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Melnikow J, Padovani A, Zhang J, Miller M, Gosdin M, Loureiro S, Daniels B. Patient concerns and physician strategies for addressing COVID-19 vaccine hesitancy. Vaccine 2024; 42:3300-3306. [PMID: 38627148 DOI: 10.1016/j.vaccine.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 03/19/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE COVID-19 vaccination is critical for reducing serious illness and hospitalizations, yet many remain hesitant. We conducted a survey of frontline physicians to identify patient concerns and physician strategies to address COVID-19 vaccine-hesitancy. METHODS A national random sample of physicians in frontline specialties selected from a comprehensive list of practicing physicians in the U.S. were emailed a survey in August 2021. Multiple choice and open-ended questions inquired about patient concerns related to the COVID-19 vaccines and strategies used by physicians to counter vaccine misinformation and encourage vaccine-hesitant patients. Weighting was applied to achieve representativeness and reduce non-response bias. Network analysis examined co-occurring patient concerns. Open-ended responses on communication strategies were coded via thematic analysis. Multi-variable logistic regression examined associations between physician and pandemic characteristics with patient concerns and use of communication strategies. RESULTS 531 physicians responded: primary care (241); emergency medicine (142); critical care (84); hospitalists (34); and infectious disease (30). Weighted response balance statistics showed excellent balance between respondents and nonrespondents. On average, physicians reported four patient vaccine concerns. Safety, side effects, vaccine misinformation, and mistrust in government were most common, and often co-occurring. 297 physicians described communication strategies: 180 (61 %) provided vaccine education and 94 (32 %) created a safe space for vaccine discussion. Narrative responses from physicians provided compelling examples of both successes and communication challenges arising from misinformation. Compared with emergency medicine, critical care (OR 2.45, 95 % CI 1.14, 5.24), infectious disease (OR 2.45, 95 % CI 1.00, 6.02), and primary care physicians (OR 1.66, 95 % CI 1.02, 2.70) were more likely to provide communication strategies. CONCLUSIONS Many physicians engage with vaccine hesitant patients using a variety of strategies. Dissemination of effective system and physician-level communication interventions could enhance physician success.
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Affiliation(s)
- Joy Melnikow
- Center for Healthcare Policy and Research, University of California, Davis, CA, USA.
| | | | - Jingwen Zhang
- Department of Communication, University of California, Davis, CA, USA.
| | - Marykate Miller
- Center for Healthcare Policy and Research, University of California, Davis, CA, USA.
| | - Melissa Gosdin
- Center for Healthcare Policy and Research, University of California, Davis, CA, USA.
| | - Sabrina Loureiro
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.
| | - Brock Daniels
- Department of Emergency Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.
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Ghanem D, Shu H, Bergstein V, Marrache M, Love A, Hughes A, Sotsky R, Shafiq B. Educating patients on osteoporosis and bone health: Can "ChatGPT" provide high-quality content? Eur J Orthop Surg Traumatol 2024:10.1007/s00590-024-03990-y. [PMID: 38769125 DOI: 10.1007/s00590-024-03990-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE The rise of artificial intelligence (AI) models like ChatGPT offers potential for varied applications, including patient education in healthcare. With gaps in osteoporosis and bone health knowledge and adherence to prevention and treatment, this study aims to evaluate the accuracy of ChatGPT in delivering evidence-based information related to osteoporosis. METHODS Twenty of the most common frequently asked questions (FAQs) related to osteoporosis were subcategorized into diagnosis, diagnostic method, risk factors, and treatment and prevention. These FAQs were sourced online and inputted into ChatGPT-3.5. Three orthopedic surgeons and one advanced practice provider who routinely treat patients with fragility fractures independently reviewed the ChatGPT-generated answers, grading them on a scale from 0 (harmful) to 4 (excellent). Mean response accuracy scores were calculated. To compare the variance of the means across the four categories, a one-way analysis of variance (ANOVA) was used. RESULTS ChatGPT displayed an overall mean accuracy score of 91%. Its responses were graded as "accurate requiring minimal clarification" or "excellent," with a mean response score ranging from 3.25 to 4. No answers were deemed inaccurate or harmful. No significant difference was observed in the means of responses across the defined categories. CONCLUSION ChatGPT-3.5 provided high-quality educational content. It showcased a high degree of accuracy in addressing osteoporosis-related questions, aligning closely with expert opinions and current literature, with structured and inclusive answers. However, while AI models can enhance patient information accessibility, they should be used as an adjunct rather than a substitute for human expertise and clinical judgment.
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Affiliation(s)
- Diane Ghanem
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, 21287, USA.
| | - Henry Shu
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | | | - Majd Marrache
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Andra Love
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Alice Hughes
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Rachel Sotsky
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Babar Shafiq
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, 21287, USA
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3
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Vieira LG, Schneider G, Margatho AS, Braga FTMM, Vasques CI, Møller T, Ferreira EB, Silveira RCDCP. Teaching-Learning Programs to Prevent and Control Infections Related to Long-Term Central Venous Access Device in Cancer Patients: A Systematic Review. Semin Oncol Nurs 2024:151650. [PMID: 38705798 DOI: 10.1016/j.soncn.2024.151650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/11/2024] [Accepted: 04/14/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES To evaluate the effectiveness of teaching-learning programs for cancer patients and/or their caregivers or family in preventing and controlling infections associated with long-term central venous access devices. DATA SOURCES This systematic review used the CINAHL, Cochrane Library, EMBASE, LILACS, and MEDLINE via PubMed portal, Scopus, and Web of Science. Google Scholar was used for the gray literature search. The included studies were analyzed, and the obtained data were qualitatively synthesized. The risk of bias was assessed using Cochrane tools: RoB 2 and ROBINS-I. The certainty of the evidence was evaluated using the GRADE. The review protocol was registered in PROSPERO (CRD42021267530). CONCLUSION The teaching-learning programs were implemented through theoretical-practical and theoretical dimensions in five and two studies, respectively. The risk of bias in the studies was low, moderate, severe, and high in one, three, two, and one of them, respectively. The certainty was very low. Teaching-learning programs on central venous access devices care for cancer patients and/or their caregivers or families could be effective in reducing infection rates. IMPLICATIONS FOR NURSING PRACTICE This systematic review addressed the teaching-learning programs for preventing and controlling infections associated with long-term central venous access devices. We identified that the most programs were effective in reducing the infection rates. The results may influence the clinical practice of oncology nurses, and consequently, the educational strategies and methods provided not only to these patients but for caregivers and families.
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Affiliation(s)
- Leticia Genova Vieira
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Guilherme Schneider
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | | | - Tom Møller
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Twohig P, Walsh E, Trujillo S, Manatsathit W, Peeraphatdit TB. Evaluating online patient education materials for liver cirrhosis. Ir J Med Sci 2024:10.1007/s11845-024-03645-1. [PMID: 38446347 DOI: 10.1007/s11845-024-03645-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND & AIMS Liver cirrhosis affects 4.5 million adults in the United States (US). As more patients educate themselves online, we evaluated the accessibility, quality, understandability, accuracy, readability, and comprehensiveness (AQUA-RC) of online patient education materials for cirrhosis. METHODS Cross-sectional analysis using Google® and YouTube® on a cleared internet browser from 12 cities across the US. The authors independently reviewed the top 25 search results from each platform using search terms "liver cirrhosis" and "cirrhosis". Accessibility was evaluated from twelve cities in six regions across the US. We evaluated resource quality using the DISCERN score, understandability using the PEMAT score, readability using the Flesch-Kinkaid score, and accuracy/comprehensiveness using a list of author-generated criteria. AQUA-RC was compared between 1) academic websites (AW) vs. non-academic websites (NAW), and 2) websites vs. YouTube® videos. RESULTS 28 websites and 25 videos were included. Accessibility was equal across all regions. Websites had higher average quality scores than videos, although this was not statistically significant (p = 0.84). Websites were more understandable than videos (p < 0.00001). Both websites and videos were 100% accurate. Readability for websites was higher than recommended standards. Websites were more comprehensive than videos (p = 0.02). CONCLUSION Online patient education materials for cirrhosis in the US are equally accessible, but readability and understandability are too complex. Websites are of greater quality, accuracy, and comprehensiveness than YouTube videos, which are often narrowly focused and targeted at the medical community rather than patients. Further efforts should be made to improve online patient education and expand content across platforms.
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Affiliation(s)
- Patrick Twohig
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Erin Walsh
- Division of Gastroenterology & Hepatology, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA, 15212, USA
| | - Sophie Trujillo
- Division of Gastroenterology & Hepatology, University of California-Irvine, 3390 University Avenue, Riverside, CA, 92501, USA
| | - Wuttiporn Manatsathit
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Thoetchai Bee Peeraphatdit
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198, USA
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Krishnakumar D, Hessler Jones D, Potter MB. Self-Management Support Improves Diabetes Outcomes Without Exacerbating Inequities. J Am Board Fam Med 2024; 37:303-308. [PMID: 38740490 DOI: 10.3122/jabfm.2023.230324r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Previous research has found an association between low health literacy and poor clinical outcomes in type 2 Diabetes Mellitus (T2DM) patients. We sought to determine if this association can be mitigated by a self-management support (SMS) program provided by trained health workers using a technology assisted menu driven program, called Connection to Health (CTH). METHODS This study is a secondary analysis from a randomized trial of 2 similar versions of CTH implemented in 12 Northern California community health centers. As part of this, each participant completed a single validated question to assess health literacy. We used unadjusted and adjusted linear regression analyses to determine the extent to which baseline health literacy was predictive of prepost changes in hemoglobin A1c (HbA1c). RESULTS Of 365 participants for whom prepost HbA1c data were available, HbA1c concentrations declined by an average of 0.76% (from 9.9% to 9.2%, 95% CI (0.53%-1.0%). Almost 114 (31.2%) of the participants had low health literacy, but there was no significant association between health literacy and the reduction in HbA1c concentrations in either the unadjusted or adjusted models, nor did baseline health literacy predict prepost changes in body mass index, medication adherence, exercise, or diet. DISCUSSION The study found that implementing the CTH program in 2 versions via a randomized clinical trial improved HbA1c concentrations without increasing disparities between participants with high and low health literacy. This suggests CTH-like programs can enhance diabetes outcomes in community health centers without exacerbating inequities for those with low health literacy.
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Affiliation(s)
- Devika Krishnakumar
- From the Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (DK); Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA (DHS, MBP).
| | - Danielle Hessler Jones
- From the Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (DK); Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA (DHS, MBP)
| | - Michael B Potter
- From the Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (DK); Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA (DHS, MBP)
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Jiang A, Perry T, Walker K, Burfoot A, Patterson L. Surgical sensation during caesarean section: a qualitative analysis. Int J Obstet Anesth 2024; 57:103935. [PMID: 37925355 DOI: 10.1016/j.ijoa.2023.103935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 08/13/2023] [Accepted: 10/02/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Caesarean section (CS) is a major abdominal surgery performed usually on a young and healthy population under neuraxial anesthesia with little to no sedation. This creates a distinct surgical experience whereby patients are aware of the surgical process, physical sensations, and their environment. This study aimed to provide an in-depth descriptive assessment of subjective surgical experience during CS under regional anaesthesia. We expected the information gained would enhance our current understanding and better alleviate patient anxiety through informed counselling. METHODS This qualitative descriptive study was conducted at a Canadian academic centre. Twenty patients participated in semi-structured interviews within a week of CS, using an interview guide developed for this study. Patient medical records were reviewed to collect demographic and surgical information. Thematic analysis was conducted using an inductive approach to determine common themes. RESULTS Nine themes were identified. Five themes were identified in the category of surgical sensation and four themes were identified in the category of peri-operative education. CONCLUSIONS Patients commonly experienced pressure and movement sensations at varying intensity, and most did not experience pain. Environmental factors, including sounds and distraction by the newborn, affected perception of surgical sensation. Patients wish to receive pre-operative counselling regarding potential surgical sensations, as well as ongoing communication from their anaesthesiologist. These results can be used to guide informed discussions with patients and direct further investigation in this area.
