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1.
Pan Afr Med J ; 33: 260, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692826

RESUMO

Introduction: Dietary management is considered to be one of the cornerstones of diabetes care. Improvement of dietary practice alone can reduce glycosylated hemoglobin (HbA1c) by an absolute 1 to 2% with the greatest impact at the initial stages of diabetes. Methods: Data from Hospital based cross sectional study were used to assess the level of dietary adherence and its determinants among diabetic patients. The morisky 8 item medication adherence scale was used to develop 10 item tool for evaluation of dietary adherence. Multiple logistic regression was conducted to identify factors which affect dietary adherence and variables with P vale < 0.05 were considered statistically significant. Results: More than half of 303 participants (55.7%) were found to be non-adherent to the recommended dietary approach. Gathering with family and friends and eating out were the major reasons for not being compliant with the recommended regimen. Attending diabetic nutrition education (AOR=2.8 95% C 1.97, 5.61) and having the disease for more than 10 years (AOR 2.9 95% CI 1.32, 5.84) were statistically significant with adherence to dietary recommendation. Conclusion: Non-adherence to recommended dietary practice was observed in more than fifty percent of patients; it is therefore a major public health problem. Attending diabetic nutrition education and length of diabetes greater than 10 years were the factors associated with adherence to dietary recommendation. This findings indicate that it is important to design strategies to help patients understand their dietary regimens and improve their adherence.


Assuntos
Diabetes Mellitus/dietoterapia , Cooperação do Paciente/estatística & dados numéricos , Educação de Pacientes como Assunto/métodos , Adulto , Estudos Transversais , Etiópia , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
2.
J Surg Orthop Adv ; 28(3): 209-214, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31675298

RESUMO

This study evaluated the readability of online patient education materials on shoulder surgery. Medical and nonmedical institution web sites were compared and it was hypothesized that medical institution materials are written at lower grade levels than nonmedical institution materials, because medical institutions understand physician-patient interactions. Eighty-six articles were scored according to 10 readability tests: cumulative combined average grade level was 12.5 ± 2.8 and average Flesch reading score was 43.5 ± 12.6 (college level). The average composite grade level readability for medical institution web sites was 13 ± 2, significantly higher than for nonmedical institution web sites (11.9 ± 2.1; p = .017). Patient education materials available online are written at a higher level than American Medical Association and National Institutes of Health guidelines. Medical institution articles are written at a statistically significant higher grade level than nonmedical institution articles, but the difference is small and both rate poorly compared with current standards. (Journal of Surgical Orthopaedic Advances 28(3):209-214, 2019).


Assuntos
Alfabetização em Saúde , Ortopedia , Educação de Pacientes como Assunto , Ombro , Compreensão , Humanos , Internet , Leitura , Ombro/cirurgia , Estados Unidos
3.
J Surg Orthop Adv ; 28(3): 232-236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31675301

RESUMO

Increased opioid use in the United States has resulted in greater incidence of misuse. Orthopaedic patients are more likely to be prescribed opioids for pain. Low health literacy is related to opioid misuse; therefore, orthopaedic patient education tools on use of opioids must be easy to read, understand, and use for patients of all skill levels to be effective. This project aimed to review a broad array of opioid patient education tools and evaluate them from a health literacy perspective. Content evaluation revealed that not all tools expressed the same essential messaging. The mean readability score of the tools assessed was 9.5 grade; higher than the national and recommended 8th-grade reading level. Therefore, many opioid patient education tools may be difficult for patients to read and understand. Improvements in readability and other health literacy best practices are recommended to improve reading, comprehension, and use of opioid patient education tools. (Journal of Surgical Orthopaedic Advances 28(3):232-236, 2019).


Assuntos
Analgésicos Opioides , Alfabetização em Saúde , Procedimentos Ortopédicos , Educação de Pacientes como Assunto , Compreensão , Humanos , Internet , Leitura , Estados Unidos
4.
Medicine (Baltimore) ; 98(41): e17289, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593081

