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Cordray H, Wright EA, Patel C, Raol N, Prickett KK. A Mobile Application for Child-Focused Tonsillectomy Education: Development and User-Testing. Laryngoscope 2024; 134:2455-2463. [PMID: 37983833 DOI: 10.1002/lary.31198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/17/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Patient education is central to Enhanced Recovery After Surgery protocols, but child-focused materials are lacking. We developed and piloted a mobile application to support accessible, interactive patient and caregiver education about pediatric tonsillectomy. METHODS Thirty children ages 5-12 who were preparing for tonsillectomy, their caregivers, and six attending otolaryngologists participated in a user-testing trial of a web-based prototype. The trial measured feasibility, fidelity, and patient-centered outcomes. Patients and caregivers rated usability/likeability on the mHealth App Usability Questionnaire. Otolaryngologists rated quality on the Mobile App Rating Scale. The full mobile application, "Ready for Tonsillectomy," was then developed for iOS and Android. RESULTS Enrollment was 88.2%, retention was 90.0%, and use was 96.3%. Mean (SD) patient ratings for usability/likeability were 6.3 (1.1) out of 7; caregiver ratings were 6.5 (1.1). In common themes from open-ended feedback, patients described the application as helpful and appealing, and caregivers described it as informative, easy to understand, calming, and easy to use. Among caregivers who used the application during recovery, 92.3% reported that it helped them manage their child's pain. Providers would recommend the application to many or all of their patients (mean [SD]: 4.7 [0.5] out of 5). Mean provider ratings for domains of engagement, functionality, aesthetics, information quality, subjective quality, and app-specific value ranged from 4.1 to 4.8 out of 5. CONCLUSION Feasibility and fidelity were high. Families and otolaryngologists endorsed the resource as an engaging, informative tool that supports positive coping. Our mobile application offers a patient-centered solution readily scalable to other surgeries. LEVEL OF EVIDENCE NA Laryngoscope, 134:2455-2463, 2024.
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Affiliation(s)
- Holly Cordray
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Emily A Wright
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Chhaya Patel
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Nikhila Raol
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kara K Prickett
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
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Rossi NA, Benavidez M, Nuti SA, Hajiyev Y, Hughes CA, Pine HS. Viral voices: A multi-platform analysis of tonsillectomy on social media. Int J Pediatr Otorhinolaryngol 2024; 176:111816. [PMID: 38104524 DOI: 10.1016/j.ijporl.2023.111816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/25/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To assess the influence of social media platforms, including TikTok, Instagram, and Facebook, in shaping public perceptions about tonsillectomies and to identify the nature of the content disseminated on these platforms. METHODS A comprehensive analysis of 1482 relevant social media posts related to tonsillectomies was conducted across major platforms, including TikTok, Instagram, and Facebook. Content was categorized based on author, topic of the post, timeframe, and overall tone. The study also compared engagement metrics across platforms. RESULTS TikTok emerged as the most engaging platform with a mean of 3272.8 likes per post. Patients drove 61.6 % of the discourse, with 63.9 % of discussions being lifestyle oriented. Educational content constituted 12.5 % of the overall discourse. Sentiments towards the procedure were almost evenly split, with 29.4 % positive and 28.5 % negative; 92 % of the negative posts were authored by patients. CONCLUSIONS Patients were the most common social media authors, driving the conversation and a significant portion expressing negative views. Physicians, conversely, showed a low level of social media engagement. By understanding and addressing online narratives, clinicians can offer more informed patient support, debunk myths, and provide empathetic insights, ensuring positive patient experiences in the era of digital health communication.
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Affiliation(s)
- Nicholas A Rossi
- Department of Otolaryngology - Head & Neck Surgery, University of Texas Medical Branch, Galveston, TX, USA.
| | - Mia Benavidez
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Shiva A Nuti
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Yusif Hajiyev
- Department of Otolaryngology - Head & Neck Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Charles A Hughes
- Department of Otolaryngology - Head & Neck Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Harold S Pine
- Department of Otolaryngology - Head & Neck Surgery, University of Texas Medical Branch, Galveston, TX, USA
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Dobrina R, Cassone A, Dal Cin M, Ronfani L, Giangreco M, Schreiber S, Zanchiello S, Starec A, Brunelli L, Brumatti LV, Bicego L. Study protocol for a randomised controlled trial to determine the effectiveness of a mHealth application as a family supportive tool in paediatric otolaryngology perioperative process (TONAPP). Trials 2023; 24:355. [PMID: 37231477 DOI: 10.1186/s13063-023-07376-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Otorhinolaryngology (ORL) surgery is common in children, but hospitalisation, surgery, and home care after discharge are stressful experiences for young patients and their family caregivers. Findings from literature highlight a lack of time in hospitals to support ORL surgery children and their caregivers through the perioperative process, along with the risks of caregivers' autonomous web or social media resources investigation. Therefore, this study aims to evaluate the effectiveness of a mobile health application with content to support ORL patients and their caregivers in the perioperative period to reduce caregiver anxiety and child distress compared to standard care. METHODS An open-label, two-arm randomised control trial design is being adopted. The intervention consists of a mobile health application with content to support ORL patients and their caregivers during the perioperative period. One hundred eighty participants will be enrolled and randomly assigned to the experimental group using the mHealth application or the control group. The control group receives standard information and education about the ORL perioperative period from healthcare providers orally or through brochures. The primary outcome is the difference between the intervention and control groups in preoperative caregiver state anxiety. Secondary outcome measures include children's distress before surgery and family preparation for hospitalisation. DISCUSSION The results of this study will be critical to the implementation of a new and safe model for the management of care and education in paediatrics. This model can achieve positive organisational and health outcomes by supporting continuity of care and empowering citizens to have informed participation and satisfaction in paediatric health promotion and management. TRIAL REGISTRATION Trial identifier: NCT05460689 registry name: ClinicalTrials.gov. Date of registration: July 15, 2022. Last update posted: February 23, 2023.
