1
|
de Sá JS, Santana MDO, dos Santos MG, Benedito JCDS, Teston EF. Tecnologias educacionais utilizadas para promoção do autocuidado de pessoas com diabetes mellitus: revisão integrativa. Rev Bras Enferm 2023; 76Suppl 4:e20230049. [PMID: 38088712 PMCID: PMC10704671 DOI: 10.1590/0034-7167-2023-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 08/04/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To summarize the scientific productions that used educational technologies to promote self-care for people with diabetes. METHOD Integrative review carried out from October 2022 to January 2023, in the databases: LILACS; Scopus; Embase; PubMed/MEDLINE and CINAHL. The search was paired, and the sample consisted of ten articles. The levels of evidence were analyzed by the Hierarchy of Evidence for Intervention Studies, and the results were synthesized for interpretation of the findings. RESULTS The educational technologies identified to promote self-care were: mobile applications, interactive platforms, print, telemonitoring, video and simulation. The focus of the contents was on the promotion of foot care, prevention of neuropathy, self-management, knowledge, and expectation of people with diabetes and prevention of acute complications. CONCLUSION The synthesis of knowledge about educational technologies to promote self-care for people with diabetes pointed to the need for robust evidence.
Collapse
Affiliation(s)
- Jennyfer Soares de Sá
- Universidade Federal do Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | | | - Elen Ferraz Teston
- Universidade Federal do Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| |
Collapse
|
2
|
Van Arsdale S, Cooper V, Bernhardt JS, Barrientos S, Messina LA, Gandhi S, Ferry LH, Shell D, Deuster PA. Bridging Total Force Fitness and Whole Health in Cardiovascular Disease Prevention. Mil Med 2023; 188:38-42. [PMID: 37665591 DOI: 10.1093/milmed/usad166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/14/2023] [Accepted: 07/19/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION The Cardiovascular Disease (CVD) Prevention project is a VA-DoD initiative, supported by the Joint Incentive Fund. The goal of the project is to create an innovative, 3D virtual space within the VA-Virtual Medical Center (VA-VMC) platform that provides Veterans and Active Duty Service Members with educational resources on the prevention of CVD. MATERIALS AND METHODS The Performance Health and Wellness Center is a new center within the VA-VMC. The space enables users to explore information and actionable resources on various risk factors related to CVD through independent and provider-led instruction, using a personalized 3D avatar. RESULTS Partners of DoD and VA envision users engaging with the learning resources securely and with a sense of anonymity, which can foster self-directed learning and healthy behavior change. The DoD is particularly invested in promoting CVD prevention through the early adoption of positive health behaviors and the Total Force Fitness framework. The VA team is also committed to supporting users by providing professionally led classes and support groups on various CVD risk factors like tobacco, diabetes, nutrition, and exercise. CONCLUSIONS This project is a unique and important collaboration during a time when telehealth and telemedicine services are in greater demand. The VA-VMC advances accessible, relevant, and evidence-based educational services for DoD and VA populations, and the Performance Health and Wellness Center, itself, presents Total Force Fitness concepts and a whole-person care approach while encouraging users to be actively involved in shared decision-making with their health care providers.