RESUMO

INTRODUCTION: Fibromyalgia (FM) is a chronic condition characterized by chronic pain, fatigue and loss of function which significantly impairs quality of life. Although treatment of FM remains disputed, some studies point at the efficacy of interdisciplinary therapy. This study aims to analyze the effectiveness, cost-utility and benefits of a multicomponent therapy on quality of life (main variable), functional impact, mood and pain in people suffering from FM that attend primary care centers (PCCs) of the Catalan Institute of Health (ICS). METHODS AND ANALYSIS: A 2-phase, mixed methods study has been designed following Medical Research Council guidance. Phase 1: Pragmatic randomized clinical trial with patients diagnosed with FM that attend one of the 11 PCCs of the ICS Gerència Territorial Terres de l'Ebre. We estimate a total sample of 336 patients. The control group will receive usual clinical care, while the multicomponent therapy group (MT group) will receive usual clinical care plus group therapy (consisting of health education, exercise and cognitive-behavioural therapy) during 12 weeks in 2-hourly weekly sessions. ANALYSIS: the standardized mean response and the standardized effect size will be assessed at 3, 9, and 15 months after the beginning of the study using multiple linear regression models. Utility measurements will be used for the economic analysis. Phase 2: Qualitative socio constructivist study to evaluate the intervention according to the results obtained and the opinions and experiences of participants (patients and professionals). We will use theoretical sampling, with 2 discussion groups of participants in the multicomponent therapy and 2 discussion groups of professionals of different PCCs. A thematic content analysis will be carried out. ETHICS AND DISSEMINATION: This study protocol has been approved by the Clinical Research Ethics Committee of the Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (code P18/068). Articles will be published in international, peer-reviewed scientific journals. TRIAL REGISTRATION: Clinical-Trials.gov: NCT04049006.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Terapia por Exercício/métodos , Fibromialgia/terapia , Educação de Pacientes como Assunto/métodos , Atenção Primária à Saúde/métodos , Qualidade de Vida , Adulto , Terapia Cognitivo-Comportamental/economia , Terapia Combinada , Análise Custo-Benefício , Terapia por Exercício/economia , Estudos de Viabilidade , Feminino , Fibromialgia/economia , Fibromialgia/psicologia , Implementação de Plano de Saúde , Humanos , Masculino , Avaliação de Processos e Resultados (Cuidados de Saúde) , Aceitação pelo Paciente de Cuidados de Saúde , Cooperação do Paciente , Educação de Pacientes como Assunto/economia , Atenção Primária à Saúde/economia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
7.
Sante Publique ; Vol. 31(3): 405-415, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31640328

RESUMO

INTRODUCTION: Poor oral health in persons with schizophrenia is a major public health issue affecting 600,000 people in France. The aim of this article was to present the different stages in the development of a specific oral health educational program for persons with schizophrenia. It takes into account experimental knowledge of these persons and presents the results of the feasibility study. PATIENTS AND METHOD: The focus group method was applied to a group of health professionals and users to highlight an exploratory corpus in order to develop an oral health educational program. An expert group including persons with schizophrenia among others validated the fields and tools of this program. A feasibility study was then conducted in a control group of 7 persons with schizophrenia. RESULTS: Altogether, 26 persons participated in this feasibility study. The main fields investigated by the expert group aimed to promote personal responsibility for one's health, to improve access to the healthcare system and to promote the global management of health. The feasibility study showed the ability of this program to change persons with schizophrenia representations and knowledge of this health problem. Most educational tools were considered relevant. CONCLUSION: An oral health educational program was built as part of a caregiver-persons with schizophrenia partnership and showed its feasibility. A multicentric randomized trial is currently ongoing to assess the efficacy of this program with a high level of proof.


Assuntos
Cuidadores/psicologia , Saúde Bucal/educação , Educação de Pacientes como Assunto/organização & administração , Esquizofrenia/terapia , Estudos de Viabilidade , Grupos Focais , França , Humanos
8.
Sante Publique ; Vol. 31(3): 459-467, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31640334

RESUMO

INTRODUCTION: Patient education is an important component in the management and monitoring of chronic diseases. It plays an important role in the decline of the disease severity, mortality and socioeconomic burden and the complications of these chronic diseases. In Côte d'Ivoire, there are few studies to evaluate the reality of this activity. OBJECTIVE: To explore the practice of patient education in Ivory Coast. METHOD: This qualitative study has been carried out by means of semi-structured interviews with 24 healthcare professionals including 14 health managers for individual interviews and 10 care providers for focus group discussion. RESULTS: There are various representations of therapeutic patient education among health professionals. There was no real distinction between patient education and the broader concept of health education. Absence of national patient education policy, the lack of training in TPE and lack of experience of educational practice lead health professionals to realize an unstructured educational activity. CONCLUSION: These results show the need for Côte d'Ivoire to have a national policy of patient education to educate patients in accordance with international recommendations.


