1
|
Oikarinen AK, Kähkönen O, Kaakinen P, Kääriäinen M, Virtanen M, Paalimäki-Paakki K, Hylkilä K, Männikkö N, Kerimaa H, Kivelä K, Jansson M, Kajula O, Männistö M, Lahtinen M, Vanhanen M, Rajala M. Nurses' experiences of competence in lifestyle counselling with adult patients in healthcare settings: A qualitative systematic literature review. J Clin Nurs 2024; 33:1684-1708. [PMID: 38332566 DOI: 10.1111/jocn.17050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
AIMS AND OBJECTIVES To identify and synthesise nurses' experiences of competence in lifestyle counselling with adult patients in healthcare settings. BACKGROUND Modifiable lifestyle risk behaviours contribute to an increased prevalence of chronic diseases worldwide. Lifestyle counselling is part of nurses' role which enables them to make a significant contribution to patients' long-term health in various healthcare contexts, but requires particular competence. DESIGN Qualitative systematic literature review and meta-aggregation. METHOD The review was guided by Joanna Briggs Institute's methodology for conducting synthesis of qualitative studies. PRISMA-checklist guided the review process. Relevant original studies were search from databases (CINAHL, PubMed, Scopus, Medic and Psych Articles, Ebscho Open Dissertations and Web of Science). After researcher consensus was reached and quality of the studies evaluated, 20 studies were subjected to meta-aggregation. RESULTS From 20 studies meeting the inclusion criteria, 75 findings were extracted and categorised into 13 groups based on their meaning, resulting in the identification of 5 synthesised findings for competence description: Supporting healthy lifestyle adherence, creating interactive and patient-centred counselling situations, acquiring competence through clinical experience and continuous self-improvement, collaborating with other professionals and patients, planning lifestyle counselling and managing work across various stages of the patient's disease care path. CONCLUSION The review provides an evidence base that can be used to support nurses' competence in lifestyle counselling when working with adult patients in healthcare settings. Lifestyle counselling competence is a complex and rather abstract phenomenon. The review identified, analysed and synthesised the evidence derived from nurses' experience which shows that lifestyle counselling competence is a multidimensional entity which relates to many other competencies within nurses' work. IMPLICATIONS FOR THE PROFESSION Recognising the competencies of nurses in lifestyle counselling for adult patients can stimulate nurses' motivation. The acquisition of these competencies can have a positive impact on patients' lives and their health. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution. IMPACT The research may enhance nurses' competence in lifestyle counselling, leading to improved health outcomes, better adherence to recommendations and overall well-being. It may also drive the development of interventions, improving healthcare delivery in lifestyle counselling. REPORTING METHOD The review was undertaken and reported using the PRISMA guidelines. PROTOCOL REGISTRATION Blinded for the review.
Collapse
Affiliation(s)
- Anne Kaarina Oikarinen
- Research Unit of Health Science and Technology, Medical Research Centre Oulu, Faculty of Medicine, Oulu University, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
| | - Outi Kähkönen
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Pirjo Kaakinen
- Research Unit of Health Science and Technology, Medical Research Centre Oulu, Faculty of Medicine, Oulu University, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
| | - Maria Kääriäinen
- Research Unit of Health Science and Technology, Medical Research Centre Oulu, Faculty of Medicine, Oulu University, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
| | - Mari Virtanen
- Helsinki Metropolia University of Applied Sciences, Helsinki, Finland
| | | | - Krista Hylkilä
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
- Research Unit of Health Science and Technology, Faculty of Medicine, Oulu University, Oulu, Finland
| | - Niko Männikkö
- Research Unit of Health Science and Technology, Medical Research Centre Oulu, Faculty of Medicine, Oulu University, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
| | - Heli Kerimaa
- Research Unit of Health Science and Technology, Medical Research Centre Oulu, Faculty of Medicine, Oulu University, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
| | - Kirsi Kivelä
- Wellbeing Services Country of North Ostrobothnia, Oulu, Finland
| | - Miia Jansson
- Research Unit of Health Science and Technology, Medical Research Centre Oulu, Faculty of Medicine, Oulu University, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
- RMIT University, Melbourne, Australia
| | - Outi Kajula
- Oulu University of Applied Sciences, Oulu, Finland
| | - Merja Männistö
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
- Master School at Diaconia University of Applied Sciences, Helsinki, Finland
| | - Minna Lahtinen
- Research Unit of Health Science and Technology, Medical Research Centre Oulu, Faculty of Medicine, Oulu University, Oulu, Finland
| | - Minna Vanhanen
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
- Oulu University of Applied Sciences, Oulu, Finland
| | - Mira Rajala
- Research Unit of Health Science and Technology, Medical Research Centre Oulu, Faculty of Medicine, Oulu University, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence Group, Helsinki, Finland
| |
Collapse
|
2
|
Ghisi GLDM, Aultman C, Vanzella L, Konidis R, Sandison N, Oh P. Effectiveness of a virtual vs. in-person group-based education curriculum to increase disease-related knowledge and change health behaviour among cardiac rehabilitation participants. PATIENT EDUCATION AND COUNSELING 2024; 118:108021. [PMID: 37866071 DOI: 10.1016/j.pec.2023.108021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To investigate the effectiveness of a virtual 12-week group-based education curriculum and to compare results with a retrospective cohort that received the same education in-person for 24 weeks. METHODS Participants completed online surveys (pre- and post-intervention) assessing disease-related knowledge, adherence to the Mediterranean diet, exercise self-efficacy, and satisfaction. The number of steps taken per day was recorded using a wearable device. Paired t tests and repeated measures ANOVA were used. A Bonferroni correction was applied(p < 0.01). RESULTS 80 CR participants receiving virtual education completed both assessments. Following virtual education, participants significantly increased knowledge(p < 0.001), adherence to the Mediterranean diet(p < 0.001) and number of daily steps(p = 0.01). These results were similarly observed in the in-person education group(n = 80), with no significant differences between groups. Virtual education participants decreased their self-efficacy post-intervention(p < 0.001); in contrast, participants of the in-person education increased their exercise self-efficacy(p < 0.001). Overall,31% of virtual and 71% of in-person education participants reported being satisfied with the education delivery format. CONCLUSIONS A virtual group-based education curriculum was effective at improving knowledge and changing behaviour. Similar results were observed in those that received in-person education. Tailoring virtual education interventions to support exercise self-efficacy is warranted. PRACTICE IMPLICATION This study strengthens the evidence supporting virtual education in CR.
