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1.
Cancer Control ; 28: 1073274821989709, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33563050

RESUMEN

The 2019 novel coronavirus (COVID-19) pandemic has prompted the reorganization in the scheduling and method of care for many patients, including patients diagnosed with cancer. Cancer patients, who have an immunocompromised status, may be at a higher risk of severe symptoms from infection with COVID-19. While information is rapidly evolving regarding COVID-19, Canada, both nationally and provincially, has been conveying new information to patients online. We assessed the content and readability of COVID-19-related online Canadian patient education material (PEM) for cancer patients to determine if the content of the material was written at a grade reading level that the majority of Canadians can understand. PEMs were extracted from provincial cancer agencies and the national Canadian Cancer Society, evaluated using 10 readability scales, qualitatively analyzed to identify their themes and difficult word content. Thirty-eight PEMs from both national and provincial cancers associations were, on average, written above the recommended 7th grade level. Each of the associations' average grade levels were: BC Cancer (11.00 95% confidence interval [CI] 8.27-13.38), CancerControl Alberta (10.46 95% CI 8.29-12.62), Saskatchewan Cancer Agency (11.08 95% CI 9.37-12.80), Cancer Care Manitoba (9.55 95% CI 6.02-13.01), Cancer Care Ontario (9.35 95% CI 6.80-11.90), Cancer Care Nova Scotia (10.95 95% CI 9.86-12.04), Cancer Care Eastern Health Newfoundland and Labrador (10.14 95% CI 6.87-13.41), and the Canadian Cancer Society (10.06 95% CI 8.07-12.05). Thematic analysis identified 4 themes: public health strategy, information about COVID-19, patient instructions during COVID-19, and resources. Fifty-three percent of the complex words identified were medical jargon. This represents an opportunity to improve PEM readability, to allow for greater comprehension amongst a wider target audience.


Asunto(s)
/prevención & control , Servicios de Salud , Oncología Médica/métodos , Neoplasias/terapia , Educación del Paciente como Asunto/métodos , /aislamiento & purificación , /epidemiología , Canadá , Comprensión , Alfabetización en Salud , Humanos , Neoplasias/diagnóstico , Pandemias , Educación del Paciente como Asunto/estadística & datos numéricos , Educación del Paciente como Asunto/tendencias , Lectura , /fisiología
3.
Artículo en Inglés | MEDLINE | ID: mdl-33579729

RESUMEN

BACKGROUND: The global COVID-19 pandemic has impacted on the mental health of individuals, particularly those with chronic illnesses. We aimed to quantify stress, anxiety and depression among individuals with Inflammatory bowel disease (IBD) in Australia during the pandemic. METHODS: An electronic survey was made available to IBD patients Australia-wide from 17 June to 12 July 2020. Respondents with an underlying diagnosis of IBD and over 18 years of age were included. A validated questionnaire (Depression, Anxiety, Stress Score-21, DASS21) was used to assess depression, anxiety and stress. Data on potential predictors of depression, anxiety and stress were collected. RESULTS: 352 participated in the survey across Australia. 60.5% of respondents fulfilled DASS criteria for at least moderate depression, anxiety or stress. 45% reported a pre-existing diagnosis of depression and/or anxiety. Over 2/3 of these respondents reported worsening of their pre-existing depression/anxiety due to the current pandemic. Of those without a pre-existing diagnosis of anxiety or depression, high rates of at least moderate to severe depression (34.9%), anxiety (32.0%) and stress (29.7%) were noted. Younger age (OR 0.96, 95% CI 0.94 to 0.98, p<0.001), lack of access to an IBD nurse (OR 1.81, 95% CI 1.03 to 3.19, p=0.04) and lack of education on reducing infection risk (OR 1.99, 95% CI 1.13 to 3.50, p=0.017) were associated with significant stress, anxiety and/or depression. CONCLUSION: High prevalence of undiagnosed depression, anxiety and stress was identified among respondents. Improved access to IBD nurse support and greater attention to education are modifiable factors that may reduce depression, anxiety and/or stress among patients with IBD during the pandemic.


