Effect of self-management education using pictogram-based content of health information on outcomes in Korean patients with chronic obstructive pulmonary disease: A randomized controlled trial.

OBJECTIVES: This study aimed to evaluate the effects of pictogram-based self-management education on the symptom experience, self-efficacy, self-management adherence, and health-related quality of life (HRQoL) in individuals with chronic obstructive pulmonary disease (COPD). METHODS: Sixty COPD patients were enrolled from a pulmonology clinic at C hospital in southwestern Korea and subsequently randomized into two groups. RESULTS: A significant improvement in self-efficacy scores was noted (t = -2.16, p = .035) in the intervention group compared to the control group. No significant differences were observed in symptom experience (t = 0.48, p = .637), self-management adherence (t = -0.33, p = .742), and HRQoL (t = -0.52, p = .608). CONCLUSION: Our findings suggest that the utilization of pictogram-based content in self-management education can be an effective tool for enhancing self-efficacy among COPD patients. Further research is required to evaluate the long-term effects on a broader sample size.

Development of Self-Management Pictorial Health Information and Comparison of Korean Patients' With Chronic Obstructive Pulmonary Disease and Health Care Professionals' Perceptions.

The current study aimed to evaluate pictorial health information (HI) in chronic obstructive pulmonary disease (COPD) patient self-management. Each of 14 literal examples of COPD HI was transformed into three pictorials. The preliminary pictorial COPD HI was validated by 10 experts. In total, 60 patients with COPD and 50 health care professionals (HCPs) were selected to perceive the intended meanings in the pictorial HI. All 42 pictures scored ≥0.8 on the content validity index. Patients chose pictorial HI with descriptions of subjective expressions or those that reflected a patient's actual life, whereas HCPs selected HI that was described in simple, direct, and abstract expressions. Results indicate that HCPs are better suited to provide real life-friendly pictorial HI to patients with COPD. Therefore, it is expected that developing pictograms with patients with COPD could help convey intended meanings. [Journal of Gerontological Nursing, 48(10), 41-46.].

Factors Associated with Non-Adherence to Self-Management Among Patients with Chronic Obstructive Pulmonary Disease: A Survey Using the Delphi Technique and Analytic Hierarchy Process.

Background: The relevant factors and patterns of non-adherence to self-management among patients with chronic obstructive pulmonary disease (COPD) need to be elucidated to improve self-management. Purpose: This study was a survey to prioritize the relevance of factors associated with non-adherence to COPD self-management using the Delphi technique and analytic hierarchy process (AHP). Patients and Methods: A total of 15 expert panels were established to determine the priority of relevant factors in a three-round Delphi survey and an AHP. To develop the preliminary conceptual framework for non-adherence to COPD self-management, findings from a systematic literature review, a qualitative study using in-depth interviews with COPD patients, and the first round of the Delphi survey were integrated. Based on the preliminary framework, the content validity ratio (CVR) was analyzed to examine the consensus among expert panels in the second and third rounds of the Delphi survey, and the relative weight was determined by pairwise comparisons between alternative factors in the AHP. Results: In developing the preliminary conceptual framework, 8 factor categories and 53 factors were identified as relevant to non-adherence to COPD self-management. Of the 53 factors, 22 factors with a CVR of 0.49 or higher were identified in the Delphi survey. A total of 14 of the 53 factors were common to both the Delphi survey and AHP with high weights. The most notable factors were prolonged treatment, experience of treatment failure, and unknown effects of medication. Conclusion: Through consensus decision-making by experts, 14 factors were identified as relevant factors associated with non-adherence to COPD self-management. A hierarchical and systematic framework incorporating factors associated with non-adherence to COPD self-management was developed in this study. Further research is needed to develop intervention strategies based on factors associated with non-adherence to COPD self-management.

Development of pictogram-based content of self-management health information for Korean patients with chronic obstructive pulmonary disease.

BACKGROUND: Adherence to self-management greatly impacts patients with chronic obstructive pulmonary disease (COPD) patients. However, most patients with COPD have a limitation in understanding text-based self-management plans owing to low health literacy. Thus, strategies to improve self-management in patients with COPD should be developed. OBJECTIVES: This study aimed to develop pictogram-based content comprising self-management health information for patients with COPD. METHODS: Items for COPD self-management health information were selected based on in-depth interviews with patients and text network analysis conducted in our previous study and a systematic literature review to develop preliminary pictogram-based content. Then, 30 patients with COPD and 10 healthcare professionals (HCPs) were recruited to evaluate the preliminary content using a client satisfaction questionnaire with a maximum score of 32. RESULTS: Content was developed with one item related to disease knowledge while the other 20 concerned self-management. Patients (28.70 ± 2.94) and HCPs (27.40 ± 2.84) evaluated the content as high quality with adjustments made to increase the size of the letters and shorten the number of items for readability. Twenty-one items were collated in the final booklet, while 14 of the 21 items were incorporated into a poster. CONCLUSIONS: This study indicates that the pictogram-based content was sufficiently well designed and received good evaluations from both patients with COPD and HCPs. Therefore, it may have prospects for enhancing self-management in patients with COPD. However, the effect of the content on the outcomes of older patients with COPD and low health literacy will need to be validated in future research.

[Influence of Learning Presence of Non-Face-to-Face Class Experience in Nursing Students on Academic Achievement: Mediating Effect of Learning Flow and Moderated Mediation of Digital Literacy].

PURPOSE: This study aimed to identify the mediating effect of learning flow and the moderated mediation effect of digital literacy on the effect of the learning presence of non-face-to-face class experience in nursing students on academic achievement. METHODS: Participants were 272 nursing students from six universities in two different cities. A self-report questionnaire was used to measure learning presence, learning flow, digital literacy, and academic achievement. Analysis was performed using SPSS 26.0 and SPSS PROCESS Macro (4.0). RESULTS: The mediating effect of learning flow on the effect of learning presence on academic achievement was 0.42, and the moderated mediation index of digital literacy was 0.17. Learning flow showed a mediating effect on the relationship between learning presence and academic achievement. Digital literacy had a moderated mediation effect on the relationship between learning presence and academic achievement that was mediated by learning flow. CONCLUSION: The intensity of the mediating effect of nursing students' learning presence on academic achievement through learning flow increases as the level of digital literacy increases. These results suggest that educational programs considering the level of learning presence, learning flow, and digital literacy are required to promote the academic achievement of nursing college students.