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1.
Eur J Endocrinol ; 183(6): 551-559, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33055299

RESUMO

Introduction: The low prevalence of pituitary diseases makes patient autonomy crucial, and self-management programs should be more common. Objectives: To assess the efficacy of an education program for patients with pituitary diseases in terms of patients' quality of life, satisfaction and goal attainment. Design and methods: Adult patients with pituitary disorders were recruited in a tertiary referral center and chose at least three of eight possible sessions on various topics, from disease management to psychosocial issues. Patients were included if they attended at least three sessions between 2012 and 2016 and completed the initial, final, and follow-up questionnaires. Data on quality of life (SF36), satisfaction and goal attainment were analyzed. Results: Fifty-three patients were included (33 women; mean age, 53.5 years). There were a significant quality of life improvements in terms of physical and psychic limitation scores at the final assessment that persisted at follow-up evaluation. Most patients reached their objectives, especially those on sharing experiences and improving autonomy and self-confidence. More than half set new objectives at the end of the program, the most popular one being to reinforce their knowledge of their pituitary disease, its evolution and treatment (17.1% of patients). The mean overall satisfaction score was 3.75/4. At follow-up evaluation, patients reported improved self-management of pituitary disease (3.6/5) and improved self-efficacy (3.8/5). Conclusion: Individualizing the educational objectives of patients with pituitary disease improves the way they live with their disease. If confirmed in other cohorts, this approach could become the gold standard for education programs in rare endocrine diseases.


Assuntos
Educação de Pacientes como Assunto/normas , Doenças da Hipófise/psicologia , Doenças da Hipófise/terapia , Autogestão/psicologia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/métodos , Projetos Piloto , Doenças da Hipófise/diagnóstico , Qualidade de Vida/psicologia , Autogestão/métodos , Inquéritos e Questionários/normas
2.
J Med Internet Res ; 22(10): e22068, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-32946412

RESUMO

BACKGROUND: The COVID-19 pandemic has markedly affected renal transplant care. During this time of social distancing, limited in-person visits, and uncertainty, patients and donors are relying more than ever on telemedicine and web-based information. Several factors can influence patients' understanding of web-based information, such as delivery modes (instruction, interaction, and assessment) and social-epistemological dimensions (choices in interactive knowledge building). OBJECTIVE: The aim of this study was to systemically evaluate the content, delivery modes, and social-epistemological dimensions of web-based information on COVID-19 and renal transplantation at time of the pandemic. METHODS: Multiple keyword combinations were used to retrieve websites on COVID-19 and renal transplantation using the search engines Google.com and Google.nl. From 14 different websites, 30 webpages were examined to determine their organizational sources, topics, delivery modes, and social-epistemological dimensions. RESULTS: The variety of topics and delivery modes was limited. A total of 13 different delivery modes were encountered, of which 8 (62%) were instructional and 5 (38%) were interactional; no assessment delivery modes were observed. No website offered all available delivery modes. The majority of delivery modes (8/13, 62%) focused on individual and passive learning, whereas group learning and active construction of knowledge were rarely encountered. CONCLUSIONS: By taking interactive knowledge transfer into account, the educational quality of eHealth for transplant care could increase, especially in times of crisis when rapid knowledge transfer is needed.


Assuntos
Infecções por Coronavirus/epidemiologia , Internet , Transplante de Rim , Conhecimento , Doadores Vivos/educação , Educação de Pacientes como Assunto , Pneumonia Viral/epidemiologia , Telemedicina , Betacoronavirus , Humanos , Pandemias , Educação de Pacientes como Assunto/normas , Educação de Pacientes como Assunto/estatística & dados numéricos , Ferramenta de Busca , Incerteza
3.
J Bras Nefrol ; 42(2 suppl 1): 12-14, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877492

RESUMO

Patients with Chronic Kidney Disease are among those individuals at increased risk for developing more serious forms of Covid-19. This increased risk starts in the pre-dialysis phase of the disease. Providing useful information for these patients, in language that facilitates the understanding of the disease, can help nephrologists and other healthcare professionals to establish a more effective communication with these patients and help minimize contagion and the risks of serious illness in this population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Educação de Pacientes como Assunto/normas , Pneumonia Viral/prevenção & controle , Insuficiência Renal Crônica/complicações , Atividades Cotidianas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos , Higiene das Mãos/métodos , Higiene das Mãos/normas , Instalações de Saúde , Pessoal de Saúde , Humanos , Nefrologia/normas , Espaço Pessoal , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Diálise Renal , Fatores de Risco , Avaliação de Sintomas
4.
Med J Aust ; 213(1): 30-43, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32578226