Asunto(s)
Ansiedad/epidemiología , Depresión/epidemiología , Enfermedades Inflamatorias del Intestino/psicología , Pandemias , Estrés Psicológico/epidemiología , Adulto , Australia/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Enfermedades Inflamatorias del Intestino/enfermería , Masculino , Persona de Mediana Edad , Atención de Enfermería , Educación del Paciente como Asunto , Prevalencia , Conducta de Reducción del Riesgo
4.
Rev Bras Enferm ; 74Suppl 1(Suppl 1): e20200602, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33605362

RESUMEN

OBJECTIVE: To report the experience of a Virtual Culture Circle with Brazilian families about coping with COVID-19, as a space that promotes health during the pandemic. METHOD: Experience resulting from an extension action, the Virtual Culture Circle was held based on Paulo Freire's Research Itinerary. It counted with the participation of seven families from different locations in Brazil. During the dialogues, a house was built: the foundation represented the thematic research; walls and roof, coding and decoding; doors and windows, the critical unveiling. RESULTS: The action-reflection-action process favored the approach and integration of the participants of the Culture Circle; despite the geographical distance, it is an innovative strategy for empowerment and health promotion. FINAL CONSIDERATIONS: The Virtual Culture Circle constituted a soft technology for health care and can be explored as a tool for promoting health, especially in scenarios where face-to-face meetings are an impossibility.


Asunto(s)
Adaptación Psicológica , Promoción de la Salud/métodos , Educación del Paciente como Asunto/métodos , Realidad Virtual , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa
5.
Nutrients ; 13(2)2021 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-33530570

RESUMEN

Childhood obesity is a worldwide health emergency. In many cases, it is directly linked to inappropriate eating habits and a sedentary lifestyle. During lockdown aimed at containing the coronavirus disease (COVID-19) spread, children have been forced to stay at home. The present study aimed at investigating the lifestyles of outpatients (aged 5-17 years) with complicated obesity enrolled in the day-hospital food education program at the Children's Hospital Bambino Gesù in Rome. A survey was performed based on a structured questionnaire, investigating dietary habits and lifestyles. The questionnaire answers were rated as "yes/no/sometimes" or "often/never/sometimes". Eighty-eight families correctly completed the questionnaire between March and May 2020. The results highlighted that 85.2% (N = 75) of the patients ate breakfast regularly, and 64.3% (N = 72) consumed fruit as an afternoon snack. However, 21.6% (N = 19) did just "often" home workouts, and 50.0% (N = 44) reported an increase of feeling hungry with "sometimes" frequency. There is a significant relationship of feeling hungry with gender (p < 0.0001) and age (p = 0.048) and, also, between gender with having breakfast (p = 0.020) and cooking (p = 0.006). Living a healthy lifestyle during lockdown was difficult for the outpatients, mainly due to the increase in a sedentary lifestyle and the increase in feeling hungry, but some healthy eating habits were maintained, as advised during the food education program provided before lockdown.


Asunto(s)
/prevención & control , Dieta Saludable , Conducta Alimentaria , Educación del Paciente como Asunto , Obesidad Pediátrica/prevención & control , Cuarentena , Encuestas y Cuestionarios , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Obesidad Pediátrica/epidemiología
7.
J Korean Med Sci ; 36(3): e31, 2021 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-33463097

RESUMEN

The coronavirus disease 2019 pandemic has caused a breakdown in the healthcare system worldwide. The need to rapidly update guidelines in order to control the transmission in the population and for evidenced-based healthcare care has led to the need for timely, voluminous and valid research. Amid the quest for a vaccine and better therapies, researchers clamouring for information has led to a wide variety of ethical issues due to the unique situation. This paper aims to examine the positive and negative aspects of recent changes in the process of obtaining informed consent. The article outlines the various aspects, from history, previously described exemptions to consenting as well as those implemented during the pandemic and the current impact of virtual methods. Further, the authors make recommendations based on the outcome of suggested adjustments described in the literature. This article looks into increasing the awareness of physicians and researchers about ethical issues that need to be addressed to provide optimal care for patients while assuring their integrity and confidentiality.


Asunto(s)
Consentimiento Informado/ética , Edición/ética , /prevención & control , /transmisión , Medicina Basada en la Evidencia , Disparidades en Atención de Salud/ética , Humanos , Pandemias , Educación del Paciente como Asunto/ética , Relaciones Médico-Paciente/ética
8.
Medicine (Baltimore) ; 100(2): e23972, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466136

