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1.
Michael Anthony Fajardo Guy Balthazaar Alexandra Zalums Lyndal Trevena Carissa Bonner 《Patient education and counseling》2019,102(3):467-473
Objective
The study aim was to identify all freely available online diabetes risk calculators and to evaluate their suitability for patients with low health literacy.Methods
Online diabetes risk calculators were identified by an environmental scan. The Patient Education Material Assessment Tool for Printable Materials was used to determine understandability and actionability scores. A high-risk profile was used to compare the risk results obtained with each calculator.Results
Thirty-five risk calculators were identified; 51% had no described model, 23% reported absolute risk and 31% used visual aids. The estimated risk for the same profile ranged from low to very high. The mean understandability score was 79% (SD?=?19%) and the mean actionability score was 42% (SD?=?30%).Conclusions
Online diabetes risk calculators are generally understandable, but not very actionable, and may not be completely suitable for use by patients with low health literacy. The estimated risk is highly variable depending on the underlying model used for the calculation.Practice Implications
Patients and healthcare providers need to exercise caution when selecting a diabetes risk calculator. 相似文献2.
Özlem Örsal Pınar Duru Özgül Örsal Kazım Tırpan Abdullah Çulhacı 《Patient education and counseling》2019,102(2):376-382
Objective
The aim of the study was to examine the relationships between health literacy, primary care satisfaction levels and health awareness of the patients who were admitted to primary care centers (Family Health Centers).Methods
This is a cross-sectional study conducted on individuals who were admitted to Family Health Centers (n?=?1.055) in Eskisehir province. The study data were collected by using Turkish Health Literacy Scale, the European Patients Evaluate General/Family Practice Scale and Health Awareness Scale.Results
As health literacy of participants increases, health awareness and satisfaction with primary care also increases (for each, p?<?.001). Health awareness increases health literacy by 0.55 points, health literacy increases satisfaction in primary care by 0.26 points.Conclusion
In the province of Eskisehir, the health literacy level of 7 out of 10 patients, who admitted to the primary care institution, is inadequate or problematic. As health awareness of participants increases, their level of health literacy also increases. As health literacy of participants increases, their satisfaction with family physicians also increases.Practice implications
As an integral part of preventive health services, studies should be performed to increase and improve the level of health literacy of patients who are admitted to primary care services. 相似文献3.
Objective
Information overload can negatively impact positive health behaviors such as cancer screening. The 8-item Cancer Information Overload (CIO) scale appears to be the only validated measure of health-related information overload. The present study assesses the validity of the CIO scale when modified for use in patients with atrial fibrillation (AF) residing in Australia.Methods
We conducted a secondary analysis of data from a study of adult Australian patients with AF (N?=?386) in which a modified version of the CIO scale was used. In the present study, we examined the construct (convergent and divergent) validity and performed an exploratory factor analysis for the modified scale.Results
All items on the modified-CIO scale appear to load onto a single factor. As predicted, higher education levels (rs=-.24, p?<?.001) and higher oral anticoagulant knowledge (rs=-.17, p?=?.001) were significantly associated with lower modified-CIO scores; no other demographic characteristics were significantly associated with CIO scores.Conclusion
When adapted to the AF context, the modified-CIO scale appears to be a valid measure of information overload.Practice Implications
A valid scale is required to measure information overload accurately. Knowledge of the interplay between information overload and various health behaviors help focus future efforts to support patient empowerment. 相似文献4.
Anna Udvardi 《Patient education and counseling》2019,102(2):388-393
Objective
The aim of the study is to show how qualitative, linguistic analysis can be purposefully integrated into health communication research, based on the functions and outcomes of medical communication proposed by de Haes and Bensing 2009 [1].Methods
This article proposes a theoretical framework advancing health communication research and does not present primary research. The cited papers were selected on the basis of their relevance to the current purpose of the study, without the intention of being exhaustive.Results
Linguistic and conversation analytic research supports the legitimacy of commonly recommended patient-centered communication skills. However, research that directly relates linguistic analysis to certain functions and outcomes of the medical interview is sparse.Conclusion
Integrating linguistics into health communication research enhances the evidence base of healthcare communication and helps to develop effective communication training materials.Practice implications
Future research designs should purposefully and directly connect linguistic analysis with the functions and the outcomes of the medical interview. 相似文献5.
