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1.
Br J Nurs ; 28(22): 1450-1454, 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31835933

RESUMO

The aim of this quality improvement project was to improve patients' knowledge about their vitamin B12 deficiency by developing an information leaflet and engaging nursing staff in providing this educational tool to patients with the condition. Following two 'plan, do, study, act' cycles to test and improve implementation of the leaflet, the nursing team met the goal of 100% compliance with providing educational information to patients. An increase in patient knowledge following provision of the leaflet was predicted, and achieved.


Assuntos
Comunicação , Relações Enfermeiro-Paciente , Educação de Pacientes como Assunto/métodos , Deficiência de Vitamina B 12/enfermagem , Humanos , Folhetos , Melhoria de Qualidade
3.
MMW Fortschr Med ; 161(Suppl 6): 3-8, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31587170

RESUMO

BACKGROUND: Family members of patients with severe illness are burdened with the care and participation in challenging decisions regarding medical treatment and care in addition to the challenges of their own lives. They express a wish for low-threshold support services. However, there are few publications on targeted interventions for the support of family members of patients with a serious illness. METHOD: An information brochure was developed on the basis of a systematic review and its feasibility and acceptance were tested with an evaluation sheet, handed out to family members in 3 different settings (3 palliative care units, 21 family practices, and 2 home palliative care services) over a period of 6 weeks. Satisfaction was measured using a 5-point Likert scale (1 = very satisfied, 5 = not satisfied at all). To assess the acceptance of the brochure the participants were asked about their willingness to read. The benefit was judged on questions of information gain. In addition, deficiencies could be named and suggestions for improvement could be made. RESULTS: Overall, 27 evaluation sheets were analysed. 93% of the participating relatives read the whole brochure. 63% of the relatives were satisfied or very satisfied with the flyer (median 2 = satisfied). 70% of the relatives said they had received new information. CONCLUSIONS: In this feasibility study, the acceptance and usefulness of the information flyer for a large number of relatives was confirmed. Such an information flyer thus provides a low-threshold supplement to the support of families in the care at the end of life.


Assuntos
Disseminação de Informação/métodos , Folhetos , Relações Profissional-Família , Família/psicologia , Estudos de Viabilidade , Serviços de Assistência Domiciliar , Humanos , Cuidados Paliativos
4.
Urology ; 134: 135-142, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31494212

RESUMO

OBJECTIVES: To evaluate possible discrepancies between patients' expectations concerning sexual side effects related to prostate cancer treatment, based on the obtained information prior to treatment. Moreover, to determine if demographic or clinical factors may have an effect on the accuracy of patients' expectations concerning sexual side effects after treatment. METHODS: A multicenter, cross-sectional survey was performed among men treated with prostatectomy, brachytherapy, external-beam radiotherapy and/or hormonal therapy. RESULTS: In total, 412 questionnaires were analyzed. Of men with sexual side effects after treatment, 1 in 3 (32.5%, n = 109) reported their complaints as worse than expected; significantly more often reported by men treated surgically (P = .001), men with a local stage tumor (P = .005) and by men with a lower prostate-specific antigen level at diagnosis (P = .046). It was significantly less often reported by men treated with radiotherapy combined with hormonal therapy (P = .031). Men who used brochures as an information source reported their sexual side effects significantly less often as worse than expected (P < .001). CONCLUSION: One in three men with sexual side effects after prostate cancer treatment, experienced their complaints as worse than expected based on the obtained information prior to treatment. Men treated with radiotherapy combined with hormonal therapy indicated less discrepancy between expectations and developed sexual side effects, whereas prostatectomy, low stage tumor and low prostate-specific antigen level were associated with more discrepancy. Brochures should be administered additionally to verbal information to improve patients' understanding of possible sexual side effects and to enhance the accuracy of patients' expectations.


Assuntos
Disfunção Erétil/etiologia , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias da Próstata/terapia , Idoso , Antagonistas de Androgênios/efeitos adversos , Braquiterapia/efeitos adversos , Estudos Transversais , Humanos , Masculino , Países Baixos , Folhetos , Educação de Pacientes como Assunto , Antígeno Prostático Específico/sangue , Prostatectomia/efeitos adversos , Radioterapia Adjuvante/efeitos adversos , Inquéritos e Questionários
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46724

RESUMO

Folheto da campanha da Semana Mundial do Aleitamento Materno - SMAM 2019, que tem como tema: Empoderar mães e pais, favorecer a amamentação. Hoje e para o futuro!.


