Adaptation of the health literacy universal precautions toolkit for rheumatology and cardiology – Applications for pharmacy professionals to improve self-management and outcomes in patients with chronic disease

Over a decade of research in health literacy has provided evidence of strong links between literacy skills of patients and health outcomes. At the same time, numerous studies have yielded insight into efficacious action that health providers can take to mitigate the negative effects of limited literacy. This small study focuses on the adaptation, review and use of two new health literacy toolkits for health professionals who work with patients with two of the most prevalent chronic conditions, arthritis and cardiovascular disease. Pharmacists have a key role in communicating with patients and caregivers about various aspects of disease self-management, which frequently includes appropriate use of medications. Participating pharmacists and staff offered suggestions that helped shape revisions and reported positive experiences with brown bag events, suggestions for approaches with patients managing chronic diseases, and with concrete examples related to several medicines [such as Warfarin^©] as well as to common problems [such as inability to afford needed medicine]. Although not yet tested in community pharmacy sites, these publically available toolkits can inform professionals and staff and offer insights for communication improvement.     

基于案例的Teach-back在肿瘤患者预防跌倒 健康教育中的应用

目的 探讨基于案例的Teach-back法在肿瘤患者预防跌倒健康教育中的应用效果。方法 选取我科2016年6-12月120例肿瘤患者作为对照组,2017年1-6月140例肿瘤患者作为观察组。对照组实施传统预防跌倒健康教育,观察组采用基于案例的Teach-back法实施预防跌倒的健康教育。比较2组患者跌倒防范措施依从率、跌倒发生率的差异。结果 观察组患者跌倒防范措施依从率为97.63%,明显高于对照组的85.18%(χ²=2 774.640,P<0.001),患者跌倒发生率低于对照组(χ²=5.119,P=0.024)。结论 在肿瘤跌倒高风险患者中运用基于案例的Teach-back对患者进行健康教育,能有效提高患者跌倒防范措施的依从率,降低患者跌倒发生率,值得临床推广。     

Characteristics of teach-back as practiced in a university health center,and its association with patient understanding,self-efficacy,and satisfaction

ObjectivesThe purpose of this research was to investigate the extent to which recommended characteristics of teach-back were employed by providers in a university Student Health Services department, and to evaluate its association with patient understanding, self-efficacy, and satisfaction.MethodThe study employed a causal comparative design. Audio recordings of 87 primary care interviews were transcribed and coded for presence and characteristics of teach-back. Patients and providers filled out post-encounter questionnaires.ResultsWhen teach-back was used, most recommended characteristics of teach-back were regularly employed. However, providers rarely placed the onus for understanding on themselves, and almost never “closed the loop” by asking patients to repeat back information until they got it correct. Teach-back was associated with higher patient self-efficacy, and high fidelity of implementation with better patient understanding of the reason for the treatment plan.ConclusionsFindings add to existing evidence regarding effectiveness of teach-back. Additional benefits may be realized when implementation is true to recommended characteristics. More research is needed into the necessity of closing the loop and placing onus on the provider.Practice implicationsGiven that neither patients nor providers accurately gauged the level of patient understanding in the medical encounter, teach-back may offer a simple, quick means of reinforcing provider health information and raising patient self-efficacy.     

微视频联合Teach-back教学对呼吸与危重症医学科技能带教效果的影响

目的 探讨分析微视频联合Teach-back教学对呼吸与危重症医学科技能带教效果的影响.方法 选择2019年1月—2020年7月院中130名呼吸与危重症医学科实习护士,按照组间基本特征具有可比性的原则分为对照组和观察组,每组65名.对照组接受常规教学,观察组进行微视频联合Teach-back教学,对两组实习护士带教效果...     

