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Blöndal K, Sveinsdóttir H, Ingadottir B. Patients' expectations and experiences of provided surgery-related patient education: A descriptive longitudinal study. Nurs Open 2022; 9:2495-2505. [PMID: 35666048 PMCID: PMC9374389 DOI: 10.1002/nop2.1270] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 04/03/2022] [Accepted: 05/13/2022] [Indexed: 11/08/2022] Open
Abstract
AIMS The aim of this study was to explore the educational expectations and experiences of surgical patients. DESIGN Prospective, longitudinal, descriptive and two-centre study. Data were collected with questionnaires at the hospital and 6 weeks and 6 months postsurgery. METHODS Patients undergoing elective surgery and hospitalized overnight from January to July 2016 answered questions about the content of received pre-operative and pre-discharge education, topics they wanted more information on, sources of information, satisfaction with and usefulness of the information and if their recovery was as expected. RESULTS Patients (N = 697, 49% male, mean age 64.1 [SD 12.6] years) perceived the provided education as useful and satisfactory but less so after discharge. Most common topics which they expected more education about were postoperative complications, pain management, fatigue, lack of stamina and expected recovery time. Most patients received information through face-to-face teaching (79.7%) and in writing (78.4%). Expectations on recovery were related to patients' satisfaction with the education and how useful they evaluated it.
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Affiliation(s)
- Katrín Blöndal
- Surgical ServicesLandspitali University HospitalReykjavíkIceland
- Faculty of NursingSchool of Health Sciences, University of IcelandReykjavikIceland
| | - Herdís Sveinsdóttir
- Surgical ServicesLandspitali University HospitalReykjavíkIceland
- Faculty of NursingSchool of Health Sciences, University of IcelandReykjavikIceland
| | - Brynja Ingadottir
- Surgical ServicesLandspitali University HospitalReykjavíkIceland
- Faculty of NursingSchool of Health Sciences, University of IcelandReykjavikIceland
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Jóhannsdóttir TB, Ingadottir B, Svavarsdóttir MH. Rural patients' experience of education, surveillance, and self-care support after heart disease related hospitalisation: a qualitative study. Int J Circumpolar Health 2021; 80:2007667. [PMID: 34839809 PMCID: PMC8635654 DOI: 10.1080/22423982.2021.2007667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Abstract
People living in rural Iceland have a higher rate of cardiovascular risk factors and healthcare utilisation compared to people in urban areas.The aim of this qualitative study was to explore the experiences of people with coronary heart disease, living in rural Iceland regarding patient education, surveillance, and self-care support. The participants (N = 14, age 52‒79 years, 8 male), were interviewed 6 to 12 months after hospital discharge following a cardiac event (in 2018‒2019). Systematic text-condensation was used for analysis. The findings were categorised into three main themes: Education and support describes inadequate patient education and support from health-care professionals after discharge from hospitaland how the internet was the main information source supplemented with spouse's and family support. Local healthcare services describe thelack of and importance of access to health-care professionals, stable services, and underutilisation of telemedicine and primary healthcare in the local area, and Self-care behaviour describes the lack of professional support with lifestyle changes and how the participants manage self-care as well as their attitudes towards the disease.The results indicate that access to continuous healthcare services and person-centred support focusing on prevention strategies are widely impaired in rural areas in Iceland.
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Affiliation(s)
| | - Brynja Ingadottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland and Landspitali University Hospital, Reykjavik, Iceland
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Klompstra L, Liljeroos M, Lundgren J, Ingadottir B. A Clinical Tool (CUE-tool) for Health Care Professionals to Assess the Usability and Quality of the Content of Medical Information Websites: Electronic Delphi Study. J Med Internet Res 2021; 23:e22668. [PMID: 33595439 PMCID: PMC7929737 DOI: 10.2196/22668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 02/02/2023] Open
Abstract
Background As patients are increasingly searching for information about their medical condition on the internet, there is a need for health professionals to be able to guide patients toward reliable and suitable information sources on the internet. Objective The aim of the study was to develop a clinical tool for health care professionals to assess the usability and quality of the content of websites containing medical information that could be recommended to patients. Methods A 3-round modified electronic Delphi (eDelphi) study was conducted with 20 health care professionals. Results In round one of the eDelphi study, of the 68 items initially created, 41 items (29 on usability and 12 on content) were rated as important or very important by more than half of the panel and thus selected for further evaluation in round two. In round two, of the 41 items chosen from round 1, 19 were selected (9 on usability and 10 on content) as important or very important by more than half of the panel for further evaluation. As a result of round three, 2 items were combined as a single item, leaving the instrument with 18 items in total (8 on usability and 10 on content). The tool is freely accessible online. Conclusions The CUE-tool can be used to (1) evaluate the usability and reliability of the content of websites before recommending them to patients as a good information source; (2) identify websites that do not have reliable content or may be difficult for patients to use; (3) develop quality websites by using the criteria in the CUE-tool; and (4) identify different qualities between different websites.