Assuntos
Folhetos , Promoção da Saúde , Serviços de Saúde Materno-Infantil , Política de Saúde , Equidade de Gênero , Aleitamento Materno , Leite Humano
6.
J Stroke Cerebrovasc Dis ; 28(11): 104317, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31401045

RESUMO

BACKGROUND: Obstructive sleep apnea (OSA) occurs in about 70% of stroke and transient ischemic attack (TIA) patients and is associated with poor function and recurrent vascular events. Continuous Positive Airway Pressure (CPAP) has been shown to improve poststroke/TIA outcomes but adherence is generally poor. This study aimed to develop and conduct a preliminary assessment of educational materials for poststroke/TIA OSA. METHODS: This blinded pilot study involved the randomization of stroke/TIA patients to either an intervention group (who viewed an educational pamphlet and slideshow) or a control group (standard of care). Patient ratings were used to evaluate the educational materials. Changes in knowledge, daytime sleepiness, functional outcomes of sleep, and CPAP use were assessed at baseline and 6 months. RESULTS: Total 93% of eligible patients consented to participate. Forty-eight participants were randomized to the control group (n = 23) or intervention group (n = 25). In the intervention group, all patients agreed or strongly agreed that the information in the educational materials was useful and that the wording was easy to understand. There were no significant changes in knowledge, daytime sleepiness, and functional outcomes of sleep between both groups at 6 months. In those who used CPAP, there was no significant difference in mean hours of CPAP use at the 6-month follow-up. CONCLUSIONS: The educational program was feasible and easy to understand amongst stroke/TIA patients but did not lead to a significant change in outcomes or CPAP use. The lessons learned can be used to facilitate future development of educational materials and plan an adequately-powered trial.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Ataque Isquêmico Transitório/complicações , Educação de Pacientes como Assunto , Apneia Obstrutiva do Sono/etiologia , Acidente Vascular Cerebral/complicações , Idoso , Idoso de 80 Anos ou mais , Recursos Audiovisuais , Pressão Positiva Contínua nas Vias Aéreas , Estudos de Viabilidade , Feminino , Humanos , Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/fisiopatologia , Masculino , Pessoa de Meia-Idade , Folhetos , Cooperação do Paciente , Satisfação do Paciente , Projetos Piloto , Medição de Risco , Fatores de Risco , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
7.
Knee ; 26(5): 1026-1031, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31434628

RESUMO

BACKGROUND: This study examined the effects of a patient information leaflet on outcomes related to patient satisfaction following knee arthroscopy. METHODS: Cohort study of patients listed for knee arthroscopy under the care of a single surgeon over a nine-month period (May 2017-January 2018) following the introduction of an information leaflet as an adjunct to the consent process. Outcome data was collected postoperatively through telephone follow-up. Outcome measures included feelings of involvement with decision-making, expectations being met, satisfaction, postoperative pain numerical rating scales and the Forgotten Joint Score-12. RESULTS: Fifty-five patients were consented by the operating surgeon, of which 28 (50.9%) received a leaflet and 27 (49.1%) did not. Patients who received the information leaflet felt more involved in and informed about the decision to have an operation than patients who did not (p = 0.016), however there were no differences in any other outcomes between patients who did and did not receive a leaflet (p > 0.05). CONCLUSIONS: The use of an information leaflet as an adjunct to the preoperative consultation is an effective way of helping patients feel more involved in the surgical decision-making process, however this does not influence overall outcome or satisfaction metrics.


