结直肠癌术后患者营养信息获取行为的质性研究

目的 了解结直肠癌术后患者营养信息获取行为,引导其发挥自身驱动力,增强营养信息储备,促使健康行为形成。方法 运用描述性质性研究方法,对21例结直肠癌术后患者就营养信息获取行为进行深度访谈,采用内容分析法分析访谈资料。结果 提炼出4个主题：营养信息需求(内容多样化)、营养信息获取渠道（医护人员健康教育、互联网信息获取、同伴支持）、营养信息获取模式（问题解决型、偶遇求取型、长期关注型、权威引导型）、营养信息获取的影响（正面影响、负面影响）。结论 结直肠术后患者存在多样化营养信息需求,常通过各种渠道获取信息,获取的模式因人而异,且信息获取的影响具有两面性。建议通过搭建专业平台、畅通营养信息获取渠道、制定针对性健康教育策略增加患者营养信息储备,发挥信息的正向引导作用。     

The introduction of a paediatric anaesthesia information leaflet: an audit of its impact on parental anxiety and satisfaction

BACKGROUND: A paediatric anaesthesia information leaflet was produced to address preoperative parental anxiety and to facilitate informed parental consent. METHODS: An audit was undertaken to assess the impact of introducing the leaflet. This addressed the information needs and expectations of parents of children undergoing anaesthesia, parental satisfaction with information provision and parental preoperative anxiety. RESULTS: The audit revealed that parents expect to be provided with information, although not necessarily in written form. However, the majority who received the information leaflet concluded that verbal information alone would not have been sufficient. The information leaflet was found to be accessible, informative and useful and those who received it reported greater satisfaction with information provision than a control group. Many parents perceived that it resulted in lower levels of preoperative anxiety CONCLUSIONS: A decision was therefore undertaken that routine use of the leaflet would continue on all of the paediatric surgical wards. However, the study also indicated that leaflets should not replace verbal communication with nursing and medical staff, who remain important sources of information.     

Patient-centered approaches to creating understandable health information

As care delivery shifts to further include patients in shared decision-making, patient-centered health information can balance the information asymmetry between patients and providers. Patient health literacy, numeracy, and graph literacy must match that of health information materials to create understandable health information that empowers patients to participate in shared decision-making. We consider an iterative approach focused on three key steps: assessment of the specific information needs of the selected patient community, assessment of that community’s ability to receive and understand health information, and evaluation of the materials developed to assess effectiveness. This structured approach using validated tools maximizes the likelihood of meeting patient needs to improve health outcomes.     

Does an Information Leaflet about Surgical Site Infection (SSI) Improve Recollection of Information and Satisfaction of Patients? A Randomized Trial in Patients Scheduled for Digestive Surgery

Background  

A previous study suggested that most surgical patients do not remember having received information about surgical site infection (SSI). In other fields, written information has been suggested to improve patient satisfaction and recollection of information. Our objective was to assess if providing patients with written information about SSI, in addition to oral information, could influence patient satisfaction, recall of information, and opinion regarding SSI.     

Structure and content of chronic kidney disease information on the World Wide Web: barriers to public understanding of a pandemic

Chronic kidney disease (CKD) is a pandemic and the need to inform those at risk has never been more important. The World Wide Web (WWW) is no w considered a key source of health information, but the quality and utility of this information has been challenged. In this article, we assess structural, content, and linguistic barriers to accessed CKD information and discuss the implications of limited Internet access to communicating health. Technical (number of hyperlinks), content (number of six core CKD and risk factor information domains included), and linguistic (readability and variation in readability) barriers were assessed for websites offered by 12 kidney disease associations. The Flesch Reading Ease Index method was used to estimate readability scores, and variation in the readability of information was assessed. Eleven websites met inclusion criteria. Six of 11 websites provided information in all 6 domains of CKD information. A mean of 4 hyperlinks (range 3-5) was clicked before CKD information was available and a mean of 6 hyperlinks (range 4-12) was clicked to access all available CKD information. Mean readability scores for all six domains of CKD information exceeded national average literacy skills and far exceeded the 5th grade level readability desired for informing vulnerable populations. Information about CKD and diabetes consistently had higher readability scores. The WWW currently has little utility for informing populations at greatest risk for CKD. Barriers to accessing CKD information on the WWW are socioeconomic, technical, and linguistic. Having lower socioeconomic status, less access to computers and the WWW, multiple website hyperlinks, incomplete information, difficult readability, and significant variation in readability of CKD information on the WWW are social, structural, and content barriers to communicating CKD information. This may contribute to the growing epidemics of diminished public understanding about CKD, and disparities in CKD health status experienced by racial/ethnic minority populations globally.     