A scoping review of communication tools applicable to patients and their primary care providers after discharge from hospital

ObjectiveTransitions from hospital to home are high-risk episodes. Communication problems between patients/carers and their primary healthcare providers are a central part of the risk. This literature review aimed to identify any existing tools or information (including secondary care instruments) that would facilitate designing new communication instruments for primary care to manage and mitigate risk at discharge.MethodFive databases (Pubmed, Embase, Cinahl, Web of Science and Cochrane) were searched using a three stem approach (primary/transitional care, discharge period, communication). A dual reviewer system was used, following PRISMA guidelines.ResultsFrom 61 full text articles a total of ten tools were found, 25 articles contained other useful content, 19 further tools were found in grey literature. Most material originated from the USA and described hospital-based transitional care interventions.ConclusionNo ready-made patient/provider communication tool for the post-discharge period in primary care was found. Future communication tools should enhance education and engagement of patients so they feel able to initiate communication.Practice implicationsCollating post-discharge communication material is of importance to improving the safety of care transitions and will enable creation of new tools specifically designed for primary care. These tools will improve patient activation (‘the knowledge, skills and confidence a person has in managing their own health and care’) with the ultimate aim of reducing error and harm in primary care through improved communication of healthcare decisions.     

Teach-back方法对改善乳腺癌术后患者淋巴水肿上肢功能的作用

目的探讨Teach-back方法对改善乳腺癌术后患者淋巴水肿上肢功能的效果。方法选取2018年10月至2019年10月无锡第二人民医院收治的乳腺癌术后淋巴水肿患者104例,根据随机数字表分为观察组及对照组各52例。两组患者均行患肢功能锻炼,对照组锻炼期间行常规健康指导,观察组采用Teach-back方法指导患者进行功能锻炼。比较两组患者功能锻炼依从性、功能锻炼技能掌握评分、患者功能恢复及生活质量改善情况。结果干预后观察组患者功能锻炼依从性评分、功能锻炼技能掌握评分、Constant-Murley肩关节功能评分及生活质量总评分高于对照组(均P<0.05),且患肢淋巴水肿较对照组明显改善(P<0.05)。结论Teach-back方法能有效提高乳腺癌术后淋巴水肿患者功能锻炼依从性及技能,从而有效减轻患者淋巴水肿,改善患肢功能,提高患者术后生活质量。     

Teach-back方法在先天性心脏病患儿父母健康教育中的应用评价杨玲 夏英华 边燕

【】目的 探讨Teach-back健康教育在先天性心脏病介入治疗中的应用。方法 选择2015年1~12月在我院小儿心血管科行介入治疗的60名先天性心脏病患儿的父母作为研究对象,对照组采用传统的健康教育方法,实验组采用Teach-back健康教育对患儿父母实施宣教。结果 实施Teach-back健康教育后实验组患儿父母与对照组比较,疾病知识得分由8.02±0.78增加到9.67±0.66、日常护理方法得分由8.83±1.01增加到9.94±0.92、复诊要求由9.11±0.92增加到9.95±0.87;实验组患儿父母出院时SAS得分显著低于对照组;患儿父母满意度得分由92.82±5.42提高到98.21±5.09。结论 Teach-back健康教育可以改善健康教育效果,降低患儿父母焦虑水平,提高对护理的满意度。     

回授法饮食管理对腹膜透析患者饮食依从性及营养状况的影响

目的 探讨回授法饮食管理对改善腹膜透析患者饮食依从性及营养状况的效果。方法 采用抽签法,将新院区腹膜透析患者纳入试验组,老院区患者纳入对照组,分别便利抽取40例,试验组在常规饮食管理的基础上,实施回授法饮食管理,对照组实施常规饮食管理。结果 干预3个月后,试验组饮食依从态度总分、饮食依从行为总分均高于对照组,差异有统计学意义（P<0.001）;3日饮食日记结果中蛋白质、饮食热量、总热量、钠、钾、液体摄入量等与对照组相比,差异均有统计学意义（P<0.05）;与对照组相比,试验组营养不良发生率降低（ χ²=6.646,P=0.010）,血红蛋白（t=2.247,P=0.036）、白蛋白水平（t=2.547,P=0.017）有所改善。结论将回授法应用到腹膜透析患者的饮食管理中可提高患者的饮食依从性,督促患者形成良好的饮食行为,改善患者的营养状况。