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Affiliation(s)
- Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden.,Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Johan Lundgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Brynja Ingadottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali University Hospital, Reykjavik, Iceland
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Halldorsdottir H, Thoroddsen A, Ingadottir B. Impact of technology-based patient education on modifiable cardiovascular risk factors of people with coronary heart disease: A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:2018-2028. [PMID: 32595027 DOI: 10.1016/j.pec.2020.05.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 02/19/2020] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To collect evidence on what types of technology and content are most effective in helping people with coronary heart disease (CHD) to change their modifiable cardiovascular risk factors. METHODS A literature search was performed to find relevant studies published between 1 January 2008 and 31 December 2018 in PubMed, CINAHL, PROQUEST and Scopus databases. Selected outcomes were risk factors (exercise, diet, blood pressure, blood sugar, cholesterol, body mass index, tobacco use). The quality of the studies was evaluated according to Joanna Briggs Institute Reviewers Manual Checklists for risk for bias, TIDieR for quality of interventions, and PRISMA statement for presenting results. RESULTS Eighteen quantitative (17 RCT´s and one quasi-experimental) studies were included. Patient education delivered through telephone, text messaging, webpages, and smartphone applications resulted in significant changes in some risk factors of people with CHD. Sufficient descriptions of the content and intervention methods were lacking. CONCLUSION Patient education delivered with technology can help people with CHD to modify their risk factors. There is a need for better descriptions of the content and delivery of educational interventions in studies. PRACTICE IMPLICATIONS Patient education needs to be delivered with technological solutions that best support the multidimensional needs of CHD patients.
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Affiliation(s)
- Hulda Halldorsdottir
- Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
| | - Asta Thoroddsen
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Brynja Ingadottir
- Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland; Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Kynoch K, Ramis MA, Crowe L, Cabilan CJ, McArdle A. Information needs and information seeking behaviors of patients and families in acute healthcare settings: a scoping review. ACTA ACUST UNITED AC 2020; 17:1130-1153. [PMID: 31192898 DOI: 10.11124/jbisrir-2017-003914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The objective of this scoping review was to explore the information needs and information seeking behaviors of patients and families from healthcare providers in acute healthcare settings in existing literature. INTRODUCTION A well-informed family can be crucial to a patient's capacity to cope with their diagnosis and hospital care during acute or chronic illness. Information is therefore critical to both the patient's and family's understanding of the illness and healthcare process. Providing appropriate and timely information can empower patients and families with knowledge and alleviate the anxiety and stress associated with a hospital admission. However, acutely ill patients and families in different acute care settings have considerable and differing information needs. INCLUSION CRITERIA This scoping review included studies undertaken in acute healthcare facilities where patients were over 18 years of age and family members were of any sex, culture and ethnicity. Family was defined as anyone connected to the patient by blood, marriage or other significant relationship. Healthcare provider perspectives of family and patient information needs were excluded. Concepts related to type of information, timing of information, preferences for who delivers the information and method of information delivery. Qualitative and quantitative study designs published from 2010 to 2017 in English were included. METHODS Multiple databases were searched to find published and unpublished studies. A three-step search strategy was utilized. A charting table was developed for the data extraction process to record data relating to the review objectives. Specific data extracted included details on research design, geographical location, year of publication, characteristics of study population, research aims and outcomes as well as key findings related to patient and family information needs. RESULTS The scoping review included 109 studies from across 34 countries. Of these studies, 68 used quantitative research designs, 29 were qualitative in nature and 12 included studies reported using mixed methods. One study used an action research methodology. Nine studies were specific to family information needs. A majority of studies were conducted in the cancer care context, with other acute settings comprising intensive care units, surgical settings and individual medical or surgical units/wards within and across the hospital. While most of the included studies addressed the type of content patients and/or families prefer, a few studies explored the timing of information provision. CONCLUSIONS The international literature on information needs of patient and families comprises multiple published studies on differing aspects of the topic and situated within various acute care contexts. Despite the broad nature of the research, studies suggest that preferences regarding information content, timing of information delivery and choices regarding who delivers information vary across contexts and according to the patient/family member. The complexity behind this variation and strategies to address tailoring information delivery requires further in-depth research.
