Objectif : la prescription médicamenteuse en soins primaires serait responsable d’effets indésirables chez 25 % des patients avec des conséquences graves dans 13 % des cas. Notre objectif a été ...d’élaborer une brochure interactive permettant d’informer et d’impliquer le patient en vue de prévenir les effets indésirables médicamenteux. Méthodes : le processus de production et d’évaluation de la brochure a nécessité plusieurs étapes : une revue de la littérature médicale internationale, une enquête Delphi, une évaluation de la lisibilité du texte, une étude qualitative de terrain, un travail linguistique, un travail d’infographie. Pour l’enquête Delphi 27 experts (patients, médecins généralistes, praticiens de santé publique, cardiologues, gériatres, psychologue, économiste, pharmaciens, infirmière, éthicien) ont été sollicités. Pour l’étude qualitative de terrain, un échantillon hétérogène de sept médecins, treize patients et deux aidants a été constitué. Résultats : une brochure interactive comprenant des items d’information sur le bénéfice et les risques des antihypertenseurs et un plan de soins à remplir par le patient suivi d’une fiche de signalement d’effets indésirables médicamenteux a été élaborée. Suite à l’étude de terrain, les phrases ambiguës et les termes médicaux peu compréhensibles ont été reformulés. Le temps nécessaire pour présenter la brochure ainsi que sa facilité d’emploi étaient des critères majeurs d’acceptabilité pour les soignants. Pour les patients il était nécessaire de mettre en évidence un bénéfice attendu pour susciter leur intérêt vis-à-vis de la brochure. Conclusion : le processus de développement utilisé a permis d’élaborer une brochure compréhensible et acceptable en soins primaires pour prévenir les effets indésirables des antihypertenseurs et leur gravité.
BACKGROUND AND OBJECTIVES:Because patients who are to undergo surgery must give their consent to planned postoperative care, clear and complete information on postoperative pain management should be ...given. The aim of this quality-of-care study was to evaluate by inquiry the impact of written information describing postoperative pain management on the quality and type of information retained, and patient participation in discussing and agreeing to the postoperative pain management programme during the presurgical anaesthesiology consultation.
METHODS:Prospective before and after interventional surveys, each lasting 3 weeks and conducted at a 6-month interval (time required to prepare the written information), used a standardized anonymous questionnaire given to patients after the anaesthesiology consultation. Questions requiring a ‘yesʼ or ‘noʼ response assessed the quality of information and what information was retained by the patient, the extent of the patientʼs interaction during the discussion with the anaesthesiologist and his/her agreement with the postoperative pain management programme.
RESULTS:Among the 180 before-group patients included, 16.7% reported receiving verbal information during the anaesthesiology consultation, none retained all seven principal side-effects of morphine, 14.4% considered the information to be thorough, 20.6% understood it, 16.7% claimed that it had helped them participate in the discussion and 14.4% concurred with the postoperative pain management programme. Compared to the before inquiry, significantly higher percentages of the 107 after-group patients (given written information before the anaesthesiology consultation) responded as having received verbal information during the anaesthesiology consultation (57.0%), retained morphineʼs main side-effects (12.1%), deemed the information thorough (58.9%) and understandable (53.3%), had participated in the discussion (47.7%) and agreed with the postoperative pain management programme (51.4%).
CONCLUSION:Written information on postoperative pain management distributed before the presurgical anaesthesiology consultation improved the quality of information retained, facilitated discussion with the anaesthesiologist and patient agreement with the postoperative pain management programme.
To evaluate the effectiveness of an information leaflet in improving patient understanding of the procedure and complications of septoplasty.
The baseline knowledge of a group of patients who had ...attended a pre-assessment clinic prior to septoplasty was assessed. The procedure and its complications were then verbally explained. The patients' knowledge was then re-assessed on the morning of surgery and any improvements noted. In the second arm of the study, an information leaflet was introduced at the time of verbal instruction and any differences in improvement in knowledge were assessed.
Data from the two groups were analysed using an analysis of covariance with differences in baseline (pre-instruction) knowledge controlled. Additional improvements in mean recall score following leaflet distribution were highly statistically significant when compared with mean recall in the control group (p<0.001).
The use of information leaflets increases patients' knowledge about a surgical procedure and its potential complications.
The aim of this project was to develop and evaluate a decision‐making guide for patients with colorectal cancer contemplating adjuvant therapy. Initially, a focus group was held, and then a draft ...booklet was developed, which was reviewed by patients and professionals. A subsequent revised booklet and a questionnaire were mailed to 24 patients and 32 professionals for evaluation. Further changes resulted in the final 100‐page decision‐making guide, which had a Flesch‐Kincaid reading level of 8.0 and DISCERN rating 5. Seventeen patients (71%) and 22 professionals (69%) completed the questionnaire. All patients agreed/strongly agreed the guide was ‘informative’ and ‘written in a way you like’ and 94% considered it ‘helpful for making decisions’. Professionals found it ‘informative’ (95%), ‘written in a pleasing style’ (95%), ‘easy to understand’ (91%) and felt it would ‘help patients make decisions’ (76%), ‘be appropriate to give to patients’ (91%) and would ‘improve patient knowledge and preparedness’ (100%). Further work aims to assess the impact of the guide upon patient outcomes.
