Efficacy of patient information concerning casts applied post-fracture

Introduction: Serious complications can result when casts are used for bone immobilization following fracture. Adequate patient information regarding cast care and possible complications is vital for prevention. This study examines the effectiveness of verbal and written patient information regarding cast safety. Methods: Patients (n= 109; age ≥18 years) from three Western Australian teaching hospitals were interviewed using a custom‐designed questionnaire. Patients' understanding of cast care and possible complications were tested by recall of seven categories of information, notably: pain, swelling, cast care, itching, neural signs, vascular signs/symptoms, exercise/rest. A follow‐up phone call (3–8 weeks after initial interview) was conducted to elicit complications and determine information recall. Results: Written information was received by 62% of patients; however, overall, only 35% claimed to have read the information provided. Of these, the highest recall was in four of seven information categories. A high proportion of those given only verbal information had poor recall (≤2 categories, defined a priori). In contrast, patients who also received written information had better recall (three or more categories, defined a priori, P= 0.031). Four of the 109 patients developed complications attributable to the cast (three had pressure ulcers and one had a deep vein thrombosis). Conclusion: Patient recall of information concerning cast care and possible complications was no more than 60%. The provision of written information was associated with a significantly higher awareness of possible complications. The results indicate that for fracture care, the delivery and use of information protocols can be greatly improved.     

三明治教学法在老年病房护士安全知识培训中的应用

目的提高老年病房护士临床护理安全培训效果。方法将98临床护士随机分为观察组和对照组各49人,对照组采用常规教学法,即护士课前预习,教师讲解,小组讨论及汇总的方法;观察组采用三明治教学方法,包括教师引导,小组讨论,交叉讨论,小结汇报,教师点评,案例分析等方式。培训均为2h。结果观察组理论考核成绩显著高于对照组(P0.01);观察组护士对本组教学法9个调查条目评价为好者达83.7%~100%。结论三明治教学法用于老年病房护士安全知识培训有利于提高培训效果,且深受临床护士好评。     

三明治教学法在老年病房护士安全知识培训中的应用

目的提高老年病房护士临床护理安全培训效果。方法将98临床护士随机分为观察组和对照组各49人,对照组采用常规教学法,即护士课前预习,教师讲解,小组讨论及汇总的方法;观察组采用三明治教学方法,包括教师引导,小组讨论,交叉讨论,小结汇报,教师点评,案例分析等方式。培训均为2h。结果观察组理论考核成绩显著高于对照组（P〈0.01）;观察组护士对本组教学法9个调查条目评价为好者达83.7%~100%。结论三明治教学法用于老年病房护士安全知识培训有利于提高培训效果,且深受临床护士好评。     

A patient information booklet about anesthesiology improves preoperative patient education

PURPOSE: Preadmission clinics provide a limited timeframe in which patients can discuss the risks and benefits of various forms of anesthesia. We hypothesized that the provision of a patient information booklet would clarify and reinforce salient perioperative topics related to anesthesia. METHODS: A prospective study was carried out in two phases. In Phase I, anesthesiologists were surveyed to determine the key topics routinely discussed during a preadmission clinic visit. Subsequently, we developed an illustrated booklet highlighting some of the topics identified during the survey. In Phase II, the booklet was evaluated by a questionnaire designed to assess patient knowledge about perioperative issues. This questionnaire was administered to a control group of patients who did not receive the booklet and a study group who received the booklet. Statistical significance was established at P<0.05. RESULTS: In Phase I, 65 anesthesiologists completed the survey of their current practice in the preadmission clinic. The survey revealed no uniformity in overall information provision, but indicated that certain issues were routinely discussed with patients. In Phase II, 322 patients were enrolled. Patients in the study groups scored significantly higher on the knowledge assessment questionnaire than did patients in the control group. Both education and country of origin influenced the scores of patients in the control group, but not in the study group. CONCLUSION: A simple, illustrated patient information booklet, when appropriately written and illustrated, is an effective means of standardizing the communication of the risks and benefits of anesthesia in a preadmission clinic. A booklet with a focus on plain language usage and simple illustrations appears to be an advantageous educational tool even in culturally diverse populations.     

