The readability of a text written by the target group is an essential concept in the scope of patienteducation. Following design, corrections, and revisions; hundreds of patienteducation pamphlets are annually published in healthcare centers by experts and professionals and different indices are employed for their evaluation process. But it seems that majority of these indices are qualitative and general and do not benefit form enough transparency. Some of these manuscripts are written by students under the supervision of professors and experienced nurses and some others are developed by experts with relevant education, expertise, as well as theoretical and clinical skills. Therefore, the basic questions raised are what indices can be used in the evaluation of such materials? How such indices can become quantitative or judgments about educational contents for patients can be made objective? How the grounds of corrections and revisions can be based on objective and real research findings considering the direct and indirect expenses? In this respect, reviews showed that there are indices to accomplish such objectives which can be obtained through further investigations and validations. The application of readability indexes in order to change the level of pamphlets is based on the needs of society and the average level of literacy in society is likely to be affected in different periods. There are two techniques for the content analysis of educational materials including readability formulas and use of qualitative evaluation tools for written materials (5, 6).
ABSTRACT Introduction: Although, the effects of patienteducation on the effective anticoagulant management, among patients undergoing heart valve replacement with a mechanical prosthesis, have been reported, the evidence of this association remains inconclusive. Aim: To investigate the effect of a nurse-led patienteducation program for oral anticoagulant therapy on the incidence of thromboembolic and hemorrhagic episodes after surgical heart valve replacement. Methods: A quasi-experimental study was conducted. Patients were allocated to a) a control group (n=100), including those who received the usual education on oral anticoagulants, and b) an intervention group (n=100), with those who attended a nurse-led education program, postoperatively, including verbal courses and written material through an education booklet. We investigated the incidence of hemorrhagic and thromboembolic episodes three months after patients’ hospital discharge. Patients’ socio-demographic and clinical characteristics were obtained using a structured short questionnaire and through the medical and nursing patient records review. Patients’ follow-up data were collected via phone interviews. Results: The baseline characteristics were similar for both groups. Patients who received nurse-led education on oral anticoagulant therapy had a significantly lower 3-month incidence of hemorrhagic episodes compared with controls (1% vs. 14%, p<0.001). However, we found insignificant differences in the 3-month incidence of thromboembolic events between the two groups. Conclusion: The implementation of a nurse-led education program on oral anticoagulants management failed to show effectiveness on the 3-month incidence of thromboembolic episodes. However, this educational intervention seems to be superior to the general patienteducation, leading to the significantly lower occurrence of hemorrhagic episodes.
This randomised study proves positive effects of patienteducation on achieving improvements in therapeutic immunosup- pression levels. Tablet-PC based education proved non-inferior to personal conventional education and may help physicians to improve effectiveness of education. Due to limitations in computer literacy and handling of electronic devices, specialist input was still required. Tablet-PC education now represents an integral component in our routine management of outpatients demon- strating poor immunosuppressive treatment control. Once estab- lished, the same equipment may be used for different aspects of patienteducation (e.g., therapy with azithromycine or bronchial stenting), adding greatly to their cost effectiveness.
Our results are consistent with previous findings[6,15,16,17,18] and raise some issues. First, the use of surrogate outcomes is particularly problematic in studies of educational interventions, which showed a poor association of surrogate and relevant outcomes. Indeed, improving knowledge and coping skills does not necessarily lead to positive behavioural change, and such change does not always result in better health outcomes[2,7,8,19].We found that one third of RCTs of educational interventions do not use patient-important outcomes, only surrogate outcomes, so some of the healthcare research conducted in patienteducation will be of little use for both clinicians and patients.
were scored on the following: ownership (statement of pro- vider, or any form of support), purpose (education, profits), authorship (author’s name), author qualification, attribution (references and sources citation), interactivity, and currency (first posting date and subsequent revision dates). Each of these characteristics were further divided into other subhea- dings (Table 1), which then received a score of 0, 1, or 2, depending on the amount of information provided, for a total score of 13.
r egar d in g im m edi at e p o st o per at i v e rehabilitat ion and it s dosage w ere limited, best possible effort w as m ade t o for m ulat e t he dosage and descript ion of exercises during t his phase w it h t hese limit ed evidences. How ever more randomized cont rolled t rials are needed t o come t o a conclusive dosage. Post operat ive exercises of t he init ial phase i.e. from 1-3 w eeks w as included in t he booklet , for lat er m ore specific rehabilitat ion patient s w ould be advised t o go t o outpat ient rehabilitation depart ment as t he mot ive of pat ient educat ion material is not t o provide it as a subst it ut ion for physiot herapy. The expert team was alt hough consulted for t he images but no detailed analysis or review of images was done because of lack of t ime. After modificat ions were done in step 3, t he final booklet was completed by making an att ract ive front cover by t he researcher. The follow ing informat ion was also provided in t he booklet : cont act inform at ion for any suggest ions, t he copyr ight st at em ent , t he out com es of t he surgery may vary, all exercises described is for init ial phase of rehabilitat ion and may not be p er f o r m ed by ever y pat i en t . Fi n al l y acknow ledgem ent and list of cont ent s w as added before t he actually content of t he booklet st art s.
