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Promoting parental education of infants hospitalized in a children's hospital in Tabriz, Iran: a best practice implementation project. JBI Evid Implement 2020; 19:288-295. [PMID: 34491924 DOI: 10.1097/xeb.0000000000000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Parents of infants admitted to hospital have high information needs. A good educational program will improve the outcomes and communication needs of these parents. Results from some studies have shown that patient education in Iran is inappropriate and should be improved. OBJECTIVES The aim of this evidence implementation project was to evaluate the current practice and implement the best practice related to promoting patient education in a children's hospital in Tabriz, Iran. METHODS A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Eight audit criteria that represent the best practice recommendations for patient education were used. A baseline audit was conducted followed by implementing multiple strategies, and the project was finalized with a follow-up audit to determine a change in practice. RESULTS Significant improvements in the follow-up audit in comparison with the baseline audit were as follows: evaluation of patient learning has been undertaken to determine met and unmet needs (from 65 to 77%); patients' learning needs, readiness to learn, and their learning style have been assessed before the implementation of an educational initiative (from 55 to 66%); and educational resources in different formats (e.g., written handouts, brochures, and links to online materials) are available in the ward (from 33 to 77%). Strategies that were implemented to achieve change in practice included conducting workshops and conferences, determining a trained nurse as responsible for educating parents, training in discharge time, the presentation of educational films daily, conducting group training, and installing related posters in the department and patient's room. The other five criteria were less compliant with best practice in the follow-up audit rather than the baseline audit; however, all of them except one (Criterion 3) were still up to 75% compliant, which is considered excellent by the audit team. CONCLUSION The follow-up audit results indicated an improvement in providing parental education. It can be concluded that these interventions can facilitate the implementation of evidence into clinical practice.
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Hirsch JK, Toussaint L, Offenbächer M, Kohls N, Hanshans C, Vallejo M, Rivera J, Sirois F, Untner J, Hölzl B, Gaisberger M, Ndosi M. Educational needs of patients with rheumatic and musculoskeletal diseases attending a large health facility in Austria. Musculoskeletal Care 2020; 18:391-396. [PMID: 32314524 DOI: 10.1002/msc.1474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Patient education is an important part of the management of rheumatic and musculoskeletal diseases. Given that patients with diverse diseases do not have the same needs, it is crucial to assess the educational requirements of targeted groups to provide tailored educational interventions. The aim of our study was to assess educational needs of a large cohort of patients with different rheumatic and musculoskeletal diseases attending a health facility in Austria. METHODS We assessed educational needs, via an online survey of patients with fibromyalgia (FMS), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) recruited from an Austrian health-care facility, using the Austrian version of the Educational Needs Assessment Tool (OENAT). RESULTS For our sample of 603 patients, AS (62%), RA (15%), and FMS (24%), there were no educational need differences for the domains of movements, disease process, and self-help measures. Patients with FMS had less need for pain management education and greater need for education about feelings, than other disease groups. Patients with RA had a greater need for education related to treatments than other groups, and patients with AS had a greater need for treatment education than patients with FMS. Patients with AS reported greater need for support system education than other patient groups. CONCLUSION Educational needs vary by disease groups, suggesting that health-care professionals should assess disease-specific needs for education to provide optimal assistance in disease management for patients.