RESUMO

INTRODUCTION: The incidence of type 2 diabetes mellitus has increased in children and adolescents due largely to the obesity epidemic, particularly in high risk ethnic groups. ß-Cell function declines faster and diabetes complications develop earlier in paediatric type 2 diabetes compared with adult-onset type 2 diabetes. There are no consensus guidelines in Australasia for assessment and management of type 2 diabetes in paediatric populations and health professionals have had to refer to adult guidelines. Recent international paediatric guidelines did not address adaptations to care for patients from Indigenous backgrounds. MAIN RECOMMENDATIONS: This guideline provides advice on paediatric type 2 diabetes in relation to screening, diagnosis, diabetes education, monitoring including targets, multicomponent healthy lifestyle, pharmacotherapy, assessment and management of complications and comorbidities, and transition. There is also a dedicated section on considerations of care for children and adolescents from Indigenous background in Australia and New Zealand. CHANGES IN MANAGEMENT AS A RESULT OF THE GUIDELINES: Published international guidelines currently exist, but the challenges and specifics to care for children and adolescents with type 2 diabetes which should apply to Australasia have not been addressed to date. These include: recommendations regarding care of children and adolescents from Indigenous backgrounds in Australia and New Zealand including screening and management; tighter diabetes targets (glycated haemoglobin, ≤ 48 mmol/mol [≤ 6.5%]) for all children and adolescents; considering the use of newer medications approved for adults with type 2 diabetes under the guidance of a paediatric endocrinologist; and the need to transition adolescents with type 2 diabetes to a diabetes multidisciplinary care team including an adult endocrinologist for their ongoing care.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/terapia , Adolescente , Australásia/epidemiologia , Criança , Comorbidade , Complicações do Diabetes/diagnóstico , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/terapia , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Estilo de Vida , Masculino , Programas de Rastreamento/normas , Educação de Pacientes como Assunto/normas , Transição para Assistência do Adulto/normas
5.
Eur J Endocrinol ; 183(2): 119-127, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32580144

RESUMO

Objective: Patients with adrenal insufficiency (AI) suffer from impaired quality of life and are at risk of adrenal crisis (AC) despite established replacement therapy. Patient education is regarded an important measure for prevention of AC and improvement of AI management. A standardized education programme was elaborated for patients with chronic AI in Germany. Design: Longitudinal, prospective, questionnaire-based, multi-centre study. Methods: During 2-h sessions, patients (n = 526) were provided with basic knowledge on AI, equipped with emergency cards and sets and trained in self-injection of hydrocortisone. To evaluate the education programme, patients from eight certified centres completed questionnaires before, immediately after and 6-9 months after training. Results: 399 completed data sets were available for analysis. Questionnaire score-values were significantly higher after patient education, indicating successful knowledge transfer (baseline: 17 ± 7.1 of a maximum score of 29; after training: 23 ± 4.2; P < 0.001), and remained stable over 6-9 months. Female sex, younger age and primary cause of AI were associated with higher baseline scores; after education, age, cause of AI and previous adrenal crisis had a significant main effect on scores. 91% of patients would dare performing self-injection after training, compared to 68% at baseline. An improvement of subjective well-being through participation in the education programme was indicated by 95% of the patients 6-9 months after participation. Conclusion: Patient group education in chronic AI represents a helpful tool for the guidance of patients, their self-assurance and their knowledge on prevention of adrenal crises. Repeated training and adaptation to specific needs, for example, of older patients is needed.


Assuntos
Insuficiência Adrenal/tratamento farmacológico , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/normas , Doença Aguda/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Etiquetas de Emergência Médica , Tratamento de Emergência , Feminino , Alemanha , Terapia de Reposição Hormonal , Humanos , Hidrocortisona/administração & dosagem , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Autoadministração , Inquéritos e Questionários , Adulto Jovem
6.
PLoS One ; 15(6): e0234926, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559237