Marita S. Fønhus Therese K. Dalsbø Marit Johansen Atle Fretheim Helge Skirbekk Signe Flottorp 《Patient education and counseling》2019,102(3):474-485
Objective
To assess the effectiveness of patient-mediated interventions on healthcare professionals' performance.Methods
We conducted a systematic Cochrane review according to established guidelines. We searched predefined databases in 2016 and 2017. Two review authors independently assessed studies for inclusion, extracted data, assessed risk of bias, performed meta-analyses, and assessed the certainty of the evidence (GRADE).Results
We included 25 randomised studies with a total of 12 268 patients. We found that patient-reported health information interventions and patient education interventions probably improve healthcare professionals' adherence to recommended clinical practice (moderate certainty evidence). We also found that patient information interventions may improve healthcare professionals' adherence to recommended clinical practice (low certainty evidence). Patient decision aids may make little or no difference to the number of healthcare professionals’ adhering to recommended clinical practice (low-certainty evidence).Conclusion
Our findings strengthen the belief that patient-mediated interventions have the potential to improve professional practice, especially patient-reported health information interventions and patient education interventions.Practice implications
Our findings show that patient-reported health information interventions and patient education interventions are relevant approaches to improve professional practice. Thus, it seems reasonable to conclude that these types of patient-mediated interventions can contribute to improving the quality of healthcare services. 相似文献6.
Maryam Peimani Fateme Monjazebi Robabeh Ghodssi-Ghassemabadi Ensieh Nasli-Esfahani 《Patient education and counseling》2018,101(3):460-466
Objective
This study aims to assess the effectiveness of a peer support intervention, in which patients with T2DM were provided ongoing self-management support by trained peers with diabetes directed at improving self-care behaviors, self-efficacy and life quality.Methods
In this randomized controlled trial, 200 patients referred to a diabetes specialty clinic were allocated to peer support or control group. Participants in both groups received usual education by diabetes educators.Intervention participants worked with the trained volunteer peers who encouraged participants to engage in daily self-management and to discuss and share their experiences and challenges of diabetes management. The primary outcomes were HbA1c, BMI, self-care behaviors, self-efficacy and life qualityResults
After 6 months, patients in the peer support group experienced a significant decline in mean A1c value (P = 0.045). Also, mean diabetes self-management scores, mean self-efficacy scores and mean quality of life scores significantly improved in peer support group compared to control group (P values <0.001).Conclusion
Peer support activities can be successfully applied in diabetes self-management, especially in areas with a shortage of professionals and economic resources.Practice implications
Peer support strategies should be integrated into our healthcare system to meet minimum needs of people with T2DM in Iran. 相似文献7.
8.
Michelle L. Litchman Erin Rothwell Linda S. Edelman 《Patient education and counseling》2018,101(3):518-523
Objective
The use of the diabetes online community (DOC) is growing across all age groups. The aim of this exploratory study was to describe why older adults participated in the DOC, and how DOC users interacted with their healthcare providers.Methods
Telephone interviews (N = 20) were conducted with older adult DOC users (born between 1946 and 1964) living in the United States. Interviews were analyzed using qualitative content analysis adhering to rigor and reproducibility standards.Results
Themes that emerged from the data related to DOC participation included: information to improve self-care, emotional support, belonging to a community, validation of information, cause for concern and interaction with healthcare providers. Participants used the DOC for day to day diabetes management advice and healthcare providers for medical information and care.Conclusion
Participants highly valued the DOC and regarded their participation as a way to increase knowledge to improve self-care and reciprocate emotional support with others for diabetes management. The DOC filled gaps in knowledge and support participants were not able to get elsewhere.Practice implications
The DOC serves as an important source of information and support for individuals with diabetes and may be a cost-effective strategy to augment standard diabetes care. 相似文献9.
