Patient education self-management during surgical recovery: combining mobile (iPad) and a content management system.

OBJECTIVE: The objective of this investigation was to assess whether a new electronic health (e-health) platform, combining mobile computing and a content management system, could effectively deliver modular and "just-in-time" education to older patients following cardiac surgery. SUBJECTS AND METHODS: Patients were provided with iPad(®) (Apple(®), Cupertino, CA) tablets that delivered educational modules as part of a daily "to do" list in a plan of care. The tablet communicated wirelessly to a dashboard where data were aggregated and displayed for providers. RESULTS: A surgical population of 149 patients with a mean age of 68 years utilized 5,267 of 6,295 (84%) of education modules delivered over a 5.3-day hospitalization. Increased age was not associated with decreased use. CONCLUSIONS: We demonstrate that age, hospitalization, and major surgery are not significant barriers to effective patient education if content is highly consumable and relevant to patients' daily care experience. We also show that mobile technology, even if unfamiliar to many older patients, makes this possible. The combination of mobile computing with a content management system allows for dynamic, modular, personalized, and "just-in-time" education in a highly consumable format. This approach presents a means by which patients may become informed participants in new healthcare models.

Health-related quality of life in inflammatory bowel disease: psychosocial, clinical, socioeconomic, and demographic predictors.

BACKGROUND AND AIMS: Individuals with inflammatory bowel disease (IBD) have impaired health-related quality of life (HRQOL). Managing HRQOL is increasingly becoming an important treatment consideration in IBD. Understanding factors that impact HRQOL may facilitate interventions to improve HRQOL and overall IBD management. We hypothesized that psychosocial variables, namely perceived stress, perceived social support, and knowledge, would be associated with HRQOL among individuals with IBD. METHODS: A total of 134 adults with IBD were recruited online from IBD support groups. HRQOL was measured using the inflammatory bowel disease questionnaire (IBDQ). Perceived stress, perceived social support, and knowledge of IBD were measured using standardized questionnaires. Clinical and demographic variables were gathered through a 16-item study questionnaire. Univariate analyses were conducted to determine which variables were associated with HRQOL, and those that were statistically significant were entered into a multivariate regression model. RESULTS: Results from univariate analyses revealed significantly lower HRQOL in individuals who: reported higher perceived stress, higher number of previous hospitalizations and relapses, lower perceived support, lower income, were unemployed, and were female. Multivariate analyses revealed that the variables most strongly associated with HRQOL were perceived stress (p<0.001), number of previous IBD relapses (p<0.001), gender (p<0.001), and perceived social support (p<0.05). CONCLUSION: Individuals with IBD who report higher perceived stress, lower perceived social support, greater number of relapses, or are female may be at increased risk for decreased HRQOL. Prospective studies should investigate how interventions addressing these factors may lead to improved HRQOL.

Disease-specific knowledge, coping, and adherence in patients with inflammatory bowel disease.

BACKGROUND: Little is known about the effects of disease-related education and knowledge in individuals with inflammatory bowel disease (IBD). The limited available research on this topic suggests there may be potential benefits to disease-related patient education. We hypothesized that individuals with greater IBD knowledge would have more coping strategies and higher medication adherence. METHODS: A total of 111 adults with IBD residing in the United States were recruited online by convenience sampling from IBD support group forums. IBD knowledge, coping, and medication adherence were assessed using standardized questionnaires. Data on seventeen clinico-demographic variables were also collected. A Pearson correlation was conducted to examine the relationship between IBD knowledge and use of coping strategies and also between IBD knowledge and medication adherence. Multivariate regression and one-way ANOVA tests were used to assess the continuous and categorical clinico-demographic variables, respectively, for potential confounding. RESULTS: A significant positive association was found between greater IBD knowledge and active coping scores (r = 0.189, P = 0.024), instrumental support scores (r = 0.160, P = 0.047), planning scores (r = 0.159, P = 0.048), and emotional support scores (r = 0.159, P = 0.048). A relationship between knowledge and adherence score was not found. Significant relationships were found between four clinico-demographic variables and coping. CONCLUSION: Greater IBD knowledge appears to be associated with the use of more adaptive coping strategies in patients with IBD, suggesting that providing disease-related patient education may enhance coping in this population. Future studies should explore the utility of formal disease-related patient education in improving these and other outcomes.