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Affiliation(s)
- Raffaella Dobrina
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
| | - Andrea Cassone
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Margherita Dal Cin
- Department of Health Prevention, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Manuela Giangreco
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Silvana Schreiber
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | | | | | - Laura Brunelli
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Liza Vecchi Brumatti
- Scientific Direction, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
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Wozney L, Vakili N, Chorney J, Clark A, Hong P. The Impact of a Text Messaging Service (Tonsil-Text-To-Me) on Pediatric Perioperative Tonsillectomy Outcomes: Cohort Study With a Historical Control Group. JMIR Perioper Med 2022; 5:e39617. [PMID: 36125849 PMCID: PMC9533209 DOI: 10.2196/39617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Tonsillectomy is a common pediatric surgical procedure performed in North America. Caregivers experience complex challenges in preparing for their child's surgery and coordinating care at home and, consequently, could benefit from access to educational resources. A previous feasibility study of Tonsil-Text-To-Me, an automated SMS text messaging service that sends 15 time-sensitive activity reminders, links to nutrition and hydration tips, pain management strategies, and guidance on monitoring for complications, showed promising results, with high levels of caregiver satisfaction and engagement. OBJECTIVE This study aimed to pilot-test Tonsil-Text-To-Me in a real-world context to determine whether and how it might improve perioperative experiences and outcomes for caregivers and patients. METHODS Caregivers of children aged 3 to 14 years undergoing tonsillectomy were included. Data from a historical control group and an intervention group with the same study parameters (eg, eligibility criteria and surgery team) were compared. Measures included the Parenting Self-Agency Measure, General Health Questionnaire-12, Parents' Postoperative Pain Measure, Client Satisfaction Questionnaire-8, and engagement analytics, as well as analgesic consumption, pain, child activity level, and health service use. Data were collected on the day before surgery, 3 days after surgery, and 14 days after surgery. Participants in the intervention group received texts starting 2 weeks before surgery up to the eighth day after surgery. Descriptive and inferential statistics were used. RESULTS In total, 51 caregivers (n=32, 63% control; n=19, 37% intervention) who were predominately women (49/51, 96%), White (48/51, 94%), and employed (42/51, 82%) participated. Intervention group caregivers had a statistically significant positive difference in Parenting Self-Agency Measure scores (P=.001). The mean postoperative pain scores were higher for the control group (mean 10.0, SD 3.1) than for the intervention group (mean 8.5, SD 3.7), both of which were still above the 6/15 threshold for clinically significant pain; however, the difference was not statistically significant (t39=1.446; P=.16). Other positive but nonsignificant trends for the intervention group compared with the control group were observed for the highest level of pain (t39=0.882; P=.38), emergency department visits (χ22=1.3; P=.52; Cramer V=0.19), and other measures. Engagement with resources linked in the texts was moderate, with all but 1 being clicked on for viewing at least once by 79% (15/19) of the participants. Participants rated the intervention as highly satisfactory across all 8 dimensions of the Client Satisfaction Questionnaire (mean 29.4, SD 3.2; out of a possible value of 32.0). CONCLUSIONS This cohort study with a historical control group found that Tonsil-Text-To-Me had a positive impact on caregivers' perioperative care experience. The small sample size and unclear impacts of COVID-19 on the study design should be considered when interpreting the results. Controlled trials with larger sample sizes for evaluating SMS text messaging interventions aimed to support caregivers of children undergoing tonsillectomy surgery are warranted.
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Affiliation(s)
- Lori Wozney
- Mental Health and Addictions, Policy and Planning, Nova Scotia Health, Dartmouth, NS, Canada
| | - Negar Vakili
- Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada
| | - Jill Chorney
- Mental Health and Addictions, IWK Health, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Alexander Clark
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Paul Hong
- Division of Otolaryngology, IWK Health, Halifax, NS, Canada
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
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Ward LM, LaRosa AH, Prakash Y, Cohen MB, Levi JR. Internet and social media research by parents of pediatric otolaryngologic patients. Am J Otolaryngol 2022; 43:103518. [PMID: 35696816 DOI: 10.1016/j.amjoto.2022.103518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/30/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE Public access to medical information has increased dramatically with the growth and accessibility of the Internet. The goal of this study is to characterize how parents use the Internet to understand and make decisions about their child's otolaryngologic surgery. MATERIALS AND METHODS A survey was distributed to parents of pediatric patients undergoing otolaryngologic procedures to assess if and how parents gather information about their child's surgery. RESULTS 105 parents completed the survey. 59.4% of parents gathered online information about their child's surgery. 86% of these parents used Google, 36% used YouTube, 16% used Wikipedia, and 9% used a hospital website. Most searched for general information about the surgery, followed by risks, pain/recovery, and specifics about the surgery. 69% reported that the information found influenced the healthcare decisions they made for their child. 86% felt the information was trustworthy. 21% discussed the information with their child's surgeon. 17% gathered information about their child's surgeon, of which 73% were interested in the surgeon's experience. 69% reported this influenced their choice of surgeon. CONCLUSIONS Most parents of pediatric otolaryngologic patients use the Internet to gather information about their child's surgery, view that information as accurate, and use that information to make healthcare decisions. However, less than one quarter of parents discuss the information with their child's surgeon. It is critical to understand how parents use the Internet for healthcare information so otolaryngologists can better direct their patients' parents to appropriate and accurate resources.