Collapse
Affiliation(s)
- Stephanie Van Arsdale
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Vaughn Cooper
- Production & Delivery, Institute for Learning, Education and Development (ILEAD), Washington, DC 20420, USA
| | - Jaime S Bernhardt
- Client Relations, Institute for Learning, Education and Development (ILEAD), Washington, DC 20420, USA
| | - Stephanie Barrientos
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Lauren A Messina
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Sabina Gandhi
- Preventive Medicine Section, VA Loma Linda Healthcare System (605-111PM), Loma Linda, CA 92357, USA
| | - Linda Hyder Ferry
- Preventive Medicine Section, VA Loma Linda Healthcare System (605-111PM), Loma Linda, CA 92357, USA
- Preventive Medicine and Family Medicine Department, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Donald Shell
- Health Services Policy and Oversight OASD(HA), Disease Prevention, Disease Management and Population Health Policy & Oversight, Defense Health Headquarters, Falls Church, VA 22042, USA
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| |
Collapse
|
3
|
Bishop E, Allington D, Ringrose T, Martin C, Aldea A, García-Jaramillo M, León-Vargas F, Leal Y, Henao D, Gómez AM. Design and Usability of an Avatar-Based Learning Program to Support Diabetes Education: Quality Improvement Study in Colombia. J Diabetes Sci Technol 2023; 17:1142-1153. [PMID: 36377096 PMCID: PMC10563524 DOI: 10.1177/19322968221136141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This quality improvement study, entitled Avatar-Based LEarning for Diabetes Optimal Control (ABLEDOC), explored the feasibility of delivering an educational program to people with diabetes in Colombia. The aim was to discover how this approach could be used to improve awareness and understanding of the condition, the effects of treatment, and strategies for effective management of blood-glucose control. METHODS Individuals with diabetes were recruited by Colombian endocrinologists to a human-centered study to codesign the educational program, using the Double Diamond model. Participants contributed to two phases. The first phase focused on gathering unmet educational needs and choice of curriculum. Three prototypes were developed as a result. During phase 2, a different group of participants engaged with the program for several weeks, before reporting back. RESULTS Thirty-six participants completed a Web survey during phase 1, and five were also interviewed by telephone. The majority (33 of 36; 91%) were receptive to the prospect of educational interventions and ranked the chosen topic of hypoglycemia highly. In phase 2, the three prototypes were tested by 17 participants, 10 of whom also gave feedback in focus groups. The response was overwhelmingly positive, with 16 of 17 (94%) stating they would use a program like this again. The 3D version was the most highly rated. CONCLUSIONS Immersive, avatar-based programs, delivered through smartphone, have the potential to deliver educational information that is trusted, engaging, and useful. Future work includes expansion of the curriculum, evaluation with a larger group, and exploration of the prospective role of artificial intelligence in personalizing this form of educational intervention.
Collapse
Affiliation(s)
| | | | | | - Clare Martin
- Faculty of Technology, Design and
Environment, Oxford Brookes University, Oxford, UK
| | - Arantza Aldea
- Faculty of Technology, Design and
Environment, Oxford Brookes University, Oxford, UK
| | | | - Fabian León-Vargas
- Faculty of Mechanical, Electronic and
Biomedical Engineering, Universidad Antonio Nariño, Bogotá, Colombia
| | - Yenny Leal
- Institut d’Investigació Biomèdica de
Girona Dr. Josep Trueta, Girona, Spain
| | - Diana Henao
- Endocrinology Unit, Hospital
Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ana Maria Gómez
- Endocrinology Unit, Hospital
Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| |
Collapse
|
4
|
Kim TW, Kim SH. Effectiveness of patient education on total knee arthroplasty: A systematic review and meta-analysis. J Clin Nurs 2023; 32:2383-2398. [PMID: 35429079 DOI: 10.1111/jocn.16324] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/06/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES This study was designed to examine the contents and methods of patient educational interventions about total knee arthroplasty (TKA) and their effectiveness in reducing postoperative pain and enhancing range of motion (ROM) in the literature. BACKGROUND Patient education has been provided to facilitate recovery after TKA; however, little is known about the contents and methods of the interventions and their effectiveness in reducing postoperative pain and enhancing ROM. DESIGN This is a systematic review and meta-analysis of randomised controlled trials (RCTs). METHODS Published studies from June 1998-June 2021 were identified from electronic databases. Two independent investigators assessed the quality of the studies by using the revised Cochrane risk-of-bias tool. Meta-analyses with random-effects models were conducted to assess the effectiveness of the interventions using the Comprehensive Meta-Analysis Software. The study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. RESULTS Among 12 articles that met the inclusion criteria, three interventions provided education on pain management and mobility/exercises. The most common educational methods were the combinations of oral explanation, written materials, and audiovisual materials, group discussion, while four studies used information technology (IT) devices. The meta-analysis demonstrated that the educational interventions using IT devices were effective in improving pain and ROM, but not the interventions that did not use IT devices. CONCLUSION Structured education for pain management, communication and/or exercise support programs utilising diverse methods have been provided to patients undergoing TKA. Using IT devices could successfully enhance the effectiveness of educational interventions for patients undergoing TKA. RELEVANCE TO CLINICAL PRACTICE Integration of postoperative pain management and mobility/exercises with the use of IT devices should be actively considered in providing patient education in clinical nursing practice.