Pratique de soins: information avant coloscopie

Informed consent is an ethical and legal issue. Invasive procedures such as colonoscopy require shared information, shared decision making and shared responsibilities between physicians and patients. Complete and unbiased information about the nature of the procedure and the indication for it, as well as the risks, benefits and alternatives must be provided. The amount of information patients require in order to provide informed consent is sometimes difficult to assess and is often underestimated by doctors. Traditionally this information has been provided verbally. Additional information is often provided in the form of leaflets. Only a few studies have tested the effects of providing information on precolonoscopy anxiety and knowledge.     

Is a pre‐anaesthetic information form really useful?

Background: All patients should be fully informed about the risks and benefits of anaesthetic procedures before giving a written consent. Moreover, the satisfaction level may vary in proportion to the information given. We aimed to determine, in a single‐blind randomized‐controlled study, whether an information form given before the pre‐anaesthetic consultation could improve perceived information, information gain and satisfaction level. Methods: Two hundred patients ASA 1–3 scheduled for an elective orthopaedic surgery were randomized into two groups: a group that received an information form before the pre‐anaesthetic consultation (IF group) and a control group (no information form). A standardized questionnaire was submitted after the pre‐anaesthetic consultation and after the operation. This 17‐item questionnaire explored perceived information (five items), information gain (three items) and satisfaction level (nine items). The items of each topic were pooled and compared between groups. Results: One hundred and eighty‐five patients (92.5%) completed the study. The IF group had better perceived information (IF group 73% vs. control group 63%, P=0.002), higher information gain (IF group 75% vs. control group 62%, P=0.001) and a higher satisfaction level (IF group 95% vs. control group 92%, P=0.048). Conclusions: Our study suggests that an information form given before the pre‐anaesthetic consultation enhances perceived information, information gain and satisfaction level.     

Informed consent in trauma: Does written information improve patient recall of risks? A prospective randomised study

Informed consent is vital to good surgical practice. Pain, sedative medication and psychological distress resulting from trauma are likely to adversely affect a patient's ability to understand and retain information thus impairing the quality of the consent process. This study aims to assess whether provision of written information improves trauma patient's recall of the risks associated with their surgery. 121 consecutive trauma patients were randomised to receive structured verbal information or structured verbal information with the addition of supplementary written information at the time of obtaining consent for their surgery. Patients were followed up post-operatively (mean 3.2 days) with a questionnaire to assess recall of risks discussed during the consent interview and satisfaction with the consent process. Recall of risks discussed in the consent interview was found to be significantly improved in the group receiving written and verbal information compared to verbal information alone (mean questionnaire score 41% vs. 64%), p=0.0014 using the Mann-Whitney U test. Patient satisfaction with the consent process was improved in the group receiving written and verbal information and 90% of patients in both groups expressed a preference for both written and verbal information compared to verbal information alone. Patients awaiting surgery following trauma can pose a challenge to adequately inform about benefits conferred, the likely post operative course and potential risks. Written information is a simple and cost-effective means to improve the consent process and was popular with patients.     