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Quality Assessment of Online Resources for Thoracic Outlet Syndrome Patients. Ann Vasc Surg 2022; 85:96-104. [DOI: 10.1016/j.avsg.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 11/22/2022]
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Jaaniste T, Wood JG, Johnson A, Nguyen H, Chan DB, Powell A, Pfeiffer G, Wong B, Champion GD. Trajectory of Pain, Functional Limitation, and Parental Coping Resources Following Pediatric Short-stay Surgery: Factors Impacting Rate of Recovery. Clin J Pain 2021; 37:698-706. [PMID: 34369414 DOI: 10.1097/ajp.0000000000000966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although there are many benefits of short-stay hospital admissions for high volume, pediatric surgical procedures, this model of care places greater responsibility on parents for the management of children's pain. This study aimed to document the trajectory of child pain outcomes and a range of parent-reported functional outcomes following discharge from a short-stay surgical admission. Moreover, we aimed to document the trajectory of parental perceived personal coping resources. Second, we assessed whether parental dispositional factors, assessed before hospital discharge, predicted the child's pain intensity and parent-reported functional recovery. METHODS Participants included children (aged 4 to 14 y) admitted for a short-stay tonsillectomy or appendectomy, and their parents. Parents completed a questionnaire before discharge from hospital. Demographic and surgical information was recorded from medical records. Following discharge, daily assessments of pain and functioning were carried out over a 10-day period using iPods or mobile phones. Predischarge and postdischarge data were obtained for 55 child and parent dyads. RESULTS Pain intensity scores returned to low levels (2/10 or less) by day 5 for appendectomy and day 10 for tonsillectomy. Parents' perceived personal coping resources increased more slowly following tonsillectomy than appendectomy. Controlling for time since surgery and parental coping resources, parental pain-related catastrophizing was a significant predictor of child pain and functional recovery. DISCUSSION Short-stay surgery results in parents facing considerable burden in managing their child's pain and functional impairment over a 10-day period. The potential value of screening for parental pain-related catastrophizing before discharge from hospital warrants further consideration and may enable identification of children likely to experience poorer recovery.
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Affiliation(s)
- Tiina Jaaniste
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Jordan G Wood
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Anya Johnson
- Work and Organisational Studies, University of Sydney Business School, Darlington, NSW, Australia
| | - Helena Nguyen
- Work and Organisational Studies, University of Sydney Business School, Darlington, NSW, Australia
| | - David Bertrand Chan
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Alexandra Powell
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Genevieve Pfeiffer
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Brandon Wong
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - G David Champion
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
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Corrêa CDC, Piña SP, Evangelisti M, Villa MP, Weber SAT. Quality of the Italian Websites for Parental Guidance on the Indications for Tonsillectomy in Children. Int Arch Otorhinolaryngol 2021; 25:e446-e452. [PMID: 34377183 PMCID: PMC8321631 DOI: 10.1055/s-0040-1716569] [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] [Received: 01/11/2020] [Accepted: 07/17/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction The quality of information on websites about tonsillectomy regarding the knowledge level may be low. Tonsillectomy is a surgical procedure to hypertrophy of the palatine and pharyngeal tonsils. So, it is an invasive procedure with possible complications, which creates insecurity in parents. Significantly, Internet searches have been increased to address possible health concerns, questioning the quality of websites about tonsillectomy. Objective To evaluate the readability, reliability, and comprehensiveness of the Italian websites dedicated to parental guidance regarding the indications for tonsillectomy in children. Methods The search engine google.it was used to search the websites. The Gulpease index, which is a widely used readability formula ranging from 0 (difficult) to 100 (easy readability), was employed to evaluate these websites. The Health on the Net Code of Conduct (HONcode) was used to assess the quality of information, by taking ethical principles into account, with values ranging from 0 to 13. The content comprehensiveness of the web pages was assessed by assigning points ranging from 1 (very insufficient) to 5 (very satisfying) to each page. A final comparison with previous studies on tonsillectomy published on websites from other countries was performed. Results Fourteen Italian websites were selected, and the Gulpease index showed a mean average of 40.77 ± 8.45. The mean of the HONcode analysis was 6.00 ± 1.92, in which the principles with the poorest scores were Attribution and Update . As far as the comprehensiveness of the websites is concerned, the resulting mean was 2.57 ± 0.77, in which Indications was the topic with the highest mean, whereas Benefits was the one with the lowest. Conclusion The Italian websites were characterized by a lower readability level, a middle position regarding ethical principles, and the same (insufficient) comprehensiveness of tonsillectomy when compared with websites from different countries.