Collapse
Affiliation(s)
- Tae Woo Kim
- Kyungpook National University Hospital, Daegu, South Korea
| | - Su Hyun Kim
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| |
Collapse
|
5
|
Krutter S, Schuessler N, Kutschar P, Šabić E, Dellinger J, Klausner T, Nestler N, Beasley M, Henderson B, Pitzer S, Mitterlehner B, Langegger D, Winkler A, Kloesch M, Eßl-Maurer R, van der Zee-Neuen A, Osterbrink J. Piloting of the virtual telecare technology 'Addison Care' to promote self-management in persons with chronic diseases in a community setting: protocol for a mixed-methods user experience, user engagement and usability pilot study. BMJ Open 2022; 12:e062159. [PMID: 36123104 PMCID: PMC9486344 DOI: 10.1136/bmjopen-2022-062159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Chronic diseases in older adults are one of the major epidemiological challenges of current times and leading cause of disability, poor quality of life, high healthcare costs and death. Self-management of chronic diseases is essential to improve health behaviours and health outcomes. Technology-assisted interventions have shown to improve self-management of chronic diseases. Virtual avatars can be a key factor for the acceptance of these technologies. Addison Care is a home-based telecare solution equipped with a virtual avatar named Addison, connecting older persons with their caregivers via an easy-to-use technology. A central advantage is that Addison Care provides access to self-management support for an up-to-now highly under-represented population-older persons with chronic disease(s), which enables them to profit from e-health in everyday life. METHODS AND ANALYSIS A pragmatic, non-randomised, one-arm pilot study applying an embedded mixed-methods approach will be conducted to examine user experience, usability and user engagement of the virtual avatar Addison. Participants will be at least 65 years and will be recruited between September 2022 and November 2022 from hospitals during the discharge process to home care. Standardised instruments, such as the User Experience Questionnaire, System Usability Scale, Instrumental Activities of Daily Living scale, Short-Form-8-Questionnaire, UCLA Loneliness Scale, Geriatric Depression Scale, Stendal Adherence with Medication Score and Self-Efficacy for Managing Chronic Diseases Scale, as well as survey-based assessments, semistructured interviews and think-aloud protocols, will be used. The study seeks to enrol 20 patients that meet the criteria. ETHICS AND DISSEMINATION The study protocol has been approved by the ethic committee of the German Society for Nursing Science (21-037). The results are intended to be published in peer-reviewed journals and disseminated through conference papers. TRIAL REGISTRATION NUMBER DRKS00025992.