RESUMEN

BACKGROUND: The purpose of this experiment is to evaluate the impact of the care of Parkinson disease nurse specialist on improving motor symptoms and life quality for patients with Parkinson disease (PD). METHOD: This is a randomized controlled research, and it will be conducted from April 2021 to October 2021 at Sichuan Provincial People's Hospital. The experiment was granted through the Research Ethics Committee of Sichuan Provincial People's Hospital (004510293). All the patients suffer from PD, age 18 years or older, both female and male, regardless of the duration or severity of this disease are eligible. The exclusion criteria contains: lack sufficient knowledge to complete questionnaires, serious physical comorbidities or refuse to take part in the program. In our experiment, the major result measures are motor symptoms and life quality. For the measurement of life quality, we will utilize Parkinson disease Questionnaire-39, the most extensively utilized the scale of life quality in PD. The evaluation of motor symptoms severity is carried out with the revision of Unified Parkinson Disease Rating Scale sponsored by Movement Disorder Society. RESULTS: Table 1 indicates clinical outcomes at different time points. CONCLUSION: The Parkinson's disease nurse specialist care may promote the life quality in the PD patients. TRIAL REGISTRATION NUMBER: researchregistry 6284.


Asunto(s)
Enfermedad de Parkinson/enfermería , Enfermedad de Parkinson/psicología , Calidad de Vida/psicología , Humanos , Planificación de Atención al Paciente/organización & administración , Educación del Paciente como Asunto/organización & administración , Automanejo/métodos , Índice de Severidad de la Enfermedad
9.
Medicine (Baltimore) ; 100(1): e24208, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33429812

RESUMEN

OBJECTIVE: To explore the influence of the education of lifestyle in the type 2 diabetes mellitus (T2DM) patients with microalbuminuria as a part of the enhanced multifactorial intervention. METHODS: This study will be conducted from May 2021 to August 2022 at Ningbo No.6 hospital. The experiment was granted through the Research Ethics Committee of Ningbo No.6 hospital (539D035). The patients will be included if they are between 18 and 65 years old and are diagnosed with T2DM with microalbuminuria and the patients who have signed the written informed consent. While the patients will be excluded if they have serious physical comorbidities and patients who are unwilling to offer the informed consent to take part in this experiment. We measure the clinical examination (fasting blood-glucose, glycosylated hemoglobin and routine urine test) timely. Detail of daily dietary intake and lifestyle factors are also recorded. RESULTS: Table 1 reflects the comparison of the biochemical and clinical variables and the lifestyle factors. CONCLUSION: Lifestyle education is effective in facilitating the control of T2DM and reducing microalbuminuria. TRIAL REGISTRATION NUMBER: researchregistry6348.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Educación del Paciente como Asunto , Asunción de Riesgos , Albuminuria/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Humanos
11.
Medicina (Kaunas) ; 57(1)2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33430427

RESUMEN

Background and objectives: Limited evidence exists exploring perceptions of which aspects of a pain management program are perceived as valuable and impactful. The aim of this study was to explore patient beliefs about which aspects of a pain management program were valued and/or had perceived impact. Materials and Methods: One-on-one structured interviews were conducted with 11 adults three months after their completion of the Spark Pain Program at Westmead Hospital, Sydney, Australia. Concepts in the transcripts were inductively identified and explored, utilizing thematic analysis to better understand their relevance to the study aim. Results: Four themes emerged: (1) "The program overall was positive, but…"; (2) "I valued my improved knowledge and understanding of pain, but…"; (3) "I valued the stretching/relaxation/pacing/activity monitoring"; and (4) "I valued being part of a supportive and understanding group". Participants reported that they liked being treated as an individual within the group. A lack of perceived personal relevance of key messages was identified in some participants; it appears that patients in pain programs must determine that changes in knowledge, beliefs, and attitudes are personally relevant in order for the changes to have a significant impact on them. Conclusions: This study provides new insights into aspects of a pain management program that were perceived as valuable and impactful, areas that "missed the mark", and hypotheses to guide the implementation of service delivery and program redesign.


Asunto(s)
Dolor Crónico/terapia , Terapia por Ejercicio , Conocimientos, Actitudes y Práctica en Salud , Ejercicios de Estiramiento Muscular , Manejo del Dolor/métodos , Educación del Paciente como Asunto , Terapia por Relajación , Adulto , Anciano , Actitud Frente a la Salud , Australia , Duración de la Terapia , Femenino , Objetivos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Percepción , Solución de Problemas , Investigación Cualitativa
12.
Postgrad Med ; 133(1): 1-9, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33423590