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Affiliation(s)
- Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Loren Toussaint
- Department of Psychology, Luther College, Decorah, Iowa, USA
| | | | - Niko Kohls
- Department of Integrative Health Promotion, University of Applied Science, Coburg, Germany
| | - Christian Hanshans
- Department of Applied Sciences and Mechatronics, University of Applied Science, Munich, Germany
| | - Miguel Vallejo
- Department of Psychology, National Distance Education University, Madrid, Spain
| | - Javier Rivera
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Fuschia Sirois
- Department of Psychology, University of Sheffield, Sheffield, UK
| | | | | | - Martin Gaisberger
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
| | - Mwidimi Ndosi
- Department of Nursing and Midwifery, University of the West of England, Bristol, UK
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Grønning K, Lim S, Bratås O. Health status and self-management in patients with inflammatory arthritis-A five-year follow-up study after nurse-led patient education. Nurs Open 2020; 7:326-333. [PMID: 31871717 PMCID: PMC6917950 DOI: 10.1002/nop2.394] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/27/2019] [Accepted: 09/09/2019] [Indexed: 01/13/2023] Open
Abstract
Aim The aim of this study was to investigate changes in patients' self-management and health status five years after nurse-led patient education. Design A longitudinal study. Methods We collected self-reported data on physical function, pain, tiredness, disease activity, psychological status, patient activation and self-efficacy from a sample of Norwegian-speaking adults with inflammatory arthritis that had participated in a randomised controlled study investigating the effects of nurse-led patient education. Changes and associations in patients' health status and self-management were analysed with paired sample t tests and multivariable linear regression analyses, respectively. Results Except from a small deterioration in patients' physical function, there were no changes in patients' health status 5 years after the nurse-led patient education. Patients' self-management skills were improved after 5 years. Self-efficacy was positively associated with female gender, patient activation, less tiredness and less psychological distress.
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Affiliation(s)
- Kjersti Grønning
- Department of Public Health and NursingNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of RheumatologyTrondheim University HospitalSt.Olavs Hospital Prinsesse Kristinas gate 3TrondheimNorway
| | - Siriwan Lim
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Ola Bratås
- Department of Public Health and NursingNorwegian University of Science and Technology (NTNU)TrondheimNorway
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Nurses' roles in the management of chronic inflammatory arthritis: a systematic review. Rheumatol Int 2018; 38:2027-2036. [PMID: 30128732 PMCID: PMC6208652 DOI: 10.1007/s00296-018-4135-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/14/2018] [Indexed: 01/10/2023]
Abstract
In 2011 EULAR first published recommendations for the potential role of nurses in the management of patients with rheumatic diseases. To perform a literature update for the role of nurses in the management of chronic inflammatory arthritis (CIA) from 2010 to 2018. A systematic literature review (SLR) was performed according to the PRISMA guidelines, in accordance with the search strategies and eligibility criteria of the EULAR taskforce. The eligibility criteria were “inflammatory arthritis”, “interventions undertaken by nurses” and “relevant outcomes to answer the research questions”. Exclusion criteria were in itself contradictory outcomes, insufficient data, consideration if they did not clearly distinguish between nurses and health professionals or focused on chronic other than rheumatic diseases. Systematic reviews were classified as descriptive and excluded. Quality of selected trials was determined according to Oxford—levels of evidence 2009. A total of 48 articles and 10 abstracts were identified fulfilling the eligibility and exclusion criteria. Recommendation 1 has been well established in Europe so far. New evidence strengthens the recommendation 3, and—at least in part—recommendation 6. High evidence strengthens recommendation 4, especially for outpatients with low and stable disease activity. Some new evidence also exists for recommendations 7 and 8. This SLR reveals new evidence for the role of nurses in managing CIA patients since 2010, especially for RA-patients with low disease activity or in remission.