Assuntos
Doença Crônica/terapia , Pessoal de Saúde/psicologia , Educação de Pacientes como Assunto/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Costa do Marfim , Humanos , Pesquisa Qualitativa
9.
Rev Lat Am Enfermagem ; 27: e3186, 2019 Oct 14.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31618386

RESUMO

OBJECTIVE: to identify in the scientific literature the technologies developed to promote health education for the community elderly. METHOD: integrative review that included original articles indexed by Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Science Direct, and Cochrane databases, without restriction of time and language. Results were analyzed descriptively, in five analytical categories. RESULTS: Fifteen articles published on national and international journals were selected, with predominance of experimental studies that tested the effects of such technologies. The types of educational technology developed were printed materials, software and video, as well as mock-up and telephone support. Falls in the elderly were the most discussed theme. The studies have shown that the types of technology found are feasible to promote health education for the community elderly. CONCLUSION: The technologies developed to promote health education for the elderly were multiple and proved effective for use in community interventions.


Assuntos
Tecnologia Educacional/métodos , Educação em Saúde/métodos , Promoção da Saúde/métodos , Acidentes por Quedas/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Recursos Audiovisuais , Humanos , Educação de Pacientes como Assunto/métodos , Software
11.
Lakartidningen ; 1162019 Oct 07.
Artigo em Sueco | MEDLINE | ID: mdl-31593289

RESUMO

The medical and nursing care of preterm infants has improved over the last decades, including the involvement of parents in the daily care. Previously parents could only visit a few scheduled hours per day but today most neonatal units in Sweden strive to let the parents be the primary caregivers, with the right to stay at the unit during the entire hospitalization period. Despite this development, there is still need for a number of improvements, not only in the neonatal care but also during the complicated pregnancy.


Assuntos
Terapia Intensiva Neonatal/organização & administração , Poder Familiar , Nascimento Prematuro , Papel (figurativo) , Aleitamento Materno , Continuidade da Assistência ao Paciente , Pai , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Serviços de Saúde Materna/organização & administração , Mães , Alta do Paciente , Educação de Pacientes como Assunto , Gravidez , Apoio Social , Suécia
12.
Nursing ; 49(11): 24-32, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31651771

RESUMO

Parkinson disease (PD) is a progressive, incurable disease caused by dopamine deficiency. This article provides an overview of this neurodegenerative disorder and offers information for optimal outcomes.


Assuntos
Doença de Parkinson/enfermagem , Humanos , Diagnóstico de Enfermagem , Doença de Parkinson/fisiopatologia , Educação de Pacientes como Assunto
13.
Am Surg ; 85(10): 1198-1203, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657324

RESUMO

Overdose of opioids is the number one cause of accidental death in the United States, and surgeons are overprescribing these medications. The aim of this study was to assess the feasibility of implementing postoperative opioid prescribing guidelines for general surgery procedures at a public hospital, where patients have lower socioeconomic status, public insurance, and limited access to care. We implemented a quality improvement project, which included in-service training for surgical staff and distribution of standardized guidelines. An infographic for patients was created to facilitate education on postoperative pain management. Pre- and postintervention opioid prescriptions and emergency room visits were compared for patients undergoing common general surgery procedures (inguinal hernia repair, appendectomy, and laparoscopic cholecystectomy). The median number of narcotic pills prescribed significantly decreased from 30 (n = 64) to 15 (n = 63) after the intervention (P < 0.0001). Morphine milligram equivalents decreased from a median [range] of 150 [20,600] to 90 [5,300] (P < 0.0001). The percentage of patients with postoperative pain-related emergency department visits remained low (1.6%). Standardization of postoperative opioid prescription practices was successfully implemented at a public hospital without an increase in the number of emergency room visits for pain.


Assuntos
Analgésicos Opioides/uso terapêutico , Manejo da Dor/normas , Dor Pós-Operatória/tratamento farmacológico , Melhoria de Qualidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Apendicectomia/efeitos adversos , Colecistectomia Laparoscópica/efeitos adversos , Prescrições de Medicamentos/normas , Serviço Hospitalar de Emergência/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Herniorrafia/efeitos adversos , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Adulto Jovem
14.
BMC Infect Dis ; 19(1): 774, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488064