Collapse
Affiliation(s)
- Simon Krutter
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Nadine Schuessler
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Patrick Kutschar
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Edin Šabić
- Department of Psychology, New Mexico State University, Las Cruces, New Mexico, USA
- Electronic Caregiver Inc, Las Cruces, New Mexico, USA
| | - Johanna Dellinger
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Tabea Klausner
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Nadja Nestler
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | | | - Stefan Pitzer
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Barbara Mitterlehner
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Doris Langegger
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Anna Winkler
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Michael Kloesch
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Roland Eßl-Maurer
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Antje van der Zee-Neuen
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Jürgen Osterbrink
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg, Salzburg, Austria
- Brooks College of Health, University of North Florida, Jacksonville, Florida, USA
| |
Collapse
|
6
|
Geirhos A, Stephan M, Wehrle M, Mack C, Messner EM, Schmitt A, Baumeister H, Terhorst Y, Sander LB. Standardized evaluation of the quality and persuasiveness of mobile health applications for diabetes management. Sci Rep 2022; 12:3639. [PMID: 35256661 PMCID: PMC8901695 DOI: 10.1038/s41598-022-07544-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/02/2022] [Indexed: 11/08/2022] Open
Abstract
This study evaluates diabetes self-management mobile health applications available from European app stores with respect to quality, concordance with recommended self-management tasks and implementation of persuasive system design principles. The European Play Store and Apple App Store were systematically searched and relevant apps were tested. Two raters independently assessed app quality using the Mobile Application Rating Scale and conducted a content analysis of provided persuasive system design principles and self-management tasks. A total of 2,269 mobile health applications were identified and 120 could be included in the evaluation. The overall quality was rated as moderate M = 3.20 (SD = 0.39, min = 2.31, max = 4.62), with shortcomings in the subcategories of engagement (M = 2.80, SD = 0.67) and information quality (M = 2.26, SD = 0.48). Scientific evidence is available for 8% of the apps. The reviewed apps implemented a median of three persuasive system design principles (range 0-15) and targeted a median of 4.5 (range 1-8) self-management tasks, however, with a lack of information about psychosocial coping strategies. Most available diabetes self-management apps lack a scientific evidence base. Persuasive system design features are underrepresented and may form a promising tool to improve app quality. Furthermore, the interaction of physical and behavioral health should be improved in existing diabetes self-management mobile health applications.
Collapse
Affiliation(s)
- A Geirhos
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - M Stephan
- Department of Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs University Freiburg, Freiburg, Germany
| | - M Wehrle
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - C Mack
- Department of Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs University Freiburg, Freiburg, Germany
| | - E-M Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - A Schmitt
- Research Institute of the Diabetes Academy Mergentheim, Diabetes Center Mergentheim (DZM), Bad Mergentheim, Germany
| | - H Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - Y Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - L B Sander
- Department of Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs University Freiburg, Freiburg, Germany.
| |
Collapse
|
7
|
Lee Y, Lee NY, Lim HJ, Sung S. Weight Reduction Interventions Using Digital Health for Employees with Obesity: A Systematic Review. Diabetes Metab Syndr Obes 2022; 15:3121-3131. [PMID: 36246516 PMCID: PMC9555217 DOI: 10.2147/dmso.s384450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/05/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to systematically review the literature on randomized controlled trials on weight reduction interventions using digital health for employees with obesity. METHODS All relevant articles published until September 2021 were systematically identified from six electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, RISS, and KISS. Data selection and extraction were independently performed by three researchers. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Randomized Controlled Trials. The results were narratively synthesized. RESULTS Eleven studies were included in the systematic review. All studies had a low risk of bias. The settings and sample sizes of the included studies were different. The contents of the interventions included nutrition, physical activity, behavioral change, incentives, and motivation. Four studies were based on social cognitive theory. A total of ten studies delivered web-based intervention, while the other used tele-monitoring device. A wide range of intervention strategies was used including providing online resources, tele-counseling, and patient-tailored advice. As a result of the intervention, a total of seven studies showed a significant weight reduction in both the intervention and comparison groups, with significant differences between groups. CONCLUSION Until now, use of digital health in weight reduction interventions for employees with obesity has been conducted on a web-based. Various contents such as nutrition, physical activity and theories were explored. Further study is required using more diverse delivery methods such as mobile application, use of wearable devices.