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Affiliation(s)
- A Jiang
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
| | - T Perry
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - K Walker
- Department of Sociology, Queen's University, Kingston, Ontario, Canada
| | - A Burfoot
- Department of Sociology, Queen's University, Kingston, Ontario, Canada
| | - L Patterson
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada
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7
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Patil S, Patil MV, Bagalkotkar A, Wali S. Cyclophosphamide Toxicity in Pediatric Nephrotic Syndrome Patient: A Case Report and Literature Review. Curr Drug Saf 2024; 19:CDS-EPUB-137123. [PMID: 38204270 DOI: 10.2174/0115748863281214231213075642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Primary membranous nephropathy is a rare presentation in children. Patients unresponsive to steroids and experiencing frequent relapse are considered steroid-resistant. They often require complex treatment regimens consisting of immunosuppressants like cyclophosphamide, tacrolimus, and cyclosporin A. CASE In the present case, a 5-year-old child was suffering from steroid-resistant nephrotic syndrome for the past 10 months. He was initially treated with prednisolone 20mg but was subsequently found to be steroid-resistant. A renal biopsy revealed primary podocytopathy with immunocomplex deposits in podocyte tissues, suggesting primary membranous nephropathy as the cause of SRNS (steroid-resistant nephrotic syndrome). Cyclophosphamide 25mg twice daily was added to the treatment plan since the child did not tolerate tacrolimus therapy. During a subsequent follow-up, the physician reduced the cyclophosphamide 25mg dose to once a day, but parents misinterpreted this, and the child received a larger dose, cyclophosphamide 25mg, four times a day for 20 days. This resulted in cyclophosphamide toxicity-induced neutropenia, alopecia and posing the child at greater risk of sepsis. CONCLUSION Nephrotic syndrome is a chronic disease that demands extensive treatment plans and strict monitoring. Medication errors are common among parents or caregivers of pediatric patients. This case is a take-home message emphasizing the significance of patient-centered communication in preventing medication errors. A clinical pharmacist can aid in conveying simple and unambiguous information to parents or caregivers.
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Affiliation(s)
- Soumya Patil
- Department of Pharmacy Practice, KLE College of Pharmacy, A Constituent Unit of KLE Academy of Higher Education and Research (KAHER), Belgaum-590010, Karnataka, India
| | - Mahantesh V Patil
- Department of Pediatrics, J N Medical College, A Constituent Unit of KLE Academy of Higher Education and Research (KAHER), Belgaum-590010, Karnataka, India
| | - Apoorva Bagalkotkar
- Department of Pediatrics, J N Medical College, A Constituent Unit of KLE Academy of Higher Education and Research (KAHER), Belgaum-590010, Karnataka, India
| | - Shashikala Wali
- Department of Pharmacy Practice, KLE College of Pharmacy, A Constituent Unit of KLE Academy of Higher Education and Research (KAHER), Belgaum-590010, Karnataka, India
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Frenzel O, Steig J, Hodges A. Assessing a Medication Safety and Disposal Educational Program using the Health Belief Model. Innov Pharm 2023; 14:10.24926/iip.v14i3.5546. [PMID: 38487380 PMCID: PMC10936446 DOI: 10.24926/iip.v14i3.5546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Background: Self-medication practices continue to grow due to reclassification of prescription to OTC status and self-care information on the internet, however unintended injuries and inappropriate use of medications continue to challenge healthcare providers during the provision of patient care. Pharmacists have an integral role in pharmacovigilance and patient education activities to ensure safe medication use, storage, and disposal practices. Objectives: The objective of this medication safety and disposal educational program was to provide comprehensive informational support to the community coupled with an assessment using the Health Belief Model (HBM) to gauge participants' perceived behavior change. Methods: The HBM was selected to assess the understanding of the community members' benefits and barriers to safe medication practices. The HBM posits that health behaviors are influenced by perceptions of a diseases' severity, perceived susceptibility, perceived barriers to health practices, perceived benefits of health practices, self-efficacy, and cues to action. An 8 item pre/post survey following the HBM constructs was developed which used a 5 point Likert scale. Results: A total of 25 senior participants attended the educational program. Twenty-three pre/post surveys were completed (RR=92%). Five items revealed a statistically significant change from pre to post-educational content including understanding risk of herbal/OTC products (p=0.021), improved awareness of medication disposal methods (p=0.044), comprehension of OTC 'Drug Facts' information (p=0.004), understanding OTC label information to prevent medication interactions and side effects (p=0.008), and routinely reviewing expiration dates on medications and disposing of these properly (p=0.019). Conclusion: This study suggests a comprehensive approach which covers a wide range of medication safety topics and disposal practices can successfully improve the knowledge and skill of community participants and potentially improve medication harm reduction practices.
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Affiliation(s)
- Oliver Frenzel
- North Dakota State University, Department of Pharmacy Practice
| | - Jayme Steig
- North Dakota State University, Department of Pharmacy Practice
| | - Alyssa Hodges
- North Dakota State University, Department of Pharmacy Practice
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Reading Turchioe M, Mangal S. Health literacy, numeracy, graph literacy, and digital literacy: An overview of definitions, evaluation methods, and best practices. Eur J Cardiovasc Nurs 2023:zvad085. [PMID: 37590968 DOI: 10.1093/eurjcn/zvad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
Health literacy is an important skill for people receiving care. Those with limited literacy face disparities in their care and health outcomes when strategies for addressing literacy are not used when delivering health information. In this article, we introduce the importance of considering health literacy, defining it and related concepts including numeracy, graph literacy, and digital literacy, and discuss open questions about measuring health literacy in clinical care. Finally, we present best practices, including assuming "universal precautions," carefully considering wording, leveraging visualizations, recognizing cultural differences in interpretation, guidance on pilot testing, and considering digital literacy when developing electronic materials.
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Yıldırım Z, Kaşıkçı M. The effect of education on self-care agency and rational drug use of patients with COPD. Patient Educ Couns 2023; 114:107804. [PMID: 37257261 DOI: 10.1016/j.pec.2023.107804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 04/28/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This study examined the effects of education given to patients diagnosed with the COPD on self-care agency and rational drug use. METHODS This study has a pretest-posttest quasi-experimental design. Participants were divided into two groups, those who received training with the COPD Guide booklet (n = 40) and routine clinical care (n = 43). RESULTS As a result of the study found a statistically significant difference between the self-care agency and rational drug use scale post-test mean scores of the patients in the intervention and control group in favor of the intervention group (p < 0.01). CONCLUSION Education on COPD management increased patients' self-care agency and their information, attitudes, and behaviors regarding rational drug use. PRACTICE IMPLICATIONS Clinicians can integrate a COPD Guide into routine care for patients with COPD.
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Affiliation(s)
- Zeynep Yıldırım
- Atatürk University Campus/ Faculty of Nursing Department of Fundamental of Nursing, Atatürk University, Erzurum, Turkey.
| | - Mağfiret Kaşıkçı
- Atatürk University Campus/ Faculty of Nursing Department of Fundamental of Nursing, Atatürk University, Erzurum, Turkey.
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Kilpatrick M, Hutchinson A, Manias E, Bouchoucha SL. Nurses' knowledge and implementation of Antimicrobial Stewardship and Infection Prevention strategies in acute paediatric settings. J Hosp Infect 2023:S0195-6701(23)00141-X. [PMID: 37160230 PMCID: PMC10164287 DOI: 10.1016/j.jhin.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Nurses are the first point of contact for patients and are responsible for monitoring and reporting signs of infection. The COVID-19 pandemic cemented nurses' leadership role in infection prevention. Despite this, nurses' contribution to Antimicrobial Stewardship initiatives remains under-recognised. The aim in this study was to determine how paediatric nurses understood their role and contribution to antimicrobial stewardship and infection prevention and control practices in three different acute paediatric wards. METHODS Forty-three nurses were recruited from an adolescent ward, an oncology ward and a surgical ward in a metropolitan tertiary children's hospital for a qualitative exploratory descriptive study. RESULTS Thematic and content analysis derived three themes from the data: Understanding of preventable infections, Embracing evidence-based guidelines to protect the patient, and Roles in preventing and controlling infections and antimicrobial stewardship. Associated subthemes were: Desensitised to COVID-19, Understanding Infection Prevention and Control Precautions, Correct Use of Hospital Policy and Guidelines, Restrictions Associated with the Use of Electronic Medical Records, Understanding of Sepsis Management and the Importance of Timely Micro-Biological Testing, Ambivalence on Antimicrobial Stewardship roles, and High priority placed on consumer education. CONCLUSION Nurses' understanding of their role focused on practices such as performing hand hygiene, standard precautions and reporting the use of high-risk antimicrobials. A lack of understanding of paediatric COVID-19 transmission and presentations was also reported. Education on best practice in infection prevention and AMS was recognised as crucial for both nurses and parents.
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Affiliation(s)
- Mataya Kilpatrick
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation.
| | - Ana Hutchinson
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation; Deakin University Geelong, Australia, Centre for Quality and Patient Safety Research. Epworth Healthcare Partnership
| | - Elizabeth Manias
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation; Monash University, Australia, School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences
| | - Stéphane L Bouchoucha
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation
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12
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Joseph FJ, Vanluchene HER, Goldberg J, Bervini D. 3D-printed head model in patient's education for micro-neurosurgical aneurysm clipping procedures. World Neurosurg 2023:S1878-8750(23)00555-7. [PMID: 37087042 DOI: 10.1016/j.wneu.2023.04.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and 3D reconstruction from Digital Subtraction Angiography (DSA) are currently used in clinical consultations for patients diagnosed with intracranial aneurysms; however, they have limitations in helping patients understand the disease and possible treatments. This study investigates the use of a 3D-printed model of the patients' neurosurgical anatomy and vascular pathology as an educational tool in outpatient clinics. METHODS A 3D-printed model of a middle cerebral artery aneurysm was created for use during patient consultations to discuss microsurgical treatment of unruptured cerebral aneurysms. In total, 38 patients and 5 neurosurgeons were included in the study. After the consultation, the patients and neurosurgeons received a questionnaire to assess the effectiveness of the 3D-printed model as an educational tool. RESULTS The 3D model improved the patients' understanding of the diagnosis, the aneurysm's relationship to the parent artery; the treatment process as well as the risks if left untreated. The patients found the 3D model to be an interesting tool (97%). The neurosurgeons were satisfied with the 3D-printed model as a patient encounter tool, they found the model effective during consultation (87%) and better than the conventional education tools used during consultations (97%). CONCLUSION Using a 3D model improves communication, enhances the patient's understanding of the pathology and its treatment and potentially facilitates the informed consent process in patients undergoing intracranial aneurysm surgery.
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Affiliation(s)
- Fredrick J Joseph
- Image Guided Therapy, ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008 Bern, Switzerland.
| | - Hanne E R Vanluchene
- Image Guided Therapy, ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008 Bern, Switzerland
| | - Johannes Goldberg
- Department of Neurosurgery, Bern University Hospital and University of Bern, Freiburgstrasse 16, 3010 Bern, Switzerland
| | - David Bervini
- Department of Neurosurgery, Bern University Hospital and University of Bern, Freiburgstrasse 16, 3010 Bern, Switzerland
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Parang L, Vakili V, Aliabadi MM. Impact of maternal psychosomatic empowerment during pregnancy on the improvement of mental health and maternal and fetal outcomes: A pilot study. Patient Educ Couns 2023; 109:107625. [PMID: 36708688 DOI: 10.1016/j.pec.2023.107625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/31/2022] [Accepted: 01/07/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To investigate the effect of maternal psychosomatic empowerment during pregnancy on improving mental health in Mashhad, Iran. METHODS In this quasi-experimental pilot study, 90 pregnant women were assigned into two groups. The intervention group was provided training sessions and routine care, while the control group only received routine care. The General Health Questionnaire - 28 (GHQ - 28) and Edinburgh Postnatal Depression Scale (EPDS) were completed by mothers in both groups. The data were analyzed in SPSS software by multivariate analysis of variance for repeated measures. RESULTS The mean GHQ scores were reduced from 39.3 ± 14.8 and 43.1 ± 12.84 in the first stage to 15.7 ± 8.66 and 22.72 ± 11.3 in the fourth stage in the intervention and control groups, respectively. The results demonstrated a significant difference among the GHQ scores obtained at four stages (F = 244.057, P < 0.001), regardless of the group factor. CONCLUSIONS The mothers subjected to the training sessions had a lower level of depression than their counterparts in the control group. PRACTICE IMPLICATIONS The findings encourage healthcare providers to improve mothers' mental health by implementing psychosomatic empowerment training during pregnancy.