RESUMO

BACKGROUND: Communication and shared decision-making (SDM) are essential to patient-centered care. Hospital-based palliative care with patients with limited health literacy (LHL) poses particular demands on communication. In this context, patients' emotions and vulnerable condition impact their skills to obtain, understand, process and apply information about health and healthcare even more. If healthcare providers (HCPs) meet these demands, it could enhance communication. In this study, HCPs were interviewed and asked for their strategies, barriers and suggestions for improvement regarding communication and SDM with LHL patients in hospital-based palliative care. METHODS: A qualitative interview study was conducted in 2018 in four Dutch hospitals with 17 HCPs-11 physicians and 6 nurses. Transcripts were analyzed using thematic analysis. RESULTS: In general HCPs recognized limited literacy as a concept, however, they did not recognize limited health literacy. Regarding SDM some HCPs were strong advocates, others did not believe in SDM as a concept and perceived it as unfeasible. Furthermore, five themes, acting as either strategies, barriers or suggestions for improvement emerged from the interviews: 1) time management; 2) HCPs' communication skills; 3) information tailoring; 4) characteristics of patients and significant others; 5) the content of the medical information. CONCLUSIONS: According to HCPs, more time to communicate with their patients could resolve the most prominent barriers emerged from this study. Further research should investigate the organizational possibilities for this and the actual effectiveness of additional time on effective communication and SDM. Additionally, more awareness for the concept of LHL is needed as a precondition for recognizing LHL. Furthermore, future research should be directed towards opportunities for tailoring communication, and the extent to which limited knowledge and complex information affect communication and SDM. This study provides first insights into perspectives of HCPs, indicating directions for research on communication, SDM and LHL in hospital-based palliative care.


Assuntos
Tomada de Decisão Clínica/métodos , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/métodos , Cuidados Paliativos/psicologia , Feminino , Letramento em Saúde/normas , Humanos , Masculino , Relações Enfermeiro-Paciente , Enfermeiras e Enfermeiros/psicologia , Cuidados Paliativos/métodos , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/normas , Relações Médico-Paciente , Médicos/psicologia , Melhoria de Qualidade
10.
Acta Cytol ; 64(5): 425-432, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32396906

RESUMO

AIM: YouTube is one of the most popular video-sharing platforms and is used by many people as a source of information regarding health conditions. Although there are many studies examining YouTube health-related videos in terms of quality, content and accuracy, there is not any study observing the content of YouTube videos about the "Pap smear test." Therefore, we intended to evaluate YouTube videos related to the Pap smear test. METHODS: We made a search by typing "Pap smear test" and observed the first 100 videos. According to our selection criteria, only 42 videos were reviewed. We used 3 different questionnaires to rate the videos. The videos were independently rated by 2 gynecologists in terms of technical aspects, follow-up protocol, and video quality. RESULTS: Our study showed that clarity of the technical aspects of Pap smear testing (Q1) was 40% and that of the follow-up protocol (Q2) was only 11%. In terms of video quality (Q3), the adequacy rate was 34%. There was a statistically significant negative correlation between search rank and the video power index (which increased as the ranking decreased to rank 1, r: -0.481). CONCLUSION: We did not find quality and reliable information on YouTube videos about the Pap smear test, which is important for early detection of cervical cancers. While preparing health-related videos for YouTube and similar websites, the support of professional healthcare workers will help provide more accurate content.


Assuntos
Informação de Saúde ao Consumidor/normas , Teste de Papanicolaou/psicologia , Educação de Pacientes como Assunto/normas , Mídias Sociais/estatística & dados numéricos , Esfregaço Vaginal/psicologia , Gravação em Vídeo , Feminino , Humanos , Inquéritos e Questionários
11.
Acta Diabetol ; 57(9): 1049-1056, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32248347

RESUMO

AIMS: The past 3 decades witnessed the rapid growth of diabetes in China. To better serve large numbers of patients, the Chinese Medical Doctor Association launched metabolic management center (MMC) program which is featured with a one-stop and comprehensive diabetes management mode in 2016. It is worth exploring whether MMC model is better than conventional models in management. METHODS: In this study, 228 patients with type 2 diabetes were recruited, and 193 patients completed the study. Therapeutic effects and health care costs were analyzed. RESULTS AND CONCLUSIONS: Our results showed that decreases in HbA1C and TG/HDL-C values were significantly greater in the MMC group than in the control group. The increase in HDL-C was significantly higher in the MMC group than in the control group. The percentage of patients whose HbA1C lower than 7% was significantly higher in the MMC group. The results of the UKPDS model simulation showed that within 30 years, with the slight increases in treatment costs, the average life expectancy and total QALE of the MMC group are higher than those of the control group by 0.61 and 0.51 year, respectively. Further study showed that the drug intervention in the MMC group was significantly stronger. In addition, the questionnaires revealed that MMC group performed better in diabetes knowledge tests and have higher patient satisfaction rates of medical services. More patients in the MMC group adopted a more favorable diet strategy. These advantages enable MMC to achieve more short-term and long-term benefits in diabetes treatment than conventional mode.