Collapse
Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Crystal Aultman
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Lais Vanzella
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Renee Konidis
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Nicole Sandison
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| |
Collapse
|
3
|
Vázquez-Calatayud M, Olano-Lizarraga M, Quesada-Melero AM, Rumeu-Casares C, Saracíbar-Razquin M, Paloma-Mora B. Nursing capacity building in health coaching with hospitalised chronic heart failure patients: a quasi-experimental study. Contemp Nurse 2023; 59:443-461. [PMID: 37751247 DOI: 10.1080/10376178.2023.2262612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Difficulty in adherence to treatment and self-care behaviours is a leading cause of preventable readmission in people with chronic heart failure (CHF). Although there is evidence of benefits of health coaching for the management of this situation, few interventions have been tested in the hospital setting. AIM To evaluate a coaching programme (H-Coaching) designed to develop nursing capacity in health coaching for chronic heart failure inpatients. METHODS A quasi-experimental pre-post study including all nurses in a single centre cardiology ward (N = 19). The intervention consisted of two training packages: (1) five theoretical-practical sessions on health-coaching competencies, emotional intelligence, communication and support of chronic heart failure patients in their illness in the hospital setting; and (2) training sessions seven months after the first training package to reinforce the theoretical and practical knowledge. On four occasions, the Competence Instrument of Health Education for the Nursing professional was used to measure nurses' knowledge, skills and attitudes in health coaching for chronic heart failure patients. RESULTS The difference between the preintervention and postintervention scores were statistically significant for knowledge [mean difference = 1.00 (95% CI -1.45 to -0.51; p = 0.000)], skills in general [mean difference = 0.50 (95% CI -1.41 to -0.21; p = 0.015)] and personal/social skills [mean difference = 1.00 (95% CI -1.10 to -0.01; p = 0.048)]. While attitudinal and affective domains did not differ, there were differences in knowledge and skills. CONCLUSION The H-Coaching programme proved to be effective for building nursing capacity in health coaching CHF inpatients. Similar programmes designed to improve knowledge in verbal and nonverbal communication techniques, and skills for coaching interventions adapted to meet the needs of individual patients, should be tested in future interventional experimental studies. CLINICAL TRIAL REGISTRATION NUMBER NCT05300880. IMPACT STATEMENT To our knowledge, this is the first nursing training intervention in health coaching for chronic heart failure the inpatient setting. This study has demonstrate improvements in both the knowledge and personal and social skills of cardiology nurses with regard to the development of health coaching in a hospital setting. Given the study design, further research is warranted. PLAIN LANGUAGE SUMMARY Many patients with chronic heart failure have problems in adhering to the treatment and self-care behaviours and this is one of the main causes of preventable readmission. To promote self-care, patients need to be empowered to integrate these habits into their daily lives and we should implement innovative strategies to achieve this. Health coaching is an ideal alternative to this but very few nurses in the hospital cardiology setting are experienced in health coaching. Our study has shown preliminary results demonstrating that a structured theoretical and practical training programme for nurses can improve nurses' knowledge and skills in health coaching for inpatient patients with chronic heart failure. This study provides an opportunity for future research to demonstrate whether nurses with this training have a positive impact on the health outcomes of chronic heart failure patients and, more specifically, on their levels of self-care and empowerment.
Collapse
Affiliation(s)
- Mónica Vázquez-Calatayud
- Clínica Universidad de Navarra, Avda. Pío XII 36, 31008 Pamplona, Spain
- School of Nursing, Universidad de Navarra, Campus Universitario, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
- Navarra's Health Research Institute (IdiSNA), Pamplona, Spain
| | - Maddi Olano-Lizarraga
- School of Nursing, Universidad de Navarra, Campus Universitario, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
- Navarra's Health Research Institute (IdiSNA), Pamplona, Spain
| | | | - Carmen Rumeu-Casares
- Clínica Universidad de Navarra, Avda. Pío XII 36, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
| | - Maribel Saracíbar-Razquin
- School of Nursing, Universidad de Navarra, Campus Universitario, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
- Navarra's Health Research Institute (IdiSNA), Pamplona, Spain
| | - Beatriz Paloma-Mora
- Clínica Universidad de Navarra, Avda. Pío XII 36, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
| |
Collapse
|
4
|
Wasilewski M, Vijayakumar A, Szigeti Z, Sathakaran S, Wang KW, Saporta A, Hitzig SL. Barriers and Facilitators to Delivering Inpatient Cardiac Rehabilitation: A Scoping Review. J Multidiscip Healthc 2023; 16:2361-2376. [PMID: 37605772 PMCID: PMC10440091 DOI: 10.2147/jmdh.s418803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Objective The purpose of this scoping review was to summarize the literature on barriers and facilitators that influence the provision and uptake of inpatient cardiac rehabilitation (ICR). Methods A literature search was conducted using PsycINFO, MEDLINE, EMBASE, CINAHL and AgeLine. Studies were included if they were published in English after the year 2000 and focused on adults who were receiving some form of ICR (eg, exercise counselling and training, education for heart-healthy living). For studies meeting inclusion criteria, descriptive data on authors, year, study design, and intervention type were extracted. Results The literature search resulted in a total of 44,331 publications, of which 229 studies met inclusion criteria. ICR programs vary drastically and often focus on promoting physical exercises and patient education. Barriers and facilitators were categorized through patient, provider and system level factors. Individual characteristics and provider knowledge and efficacy were categorized as both barriers and facilitators to ICR delivery and uptake. Team functioning, lack of resources, program coordination, and inconsistencies in evaluation acted as key barriers to ICR delivery and uptake. Key facilitators that influence ICR implementation and engagement include accreditation and professional associations and patient and family-centred practices. Conclusion ICR programs can be highly effective at improving health outcomes for those living with CVDs. Our review identified several patient, provider, and system-level considerations that act as barriers and facilitators to ICR delivery and uptake. Future research should explore how to encourage health promotion knowledge amongst ICR staff and patients.