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Affiliation(s)
- Kate Kynoch
- Evidence in Practice Unit, Mater Misericordiae Limited, South Brisbane, Australia.,The Queensland Centre for Evidence Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence
| | - Mary-Anne Ramis
- Evidence in Practice Unit, Mater Misericordiae Limited, South Brisbane, Australia.,The Queensland Centre for Evidence Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence
| | - Linda Crowe
- Evidence in Practice Unit, Mater Misericordiae Limited, South Brisbane, Australia.,The Queensland Centre for Evidence Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence
| | | | - Annie McArdle
- Parent Education and Support Services, Mater Mothers' Hospital, South Brisbane, Australia
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Ingadottir B, Thylén I, Ulin K, Jaarsma T. Patients are expecting to learn more: A longitudinal study of patients with heart failure undergoing device implantation. PATIENT EDUCATION AND COUNSELING 2020; 103:1382-1389. [PMID: 32122674 DOI: 10.1016/j.pec.2020.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the educational expectations and experiences of patients with heart failure in relation to device implantation. METHODS In this longitudinal study, patients at six Swedish and Icelandic hospitals answered instruments about their knowledge expectations, before the device implantation, and about the knowledge they had received at two weeks, six months and 12 months after the procedure. Predictors for fulfillment of knowledge expectations were assessed with linear mixed model analysis. RESULTS Patients (N = 133, mean age 69.8 (±9.7) years, 80 % men) had high knowledge expectations, which for 83 % of them were unfulfilled. Predictors for fulfillment of knowledge expectations were access to knowledge from healthcare professionals (β 0.74, 95 % CI: 0.42-1.10), educational level (β -0.30, 95 % CI: -0.52 to -0.07) and knowledge expectations (β -1.03, 95 % CI: -1.30 to -0.80). Healthcare professionals were the main information source (89 %), 74 % of patients received written information, and 19 % had used the Internet. CONCLUSIONS Patients receive less knowledge than they expect, and individual factors and communication with healthcare professionals are related to their experience. Face-to-face is the most common method of delivering education. PRACTICE IMPLICATIONS Healthcare professionals should assess patients' expectations for information and consider implementing more diversity in their educational practices.
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Affiliation(s)
- Brynja Ingadottir
- Faculty of Nursing, School of Health Sciences, Univeresity of Iceland, Reykjavik, Iceland; Landspitali, the National University Hospital of Iceland, Reykjavik, Iceland.
| | - Ingela Thylén
- Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kerstin Ulin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, Geriatrics and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Julius Center, University Medical Center, Utrecht, the Netherlands
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Lee C, Jafari M, Brownbridge R, Phillips C, Vanstone JR. The viral prescription pad - a mixed methods study to determine the need for and utility of an educational tool for antimicrobial stewardship in primary health care. BMC FAMILY PRACTICE 2020; 21:42. [PMID: 32087685 PMCID: PMC7035666 DOI: 10.1186/s12875-020-01114-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 02/18/2020] [Indexed: 12/17/2022]
Abstract
Background In order to combat rising rates of antimicrobial resistant infections, it is vital that antimicrobial stewardship become embedded in primary health care (PHC). Despite the high use of antimicrobials in PHC settings, there is a lack of data regarding the integration of antimicrobial stewardship programs (ASP) in non-hospital settings. Our research aimed to determine which antimicrobial stewardship interventions are optimal to introduce into PHC clinics beginning to engage with an ASP, as well as how to optimize those interventions. This work became focused specifically around management of viral upper respiratory tract infections (URTIs), as these infections are one of the main sources of inappropriate antibiotic use. Methods This mixed methods study of sequential explanatory design was developed through three research projects over 3 years in Regina, Saskatchewan, Canada. First, a survey of PHC providers was performed to determine their perceived needs from a PHC-based ASP. From this work, a “viral prescription pad” was developed to provide a tool to help PHC providers engage in patient education regarding appropriate antimicrobial use, specifically for URTIs. Next, interviews were performed with family physicians to discuss their perceived utility of this tool. Finally, we performed a public survey to determine preferences for the medium by which information is received regarding symptom management for viral URTIs. Results The majority of PHC providers responding to the initial survey indicated they were improperly equipped with tools to aid in promoting conversations with patients and providing education about the appropriate use of antimicrobials. Following dissemination of the viral prescription pad and semi-structured interviews with family physicians, the viral prescription pad was deemed to be a useful educational tool. However, about half of the physicians interviewed indicated they did not actually provide a viral prescription to patients when providing advice on symptom management for viral URTIs. When asked about their preferences, 76% of respondents to the public survey indicated they would prefer to receive written or a combination of verbal and written information in this circumstance. Conclusions PHC providers indicated a need for educational tools to promote conversations with patients and provide education about the appropriate use of antimicrobials. Viral prescription pads were regarded by family physicians and patients as useful tools in facilitating discussion on the appropriate use of antimicrobials. PHC providers should exercise caution in opting out of providing written forms of information, as many respondents to the general public survey indicated their preference in receiving both verbal and written information.