RESUMEN

Pregabalin is one of the first-line treatments approved for the management of neuropathic pain (NeP). While many patients benefit from treatment with pregabalin, they are often treated with suboptimal doses, possibly due to unfamiliarity around prescribing the drug and/or side effects that can occur with up-titration. This narrative review discusses key aspects of initiating, titrating, and managing patients prescribed pregabalin therapy, and addresses concerns around driving and the potential for abuse, as well as when to seek specialist opinion. To ensure that patients derive maximum therapeutic benefit from the drug, we suggest a 'low and slow' dosing approach to limit common side effects and optimize tolerability alongside patients' expectations. When requiring titration to higher doses, we recommend initiating 'asymmetric dosing,' with the larger dose in the evening. Fully engaging patients in order for them to understand the expected timeline for efficacy and side effects (including their resolution), can also help determine the optimal titration tempo for each individual patient. The 'low and slow' approach also recognizes that patients with NeP are heterogeneous in terms of their optimal therapeutic dose of pregabalin. Hence, it is recommended that general practitioners closely monitor patients and up-titrate according to pain relief and side effects to limit suboptimal dosing or premature discontinuation.


Asunto(s)
Analgésicos/administración & dosificación , Neuralgia/tratamiento farmacológico , Pregabalina/administración & dosificación , Pregabalina/efectos adversos , Factores de Edad , Analgésicos/uso terapéutico , Conducción de Automóvil , Comorbilidad , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas , Quimioterapia Combinada , Humanos , Cumplimiento de la Medicación , Dimensión del Dolor , Educación del Paciente como Asunto , Pregabalina/uso terapéutico , Factores Sexuales , Trastornos Relacionados con Sustancias/prevención & control
14.
BMJ Open Respir Res ; 8(1)2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33414261

RESUMEN

INTRODUCTION: The COVID-19 pandemic has impacted specialty chronic obstructive pulmonary disease (COPD) care. We examined the degree to which care has moved to remote approaches, eliciting clinician and patient perspectives on what is appropriate for ongoing remote delivery. METHODS: Using an online research platform, we conducted a survey and consensus-building process involving clinicians and patients with COPD. RESULTS: Fifty-five clinicians and 19 patients responded. The majority of clinicians felt able to assess symptom severity (n=52, 95%), reinforce smoking cessation (n=46, 84%) and signpost to other healthcare resources (n=44, 80%). Patients reported that assessing COPD severity and starting new medications were being addressed through remote care. Forty-three and 31 respondents participated in the first and second consensus-building rounds, respectively. When asked to rate the appropriateness of using remote delivery for specific care activities, respondents reached consensus on 5 of 14 items: collecting information about COPD and overall health status (77%), providing COPD education and developing a self-management plan (74%), reinforcing smoking cessation (81%), deciding whether patients should seek in-person care (72%) and initiating a rescue pack (76%). CONCLUSION: Adoption of remote care delivery appears high, with many care activities partially or completely delivered remotely. Our work identifies strengths and limitations of remote care delivery.


Asunto(s)
Actitud del Personal de Salud , Educación del Paciente como Asunto , Pautas de la Práctica en Medicina , Enfermedad Pulmonar Obstructiva Crónica/terapia , Automanejo , Cese del Hábito de Fumar , Telemedicina/métodos , Adulto , Anciano , Actitud Frente a la Salud , Prestación de Atención de Salud/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros , Aceptación de la Atención de Salud , Fisioterapeutas , Médicos , Pautas de la Práctica en Enfermería , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Reino Unido
15.
Med Clin North Am ; 105(1): 187-197, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33246518

RESUMEN

Primary care providers frequently care for complaints of the hands and feet. Here, the author describes the typical presentations of hand osteoarthritis, carpal tunnel syndrome, ganglion cysts, plantar fasciitis, onychomycosis, and Morton neuroma. Useful physical examination techniques are described. The history and physical examination are usually sufficient to diagnose these conditions without the need for more advanced testing. All of these conditions have evidence-based therapy that can be initiated by the primary care provider. These treatments as well as reasons to refer to a specialist are reviewed.


Asunto(s)
Enfermedades del Pie/diagnóstico , Enfermedades del Pie/terapia , Mano , Síndrome del Túnel Carpiano/diagnóstico , Síndrome del Túnel Carpiano/terapia , Fascitis Plantar/diagnóstico , Fascitis Plantar/terapia , Ganglión/diagnóstico , Ganglión/terapia , Articulaciones de la Mano , Humanos , Anamnesis , Neuroma de Morton/diagnóstico , Neuroma de Morton/terapia , Onicomicosis/diagnóstico , Onicomicosis/terapia , Osteoartritis/diagnóstico , Osteoartritis/terapia , Educación del Paciente como Asunto , Examen Físico , Automanejo
16.
J Surg Res ; 257: 597-604, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32932192