Collapse
Affiliation(s)
- Yewon Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Fresenius Medical Care Southern Manhattan, New York, NY, USA
| | - Na Young Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Hee Jeong Lim
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Sumi Sung
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Correspondence: Sumi Sung, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea, Tel +82 2 6072 5374, Fax +82 2 2072 0318, Email
| |
Collapse
|
8
|
Ghozali M, Amalia Islamy ID, Hidayaturrohim B. Effectiveness of an educational mobile-app intervention in improving the knowledge of COVID-19 preventive measures. INFORMATICS IN MEDICINE UNLOCKED 2022; 34:101112. [PMID: 36285324 PMCID: PMC9585884 DOI: 10.1016/j.imu.2022.101112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 11/28/2022] Open
|
9
|
Come for Information, Stay for Support: Harnessing the Power of Online Health Communities for Social Connectedness during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312743. [PMID: 34886468 PMCID: PMC8656945 DOI: 10.3390/ijerph182312743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic created a globally shared stressor that saw a rise in the emphasis on mental and emotional wellbeing. However, historically, these topics were not openly discussed, leaving those struggling without professional support. One powerful tool to bridge the gap and facilitate connectedness during times of isolation is online health communities (OHCs). This study surveyed Health Union OHC members during the pandemic to determine the degree of COVID-19 concern, social isolation, and mental health distress they are facing, as well as to assess where they are receiving information about COVID-19 and what sources of support they desire. The survey was completed in six independent waves between March 2020 and April 2021, and garnered 10,177 total responses. In the United States, OHCs were utilized significantly more during peak lockdown times, and the desire for emotional and/or mental health support increased over time. Open-ended responses demonstrated a strong desire for connection and validation, which are quintessential characteristics of OHCs. Through active moderation utilizing trained moderators, OHCs can provide a powerful, intermediate and safe space where conversations about mental and emotional wellbeing can be normalized and those in need are encouraged to seek additional assistance from healthcare professionals if warranted.
Collapse
|
10
|
Kim SK, Kim HS, Chung SS. Effects of an Individualized Educational Program for Korean Patients With Chronic Low Back Pain: A Randomized Controlled Trial. J Nurs Res 2021; 29:e177. [PMID: 34593721 DOI: 10.1097/jnr.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Most patients with low back pain prefer to ignore symptoms and avoid medical management because of incorrect perceptions about this condition. However, over 90% of patients with chronic low back pain are hardly unable to perform daily activities, with 50% reporting that their daily activities have been severely impeded. PURPOSE In this study, an individualized educational program was developed and implemented in a sample of Korean patients with chronic low back pain, and the effectiveness of this program was evaluated. METHODS This study was conducted as a randomized controlled trial with outpatients (n = 43) in an orthopedic clinic. The Analysis, Design, Development, Implementation, and Evaluation model was applied to develop the educational program. The experimental group was provided with an educational booklet and contacted via biweekly personalized telephone and face-to-face counseling sessions. The control group was provided the educational booklet only. SAS Version 9.4 was used to analyze collected data using the χ2 test, t test, Fisher's exact test, Wilcoxon test, linear regression analysis, and Spearman partial correlation analysis. RESULTS After 8 weeks, the experimental group demonstrated a significantly greater reduction in maximum, average, and current low back pain experienced within the immediately preceding 24 hours than the control group (p = .001, p = .002, and p = .014, respectively). In addition, daily living disability showed a greater reduction, and average back muscle strength showed a more significant improvement in the experimental group than in the control group (p = .001 and p = .035). The difference in medication adherence between the groups was not statistically significant (p = .089). The experimental group rated an average of 4.3 out of 5.0 points on the program satisfaction scale, indicating an 86% rate of satisfaction. CONCLUSIONS/IMPLICATIONS FOR PRACTICE In this study, the individualized educational program was shown to be effective in helping alleviate symptoms in patients with chronic low back pain, decrease daily living disability, and improve average back muscle strength. It was further demonstrated that following up with expert medical staffs can motivate patients to incorporate the recommendations of the program into their daily routine, leading to higher patient satisfaction.