Assuntos
Artroscopia/psicologia , Articulação do Joelho/cirurgia , Educação de Pacientes como Assunto/métodos , Cuidados Pré-Operatórios/métodos , Adulto , Estudos de Coortes , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Motivação , Folhetos , Satisfação do Paciente , Cuidados Pré-Operatórios/psicologia , Resultado do Tratamento
8.
Artigo em Inglês | MEDLINE | ID: mdl-31466419

RESUMO

(1) Introduction: Poor uptake of referral for ear and hearing services in Malawi has been demonstrated in previous research. A multi-component educational intervention was developed to address poor uptake. The aim of this study was to explore the feasibility and acceptability of the intervention. In addition, we aimed to provide a case study of an intervention development and feasibility testing process in preparation for a potential randomised trial. (2) Methods: The intervention included three components: (i) an information booklet; (ii) personalised counselling by a community health worker and an expert mother; (iii) a text message reminder. To assess feasibility, the counselling and information booklet were provided for caregivers of eligible children (<18 years) at ear and hearing outreach camps in Thyolo. Text message reminders were sent to caregivers after the camps. After 4 weeks, all caregivers were revisited and completed a structured questionnaire and a subset were interviewed in-depth. (3) Results: 30 children were recruited, and 53% took up the referral. Interviews found counselling with a booklet was acceptable. It provided motivation, enabled a two-way conversation, and helped dispel fear. It allowed information to be shared with social networks, initiating conversations about raising funds. The text message reminder was reported to be a valued prompt. Challenges to feasibility included low network coverage, and time needed for counselling. Residual barriers included the costs of transportation. The cost was £3.70/camp. (4) Conclusions: The study found that counselling with an information booklet was feasible and acceptable. The process of testing the feasibility of the intervention identified some adaptations to the intervention components and delivery which could be implemented before it is tested in a trial. This study highlighted the value of the feasibility testing process.


Assuntos
Otopatias , Folhetos , Encaminhamento e Consulta , Adolescente , Adulto , Atitude Frente a Saúde , Cuidadores , Criança , Pré-Escolar , Agentes Comunitários de Saúde , Custos e Análise de Custo , Estudos de Viabilidade , Feminino , Humanos , Malaui , Masculino , Pessoa de Meia-Idade , Motivação , Inquéritos e Questionários , Mensagem de Texto , Transportes , Adulto Jovem
9.
BMC Health Serv Res ; 19(1): 592, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438940

RESUMO

BACKGROUND: The 'Surviving Crying' study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS). The resulting service includes three materials: a website, a printed booklet, and a Cognitive Behaviour Therapy (CBT) programme delivered to parents by a qualified professional. This study aimed to measure whether parents used the materials and to obtain parents' and NHS professionals' evaluations of whether they are fit for purpose. Parents were asked about participating in a randomised controlled trial (RCT) to evaluate the materials fully in health service use. METHODS: Participants were 57 parents with babies they judged to be crying excessively and 96 NHS Health Visitors (HVs). Parental use and parents' and HVs' ratings of the Surviving Crying materials were measured. RESULTS: Thirty four parents reported using the website, 24 the printed booklet and 24 the CBT sessions. Parents mostly accessed the website on mobile phones or tablets and use was substantial. All the parents and almost all HVs who provided data judged the materials to be helpful for parents and suitable for NHS use. If offered a waiting list control group, 85% of parents said they would have been willing to take part in a full RCT evaluation of the Surviving Crying package. DISCUSSION AND CONCLUSIONS: The findings identify the need for materials to support parents of excessively crying babies within national health services in the UK. The Surviving Crying support package appears suitable for this purpose and a full community-level RCT of the package is feasible and likely to be worthwhile. Limitations to the study and barriers to delivery of the services were identified, indicating improvements needed in future research. TRIAL REGISTRATION: Study Registration no. ISRCTN84975637 .


Assuntos
Terapia Cognitivo-Comportamental/métodos , Choro/psicologia , Pais/psicologia , Apoio Social , Adulto , Atitude do Pessoal de Saúde , Estudos de Viabilidade , Feminino , Humanos , Lactente , Internet , Masculino , Folhetos , Poder Familiar/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Satisfação do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Telemedicina/métodos , Reino Unido
10.
Pediatrics ; 144(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31292219