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Affiliation(s)
- Christine Lee
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Maryam Jafari
- Dr. T. Bhanu Prasad Medical Professional Corporation, 3401B Pasqua St., Regina, SK, S4S 7K9, Canada
| | - Regan Brownbridge
- College of Medicine, University of Saskatchewan, 107 Wiggins Rd., Saskatoon, SK, S7N 5E5, Canada
| | - Casey Phillips
- Antimicrobial Stewardship Program, Saskatchewan Health Authority - Regina Area, 4B35, 1440 - 14th Ave., Regina, SK, S4P 0W5, Canada
| | - Jason R Vanstone
- Stewardship and Clinical Appropriateness, Saskatchewan Health Authority - Regina Area, 4B35, 1440 - 14th Ave., Regina, SK, S4P 0W5, Canada.
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Zhao J, Davis SP. An integrative review of multimodal pain management on patient recovery after total hip and knee arthroplasty. Int J Nurs Stud 2019; 98:94-106. [DOI: 10.1016/j.ijnurstu.2019.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 05/21/2019] [Accepted: 06/21/2019] [Indexed: 01/25/2023]
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Ingadottir B, Blondal K, Thue D, Zoega S, Thylen I, Jaarsma T. Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study. JMIR Serious Games 2017; 5:e10. [PMID: 28490419 PMCID: PMC5443914 DOI: 10.2196/games.6894] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/07/2017] [Accepted: 03/24/2017] [Indexed: 11/15/2022] Open
Abstract
Background Postoperative pain is a persistent problem after surgery and can delay recovery and develop into chronic pain. Better patient education has been proposed to improve pain management of patients. Serious games have not been previously developed to help patients to learn how to manage their postoperative pain. Objective The aim of this study was to describe the development of a computer-based game for surgical patients to learn about postoperative pain management and to evaluate the usability, user experience, and efficacy of the game. Methods A computer game was developed by an interdisciplinary team following a structured approach. The usability, user experience, and efficacy of the game were evaluated using self-reported questionnaires (AttrakDiff2, Postoperative Pain Management Game Survey, Patient Knowledge About Postoperative Pain Management questionnaire), semi-structured interviews, and direct observation in one session with 20 participants recruited from the general public via Facebook (mean age 48 [SD 14]; 11 women). Adjusted Barriers Questionnaire II and 3 questions on health literacy were used to collect background information. Results Theories of self-care and adult learning, evidence for the educational needs of patients about pain management, and principles of gamification were used to develop the computer game. Ease of use and usefulness received a median score between 2.00 (IQR 1.00) and 5.00 (IQR 2.00) (possible scores 0-5; IQR, interquartile range), and ease of use was further confirmed by observation. Participants expressed satisfaction with this novel method of learning, despite some technological challenges. The attributes of the game, measured with AttrakDiff2, received a median score above 0 in all dimensions; highest for attraction (median 1.43, IQR 0.93) followed by pragmatic quality (median 1.31, IQR 1.04), hedonic quality interaction (median 1.00, IQR 1.04), and hedonic quality stimulation (median 0.57, IQR 0.68). Knowledge of pain medication and pain management strategies improved after playing the game (P=.001). Conclusions A computer game can be an efficient method of learning about pain management; it has the potential to improve knowledge and is appreciated by users. To assess the game’s usability and efficacy in the context of preparation for surgery, an evaluation with a larger sample, including surgical patients and older people, is required.
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Affiliation(s)
- Brynja Ingadottir
- Landspitali - the National University Hospital of Iceland, Surgical Services, Reykjavik, Iceland.,Division of Nursing, Department of Social and Welfare Studies, Linkoping University, Linkoping, Sweden.,Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Katrin Blondal
- Landspitali - the National University Hospital of Iceland, Surgical Services, Reykjavik, Iceland.,Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - David Thue
- School of Computer Science, Reykjavik University, Reykjavik, Iceland
| | - Sigridur Zoega
- Landspitali - the National University Hospital of Iceland, Surgical Services, Reykjavik, Iceland.,Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Ingela Thylen
- Department of Cardiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - Tiny Jaarsma
- Division of Nursing, Department of Social and Welfare Studies, Linkoping University, Linkoping, Sweden
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