Collapse
Affiliation(s)
- Seong-Kyong Kim
- PhD, RN, General Manager, Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Hee-Seung Kim
- PhD, RN, Emeritus Professor, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Soo Chung
- PhD, MD, Orthopedist, Department of Orthopedic Surgery, Bumin Hospital, Busan, Republic of Korea
| |
Collapse
|
11
|
Chalfont G, Mateus C, Varey S, Milligan C. Self-Efficacy of Older People Using Technology to Self-Manage COPD, Hypertension, Heart Failure, or Dementia at Home: An Overview of Systematic Reviews. THE GERONTOLOGIST 2021; 61:e318-e334. [PMID: 32530031 DOI: 10.1093/geront/gnaa045] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although telehealth research among the general population is voluminous, the quality of studies is low and results are mixed. Little is known specifically concerning older people and their self-efficacy to engage with and benefit from such technologies. This article reviews the evidence for which self-care telehealth technology supports the self-efficacy of older people with long-term conditions (LTCs) living at home. RESEARCH DESIGN AND METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) guidelines, this overview of systematic reviews focused on four LTCs and the concept of "self-efficacy." Quality was appraised using R-AMSTAR and study evaluation was guided by the PRISMS taxonomy for reporting of self-management support. Heterogeneous data evidencing technology-enhanced self-efficacy were narratively synthesized. RESULTS Five included articles contained 74 primary studies involving 9,004 participants with chronic obstructive pulmonary disease, hypertension, heart failure, or dementia. Evidence for self-care telehealth technology supporting the self-efficacy of older people with LTCs living at home was limited. Self-efficacy was rarely an outcome, also attrition and dropout rates and mediators of support or education. The pathway from telehealth to self-efficacy depended on telehealth modes and techniques promoting healthy lifestyles. Increased self-care and self-monitoring empowered self-efficacy, patient activation, or mastery. DISCUSSION AND IMPLICATIONS Future research needs to focus on the process by which the intervention works and the effects of mediating variables and mechanisms through which self-management is achieved. Self-efficacy, patient activation, and motivation are critical components to telehealth's adoption by the patient and hence to the success of self-care in self-management of LTCs. Their invisibility as outcomes is a limitation.
Collapse
Affiliation(s)
- Garuth Chalfont
- Centre for Ageing Research, Division of Health Research, Faculty of Health and Medicine, Health Innovation 1, Lancaster University, UK
| | - Céu Mateus
- Health Economics, Division of Health Research, Faculty of Health and Medicine, Health Innovation One, Lancaster University, UK
| | - Sandra Varey
- Centre for Ageing Research, Division of Health Research, Faculty of Health and Medicine, Health Innovation 1, Lancaster University, UK
| | - Christine Milligan
- Centre for Ageing Research, Division of Health Research, Faculty of Health and Medicine, Health Innovation 1, Lancaster University, UK
| |
Collapse
|
12
|
Breast cancer-related lymphedema patient and healthcare professional experiences in lymphedema self-management: a qualitative study. Support Care Cancer 2021; 29:8027-8044. [PMID: 34226959 DOI: 10.1007/s00520-021-06390-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Breast cancer-related lymphedema (BCRL) self-management plays an important role in the lymphedema therapy. However, clinical knowledge of BCRL self-management remains minimal. This study aims to explore the experience surrounding lymphedema self-management from the perspectives of BCRL patients and healthcare professionals. METHODS Semi-structured interviews were implemented with BCRL patients and healthcare professionals. Audio-recordings of interviews were transcribed verbatim and thematic analysis was undertaken to analyze the interview data. RESULTS Thirteen BCRL patients (aged 34-65 years) and nine healthcare professionals (2 physicians, 4 nurses, and 3 lymphedema therapists) were interviewed. Five themes emerged from interviews with participants: knowledge-attitude-practice surrounding lymphedema self-management, emotional reactions towards lymphedema self-management, factors influencing lymphedema self-management, support needs for lymphedema self-management, healthcare professional support of BCRL self-management. CONCLUSIONS This study showed knowledge-attitude-practice, feelings, influencing factors, roles, dilemmas, and support needs regarding BCRL self-management. Greater effort is required for healthcare professionals to strengthen the lymphedema self-management. Providing more educational program and holistic support, and strengthening the facilitators and controlling the barriers might benefit promoting lymphedema self-management. Likewise, healthcare professionals need adequate training to be able to meet patients' self-management support needs.
