Study Type – Therapy (RCT) Level of Evidence 1b
OBJECTIVE
To compare the comprehension gained by standard consent (SC) vs a unique interactive multimedia presentation (IMP), for radical prostatectomy ...(RP), as informed consent for RP requires that the patient understands the procedure and potential complications.
PATIENTS AND METHODS
Forty patients undergoing RP were prospectively randomized to SC or IMP, followed by a 26‐question test on critical aspects of the surgery and its implications. The groups were crossed over and re‐tested, with a subsequent statistical analysis. SC involved typical verbal interaction and consultation with physicians and nurses, whilst the IMP provided consistent and animated information on these topics, and included multiple‐choice questions probing understanding of key points. Progression through the IMP only occurred with correct responses; incorrect responses prompted a review of the information before repeating the question. Telephone interviews assessed usability, overall understanding, educational level and primary language.
RESULTS
The patient groups had similar demographics. The IMP group (78%) had significantly higher knowledge test scores (P < 0.001) than the SC group (57%), suggesting a better understanding of the implications of surgery. This was maintained on crossover, with the SC group scores improving by 11% compared to testing before IMP (P < 0.001). The initial IMP group scores were unchanged on crossover and repeat testing (P < 0.05).
CONCLUSION
IMP provides better patient understanding than SC for RP, by ensuring that the procedure and risks have been explained consistently, and by actively testing the patient. Such tools assist in obtaining ethical and legally informed consent, thus increasing patient knowledge whilst reducing patient anxiety and potential dissatisfaction or medico‐legal consequences when less than ideal outcomes occur.
Resumo OBJETIVO: caracterizar os materiais educativos impressos sobre esquistossomose produzidos no Brasil, nos níveis federal, estadual e municipal. MÉTODOS: os materiais foram caracterizados ...considerando-se as categorias 'formato', 'parasito e hospedeiro intermediário', 'hospedeiro definitivo' (doente) e 'doença'. RESULTADOS: dos 60 materiais avaliados, três não traziam informação sobre as atividades de risco e 41 indicavam mais de um nome popular para a doença, possibilitando maior alcance do público-alvo nas diversas áreas endêmicas; em 53 materiais, o ciclo biológico estava ausente ou incorreto; o molusco, hospedeiro intermediário, estava retratado incorretamente, com imagens estereotipadas em 39 materiais, e ausente em um; o diagnóstico foi mencionado em 36 materiais. CONCLUSÃO: os materiais educativos impressos avaliados mostraram incorreções que podem comprometer o trabalho de educação em saúde; ademais, o diagnóstico da esquistossomose foi pouco abordado.
This paper reports on the potential value and feasibility of providing patients with a personalised discharge summary of their critical care stay.
Fifty-one patient discharge summaries, written by ...nurses during a randomised controlled trial, were retrospectively analysed for readability, structure and quality. A questionnaire survey completed by trial patients (n=42), their relatives (n=21) and nurses (n=170) explored user experience and feasibility. Quantitative questionnaire data were analysed descriptively and inferentially; qualitative data were subjected to content analysis.
Most completed summaries achieved at least an average readability score and were of an acceptable quality. Motivation, time constraints and competing priorities were identified as key barriers to writing an effective summary; however, in the majority of cases, writing them had taken less than 15minutes. Questionnaire data support that patient discharge summaries can help patients, relatives and ward nurses better understand and patients accept, what happened in critical care.
Patient discharge summaries are likely to be a useful adjunct to existing discharge information, but further work is required to determine when and how they should be provided. With appropriate training and support, it is feasible for nurses to write discharge summaries in a busy critical care environment.
Implanted ports are frequently used for patients with cancer who require IV chemotherapy. In addition to verbal communication with healthcare providers, patients with cancer may benefit from written ...information.
This pre/post study evaluated the effectiveness of an informational booklet by improving knowledge about ports and assessed the history, need, and preferences for information.
Patients with cancer who had an implanted port for at least six months were provided with an informational booklet about ports. Knowledge about ports was tested before (T0) and after (T1) patients read the booklet. Information needs and preferred sources of information were also assessed at T0. Patients reported their opinions of the booklet at T1.
The sample included 129 patients; 49% were male, with a mean age of 59 years. Most patients want to receive as much information as possible, preferably before the port is implanted. However, 43% of patients reported they had received little information about ports. After reading the booklet, patients' knowledge, which was measured with a validated seven-item instrument, improved from T0 to T1 (p < 0.001, effect size = 0.689). Oncology nurses, by providing written and verbal information, can increase patients' knowledge about implanted ports and their confidence in caring for their ports.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Pharmacists may be the first health care contact consulted about erectile dysfunction (ED).
To assess pharmacists' ability to detect ED and encourage patients to seek medical evaluation.