Assuntos
Assistência Integral à Saúde , Diabetes Mellitus Tipo 2/economia , Diabetes Mellitus Tipo 2/terapia , Autogestão , Padrão de Cuidado , China/epidemiologia , Assistência Integral à Saúde/métodos , Assistência Integral à Saúde/organização & administração , Assistência Integral à Saúde/normas , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/economia , Educação de Pacientes como Assunto/organização & administração , Educação de Pacientes como Assunto/normas , Satisfação do Paciente , Avaliação de Programas e Projetos de Saúde , Autogestão/economia , Autogestão/métodos , Autogestão/psicologia , Padrão de Cuidado/economia , Padrão de Cuidado/organização & administração , Padrão de Cuidado/normas , Inquéritos e Questionários
13.
J Plast Reconstr Aesthet Surg ; 73(8): 1534-1539, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32241738

RESUMO

BACKGROUND: Shared decision-making is a key component of patient-centered care and has been shown to improve patient satisfaction and quality of life. Herein, we study the impact of a standardized patient education class for prospective breast reconstruction patients on clinic efficiency, access to care, and perception on shared decision-making. METHODS: The number of new patient consultations per clinic, as well as average duration of the first individual clinic encounter, was compared before and after the introduction of a standardized education class given by the senior author to all new breast reconstruction patients. To evaluate patients' perception of shared decision-making, the 9-item Shared Decision-Making Questionnaire (SDM-Q9) and the Satisfaction with Information scale of the BREAST-Q Reconstruction Module were electronically distributed among the patients and compared between the two groups. RESULTS: Introduction of the patient education class was associated with a significant reduction in the duration of new patient encounters compared to historic controls (31.8 min vs. 53.5 min, p < 0.01) along with permitting a 43% increase in new patient visits. No differences in self-perceived patient education and autonomy were seen between class participants and historic controls in the SDM-Q9 scores (p = 0.58) and BREAST-Q scores (p = 0.14). CONCLUSION: The introducing a standardized patient education class translated into a significant reduction in the duration of individual new patient encounters, thereby increasing patient access to care, while maintaining high-quality standards of self-perceived patient education and shared decision-making.


Assuntos
Neoplasias da Mama/cirurgia , Tomada de Decisões , Acesso aos Serviços de Saúde , Mamoplastia , Educação de Pacientes como Assunto/normas , Feminino , Humanos , Pessoa de Meia-Idade
14.
Public Health Res Pract ; 30(1)2020 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-32152614

RESUMO

OBJECTIVE: Multilingual patient education materials (PEMs) in Australia are normally prepared initially in English (source text) and then translated into other languages. The aim of this study was to evaluate whether the source texts for publicly available multilingual diabetes PEMs in Australia were written at the reading level recommended by health literacy guidelines (eighth-grade reading level). STUDY TYPE: Nonexperimental descriptive study. METHODS: All publicly accessible multilingual fact sheets on diabetes self-management from the Diabetes Australia and National Diabetes Services Scheme websites were collected. Readability was analysed using five different readability indices: Flesch Kincaid Grade Level (FKGL), Gunning Fog Score (GFS), Coleman Liau Index (CLI), Simplified Measure of Gobbledygook Index (SMOG) and Automated Readability Index (ARI). The average number of syllables per word and the average number of words per sentence were also calculated. RESULTS: The average reading grade level of included PEMs was above Grade 10 (mean 10.4; standard deviation [SD] 0.9). The average number of syllables per word was 1.5 (SD 0.1), and the average number of words per sentence was 17 (SD 0.9). CONCLUSIONS: English-language source texts for national multilingual diabetes PEMs examined in this study were written at a readability level significantly higher than that recommended in health literacy guidelines. This was likely due to the use of polysyllabic words and complex medical terms, which are especially problematic when they are not defined. Improving readability of English-language source texts may help to ensure that the translated PEMs are more readable and accessible to their target readers. In conjunction with addressing other features that can make written materials easier to understand, this may help to better support diabetes self-management.


