Online Patient Information for Hysterectomies: A Systematic Environmental Scan of Quality and Readability

ObjectiveHysterectomy is a common gynaecological procedure, and therefore online information is highly valuable to patients. Our objective was to evaluate the quality, readability, and comprehensiveness of online patient information on hysterectomy.MethodsThe first 25 patient-directed websites on hysterectomy, identified using 5 online search engines (Google, Yahoo, AOL, Bing, Ask.com) as well as clinical professional societies, were assessed using validated tools for quality (DISCERN, JAMA benchmark), readability (Flesch-Kincaid Grade Level [FKGL], Gunning Fog, Simple Measure of Gobbledygook [SMOG], Flesch Reading Ease Score [FRES]), and completeness of information.ResultsWe identified 50 websites for inclusion. Overall, websites were of good quality (median DISCERN score 53/80 [interquartile range {IQR} 47–61]; median JAMA score 3/4 [IQR 1–4]). Most websites described surgical risks (39, 78%), benefits (45, 90%), and types of hysterectomy (48, 96%). Content readability corresponded to grade 11 using FKGL (median 11.1 [IQR 10.2–13.0]) and SMOG (median 10.9 [IQR 10.2–12.4]), or 15 years education using Gunning Fog (median 14.7 [IQR 13.8–16.4]). Websites were assessed as difficult to read using FRES (median 45.6/100 [IQR 37.9–50.9]). No differences were observed in readability scores when we compared websites from clinical professional societies, government, health care, or academic organizations with other websites (P > 0.05).ConclusionOnline patient information on hysterectomy is of good quality and comprehensive. However, the content is above the American Medical Association’s recommended grade 6 reading level. Website authors should consider readability to make their content more accessible to patients.     

PBL和PACS在医学影像学教学中的应用

目的浅析影像学教学中开展图像存档和传输系统(PACS)与以问题为导向的教学方法(PBL)相结合的教学方式的作用。方法对本院48名医学影像学医学生开展研究,研究时间开始于2018年1月,结束于2019年1月,依据随机数字法将其分成对照组24例与观察组24例,将传统教学模式应用在对照组教学中,将PBL和PACS相结合的授课形式应用在观察组教学中,比较两组理论成绩以及临床实践能力。结果在理论考核项目和临床实践考核得分方面,观察组均高于对照组(P<0.05)。结论采用PBL和PACS相结合的授课模式,可有效提升医学影像学教学质量,保障学生更加有效地掌握理论知识以及专业技能。     

健康教育联合快速康复外科理念对 经皮肾镜碎石术患者的效果

〔摘 要〕 目的：研究情景式健康教育联合快速康复外科（ERAS）理念对行经皮肾镜碎石术（PCNL）患者的护理效果。 方法：选取英德市人民医院 2019 年 1 月至 2021 年 1 月收治的 60 例行 PCNL 患者为研究对象，按照随机数字表法分为观察 组和对照组，各 30 例。对照组常规护理，观察组采用情景式健康教育联合 ERAS 干预，干预后比较两组患者主观感受、 住院期间各项指标及并发症发生率。结果：观察组患者焦虑评分、口干饥饿感评分、术后寒颤、导管不适、下床活动时 间、术后疼痛评分均显著低于对照组，差异具有统计学意义（P ＜ 0.05）；观察组患者住院时间及住院费用均显著少于对 照组，差异具有统计学意义（P ＜ 0.05）；观察组患者护理满意度（96.67 %）高于对照组（80.00 %），术后并发症发生率 （3.33 %）显著低于对照组（20.00 %），差异具有统计学意义（P ＜ 0.05）。结论：情景式健康教育联合 ERAS 护理可显 著加快PCNL患者术后恢复，减少并发症发生，缩短住院时间，减少患者疼痛及不适感，从而提高患者满意度，减少住院费用。     

A quasi-cluster randomized controlled trial of a classroom-based mental health literacy educational intervention to promote knowledge and help-seeking/helping behavior in adolescents

IntroductionSchool-based education is a potentially effective approach for improving mental health literacy (MHL) in adolescents. This study evaluated the effects of the “Short MHL Program (SMHLP)”, a brief (50 min), school teacher-led program, on MHL in adolescents in a quasi-cluster randomized controlled trial.MethodsA total of 975 high school first graders (age 15–16) in Japan were allocated to classes such that gender and academic achievement ratios were almost equivalent at the time of admission to the high school. They were assigned at the class level to the SMHLP (n = 364 from 10 classes) or a control group (n = 611 from 17 classes). The program consisted of a 50-minute session and was delivered by a school teacher. The students completed a self-report questionnaire at 3 time points: pre-, (immediately) post- and 2-month follow-up. Outcomes included “Knowledge about mental health/illnesses”, “Recognition of the necessity to seek help”, “Intention to seek help”, and “Intention of helping peers”. Mixed effects modeling was employed for analyses.ResultsScores of all outcomes were significantly improved in the intervention group compared to the control group post-intervention (p < .001). These improvements were maintained at 2-months follow-up for all outcomes (p < .001–.05). Questionnaire scores did not differ between groups at baseline.ConclusionsThe effect of the SMHLP was confirmed in grade 10 students. Brief, yet effective programs can be a viable option to promote understanding of mental health problems and have the potential to be incorporated into regular school curriculum. "     

Validation of the Knowledge of Genome Sequencing (KOGS) scale in cancer patients

IntroductionThe Knowledge of Genome Sequencing (KOGS) questionnaire was recently developed to measure knowledge of genomic sequencing (GS), with preliminary psychometric data supporting its reliability and validity. The aim of this study was to test the reliability and validity of the KOGS in a larger sample, and to confirm its utility in a cancer setting.MethodsThe Genetic Cancer Risk in the Young (RisC) study recruits participants with a personal history of cancer, to investigate heritable cancer causes and future cancer risk using germline GS. Participants (n = 261) in a psychosocial substudy of RisC completed a questionnaire after consent to RisC but before GS, including the KOGS, the Intolerance of Uncertainty Scale, the Chew health literacy scale and items assessing demographic and disease variables. Confirmatory factor analysis (CFA), Cronbach alpha and correlational analyses were undertaken.ResultsThe CFA testing a single-factor model yielded a good model fit, χ2/df = 2.43, comparative fit index (CFI) = 0.97, root mean square error of approximation (RMSEA) = 0.07 and weighted mean root square (WRMR) = 1.03. Factor loadings of all items were above 0.60 and ranged between.66 and.93. The single factor score demonstrated excellent internal consistency (α = 0.82). KOGS scores were significantly associated with health literacy (r = 0.23, p < .001), having a university education [t(258) = ?4.53, p < .001] and having a medical or science background [t(259) = ?3.52, p < .001] but not with speaking a language other than English at home, time since diagnosis, previous genetic counselling/testing or intolerance of uncertainty.DiscussionThis study confirmed a single-factor structure for the KOGS, and its reliability and validity in a cancer population. Associations with measures of health literacy and education were significant and positive as expected, supporting the KOG’s construct validity. Previous genetic counselling may not be sufficient to provide specific knowledge of GS.