve analysis, content and DISCERN score showed above excellent discrimination ability for high-quality videos based on GQS (P < 0.001) and total score (P < 0.001). Conclusions YouTube videos related to TMD contained low quality and scientifically inaccurate information that could negatively influence patients with TMD.
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Affiliation(s)
- Moon Jong Kim
- Department of Oral Medicine, Seoul National University Gwanak Dental Hospital, Seoul, Korea (ROK)
| | - Ji Rak Kim
- Department of Oral Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea (ROK)
| | - Jung Hwan Jo
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Korea (ROK),Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea (ROK)
| | - Ju Sik Kim
- Department of Dentistry, Seoul National University Hospital, Seoul, Korea (ROK)
| | - Ji Woon Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Korea (ROK),Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea (ROK),Dental Research Institute, Seoul National University, Seoul, Korea (ROK),Ji Woon Park, Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Wozney L, Curran J, Archambault P, Cassidy C, Jabbour M, Mackay R, Newton A, Plint AC, Somerville M. Electronic Discharge Communication Tools Used in Pediatric Emergency Departments: Systematic Review. JMIR Pediatr Parent 2022; 5:e36878. [PMID: 35608929 PMCID: PMC9270703 DOI: 10.2196/36878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Electronic discharge communication tools (EDCTs) are increasingly common in pediatric emergency departments (EDs). These tools have been shown to improve patient-centered communication, support postdischarge care at home, and reduce unnecessary return visits to the ED. OBJECTIVE This study aimed to map and assess the evidence base for EDCTs used in pediatric EDs according to their functionalities, intended purpose, implementation context features, and outcomes. METHODS A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) procedures for identification, screening, and eligibility. A total of 7 databases (EBSCO, MEDLINE, CINAHL, PsycINFO, EMBASE Scopus, and Web of Science) were searched for studies published between 1989 and 2021. Studies evaluating discharge communication-related outcomes using electronic tools (eg, text messages, videos, and kiosks) in pediatric EDs were included. In all, 2 researchers independently assessed the eligibility. Extracted data related to study identification, methodology, settings and demographics, intervention features, outcome implementation features, and practice, policy, and research implications. The Mixed Method Appraisal Tool was used to assess methodological quality. The synthesis of results involved structured tabulation, vote counting, recoding into common metrics, inductive thematic analysis, descriptive statistics, and heat mapping. RESULTS In total, 231 full-text articles and abstracts were screened for review inclusion with 49 reports (representing 55 unique tools) included. In all, 70% (26/37) of the studies met at least three of five Mixed Method Appraisal Tool criteria. The most common EDCTs were videos, text messages, kiosks, and phone calls. The time required to use the tools ranged from 120 seconds to 80 minutes. The EDCTs were evaluated for numerous presenting conditions (eg, asthma, fracture, head injury, fever, and otitis media) that required a range of at-home care needs after the ED visit. The most frequently measured outcomes were knowledge acquisition, caregiver and patient beliefs and attitudes, and health service use. Unvalidated self-report measures were typically used for measurement. Health care provider satisfaction or system-level impacts were infrequently measured in studies. The directionality of primary outcomes pointed to positive effects for the primary measure (44/55, 80%) or no significant difference (10/55, 18%). Only one study reported negative findings, with an increase in return visits to the ED after receiving the intervention compared with the control group. CONCLUSIONS This review is the first to map the broad literature of EDCTs used in pediatric EDs. The findings suggest a promising evidence base, demonstrating that EDCTs have been successfully integrated across clinical contexts and deployed via diverse technological modalities. Although caregiver and patient satisfaction with EDCTs is high, future research should use robust trials using consistent measures of communication quality, clinician experience, cost-effectiveness, and health service use to accumulate evidence regarding these outcomes. TRIAL REGISTRATION PROSPERO CRD42020157500; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=157500.
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Affiliation(s)
- Lori Wozney
- Mental Health and Addictions, Nova Scotia Health, Dartmouth, NS, Canada
| | - Janet Curran
- IWK Health, Strengthening Transitions in Care Lab, Halifax, NS, Canada
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Patrick Archambault
- Département de médecine d'urgence, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Levis, QC, Canada
| | | | - Mona Jabbour
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Rebecca Mackay
- IWK Health, Strengthening Transitions in Care Lab, Halifax, NS, Canada
| | - Amanda Newton
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Amy C Plint
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mari Somerville
- IWK Health, Strengthening Transitions in Care Lab, Halifax, NS, Canada
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de Steenwinkel M, Haagsma JA, van Berkel ECM, Rozema L, Rood PPM, Bouwhuis MG. Patient satisfaction, needs, and preferences concerning information dispensation at the emergency department: a cross-sectional observational study. Int J Emerg Med 2022; 15:5. [PMID: 35073836 PMCID: PMC8903487 DOI: 10.1186/s12245-022-00407-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background Patient satisfaction is an important indicator of emergency care quality and has been associated with information dispensation at the emergency department (ED). Optimal information dispensation could improve patient experience and expectations. Knowing what kind of information patients want to receive and the preferred way of information dispensation are essential to optimize information delivery at the ED. The purpose of this cross-sectional observational study was to evaluate patient satisfaction concerning information dispensation (including general, medical, and practical information), the need for additional information, and preferences with regard to the way of information dispensation at the ED of a teaching hospital in the Netherlands. Results Four hundred twenty-three patients (patients ≥ 18 years with Glasgow Coma Scale 15) were enrolled (response rate 79%). The median patient satisfaction score concerning the overall information dispensation at the ED was 7.5 on a rating scale 0–10. Shorter length of ED stay was associated with higher patient satisfaction in multivariate analysis (P < 0.001). The majority of respondents were satisfied regarding medical (n = 328; 78%) and general information (n = 233; 55%). Patients were less satisfied regarding practical information (n = 180; 43%). Respondents who indicated that they received general, medical and practical information were significantly more often satisfied compared to patients who did not receive this information (P < 0.001). Two thirds (n = 260; 62%) requested more general information. Half of the respondents (n = 202; 48%) requested more practical information and a third (n = 152; 36%) requested more medical information. The preferred way for receiving information was orally (n = 189; 44.7%) or by leaflets (n = 108; 25.5%). Conclusion The majority of respondents were satisfied concerning information dispensation at the ED, especially regarding medical information. Respondents requested more general and practical information and preferred to receive the information orally or by leaflets.
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Affiliation(s)
- Marank de Steenwinkel
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Juanita A Haagsma
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Esther C M van Berkel
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Lotte Rozema
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Pleunie P M Rood
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Marna G Bouwhuis
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
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