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Affiliation(s)
- Ladan Parang
- Department of Community and Family Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Veda Vakili
- Department of Community and Family Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Onishi E, Lucas JA, Maeno T, Bailey SR. Associations Between High Pain Catastrophizing and Opioid-Related Awareness and Beliefs Among Patients in Primary Care. J Am Board Fam Med 2023; 36:267-276. [PMID: 36948540 DOI: 10.3122/jabfm.2022.220311r2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Limited studies are available on patients' perspectives regarding opioid-related awareness, beliefs, and pain management in primary care settings in the US. Pain catastrophizing (PC) is a cascade of negative thoughts and emotions in response to actual or anticipated pain. High PC is 1 of the strongest predictors of negative pain outcomes. METHOD A cross-sectional survey was administered at Family Medicine clinics in the Pacific Northwest, November 2018-January 2019. Logistic regression was used to model the adjusted odds of participants' awareness and beliefs on opioid epidemic issues, side effects/risks, and general beliefs by opioid prescription expectations and PC. RESULTS 108 participants completed the survey. Compared with participants with low PC, high PC participants were 74% less likely to be aware of opioid epidemic issues (OR = 0.26, P = .005, 95% CI:0.10-0.67), 62% less likely to be aware of opioid side effects/risks (OR = 0.38 P = .040, 95% CI: 0.15-0.96) and had 2.4 times increased odds of holding more positive beliefs about opioids and/or stronger beliefs regarding pain control, yet the latter did not reach statistical significance (OR = 2.40 P = .083, 95% CI: 0.89-6.47). CONCLUSION Significant gaps existed among our participants with high PC in their awareness of opioid epidemic issues and side effects/risks compared with their low PC counterparts. They may also carry positive beliefs regarding opioids and pain-control in general. In any pain care, it seems important to identify patients with high pain catastrophizing. Doing so may facilitates exploration of their beliefs and expectations regarding pain management and aids in tailoring individualized treatment and prevent adverse side effects.
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Affiliation(s)
- Eriko Onishi
- From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (EO, JAL, SRB); Department of Primary Care and Medical Education, University of Tsukuba, Japan (TM).
| | - Jennifer A Lucas
- From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (EO, JAL, SRB); Department of Primary Care and Medical Education, University of Tsukuba, Japan (TM)
| | - Tetsuhiro Maeno
- From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (EO, JAL, SRB); Department of Primary Care and Medical Education, University of Tsukuba, Japan (TM)
| | - Steffani R Bailey
- From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (EO, JAL, SRB); Department of Primary Care and Medical Education, University of Tsukuba, Japan (TM)
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15
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Chai BS, Ingledew PA. Characteristics Assessment of Online YouTube Videos on Radiotherapy for Breast Cancer. Clin Breast Cancer 2023; 23:e230-e238. [PMID: 36922301 DOI: 10.1016/j.clbc.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/09/2023] [Accepted: 02/20/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Radiotherapy (RT) is an important component of breast cancer management but is underutilized due to barriers such as the lack of proper education. YouTube is commonly used for obtaining health information, yet the quality of information has been a previous concern. This study systematically evaluates the characteristics of educational YouTube videos on RT for breast cancer. MATERIALS AND METHODS A total of 200 YouTube videos were identified by recording the top 50 videos of 4 searches. Duplicates were removed, videos were rank ordered and screened against pre-determined inclusion criteria, then the first 50 videos were reviewed using a video assessment tool. Two independent reviewers were used. Positively skewed distributions were observed for most general parameters including views, likes, length and View Ratio. RESULTS The USA (66%) or UK (20%) were the most common locations of publication. Publishers were frequently affiliated with health care facilities (48%) or non-profits (30%). The interview using a physician (68%) or patient (26%) was the most common media type, and B-roll footage with narration (48%) was the second most common. Most videos were targeted towards patients (96%), had comments (56%) and subtitles available (96%). The most common themes identified were Explaining RT (54%), Acute Side Effects (40%) and Patient Care Experience (32%). CONCLUSION This review is useful to inform the future development of video resources for health education in this topic. Though parameters were variable and inconsistently followed best practice guidelines, YouTube remains as a potentially important tool for the dissemination of health information.
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Affiliation(s)
- Brandon S Chai
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Paris-Ann Ingledew
- Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, Canada; BC Cancer- Vancouver, Department of Radiation Oncology, Vancouver, Canada.
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16
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Pham T, Patel P, Mbusa D, Kapoor A, Crawford S, Sadiq H, Rampam S, Wagner J, Gurwitz JH, Mazor KM. Impact of a pharmacist intervention on DOAC knowledge and satisfaction in ambulatory patients. J Thromb Thrombolysis 2023; 55:346-354. [PMID: 36510110 DOI: 10.1007/s11239-022-02743-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/14/2022]
Abstract
Patient education of high-risk medications such as direct oral anticoagulants (DOACs) is limited in ambulatory care settings. Clinical pharmacists are uniquely equipped to educate patients about DOACS but seldom interact with patients in those settings where patient education and satisfaction are often overlooked. Recently, the Anticoagulation Forum endorsed a checklist (DOAC Checklist) to guide and educate patients initiating or resuming DOACs. We assessed the impact on knowledge and satisfaction of an intervention framed around the checklist. Randomized clinical trial. Ambulatory patients starting a DOAC or resuming one after setback (bleeding, stroke, or transient ischemic attack) in an ambulatory setting (office, emergency department, or short stay hospitalization). Three educational clinical pharmacist tele-visits, hotline access to the pharmacist, and coordination with continuity providers in 3 months. Patient knowledge scores from a 15-item DOAC-related questionnaire and satisfaction scores from an abbreviated version of the Duke Anticoagulation Satisfaction Survey (DASS). Of 561 randomized patients, 436 completed our follow-up surveys. Knowledge scores were similar for the 233 intervention patients vs. 203 control patients (63.7% vs 62.2% correct). Satisfaction scores on the 7-point Likert scale were virtually identical (6.24 and 6.22). Our pharmacist-led intervention framed around the DOAC checklist had little impact on knowledge and satisfaction. Delays between intervention end and completion of the follow-up questionnaires may have obscured benefits experienced earlier. More intensive education or strategies other than telephone-based consultation may be required to produce sustained knowledge.TRN: NCT04068727 retrospectively registered on August 22, 2019.
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Affiliation(s)
- Thu Pham
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
| | - Parth Patel
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
| | - Daniel Mbusa
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
| | - Alok Kapoor
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA.
| | - Sybil Crawford
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
| | - Hammad Sadiq
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
| | - Sanjeev Rampam
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
| | - Joann Wagner
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
| | - Jerry H Gurwitz
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
- Reliant Medical Group, Worcester, MA, USA
| | - Kathleen M Mazor
- Department of Medicine, University of Massachusetts Chan Medical School, 55 Lake Ave North - S6-750, Worcester, MA, 01605, USA
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Abbasnia F, Aghebati N, Miri HH, Etezadpour M. Effects of Patient Education and Distraction Approaches Using Virtual Reality on Pre-operative Anxiety and Post-operative Pain in Patients Undergoing Laparoscopic Cholecystectomy. Pain Manag Nurs 2023; 24:280-288. [PMID: 36658058 DOI: 10.1016/j.pmn.2022.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 12/06/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fear of post-operative pain often contributes to pre-operative anxiety; accordingly, pain and anxiety are among the most common complications in patients undergoing laparoscopic cholecystectomy (LC). AIM The present study aimed to determine the effects of patient education and distraction using virtual reality (VR) on pre-operative anxiety and post-operative pain in patients undergoing LC. METHOD This randomized clinical trial included 150 patients in the surgery wards of educational hospitals in Mashhad, Iran, in 2020. The participants were randomly assigned to three groups of education, distraction, and control. The education and distraction groups watched two five-minute animations and three 360-degree images of nature using VR glasses 2 hours before and 4 hours after the surgery, respectively. On the other hand, the control group received routine care. Anxiety was measured using Spielberger's State Anxiety Inventory before and half an hour after the intervention. Moreover, the pain was measured using the visual analog scale and McGill Pain Questionnaire. RESULTS The results demonstrated a significant reduction in the two VR groups regarding the pre-operative anxiety mean scores, compared with the control group (p < .001). Furthermore, a significant reduction was observed in post-operative pain scores of patients in the two intervention groups compared with the control group (p = .001). CONCLUSIONS As evidenced by the results, both VR approaches of patient education and distraction equally decreased pre-operative anxiety and post-operative pain in patients undergoing LC.
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Affiliation(s)
- Fatemeh Abbasnia
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Aghebati
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hamid Heidarian Miri
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Tramontano M, Cascioli S, Magnotti L, Sovani M, Gaita A, Galeoto G, Berardi A, Valente D, De Angelis S, Salvia A. Therapeutic educational workshops for caregivers of patients with severe acquired brain injury. Clin Ter 2023; 174:14-22. [PMID: 36655639 DOI: 10.7417/ct.2023.5003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Abstract Severe acquired brain injury (sABI) leads to a wide range of functional limitations in cognitive, moto and behavioural abilities. These changes impact the patient's family in terms of the feeling of emotional and physical health, social life and financial condition. Caregivers are often intensely involved in the patient's management exposing them to negative effects of caregiving including stress, mood disorders and decreased quality of life. Implementing forms of active involvement of caregivers in the rehabilitative program could be useful. Thus, in the present study, therapeutic educational workshops (TEWs) for caregivers during the post-acute intensive hospitalization were organized during the post-acute intensive hospitalization of patients with sABI. The caregivers were asked to participate in the workshops to actively involve them in the patient's care and neurorehabilitation program. Each workshop session provided indications regarding the management of the patient with aphasia, neglect, behavioural and swallowing disorders. A questionnaire of 22 items has been designed in order to represent possible indicators of usefulness and effectiveness of the TEWs. The primary aim of this study was to develop a reliable and valid questionnaire able to assess the caregivers' satisfaction with the modalities of carrying out the TEW as a novel activity during the post-acute hospitalization of patients with sABI. The second aim was to assess the caregivers' satisfaction with the utility of the TEW as a tool to enhance their skills in the management of patients' disabilities. 100 caregivers of patients with sABI who attended at least one TEW session and completed the questionnaire were included in the analysis. In conclusion the administered questionnaire has proven to be a valid and reliable tool to evaluate sABI caregivers' satisfaction with TEW. Moreover, caregivers were satisfied with the organization of the TEW and with their usefulness in the management of the patients with sABI.
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Affiliation(s)
| | - S Cascioli
- Santa Lucia Foundation, IRCCS Rome, Italy
| | - L Magnotti
- Santa Lucia Foundation, IRCCS Rome, Italy
| | - M Sovani
- Santa Lucia Foundation, IRCCS Rome, Italy
| | - A Gaita
- Santa Lucia Foundation, IRCCS Rome, Italy
| | - G Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - A Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - D Valente
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | | | - A Salvia
- Santa Lucia Foundation, IRCCS Rome, Italy
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Monteiro R, Costa P. Survey on the knowledge of Portuguese society about Nuclear Medicine: A snapshot of the reality in the beginning of the decade. J Med Imaging Radiat Sci 2022; 53:571-579. [PMID: 36457232 DOI: 10.1016/j.jmir.2022.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/22/2022] [Accepted: 09/29/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nuclear Medicine has grown exponentially over the years, since it is useful in the early diagnosis and treatment of several pathologies. However, this field appears to be not widely recognized at the public level. METHODS An exploratory/descriptive cross-sectional study using a national survey assessed the Portuguese population's knowledge of Nuclear Medicine. A total of 211 questionnaires were collected and analyzed. The study population is made up of Portuguese adult citizens. RESULTS The study revealed a lack of knowledge about Nuclear Medicine. Some respondents were aware of this field, however a significant number have low or no knowledge at all. Most individuals are not aware about the Nuclear Medicine Departments in their home districts. DISCUSSION/CONCLUSION This project found limited knowledge within the Portuguese population about ionizing radiation in medical procedures, and mainly in Nuclear Medicine. Data highlighted the need to implement awareness campaigns to disseminate knowledge on this field. Health professionals should be aware about the lack of knowledge on this field by patients and public.