Una Stenberg Andre Vågan Maria Flink Vibeke Lynggaard Kari Fredriksen Karl Fredrik Westermann Frode Gallefoss 《Patient education and counseling》2018,101(6):1006-1035
Objectives
To provide a comprehensive overview of health economic evaluations of patient education interventions for people living with chronic illness.Methods
Relevant literature published between 2000 and 2016 has been comprehensively reviewed, with attention paid to variations in study, intervention, and patient characteristics.Results
Of the 4693 titles identified, 56 articles met the inclusion criteria and were included in this scoping review. Of the studies reviewed, 46 concluded that patient education interventions were beneficial in terms of decreased hospitalization, visits to Emergency Departments or General Practitioners, provide benefits in terms of quality-adjusted life years, and reduce loss of production. Eight studies found no health economic impact of the interventions.Conclusions
The results of this review strongly suggest that patient education interventions, regardless of study design and time horizon, are an effective tool to cut costs. This is a relatively new area of research, and there is a great need of more research within this field.Practice implications
In bringing this evidence together, our hope is that healthcare providers and managers can use this information within a broad decision-making process, as guidance in discussions of care quality and of how to provide appropriate, cost-effective patient education interventions. 相似文献10.
Huabin Luo Shivajirao P. Patil Qiang Wu Ronny A. Bell Doyle M. Cummings Alyssa D. Adams Bertha Hambidge Kay Craven Fei Gao 《Patient education and counseling》2018,101(10):1846-1851
Objectives
This study aimed to validate a new consolidated measure of health literacy and numeracy (health literacy scale [HLS] plus the subjective numeracy scale [SNS]) in patients with type 2 diabetes (T2DM).Methods
A convenience sample (N?=?102) of patients with T2DM was recruited from an academic family medicine center in the southeastern US between September-December 2017. Participants completed a questionnaire that included the composite HLS/SNS (22 questions) and a commonly used objective measure of health literacy—S-TOFHLA (40 questions). Internal reliability of the HLS/SNS was assessed using Cronbach’s alpha. Criterion and construct validity was assessed against the S-TOFHLA.Results
The composite HLS/SNS had good internal reliability (Cronbach’s alpha?=?0.83). A confirmatory factor analysis revealed there were four factors in the new instrument. Model fit indices showed good model-data fit (RMSEA?=?0.08). The Spearman’s rank order correlation coefficient between the HLS/SNS and the S-TOFHLA was 0.45 (p?<?0.01).Conclusions
Our study suggests that the composite HLS/SNS is a reliable, valid instrument. 相似文献11.
Jette Ammentorp Maiken Wolderslund Connie Timmermann Henry Larsen Karina Dahl Steffensen Annegrethe Nielsen Marianne E. Lau Bodil Winther Lars Henrik Jensen Elisabeth Assing Hvidt Niels Christian Hvidt Pål Gulbrandsen 《Patient education and counseling》2018,101(4):639-646
Objective
This paper aims to demonstrate how the use of participatory action research (PAR) helped us identify ways to respond to communication challenges associated with shared decision-making (SDM) training.Methods
Patients, relatives, researchers, and health professionals were involved in a PAR process that included: (1) two theatre workshops, (2) a pilot study of an SDM training module involving questionnaires and evaluation meetings, and (3) three reflection workshops.Results
The PAR process revealed that health professionals often struggled with addressing existential issues such as concerns about life, relationships, meaning, and ability to lead responsive dialogue. Following the PAR process, a communication programme that included communication on existential issues and coaching was drafted.Conclusion
By involving multiple stakeholders in a comprehensive PAR process, valuable communication skills addressing a broader understanding of SDM were identified. A communication programme aimed to enhance skills in a mindful and responsive clinical dialogue on the expectations, values, and hopes of patients and their relatives was drafted.Practical implications
Before integrating new communication concepts such as SDM in communication training, research methods such as PAR can be used to improve understanding and identify the needs and priorities of both patients and health professionals. 相似文献12.