Assuntos
Compreensão , Diabetes Mellitus , Multilinguismo , Educação de Pacientes como Assunto/normas , Austrália , Letramento em Saúde , Humanos , Idioma , Leitura , Autocuidado
16.
Eur J Cancer ; 128: 60-82, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32113941

RESUMO

Invasive cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers in the white populations, accounting for 20% of all cutaneous malignancies. Factors implicated in cSCC etiopathogenesis include ultraviolet radiation exposure and chronic photoaging, age, male sex, immunosuppression, smoking and genetic factors. A collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organisation of Research and Treatment of Cancer (EORTC) was formed to update recommendations on cSCC classification, diagnosis, risk stratification, staging and prevention, based on current literature, staging systems and expert consensus. Common cSCCs are typically indolent tumors, and most have a good prognosis with 5-year cure rates of greater than 90%, and a low rate of metastases (<4%). Further risk stratification into low-risk or high-risk common primary cSCC is recommended based on proposed high-risk factors. Advanced cSCC is classified as locally advanced (lacSCC), and metastatic (mcSCC) including locoregional metastatic or distant metastatic cSCC. Current systems used for staging include the American Joint Committee on Cancer (AJCC) 8th edition, the Union for International Cancer Control (UICC) 8th edition, and Brigham and Women's Hospital (BWH) system. Physical examination for all cSCCs should include total body skin examination and clinical palpation of lymph nodes, especially of the draining basins. Radiologic imaging such as ultrasound of the regional lymph nodes, magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography-computed tomography (PET-CT) scans are recommended for staging of high-risk cSCC. Sentinel lymph node biopsy is currently not recommended. Nicotinamide, oral retinoids, and topical 5-FU have been used for the chemoprevention of subsequent cSCCs in high-risk patients but are not routinely recommended. Education about sun protection measures including reducing sun exposure, use of protective clothing, regular use of sunscreens and avoidance of artificial tanning, is recommended.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Consenso , Dermatologia/normas , Oncologia/normas , Neoplasias Cutâneas/diagnóstico , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/prevenção & controle , Humanos , Linfonodos/diagnóstico por imagem , Imagem por Ressonância Magnética/normas , Estadiamento de Neoplasias/normas , Educação de Pacientes como Assunto/normas , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/normas , Roupa de Proteção/normas , Medição de Risco/normas , Pele/diagnóstico por imagem , Pele/patologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/prevenção & controle , Sociedades Médicas/normas , Luz Solar/efeitos adversos , Protetores Solares/administração & dosagem , Ultrassonografia/normas
17.
Eur J Cancer ; 128: 83-102, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32113942

RESUMO

In order to update recommendations on treatment, supportive care, education and follow-up of patients with invasive cutaneous squamous cell carcinoma (cSCC), a multidisciplinary panel of experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer was formed. Recommendations were based on evidence-based literature review, guidelines and expert consensus. Treatment recommendations are presented for common primary cSCC (low risk, high risk), locally advanced cSCC, regional metastatic cSCC (operable or inoperable) and distant metastatic cSCC. For common primary cSCC (the most frequent cSCC type), first-line treatment is surgical excision with postoperative margin assessment or microscopically controlled sugery. Safety margins containing clinical normal-appearing tissue around the tumour during surgical excision and negative margins as reported in the pathology report are necessary to minimise the risk of local recurrence and metastasis. In case of positive margins, a re-excision shall be done, for operable cases. Lymph node dissection is recommended for cSCC with cytologically or histologically confirmed regional nodal involvement. Radiotherapy should be considered as curative treatment for inoperable cSCC, or for non-surgical candidates. Anti-PD-1 antibodies are the first-line systemic treatment for patients with metastatic or locally advanced cSCC who are not candidates for curative surgery or radiation, with cemiplimab being the first approved systemic agent for advanced cSCC by the Food and Drug Administration/European Medicines Agency. Second-line systemic treatments for advanced cSCC include epidermal growth factor receptor inhibitors (cetuximab) combined with chemotherapy or radiation therapy. Multidisciplinary board decisions are mandatory for all patients with advanced disease who require more than surgery. Patients should be engaged with informed decisions on management and be provided with best supportive care to optimise symptom management and improve quality of life. Frequency of follow-up visits and investigations for subsequent new cSCC depend on underlying risk characteristics.