Sensitivity to ethnic and cultural diversity. As we in the medical community focus on which foods are most important for optimal health, ethnic and cultural diversity becomes an important point for consideration. The typical diet of our study population as revealed by food diaries included high calorie, high fat intake. Subjects were not used to eating whole grains, fruits and vegetables, legumes, and nuts. The low-glycemic-load, Mediterranean diet was a drastic change for many, and required new culinary skills and, as ma ny suggested, “a new palate”. Subjects found it difficult to give up creamy sauces, breads, and southern iced tea. To combat food traditions replete with high carbohydrates, fried, fatty foods, and sweetened beverages, patienteducation was a highly effective tool. Most participants began the study with a very limited food repertoire, but after expanding the types of foods in their diet they saw that it was possible to follow the dietary food plan. Frequently this involved trying new foods; for example, at the start of the study, many did not know what whole grains were, or how to purchase them. Once patients understood the role of phytonutrients in health, and could identify foods containing “good fats”, they became motivated to eat a variety of fruits and vegetables, legumes, and nuts. Simply eliminating soda from the diet resulted in a significant decrease in carbohydrate intake. While dialogue is ongoing with regard to the types of diet that are best for human health, clearly identifying a diversity of healthy foods that can be integrated easily into ethnic traditions or cultural lifestyles will improve reception of and adherence to lifestyle changes.
9 . Gibson PG, Walters EH, Coughlanj, Wilson AJ, Hensley MJ, Abram- son M, et al. Limited (information only) patienteducation programs for adults with asthma. Cochrane Database Syst Rev CD001005 2000;2. 10. Green RJ, Adam B, Greenblatt MM, Plit M, Jones S. Asthma manage- ment and perceptions in rural South Africa. Ann Allergy Asthma Im- munol 2001;86:343-7.
Results: The final version of the tool had 19 questions arranged in ten areas of importance for patienteducation. The proposed questionnaire had a clarity index of 8.94 ± 0.83. The intraclass correlation coefficient was 0.856, and Cronbach’s alpha, 0.749. Factor analysis revealed five factors associated with the knowledge areas. Comparing the final scores with the characteristics of the population evidenced that low educational level and low income are significantly associated with low levels of knowledge.
type of sample and the fact that participants were recruited from only one site also limits this study. Therefore, the Portuguese CADE-Q SV should be administered in other health programs and Brazilian states, to ensure it is appropriate and performs well in more general settings. Finally, future research is needed to assess whether the scale is sensitive to change, such as following participation in CR, or to test implementation of new education materials. Second, whether CADE-Q SV is a valuable and valid tool to identify knowledge differences in CR patients should be explored. 30 For this study patients did not receive any
Patients use medical services and participate according to their level of health literacy. Medical services are offered offline or online. Medical services based on the information management capabilities of the Patient Centered Infrastructure are better understood by patients and support patient participation in healthcare procedures. Patients get decision support by consuming second opinion services or from the specific patient community that is associated with a service. Patients may document their personal level of health literacy by giving fine grained access to their
Event reporting is critical for identifying patient safety issues and represents a core prerequisite of effective clinical risk management (31). Effective events reporting requires an atmosphere in which employees can, with no fear of punishment, report the actual or potential errors and mistakes which is the main property of a non-punitive safety culture 2, the present study showed that this aspect of safety culture had the lowest score in all of these hospitals. Similar findings have been observed in previous studies (31, 33) Amiresmaili et al. (30) found that punitive response to error to be the most significant weakness of patient safety culture in their study, this finding reinforce the necessity of developing a non-punitive climate in Iranian hospitals, in addition, Jeongeun et al. concluded that most of nurses in Korean hospitals do not feel free to express their concern on patient safety issues, and the fact that event reporting and safety culture did not caught attentions sufficiently(33) It is apparent that when there is fear in the hospital, staff will do everything possible to hide errors and filter data (34) because they believe that mistakes they make are kept in their personal file and if this kind of perception is institutionalized across the hospital, no learning based on previous mistakes will be achieved and this seriously threaten patient safety.