Collapse
Affiliation(s)
- Marina Wasilewski
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
| | - Abirami Vijayakumar
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Zara Szigeti
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sahana Sathakaran
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Adam Saporta
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| | - Sander L Hitzig
- St. John’s Rehab, Sunnybrook Research Institute, North York, Ontario, Canada
| |
Collapse
|
5
|
Eskolin SE, Inkeroinen S, Leino-Kilpi H, Virtanen H. Instruments for measuring empowering patient education competence of nurses: Systematic review. J Adv Nurs 2023. [PMID: 36808623 DOI: 10.1111/jan.15597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/04/2023] [Accepted: 02/05/2023] [Indexed: 02/23/2023]
Abstract
AIM This review aimed to identify validated self-reported instruments used to measure nurses' competence or attribute(s) of competence in empowering patient education, to describe their development and main content and critically appraise and summarize the quality of the instruments. DESIGN Systematic review. DATA SOURCES Electronic databases of PubMed, CINAHL and ERIC were searched from January 2000 to May 2022. REVIEW METHODS Data was extracted following predetermined inclusion criteria. With the support of the research group, two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist (COSMIN). RESULTS A total of 19 studies reporting 11 instruments were included. The instruments measured varied attributes of competence and the contents were heterogenous reflecting the complex nature of both empowerment and competence as concepts. Overall, the reported psychometric properties of the instruments and methodological quality of the studies were at least adequate. However, there was variation in the testing of the instruments' psychometric properties and lack of evidence limited the evaluation of both the methodological quality of the studies and quality of instruments. CONCLUSION The psychometric properties of the existing instruments assessing nurses' competence in empowering patient education need to be tested further, and future instrument development should be built on a clearer definition of empowerment as well as on more rigorous testing and reporting. In addition, continued efforts to clarify and define both empowerment and competence on the conceptual level are needed. IMPACT Evidence on nurses' competence in empowering patient education and its valid and reliable assessment instruments is scarce. Existing instruments are heterogenous and are often missing proper testing of validity and reliability. These findings contribute to further research on developing and testing the instruments of competence in empowering patient education and strengthening nurses' empowering patient education competence in the clinical practice.
Collapse
Affiliation(s)
| | - Saija Inkeroinen
- Department of Nursing Sciences, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Sciences, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Heli Virtanen
- Department of Nursing Sciences, University of Turku, Turku, Finland
| |
Collapse
|
6
|
Ni Y, Wen Y, Bao Y, Xu Y, Chen Z, Yang X, He J, You G. Nurses' perspectives on the barriers to and facilitators of the implementation of secondary prevention for people with coronary heart disease: a qualitative descriptive study. BMJ Open 2022; 12:e063029. [PMID: 36167370 PMCID: PMC9516137 DOI: 10.1136/bmjopen-2022-063029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To identify the barriers to and facilitators of secondary prevention among people with coronary heart disease from the perspectives of nurses. DESIGN A qualitative descriptive design using face-to-face semistructured interviews. SETTING This study was conducted in China from October to November 2021. PARTICIPANTS Registered nurses who had experience conducting secondary prevention for coronary heart disease were purposively recruited. Twelve nurses from 10 hospitals participated in this study. The data were analysed using content analysis based on the Theoretical Domains Framework. RESULTS Based on the Theoretical Domains Framework, barriers to and facilitators of secondary prevention were identified within four key themes: nurse attributes (eg, knowledge and skills, motivation), patient characteristics (eg, age, education and economic conditions), the environmental context and resources (eg, organisational support, including financial support, clarity of responsibilities) and social influence (eg, economic development level, patient feedback). CONCLUSIONS This research highlights the importance of nurses' motivation for delivering preventive care. Organisations should provide adequate support and establish a quality management system to maintain the quality of secondary prevention.
Collapse
Affiliation(s)
- Yunxia Ni
- West China School of Nursing, Sichuan University/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ya Wen
- West China School of Nursing, Sichuan University/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yun Bao
- West China School of Nursing, Sichuan University/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Xu
- West China School of Nursing, Sichuan University/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhonglan Chen
- West China School of Nursing, Sichuan University/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xuemei Yang
- West China School of Nursing, Sichuan University/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Juan He
- West China School of Nursing, Sichuan University/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guiying You
- West China School of Nursing, Sichuan University/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
7
|
Boland K, Pigott T, Forbes R. ‘I am the educator and the learner at the same time’: a qualitative survey of the knowledge and use of adult learning theory in UK musculoskeletal physiotherapists' patient education. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Patient education is a core component of musculoskeletal care, yet broad definitions exist and effective delivery methods are unclear. Musculoskeletal physiotherapists' use of patient education has been described as individualised and collaborative, reflecting a person-centred model of care. However, discrepancies between perceived and actual practice, and therapist-centred approaches to education, have been observed. Little is known about the theoretical basis of musculoskeletal physiotherapists' patient education practice, yet the adult learning theory frames how adults interact with education and echoes the principles of person-centred care. The aim of this study was to analyse the use of adult learning theory to inform patient education practice among UK musculoskeletal physiotherapists. Methods This study used a novel, online questionnaire to collect quantitative and qualitative data from a self-selecting sample of UK musculoskeletal physiotherapists, using a multimodal recruitment strategy. Complete responses were provided by 66 participants. Categorical and narrative data were collected and descriptive and thematic analyses undertaken. Results Participants generally self-rated their educational competencies highly, with the exception of evaluating patient education. Participants were more familiar with reflective and self-directed learning than with other adult learning theories. Two main themes were described: implicit adult learning theory knowledge and challenges in applying adult learning theory. Conclusions The results suggest that musculoskeletal physiotherapists may have implicit knowledge of adult learning theory, yet challenges exist in applying them. This finding supports the establishment of ongoing training in educational skills for physiotherapists and could be used as a catalyst for musculoskeletal physiotherapists to reflect on their knowledge and use of adult learning theory.