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Affiliation(s)
- Camila de Castro Corrêa
- Graduation Course of Speech-Language and Hearing Pathology, Universidade de Brasília, Brasília, DF, Brazil
- Graduation Course of Speech-Language and Hearing Pathology, Centro Universitário Planalto do Distrito Federal (UNIPLAN), Brasília, DF, Brazil
| | - Sofia Prata Piña
- Department of Ophthalmology, Otolaryngology, and Head and Neck Surgery, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
| | - Melania Evangelisti
- Pediatric Sleep Disease Center, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Maria Pia Villa
- Pediatric Sleep Disease Center, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Silke Anna Theresa Weber
- Department of Ophthalmology, Otolaryngology, and Head and Neck Surgery, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
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Spiegel JL, Weiss BG, Stoycheva I, Canis M, Ihler F. [Assessment of German-Language Information on Sudden Sensorineural Hearing Loss in the Internet]. Laryngorhinootologie 2021; 100:618-626. [PMID: 34077975 DOI: 10.1055/a-1472-6130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES As a result of digitalization, the internet embodies the essential information medium. Especially, patients with sudden sensorineural hearing loss (SSNHL) require profound education due to unclear scientific evidence. Thus, our study investigated a German-language internet search about SSNHL. DESIGN The first 30 Google-search results with the term "Hörsturz" (SSNHL in German) were categorized, readability-statistic with different readability-scores (FRES: 0=complex, 100=easy; FKL; SMOG; GFI) calculated, and misinformation documented. A structured content-analysis was performed with the DISCERN-questionnaire (1=low, 5=high quality). Certification of the Health-On-The-Net-Foundation (HON) assessed the abidance of recommended standards. RESULTS 18 websites (60.0%) accounted for digital media, 7 (23.3%) manufacturers of medical devices, 2 (6.7%) government institutions, and respectively 1 (3.3%) healthcare provider, support-group, and scientific article. Mean word count was 1307.0±840.2, last update 17.1±32.5 months ago, and FRES 36.1±13.9, with the most difficult text by the scientific article (13.7). Mean of DISCERN was 2.2±0.7 with worst rating of manufacturers of medical devices (1.6±0.5). 2 websites (6.7%) were HON-certified, and 14 (46.7%) contained misinformation. CONCLUSION Internet-based patient-information should be assessed cautiously due to poor readability, potential conflict of interests, low quality, or wrong information. Hence, healthcare providers and professional associations are urged to provide high-quality patient-information in the internet.
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Affiliation(s)
- Jennifer L Spiegel
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum der Universität München, LMU München
| | - Bernhard G Weiss
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum der Universität München, LMU München
| | - Ivelina Stoycheva
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum der Universität München, LMU München
| | - Martin Canis
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum der Universität München, LMU München
| | - Friedrich Ihler
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum der Universität München, LMU München.,Deutsches Schwindel- und Gleichgewichtszentrum, Klinikum der Universität München, LMU München
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Xing MH, Chai RL. The Patient Perspective: Evaluating the Accessibility of Transoral Robotic Surgery Online Resources. Ann Otol Rhinol Laryngol 2021; 131:27-38. [PMID: 33843290 DOI: 10.1177/00034894211007248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The varied treatment options available to patients with HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) can cause significant patient confusion. In particular, transoral robotic surgery (TORS) has become widely used for treatment of HPV-positive OPSCC. As patients commonly refer to the internet for additional information, we aim to evaluate the quality of online patient educational materials for TORS in comparison to other otolaryngology surgical procedures. METHODS The terms "transoral robotic surgery," "glossectomy," "thyroidectomy," and "neck dissection" were searched on Google. Flesch reading ease, Flesh-Kincaid Grade Level, MD review rates, and PEMAT understandability and actionability were assessed for each search term. Google trends was used to determine search interest for each term between May 2015 and May 2020. RESULTS Of the 30 TORS websites that met inclusion criteria, the average FRE and FKGL scores were 40.74 and 11.60 (that of an average high school senior). The FRE and FKGL scores for TORS were all statistically significantly lower than those of all comparator search terms (P < .05). Only 1 out of 30 TORS sites were MD reviewed, representing the lowest MD review rate across all search terms. Understandability and actionability scores for TORS were also the lowest across all search terms at 77.71% and 2.66%, respectively. TORS had the lowest search interest. CONCLUSIONS In comparison to other common otolaryngology procedures, TORS websites are the least patient friendly. As TORS becomes a more widely used procedure, it is critical that TORS websites become higher quality resources that patients can reliably reference.
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Affiliation(s)
- Monica H Xing
- Thyroid, Head and Neck Cancer Foundation, New York, NY, USA
| | - Raymond L Chai
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Critical analysis of the quality of internet resources for patients with varicose veins. J Vasc Surg Venous Lymphat Disord 2020; 9:1017-1024.e7. [PMID: 33340728 DOI: 10.1016/j.jvsv.2020.12.072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/05/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patients increasingly seek information on their medical conditions from the internet. The present study evaluated the quality and readability of readily available online patient resources for varicose veins. METHODS An internet search for "varicose veins" was conducted using the meta-search engines Yippy and Dogpile and the general search engines Google, Yahoo, and Bing with a cleared-cache web browser in July 2019. Two trained raters scored the websites separately on the dimensions of accessibility, accountability, interactivity, structure, and content. Any discrepancies were discussed, and a consensus was reached. Readability was calculated using four readability metric systems. Rater consistency was evaluated using kappa, weighted kappa, and interrater correlation coefficient, as indicated. RESULTS A total of 189 websites met the inclusion criteria. The total median quality score was 15.6 (interquartile range [IQR], 13.1-20.5; range, 7.4-31.3) of 38. The websites scored a median of 4 (IQR, 1-8) of 15 for accountability, 2 (IQR, 2-2) of 5 for interactivity, 4 (IQR, 2-4) of 4 for organization, and 6.4 (IQR, 3.9-7.9) of 14 for weighted content. Most websites (81.5%) were accessible. However, the overall readability was poor. The median Flesch-Kincaid reading ease score was 55.1 (IQR, 49.4-6.7), indicating that the text was fairly difficult to read. The median grade level was 10th grade using both the Flesch-Kincaid grade level and simple measure of the Gobbledygook index and 11th to 12th grade using the new Dale-Chall readability formula. Government websites were the most accountable, featured the best content, and were the most readable. The website traffic had a positive, nonlinear correlation with the total score and a negative, nonlinear correlation with the website rank (or position on the search result page). Website rank correlated negatively with the total score, although the correlation was weak. CONCLUSIONS The quality of the online patient resources on varicose veins varies greatly, and the readability for most sites is poor. Government-sponsored websites had the highest quality and were the most readable. Physicians are advised to consider providing a list of appropriate websites to their patients to better inform them, avoid confusion, and ensure appropriate delivery of accurate and readable information.