A critical appraisal of internet resources on colorectal cancer

Objective The significance of the internet as a source of healthcare information for professionals and public is widely recognized. Access to good quality information is very important for informed decisions making on healthcare issues. This is an introduction to the critical appraisal of clinical information on the internet, discussion of the significance of quality checking of healthcare internet resources and the application of critical appraisal tools to selected internet resources on colorectal cancer care. Methods Internet resources were identified on the basis of a general criterion that it provides information on colorectal cancer and selected on the basis of explicit inclusion and exclusion criteria. Each selected website is assessed for quality of information with validated criteria. Results The search strategy identified 10 well known internet resources on healthcare information (e.g. Cochrane, NICE) and 12 websites which are dedicated to cancer related information (e.g. CancerBacup, cancer.gov). The websites of NHS Direct, cancerBACUP, cancer.gov, NICE and Cancer Survivors Network were qualified as resources providing good quality information. Discussion The critical appraisal process assures quality of the available information and the tool is applicable to all healthcare related internet resources. The process is discussed with respect to colorectal cancer information resources and will be equally useful to healthcare professional and public. The healthcare professionals can apply the tool in practice and advise the public more confidently on internet information.     

Informed consent for total hip arthroplasty: does a written information sheet improve recall by patients?

OBJECTIVE: To ascertain whether a written information sheet is acceptable to patients and improves recall of the consent interview. DESIGN: Prospective randomised controlled study using questionnaires, comparing a group of patients given information in a written sheet with appropriate explanation to a group given verbal information alone. SETTING: A specialist orthopaedic surgery unit. PATIENTS: The test group was 126 patients undergoing revision or primary total hip arthroplasty; 65 patients were given information verbally, 61 patients were given written information. OUTCOME MEASURE: Patients' recall of information given, tested with a questionnaire completed on admission (mean of 18 days later). RESULTS: The patients receiving written information scored significantly higher (48% correct answers) than the patients receiving verbal information (38% correct answers). CONCLUSIONS: Written information sheets contribute to the process of informed consent. As patients' recall of information is generally poor, the sheets may also be useful medicolegally, as a permanent record of what was discussed.     

Evaluating the quality of patient leaflets about renal replacement therapy across UK renal units.

BACKGROUND: Enhancing patient participation is a priority for renal services. Good quality information is fundamental to facilitate patient involvement, but in other health contexts it has been found to be sub-optimal. This research aims to audit the provision of patient information by renal units and charities and to assess the quality of written information about dialysis treatment options. METHODS: All UK renal units were sent a questionnaire about the patient information they provided. Renal units and charities that provided dialysis leaflets were asked to forward copies. Leaflet quality and content were assessed by a coding frame informed by information and decision aid checklists. RESULTS: Out of 105, 67 completed questionnaires were returned. Services provide patients with large amounts of information in several media (leaflets, meetings with nurses and patients, videos); computers were not used frequently. Out of 47, 32 units forwarded leaflets about dialysis, and 31 different leaflets. Most leaflets were difficult to understand and rarely included risk information or treatment limitations. No leaflets included techniques to assist patient involvement or decision-making; their primary goal was to inform. CONCLUSIONS: These data suggest an unsystematic pattern of information provision across the UK. Vast resources have been spent on providing information to patients that is difficult to comprehend and incomplete. Research needs to identify which resources are effective in meeting patient needs and at what point in their illness. A centralized system to guide renal services in the design and development of information resources may help meet the differing goals of education, choice facilitation and preparation for self-management.     

Information of the patient: the characteristics of implant breast augmentation

Delivering full information and obtaining enlightened assent is an unavoidable stage before each operation. This paper presents the different "rules" that defines this information duty in France. The assimilation of these different elements: sources, contents and the weight of the information can help the surgeon to carry out the consultation before breast augmentation with more efficiency and objectivity. This preoperative consultation can be divided into 10 steps. Each step is submitted to specific directives, which will depend on the scientific, the law, and the jurisprudence evolution. Therefore, in addition to this article, one can find the new information card concerning implant breast augmentation of the French society of plastic reconstructive and aesthetic surgery. This card is the first update of the previous information cards published in 2002. This card guarantees clear, simple and complete information being a base for information duty.     