Collapse
Affiliation(s)
- Katy Boland
- School of Health & Society, University of Salford, Manchester, UK
| | - Tim Pigott
- School of Health & Society, University of Salford, Manchester, UK
| | - Roma Forbes
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
8
|
Pueyo-Garrigues M, Pardavila-Belio MI, Canga-Armayor A, Esandi N, Alfaro-Díaz C, Canga-Armayor N. nurses' knowledge, skills and personal attributes for providing competent health education practice, and its influencing factors: A cross-sectional study. Nurse Educ Pract 2021; 58:103277. [PMID: 34929565 DOI: 10.1016/j.nepr.2021.103277] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 11/18/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022]
Abstract
AIM To explore nurses' knowledge, skills and personal attributes for competent health education practice and their association with potential influencing factors. BACKGROUND Clinical nurses are expected to perform effective health education interventions, but they do not feel competent. The self-assessment of the health education competence and its conditional factors is paramount for professional development. DESIGN A cross-sectional study. METHODS A total of 458 clinical nurses from two health specialized centers in Spain participated in this study. Data were collected using the Nurse Health Education Competence Instrument and a second self-report questionnaire from January to February 2019. Descriptive statistics, t-test, analysis of variance, Pearson's and Spearman's correlation and multiple linear regression were used to analyse the data. The STROBE guideline was used RESULTS: The mean scores of the knowledge (70.10 ± 15.11), skills (92.14 ± 15.18) and personal attributes scales (32.32 ± 5.89) were found to be low to moderate. The main influencing factors for the health education implementation were lack of education and training (71.4%), lack of time (67.5%) and high workload (67.3%). Nurses with higher educational level and perceived self-efficacy for competently providing health education, more extensive professional experience and previous training in health education rated higher in knowledge, skills and personal attributes. Age and years of experience were negatively correlated with knowledge scores, but positively with the rest of domains of the competence and self-efficacy. The regression models for the overall health education competence's domains were significant (p < 0.001) with R2 values ranging from 28.0% to 49.3%. Self-efficacy, previous health education training and working in intensive care units were found to be significant in all cognitive, psychomotor and attitudinal scales. CONCLUSION Clinical nurses reported on some skills and personal attributes for health education practice, but they seem to lack health education knowledge necessary for a competent practice. This study suggested that effective education and training and supportive organizational cultures are key to enhance nurses' health education competence. Identifying nurses' educational needs on the main domains of the competence and its intrinsic/extrinsic influential factors may assist in both planning and organizing tailored training strategies and in promoting appropriate environments to support a high-quality health education practice TWEETABLE ABSTRACT: Nurses' knowledge, skills and attitudes about health education competence are low to moderate. Training and organizational support are key.
Collapse
Affiliation(s)
- M Pueyo-Garrigues
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain.
| | - M I Pardavila-Belio
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain.
| | - A Canga-Armayor
- University of Navarra, School of Nursing, Nursing Care for Adult Patients Department, Campus Universitario, 31008 Pamplona, Spain.
| | - N Esandi
- University of Navarra, School of Nursing, Nursing Care for Adult Patients Department, Campus Universitario, 31008 Pamplona, Spain.
| | - C Alfaro-Díaz
- University of Navarra, School of Nursing, Nursing Care for Adult Patients Department, Campus Universitario, 31008 Pamplona, Spain.
| | - N Canga-Armayor
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain.
| |
Collapse
|
9
|
Ricci L, Villegente J, Loyal D, Ayav C, Kivits J, Rat AC. Tailored patient therapeutic educational interventions: A patient-centred communication model. Health Expect 2021; 25:276-289. [PMID: 34816546 PMCID: PMC8849242 DOI: 10.1111/hex.13377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/02/2021] [Accepted: 10/17/2021] [Indexed: 11/07/2022] Open
Abstract
Background Tailoring therapeutic education consists of adapting the intervention to patients' needs with the expectation that this individualization will improve the results of the intervention. Communication is the basis for any individualization process. To our knowledge, there is no guide or structured advice to help healthcare providers (HCPs) tailor patient education interventions. Objectives We used a data‐driven qualitative analysis to (1) investigate the reasons why HCPs tailor their educational interventions and (2) identify how this tailoring is effectively conducted. The perspective aimed to better understand how to individualize therapeutic patient education and to disentangle the different elements to set up studies to investigate the mechanisms and effects of individualization. Design Individual semistructured interviews with 28 HCPs involved in patient education were conducted. The present study complied with the COREQ criteria. Results Why individualization is necessary: participants outlined that the person must be thought of as unique and that therapeutic education should be adapted to the patient's personality and cognitive abilities. The first step in the individualization process was formalized by an initial patient assessment. Several informal practices were identified: if needed, giving an individual time or involving a specific professional; eliciting individual objectives; reinforcing the relationship by avoiding asymmetrical posture; focusing on patients' concerns; leading sessions in pairs; and making the patient the actor of decisions. Conclusion From our thematic data analysis, a model for tailoring patient education interventions based on the Haes and Bensing medical communication framework is proposed. The present work paves the way for evaluation, then generation of recommendations and finally implementation of training for individualization in educational interventions. Short Informative Tailoring in therapeutic education consists of an adaptation to patients' needs. Communication is the basis for any individualization process. There is no model of patient‐centred communication in educational interventions. From semistructured interviews with HCPs, we propose a patient‐centred communication model for tailoring patient education intervention.
Collapse
Affiliation(s)
- Laetitia Ricci
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - Julie Villegente
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France.,Université de Reims Champagne-Ardenne, Reims, France
| | | | - Carole Ayav
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | | | - Anne-Christine Rat
- Université de Lorraine, APEMAC, Nancy, France.,University of Caen Normandie, Caen, France.,Rheumatology Department, University Hospital Center Caen, Caen, France
| |
Collapse
|
10
|
Dong T, Xin L, Wang F, Lin Y, Lv X, Zheng Y. Significance of integrated health education combined with life intervention style in patients with coronary atherosclerotic heart disease with hyperlipidemia. Minerva Surg 2021; 77:406-408. [PMID: 34790924 DOI: 10.23736/s2724-5691.21.09195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Tongjun Dong
- Catheter Room, Cangzhou Central Hospital, Cangzhou, China -
| | - Lidong Xin
- Catheter Room, Cangzhou Central Hospital, Cangzhou, China
| | - Fengyun Wang
- Catheter Room, Cangzhou Central Hospital, Cangzhou, China
| | - Yu Lin
- Catheter Room, Cangzhou Central Hospital, Cangzhou, China
| | - Xiaoping Lv
- Digestive Endoscope, Cangzhou Central Hospital, Cangzhou, China
| | - Ye Zheng
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou, China
| |
Collapse
|
11
|
Keessen P, van Duijvenbode IC, Latour CH, Kraaijenhagen RA, Janssen VR, Jørstad HT, Scholte Op Reimer WJ, Visser B. Design of a remote coaching program to bridge the gap from hospital discharge to cardiac rehabilitation: an intervention mapping study. (Preprint). JMIR Cardio 2021; 6:e34974. [PMID: 35612879 PMCID: PMC9178457 DOI: 10.2196/34974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/18/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Paul Keessen
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Ingrid Cd van Duijvenbode
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Corine Hm Latour
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | | | - Veronica R Janssen
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Harald T Jørstad
- Department of Cardiology, Heart Center, Amsterdam University Medical Center, Amsterdam, Netherlands
| | | | - Bart Visser
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| |
Collapse
|
12
|
Boyde M, Tuckett A, Ty J. Teacher-as-actor: Investigating the barriers and facilitators of patient education among hospitalized patients in a cardiology clinical unit. Nurs Health Sci 2021; 23:871-879. [PMID: 34431188 DOI: 10.1111/nhs.12874] [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: 04/15/2021] [Revised: 08/01/2021] [Accepted: 08/20/2021] [Indexed: 11/29/2022]
Abstract
Patient education enables people with cardiovascular disease to develop self-management behaviors. This study aimed to explore facilitators and barriers to teaching patients in a clinical cardiology unit with a single site qualitative investigation involving 21 registered nurses attending four focus groups. This study identified barriers related to patient factors including individual characteristics and responses to education, comorbidities, acuity, and evolving diagnosis, while for nurses the barriers were lack of knowledge and expertise. Barriers associated with the physical environment included nursing workload issues and lack of resources. Facilitators included patients being engaged in the process of education, prepared, and ready to be educated, while a conducive physical environment was also seen as a facilitator. This study exposed inhibiting and enabling variables associated with the exchange between patients and nurses by viewing the nurse and the patient as actors and audience in a theatrical model where communicating to teach patients is seen as a collaborative art. The nurse who understands the barriers and facilitators to teaching will more likely engage the patient in successful learning and development of self-care behaviors.