Collapse
|
13
|
Grønning K, Lim S, Bratås O. A longitudinal study of educational needs among patients with inflammatory arthritis. Musculoskeletal Care 2021; 20:151-157. [PMID: 34091994 DOI: 10.1002/msc.1575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Patient education is important in the follow-up and disease management for patients with chronic inflammatory arthritis. Patients' needs for education and information varies, and it is important that the education is tailored to the individual patient. Hence, the aim of this study is to investigate whether patients' educational needs change over time, and which demographic, disease-related or self-management characteristics that are associated with patients' educational needs. METHODS The Mann-Whitney U-test was used to study patients' longitudinal educational needs and whether their needs change over time, while multivariable linear regression analyses were used to investigate associations between patients' educational needs and demographic variables, disease-related and self-management characteristics. RESULTS There were no changes in patients' educational needs in the domains of managing pain, movement, feelings, arthritis process and treatment from health professionals during the study period of seven years. A small decrease in educational needs in the domains self-help measures (p-value 0.047) and support from others (p-value 0.010) was detected. The regression analyses showed that higher educational needs were associated with being female, lower educational level, shorter disease duration, and a lower level of patient activation. CONCLUSIONS Patients with chronic inflammatory arthritis have continual needs for patient education throughout their disease trajectory. Nurses and health care professionals must therefore ask their patients what kind of education they need at every follow-up throughout the disease course.
Collapse
Affiliation(s)
- Kjersti Grønning
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Rheumatology, The University Hospital, St.Olavs Hospital, Trondheim, Norway
| | - Siriwan Lim
- Yong Loo Lin School of Medicine, Clinical Research Centre, Alice Lee Centre for Nursing Studies, Singapore
| | - Ola Bratås
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
14
|
Lombardo L, Wynne R, Hickman L, Ferguson C. New technologies call for new strategies for patient education. Eur J Cardiovasc Nurs 2021; 20:399-401. [PMID: 33847350 DOI: 10.1093/eurjcn/zvab026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Lien Lombardo
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney Local Health District & Western Sydney University, Blacktown Hospital, Marcel Crescent, Blacktown, NSW 2148, Australia
| | - Rochelle Wynne
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney Local Health District & Western Sydney University, Blacktown Hospital, Marcel Crescent, Blacktown, NSW 2148, Australia
- School of Nursing & Midwifery, Deakin University, Gheringhap Street, Geelong, VIC 3220, Australia
| | - Louise Hickman
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2009, Australia
| | - Caleb Ferguson
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney Local Health District & Western Sydney University, Blacktown Hospital, Marcel Crescent, Blacktown, NSW 2148, Australia
| |
Collapse
|
15
|
Hwang Y, Lee D, Kim YS. Educational Needs Associated with the Level of Complication and Comparative Risk Perceptions in People with Type 2 Diabetes. Osong Public Health Res Perspect 2020; 11:170-176. [PMID: 32864307 PMCID: PMC7442446 DOI: 10.24171/j.phrp.2020.11.4.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives This study aimed to identify the educational needs of people with type 2 diabetes according to risk perceptions and the level of severity of complications. Methods There were 177 study participants who were outpatients of the internal medicine department at a university hospital located in the Republic of Korea, who consented to participate in the survey from December 10, 2016 to February 10, 2017. The data were analyzed using descriptive statistics, Pearson correlation, ANOVA with post-hoc comparison, and multiple regression analysis. Type 2 diabetes complications were classified into 3 groups: no complications, common complications, and severe complications. Results There were statistically significant positive correlations between educational needs and comparative risk perceptions, and the level of complication and comparative risk perception. Multiple regression analysis revealed that the factor predicting educational needs of type 2 diabetes people was their comparative risk perceptions, rather than the severity of diabetes complications or sociodemographic variables. Conclusion Since risk perception is the factor that indicates the educational needs of people with type 2 diabetes, there is a need to explore factors which increase risk perception, in order to meet educational needs. The findings suggest that a more specific and individualized educational program, which focuses on each person's risk perceptions, should be developed.