乳腺癌病人信息接收及其影响因素现况调查

目的:了解乳腺癌病人信息接收水平及其影响因素。方法:采用横断面研究设计,对474例乳腺癌病人运用生命质量信息接收评价量表(quality of life questionnaire-information 25,QLQ-INFO25)进行问卷调查和分析。结果:乳腺癌病人信息接收总分为(41.2±11.8)分(满分100分),4个维度得分从高到低依次为医疗检测信息(42.4±23.0)、治疗信息(39.5±17.5)、疾病信息(39.5±19.6)和其他服务信息(28.8±17.3)。单条目中希望接收更多信息(82.3±38.2)得分最高。不同年龄(P=0.03)、不同文化程度(P<0.001)、不同治疗阶段(P     

Evaluation of pediatric surgery information on the Internet

BACKGROUND/PURPOSE: Increasing numbers of parents use the Internet to obtain information about their child's medical diagnosis. Unfortunately, this information is not screened or regulated. The authors sought to evaluate the information available on the Internet regarding intersex anomalies as a representative pediatric surgical diagnosis. METHODS: Six search engines were searched for ambiguous genitalia. The first 30 sites on each search engine were reviewed. Sites were reviewed to identify information that did not conform to accepted recommendations for evaluation and treatment. RESULTS: Searches for ambiguous genitalia and synonyms found 0 to 44,471 sites per search engine. Of the 300 sites reviewed, only 45 represented 8 unique sites offering medical information. Five of these sites conformed to recommendations in 2 standard pediatric surgery texts, whereas 3 offered misleading information or information that did not conform to text recommendations. Of the total 300 sites, only 5 (1.6%) of accessible pages offered appropriate medical information to parents. CONCLUSIONS: Parent-oriented information regarding intersex anomalies is difficult to find on the Internet. Over one third of sites containing medical information failed to conform to standard pediatric surgical recommendations for treatment. Pediatric surgeons should help parents effectively use Internet information.     

Information needs on breast cancer genetic and non-genetic risk factors in relatives of women with a BRCA1/2 or PALB2 pathogenic variant

ObjectivesComprehensive breast cancer (BC) risk models integrating effects of genetic (GRF) and non-genetic risk factors (NGRF) may refine BC prevention recommendations. We explored the perceived information received on BC risk factors, and related characteristics, in female relatives of women with a BRCA1/2 or PALB2 pathogenic variant, undergoing BC risk assessment using the CanRisk© prediction tool.MethodsOf 200 consecutive cancer-free women approached after the initial genetic consultation, 161 (80.5%) filled in questionnaires on their perception of information received and wished further information on BC risk factors (e.g., being a carrier of a moderate risk altered gene, personal genetic profile, lifestyles). Multilevel multivariate linear models were performed accounting for the clinician who met the counselee and exploring the effect of counselees’ socio-demographic, familial and psychological characteristics on the perceived extent of information received.ResultsPerceived no/little information received and wish for further information were more frequent for NGRF (>50%) than for GRF, especially high-risk genes (<20%). Perceived amount of information received and desire for further information were inversely correlated (p=<0.0001). Higher education level related to lower perceived levels of information received on GRF. Younger counselees' age (β = 0.13, p = 0.02) and less frequent engagement coping (e.g., inclination to solicit information) (β = 0.24, p = 0.02) related to lower perceived information received about NGRF. Other assessed counselees’ features were not found to be associated to GRF and NGRF information perception.ConclusionsAwareness of counselees’ perceived lack of information on BC risk factors indicates a need to enhance evidence-based information on BC NGRF especially.     

Trochanteric bursitis information on the internet; can we trust the information presented?

Trochanteric bursitis is one of the most common causes of lateral hip pain in adults. The prevalence of unilateral trochanteric bursitis is 15.0% in women and 8.5% in men. Access to internet based information has increased dramatically and health related information is now one of the most popular searches in online activity, despite this the quality of information can vary. The objective of this paper is to examine the quality and readability of internet based information of trochanteric bursitis. Overall, we have found a high variability among not only the quality but also the readability of information published. Websites that appeared first on each search engine for trochanteric bursitis did not necessarily score better, demonstrating the importance of providing patients with high quality resources. Future articles should use more critical appraisal tools in order to provide the reader with more high quality and readable information.     