Collapse
Affiliation(s)
- Mary Boyde
- Cardiology, Building 1, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Anthony Tuckett
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.,Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia
| | - Jerry Ty
- Cardiology, Building 1, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| |
Collapse
|
13
|
Nurmeksela A, Pihlainen V, Kettunen T, Laukkanen J, Peltokoski J. Nurse-led counseling for coronary artery disease patients: A 1-year follow-up study. Nurs Health Sci 2021; 23:678-687. [PMID: 33991019 DOI: 10.1111/nhs.12852] [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: 12/18/2020] [Revised: 04/12/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
Nurse-led counseling and systematic follow-up have been shown to reduce cardiovascular risk factor levels. The study aims were to investigate if cardiovascular risk factor levels could be reduced in patients with coronary artery disease with a nurse-led intervention and to report patients' evaluations of nurse-led counseling. The study design was a real-life longitudinal follow-up counseling intervention. Data were collected from November 2017 to May 2020. The nurse-led intervention and patients' follow-up time was 1 year. Of the 78 patients recruited, 74 completed the study. The most significant findings were in the levels of total cholesterol, low-density lipoprotein cholesterol, and triglycerides at every follow-up visit compared to their baseline levels and that waist circumference decreased during the 1-year follow-up. Patients assessed the quality of nurse-led counseling to be very good, though it decreased slightly during follow-up. The results suggest the integrated care path and specialized and primary care for coronary artery disease patients need further development. More research is needed on how to strengthen patients' self-management and what kind of counseling would best promote it.
Collapse
Affiliation(s)
- Anu Nurmeksela
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | | | - Tarja Kettunen
- Faculty of Sport and Health Sciences and Central Finland Health Care District, Unit of Primary Health Care, University of Jyvaskyla, Jyvaskyla, Finland.,Unit of Primary Health Care, Jyvaskyla, Finland
| | - Jari Laukkanen
- Department of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Central Finland Health Care District, Jyvaskyla, Finland
| | | |
Collapse
|
14
|
Jung MJ, Roh YS. A Validation Study of the Korean Version of the Nurses' Patient Education Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115609. [PMID: 34073972 PMCID: PMC8197320 DOI: 10.3390/ijerph18115609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate the internal consistency reliability and construct validity of the Korean version of the Nurses’ Patient Education Questionnaire. An accurate assessment of nurses’ perceived patient education competency is required, and these needs assessment results can provide the evidence for designing a continuing education to empower and equip nurses with optimal competency for patient education. A cross-sectional study was used to which a convenience sample of 262 hemodialysis unit nurses in the Republic of Korea. In the exploratory factor analysis, the questionnaire consisted of 26 items belonging to seven factors: (1) nurse belief and knowledge; (2) documentation of patient education activities; (3) collegial teamwork; (4) educational environment; (5) interdisciplinary cooperation; (6) education foundation; and (7) health care organization, all of which accounted for 70.2% of the variance. The internal consistency reliability was 0.91 for the overall scale and each factor at 0.70 to 0.77. The questionnaire provides a valid and reliable instrument to assess nurses’ patient education competency.
Collapse
Affiliation(s)
- Myung-Jin Jung
- College of Nursing, Korea University, Seoul 02841, Korea;
| | - Young-Sook Roh
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea
- Correspondence: ; Tel.: +82-2-820-5978
| |
Collapse
|
15
|
Rehabilitation and Prevention of Hand Eczema. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
16
|
Hassankhani H, Haririan H, Jafari A, Porter JE, O'Brien F, Feizollahzadeh H. Learning Needs of Iranian Patients with Coronary Heart Disease: A Cross-sectional, Comparative Study. Clin Nurs Res 2020; 30:193-199. [PMID: 31924108 DOI: 10.1177/1054773819898808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patient education requires modification as it is either nonexistent or implemented irregularly or inadequately. STUDY’S PURPOSE To examine the learning needs of patients with coronary heart disease from the perspective of the patients, their relatives, and health care providers. METHODOLOGY The cross-sectional, comparative study conducted at two cardiac hospitals of Tabriz and Ardebil, Iran from May 2016 to September 2016.Through convenience sampling perceptions of 137 patients, 137 relatives, 33 cardiologists, and 108 nurses were compared using the Cardiac Learning Need Inventory questionnaire. MAJOR RESULTS The most important learning needs of patients from the perspective of physicians, nurses, and patients' relatives was information about risk factors. In contrast, patient's perceived information about medication to be their most important learning need. CLINICAL IMPLICATIONS Patients' perceptions of their educational needs was different from the perceptions of physicians, nurses, and relatives of the patients. Therefore, when planning patient education a comprehensive review of the patients' learning needs is required in order to develop a suitable education plan by prioritizing patients' educational needs.