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Chen LW, Harris VC, Jia JL, Xie DX, Tufano RP, Russell JO. Search Trends and Quality of Online Resources Regarding Thyroidectomy. Otolaryngol Head Neck Surg 2020; 165:50-58. [PMID: 33138718 DOI: 10.1177/0194599820969154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Thyroidectomy is one of the most common procedures performed in head and neck surgery. The quality of online resources for thyroidectomy is unknown. We aim to evaluate search trends and online resource quality regarding thyroidectomy. STUDY DESIGN Cross-sectional analysis. SETTING Websites appearing on Google search. METHODS The first 30 Google websites for thyroidectomy were reviewed, excluding research, video, and restricted sites. Search patterns were obtained with Google Trends. Quality was measured by readability (Flesch Reading Ease and Flesch-Kinkaid Grade Level), understandability and actionability (Patient Education Materials Assessment Tool), and clinical practice guideline (CPG) compatibility. Fleiss kappa interrater reliability analysis was performed for 2 raters. RESULTS Twenty-one sites were evaluated. Search popularity for thyroidectomy has increased since 2004. Median reading ease was 42.2 (range, 15.4-62.7) on a scale from 1 to 100, with 100 indicating maximum readability. Median reading grade level was 12 (range, 7-16). Thyroidectomy resources were poorly understandable (median, 66%; range, 21%-88%) and actionable (median, 10%; range, 0%-60%). Median CPG compatibility was 4 out of 5 (range, 0-5). Interrater reliability ranged from substantial to moderate for understandability (0.78), actionability (0.57), and CPG compatibility (0.58), with P < .05 for all results. CONCLUSION Online resources about thyroidectomy vary in quality and reliability and are written at grade levels above the average reading level of the public. Providers should be aware of existing resources and work to create education resources that meet universal health literacy guidelines. The framework provided in this article may also serve as a guide and provide tangible steps that providers can take to help patients access care.
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Affiliation(s)
- Lena W Chen
- Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vandra Chatrice Harris
- Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Justin Lee Jia
- School of Medicine, Stanford University, Stanford, California, USA
| | - Deborah Xingchun Xie
- Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ralph Patrick Tufano
- Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jonathon Owen Russell
- Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Farias N, Rose-Davis B, Hong P, Wozney L. An Automated Text Messaging System (Tonsil-Text-To-Me) to Improve Tonsillectomy Perioperative Experience: Exploratory Qualitative Usability and Feasibility Study. JMIR Perioper Med 2020; 3:e14601. [PMID: 33393931 PMCID: PMC7709859 DOI: 10.2196/14601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/11/2019] [Accepted: 10/22/2019] [Indexed: 12/14/2022] Open
Abstract
Background Inexperience and forgetting perioperative care instruction are significant drivers of parental stress during pediatric tonsillectomy care. With the widespread use of mobile technology, parents now desire a system that provides them with information that is timely, accessible, and comprehensive. Tonsil-Text-To-Me (TTTM) is a text messaging system that sends out automated and timed texts to parents of children who are undergoing tonsillectomy. Objective The objective of this study was to pilot-test TTTM to assess for feasibility and usability and collect suggestions for system improvements desired by parents from a pediatric otolaryngology text message service. Methods Parents of pediatric patients who were being scheduled for tonsillectomy with or without adenoidectomy were prospectively enrolled. An exploratory qualitative study using a semistructured interview guide was performed after parents received the automated texts 2 weeks before and 1 week after their child’s surgery. Results A total of 7 parents were interviewed (data saturation was reached). Participants were all of maternal relation to the patient. Overall, all parents felt that the TTTM service was an improvement to the current standard model of information delivery. Parents also reported that the text messages reduced their anxiety and improved their performance when caring for their children during the perioperative period. No parents expressed privacy concerns about receiving texts and regarding the information included in the messages. Service suggestions showed that parents were eager for more information and had a high threshold for message reception regarding their child’s surgical care. Conclusions All parents expressed enthusiasm for a text message service during their child’s tonsillectomy perioperative period. The care instructions and reminders provided to parents via automated and timed text messages may be a strategy to improve information delivery in a simple and accessible format that could empower families in their own health care.