This ...observational study conducted in Greece and Spain included men without a valid prescription for an ED medication but with a history indicating ED risk and/or who consulted a pharmacist about ED. Pharmacists completed a questionnaire about the patient. Patients completed the Sexual Health Inventory for Men (SHIM); men with a score ≤21 (cutoff for ED) were educated (by case pharmacists) and referred and encouraged to see a physician (by case and control pharmacists).
Proportion of men with a SHIM score ≤21 and, of those, the proportion who visited a physician and credited the pharmacist for their visit. ANCOVA and chi-square test were used for continuous and categorical data, respectively.
Among the 451 men (mean±SD age, 54.9±12.9years) questioned about ED, 90% had a risk factor (usually hypertension, hypercholesterolemia, or diabetes), 28% had a previous diagnosis, 36% sought internet information, 38% self-medicated, 10% took medication obtained outside the pharmacy setting, and the first health care professional approached was a pharmacist (50%), physician (18%), or nurse (1%) at a median of 6 (range, 0–360) months after symptom onset. The SHIM score was ≤21 in 348 (77%) men. A lower score (indicating increased ED severity) was associated with increased age and with benign prostate hyperplasia, depression, diabetes, or prostate cancer. In the minority of men contacted for follow-up, less than one-third had visited their physician, despite pharmacist encouragement.
Pharmacists are often the first health care contact regarding ED and are highly accurate in its detection. Further research is needed to optimize the pharmacist's role in early detection, education, and motivating patients to be evaluated by a physician. Martin Morales A, Hatzichristou D, Ramon Lladós J, Pascual Renedo V, and Pimenidou A. Community pharmacy detection of erectile dysfunction in men with risk factors or who seek treatment or advice but lack a valid prescription. J Sex Med 2013;10:2303–2311.
Background.
Providing advice to wear good quality shoes with appropriate fit is one of the possibilities GPs have when treating patients with foot problems.
Objectives.
The aims of this study are to ...(i) determine which shoe characteristics are important when providing shoe advice; (ii) develop a shoe advice leaflet and (iii) evaluate if women choose better shoes with the aid of the leaflet.
Methods.
We performed a literature search on the effect of separate shoe characteristics on foot pathologies and kinematics and developed an information leaflet with the aid of multidisciplinary experts. The leaflet was tested in a group of women aged 50 years or over who did not receive podiatric treatment or shoe advice in the year prior to the study. The women were asked to select shoes; half of them were provided with the leaflet. Shoe characteristics were scored blinded for the condition by two podiatrists. Data were analysed using a t-test for independent measures.
Results.
The developed leaflet contains nine shoe characteristics. A total of 57 women ranging from 54 to 86 years old (average 69) consented to participate in testing the efficacy of the leaflet. Women using the leaflet (n = 29) selected better shoes than without (P = 0.049).
Conclusions.
Based on a literature search and expert opinion, we have developed an information leaflet for GPs to provide as a supplement to oral shoe advice. Women using this leaflet were able to select shoes of better quality and better fit than women selecting shoes without using the leaflet.
Abstract Objective To compare the effects of two health information texts on patient recognition memory, a key aspect of comprehension. Methods Randomized controlled trial ( N = 60), comparing the ...effects of experimental and control colorectal cancer (CRC) screening texts on recognition memory, measured using a statement recognition test, accounting for response bias (score range −0.91 to 5.34). The experimental text had a lower Flesch–Kincaid reading grade level (7.4 versus 9.6), was more focused on addressing screening barriers, and employed more comparative tables than the control text. Results Recognition memory was higher in the experimental group (2.54 versus 1.09, t = −3.63, P = 0.001), including after adjustment for age, education, and health literacy ( β = 0.42, 95% CI: 0.17, 0.68, P = 0.001), and in analyses limited to persons with college degrees ( β = 0.52, 95% CI: 0.18, 0.86, P = 0.004) or no self-reported health literacy problems ( β = 0.39, 95% CI: 0.07, 0.71, P = 0.02). Conclusion An experimental CRC screening text improved recognition memory, including among patients with high education and self-assessed health literacy. Practice implications CRC screening texts comparable to our experimental text may be warranted for all screening-eligible patients, if such texts improve screening uptake.
Purpose To create and validate educational material for patients undergoing orthognathic surgery. Methods The design included five phases: (a) a review of the literature regarding surgical ...complications; (b) gathering information on the needs of patients through blogs and virtual communities; (c) evaluating patient perceptions of the post-operative period through a focus group; (d) obtaining information through specialists using the Delphi technique and validation by judges; and (e) validation by patients in terms of understanding the exhibited material. Results The first three phases of the study and the first round of the Delphi technique assisted in generating the perioperative patient booklet. The following rounds of the Delphi technique introduced modifications to improve the material, with the judges agreeing on the final material to be validated by patients. Conclusion Creating a booklet involves more than simply writing summarized ideas on a paper and handing it to the patient. One must understand the population, involve the relevant professionals, and obtain high-quality graphic aids for this type of educational material.
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