Collapse
Affiliation(s)
- Hadi Hassankhani
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamidreza Haririan
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Joanne E Porter
- School of Nursing, Midwifery and Healthcare, Federation University Australia, Australia
| | - Frances O'Brien
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | | |
Collapse
|
17
|
Rehabilitation and Prevention of Hand Eczema. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_71-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
18
|
Fawkes K, Moore J. Newly registered nurses' experiences of delivering patient education in an acute care setting: an exploratory study. J Res Nurs 2019; 24:556-567. [PMID: 34394577 DOI: 10.1177/1744987119869770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Nurses' education of patients is important for building the knowledge and skills necessary for self-management. Little is known of newly registered nurses' preparedness to deliver patient education, or of their experiences in clinical contexts where they may encounter barriers. Aims The aim of this study was to explore newly registered nurses' patient education role in an acute hospital setting. Methods A purposive sample of seven newly registered nurses from an NHS teaching hospital in England were interviewed to explore their understanding and experiences of educating patients. An interpretive phenomenological approach was used to analyse responses. Results Three superordinate themes were identified: the professional self; the ward environment; and the nurse-patient relationship. Tensions existed between the ideals newly registered nurses brought to registered practice and the practice-based realities of patient education, which was often delivered informally with limited patient involvement in collaborative goal setting. Few newly registered nurses recalled more than superficial preparation in university for the role and some were encouraged by senior colleagues to downplay the importance of patient education. Conclusions The patient-education aspirations of newly registered nurses need to be nurtured. Educational institutions have an important role to play as do experienced nurses, making explicit the education they routinely deliver and supporting newly registered nurses to build their own pedagogic expertise.
Collapse
Affiliation(s)
- Karen Fawkes
- Senior Clinical Teacher, Adult Nursing Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, United Kingdom
| | - Jaqualyn Moore
- Lecturer, Adult Nursing Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, United Kingdom
| |
Collapse
|
19
|
Development and Reliability Testing of a Patient Education Performance Tool for Physical Therapy Students. ACTA ACUST UNITED AC 2019. [DOI: 10.1097/jte.0000000000000074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
20
|
Dale JG, Midthus E, Dale B. Using information and communication technology in the recovery after a coronary artery bypass graft surgery: patients' attitudes. J Multidiscip Healthc 2018; 11:417-423. [PMID: 30214223 PMCID: PMC6121744 DOI: 10.2147/jmdh.s175195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients who have undergone a coronary artery bypass graft (CABG) surgery are exposed to physical and mental problems after discharge from the specialist hospital and are often in need of post-discharge support and follow-up. AIM This study aimed to explore the attitudes of CABG patients toward using information and communication technology (ICT) during the first year of recovery after discharge from hospital. METHODS A cross-sectional design utilizing an electronic survey was employed. The sample consisted of 197 patients who had undergone a CABG surgery during 2015. The questionnaire included questions about follow-up needs, contacts with health professionals, use of the Internet, and attitudes toward using ICT in the recovery phase. RESULTS Mean age of the participants was 67.3 years; 18.3% were women. A total of 48.2% of the patient group was satisfied with the pre-discharge information. Only 27% had contacted the hospital after discharge. Whereas 58.4% of the participants had used the Internet to acquire information, only 30.4% found this information to be useful. Many patients (40%) reported that they could benefit from online health information and Skype meetings with professionals. More than 30% reported that nutritional guidance on the Internet could be motivating for choosing healthy diets, and 42.6% reported that Internet-based illustrative videotapes could be motivating for undertaking physical training. CONCLUSION ICT can be useful and resource-saving for patients who have undergone a CABG surgery, as well as for the health care services. The technology must be appropriately tailored, with regard to content and design, to be helpful for patients.
Collapse
Affiliation(s)
- Jan Gunnar Dale
- University of Agder, Institute of Health and Nursing Science, Grimstad, Norway,
| | | | - Bjørg Dale
- Centre for Care Research, Southern Norway, University of Agder, Grimstad, Norway
| |
Collapse
|
21
|
Yu F, Li H, Tai C, Guo T, Pang D. Effect of family education program on cognitive impairment, anxiety, and depression in persons who have had a stroke: A randomized, controlled study. Nurs Health Sci 2018; 21:44-53. [PMID: 30112788 DOI: 10.1111/nhs.12548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 05/22/2018] [Accepted: 06/07/2018] [Indexed: 12/14/2022]
Abstract
People who have had a stroke face high risks of cognitive impairment, anxiety, and depression. Health education for family members contributes to better outcomes in various diseases, but the effects of health education on family members of people who have had a stroke are unclear. The aim of the present study was to evaluate the effects of the family member education program (FMEP) on cognitive impairment, anxiety, and depression in persons who have had a stroke. In total, 144 persons who experienced a stroke were randomly allocated to the FMEP group or control group (1:1 ratio). In the FMEP group, the FMEP and conventional treatment were provided, while in control group only conventional treatment was provided. The increase in the Montreal Cognitive Assessment (MOCA) score from baseline to 12 months (M12 - baseline) in the FMEP group was higher compared with the control group, and the FMEP led to a decreased cognitive impairment rate (MOCA score ≤26) after 12 months compared to the control group. Changes in the Hospital Anxiety and Depression Scale anxiety and depression score (M12 - baseline) decreased in the FMEP group compared with the control group. Fewer participants with depression and a lower depression grade were observed in the FMEP group compared with the control group. The FMEP could reduce cognitive impairment, anxiety, and depression in persons who have had a stroke.
Collapse
Affiliation(s)
- Fang Yu
- Department of Basic Nursing, The Nursing College of Harbin Medical University, Harbin, China
| | - Hongyu Li
- Department of Basic Nursing, The Nursing College of Harbin Medical University, Harbin, China
| | - Chunling Tai
- Department of Basic Nursing, The Nursing College of Harbin Medical University, Harbin, China
| | - Ting Guo
- Department of Nursing, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dong Pang
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
22
|
Fu R, Song X, Su D, Li S, Gao L, Ji C. Serum STLT-1 and bilirubin levels in patients with acute coronary syndrome and correlation with prognosis. Exp Ther Med 2018; 16:241-245. [PMID: 29977364 PMCID: PMC6030865 DOI: 10.3892/etm.2018.6137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 03/29/2018] [Indexed: 12/14/2022] Open
Abstract
The serum triggering receptor expressed on myeloid cell (TREM)-like transcription factor-1 [soluble TREM-like transcript-1 (STLT-1)] and bilirubin levels were investigated in patients with acute coronary syndrome and the correlation with prognosis. A total of 125 patients of acute coronary syndrome admitted to the Department of Cardiology in People's Hospital of Rizhao were selected, including 45 cases with ST-segment elevation myocardial infarction (STEMI), 36 cases with non-ST-elevation myocardial infarction (NSTEMI) and 44 cases with unstable angina pectoris (UAP), while 48 subjects were enrolled as the normal control. The serum STLT-1 and bilirubin levels on admission and on the 3rd, 7th and 10th day after admission of patients in each group were respectively determined, the level changes of these two indicators in serum during the initial stage of acute coronary syndrome were analyzed, and their effects on prognosis of patients were analyzed. STLT-1 levels in groups STEMI, NSTEMI and UAP were higher than those in the normal control group, and serum levels of STLT-1 in groups STEMI and NSTEMI were higher than those in group UAP. Bilirubin levels in groups STEMI, NSTEMI and UAP were lower than those in the normal control group, and serum levels of bilirubin in groups STEMI and NSTEMI were lower than those in group UAP. The proportions of complications in patients of groups STEMI and NSTEMI were significantly higher than those in group UAP (P<0.05). The results showed that the timely and effective treatment administered to patients with acute coronary syndrome during the initial stage to reduce the level of STLT-1 in serum and enhance bilirubin to a relatively high level is conducive in ameliorating the prognosis of patients, which is of clinical significance.