PATI: Patient accessed tailored information: A pilot study to evaluate the effect on preoperative breast cancer patients of information delivered via a mobile application

ObjectivesThe information needs of cancer patients are highly variable. Literature suggests an improved ability to modulate personalised stress, increased patient involvement with decision making, greater satisfaction with treatment choices and reduced anxiety levels in cancer patients who have access to information. The aim of this project was to evaluate the effects of a mobile information application on anxiety levels of patients undergoing surgery for breast cancer.Materials and methodsAn application was developed for use with Apple iPad containing information on basic breast cancer biology, different treatments used and surgical techniques. Content and face validity studies were performed. A randomized control trial was designed, with a 1:2 allocation. Data collected include basic demographics and type of surgery. Questionnaires used included: the HADS, Mini-MAC, information technology familiarity and information satisfaction.ResultsA total of 39 women participated. 13 women had access to an iPad containing additional information and 26 women acted as controls. The mean age was 54 and technology familiarity was similar among both groups. Anxiety and depression scores at seven days were significantly lower in control patients without access to the additional information provided by the mobile application (p = 0.022 and 0.029 respectively).ConclusionAnxiety and depression in breast cancer patients is both multifactorial and significant, with anxiety levels directly correlating with reduced quality of life. Intuitively, information should improve anxiety levels, however, we have demonstrated that surgical patients with less information reported significantly lower anxiety. We advise the thorough testing and auditing of information initiatives before deployment.     

Doctor-patient communication: do people with spinal cord injury wish to receive written information about their medical condition from the physicians after an outpatient visit or after a readmission in the spinal unit?

STUDY DESIGN: A survey of spinal cord injury patients attending a follow-up clinic in a Regional Spinal Injuries Centre. OBJECTIVES: To investigate whether spinal cord injury patients wish to receive written information about any changes in their medical condition after an outpatient visit or, following readmission in a spinal unit. SETTING: Regional Spinal Injuries Centre, Southport, United Kingdom. METHODS: A questionnaire was developed to assess the following: (1) Whether spinal cord injury patients wished to receive written information about changes in their medical condition after an outpatient visit or following readmission in a spinal unit; and (2) Whether provision of such written information would cause needless anxiety to patients and/or their relatives/carers. RESULTS: A total of 128 adults with spinal cord injury filled in this questionnaire. One hundred and six persons (83%) wished to receive written information about any changes in their medical condition after an outpatient visit, whereas eight (6%) felt that provision of such written information was not required. 115 individuals with spinal cord injury (90%) preferred to receive a copy of the MRI scan report, with interpretation of the findings, while 11 (9%) would be happy not to receive such information. 115 persons with spinal cord injury (90%) felt that written information about their medical condition would be valuable for showing to a locum General Practitioner (GP), if necessary, who may not be acquainted with their medical status. Only eight (6%) did not perceive a need for written information to appraise a locum GP. One hundred and twenty-two persons with spinal cord injury (95%) did not feel that provision of written information would cause needless anxiety to them; only four (3%) felt the other way. One hundred and nineteen (93%) individuals with spinal cord injury wished to receive written information about changes in their medical condition after a readmission to the spinal unit, while six (5%) did not wish to receive such information. CONCLUSION: Although the vast majority of people with spinal cord injury reported they wished to receive written information, a small proportion of patients did not wish to receive such information. Acceptance of written information is not universal and clinicians must ensure that provision of written information to people with spinal cord injury should be tailored to the needs of individual patients.     

Physical information in the external urinary stream of the normal and obstructed adult male.

The qualitative status of physical information contained in the stream of the male lower urinary tract is traced from the bladder to the broken-up external stream. The progression of modifications of this information is discussed and it is argued that information remains in the drops. Electro-optical measurements of the drops leads to pulses which can be analysed for various types of information content. These confirms that there is potential clinical value in some aspects of the information.