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Affiliation(s)
- Rafaela Monteiro
- Nuclear Medicine Department, School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Pedro Costa
- Nuclear Medicine Department, School of Health, Polytechnic Institute of Porto, Porto, Portugal.
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20
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Park YE, Han JH, Tak YW, Lee Y. Production and Provision of Context-Based Patient-Specific Educational Resources. J Korean Med Sci 2022; 37:e316. [PMID: 36345258 PMCID: PMC9641148 DOI: 10.3346/jkms.2022.37.e316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/06/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Patient education is generally accompanied by instructive materials. The Korean government has recommended the provision of patient-specific educational materials (PEMs) via an electronic medical record (EMR) certification system. However, there are currently no clear standards or guidelines for including PEMs in current domestic educational materials. We investigated the benefits of integrating PEMs with the EMR certification system and the methods by which this integration can be achieved. METHODS We developed and administered three structured Delphi surveys to 26 healthcare providers in clinical settings based on data collected from separate semi-structured advisory interviews with five experts. The surveys included the following topics: 1) expected effects of patient-specific education and health-related notifications/alarms, 2) desirable methods for providing PEMs, and 3) appropriate fee-setting and government support. We distributed the Delphi surveys via e-mail and calculated the average and standard deviation of the survey responses. RESULTS PEMs are expected to have significant educational effects, such as the provision of surgery/intervention-related information, and will improve the understanding of various treatment processes/procedures. The preferred method for providing PEMs was via automatic request after receiving confirmation from healthcare providers. The provision of these materials was based on set fees and government support. The average fee per session was set at approximately USD 23 (as of October 2021, USD 1 = KRW 1,196). CONCLUSION In this study, we investigated the prerequisites, contents, methods, and fees related to the provision of effective and efficient PEMs. The study findings can facilitate the production and provision of PEMs.
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Affiliation(s)
- Ye-Eun Park
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hyun Han
- Big Data Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, Korea
| | - Yae Won Tak
- Big Data Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, Korea
| | - Yura Lee
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Kirkove D, Barthelemy N, Coucke P, Mievis C, Ben Mustapha S, Jodogne S, Dardenne N, Donneau AF, Pétré B. [Feasibility study: The medical imaging as a tool for therapeutic education in radiotherapy]. Cancer Radiother 2022; 26:1034-1044. [PMID: 35843782 DOI: 10.1016/j.canrad.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/18/2022] [Accepted: 04/01/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Assess the feasibility of a randomized controlled trial (RCT) exploring the use of medical imaging as a therapeutic education (TPE) intervention in external radiation therapy. MATERIALS AND METHODS Experimental feasibility trial of "RCT" type carried out in a single-center, between November 2019 and March 2020, following adult patients treated by thoracic radiotherapy. In addition to the information usually given, the experimental group benefited from an intervention consisting in the visualization of their own medical images using the open-source software "Stone of Orthanc". RESULTS Forty-nine patients were recruited with a refusal rate of 8.16% (4/49). 20 patients were withdrawn from the study for health reasons (COVID), 10 for medical reasons. All the remaining 15 participants completed the process. Although not significant, the experimental group showed a median gain in the perception of knowledge compared to the control group (+ 1.9 (1.6 - 2.2)) vs (+ 1.4 (1.4 - 1.8)), as well as a decrease in scores related to anxiety (- 3.0 (-4.5 - (-2.0)) vs - 1.0 (-5.0 - 0.0)) and emotional distress ((- 5.0 (- 7.5 - (- 3.5)) vs (- 2.0 (- 5.0 - (- 1.0)) A significant reduction (p=0.043) is observed for the depression score ((- 2.0 (-3.0 - (-1.5)) vs (0.0 (0.0 - 0.0)). CONCLUSION This study demonstrates the feasibility of the project, with promising preliminary results. Some adaptations in order to conduct a larger-scale RCT are highlighted.
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Affiliation(s)
- D Kirkove
- Département des Sciences de la Santé Publique, Université de Liège, B23/Avenue Hippocrate, n(o) 13, 4000 Liège, Belgique.
| | - N Barthelemy
- Service Equipe mobile de soins palliatifs, Oncologie Radiothérapie, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman/B35, 4000 Liège, Belgique
| | - P Coucke
- Département de Physique Médicale, Service médical de radiothérapie, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman/B35, 4000 Liège, Belgique
| | - C Mievis
- Service Equipe mobile de soins palliatifs, Oncologie Radiothérapie, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman/B35, 4000 Liège, Belgique
| | - S Ben Mustapha
- Service Equipe mobile de soins palliatifs, Oncologie Radiothérapie, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman/B35, 4000 Liège, Belgique
| | - S Jodogne
- Institute of Information and Communication Technologies, Electronics and Applied Mathematics, Louvain School of Engineering, 1348 Louvain-la-Neuve, Belgique
| | - N Dardenne
- Département des Sciences de la Santé Publique, Université de Liège, B23/Avenue Hippocrate, n(o) 13, 4000 Liège, Belgique; Centre Hospitalo-Universitaire Biostatistique et méthodes de recherche (B-STAT), Faculté de Médecine, Université de Liège, B23/Avenue Hippocrate, n°13, 4000 Liège, Belgique
| | - A-F Donneau
- Département des Sciences de la Santé Publique, Université de Liège, B23/Avenue Hippocrate, n(o) 13, 4000 Liège, Belgique; Centre Hospitalo-Universitaire Biostatistique et méthodes de recherche (B-STAT), Faculté de Médecine, Université de Liège, B23/Avenue Hippocrate, n°13, 4000 Liège, Belgique
| | - B Pétré
- Département des Sciences de la Santé Publique, Université de Liège, B23/Avenue Hippocrate, n(o) 13, 4000 Liège, Belgique
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Mergelsberg ELP, Olson JL, Moore S, Jensen JF, Seivwright H, Norman R, Watson NA. Providing evidence from practice: Evaluating 4.5 years of implementing diabetes education support program in carbohydrate management. Patient Educ Couns 2022; 105:2225-2233. [PMID: 35221169 DOI: 10.1016/j.pec.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To evaluate personal and economical outcomes of CarbSmart, a 3-hour person-centered, theory-based program implemented throughout Australia, targeting optimal dietary carbohydrate management. METHODS More than 500 CarbSmart programs were implemented over 4.5 years. Pre-, post-, (N = 4656) and 3-month follow-up assessments (N = 188) of knowledge, empowerment, confidence, and patient activation were collected from people with diabetes. Participant satisfaction and potential annual cost-savings were calculated. FINDINGS Repeated measures ANCOVAs showed large improvements pre- to post-program in all outcome variables (d = 0.80-1.68), which were maintained at 3-month follow-up in a sub-sample. Participant satisfaction was high (Net Promoter Score = 72.3). Potential annual cost-savings nation-wide were estimated at US$512million. CONCLUSION This paper provides evidence that CarbSmart is effective in improving behavioral indicators of self-management outcomes in Australians living with diabetes. PRACTICE IMPLICATIONS CarbSmart has the potential to prevent diabetes-related complications. However, not engaging people living with diabetes with lower levels of patient activation at baseline was recognized as a future opportunity to improve the impact of our service. Strategies are needed to engage people with lower activation levels to improve outcomes in vulnerable and at-risk populations. FUNDING The development of CarbSmart was funded by Diabetes WA, the national implementation of CarbSmart by the National Diabetes Services Scheme, an initiative of the Australian Government.
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Affiliation(s)
- Enrique L P Mergelsberg
- National Evaluation Team, National Diabetes Services Scheme (NDSS), Diabetes Australia, 3/322 Hay Street Subiaco, Western Australia 6008, Australia; School of Population Health, Curtin University, Kent Street, Perth, Western Australia 6102, Australia.
| | - Jenny L Olson
- National Evaluation Team, National Diabetes Services Scheme (NDSS), Diabetes Australia, 3/322 Hay Street Subiaco, Western Australia 6008, Australia
| | - Sheryl Moore
- Diabetes Educator, Health Services, Diabetes WA, 3/322 Hay Street Subiaco, Western Australia 6008, Australia
| | - Jessica F Jensen
- Research and Evaluation Team, Diabetes WA, 3/322 Hay Street Subiaco, Western Australia 6008, Australia
| | - Hayley Seivwright
- Research and Evaluation Team, Diabetes WA, 3/322 Hay Street Subiaco, Western Australia 6008, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Kent Street, Perth, Western Australia 6102, Australia
| | - Natasha A Watson
- National Evaluation Team, National Diabetes Services Scheme (NDSS), Diabetes Australia, 3/322 Hay Street Subiaco, Western Australia 6008, Australia; Research and Evaluation Team, Diabetes WA, 3/322 Hay Street Subiaco, Western Australia 6008, Australia
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Toulabi T, Mohammadipour F. Effects of HIS-based intervention on patient education process and patient satisfaction with nurses' education. BMC Res Notes 2022; 15:198. [PMID: 35659724 PMCID: PMC9166321 DOI: 10.1186/s13104-022-06046-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/22/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This quasi-experimental study (before and after intervention) was designed to determine the impact of hospital information system-based intervention on the patient education process and patient satisfaction in cardiac and cardiac intensive care units. RESULTS Each nurse was observed at the time of patient education on average on eight shifts (total of 256 shifts), and at last 1350 computerized reports before and after the intervention were analyzed and 150 patient satisfaction with nurses' education questionnaires were completed before and after the intervention. After the intervention, the patient education scores were significantly improved (p < 0.001). In addition, the results of a survey of patients about the level of satisfaction with the quality of patient education showed a significant increase compared to before the intervention (p < 0.001). The ability to easily, completely, and quickly edit and record the provided education, eased the process of patient education and documentation.
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Affiliation(s)
- Tahereh Toulabi
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fatemeh Mohammadipour
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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Coombs NM, Porter JE, Barbagallo M, Plummer V. Public health education by emergency nurses: A scoping review and narrative synthesis. Patient Educ Couns 2022; 105:1181-1187. [PMID: 34521560 DOI: 10.1016/j.pec.2021.08.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 08/13/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To identify the extent, range, and nature of the evidence on public health education provided by emergency nurses. METHODS A scoping review, using the methodological guidance of Joanna Briggs Institute, was conducted to scope and map the literature and research activity. Using predetermined criteria, databases, grey literature, and reference lists were searched for eligible sources. At least two authors reviewed each article. A narrative synthesis methodology was utilised to analyse and report the findings. RESULTS There was significant methodological heterogeneity between sources (n = 6). Three themes were identified: 1) Benefits of the system: An opportunity to inform the public, 2) The barriers: Time pressures and being prepared and 3) The strategies: Plan for structured and created teachable moments CONCLUSION: Limited research is being conducted in this area. Further research is needed to understand emergency nurse's practice and attitudes towards providing public health messages. PRACTICE IMPLICATIONS Emergency nurses need to utilise the 'teachable moment' for every emergency admission, providing opportunistic preventative education to improve health outcomes and reduce demand on the healthcare system.
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Affiliation(s)
- Nicole M Coombs
- School of Health/Nursing, Federation University Australia, PO Box 3191 Gippsland Mail Centre 3841, Victoria, Australia.
| | - Joanne E Porter
- School of Health/Nursing, Federation University Australia, PO Box 3191 Gippsland Mail Centre 3841, Victoria, Australia.
| | - Michael Barbagallo
- School of Health/Nursing, Federation University Australia, PO Box 3191 Gippsland Mail Centre 3841, Victoria, Australia.
| | - Virginia Plummer
- School of Health/Nursing, Federation University Australia, PO Box 3191 Gippsland Mail Centre 3841, Victoria, Australia.