Collapse
Affiliation(s)
- Rong Fu
- Department of Cardiology, People's Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China
| | - Xu Song
- Department of Respiratory Medicine, People's Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China
| | - Dexing Su
- Department of Cardiology, People's Hospital of Zhangqiu, Jinan, Shandong 250200, P.R. China
| | - Shunrong Li
- Department of Critical Care Medicine, People's Hospital of Zhangqiu, Jinan, Shandong 250200, P.R. China
| | - Lizhen Gao
- Department of Clinical Laboratory, People's Hospital of Zhangqiu, Jinan, Shandong 250200, P.R. China
| | - Chunmei Ji
- Department of Clinical Laboratory, People's Hospital of Weifang, Weifang, Shandong 261000, P.R. China
| |
Collapse
|
23
|
Cossette S, Côté J, Rouleau G, Robitaille M, Heppell S, Mailhot T, Fontaine G, Cournoyer C, Gagnon MP, Gallani MC, Tanguay JF, Dupuis J, Nigam A, Guertin MC. A Web-Based Tailored Intervention to Support Illness Management in Patients With an Acute Coronary Syndrome: Pilot Study. JMIR Cardio 2017; 1:e4. [PMID: 31758758 PMCID: PMC6834220 DOI: 10.2196/cardio.7342] [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: 01/17/2017] [Revised: 07/06/2017] [Accepted: 07/12/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Illness management after an acute coronary syndrome (ACS) is crucial to prevent cardiac complications, to foster participation in a cardiac rehabilitation (CR) program, and to optimize recovery. Web-based tailored interventions have the potential to provide individualized information and counseling to optimize patient's illness management after hospital discharge. OBJECTIVE We aimed to assess the feasibility and acceptability of a Web-based tailored intervention (TAVIE@COEUR) designed to improve illness management in patients hospitalized for an ACS. Illness management outcomes were operationalized by self-care, medication adherence, anxiety management, cardiac risk factors reduction, and enrollment in a CR program. METHODS This posttest pilot study was conducted with one group (N=30) of patients hospitalized for an ACS on the coronary care unit of a tertiary cardiology center. TAVIE@COEUR comprises three Web-based sessions, with a duration ranging from 10 to 45 min and is structured around an algorithm to allow the tailoring of the intervention to different pathways according to patients' responses to questions. TAVIE@COEUR includes 90 pages, 85 videos, and 47 PDF documents divided across session 1 (S1), session 2 (S2), and session 3 (S3). These sessions concern self-care and self-observation skills related to medication-taking (S1), emotional control and problem-solving skills (S2), and social skills and interacting with health professionals (S3). Throughout the videos, a virtual nurse (providing the intervention virtually) guides the participants in the acquisition of self-care skills. Patients completed S1 of TAVIE@COEUR before hospital discharge and were asked to complete S2 and S3 within 2 weeks after discharge. Feasibility indicators were extracted from the TAVIE@COEUR system. Data regarding acceptability (satisfaction and appreciation of the platform) and preliminary effect (self-care, medication adherence, anxiety management, risk factor reduction, and CR enrollment) were assessed through questionnaires at 1 month following discharge. Preliminary effect was assessed by comparing baseline and 1-month illness management variables. RESULTS Of the 30 participants, 20 completed S1, 10 completed S2, and 5 completed S3. Good acceptability scores were observed for ease of navigation (mean=3.58, standard deviation [SD]=0.70; scale=0-4), ease of understanding (mean=3.46, SD=0.63; scale=0-4), and applicability (mean=3.55, SD=0.74; scale=0-4). The lowest acceptability scores were observed for information tailoring (mean=2.93, SD=0.68; scale=0-4) and individual relevance (mean=2.56, SD=0.96; scale=0-4). With regard to preliminary effect, we observed an overall self-care at 1 month following discharge score higher than at baseline (mean at 1 month=54.07, SD=3.99 vs mean at baseline=49.09, SD=6.92; scale-0-60). CONCLUSIONS Although participants reported general satisfaction and appreciation of TAVIE@COEUR, acceptability and feasibility results show the need for further development of the Web-based intervention to enhance its tailoring before undertaking a full-fledged randomized controlled trial. This may be accomplished by optimizing the adaptability of TAVIE@COEUR to patients' knowledge, needs, interests, individual capabilities, and emotional and cognitive responses during session completion.
Collapse
Affiliation(s)
- Sylvie Cossette
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Research Chair in Innovative Nursing Practices, Montréal, QC, Canada
| | - Geneviève Rouleau
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Research Chair in Innovative Nursing Practices, Montréal, QC, Canada.,Faculty of Nursing, Laval University, Quebec City, QC, Canada
| | | | - Sonia Heppell
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Montreal Heart Institute, Montreal, QC, Canada
| | - Tanya Mailhot
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - Guillaume Fontaine
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | | | | | | | - Jean-Francois Tanguay
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute Research Center, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Anil Nigam
- Montreal Heart Institute Research Center, Montréal, QC, Canada
| | | |
Collapse
|
24
|
Lelorain S, Bachelet A, Bertin N, Bourgoin M. French healthcare professionals' perceived barriers to and motivation for therapeutic patient education: A qualitative study. Nurs Health Sci 2017; 19:331-339. [PMID: 28681481 DOI: 10.1111/nhs.12350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 01/20/2023]
Abstract
Therapeutic patient education is effective for various patient outcomes; however, healthcare professionals sometimes lack the motivation to carry out patient education. Surprisingly, this issue has rarely been addressed in research. Therefore, this study explores healthcare professionals' perceived barriers to and motivation for therapeutic patient education. Healthcare professionals, mainly nurses, working in different French hospitals were interviewed. Thematic content analysis was performed. Findings included a lack of skills, knowledge, and disillusionment of the effectiveness of therapeutic patient education were features of a demotivated attitude. In contrast, a positive attitude was observed when therapeutic patient education met a need to work differently and more effectively. A key factor motivating professionals was the integration of therapeutic patient education in routine care within a multidisciplinary team. To keep healthcare professionals motivated, managers should ensure that therapeutic patient education is implemented in accordance with its core principles: a patient-centered approach within a trained multidisciplinary team. In the latter case, therapeutic patient education is viewed as an efficient and rewarding way to work with patients, which significantly motivates healthcare professionals.