Assuntos
Carcinoma de Células Escamosas/terapia , Procedimentos Cirúrgicos Dermatológicos/normas , Dermatologia/normas , Oncologia/normas , Neoplasias Cutâneas/terapia , Assistência ao Convalescente/normas , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Quimiorradioterapia/métodos , Quimiorradioterapia/normas , Tomada de Decisão Clínica , Consenso , Humanos , Excisão de Linfonodo , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Linfonodos/cirurgia , Margens de Excisão , Estadiamento de Neoplasias/normas , Cuidados Paliativos/normas , Equipe de Assistência ao Paciente/normas , Educação de Pacientes como Assunto/normas , Pele/diagnóstico por imagem , Pele/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologia , Sociedades Médicas/normas , Luz Solar/efeitos adversos
18.
Obes Facts ; 13(2): 166-178, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32208386

RESUMO

BACKGROUND: It is an important condition for adequate weight loss and prevention of adverse events that bariatric surgery (BS) candidates possess good specific health knowledge. There is a paucity of standardized instruments to evaluate the specific health knowledge of patients before and after BS. Therefore, we developed a 32-item multiple-choice test covering the main aspects of life which are important after BS, and investigated the correlation of specific health knowledge with health literacy, level of depression and anxiety, percentage of excess weight loss, and specific complications of BS in postoperative patients. METHODS: Two groups participated in the cross-sectional study: the preoperative group (n = 109) was recruited from candidates for BS (gastric bypass or sleeve gastrectomy), the postoperative group (n = 110) was recruited from patients 12-74 months after BS (average 33 months, SD = 16.5). Both groups had completed a preoperative multimodal training program. Specific health knowledge was assessed with a newly developed knowledge questionnaire. Health literacy was evaluated with the short version of the European Health Literacy Survey (HLS-EU-Q16). The 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Scale (GAD-7) were used to assess the levels of depression and anxiety. RESULTS: The pre- and postoperative group did not differ with regard to the number of correctly answered questions on the knowledge questionnaire, with 75% correct answers in both groups (p = 0.059). No correlations were found with health literacy (p = 0.498) and levels of depression (preoperative group: p = 0.279; postoperative group: p = 0.242) and anxiety (preoperative group: p = 0.866; postoperative group: p = 0.119). In postoperative patients specific health knowledge was not associated with the weight loss achieved (p = 0.437). CONCLUSION: The newly designed knowledge questionnaire can be useful for screening specific knowledge of BS patients at different time points.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Letramento em Saúde/estatística & dados numéricos , Conhecimento , Obesidade/cirurgia , Educação de Pacientes como Assunto , Adulto , Cirurgia Bariátrica/educação , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/psicologia , Educação de Pacientes como Assunto/normas , Educação de Pacientes como Assunto/estatística & dados numéricos , Período Pós-Operatório , Inquéritos e Questionários , Perda de Peso/fisiologia , Adulto Jovem
19.
J Wound Ostomy Continence Nurs ; 47(2): 137-139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150139

RESUMO

PURPOSE: The purpose of this study was to determine if patients undergoing presurgical ostomy education and routine postoperative education experienced less postsurgical anxiety than patients undergoing routine preoperative education. DESIGN: Quantitative, prospective, comparison cohort study. SUBJECTS AND SETTING: The sample comprised 30 participants divided into 2 groups; one group received preoperative ostomy education and stoma site marking, along with postoperative ostomy education, while the other received only postoperative ostomy education. Each group had an equal number of males (n = 11) and females (n = 4). The mean age for the groups was 65.27 (SD = 9.97) and 61.87 (SD = 17.56) years, respectively; this difference was not statistically significant (P > .05). The intervention group included 9 patients who underwent colostomy, 4 who underwent ileostomy, and 2 who underwent urostomy. The comparison group comprised 10 patients with colostomies, 4 with ileostomies, and 1 with a urostomy. The study setting was a 385-bed tertiary hospital in Northern California. Data collection occurred from November 2, 2018, to February 22, 2019. METHODS: Postoperative anxiety levels were evaluated in both groups during their postoperative ostomy education session. Anxiety level was measured using the anxiety domain of the Hospital Anxiety and Depression Survey (HADS), which was administered during their postoperative educational session. Analysis of variance was used to compare the difference between the HADS anxiety domain scores between the groups. RESULTS: Patients who received preoperative ostomy education had statistically significant lower postsurgical anxiety scores than patients who had standard education (P < .001). CONCLUSIONS: Study findings suggest that preoperative ostomy education, when offered in addition to routine preoperative education, significantly lowers anxiety when compared to patients managed by routine preoperative education alone.


Assuntos
Ansiedade/prevenção & controle , Estomia/métodos , Educação de Pacientes como Assunto/normas , Cuidados Pré-Operatórios/psicologia , Idoso , Ansiedade/psicologia , California , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/métodos , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/normas , Estudos Prospectivos , Qualidade de Vida/psicologia , Inquéritos e Questionários
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