RESUMO

OBJECTIVES: To assess the impact of a parent educational intervention about influenza disease on child vaccine receipt. METHODS: A convenience sample of parents of children ≥6 months old with a visit at 2 New York City pediatric clinics between August 2016 and March 2017 were randomly assigned (1:1:1) to receive either usual care, an educational handout about influenza disease that was based on local data, or an educational handout about influenza disease that was based on national data. Parents received the handout in the waiting room before their visit. Primary outcomes were child influenza vaccine receipt on the day of the clinic visit and by the end of the season. A multivariable logistic regression was used to assess associations between intervention and vaccination, with adjustment for variables that were significantly different between arms. RESULTS: Parents who received an intervention (versus usual care) had greater odds of child influenza vaccine receipt by the end of the season (74.9% vs 65.4%; adjusted odds ratio 1.68; 95% confidence interval: 1.06-2.67) but not on the day of the clinic visit. Parents who received the national data handout (versus usual care) had greater odds of child influenza vaccine receipt on the day of the clinic visit (59.0% vs 52.6%; adjusted odds ratio 1.79; 95% confidence interval: 1.04-3.08) but not by the end of the season. CONCLUSIONS: Providing an educational intervention in the waiting room before a pediatric provider visit may help increase child influenza vaccine receipt.


Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Visita a Consultório Médico , Folhetos , Educação de Pacientes como Assunto/métodos , Vacinação/métodos , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Influenza Humana/epidemiologia , Masculino , Ambulatório Hospitalar
11.
Trials ; 20(1): 412, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288859

RESUMO

BACKGROUND: Opioid use has risen to epidemic proportions across Canada, with increasing evidence of harms including accidental overdose and death. Policy-makers have called for effective approaches to promote opioid reduction. One promising method from deprescribing randomized trials is to empower patients through direct-to-patient education. The current trial will evaluate the effectiveness of a government-led mail-out of educational information to adult community-dwelling, chronic opioid users on the reduction of opioids compared to usual care. METHODS: This is a pragmatic, prospective, cluster randomized, parallel-arm controlled trial, comparing mailed distribution of a direct-to-patient educational brochure for chronic opioid use (intervention arm) to usual care (control arm). Eligible participants from across Manitoba, Canada, will be identified by the Provincial Drug Programs Branch within the Manitoba Health, Seniors and Active Living Department of the Manitoba Government, allocated to primary care providers, and the latter will be randomized in clusters of family medicine practices to achieve a 1:1 ratio. The primary outcome is complete cessation of opioids after 6 months assessed using Drug Program Information Network data. Secondary outcomes include ≥ 25% dose reduction in the mean morphine milligram equivalent (MME) daily dose, reduction of daily dose to < 90 mg MME, or therapeutic switch to another opioid or non-opioid medication. Data will be analyzed using intent-to-treat generalized estimating equations. DISCUSSION: This trial will test the efficacy of a population-based, wide-scale, government-led direct-to-patient educational initiative to drive reductions in chronic opioid use by community-dwelling adults across Manitoba. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03400384 . Registered on 18 January 2018.


Assuntos
Analgésicos Opioides/administração & dosagem , Dor Crônica/tratamento farmacológico , Desprescrições , Substituição de Medicamentos , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Folhetos , Educação de Pacientes como Assunto/métodos , Analgésicos Opioides/efeitos adversos , Dor Crônica/diagnóstico , Dor Crônica/psicologia , Esquema de Medicação , Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Humanos , Manitoba , Transtornos Relacionados ao Uso de Opioides/diagnóstico , Transtornos Relacionados ao Uso de Opioides/psicologia , Formulação de Políticas , Serviços Postais , Ensaios Clínicos Pragmáticos como Assunto , Estudos Prospectivos , Fatores de Proteção , Medição de Risco , Fatores de Risco , Fatores de Tempo
12.
Medicina (Kaunas) ; 55(7)2019 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-31284666

RESUMO

Background and objectives: Lumbar spine surgery may be considered if pharmacologic, rehabilitation and interventional approaches cannot provide sufficient recovery from low back-related pain. Postoperative physiotherapy treatment in England is often accompanied by patient information leaflets, which contain important rehabilitation advice. However, in order to be an effective instrument for patients, the information provided in these leaflets must be up to date and based on the best available evidence and clinical practice. This study aims to critically analyse the current postoperative aspects of rehabilitation (exercise prescription and return to normal activity) that are provided in patient information leaflets in England as part of an evaluation of current practice following lumbar spine surgery. Materials and Methods: Patient information leaflets from English National Health Service (NHS) hospitals performing lumbar spine surgery were sourced online. A content analysis was conducted to collect data on postoperative exercise prescription and return to normal activities. Results: Thirty-two patient information leaflets on lumbar surgery were sourced (fusion, n = 11; decompression, n = 15; all lumbar procedures, n = 6). Many of the exercises prescribed within the leaflets were not based on evidence of clinical best practice and lacked a relationship to functional activity. Return to normal activity advice was also wide ranging, with considerable variation in the recommendations and definitions provided. Conclusions: This study highlights a clear variation in the recommendations of exercise prescription, dosage and returning to normal activities following lumbar spine surgery. Future work should focus on providing a consistent and patient-centred approach to recovery.