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Parkin CJ, Chung A. The Safety of Surgical Mesh - What is Online Video Content teaching our patients? BJU Int 2022; 130 Suppl 1:25-27. [PMID: 35261145 PMCID: PMC9542344 DOI: 10.1111/bju.15726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/11/2022] [Accepted: 03/01/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Cameron James Parkin
- Department of Urology, Royal North Shore Hospital, Northern Sydney Local Health District, Australia.,School of Medicine, The University of Notre Dame, Sydney, Australia.,North Shore Urology Research Group, Royal North Shore Hospital, Australia
| | - Amanda Chung
- Department of Urology, Royal North Shore Hospital, Northern Sydney Local Health District, Australia.,North Shore Urology Research Group, Royal North Shore Hospital, Australia
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Unnithan AS, Chidgey BA. Pre-Visit Education on Pain Management Options Prior to the First Clinic Visit Improves Chronic Pain Patient Satisfaction with Proposed Treatment Plans. Pain Med 2021; 22:2566-2574. [PMID: 34180994 DOI: 10.1093/pm/pnab198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study sought to evaluate if actively informing new chronic pain patients about treatment options and setting realistic expectations for care, through the use of a pre-visit informational handout prior to the first clinic visit, improved patient satisfaction with subsequently proposed treatment plans. METHODS The study was divided into two 3-month periods. During the first 3 months, with our current pain clinic practices in place, new patients (n = 147) were given surveys to establish a baseline of patient satisfaction with treatment plans proposed on their first visit. During the second 3 months, a different group of new patients (n = 156) was given a detailed informational handout which described our clinic's multimodal approach to pain management and therapeutic expectations prior to their visit with a provider. Patient satisfaction with subsequently proposed treatment plans was then assessed and compared with the baseline group. RESULTS The average patient satisfaction score for the group of patients given the informational handout was 4.21 (on a 5-point Likert scale), compared to an average score of 3.25 for the baseline group (P < .0001, unpaired t-test). 77.6% of patients given the informational handout said their proposed treatment plan met their expectations compared to 46.3% of patients in the baseline group (χ2= 31.61, two-tailed P < .0001). CONCLUSIONS Patient satisfaction with proposed chronic pain treatment plans was improved when clinic approaches to pain were explicitly outlined and therapeutic expectations were clearly established in the form of an informational handout at the outset of the first visit.
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Affiliation(s)
- Ajay S Unnithan
- Department of Anesthesiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brooke A Chidgey
- Department of Anesthesiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
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Sansone A, Cuzin B, Jannini EA. Facing Counterfeit Medications in Sexual Medicine. A Systematic Scoping Review on Social Strategies and Technological Solutions. Sex Med 2021; 9:100437. [PMID: 34619517 PMCID: PMC8766274 DOI: 10.1016/j.esxm.2021.100437] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction The counterfeit phenomenon is a largely under-reported issue, with potentially large burden for healthcare. The market for counterfeit drugs used in sexual medicine, most notably type 5 phosphodiesterase inhibitors (PDE5i), is rapidly growing. Aims To report the health risks associated with the use of counterfeit medications, the reasons driving their use, and the strategies enacted to contain this phenomenon. Methods A systematic scoping review of the literature regarding counterfeit PDE5i was carried between January and June 2021, then updated in August 2021. Main Outcome Measure We primarily aimed to clarify the main drivers for counterfeit PDE5i use, the health risks associated, and the currently available strategies to fight counterfeiters. Results One hundred thirty-one records were considered for the present scoping review. Production of fake PDE5i is highly lucrative and the lacking awareness of the potential health risks makes it a largely exploitable market by counterfeiters. Adulteration with other drugs, microbial contamination and unreliable dosages make counterfeit medications a cause of worry also outside of the sexual medicine scope. Several laboratory techniques have been devised to identify and quantify the presence of other compounds in counterfeit medications. Strategies aimed at improving awareness, providing antitampering packaging and producing non-falsifiable products, such as the orodispersible formulations, are also described. Clinical implications Improving our understanding of the PDE5i counterfeit phenomenon can be helpful to promote awareness of this issue and to improve patient care. Strengths & Limitations Despite the systematic approach, few clinical studies were retrieved, and data concerning the prevalence of counterfeit PDE5i use is not available on a global scale. Conclusion The counterfeit phenomenon is a steadily growing issue, with PDE5i being the most counterfeited medication with potentially large harmful effects on unaware consumers. Sansone A, Cuzin B, and Jannini EA. Facing Counterfeit Medications in Sexual Medicine. A Systematic Scoping Review on Social Strategies and Technological Solutions. Sex Med 2021;9:100437.
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Affiliation(s)
- Andrea Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Béatrice Cuzin
- Division of Urology and Transplantation, Edouard Herriot Hospital, Lyon, France
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Nkhoma DE, Soko CJ, Bowrin P, Manga YB, Greenfield D, Househ M, Li Jack YC, Iqbal U. Digital interventions self-management education for type 1 and 2 diabetes: A systematic review and meta-analysis. Comput Methods Programs Biomed 2021; 210:106370. [PMID: 34492544 DOI: 10.1016/j.cmpb.2021.106370] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To describe and assess digital health-led diabetes self-management education and support (DSMES) effectiveness in improving glycosylated hemoglobin, diabetes knowledge, and health-related quality of life (HrQoL) of Type 1 and 2 Diabetes in the past 10 years. DESIGN Systematic Review and Meta-Analysis. The protocol was registered on PROSPERO registration number CRD42019139884. DATA SOURCES PubMed, EMBASE, Cochrane library, Web of Science, and Scopus between January 2010 and August 2019. Study Selection and Appraisal: Randomized control trials of digital health-led DSMES for Type 1 (T1DM) or 2 (T2DM) diabetes compared to usual care were included. Outcomes were change in HbA1c, diabetes knowledge, and HrQoL. Cochrane Risk of Bias 2.0 tool was used to assess bias and GRADEpro for overall quality. The analysis involved narrative synthesis, subgroup and pooled meta-analyses. RESULTS From 4286 articles, 39 studies (6861 participants) were included. Mean age was 51.62 years, range (13-70). Meta-analysis revealed intervention effects on HbA1c for T2DM with difference in means (MD) from baseline -0.480% (-0.661, -0.299), I275% (6 months), -0.457% (-0.761, -0.151), I2 81% (12 months), and for T1DM -0.41% (-1.022, 0.208) I2 83% (6 months), -0.03% (-0.210, 0.142) I2 0% (12 months). Few reported HrQoL with Hedges' g 0.183 (-0.039, 0.405), I2 0% (6 months), 0.153 (-0.060, 0.366), I2 0% (12 months) and diabetes knowledge with Hedges' g 1.003 (0.068, 1.938), I2 87% (3 months). CONCLUSION Digital health-led DSMES are effective in improving HbA1c and diabetes knowledge, notably for T2DM. Research shows non-significant changes in HrQoL. Intervention effect on HbA1c was more impressive if delivered through mobile apps or patient portals. Further research is needed on the impact of DSMES on these outcomes, especially for newly diagnosed diabetes patients.
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Affiliation(s)
- Dumisani Enricho Nkhoma
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Taipei City, Taiwan; Nkhata Bay District Hospital, Nkhata Bay District Health Office, Nkhata Bay, Mkondezi, Malawi
| | - Charles Jenya Soko
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Taipei City, Taiwan
| | - Pierre Bowrin
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei City, Taiwan
| | - Yankuba B Manga
- Graduate Institute of Biomedical Materials and Tissue Engineering and School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
| | - David Greenfield
- The Simpson Centre for Health Services Research, South Western Sydney Clinical School, The University of New South Wales (UNSW) Medicine, Sydney, Australia
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Yu-Chuan Li Jack
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei City, Taiwan; Graduate Insitute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei City, Taiwan; Dermatology Department, Wan-Fang Hospital, Taipei City, Taiwan; International Medical Informatics Association (IMIA), Switzerland
| | - Usman Iqbal
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Taipei City, Taiwan; PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei City, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei City, Taiwan.
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Velez JA, Keene JR, Corwin M, Elko S, Potter RF. A Visual Interactive Narrative Intervention (VINI) for aphasia education: Can digital applications administer augmented input to educate stroke survivors with aphasia? Patient Educ Couns 2021; 104:2536-2543. [PMID: 33810913 DOI: 10.1016/j.pec.2021.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 03/11/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Persons with aphasia (PWA) face additional barriers to proper healthcare due to inadequate patient education by health professionals unequipped to use augmentative and alternative communication (AAC). The current study examines a digital application that evokes and sustains health information processing through AAC specifically aimed at increasing comprehension with augmented input (AI). METHODS A digital application designed to educate PWA about their health condition was compared to a video-recorded doctor providing oral-only education. Sixteen PWA received both education interventions in a crossover manner. Health information processing was assessed through heart rate (HR) and skin conductance levels (SCL), which were collected continually during each administration of education interventions. RESULTS PWA demonstrated greater cognitive processing of health information via HR and SCL indices during the digital application compared to the typical oral-only education intervention. The oral-only intervention led PWA to disengage with health information. CONCLUSION By combining visuographic materials and adapted language into a customizable narrative structure, digital applications can utilize AI to educate PWA about basic health information (i.e., diagnosis and prognosis). PRACTICE IMPLICATIONS The current study's AAC requires minimal training and can be used as an aided support in conjunction with other techniques that increase PWA's access to health information.
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Affiliation(s)
- John A Velez
- Communication Science Unit, The Media School, College of Arts + Sciences, Indiana University, Bloomington, USA.
| | - Justin Robert Keene
- Department of Journalism and Creative Media Industries, College of Media and Communication, Texas Tech University, Lubbock, USA
| | - Melinda Corwin
- Department of Speech, Language, and Hearing Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Stacy Elko
- School of Art, J.T. & Margaret Talkington College of Visual & Performing Arts, Texas Tech University, Lubbock, USA
| | - Robert F Potter
- Communication Science Unit, The Media School, College of Arts + Sciences, Indiana University, Bloomington, USA
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Quintner J, Cohen M. On "A New Definition of Pain: Update and Implications for Physical Therapy Practice and Rehabilitation Science." Sluka KA, George SZ. Phys Ther. 2021; https://doi.org/10.1093/ptj/pzab019. Phys Ther 2021; 101:6290101. [PMID: 34081767 DOI: 10.1093/ptj/pzab136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/22/2021] [Indexed: 11/14/2022]
Affiliation(s)
- John Quintner
- Arthritis and Osteoporosis Western Australia, Health Education Section, Shenton Park, Western Australia, Australia
| | - Milton Cohen
- Department of Pain Medicine, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
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Mbamalu O, Bonaconsa C, Nampoothiri V, Surendran S, Veepanattu P, Singh S, Dhar P, Carter V, Boutall A, Pennel T, Hampton M, Holmes A, Mendelson M, Charani E. Patient understanding of and participation in infection-related care across surgical pathways: a scoping review. Int J Infect Dis 2021; 110:123-134. [PMID: 34293491 DOI: 10.1016/j.ijid.2021.07.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/10/2021] [Accepted: 07/14/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To explore the existing evidence on patient understanding of and/or participation in infection-related care in surgical specialties. METHOD A scoping review of the literature was conducted. PubMed, Web of Science, Scopus, and grey literature sources were searched using predefined search criteria for policies, guidelines, and studies in the English language. Data synthesis was done through content and thematic analysis to identify key themes in the included studies. RESULTS The initial search identified 604 studies, of which 41 (36 from high-income and five from low- and middle-income countries) were included in the final review. Most of the included studies focused on measures to engage patients in infection prevention and control (IPC) activities, with few examples of antimicrobial stewardship (AMS) engagement strategies. While patient engagement interventions in infection-related care varied depending on study goals, surgical wound management was the most common intervention. AMS engagement was primarily limited to needs assessment, without follow-up to address such needs. CONCLUSION Existing evidence highlights a gap in patient participation in infection-related care in the surgical pathway. Standardization of patient engagement strategies is challenging, particularly in the context of surgery, where several factors influence how the patient can engage and retain information. Infection-related patient engagement and participation strategies in surgery need to be inclusive and contextually fit.
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Affiliation(s)
- Oluchi Mbamalu
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
| | - Candice Bonaconsa
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Vrinda Nampoothiri
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Surya Surendran
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Pranav Veepanattu
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Sanjeev Singh
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Puneet Dhar
- Department of Gastrointestinal Surgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Vanessa Carter
- e-Patient Scholar and Africa CDC Civil Society Champion for Antimicrobial Resistance; Healthcare Communications and Social Media, South Africa
| | - Adam Boutall
- Colorectal Unit, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Timothy Pennel
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
| | - Mark Hampton
- Dr Matley & Partners Surgical Practice, Cape Town, South Africa
| | - Alison Holmes
- NIHR Health Protection Research Unit in Healthcare Associated infections and Antimicrobial Resistance, Department of Medicine, Imperial College London, UK
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Esmita Charani
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa; NIHR Health Protection Research Unit in Healthcare Associated infections and Antimicrobial Resistance, Department of Medicine, Imperial College London, UK.