RESUMEN

BACKGROUND: Standardized prescribing practices are recommended to decrease opioid abuse, however, data regarding the handling and disposal of leftover narcotics are lacking. This quality improvement project and analysis evaluated implementation of standardized prescribing, opioid education, and a narcotic disposal system. METHODS: This initiative was implemented over a 1-y period among patients who underwent breast surgery. The project included the following: 1) implementation of standardized prescribing, 2) voluntary and anonymous survey analysis, and 3) preoperative education regarding risks of opioids, charcoal disposal bag distribution, and follow-up survey to assess use and use of intervention. RESULTS: Preintervention surveys were completed by 53 patients, and 60% (n = 32) underwent lumpectomy. Narcotic prescriptions were filled by 90%; median number of pills taken was 3 (range 0-24), however 93% felt that a non-narcotic was more effective. Eighty three percentage of patients had unused pills, and 58% kept these pills in an unlocked cabinet. Postintervention surveys were completed by 66 patients, and 48% (n = 32) underwent lumpectomy. Narcotic prescriptions were filled by 88%, median number of pills taken was 4 (range 0-40), and 89% of patients had pills leftover. Sixty seven percentage of patients found the education handout useful and charcoal bag use was reported by 37% (n = 17). The median postoperative pain control satisfaction score was 4.5 (5-point Likert scale, 1 = very dissatisfied, 5 = very satisfied) on both preintervention and postintervention surveys. CONCLUSIONS: This study, which included standardized prescribing parameters, opioid education, and implementation of a disposal method, was found to be feasible, beneficial, and did not compromise postoperative pain control.


Asunto(s)
Analgésicos Opioides , Prescripciones de Medicamentos/normas , Trastornos Relacionados con Opioides/prevención & control , Dolor Postoperatorio/prevención & control , Neoplasias de la Mama/cirugía , Estudios de Factibilidad , Femenino , Humanos , Mastectomía Segmentaria/efectos adversos , Persona de Mediana Edad , Dolor Postoperatorio/etiología , Educación del Paciente como Asunto , Mejoramiento de la Calidad , Administración de Residuos/instrumentación
17.
MCN Am J Matern Child Nurs ; 46(1): 21-29, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33009009

RESUMEN

PURPOSE: The aim of this study is to describe how the COVID-19 (coronavirus) pandemic has affected pregnancy, prenatal maternity care practices, and infant feeding plans among pregnant persons in the United States. STUDY DESIGN: Cross-sectional descriptive study using an app-based survey. METHODS: A link to the survey was sent via email to users of the Ovia Pregnancy app on May 20, 2020 and was open for 1 week. Participants were asked to complete the survey as it applied to their pregnancy, breastfeeding, and maternity care received during the COVID-19 pandemic, beginning approximately February 2020 through the time of the survey. There were 258 respondents who completed the survey. RESULTS: The majority (96.4%; n = 251) of pregnant women felt they received safe prenatal care during this time period. Slightly less 86.3% (n = 215) felt they received adequate prenatal care during this time period. 14.2% (n = 33) reported changing or considering changing the location where they planned to give birth due to COVID-19. Of those who reported they had begun purchasing items for their baby, 52.7% reported that the COVID-19 pandemic has affected their ability to get items they need for their baby. CLINICAL IMPLICATIONS: Although it is imperative to implement policies that reduce risk of transmission of COVID-19 to pregnant women and health care providers, it is necessary for health care providers and policy makers to listen to the collective voices of women during pregnancy about how COVID-19 has affected their birth and infant feeding plans and their perception of changes in prenatal care.


Asunto(s)
Lactancia Materna/psicología , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/psicología , Atención Prenatal/psicología , Adulto , Lactancia Materna/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Lactante , Servicios de Salud Materna/estadística & datos numéricos , Educación del Paciente como Asunto , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Atención Prenatal/estadística & datos numéricos
18.
Res Social Adm Pharm ; 17(1): 2002-2004, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33317768

RESUMEN

BACKGROUND: Community pharmacists and their teams are easy accessible healthcare providers with an important role in primary care. As a consequence of the COVID-19 epidemic, (pharmaceutical) care and specifically communication between patients and healthcare providers is compromised. OBJECTIVE: To describe the impact of the COVID-19 epidemic on the provision of pharmaceutical care in the Netherlands. METHODS: A cross-sectional study with an online questionnaire was sent to community pharmacies in the Netherlands. The questionnaire covered the following main topics: changes in pharmacy setting and logistic procedures, communication about medication and baseline characteristics. RESULTS: Pharmacies implemented hygiene measures and minimized direct patient-provider contact, e.g. by delivering medication at home to a wider range of patients (47.0%), temporarily not conducting medication reviews (55.8%) and only performing inhalation instructions via telephone (22.3%). Only a small number of pharmacies used telepharmacy, such as video calling during patient education and counseling. A total of 76.7% of the participants expressed concerns towards the pharmaceutical care for vulnerable patients. CONCLUSIONS: Our results show considerable impact of the COVID-19 epidemic on both logistic procedures and services regarding patient education and counseling. Pharmacies should be stimulated to implement telepharmacy or remote service to optimally support patients during the COVID-19 epidemic.