Assuntos
Terapia por Exercício/estatística & dados numéricos , Vértebras Lombares/cirurgia , Procedimentos Ortopédicos/normas , Educação de Pacientes como Assunto/normas , Volta ao Esporte/estatística & dados numéricos , Inglaterra , Exercício/fisiologia , Terapia por Exercício/métodos , Humanos , Dor Lombar/complicações , Dor Lombar/cirurgia , Vértebras Lombares/lesões , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/estatística & dados numéricos , Folhetos , Educação de Pacientes como Assunto/métodos , Período Pós-Operatório , Pesquisa Qualitativa , Medicina Estatal/organização & administração , Medicina Estatal/estatística & dados numéricos
13.
Rev Bras Enferm ; 72(3): 780-787, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269146

RESUMO

OBJECTIVE: to describe the validation of the booklet on self-care with the feet of people with diabetes. METHOD: methodological study, focusing on the validation of a printed booklet. The content and appearance of the booklet was validated by 23 judges divided into three groups: 11 content and appearance, seven technicians and five of the area of design and marketing. The appearance was validated by 30 people with type 2 Diabetes Mellitus. RESULTS: the judges in the nursing area allowed the validation of material with a Content Validity Index (CVI) of 0.99, judges in the area of design and marketing with Suitability Assessment of Materials (SAM) of 99.2% and the target audience with concordance index of 99.4%. CONCLUSION: the educational booklet proved to be valid and reliable educational material to be used in order to promote compliance with self-care with the feet of people with Diabetes Mellitus.


Assuntos
Pé Diabético/terapia , Folhetos , Educação de Pacientes como Assunto/normas , Autocuidado/instrumentação , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/terapia , Pé Diabético/psicologia , Humanos , Educação de Pacientes como Assunto/métodos , Autocuidado/métodos , Autocuidado/normas , Inquéritos e Questionários , Estudos de Validação como Assunto
14.
Adv Physiol Educ ; 43(3): 266-269, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31166122

RESUMO

Obesity and diabetes are two of the biggest public health problems in the modern world. One possible way to combat the rising prevalence of these diseases is through the spread of awareness about its consequences and how to prevent them. Therefore, educational interventions focused on teaching the physiological basis of these conditions might be valuable tools. However, most scholar curriculums lack high-quality material devoted to this topic. Thus we developed an educational booklet, composed of playful elements, targeted toward high school students and destined for application in classrooms. The efficacy of the developed material was validated through a pretest-posttest design, in which the students had to answer a 10-question test. After booklet completion, students had better outcomes, with an increase in the percentage of correct answers in 7 out of 10 questions contained in the test (P < 0.05). Thus we developed an effective material for usage in the high school classroom to spread the awareness of the risks of metabolic diseases and how to prevent them.


Assuntos
Diabetes Mellitus/fisiopatologia , Educação em Saúde/métodos , Obesidade/fisiopatologia , Folhetos , Jogos e Brinquedos/psicologia , Estudantes/psicologia , Adolescente , Brasil/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Instituições Acadêmicas
15.
BMC Health Serv Res ; 19(1): 267, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035985