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Affiliation(s)
- Nathan Farias
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Benjamin Rose-Davis
- Centre for Research in Family Health, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Paul Hong
- Division of Otolaryngology, Izaak Walton Killam Health Centre, Halifax, NS, Canada.,Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Lori Wozney
- Nova Scotia Health Authority, Dartmouth, NS, Canada
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Aaronson NL, Cox CT, Boss EF. Parental health literacy in pediatric otolaryngology: A pilot study. Int J Pediatr Otorhinolaryngol 2019; 125:87-91. [PMID: 31271973 DOI: 10.1016/j.ijporl.2019.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Pediatric otolaryngology bears the highest frequency of elective surgical cases in children, but little is known regarding the health literacy of these children's parents. In a questionnaire-based pilot study, we assessed parental health literacy in our pediatric otolaryngology clinic and evaluated its relation to personal demographics. We also evaluated postoperative and diagnosis-based leaflets for readability using validated measures. METHODS Parents completed the Short Assessment of Health Literacy-English (SAHL-E) and were defined as low (0-14) or high (>14) literacy based on mean scores. RESULTS Fifty parents participated (mean SAHL-E score, 17.6), and all scored >14, indicating proficient health literacy. No differences existed in mean or median scores based on demographics. Continued education after high school was associated with higher scores (P = 0.003) and was the only significant variable in multivariable linear regression. All leaflets were at or below the recommended reading level for public health information. CONCLUSIONS Parents generally had high health literacy.
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Affiliation(s)
- Nicole Leigh Aaronson
- Nemours/Alfred I. duPont Hospital for Children, Department of Surgery, Section of Otolaryngology, Wilmington, DE, USA; Thomas Jefferson University School of Medicine, Departments of Otolaryngology and Pediatrics, Philadelphia, PA, USA.
| | - Courtney T Cox
- Nemours/Alfred I. duPont Hospital for Children, Department of Surgery, Section of Otolaryngology, Wilmington, DE, USA.
| | - Emily F Boss
- Johns Hopkins University Departments of Otolaryngology and Health Policy & Management, Baltimore, MD, USA.
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Piña SP, Corrêa CDC, Carvalho LRD, Weber SAT. Comprehensiveness, readability, and reliability of Brazilian websites available for lay people's guidance on adenotonsillectomy. Braz J Otorhinolaryngol 2019; 87:66-73. [PMID: 31439530 PMCID: PMC9422416 DOI: 10.1016/j.bjorl.2019.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/29/2019] [Accepted: 06/30/2019] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Adenotonsillectomy is an invasive surgical procedure, which may encourage the search for information by the lay population through online search engines. The quality of this information, however, requires an evaluation due to the wide diversity of the available content. OBJECTIVE To evaluate the quality, in terms of ethical principles, readability and comprehensiveness, of the most accessed websites concerning guidance to parents/guardians related to their children's recommended adenotonsillectomy. METHODS The websites mentioned on the first 10 pages obtained after the search using "removal", "tonsils" and "adenoids" as keywords, after applying the inclusion and exclusion criteria, were selected. All were assessed using the Flesch Readability Index and Health on the Net Code tools, in addition to an evaluation of the content by two independent evaluators. The data were described, and the inter-rater agreement was calculated by the Kappa coefficient. RESULTS 34 websites were found, of the 100 assessed ones, which met the inclusion and exclusion criteria using the Google and Yahoo! Tools. Sixteen (47%) pages were considered reasonably difficult/difficult to read according to the Flesch Readability Index. Most of them met less than half of the analyzed ethical requirements according to the Health on the Net Code, and the overall comprehensiveness average was considered insufficient. CONCLUSION A deficit of overall quality (comprehensiveness, readability, and ethical principles) was demonstrated for the websites available to parents or guardians about the adenotonsillectomy procedure in children.
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Affiliation(s)
- Sofia Prata Piña
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, São Paulo, Brazil
| | - Camila de Castro Corrêa
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, São Paulo, Brazil
| | - Lídia Raquel de Carvalho
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Bioestatística, Botucatu, São Paulo, Brazil
| | - Silke Anna Theresa Weber
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, São Paulo, Brazil.
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Bailey CE, Kohler WJ, Makary C, Davis K, Sweet N, Carr M. eHealth Literacy in Otolaryngology Patients. Ann Otol Rhinol Laryngol 2019; 128:1013-1018. [PMID: 31195809 DOI: 10.1177/0003489419856377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: The aim of this study was to compare eHealth literacy—one’s perception of one’s ability to use the Internet for health care—among otolaryngology patients in 3 geographic settings of the same department. Setting: An academic otolaryngology department. Method: Patients’ opinions and perceptions of their eHealth literacy were assessed with a validated paper survey administered in the summer of 2017. Results: Of 381 asked, 351 people completed the survey, 149 at a university town teaching hospital clinic (group A), 101 at a nearby rural clinic (group B), and 101 at a remote rural clinic (group C). Mean scores were 30.80, 28.97, and 29.03 for groups A, B, and C, respectively. The overall mean was 29.76 ± 5.97. Three surveys reported the minimum score of 8, and 26 reported the maximum score of 40. Results were statistically significantly different among all sites ( P = .001), between groups A and B ( P = .027), and between groups A and C ( P = .0175). Women reported higher eHealth literacy (30.13 ± 6.27) than men (28.87 ± 5.11) ( P = .045). Participant age and role (patient or parent of a patient) were statistically insignificant. Mean scores were similar to those previously reported in other patient populations. Conclusions: Otolaryngology patients in a university town had better eHealth literacy than patients in more rural settings, suggesting that online medical resources and access points are less likely to be useful in rural populations.