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Shungu N, Haley SP, Berini CR, Foster D, Diaz VA. Quality of YouTube Videos on Prostate Cancer Screening for Black Men. J Am Board Fam Med 2021; 34:724-31. [PMID: 34312265 DOI: 10.3122/jabfm.2021.04.200632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/23/2021] [Accepted: 04/02/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Black men are disproportionately impacted by prostate cancer. Guidelines agree that Black men should make informed decisions about whether to engage in prostate cancer screening. YouTube is widely used among Black men and impacts understanding of health conditions. OBJECTIVES Given that misleading online health information might be especially harmful to Black men, the objective of this study was to evaluate the quality of information regarding prostate cancer screening for Black men available on YouTube. METHODS Four viewers watched the top 50 videos using the search term "Prostate Cancer Screening in Black Men." Videos were scored using the previously validated DISCERN quality criteria for consumer health information and the Patient Education Materials Assessment Tool (PEMAT). Results were compared based on video characteristics like presenter perceived demographics and viewer engagement metrics. RESULTS Inter-rater reliability testing showed consistency for the PEMAT (interclass correlation coefficient [ICC] = 0.69) and DISCERN (ICC= 0.85). Few videos (16%) met the DISCERN quality threshold (54.4/80), and 28% of videos met the PEMAT threshold (10.5/15). Less than half of videos addressed racial disparities in prostate cancer. There was no difference in quality based on perceived race of the presenter (DISCERN P = .06, PEMAT P = .43). CONCLUSIONS The overall quality of videos about prostate cancer screening in Black men is poor, including those with Black presenters. Clinicians should be aware of potential misinformation that Black patients receive from YouTube and the opportunity to improve the quality of available information about prostate cancer screening in Black men.
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Derollez C, Carriere N, Kyheng M, Dujardin K, Faillon A, Haidon D, Peres S, Defebvre L. Factors that predict a change in quality of life among Parkinson's disease patients participating in a patient education program. Rev Neurol (Paris) 2021:S0035-3787(21)00574-9. [PMID: 34183162 DOI: 10.1016/j.neurol.2021.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/06/2021] [Accepted: 01/27/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patient education is essential in Parkinson's disease (PD). However, it is not known which aspects of patient education are associated with an improvement in quality of life (QoL). OBJECTIVE To identify factors that predicted an improvement in QoL in PD patients that participate in an education program. METHODS EduPark is a community-hospital patient education program. PD Patients that had participated in the program between September 2013 and March 2017 were retrospectively included. QoL was prospectively evaluated (using the PDQ-8 questionnaire) before and after the patient's participation. We used mixed linear models (adjusted for the initial value of the PDQ-8) to determine socio-demographic and clinical variables that predicted the change in the PDQ-8 score. RESULTS A total of 181 patients were included (mean±standard deviation age: 62.9±8.2 years; disease duration: 9.1±5.3 years). 76.7% of the 103 patients having undergone a cognitive evaluation did not display cognitive impairment. We did not identify any factors that predicted the program's impact on the patient's QoL. Participation in the program was associated with a significant decrease (improvement) in the PDQ-8 score (39.4±17.81 before and 35.6±15.9 afterwards, P<0.001). CONCLUSION We did not identify any factors that were predictive of the patient education program's impact on QoL in patients with PD. Participation in the program was associated with a significant improvement in QoL. Our results suggest that Patient Education Programs should be more widely prescribed and developed in the management of PD.
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Van Bogaert W, Coppieters I, Kregel J, Nijs J, De Pauw R, Meeus M, Cagnie B, Danneels L, Malfliet A. Influence of Baseline Kinesiophobia Levels on Treatment Outcome in People With Chronic Spinal Pain. Phys Ther 2021; 101:6145902. [PMID: 33611503 DOI: 10.1093/ptj/pzab076] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 10/23/2020] [Accepted: 01/03/2021] [Indexed: 11/14/2022]
Abstract
BACKGROUND Pain neuroscience education (PNE) combined with cognition-targeted exercises is an effective treatment for people with chronic spinal pain (CSP). However, it is unclear why some patients benefit more from this treatment. We expect that patients with more pronounced maladaptive pain cognitions, such as kinesiophobia, might show poorer treatment responses. OBJECTIVE The objective of this study was to assess the influence of baseline kinesiophobia levels on the treatment outcomes of PNE combined with cognition-targeted exercises in people with CSP. This study was a secondary analysis of a multicenter, double-blind, randomized controlled trial. METHODS Outcome measures included a numeric rating scale for pain (NRS), the Pain Disability Index (PDI), quality of life (Medical Outcomes Study 36-Item Health Survey [SF-36]), Pain Catastrophizing Scale (PCS), and Pain Vigilance and Awareness Questionnaire (PVAQ). Regression models were built using treatment (PNE plus cognition-targeted exercises or neck/back school plus general exercises), baseline scores on the Tampa Scale for Kinesiophobia (TSK), and time (in months) as independent variables. RESULTS A significant 3-way interaction effect was found for the models of PDI, PCS, PVAQ, and the SF-36 mental domain, with estimates of -0.01, -0.01, -0.01, and 0.07, respectively. A significant effect of baseline TSK scores was found for the physical domain of the SF-36 (estimate = -3.16). For the NRS, no significant effect of baseline TSK scores was found. CONCLUSION Our findings indicate that PNE plus cognition-targeted exercises can successfully decrease the unfavorable influence of pretreatment kinesiophobia on disability, mental health, pain catastrophizing, and hypervigilance over time in people with CSP. Nevertheless, higher scores in pretreatment kinesiophobia might still be a key factor for the lack of improvement in pain catastrophizing and hypervigilance following treatment. Regardless of the followed treatment program, pretreatment kinesiophobia was also shown to significantly influence physical health in people with CSP. IMPACT This study provides novel insight into the unfavorable influence of kinesiophobia on treatment outcomes in people with CSP, and how PNE plus cognition-targeted exercises can limit this impact. Because this is one of the first studies to research possible predictors of this experimental treatment, its findings motivate further exploration of other possible influencing factors for treatment success of PNE plus cognition-targeted exercises. LAY SUMMARY People with chronic spinal pain and high levels of fear of movement were found to have worse treatment outcomes compared to people with low levels of fear of movement. However, our experimental treatment, which includes pain neuroscience education combined with exercise therapy that reintroduces specific movements patients might fear, can decrease this negative influence of fear of movement in these patients.
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Affiliation(s)
- Wouter Van Bogaert
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Coppieters
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Jeroen Kregel
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group, http://www.paininmotion.be
| | - Jo Nijs
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Robby De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group, http://www.paininmotion.be.,Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Anneleen Malfliet
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
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Dias KJ, Shoemaker MJ, Lefebvre KM, Heick JD. A Knowledge Translation Framework for Optimizing Physical Therapy in Patients With Heart Failure. Phys Ther 2021; 101:6149193. [PMID: 33638349 DOI: 10.1093/ptj/pzab079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/08/2020] [Accepted: 02/07/2021] [Indexed: 12/24/2022]
Abstract
The American Physical Therapy Association has supported the development of clinical practice guidelines to promote and support evidence-based practice and reduce unwarranted practice variation. Essential to the success of this effort is the generation of knowledge translation, a concept that emphasizes the translation of global knowledge to an application that can be effectively integrated into clinical practice. The Physical Therapy Clinical Practice Guideline for the Management of Individuals with Heart Failure published in the Physical Therapy Journal in January 2020 provides a broad base of knowledge related to evidence-based treatment interventions for patients with heart failure. However, the application and integration of this knowledge in clinical practice need further elucidation. Therefore, this perspective paper aims to serve as a complementary knowledge translation resource to the recently published practice guideline to maximize the utilization of contemporary evidence in clinical practice. This resource provides the physical therapist with practical guidance in the management of patients with heart failure by placing research findings in the context of other knowledge and practice norms that can be applied at the point of care and across the continuum of care. We propose a novel ABCDE (assessment, behavior modification, cardiorespiratory fitness, dosage, and education) practical framework. This clinical paradigm is grounded in ongoing physical therapist assessment throughout the episode of care, along with behavior modification, assessment of cardiorespiratory fitness, appropriate selection and dosing of interventions, and patient education. Examples highlighting the use of this model in patients with heart failure across the continuum of care are provided for application in clinical care.
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Affiliation(s)
- Konrad J Dias
- Physical Therapy Program, Maryville University of St. Louis, St. Louis, Missouri, USA
| | - Michael J Shoemaker
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, Michigan, USA
| | - Kristin M Lefebvre
- Doctor of Physical Therapy Program. Concordia St. Paul University, Saint Paul, Minnesota, USA
| | - John D Heick
- Department of Physical Therapy, Northern Arizona University, Flagstaff, Arizona, USA
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Irwin AN, Braden-Suchy N, Hartung DM. Exploring Patient Perceptions of Opioid Treatment Agreements in a Community Health Center Environment. Pain Med 2021; 22:970-978. [PMID: 33040144 DOI: 10.1093/pm/pnaa344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Describe patient attitudes toward opioid treatment agreements (OTAs) and characterize perceptions of their impact on patient care, behavior, communication with prescribers, and engagement with the health care system. DESIGN Qualitative descriptive study. SETTING Federally qualified health center with six clinic locations serving a rural population. SUBJECTS Patients were prescribed long-term opioid therapy and were required to sign an OTA through an in-person office visit with a clinical pharmacist. METHODS Patients who signed an OTA were recruited to participate in semistructured, in-person, one-on-one interviews. Data were analyzed using immersion-crystallization methods. RESULTS Among the 20 patients recruited, 50% were men; 70% were insured by the state's Medicaid program; and 85% were using opioids for hip, back, and/or neck pain. Four major themes arose from the interviews. First, individuals who use long-term opioids experience a wide variety of opioid-related fears and stigmas. Second, individuals articulated real or potential benefits from implementing OTAs. Third, opinions differed on whether OTAs affected behavior and reduced opioid misuse and diversion. Finally, individuals provided feedback on the health care system's OTA implementation process. CONCLUSIONS Patients experienced a wide variety of opioid-related fears and stigmas, including how OTA requirements can perpetuate these issues. Despite these feelings, participants articulated real or potential positive outcomes from the use of OTAs, although they were mixed on whether these agreements translated to any behavior changes. If OTAs are to become standard practice, future research is needed to describe the diversity of patient perspectives and experiences with OTAs and to evaluate their effect on patient outcomes.
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Affiliation(s)
- Adriane N Irwin
- Oregon State University College of Pharmacy, Corvallis, Oregon, USA
| | | | - Daniel M Hartung
- Oregon State University College of Pharmacy, Corvallis, Oregon, USA
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Abstract
INTRODUCTION The internet is an increasingly important resource for patients seeking health-related information. Because of this trend, the American Medical Association (AMA) and National Institutes of Health (NIH) recommend that online patient education materials (PEMs) be written between a third and seventh grade level. The present study evaluates the readability levels of ophthalmological PEMs provided by five major academic hospitals, quantifies the availability of accompanying videos and graphics, and examines the extent to which readability may be increased. METHODS In March 2021, 397 PEMs from five major academic hospitals were extracted for subsequent analysis by seven validated readability assessments. The presence of an accompanying video or graphic was noted. Statistical significance was assessed using the Kruskal-Wallis test with Dunn's multiple comparisons test and the chi-square test. RESULTS Nearly all articles were written above the recommended reading level of 7th grade. After averaging the scales for each article, the median grade level was 11.7 (interquartile range [IQR], 10.7-12.7). The PEMs with the highest median reading level were provided by the Johns Hopkins University Wilmer Institute (12.6, IQR, 11.3 - 13.6). Only 13.6% and 13.1% of articles had an accompanying video and graphic, respectively. Reduction of sentence length beneath 15 words resulted in an improvement of readability by 2.7 grade levels. CONCLUSIONS The readability of online patient resources provided by major academic hospitals were above the literacy guidelines recommended by the NIH and AMA. Furthermore, most articles did not include a video or graphic, both of which could potentially improve patient understandability of educational materials. By altering these PEMs, as demonstrated here, institutions could increase the value these articles provide for patients and therefore the quality of the patient-physician relationship.