RESUMO

BACKGROUND: The child health record booklet (CHRB) is a powerful tool for screening children under five and for education of caregivers by health workers. The objective of the present study was to assess the knowledge and utilization of CHRB by mothers and health workers in child growth monitoring and promotion (GMP) in the East Mamprusi Municipal, Northern region, Ghana. METHODS: A descriptive cross-sectional study was conducted among mothers attending child welfare clinics (CWC) and health workers providing GMP at CWC. Observational checklists were used to assess 73 CHRB on the completeness and correctness of growth charts. Mothers and health workers' knowledge on essential components of CHRB were assessed with a questionnaire. RESULTS: Weight measurements were correctly recorded in all booklets analyzed. Even though a greater proportion (70.7%) of health workers exhibited high knowledge scores on the interpretation of the essential components of the CHRB,most of the charts analyzed were not completely filled (72.6%) but rather correctly filled (74.0%). Mean knowedge score (3.4 ± 1.3) on growth charting was low among mothers who attend GMP. Work overload (26.1%), inadequate supply of CHRB (26.1%) and vaccine shortages (18.7%) were concerns raised by health workers on the effective usage of the CHRB. CONCLUSION: Knowledge scores on the child health record booklets among health workers and mothers in this part of northern Ghana were high but charting of growth of children was sub-optimal among health workers.


Assuntos
Desenvolvimento Infantil , Saúde da Criança/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Mães/educação , Folhetos , Adulto , Lista de Checagem , Saúde da Criança/normas , Pré-Escolar , Estudos Transversais , Feminino , Gana , Humanos , Lactente , Masculino , Programas de Rastreamento , Inquéritos e Questionários
16.
Br J Oral Maxillofac Surg ; 57(5): 412-418, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31054792

RESUMO

The aim and objective of this study was to evaluate the quality and readability of leaflet and online Oral and Maxillofacial Surgery patient information leaflets (PILs). The quality, readability and grade level of each PIL was assessed using the DISCERN, Flesch Reading Ease and Flesh-Kincaid Grade Level instruments respectively. In total, 140 patient information leaflets were assessed. For both leaflet and online PILs, many items of the DISCERN instrument were deemed of low quality and poorly reported. The median overall quality score was 30.2. Variation in the quality and readability scores between leaflet and online PILs and those produced by various societies was evident. Overall, PILs were deemed to be of moderate quality. Online PILs were of lower quality, more difficult to read and aimed at a higher reading age level.


Assuntos
Compreensão , Folhetos , Educação de Pacientes como Assunto/métodos , Leitura , Cirurgia Bucal , Humanos , Internet , Educação de Pacientes como Assunto/normas , Publicações/normas , Registros
17.
PLoS Med ; 16(5): e1002800, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31067237

RESUMO

BACKGROUND: Treatment decision-making regarding immunosuppressive therapy is challenging for individuals with lupus. We assessed the effectiveness of a decision aid for immunosuppressive therapy in lupus nephritis. METHODS AND FINDINGS: In a United States multicenter, open-label, randomized controlled trial (RCT), adult women with lupus nephritis, mostly from racial/ethnic minority backgrounds with low socioeconomic status (SES), seen in in- or outpatient settings, were randomized to an individualized, culturally tailored, computerized decision aid versus American College of Rheumatology (ACR) lupus pamphlet (1:1 ratio), using computer-generated randomization. We hypothesized that the co-primary outcomes of decisional conflict and informed choice regarding immunosuppressive medications would improve more in the decision aid group. Of 301 randomized women, 298 were analyzed; 47% were African-American, 26% Hispanic, and 15% white. Mean age (standard deviation [SD]) was 37 (12) years, 57% had annual income of <$40,000, and 36% had a high school education or less. Compared with the provision of the ACR lupus pamphlet (n = 147), participants randomized to the decision aid (n = 151) had (1) a clinically meaningful and statistically significant reduction in decisional conflict, 21.8 (standard error [SE], 2.5) versus 12.7 (SE, 2.0; p = 0.005) and (2) no difference in informed choice in the main analysis, 41% versus 31% (p = 0.08), but clinically meaningful and statistically significant difference in sensitivity analysis (net values for immunosuppressives positive [in favor] versus negative [against]), 50% versus 35% (p = 0.006). Unresolved decisional conflict was lower in the decision aid versus pamphlet groups, 22% versus 44% (p < 0.001). Significantly more patients in the decision aid versus pamphlet group rated information to be excellent for understanding lupus nephritis (49% versus 33%), risk factors (43% versus 27%), medication options (50% versus 33%; p ≤ 0.003 for all); and the ease of use of materials was higher in the decision aid versus pamphlet groups (51% versus 38%; p = 0.006). Key study limitations were the exclusion of men, short follow-up, and the lack of clinical outcomes, including medication adherence. CONCLUSIONS: An individualized decision aid was more effective than usual care in reducing decisional conflict for choice of immunosuppressive medications in women with lupus nephritis. TRIAL REGISTRATION: Clinicaltrials.gov, NCT02319525.