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Affiliation(s)
- Christopher Eric Bailey
- Department of Otolaryngology–Head and Neck Surgery, West Virginia University, Morgantown, WV, USA
| | | | - Chadi Makary
- Department of Otolaryngology–Head and Neck Surgery, West Virginia University, Morgantown, WV, USA
| | - Kristin Davis
- West Virginia University School of Medicine, Morgantown, WV, USA
| | | | - Michele Carr
- Department of Otolaryngology–Head and Neck Surgery, West Virginia University, Morgantown, WV, USA
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Hairston TK, Links AR, Harris V, Tunkel DE, Walsh J, Beach MC, Boss EF. Evaluation of Parental Perspectives and Concerns About Pediatric Tonsillectomy in Social Media. JAMA Otolaryngol Head Neck Surg 2019; 145:45-52. [PMID: 30452510 PMCID: PMC6439813 DOI: 10.1001/jamaoto.2018.2917] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/27/2018] [Indexed: 01/06/2023]
Abstract
Importance Tonsillectomy is common in children, but little is known about parental preferences and values concerning this surgical procedure. Twitter offers an opportunity to evaluate parental understanding and experience of tonsillectomy care. Objective To identify parental perspectives about tonsillectomy in children that may not be apparent in a routine clinical encounter. Design, Setting, and Participants In this qualitative study, social media platform Twitter was searched for posts (tweets) published between January 1, 2008, and December 31, 2017, by US-based parents about their child's tonsillectomy. Modified grounded theory was applied to develop a coding taxonomy to classify the tweets. Tweets were assessed for thematic synthesis and classification, and descriptive statistics were obtained for each theme. Main Outcomes and Measures Themes of parental experiences and perspectives about their child's tonsillectomy. Results Of the 5801 total tweets retrieved, 782 (13.5%) satisfied the inclusion criteria. Tweets were categorized under 2 overarching themes: procedural concerns (549 tweets [70.2%]) and attitudes or experiences (498 [63.7%]). Common tweets under procedural concerns mentioned surgical indication for tonsillectomy (55 tweets [7.0%]); eg, "strep-I think it's tonsil removing time…") and recovery (227 tweets [29.0%]), including child's attitude (89 tweets [11.4%]; eg, "so hard to get my daughter to eat") and parental experience (87 tweets [11.1%]; eg, "tonsillectomy recovery sucks for the parent as much as the kid!"). Common tweets regarding attitudes or experiences included the tenor of overall care (225 tweets [28.6%]; eg, "Tonsillectomy is a bear") and fears or apprehensions (209 tweets [26.6%]). Conclusions and Relevance These social media findings may be used to guide clinicians in educating and counseling parents as well as further engaging parents and children in shared decision making for tonsillectomy.
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Affiliation(s)
- Tai Kyung Hairston
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Anne R. Links
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vandra Harris
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David E. Tunkel
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan Walsh
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Emily F. Boss
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Aaronson NL, Joshua CL, Boss EF. Health literacy in pediatric otolaryngology: A scoping review. Int J Pediatr Otorhinolaryngol 2018; 113:252-259. [PMID: 30173996 DOI: 10.1016/j.ijporl.2018.08.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/09/2018] [Accepted: 08/09/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review research on status and outcomes of health literacy in pediatric otolaryngology and identify opportunities for quality improvement. METHODS We performed a scoping review, adhering to methodologic standards. A combination of MeSH terms and keywords related to health literacy in otolaryngology was used to conduct a search. Relevant studies were identified using PubMed, Ovid MEDLINE, and Google Scholar databases. Studies were selected for inclusion by two authors if they addressed the domains of pediatric otolaryngology as well as health literacy. Data were abstracted from each study on the number of participants, the setting, the study design, the outcome measure, the intervention used, and the overall theme. Authors identified prominent overarching themes and grouped studies accordingly. Results were then tabulated for further review and to discern implications for future practice and research. RESULTS Of 1046 articles identified, 20 articles were included. Studies fell into three major themes: readability of patient materials, patient recall after informed consent, and optimal patient education. Prominent findings included the following: 1. Much of the printed and electronic educational material in otolaryngology is above the recommended reading level for public health information; 2. Parents do not easily recall information provided verbally or in written form; and 3. Adding visual and multimodal components improves the success of parental education. CONCLUSION Health literacy in pediatric otolaryngology may influence comprehension of educational materials and adequacy of informed consent. Future research may address whether patient health literacy affects clinical outcomes.
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Affiliation(s)
- Nicole Leigh Aaronson
- Division of Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
| | - Catherine L Joshua
- Health Sciences Library, University of Virginia, Charlottesville, VA, USA
| | - Emily F Boss
- Departments of Otolaryngology and Health Policy & Management, Johns Hopkins University, Baltimore, MD, USA
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Krouse JH. Highlights from the Current Issue: May 2017. Otolaryngol Head Neck Surg 2018; 156:779-780. [PMID: 28457222 DOI: 10.1177/0194599817698688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- John H Krouse
- 1 Department of Otolaryngology/Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
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Harris VC, Links AR, Hong P, Walsh J, Schoo DP, Tunkel DE, Stewart CM, Boss EF. Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement. Laryngoscope 2018; 128:496-501. [PMID: 28842989 PMCID: PMC5771888 DOI: 10.1002/lary.26824] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/29/2017] [Accepted: 07/05/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Tympanostomy tube (TT) placement is common in children; however, family-centeredness and utility of online information used for decision making and understanding is unknown. We evaluate the quality of leading Internet resources describing TT placement. STUDY DESIGN Cross-sectional descriptive design. METHODS We performed a Google (Menlo Park, CA) search for terms related to TTs. We defined quality using scaled readability measures (Flesch Reading Ease and Flesch-Kincaid Grade-Level), understandability and actionability (Patient Education Materials Assessment Tool), shared decision-making centrality (Center for Medicare and Medicaid Services informed consent guidelines), and clinical practice guideline (CPG) compatibility. Three reviewers coded each measure. Fleiss κ interrater reliability analysis was performed. RESULTS Ten most frequently encountered websites were analyzed. One of 10 met national health literacy standards (mean 10th-grade level reading, median 9th, range 6-15th). All sites were understandable (mean understandability 81.9%, range 73%-92%). Most had low actionability scores (7 of 10, median 47%, mean 44.6%, range 0-80). Shared decision-making centrality was high (mean 5, range 4-6), but most did not list alternative treatment options. Although CPG compatibility was high (mean 3.4, range 1-4), many websites contained inconsistent recommendations about tube duration, follow-up, and water precautions. There was inter-rater agreement for understandability scoring (κ = 0.20; P = 0.02). CONCLUSION Internet resources about TT placement vary in quality pertaining to health literacy, principles of shared decision making, and consistency with practice guidelines. With growing emphasis on patient-/family-centered engagement in healthcare decision making, standardization of content and improved usability of educational materials for common surgical procedures in children such as tympanostomy tube placement should be a public health priority. LEVEL OF EVIDENCE NA. Laryngoscope, 128:496-501, 2018.
