The effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction of patients undergoing cardiac catheterisation.

AIMS AND OBJECTIVES: To evaluate the effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction with the information and materials received by patients undergoing cardiac catheterisation. BACKGROUND: Cardiac catheterisation is one of the most anxiety-provoking invasive procedures for patients. However, informational education using multimedia to inform patients undergoing cardiac catheterisation has not been extensively explored. DESIGN: A randomised experimental design with three-cohort prospective comparisons. METHODS: In total, 123 consecutive patients were randomly assigned to one of three groups: regular education; (group 1), accessibility-enhanced multimedia informational education (group 2) and instructional digital videodisc education (group 3). Anxiety was measured with Spielberger's State Anxiety Inventory, which was administered at four time intervals: before education (T0), immediately after education (T1), before cardiac catheterisation (T2) and one day after cardiac catheterisation (T3). A satisfaction questionnaire was administrated one day after cardiac catheterisation. Data were collected from May 2009-September 2010 and analysed using descriptive statistics, chi-squared tests, one-way analysis of variance, Scheffe's post hoc test and generalised estimating equations. RESULTS: All patients experienced moderate anxiety at T0 to low anxiety at T3. Accessibility-enhanced multimedia informational education patients had significantly lower anxiety levels and felt the most satisfied with the information and materials received compared with patients in groups 1 and 3. A statistically significant difference in anxiety levels was only found at T2 among the three groups (p = 0·004). CONCLUSIONS: The findings demonstrate that the accessibility-enhanced multimedia informational education was the most effective informational educational module for informing patients about their upcoming cardiac catheterisation, to reduce anxiety and improve satisfaction with the information and materials received compared with the regular education and instructional digital videodisc education. RELEVANCE TO CLINICAL PRACTICE: As the accessibility-enhanced multimedia informational education reduced patient anxiety and improved satisfaction with the information and materials received, it can be adapted to complement patient education in future regular cardiac care.

A pilot study of a case management program for patients with chronic obstructive pulmonary disease (COPD).

The purpose of this study was to develop a case management program for patients with chronic obstructive pulmonary disease (COPD) and to test the effects of the developed program on patient length of stay in the hospital, medical costs, disease knowledge and level of satisfaction with nursing care received. This quasi-experimental study focused on a group of 50 COPD patients (24 in the control group and 26 in the experimental one), all treated in one hospital medical ward in northern Taiwan. The control group received routine care, while those in the experimental group received a COPD case management protocol. Data for the control group was collected between September of 2003 and January 2004. Data for the experimental group was collected between April and December 2004. Data collection instruments included medical records, the COPD Knowledge Measurement scale, and the Patient Satisfaction with Nursing Care Questionnaire. Descriptive and inferential statistical analyses were applied to describe demographics, length of stay, medical cost, patient disease-related knowledge, and patient satisfaction with nursing care. Results indicated that, while the study found no significant difference in length of stay and medical cost between the two groups, the use of case management procedures improved patient disease-related knowledge and satisfaction with nursing care. This conclusion supports the premise that case management improves patient care in these two dimensions and is, thus, an effective approach in the management of patients diagnosed with secondary COPD infections.

Retention and attrition of certified care assistants in the long-term care industry from the Taipei area: an interview survey.

BACKGROUND/OBJECTIVES: The question, "do certified care assistants (CCAs), after finishing their training, devote themselves to the long-term care industry in accordance with the original expectations?", is still unknown. Few studies have focused on CCAs who have left the long-term care industry. The purposes of this study were to identify the employment status of CCAs over the January 2000-July 2002 time period who had undergone a training program sometime in 1999 and to explore the factors affecting whether the CCAs stay or leave the long-term care industry in the Taipei area. Understanding retention and attrition of CCAs is important for developing the strategies of managing manpower in this industry. DESIGN/SETTING/PARTICIPANTS: A descriptive survey design was conducted to telephone interview 826 CCAs who had trained during the 1999 certification training program in Taipei area. Three hundred and thirteen participants (an interview-completed rate of 38%) provided usable data. METHODS: A structured interview schedule was developed by authors for interview. Descriptive statistics and chi(2) test were adopted to report the subjects' characteristics and factors that influenced his/her intention to stay or leave this industry. RESULTS: One hundred and sixty-eight respondents (53.7%) had still stayed in this industry, while 145 respondents (46.3%) had left already. Major reasons for staying were personal interest in caring elderly, good financial benefits from the facility, and supportive leadership. In contrast, low wages, heavy workloads, long working hours, a high level of stress, and poor financial benefits were factors contributing to careers leaving this industry. CONCLUSIONS: Many factors affected whether CCAs stayed or left, including personal factors, work-related factors, the welfare system, the managerial system, the leadership style and the work environment. However, the sequence of these factors and their importance were different between two groups. This study has significant implications for managing the manpower of the long-term care industry.