Collapse
Affiliation(s)
- Sophie Lelorain
- University of Lille, CNRS, Teaching Hospital of Lille, UMR 9193 - SCALab - Cognitive & Affective Sciences, Lille, France
| | - Adeline Bachelet
- University of Lille, CNRS, Teaching Hospital of Lille, UMR 9193 - SCALab - Cognitive & Affective Sciences, Lille, France
| | - Nicole Bertin
- Teaching Hospital of Lille, Transversal Unit of Patient Education, Lille, France
| | - Maryline Bourgoin
- Teaching Hospital of Lille, Transversal Unit of Patient Education, Lille, France
| |
Collapse
|
25
|
Paganin AC, Beghetto MG, Hirakata VN, Hilário TS, Matte R, Sauer JM, Rabelo-Silva ER. A Vascular Complications Risk (VASCOR) score for patients undergoing invasive cardiac procedures in the catheterization laboratory setting: A prospective cohort study. Eur J Cardiovasc Nurs 2016; 16:409-417. [DOI: 10.1177/1474515116684250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- AC Paganin
- Graduate Program in Nursing, Federal University of Rio Grande do Sul, Brazil
- Unimed Hospital, Caxias do Sul, Brazil
| | - MG Beghetto
- Graduate Program in Nursing, Federal University of Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre, Brazil
| | - VN Hirakata
- Hospital de Clínicas de Porto Alegre, Brazil
| | - TS Hilário
- Graduate Program in Nursing, Federal University of Rio Grande do Sul, Brazil
| | - R Matte
- Hospital de Clínicas de Porto Alegre, Brazil
| | - JM Sauer
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Brazil
| | - ER Rabelo-Silva
- Graduate Program in Nursing, Federal University of Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre, Brazil
| |
Collapse
|
26
|
Mosleh S, Eshah N, Darawad M. Percutaneous coronary intervention and heart surgery learning needs of patients in Jordan. Int Nurs Rev 2016; 63:562-571. [DOI: 10.1111/inr.12318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S.M. Mosleh
- Department of Adult Nursing; Faculty of Nursing; Mutah University; Karak Jordan
| | - N.F. Eshah
- Faculty of Nursing; Zarqa University; Jordan
| | - M. Darawad
- Clinical Nursing Department; School of Nursing-The University of Jordan; Amman Jordan
| |
Collapse
|
27
|
Svavarsdóttir MH, Sigurdardottir AK, Steinsbekk A. What is a good educator? A qualitative study on the perspective of individuals with coronary heart disease. Eur J Cardiovasc Nurs 2015; 15:513-521. [PMID: 26588939 DOI: 10.1177/1474515115618569] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 10/27/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patient views are especially important in patient education, as patient involvement is essential. However, no empirical research clarifies what knowledge, skills and competencies are needed for health professionals to competently serve as a good educator according to the patients themselves. AIM To explore what qualities patients with coronary heart disease perceive in a good educator. METHODS A qualitative research method, with semi-structured individual interviews, was used in this study. Purposeful sampling was used to recruit participants from a general hospital in Iceland and in Norway. The data were analysed using systematic text condensation. RESULTS The participants included 17 patients who had been through a percutaneous coronary intervention and participated in formal patient education after discharge from hospital. The patients saw a good educator as one who they feel is trustworthy and who individualizes the education to patients' needs and context and translates general information to their personal situation in lay language. Building trust was dependent on the patients' perceiving the educator to be knowledgeable and good at connecting with the individual patient, so that the patients feel they are being treated as a whole person with equality and respect. CONCLUSIONS The patients perceived the capability of building trust and tailoring the education to the individual as the most prominent characteristics of a good educator. Training skills that facilitate patients' trust, being observant of the patient and his learning needs and adjusting the patient education to individual needs and situations should be key objectives in health professionals' training in patient education.
Collapse
Affiliation(s)
- Margrét H Svavarsdóttir
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway .,St Olavs Hospital, Trondheim University Hospital, Norway.,School of Health Sciences, University of Akureyri, Iceland
| | | | - Aslak Steinsbekk
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
28
|
Svavarsdóttir MH, Sigurðardóttir ÁK, Steinsbekk A. How to become an expert educator: a qualitative study on the view of health professionals with experience in patient education. BMC MEDICAL EDUCATION 2015; 15:87. [PMID: 25966846 PMCID: PMC4468802 DOI: 10.1186/s12909-015-0370-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 05/06/2015] [Indexed: 05/12/2023]
Abstract
BACKGROUND Health professionals with the level of competency necessary to provide high-quality patient education are central to meeting patients' needs. However, research on how competencies in patient education should be developed and health professionals trained in them, is lacking. The aim of this study was to investigate the characteristics of an expert educator according to health professionals experienced in patient education for patients with coronary heart disease, and their views on how to become an expert educator. METHODS This descriptive qualitative study was conducted through individual interviews with health professionals experienced in patient education in cardiac care. Participants were recruited from cardiac care units and by using a snowball sampling technique. The interviews were audiotaped and transcribed verbatim. The data were analyzed with thematic approaches, using systematic text condensation. RESULTS Nineteen Icelandic and Norwegian registered nurses, physiotherapists, and cardiologists, who had worked in cardiac care for 12 years on average, participated in the study. Being sensitive to the patient's interests and learning needs, and possessing the ability to tailor the education to each patient's needs and context of the situation was described as the hallmarks of an expert educator. To become an expert educator, motivation and active participation of the novice educator and a supportive learning environment were considered prerequisites. Supportive educational resources, observation and experiential training, and guidance from experienced educators were given as examples of resources that enhance competence development. Experienced educators expressed the need for peer support, inter-professional cooperation, and mentoring to further develop their competency. CONCLUSIONS Expert patient educators were described as those demonstrating sensitivity toward the patient's learning needs and an ability to individualize the patient's education. A supportive learning environment, inner motivation, and an awareness of the value of patient education were considered the main factors required to become an expert educator. The experienced educators expressed a need for continuing education and peer support.
Collapse
Affiliation(s)
- Margrét Hrönn Svavarsdóttir
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
- St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
- School of Health Sciences, University of Akureyri, Akureyri, Iceland.
| | | | - Aslak Steinsbekk
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
| |
Collapse
|