RESUMO

BACKGROUND: HCV (Hepatitis C virus) is a prevalent chronic disease with potentially deadly consequences, especially for drug users. However, there are no special HCV or HIV (human immunodeficiency virus)-related intervention programs that are tailored for drug users in China; to fill this gap, the purpose of this study was to explore HCV and HIV-related knowledge among drug users in MMT (methadone maintenance treatment) sites of China and to investigate the effectiveness of HCV and HIV-related education for improving the knowledge of IDUs (injection drug users) and their awareness of infection. METHODS: The study was a randomized cluster controlled trial that compared a usual care group to a usual care plus HCV/HIV-REP (HCV/HIV-Reduction Education Program) group with a 24-week follow-up. The self-designed questionnaires, the HCV- and HIV-related knowledge questionnaire and the HIV/HCV infection awareness questionnaire, were used to collect the data. Four MMT clinics were selected for this project; two MMT clinics were randomly assigned to the research group, with subjects receiving their usual care plus HCV/HIV-REP, and the remaining two MMT clinics were the control group, with subjects receiving their usual care over 12 weeks. Sixty patients were recruited from each MMT clinic. A total of 240 patients were recruited. Follow-up studies were conducted at the end of the 12th week and the 24th week after the intervention. RESULTS: At baseline, the mean score (out of 20 possible correct answers) for HCV knowledge among the patients in the group receiving the intervention was 6.51 (SD = 3.5), and it was 20.57 (SD = 6.54) for HIV knowledge (out of 45 correct answers) and 8.35 (SD = 2.8) for HIV/HCV infection awareness (out of 20 correct answers). At the 12-week and 24-week follow-up assessments, the research group showed a greater increase in HCV-/HIV-related knowledge (group × time effect, F = 37.444/11.281, P < 0.05) but no difference in their HIV/HCV infection awareness (group × time effect, F = 2.056, P > 0.05). CONCLUSION: An MMT-based HCV/HIV intervention program could be used to improve patient knowledge of HCV and HIV prevention, but more effort should be devoted to HIV/HCV infection awareness. TRIAL REGISTRATION: Protocols for this study were approved by institution review board (IRB) of Shanghai Mental Health Center (IRB:2009036), and registered in U.S national institutes of health (http://www.clinicaltrials.gov, NCT01647191 ). Registered 23 July 2012.


Assuntos
Usuários de Drogas/educação , Infecções por HIV/prevenção & controle , Hepatite C/prevenção & controle , Metadona/uso terapêutico , Tratamento de Substituição de Opiáceos , Educação de Pacientes como Assunto , Adulto , Conscientização , China/epidemiologia , Análise por Conglomerados , Usuários de Drogas/psicologia , Usuários de Drogas/estatística & dados numéricos , Eficiência Organizacional , Feminino , HIV/fisiologia , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Hepacivirus/fisiologia , Hepatite C/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Tratamento de Substituição de Opiáceos/métodos , Tratamento de Substituição de Opiáceos/estatística & dados numéricos , Educação de Pacientes como Assunto/organização & administração , Educação de Pacientes como Assunto/normas , Prevalência , Inquéritos e Questionários , Resultado do Tratamento
15.
Tijdschr Psychiatr ; 61(9): 644-648, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31560784

RESUMO

We investigated the extent to which patients in long-stay psychiatric care can benefit from e-health applications. In our psychiatric hospital, we introduced a blended care course for psycho-education on psychotic disorders, in which we combined an internet module with face-to-face group sessions. We report on our findings, illustrated with a few vignettes.


Assuntos
Educação de Pacientes como Assunto , Transtornos Psicóticos , Telemedicina , Humanos , Psicoterapia , Consulta Remota , Autocuidado
16.
Rev Infirm ; 68(253): 21-23, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31472777

RESUMO

Haemophilia is a chronic, restrictive and anxiety-inducing disease. In order to maintain a satisfactory quality of life, people can benefit from a therapeutic education programme to equip them with the skills they need to take care of their health.


Assuntos
Hemofilia A/terapia , Educação de Pacientes como Assunto , Humanos , Autocuidado
17.
Rev Infirm ; 68(253): 24-25, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31472778

RESUMO

Therapeutic patient education is an important part of the management of patients suffering from bleeding disorders. Its implementation by the multi-professional team and in consultation with patients and/or their carers establishes the foundations for the support they are given in managing their disease. Pedagogical tools play a big role in facilitating their understanding of their condition and give them the opportunity to express how they feel.