Collapse
Affiliation(s)
| | - Dongsuk Lee
- College of Nursing, Kangwon National University, Chuncheon, Korea
| | - Yeon Sook Kim
- Department of Nursing, California State University, San Bernardino, California, CA, USA
| |
Collapse
|
16
|
Wonggom P, Nolan P, Clark RA, Barry T, Burdeniuk C, Nesbitt K, O'Toole K, Du H. Effectiveness of an avatar educational application for improving heart failure patients' knowledge and self-care behaviors: A pragmatic randomized controlled trial. J Adv Nurs 2020; 76:2401-2415. [PMID: 32395836 DOI: 10.1111/jan.14414] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/11/2020] [Accepted: 04/20/2020] [Indexed: 12/28/2022]
Abstract
AIM To evaluate the effectiveness of education using avatars for improving patients' heart failure knowledge and self-care. BACKGROUND A lack of knowledge and self-care contributes to poor outcomes and rehospitalization for people with heart failure. DESIGN A multi-centred, non-blinded pragmatic randomized controlled trial. METHODS Heart failure patients were randomly assigned to intervention (avatar education application) or usual care groups. Participants were followed up at baseline, 30 and 90 days. ANCOVA was used to compare the scores of heart failure knowledge and self-care, between the two groups. Fisher's exact test was used to compare the two groups' heart failure-cause readmission. Bivariate exact binary logistic regression was used to identify the predictors associated with baseline levels of knowledge. RESULTS A total of 36 participants were recruited (between October 2018 - March 2019). The mean age of participants was 67.5 (SD 11.3) years. At enrolment, approximately half (47.2%) have been living with Heart Failure for over 5 years. Two groups were comparable at baseline in their demographic and clinical characteristics. At 90 days, the intervention group participants had a higher increase in knowledge score on the Dutch Heart Failure Knowledge Scales compared with the control group (22.2% versus 3.7% P = .002, partial η2 = 0.262, 95% CI -2.755 to -0.686). There was no between-group difference observed at 30- or 90-day follow-up, on self-care behaviour (Self-care of heart failure index) or healthcare use. Overall satisfaction with the avatar app was 91.3%. CONCLUSION The addition of a co-designed avatar app to usual care improved knowledge in our group of Heart Failure participants at 30 days and continued to increase up to 90 days. The results suggest that our avatar app was perceived as an enjoyable and engaging means of delivering critical knowledge and self-care information. IMPACT Heart failure is associated with poor clinical outcomes (i.e., readmission rates and mortality rate) and substantial economic burden. The effectiveness of Heart Failure patient education using avatar have not been investigated previously. In this study, the avatar app improved knowledge and self-care behaviours. This innovation could be used at the bedside, at home by nurses, patients and families. TRIAL REGISTRATION Australian New Zealand Trial Registry ACTRN12617001403325.
Collapse
Affiliation(s)
- Parichat Wonggom
- Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Thailand
| | - Paul Nolan
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Robyn A Clark
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Tracey Barry
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Christine Burdeniuk
- Department of Cardiology, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Katie Nesbitt
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Kathryn O'Toole
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Huiyun Du
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| |
Collapse
|