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Connelly K, Segan J, Lu A, Saini M, Cicuttini FM, Chou L, Briggs AM, Sullivan K, Seneviwickrama M, Wluka AE. Patients' perceived health information needs in inflammatory arthritis: A systematic review. Semin Arthritis Rheum 2018; 48:900-910. [PMID: 30185378 DOI: 10.1016/j.semarthrit.2018.07.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/21/2018] [Accepted: 07/26/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To identify the breadth of the literature regarding patients' perceived health information needs related to inflammatory arthritis care. METHODS A systematic scoping review of MEDLINE, EMBASE, CINAHL and PsycINFO was performed to identify relevant articles (1990 -2016) examining patients' perceived needs relating to health information in inflammatory arthritis. Data and themes were identified and categorised and risk of bias assessed. RESULTS Twenty nine studies (11 quantitative, 14 qualitative and 4 mixed methods) from 4121 identified articles were relevant for inclusion. Most focussed on rheumatoid arthritis. Key findings included: (1) Reasons for seeking health information often focussed on gaining ownership over their condition and facilitating self-management. (2) Demographic differences in information needs were inconsistent, but women and younger patients generally reported more needs. (3) Desired information content was broad, and included targeted and practical information covering disease treatment and psychosocial wellbeing. (4) Preferred information delivery method was consultation with a Rheumatologist; however group sessions had advantages for psychosocial issues while written information provided useful supplementation. (5) Barriers to meeting health information needs were around timely access. CONCLUSIONS Patients with inflammatory arthritis have high information needs, desiring practical and individualised information. When developing strategies to meet patients' information needs, aligning patient expectations with delivery methods that are accessible, cost-effective and flexible may help to optimize patient outcomes.
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Affiliation(s)
- Kathryn Connelly
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Julian Segan
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Alicia Lu
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Meher Saini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Louisa Chou
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia; MOVE: Muscle, Bone & Joint Health, Victoria, Australia
| | - Kaye Sullivan
- Monash University Library, Monash University, Melbourne, Victoria, Australia
| | - Maheeka Seneviwickrama
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
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Fusama M, Nakahara H, van Eijk-Hustings Y, Oliver S, Takeuchi T. Survey on attitudes regarding EULAR recommendations for the role of nurses involved in medical care of patients with chronic inflammatory arthritis in Japan. Mod Rheumatol 2017; 27:886-893. [PMID: 27846750 DOI: 10.1080/14397595.2016.1260199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mie Fusama
- Division of Nursing, NTT West Osaka Hospital, Osaka, Japan,
| | - Hideko Nakahara
- Division of Allergy, Rheumatology and Connective Tissue Diseases, Department of Internal Medicine, NTT West Osaka Hospital, Osaka, Japan,
| | - Yvonne van Eijk-Hustings
- Department of Patient & Care and Department of Rheumatology, University of Maastricht, Maastricht, The Netherlands,
| | | | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Patient education in rheumatoid arthritis: is the needs-based approach the way forward? Clin Rheumatol 2015; 34:1827-9. [PMID: 26384819 DOI: 10.1007/s10067-015-3063-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 08/15/2015] [Accepted: 08/18/2015] [Indexed: 10/23/2022]
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Schouffoer A, Ndosi ME, Vliet Vlieland TPM, Meesters JJL. The educational needs of people with systemic sclerosis: a cross-sectional study using the Dutch version of the Educational Needs Assessment Tool (D-ENAT). Rheumatol Int 2015; 36:289-94. [PMID: 26321625 PMCID: PMC4723617 DOI: 10.1007/s00296-015-3352-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 08/19/2015] [Indexed: 11/11/2022]
Abstract
The Dutch Educational Needs Assessment Tool (D-ENAT) systematically assesses educational needs of patients with rheumatic diseases. The present study aims to describe the educational needs of Dutch patients with systemic sclerosis (SSc). The D-ENAT was sent to 155 SSc patients registered at the outpatient clinic of a university hospital. The D-ENAT consists of 39 items in seven domains. “Each domain has different number of items therefore we normalized each domain score: (domain score/maximum) × 100) and expressed in percentage to enable comparisons between domains.” A total D-ENAT score (0–156) is calculated by summing all 39 items. In addition, age, disease duration, gender, educational level, present information need (yes/no) and information need (1–4; wanting to know nothing–everything) were recorded. Univariate regression analysis was used to examine factors associated with the D-ENAT scores. The response rate was 103 out of 155 (66 %). The mean % of educational needs scores (0–100 %; lowest–highest) were 49 % for “D-ENAT total score,” 46 % for “Managing pain,” 41 % for “Movement,” 43 % for “Feelings,” 59 % for “Disease process,” 44 % for “Treatments from health professionals,” 61 % for “Self-help measures” and 51 % for “Support systems.” No associations between the D-ENAT total score and age, disease duration, gender and educational level were found. The D-ENAT demonstrated its ability to identify educational needs of Dutch SSc patients. SSc patients demonstrated substantial educational needs, especially in the domains: “Disease process” and “Self-help measures.” The validity and practical applicability of the D-ENAT to make an inventory of SSc patients’ educational needs require further investigation.