Meghana Yajnik Jonay N. Hill Oluwatobi O. Hunter Steven K. Howard T. Edward Kim T. Kyle Harrison Edward R. Mariano 《Patient education and counseling》2019,102(2):383-387
Objective
Effects of patient education on perioperative analgesic utilization are not well defined. We designed a simple pain management educational card for total knee arthroplasty (TKA) patients and retrospectively reviewed clinical data before and after implementation to test the hypothesis that more informed patients will use less opioid.Methods
With IRB approval, we analyzed clinical data collected perioperatively on all TKA patients one month before (PRE) and one month after (POST) card implementation. The card was designed using a modified Delphi method; the front explained all analgesic medications and the Defense and Veterans Pain Rating Scale was on the back. The primary outcome was total opioid dosage in morphine milligram equivalents (MME) for the first two postoperative days. Secondary outcomes included daily opioid usage, pain scores, ambulation distance, hospital length of stay and use of antiemetics.Results
There were 20 patients in each group with no differences in baseline characteristics. Total two-day MME [median (10th–90th percentiles)] was 71 (32–285) for PRE and 38 (1–117) for POST (p?=?0.001). There were no other differences.Conclusion
Educating TKA patients in multimodal pain management using a simple tool decreases opioid usage.Practice implications
Empowering TKA patients with education can reduce opioid use perioperatively. 相似文献13.
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15.
Yen-Ming Huang Olayinka O. Shiyanbola Hsun-Yu Chan 《Patient education and counseling》2018,101(11):1906-1913
Objective
To investigate whether medication self-efficacy moderates or mediates the relationship between health literacy and medication adherence. To propose a path model that illustrates the interrelated relationship between health literacy, medication self-efficacy, medication adherence, and hemoglobin A1c (HbA1c).Methods
This cross-sectional study was performed via a face-to-face survey. Factors that may influence medication adherence and HbA1c were identified from the literature review. One hundred and seventy-four participants included were ≥20 years old with diagnosed type 2 diabetes, understood English, and were prescribed at least one oral diabetes medicine. During clinic visits, a questionnaire was administered to evaluate health literacy, medication self-efficacy, and medication adherence. HbA1c values were obtained from electronic medical records. Path analyses were conducted for data analysis.Results
Medication self-efficacy mediated but did not moderate the relationship between numeracy and diabetes medication adherence. Participants with higher numeracy skills may develop a greater level of medication self-efficacy, which in turn may result in a higher level of diabetes medication adherence and a lower level of HbA1c.Conclusion
Enhancing patients’ medication self-efficacy and numeracy skills may be imperative in intervention programs to improve diabetes medication adherence.Practice implications
An improvement in numeracy skills and medication self-efficacy is recommended to enhance diabetes medication adherence. 相似文献16.
Andrea S. Wallace Nicole L. Pierce Erica Davisson Kirstin Manges Toni Tripp-Reimer 《Patient education and counseling》2019,102(3):542-549
Objective
To evaluate an interactive tool designed to help patients communicate their social resources supportive of home recovery to health care providers.Methods
Seventy medical and surgical inpatients completed the D-CEGRM social resource interview, demographic queries, and discharge readiness surveys (RHDS) at discharge. Two weeks later, patients completed post-discharge coping difficulty surveys (PDCDS). Nurses unassociated with patients’ clinical care reviewed structured clinical notes created from the D-CEGRM and categorized patients as likely to have “inadequate” or “adequate” supportive resources for home self-management. Nurse decision making was tracked using an adjudication process, and post-hoc comparisons in patient characteristics, RHDS, and PDCDS were conducted.Results
Nurses categorized 36 patients (51%) as having inadequate resources. Number and accessibility of supports, presence of negative relationships, and previous struggles meeting health-related needs were important decision-making factors. Post-hoc comparisons revealed significant differences in demographic risk factors and discharge readiness ratings for those with inadequate vs. adequate resources.Conclusion
The D-CEGRM may be an efficient tool for patients to communicate access to social resources, and an effective facilitator of transitional care planning.Practice Implications: The D-CEGRM may provide a useful assessment of patients’ home context and guide for transitional care planning. 相似文献17.