Asunto(s)
/epidemiología , Servicios Comunitarios de Farmacia/organización & administración , Farmacéuticos/organización & administración , Adulto , Comunicación , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Educación del Paciente como Asunto/métodos , Atención Primaria de Salud/organización & administración , Rol Profesional , Encuestas y Cuestionarios , Telemedicina/organización & administración
19.
J Electrocardiol ; 64: 72-75, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33348137

RESUMEN

In response to the COVID-19 pandemic, a protocol was designed for mail-out devices and educational materials created to teach patients how to install a device for 2 weeks of continuous ambulatory ECG monitoring. We compared data collection from two sequential patient populations; one who received standard device application in the same clinic in the months before the pandemic response, and another, who received their device by mail for self-installation. Patients received a single phone call when the device was mailed and were able to contact the manufacturer as needed for support. A total of 47 devices were assessed from each group. Each group was similar in age (70 vs 65 years), and clinical indication for monitoring. Noise signal magnitude (22.34 vs 26.28%), symptom based manual activation (10 vs 8 events) and APB/recorded hour burden measurements (37.05 vs 23.36%) were similar in both groups (all comparisons were statistically non-significant). Both groups had a similar mean of hours recorded (240.37 vs. 245.05 h). Zero patient kits were lost, and all reports were delivered. Overall, it was found that a mail-delivered home-based recording platform can be reliably used to acquire clinical data with similar data quality and patient compliance as a conventional in-clinic model for long term ambulatory ECG monitoring.


Asunto(s)
Electrocardiografía Ambulatoria , Educación del Paciente como Asunto/métodos , Anciano , Electrocardiografía Ambulatoria/instrumentación , Electrocardiografía Ambulatoria/métodos , Femenino , Servicios de Atención de Salud a Domicilio , Humanos , Masculino , Persona de Mediana Edad , Automanejo
20.
J Surg Res ; 257: 1-8, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32818777

RESUMEN

BACKGROUND: In this study, we developed online interactive clinician education modules highlighting best practices to minimize opioid prescribing at discharge after surgery. The modules were implemented as part of a multicomponent quality improvement initiative across a six-hospital health system. This article describes the development and evaluation of this educational intervention. MATERIALS AND METHODS: Clinician education modules targeting surgical prescribers, nurses, and pharmacists were developed and implemented by an interdisciplinary team. Clinicians were invited to participate in an evaluation survey after completing the modules. Survey items assessed clinicians' rating of the module and intention to change clinical practice because of the module. Quantitative and qualitative survey responses were analyzed by the study team. RESULTS: A total of 2119 clinicians completed the module and 1831 of these clinicians (86.4%) completed the survey. Of clinicians completing the survey, 65.6% reported that they intend to change clinical practice after completing the module. Intended changes were related to increased knowledge and awareness, provider empowerment, opioid prescribing practices, nonopioid prescribing practices, and patient education. Many clinicians who indicated they do not intend to change practice reported that their clinical practices were already in line with module recommendations. Some clinicians did not perceive the module to be relevant to their role. CONCLUSIONS: Module completion was associated with the intention to improve clinical practice in areas related to provider empowerment, opioid prescribing, nonopioid prescribing, and patient education. Evaluation data will inform future module improvements. There is an opportunity to ensure that all clinicians, including those who are not prescribers, recognize their role in opioid stewardship.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Educación a Distancia/métodos , Educación Médica Continua/métodos , Trastornos Relacionados con Opioides/prevención & control , Cuidados Posoperatorios/educación , Pautas de la Práctica en Medicina/estadística & datos numéricos , Actitud del Personal de Salud , Humanos , Enfermeras y Enfermeros , Educación del Paciente como Asunto , Farmacéuticos , Cuidados Posoperatorios/efectos adversos , Cuidados Posoperatorios/métodos , Cirujanos/educación , Encuestas y Cuestionarios
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