Objectives: To describe the guidelines that the nurse performs the caregivers of patients on contact precautions and identify the knowledge of caregivers about the care of contact. Method: This qualitative and descriptive, against the backdrop of a state hospital located in the municipality of Rio de Janeiro, as 10 individuals accompanying patients to care for contact and 10 nurses. The project was approved by research ethics committee of the Faculty of Medicine, Federal Fluminense University, under number 267/10. Data were collected through semi-structured and analyzed in thematic categories. Results: 80% of caregivers had little knowledge of precautionary contact and 20% had no knowledge. 100% of the nurses performed their accompanying guidelines. Conclusion: We conclude that the advice given by nurses improved the understanding of the companions of patients in relation to control measures, especially use of personal protective equipment, working then for prevention of nosocomial infection. Descriptors: Nursing, Precaution, Cross infection, Health education.
Resumo: In Intensive Medicine, the presentation of medical information is done in many ways, depending on the type of data collected and stored. The way in which the information is presented can make it difficult for intensivists to quickly understand the patient’s condition. When there is the need to cross between several types of clinical data sources the situation is even worse. This research seeks to explore a new way of presenting information about patients, based on the timeframe in which events occur. By developing an interactive Patient Timeline, intensivists will have access to a new environment in real-time where they can consult the patient clinical history and the data collected until the moment. The medical history will be available from the moment in which patients is admitted in the ICU until discharge, allowing intensivist to examine data regarding vital signs, medication, exams, among others. This timeline also intends to, through the use of information and models produced by the INTCare system, combine several clinical data in order to help diagnose the future patients’ conditions. This platform will help intensivists to make more accurate decision. This paper presents the first approach of the solution designed.
Another concern, which pertains to education in general, is when the student does not do the homework, in this case, to watch the online material before class. A flipped class requires students to be willing to take responsibility for their learning. While the focus of the Flipped Classroom is no longer the faculty as the “sage on the stage” but rather the “guide on the side”, it provides a setting where students receive personal attention still held accountable for actions and academic performance (Hawks, 2014). Students who do not watch the online material before class will not be able to participate in the in-class activities fully and proceed to the application tasks. To ensure greater compliance, instructors can track the knowledge gained from the homework or they can adjust the class activities for unprepared students, if they are in fact unprepared (Kachka, 2012). This might be achieved by insisting that the unprepared students watch the video during class time (the preparatory work that is required so as to be able to proceed to the application tasks) while the rest of the class deepens their knowledge through other activities, i.e. the unprepared student misses out part of the class interaction at the beginning of the class and joins the class once the video is viewed.
Hence, the CE is focused on the concept of education as transmission of knowledge and appreciation of science as a source of knowledge; it is punctual, fragmented and constructed in a way that is not articulated with the management process and the social control, it focuses on professional categories and the technical and scientific knowledge of each area, with an emphasis on courses and training built on the diagnosis of individual needs, and puts itself in the perspective of transforming the organization in which the professional is inserted. 13
Patients were divided in two groups according to glycemic control based on the levels of HbA1C. Twenty-nine patients (53%) comprised the controlled group, and 26 (47%) were in the uncontrolled group. Table 1 compares the charac- teristics of both the patients and the IPC associated with glycemic dyscontrol. As noted, there were statistically sig- nificant differences in some patient-related factors: longer duration of DM1, non-adherence to medical indications, and dietetic transgression. It was also determined the follow- ing ICP factors were associated with uncontrolled glycemia: lower educational level, presence of depression, stress, and family dysfunction.
Few studies report outcomes related to individual behaviour, usually reported as practitioners’ working in a more collaborative manner with their colleagues from other professional groups. Of those studies which do provide evidence at this level, positive change in individual practitioners’ interactions is usually cited. A number of studies report positive changes to organizational practice resulting from the delivery of IPE. Research used to report this type of outcome usually focus on changes to interprofessional referral practices/working patterns or improved documentation (i.e. guidelines, protocols, use of shared records) related to the organization of care. A smaller amount of studies report changes to the delivery of care to patients/clients. These studies typically reported positive changes to clinical outcomes (e.g. infection rates, clinical error rates), patient satisfaction scores and/or length of patient stay.
Nutrition education for the CF patient and family should be provided at the time of diagnosis and continued as part of the routine therapeutic intervention. The recommendation of a high-energy diet with no restrictions on fat intake, the use of high-calorie supplements when indicated and optimization of enzyme replacement therapy should be emphasized. Such a program is simple and inexpensive and may prevent malnutrition, foster normal growth and weight gain, postpone the use of invasive intervention methods and possibly delay progression of lung disease.