Urawan Withidpanyawong Sanguan Lerkiatbundit Woranuch Saengcharoen 《Patient education and counseling》2019,102(1):85-92
Objectives
To investigate the effectiveness of family intervention for type 2 diabetes and to examine predictors of glycaemic control.Methods
This was a prospective randomised controlled trial. Participants with type 2 diabetes were randomly assigned to an intervention group (n?=?98) or a control group (n?=?98). A pharmacist delivered the educational sessions and encouraged family members to take an active role in self-management practices for the intervention patients. The control patients received usual care.Results
At the end of the study (9-month follow-up), greater reduction in glycosylated haemoglobin (HbA1c) occurred in the intervention group than in the control group (?1.37% and ?0.21%, respectively; P?<?0.001). Between-group differences in the improvements of low-density lipoprotein cholesterol (LDL-C) and blood pressure were found (P?<?0.05). Higher scores in diabetes knowledge of patients, family support, medication adherence, self-management and self-efficacy were seen in the intervention group than in the control group (P?<?0.05). Multivariable analysis showed family members who were spouses or women were strong predictors of improved glycaemic control.Conclusion
Family-involvement intervention is helpful in diabetes management, especially having spouses or women as caregivers.Practice implications
Family involvement should be encouraged in diabetes care. 相似文献18.
Objective
Patient education on high-risk medications such as warfarin is important, and they require quick follow-up after initiation to maximize efficacy and safety. In our Anticoagulation Clinic, two 60-minute new patient appointments are available each day, contributing to prolonged lead-time. We instituted standardized warfarin video education to shorten in-clinic-room visit time, to potentially increase new patient appointments.Methods
Patients viewed the video in the waiting area with a goal to decrease visit times by 15?min (25%), before pharmacists completed their visit. Data collected included time spent in the clinic room, education comprehension, and patient feedback.Results
Ninety patient visits were evaluated in one pre-intervention and two post-intervention phases. Patients who received video education spent less time in the clinic room versus those who had not (52.4 vs 39.4?min, p?=?0.001), and two-thirds of all post-intervention visits achieved 25% reduction in visit time. There were no significant differences in education comprehension and patient satisfaction.Conclusion
Video education significantly decreased in-clinic-room visit time, and most patients achieved a goal of 25% reduction in time spent, without a change in comprehension or patient satisfaction.Practice implications
Implementation of video education can reduce clinic times in many patients without significantly impacting patient satisfaction. 相似文献19.
Kristie B. Hadden Latrina Y. Prince Marty K. Bushmiaer Jamie C. Watson C. Lowry Barnes 《Patient education and counseling》2018,101(10):1823-1827
Objectives
This study assessed patients’ health literacy and expectations for total hip (THA) and total knee (TKA) replacement surgery, and compared health literacy levels of patients and their caregivers.Methods
A convenience sample of 200 THA/TKA participants, patients and their caregivers, participated in this study.Results
Results demonstrated no statistical difference in health literacy between patients and their caregivers. However, patients with lower health literacy had significantly lower expectations for walking after surgery.Conclusions
Practices should be aware that caregivers may not be any better equipped to consume and use complicated patient education materials than the patient they are assisting. Additionally, lower health literacy, rather than or in addition to race or social factors, may contribute to disparities in opting for THA/TKA because of lower expectations for walking after surgery.Practice implications
Healthcare practices should develop patient educational materials that are easy for all patients and caregivers to understand, especially those with low health literacy. Additional patient education and counseling may help patients with low health literacy realistically align their expectations and mitigate barriers to consenting to surgery due to low expectations. 相似文献20.
Miyong T. Kim Kim Byeng Kim Tam H. Nguyen Jisook Ko Jim Zabora Elizabeth Jacobs David Levine 《Patient education and counseling》2019,102(4):709-717