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Affiliation(s)
- Anne Schouffoer
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Rheumatology, Haga Hospital, The Hague, The Netherlands
| | - Mwidimi E Ndosi
- Academic and Clinical Unit for Musculoskeletal Nursing, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,School of Healthcare, University of Leeds, Leeds, UK
| | - Thea P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Jorit J L Meesters
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. .,Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
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Ndosi M, Johnson D, Young T, Hardware B, Hill J, Hale C, Maxwell J, Roussou E, Adebajo A. Effects of needs-based patient education on self-efficacy and health outcomes in people with rheumatoid arthritis: a multicentre, single blind, randomised controlled trial. Ann Rheum Dis 2015; 75:1126-32. [PMID: 26162769 PMCID: PMC4893097 DOI: 10.1136/annrheumdis-2014-207171] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 06/09/2015] [Indexed: 12/22/2022]
Abstract
Objectives The Educational Needs Assessment Tool (ENAT) is a self-completed questionnaire, which allows patients with arthritis to prioritise their educational needs. The aim of this study was to evaluate the effects of needs-based patient education on self-efficacy, health outcomes and patient knowledge in people with rheumatoid arthritis (RA). Methods Patients with RA were enrolled into this multicentre, single-blind, parallel-group, pragmatic randomised controlled trial. Patients were randomised to either the intervention group (IG) where patients completed ENAT, responses of which were used by the clinical nurse specialist to guide patient education; or control group (CG) in which they received patient education without the use of ENAT. Patients were seen at weeks 0, 16 and 32. The primary outcome was self-efficacy (Arthritis Self Efficacy Scale (ASES)-Pain and ASES-Other symptoms). Secondary outcomes were health status (short form of Arthritis Impact Measurement Scale 2, AIMS2-SF) and patient knowledge questionnaire-RA. We investigated between-group differences using analysis of covariance, adjusting for baseline variables. Results A total of 132 patients were recruited (IG=70 and CG=62). Their mean (SD) age was 54 (12.3) years, 56 (13.3) years and disease duration 5.2 (4.9) years, 6.7 (8.9) years for IG and CG, respectively. There were significant between-group differences, in favour of IG at week 32 in the primary outcomes, ASES-Pain, mean difference (95% CI) −4.36 (1.17 to 7.55), t=−2.72, p=0.008 and ASES-Other symptoms, mean difference (95% CI) −5.84 (2.07 to 9.62), t=−3.07, p=0.003. In secondary outcomes, the between-group differences favoured IG in AIMS2-SF Symptoms and AIMS2-SF Affect. There were no between-group differences in other secondary outcomes. Conclusions The results suggest that needs-based education helps improve patients’ self-efficacy and some aspects of health status. Trial registration number ISRCTN51523281.
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Affiliation(s)
- M Ndosi
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK School of Healthcare, University of Leeds, Leeds, UK
| | - D Johnson
- Department of Rheumatology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK Research & Development Department, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
| | - T Young
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - B Hardware
- Department of Rheumatology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
| | - J Hill
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - C Hale
- School of Healthcare, University of Leeds, Leeds, UK
| | - J Maxwell
- Department of Rheumatology, Rotherham Hospital NHS Foundation Trust, Rotherham, UK
| | - E Roussou
- Department of Rheumatology, King George Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Ilford, UK
| | - A Adebajo
- Department of Rheumatology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
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