Assuntos
Transtornos da Coagulação Sanguínea/terapia , Educação de Pacientes como Assunto , Humanos , Autocuidado
18.
Tidsskr Nor Laegeforen ; 139(13)2019 Sep 24.
Artigo em Norueguês | MEDLINE | ID: mdl-31556521

RESUMO

BACKGROUND: Low back pain is considered to be the most common single cause of sickness absence. In 2010, Sørlandet Hospital Arendal established an interdisciplinary treatment programme through the Faster Return-to-Work scheme, based on the relevant guidelines for patients with low back pain. In this study we present our experiences from six years of the treatment programme. MATERIAL AND METHOD: Patients who were referred to Sørlandet Hospital in Arendal in the period 2011-16 due to long-term symptoms of low back pain were offered interdisciplinary treatment. This included a one-to-one consultation with a doctor, four weeks of group-based low back school, and physiotherapist-led exercise as well as eight weeks of either physiotherapist-led exercise or home exercise. The degree of sick leave and functional level using scores on the Roland-Morris Disability Questionnaire (RMDQ) were reported at the outset and after 4 and 12 weeks. RESULTS: A total of 43 patients in employment completed the treatment programme. The average age was 41.9 years and 52 % were women. Altogether 57 % were on certified sick leave at the outset and the remainder were assessed as being at high risk of going on sick leave. A total of 7.5 % were placed on sick leave during the observation period, while 28.5 % of those on sick leave were declared completely fit. Altogether 52.7 % of the patients had a clinically significant reduction in RMDQ scores (> 3.5 points). INTERPRETATION: The interdisciplinary treatment programme appears to improve function and reduce sickness absent in patients with long-term low back pain. This study has a short follow-up time and no control group; the observations must therefore be interpreted with caution.


Assuntos
Dor Lombar/terapia , Manejo da Dor/métodos , Equipe de Assistência ao Paciente , Adulto , Avaliação da Deficiência , Terapia por Exercício , Feminino , Hospitais Comunitários , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Educação de Pacientes como Assunto , Modalidades de Fisioterapia , Avaliação de Programas e Projetos de Saúde , Recuperação de Função Fisiológica , Encaminhamento e Consulta , Retorno ao Trabalho , Licença Médica , Inquéritos e Questionários , Resultado do Tratamento
20.
BMC Public Health ; 19(1): 1146, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429735

RESUMO

BACKGROUND: UK African and Caribbean (AfC) communities are disproportionately burdened by type 2 diabetes (T2D). Promoting healthy eating and physical activity through structured education is the cornerstone of T2D care, however cultural barriers may limit engagement in these communities. In addition, changes in lifestyle behaviour are shaped by normative influences within social groups and contextual factors need to be understood to facilitate healthful behaviour change. The Behaviour Change Wheel (BCW) and associated COM-B framework offer intervention designers a systematic approach to developing interventions. The aim of this study was to apply the BCW in the design of a culturally sensitive self-management support programme for T2D in UK AfC communities. METHODS: An intervention development study was conducted. Focus groups were held with 41 AfC patients with T2D to understand healthful weight-management, diet and physical activity behaviours. The COM-B framework and BCW were used to evaluate the qualitative data, identify appropriate behaviour change techniques and specify the intervention components. RESULTS: Participants were motivated to avoid diabetes-related consequences although did not always understand the negative impact of their current health behaviours on long-term diabetes outcomes. Barriers to healthful behaviour included gaps in knowledge related to diet, physical activity and weight management guidance. In addition, motivation and social opportunity barriers included an acceptance of larger body sizes, rejection of body mass index for weight guidance and cultural identity being strongly linked to consumption of traditional starches. There was a lack of social opportunity to perform moderate to vigorous physical activity, although walking and dance were culturally acceptable. The resulting Healthy Eating & Active Lifestyles for Diabetes (HEAL-D) intervention uses social support, social comparison, credible sources and demonstration as key behaviour change techniques. CONCLUSION: Use of COM-B and the BCW highlighted the need for an intervention to address motivational and social opportunity barriers to engaging in healthful behaviours, as well as addressing key gaps in knowledge. This framework facilitated the linkage of theoretical behaviour constructs with evidence-based behaviour change techniques, which will enable us to evaluate operationalisation of our chosen BCTs and their impact on behaviour change in a future feasibility study.


Assuntos
Terapia Comportamental/educação , Assistência à Saúde Culturalmente Competente/métodos , Diabetes Mellitus Tipo 2/etnologia , Dieta para Diabéticos/métodos , Educação de Pacientes como Assunto/métodos , Autogestão/educação , Adulto , Grupo com Ancestrais do Continente Africano/educação , Terapia Comportamental/métodos , Região do Caribe/etnologia , Diabetes Mellitus Tipo 2/terapia , Dieta para Diabéticos/etnologia , Exercício , Feminino , Grupos Focais , Comportamentos Relacionados com a Saúde/etnologia , Dieta Saudável/etnologia , Dieta Saudável/métodos , Estilo de Vida Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Avaliação de Programas e Projetos de Saúde , Autogestão/métodos , Apoio Social , Reino Unido
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