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Affiliation(s)
- Parth A Patel
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Rhea Gopali
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Anvith Reddy
- Department of Biological Sciences, University of Georgia, Athens, GA, USA
| | - Kajol K Patel
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Lindfors P, Axelsson E, Engstrand K, Störsrud S, Jerlstad P, Törnblom H, Ljótsson B, Simrén M, Ringström G. Online Education Is Non-Inferior to Group Education for Irritable Bowel Syndrome: A Randomized Trial and Patient Preference Trial. Clin Gastroenterol Hepatol 2021; 19:743-751.e1. [PMID: 32289541 DOI: 10.1016/j.cgh.2020.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/03/2020] [Accepted: 04/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Structured education can reduce symptoms in patients with irritable bowel syndrome (IBS), but the availability of such interventions is limited and online formats could facilitate their dissemination. We compared the effectiveness of Internet-delivered vs face-to-face education in patients with IBS, hypothesizing that the online format would not be inferior. METHODS We conducted 2 trials of Internet-delivered vs face-to-face group education (3 weeks) at a gastroenterology outpatient clinic in Sweden. In the first trial, 141 patients with IBS were assigned randomly (1:1) to either Internet-delivered or face-to-face education, from August 2016 through June 2017. In the second trial, 155 patients with IBS were allowed to choose whether to receive education via the Internet or face to face, from August 2017 through September 2018. Patients completed questionnaires before, during, and after education. The primary outcome measure was the irritable bowel syndrome severity scoring system, which measures IBS severity on a scale from 0 to 500, based on abdominal pain, bloating, dissatisfaction with bowel habits, and interference with life. The primary test of noninferiority adhered to the intent-to-treat principle and concerned the difference in change up to 6 months after education, tested using the 1-sided CI for the time by group interaction in a linear mixed model fitted on data from the randomized controlled trial. A secondary per-protocol analysis used data from all treatment completers in both trials. The noninferiority margin was 40 points on the irritable bowel syndrome severity scoring system. RESULTS In the primary analysis, patients who received face-to-face education had an average reduction in irritable bowel syndrome severity score that was 12.2 points more than that of patients who received Internet education (1-sided 95% CI upper bound, 38.4). In the per-protocol analysis, patients who received face-to-face education reduced their average irritable bowel syndrome severity score by 14.7 points more than patients who received Internet education (95% CI upper bound, 35.5). Face-to-face education had significantly higher credibility and produced a significantly larger increase in self-rated knowledge, although most patients preferred Internet-delivered education. Between-group effects on secondary symptoms were small. CONCLUSIONS Based on the comparison of Internet-delivered vs face-to-face education for IBS, the upper bound of the CI for the difference in change up to 6 months after education was within the noninferiority margin of 40 points. We therefore conclude that Internet-delivered education is noninferior to face-to-face education. Future research should focus on increasing within-group effects. ClinicalTrials.gov no: NCT03466281.
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Warren CJ, Sawhney R, Shah T, Behbahani S, Sadeghi-Nejad H. YouTube and Men's Health: A Review of the Current Literature. Sex Med Rev 2021; 9:280-288. [PMID: 33610492 DOI: 10.1016/j.sxmr.2020.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION YouTube is the most used social media website, and there is a growing body of literature examining the reliability of healthcare information on this platform. Patients seeking men's health information may be more likely to use YouTube owing to the sensitivity of these issues. OBJECTIVES The objective of this study is to review the literature for studies related to the reliability of YouTube videos about men's health topics. METHODS A literature review was conducted using PubMed and Google Scholar for publications related to the reliability of YouTube videos about men's health as of July 1, 2020. RESULTS There were 17 studies related to YouTube and Men's Health. Most videos were found to be unreliable, and videos uploaded by physicians or healthcare organizations were usually more reliable. However, there were no studies in which more reliable videos had higher metrics of user engagement (views, likes, comments) than unreliable videos and there were several studies where unreliable videos had higher metrics of user engagement. In addition, the methods used to evaluate YouTube videos are not uniform across studies including the way that terms are searched (filtering by relevance vs view count) and the way in which reliability is assessed. For example, some studies create custom evaluation forms based on clinical guidelines, whereas others use validated questionnaires. The only validated questionnaire used across multiple studies was the DISCERN score criterion. CONCLUSIONS Most information on YouTube about men's health is unreliable. Videos created by physicians and healthcare organizations are more reliable, and videos that are advertisements are less reliable. Physicians and healthcare systems should continue to upload educational YouTube videos but work to increase their views and user engagement. It may benefit patients if physician organizations could work with YouTube to create verified videos disseminating healthcare information that are favored in the search algorithm. Warren CJ, Sawhney R, Shah T, et al. YouTube and Men's Health: A Review of the Current Literature. Sex Med Rev 2021;9:280-288.
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Affiliation(s)
| | | | - Tejash Shah
- Rutgers-New Jersey Medical School, Newark, USA
| | | | - Hossein Sadeghi-Nejad
- Rutgers-New Jersey Medical School, Newark, USA; Hackensack UMC-Meridian Health, Hackensack, USA.
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Dutta R, Matz EL, Overholt TL, Anderson WB, Deebel NA, Cowper M, Terlecki RP, Scarberry KA. Patient Education Is Associated With Reduced Delay to Presentation for Management of Ischemic Priapism: A Retrospective Review of 123 Men. J Sex Med 2021; 18:385-390. [PMID: 33422447 DOI: 10.1016/j.jsxm.2020.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adverse outcomes secondary to ischemic priapism (IP) are associated with time to presentation and management. AIM To characterize patterns in presentation delay as a function of etiology and patient education regarding IP risk. METHODS Following institutional review board approval, charts of IP patients presenting to our institution from 2010 to 2020 were reviewed. One episode of IP per patient was included for analysis. OUTCOMES Priapism duration in patients presenting with IP. RESULTS We identified 123 unique patients with IP. Common etiologies included erectogenic intracavernosal injection (24%), trazodone (16%), and other psychiatric medications (16%). Patients with sickle cell anemia or trait and intracavernosal injection-related IP presented sooner than idiopathic cases and those from psychiatric medication (P < .001). Etiology and provider education on IP risk were associated with presentation ≥ 24 hours. Upon multivariate analysis, only a lack of provider education was independently associated with presentation ≥ 24 hours. CLINICAL IMPLICATIONS Men who received provider-based education on the risk of IP associated with their condition or medication regimen were more likely to seek prompt medical attention for IP and, therefore, less likely to require surgery. STRENGTHS & LIMITATIONS This manuscript represents one of the largest series on priapism, an area of urologic practice in need of more evidence-based guidance. The numbers are not inflated by including multiple episodes per patient, and the data collected include etiology, time to presentation, and treatment. Limitations include a retrospective chart review study design at a single institution. CONCLUSION Educational initiatives on the risk of IP associated with particular disease states and medications should target at-risk individuals, as well as prescribers of medications associated with IP. Dutta1 R, Matz1 EL, Overholt TL, et al. Patient Education Is Associated With Reduced Delay to Presentation for Management of Ischemic Priapism: A Retrospective Review of 123 Men. J Sex Med 2021;18:385-390.
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Affiliation(s)
- Rahul Dutta
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Ethan L Matz
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Tyler L Overholt
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - William B Anderson
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Nicholas A Deebel
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Matthew Cowper
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Ryan P Terlecki
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA; Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kyle A Scarberry
- Case Western Reserve University School of Medicine, Cleveland, OH, USA; Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
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Mitchell TO, Goldenberg MN. When Doctor Means Teacher: An Interactive Workshop on Patient-Centered Education. MedEdPORTAL 2020; 16:11053. [PMID: 33324753 PMCID: PMC7732137 DOI: 10.15766/mep_2374-8265.11053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/21/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Increasingly, health care is delivered through a patient-centered model, and patients engage in shared decision-making with their medical providers. As a result, medical educators are placing more emphasis on patient-centered communication skills. However, few published curricula currently offer a comprehensive discussion of skills for providing patient-centered education (PCE), a key component of shared decision-making. We developed an interactive, two-session workshop aiming to improve students' abilities to provide PCE. METHODS Our workshop included didactic instruction, group discussion, and interactive simulations. The workshop was delivered to 50 clinical clerkship medical students. The first session concentrated on educating patients about their diagnoses, while the second session focused on providing patients with information about medications and other treatments. We used detailed and realistic role-play exercises as a core tool for student practice and demonstration of confidence. To evaluate the workshop, we used pre- and postsurveys. RESULTS The sessions were well received by students, who strongly agreed both before and after the workshop that PCE was an important skill. Students also strongly agreed that the role-play exercises were an effective tool for learning PCE. They demonstrated significant improvements in their confidence to name important elements of PCE and to deliver PCE in the future. DISCUSSION This workshop fills a curricular gap in offering a comprehensive and interactive curriculum for improving students' abilities to provide critical PCE. The format and content should be easily adaptable to various disciplines, learners, and teaching modalities.
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Webber V, Miller ME, Gustafson DL, Bajzak K. Vulvodynia Viewed From a Disease Prevention Framework: Insights From Patient Perspectives. Sex Med 2020; 8:757-766. [PMID: 32773263 PMCID: PMC7691876 DOI: 10.1016/j.esxm.2020.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Persons with vulvodynia (a chronic vulvar pain condition) suffer many barriers to diagnosis and treatment, several of which may be exacerbated by the sociocultural and geographical context in which they live. AIM We drew on the experiences of patients with vulvodynia who were living in small urban and rural communities to learn what they perceived as the major barriers to diagnosis and treatment as well as to probe for possible solutions. METHODS For this qualitative case study, we conducted 3 focus groups with a total of 10 participants, drawn from patients seen at our academic tertiary referral center, with a goal of understanding their lived experience with vulvodynia. MAIN OUTCOME MEASURES The patient dialogue was coded into themes and temporally grouped to illustrate struggles and victories in diagnosis and treatment. RESULTS Participants confirmed that healthcare provider knowledge and attitudes as well as system challenges (specialist and allied healthcare provider availability) are major barriers to timely diagnosis. Of novel interest are other factors that exacerbate distress and delay diagnosis such as patients' inadequate knowledge of sexual functioning and sociocultural messages regarding "normal" sexual activity. Our work suggests that a disease prevention framework that includes comprehensive sexual education before or at the onset of sexual activity may be of benefit in reducing the burden of vulvodynia when added to strategies to increase healthcare provider knowledge and improve access to effective treatments. CONCLUSION While healthcare provider knowledge and attitudes are often at the forefront of barriers to diagnosis, our study suggests that to minimize patient distress and expedite diagnosis, resources must also be directed to promoting comprehensive sexual health education. Webber V, Miller ME, Gustafson DL, et al. Vulvodynia Viewed From a Disease Prevention Framework: Insights From Patient Perspectives. Sex Med 2020;8:757-766.
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Affiliation(s)
- Valerie Webber
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Michelle E Miller
- Discipline of Obstetrics and Gynecology, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Diana L Gustafson
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Krisztina Bajzak
- Discipline of Obstetrics and Gynecology, Memorial University, St. John's, Newfoundland & Labrador, Canada.
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Wellman J, Murray L, Hebron C, Vuoskoski P. Pain Education in the Context of Non-Specific Low Back Pain: The Lived Experience of the Physiotherapist. An Interpretive Phenomenological Analysis. Musculoskeletal Care 2020; 18:271-300. [PMID: 32293097 DOI: 10.1002/msc.1460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/12/2020] [Accepted: 01/12/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The aim of this study was to explore the physiotherapists' lived experiences of providing pain education (PE), to people living with non-specific low back pain (NSLBP). In previous studies, PE has been associated with positive clinical outcomes within the physiotherapeutic management of NSLBP. However, the meaning of providing PE, as experienced by physiotherapists, has not been specifically explored. METHODS This study adopted a hermeneutic phenomenological approach to explore PE experiences. Six semi-structured interviews were conducted, interviews were transcribed and analysed in line with the 'interpretative phenomenological analysis' framework. RESULTS Five main thematic meaning structures emerged: Experienced significance of assessment in understanding NSLBP, PE as explaining the nature of NSLBP, Experienced challenges in providing PE, individualisation as key to PE for NSLBP and Reassurance as central to PE for people living with NSLBP. CONCLUSIONS The significance of subjective assessment, was a key component of PE, as experienced by participants. However, differences were noted between participants in addressing the sense of assessment; in seeking a physiotherapeutic understanding of the NSLBP, and in seeking to understand the situation of those who are in pain. Within the participant experience, the significance of 'patient' reassurance was highlighted, related to the individualisation and outcome of PE. Reassurance, as described by participants, was emotive and practically grounded and linked with physical activity promotion. Individualisation in PE was meaningfully related to language modification and developing positive therapeutic relationships. Physiotherapists described PE particularly challenging related to pain chronicity and psychosocial factors, which may have significant implications to practice.