Quality of information concerning cervical disc herniation on the Internet

Background ContextMany Americans seek and are influenced in their decision making by medical information on the Internet. Past studies have repeatedly found information on most medical Web sites to be deficient and of low quality. Physicians must remain aware of the quality and reliability of the information available on the Internet for patient education purposes.PurposeTo assess quality and authorship of Internet Web sites regarding a common cervical spine disorder, cervical disc herniation.Study DesignThe present study is a systematic quality assessment survey of Web sites concerning cervical disc herniation.MethodsFifty relevant and unique sites were identified. The five most popular search engines were used to identify 100 Web sites using the search term, “cervical disc herniation.” Using a validated technique, three orthopedic surgeons independently generated content quality scores and accuracy scores, then integrated into a single final total summary score for each Web site.ResultsFour of the five identified top-scoring Web sites were found to be commercial and one was academic. Most of the Web sites were found to be physician sponsored, followed by academic and commercial.ConclusionsThere is wide variability in Web site quality, with most of the Web sites failing to be sufficiently comprehensive and accurate. Physicians treating patients with cervical disc herniation must remain vigilant in guiding their patients to proper information on the Internet.     

Quality analysis of patient information on surgical treatment of haemorrhoids on the internet

Introduction

Haemorrhoids are the most common benign condition seen by colorectal surgeons. At clinic appointments, advice given about lifestyle modification or surgical interventions may not be understood fully by patients. Patients may use the internet for further research into their condition. However, the quality of such information has not been investigated before. This study assessed the quality of patient information on surgical treatment of haemorrhoids on the internet.

Methods

Four searches were carried out using the search terms ‘surgery for haemorrhoids’ and ‘surgery for piles’ on two search engines (Google and Yahoo). The first 50 results for each search were assessed. Sites were evaluated using the DISCERN instrument.

Results

In total, 200 websites were assessed, of which 144 fulfilled the inclusion criteria. Of these, 63 (44%) were sponsored by herbal remedies for haemorrhoids. Eighty-nine (62%) mentioned conservative treatment options but eleven (8%) did not include surgery in their treatment options. Only 38 sites (27%) mentioned recurrence of haemorrhoids following surgery and 28 sites (20%) did not list any complications. Overall, 19 websites (14%) were judged as being of high quality, 66 (45%) as moderate quality and 58 (40%) as low quality.

Conclusions

The quality of information on the internet is highly variable and a significant proportion of websites assessed are poor. The majority of websites are sponsored by private companies selling alternative treatments for haemorrhoids. Clinicians should be prepared to advise their patients which websites can provide high-quality information on the surgical treatment of haemorrhoids.     

Internet网上信息在护理科技论文投稿中的查询作用

利用Internet了解期刊相关信息,正确辨别护理学相关期刊的真伪,做好护理科技论文投稿前的准备,以提高期刊认知水平,帮助医护人员正确识别期刊,选择合法期刊投稿,为护理科技论文投稿提供信息参考。     

Teach-back健康教育的研究进展

介绍Teach-back的概念和在患者健康教育中实施过程、国内外应用现状、影响因素分析和应对策略,提出应用Teach-back健康教育方式能够提高患者对于医疗信息和护理技术的理解和运用,促进患者的健康结局,可为我国患者的健康教育提供指导。     

A retrospective analysis concerning physical aspects and clinical dosimetry in radiosurgery

The authors have reviewed their experience with treatments of small intracranial lesions by unconventionally fractionated stereotactic radiotherapy using a 4 MV photon beam. Treatment is carried out by multiple non coplanar arc irradiation obtained rotating the target, while kept at the isocentre of a Linac, around a vertical axis. The outmost concentration of the dose within the target volume enables consistent reduction of the amount of the absorbed dose by critical structures of the intact brain. They analyse the dose distribution and the method to optimise the choice of the therapeutic dose. Finally, some radiobiological considerations are presented.     

The simulated patient in clinical teaching

A program, using simulated patients, was devised to provide junior medical students with clinical experience in sexual, social, and marital history-taking and in sexual problem-solving. The objective of the program was to stress interview techniques and attitudes in the doctor-patient relationship. Emphasis was placed more on process than on content. Drama students as simulated patients were used to provide controlled subjects who could give feedback concerning the interviews. Fourteen drama students participated in the project for a total of 51 interviews. The results of the program indicate a positive learning experience for both the medical students and the drama students.