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Affiliation(s)
- Vandra C. Harris
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Anne R. Links
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Paul Hong
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jonathan Walsh
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Desi P. Schoo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - David E. Tunkel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Charles M. Stewart
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Emily F. Boss
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
- Department of Health Policy and Management, Johns Hopkins Medical Institutions, Baltimore, Maryland
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Xie DX, Wang RY, Chinnadurai S. Readability of online patient education materials for velopharyngeal insufficiency. Int J Pediatr Otorhinolaryngol 2018; 104:113-119. [PMID: 29287850 DOI: 10.1016/j.ijporl.2017.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/15/2017] [Accepted: 09/17/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Evaluate the readability of online and mobile application health information about velopharyngeal insufficiency (VPI). METHODS Top website and mobile application results for search terms "velopharyngeal insufficiency", "velopharyngeal dysfunction", "VPI", and "VPD" were analyzed. Readability was determined using 10 algorithms with Readability Studio Professional Edition (Oleander Software Ltd; Vandalia, OH). Subgroup analysis was performed based on search term and article source - academic hospital, general online resource, peer-reviewed journal, or professional organization. RESULTS 18 unique articles were identified. Overall mean reading grade level was a 12.89 ± 2.9. The highest reading level among these articles was 15.47-approximately the level of a college senior. Articles from "velopharyngeal dysfunction" had the highest mean reading level (13.73 ± 2.11), above "velopharyngeal insufficiency" (12.30 ± 1.56) and "VPI" (11.66 ± 1.70). Articles from peer-reviewed journals had the highest mean reading level (15.35 ± 2.79), while articles from academic hospitals had the lowest (12.81 ± 1.66). There were statistically significant differences in reading levels between the different search terms (P < 0.01) and article source types (P < 0.05). Only one mobile application was identified with VPI information, with a readability of 10.68. CONCLUSION Despite published reading level guidelines, online patient education materials for VPI are disseminated with language too complex for most readers. There is also a lack of VPI-related mobile application data available for patients. Patients will benefit if future updates to websites and disseminated patient information are undertaken with health literacy in mind. Future studies will investigate patient comprehension of these materials.
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Affiliation(s)
- Deborah X Xie
- Vanderbilt University Medical Center, Department of Otolaryngology-Head & Neck Surgery, Nashville, TN, USA
| | - Ray Y Wang
- Vanderbilt University Medical Center, Department of Otolaryngology-Head & Neck Surgery, Nashville, TN, USA
| | - Sivakumar Chinnadurai
- Children's Hospital and Clinics of Minnesota, 2530 Chicago Ave, Suite #450, Minneapolis, MN, 55404, USA.
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Song JSA, Wozney L, Chorney J, Ishman SL, Hong P. Design and validation of key text messages (Tonsil-Text-To-Me) to improve parent and child perioperative tonsillectomy experience: A modified Delphi study. Int J Pediatr Otorhinolaryngol 2017; 102:32-37. [PMID: 29106872 DOI: 10.1016/j.ijporl.2017.08.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/24/2017] [Accepted: 08/24/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Parents can struggle while providing perioperative tonsillectomy care for their children at home. Short message service (SMS) technology is an accessible and direct modality to communicate timely, evidence-based recommendations to parents across the perioperative period. This study focused on validating a SMS protocol, Tonsil-Text-To-Me (TTTM), for parents of children undergoing tonsillectomy. METHODS This study used a modified Delphi expert consensus method. Participants were an international sample of 27 clinicians/researchers. Participants rated level of agreement with recommendations across seven perioperative domains, derived systematically from scientific and lay literature. A priori consensus analysis was conducted using threshold criterion. A multidisciplinary team of local clinicians were also individually interviewed to consolidate text messages and implement recurrent suggestions. RESULTS In the modified Delphi panel, 30 statements reached threshold agreement (>3.0 of 4.0); recommendations surrounding diet (3.87) and hygiene (3.83) had the highest level of consensus, while recommendations regarding activity (3.42) and non-pharmacologic pain management (3.55) had the lowest consensus. The 30 statements reconfigured into 12 concise text messages. After further interviews with local clinicians, 14 final text messages were included in the SMS protocol to be sent two weeks preoperatively to one week postoperatively. CONCLUSION This study illustrates the development of TTTM which is designed to deliver key sequential text messages at the optimal time during the perioperative setting to parents caring for their children who are undergoing tonsillectomy.
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Affiliation(s)
- Jin Soo A Song
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lori Wozney
- Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Jill Chorney
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stacey L Ishman
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati, Cincinnati, OH, United States
| | - Paul Hong
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
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