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Affiliation(s)
- Josh Wellman
- University of Brighton, United Kingdom of Great Britain, United Kingdom
| | - Luke Murray
- University of Brighton, United Kingdom of Great Britain, United Kingdom
| | - Clair Hebron
- University of Brighton, United Kingdom of Great Britain, United Kingdom
| | - Pirjo Vuoskoski
- University of Brighton, United Kingdom of Great Britain, United Kingdom
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Walker D, Robinson S, Helliwell P, Adebajo A. Development and validation of a bi-lingual interactive tool to educate people about osteomalacia. Musculoskeletal Care 2020; 18:265-270. [PMID: 32090467 DOI: 10.1002/msc.1459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 12/31/2019] [Accepted: 01/01/2020] [Indexed: 06/10/2023]
Abstract
Osteomalacia is a condition where bone mineralisation is impaired by lack of vitamin D. It more commonly affects darker skinned individuals in the UK, especially if they wear occlusive clothing. Lifestyle changes and Vitamin D supplementation are recommended for those people most at risk through these factors, but such advice is not commonly followed. This indicates an educational need for information on osteomalacia and its treatment. Using a previously developed Mind-Map on osteomalacia, a layered and interactive" PowerPoint" style presentation was developed, using hyperlinks. The "basic" layer was translated into Urdu and validated by Urdu speaking professionals. The translation was accurate and meaningful and the tool was well received by representatives of the community. The tool was used to educate a group of 10 community leaders from the Urdu community in Stourbridge, UK. Knowledge about osteomalacia was tested in these people, before and after the education, and increased from an average of 14 to 25 points (p < 0.05). Qualitative feedback gained was very positive. Conclusion: An interactive educational tool for Osteomalacia was developed and translated into Urdu. Use of the tool resulted in increased knowledge about osteomalacia.
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Affiliation(s)
- David Walker
- Northumbria NHS Trust North Tynside General Hospital North Sheilds, UK
| | - Sandra Robinson
- Northumbria NHS Trust North Tynside General Hospital North Sheilds, UK
| | - Philip Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds, Leeds, UK
| | - Ade Adebajo
- Faculty of Medicine, Dentistry and Health University of Sheffield, Sheffield, UK
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Petrik ML, McNamara PJ, Moeschler SM, Blair BD. Communication of Recommendations for the Disposal of Unused Prescription Opioid Medications by Stakeholders in the News Media. Pain Med 2020; 20:1711-1716. [PMID: 31127840 DOI: 10.1093/pm/pnz104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The opioid epidemic is a national public health emergency that requires a comprehensive approach to reduce opioid-related deaths. Proper and timely disposal of unused prescription opioids is one method to deter improper use of these medications and prevent overdose. The objective of this study was to understand how recommendations for disposing of unused prescription opioids, including both take-back programs and toilet disposal, are communicated to the public. METHODS Two hundred sixty-three US newspaper articles published between January 1, 2014, and June 30, 2017, containing information on opioids and take-back programs were found using LexisNexis. Using content analysis, articles were coded for the presentation of and recommendation for opioid disposal practices, beliefs about environmental harm from toilet disposal, and additional strategies to reduce opioid supply. The entity responsible for the statement was also captured. RESULTS Take-back programs were presented as a recommended disposal strategy for unused prescription opioids in 88.6% of coded articles. Toilet disposal was presented as a recommended disposal strategy for unused prescription opioids in 3.4% of articles and as harmful to the environment in 16.0% of articles. Individuals from health care, government, and law enforcement were primarily involved in discussing opioid disposal practices. CONCLUSIONS Although toilet disposal is recommended by the US Food and Drug Administration (FDA) for disposal of unused prescription opioids when a take-back program is not readily available, it was infrequently presented or recommended in news media articles. These results highlight the importance of improving communication of FDA guidelines for opioid disposal in the media, particularly by health care providers, government employees, and law enforcement officials.
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Affiliation(s)
- Megan L Petrik
- Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota
| | - Patrick J McNamara
- Department of Civil, Construction and Environmental Engineering, Marquette University, Milwaukee, Wisconsin
| | - Susan M Moeschler
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Benjamin D Blair
- Department of Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St. Paul, Minnesota, USA
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Abstract
INTRODUCTION Falls prevention in hospitals is an ongoing challenge worldwide. Despite a wide variety of recommended falls mitigation strategies, few have strong evidence for effectiveness in reducing falls and accompanying injuries. Patient education programmes that promote engagement and enable people to understand their heightened falls risk while hospitalised are one approach. The aim of this scoping review is to examine the content, design and outcomes of patient education approaches to hospital falls prevention. As well as critiquing the role of patient education in hospital falls prevention, strategies that can be used in clinical practice shall be recommended. METHODS AND ANALYSIS The analysis will apply the methodological framework developed by Arksey and O'Malley and refined by the Joanna Briggs Institute. An initial limited search of Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed will be completed to identify keywords and index terms. A developed search strategy of Medical Subject Headings and text words will be conducted of PubMed, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, PsychINFO, Education Resources Information Center and grey literature databases from January 2008 to current. The reference lists of included articles will be hand searched for additional studies. Two reviewers will screen the titles and abstracts independently and analyse the full text of potential articles based on the inclusion and exclusion criteria. The data will be extracted using a structured data form. Thematic analysis and numerical synthesis of the data will be conducted, and key themes will be identified. ETHICS AND DISSEMINATION Results of this scoping review will illuminate the designs and outcomes of patient education research for hospital falls prevention in the current literature. It is anticipated that the findings will highlight best-practice educational design to inform the development of future patient-focused education for falls prevention. Study findings will be presented at relevant conferences and public forums, and published in peer-reviewed journals. Ethics approval is not required.
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Affiliation(s)
- Hazel Heng
- La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Bundoora, Victoria, Australia
| | - Dana Jazayeri
- La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Bundoora, Victoria, Australia
| | - Louise Shaw
- La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Bundoora, Victoria, Australia
| | - Debra Kiegaldie
- Healthscope and Faculty of Health Science, Youth and Community Studies, Holmesglen Institute of TAFE Morrabbin Campus, Moorabbin, Victoria, Australia
- Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Meg E Morris
- La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Bundoora, Victoria, Australia
- North Eastern Rehabilitation Centre, Healthscope Ltd, Ivanhoe, Victoria, Australia
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Rose-Davis B, Van Woensel W, Stringer E, Abidi S, Abidi SSR. Using an Artificial Intelligence-Based Argument Theory to Generate Automated Patient Education Dialogues for Families of Children with Juvenile Idiopathic Arthritis. Stud Health Technol Inform 2019; 264:1337-1341. [PMID: 31438143 DOI: 10.3233/shti190444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease of childhood, with outcomes including pain, prolonged dependence on medications, and disability. Parents of children with JIA report being overwhelmed by the volume of information in the patient education materials that are available to them. This paper addresses this educational gap by applying an artificial intelligence method, based on an extended model of argument, to design and implement a dialogue system that allows users get the educational material they need, when they need it. In the developed system, the studied model of argument was leveraged as part of the system's dialogue manager. A qualitative evaluation of the system, using cognitive walkthroughs and semi-structured interviews with JIA domain experts, suggests that these methods show great promise for providing quality information to families of children with JIA when they need it.
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Affiliation(s)
- Benjamin Rose-Davis
- NICHE Research Group, Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - William Van Woensel
- NICHE Research Group, Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Elizabeth Stringer
- Division of Pediatric Rheumatology, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Samina Abidi
- Department of Epidemiology and Population Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Syed Sibte Raza Abidi
- NICHE Research Group, Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
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Aligholipour M, Feizollahzadeh H, Ghaffari M, Jabbarzadeh F. Comparison of In-Person and MMS -Based Education in Telegram on Self-care and Fasting Blood Sugar of Patients with Diabetes Mellitus: A Randomized Clinical Trials. J Caring Sci 2019; 8:157-164. [PMID: 31598508 PMCID: PMC6778313 DOI: 10.15171/jcs.2019.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/31/2018] [Indexed: 12/05/2022] Open
Abstract
Introduction: Diabetes is a disease whose control requires effective self-care and patient education. Multimedia Messaging Service-based (MMS) education is one of the new methods for education. The purpose of this study was to investigate the effect of two types of in-person and MMS-based education in the Telegram application on self-care and weekly fasting blood sugar levels in patients with insulin-dependent diabetes. Methods: In this clinical trial, a sample of 66 patients with diabetes who referred to the Sina hospital in Tabriz, were randomly assigned into two groups: in person and MMSM-based education. Data gathering tools included a demographic form, Toobert’s self-care activities questionnaire (as primary outcome), and a checklist to record fasting blood sugar weekly measured by a glucometer. Data were analyzed using independent and paired sample t-tests, chi-square, and repeated measures ANOVA. Results: After the education the mean scores of self-care in terms of diet, exercise, foot care, and blood sugar testing activity significantly increased in both groups and results of ANCOVA of the scores for all dimensions revealed no significant difference between two groups. Reduction in the fasting weekly blood sugar levels over a 12-week period were statistically significant in both groups. But there was no significant difference between the two groups. Conclusion: MMS-based education same as in-person, improves self-care in patients with diabetes. Given the disadvantages of in-person education, this new educational strategy can be used to facilitate the patient education process and improve its quality.
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Affiliation(s)
- Mahtab Aligholipour
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Feizollahzadeh
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mozaffar Ghaffari
- Departmen of Psychology, Faculty of Education and amp; Psychology, Payame Noor University (PNU), Iran
| | - Faranak Jabbarzadeh
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Farahmand F, Khorasani P, Shahriari M. Effectiveness of a self-care education program on hypertension management in older adults discharged from cardiac-internal wards. ARYA Atheroscler 2019; 15:44-52. [PMID: 31440285 PMCID: PMC6679660 DOI: 10.22122/arya.v15i2.1787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 01/16/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND The aim of the present study was to determine the effectiveness of a self-care education (SCE) discharge program with telephone follow-ups in managing hypertension (HTN) in older patients. METHODS The study was conducted on 56 older patients with HTN who had recently been discharged from the cardiac wards of hospitals in Isfahan, Iran, in 2017. Participants were randomly allocated to the intervention and control groups. The intervention was a 60-minute SCE discharge program with 4 re-educative telephone follow-ups every 2 weeks based on 4 chapters of the designed SCE program and booklet. After coding the data and entering them into SPSS software, data were analyzed for the comparison of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as frequency of managed HTN in the intervention and control groups at baseline (before discharge), and 2 and 3 months after discharge. RESULTS Statistical tests showed no significant difference in any of the demographic and confounding variables as well as baseline BPs (P > 0.050), but at post-intervention follow-ups, after Mauchly's sphericity test, repeated measurements ANOVA showed that the effect of time (P < 0.001) and group (P = 0.043) on SBP was significant. The effect of time (P = 0.036) and group (P = 0.047) on DBP was also significant. McNemar's test showed that the frequency of managed HTN (normal BP), 3 months after discharge, was significantly higher in the intervention group compared to the control group [87.5% (n = 21) vs. 23.1% (n = 6), respectively] (P < 0.001). CONCLUSION SCE discharge program with telephone re-educative follow-ups was effective in reducing mean BP. The use of this program as a discharged plan for older adults with HTN and comparison of readmission rates for a longer period are recommended.
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Affiliation(s)
- Fatemeh Farahmand
- MSc Student, Department of Community Health and Gerontological Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvaneh Khorasani
- Assistant Professor, Nursing and Midwifery Care Research Center AND Department of Community Health and Gerontological Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Shahriari
- Associate Professor, Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences Isfahan, Iran
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Affiliation(s)
- Marina Trento
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Corso AM, Dogliotti 14, 10126, Torino, Italy.
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