Aim: The aim of this study is to develop a care package to help cancer patients improve their self‐care abilities and better prepare for a disaster, so that they can continue treatment and perform ...symptom management strategies in disaster situations.
Methods: In this study, the “Care Package for Cancer Patients in Times of Disaster”, which comprises four pamphlets, was developed through discussions among the eight members of the study group. The care package was produced by making additions and modifications, based on the findings obtained in the above two steps, to the patient education booklets developed in the area of oncology.
Results: Of the areas that cancer patients find difficult in times of disaster, the following six were extracted: difficulty in continuing treatment, the possibility of running out of pain medicines and how to store pain medicines, the possibility of not being able to go to a regular hospital, the shortage of stoma‐care appliances and other products, the possibility of exposure to infections at a shelter, and the necessity of providing care for cancer patients and their families before and after death. By incorporating these pieces of information, we developed the four pamphlets. These pamphlets are posted on the website for public use.
Conclusion: The newly developed pamphlets incorporate information on how to cope with specific situations in times of disaster, based on the findings obtained from the “Survey on Actual Conditions of Treatment and Nursing Care to Cancer Patients in Disaster Situations”.
This reference provides essential information on therapeutic nutrition and contains 135 patient education handouts that health care providers can reproduce and give to patients. Included within the ...handouts are ones on recommended dietary allowances, the latest food pyramid, prediabetes, glycemic index, mercury and fish safety, food allergy, and 16 specific diets for medical conditions. Each patient education handout is prefaced by an overview that offers guidelines on nutritional interventions and patient education. The book also includes discussions on nutritional controversies and eating disorders and a list of additional resources. The spiral binding and flip-chart format enable health care providers to find and reproduce patient handouts quickly.
Zusammenfassung
Hintergrund
Statistisch gesehen liegt die Chance von Patienten, einen Rechtsstreit wegen mangelhafter Aufklärung zu gewinnen, bei etwa 70 %. Die Beurteilung, über welche Risiken ein ...Patient hätte aufgeklärt werden müssen, wird in Österreich in aller Regel von der Bewertung eines Sachverständigen abhängen.
Ziel der Arbeit
Die Bewertung österreichischer Gerichtssachverständiger (SV), über welche bekannten Narkoserisiken aufgeklärt werden muss, wurde ausgewertet.
Material und Methoden
Es wurde ein Fragebogen an alle SV mit 79 bekannten anästhesiebezogenen Risiken versendet. Ausgewertet wurde, wie viel Prozent der SV die einzelnen Risiken als „typische Anästhesierisiken“ und als „aufklärungspflichtig“ einschätzen.
Ergebnisse
Bei 32 der 79 Risiken waren zwischen 40 und 60 % der SV der Ansicht, dass eine Aufklärungspflicht bestünde. Das heißt, dass in einem Rechtsstreit über eine fehlende Aufklärung die Bewertung der SV in der Praxis kaum vorhersehbar ist. Zudem ist aufgrund der großen Zahl an möglichen Komplikationen eine rechtskonforme Risikoaufklärung im Rahmen des derzeit üblichen Patientengesprächs nicht möglich.
Schlussfolgerung
Für die Zukunft müssen zusätzlich andere Methoden der Wissensvermittlung entwickelt werden. Zudem ist zur Verbesserung der Rechtssicherheit eine Vereinheitlichung der Bewertungskriterien anzustreben.
Cet article propose de présenter les ressources de la littérature à disposition du clinicien pour communiquer l’information sur la santé aux patients, que cela soit sous forme de guides-patients, de ...résumés simplifiés d’articles scientifiques ou encore d’outils d’aide à la prise de décisions médicales partagées. Il discutera ensuite des principaux critères de qualité de ces supports qui, comme pour tout type de littérature, doit guider le praticien dans leur utilisation critique en soulignant notamment l’importance pour ces outils d’être en adéquation avec le niveau de littératie en santé des patients.
This article aims at presenting the literature resources available to the clinician for communicating health information to patients, whether in the form of patient guides, plain language summaries of scientific articles or shared decision-making tools. He will then discuss the main quality criteria of these resources that, as with any type of scientific literature, must guide the practitioner in their critical use, in particular the importance for them to be in line with the level of health literacy of the patients.
Abstract Objective To develop an expanded version of the ensuring quality information for patients (EQIP) scale to measure quality of patient information documents. Methods We added 16 new items to ...the 20-item EQIP scale. The 36 items addressed document content, structure, and identification data. The new tool was used to rate the quality of 73 leaflets describing medical care procedures, used at a university hospital. Assessment rules were clarified on 25 documents; the remaining 48 leaflets were independently rated by two assessors. Results Inter-rater reliability was very good (mean item-specific κ statistic on 48 documents = 0.84). The intraclass correlation coefficient for the global score was 0.95. The mean global conformity score on all items was 44 (range: 21–76, S.D. = 10). Most documents stated the purpose of the medical intervention (74% fully adequate), described qualitative risks (64%), used a respectful tone (80%), provided clear information (64%) in a logical order (73%). Fewer quantified risks (7%), were balanced (33%), used everyday language (22%), provided contact details (28%), identified authors (25%) and funding sources (4%). None gave evidence-based references nor clearly mentioned patient participation. Conclusions The expanded EQIP scale was reliable, and proved useful for analysis of patient information documents. Documents partially met international standards for quality patient information. Practice implications Document producers’ efforts should focus on respecting guidelines and including patients.
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