Assuntos
Técnicas de Apoio para a Decisão , Imunossupressores/uso terapêutico , Nefrite Lúpica/tratamento farmacológico , Educação de Pacientes como Assunto , Participação do Paciente , Adulto , Comportamento de Escolha , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Alfabetização em Saúde , Humanos , Imunossupressores/efeitos adversos , Nefrite Lúpica/etnologia , Nefrite Lúpica/imunologia , Pessoa de Meia-Idade , Folhetos , Resultado do Tratamento , Estados Unidos/epidemiologia
18.
J Pediatr Nurs ; 47: 131-135, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31128419

RESUMO

PURPOSE: The purpose of this focus group was to identify the preferred method of education for low-income caregivers to learn about common childhood illnesses in an effort to meet their health literacy needs. METHODS: Focus group participants were recruited from two sources; caregivers who qualified for Women, Infants, and Children (WIC) Food and Nutrition Services and those attending a monthly prenatal health education program for low-income pregnant women. Participants were asked to rank in order of preference five educational options. The five options included a commonly used diagnosis-specific handout, a booklet of the most common childhood illnesses and symptoms, a comprehensive book of common childhood illness and symptoms, a 24-hour nurse call line, and a mobile application developed by the American Academy of Pediatrics. All options provided accurate information from professional sources. RESULTS: The ranking of the five educational options identified the mobile application developed by the American Academy of Pediatrics, KidsDoc, to be the preferred method with the commonly used diagnosis-specific handout as the least favorite option. CONCLUSION/PRACTICE IMPLICATIONS: The United States Department of Health and Human Services (USDHHS) has identified a need to change the way health information is designed and delivered. Identifying that materials should be redesigned using best practices to reduce health literacy demands and match consumer preferences, the USDHHS calls for periodic testing of materials with the intended consumers. This focus group provides valuable information and a step toward future research to address health literacy using materials identified by low-income consumers.


Assuntos
Cuidadores/educação , Serviços de Saúde da Criança/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Alfabetização em Saúde , Folhetos , Adulto , Criança , Pré-Escolar , Feminino , Grupos Focais , Humanos , Lactente , Recém-Nascido , Pobreza
19.
Laryngorhinootologie ; 98(S 01): S1-S4, 2019 Mar.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-31096293

RESUMO

Dear Colleagues,it is an extraordinary pleasure for me to present this really interesting booklet that was created at the occasion of the 90th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head & Neck Surgery. The highly significant scientific contributions from nine universities discuss different aspects of the meeting's motto entitled "Digitization in Oto-Rhino-Laryngology" and show important fields for developing and securing the future of our discipline.During the last years, digitization and artificial intelligence gain increasingly in importance for the German healthcare landscape and thus also for the field of oto-rhino-laryngology. With regard to future developments in healthcare services it is essential to impart digital competences to physicians, medical staff, but also to patients in a well-structured way. At the same time, the legal and ethical issues resulting from medical-technological progresses have to be thoroughly discussed.


Assuntos
Otolaringologia , Previsões , Humanos , Folhetos , Médicos , Universidades
20.
Clin Rehabil ; 33(7): 1139-1149, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30813767

RESUMO

OBJECTIVE: Explore qualitative differences between interventions (DVD and booklet (DVDB) versus face-to-face and booklet (F2FB) versus usual care) in the BREATHE (Breathing Retraining for Asthma Trial of Home Exercises) trial of breathing retraining for asthma. DESIGN: Quantitative process analysis exploring group expectancy, experience and practice before and after intervention delivery for the main trial. SETTING: Primary care. SUBJECTS: Adults with asthma (DVD and booklet, n = 261; F2FB, n = 132). MAIN MEASURES: Baseline - expectancy about breathing retraining; follow-up 3, 6 and 12 months - self-efficacy, treatment experience (enjoyment of treatment, perceptions of physiotherapist, perceptions of barriers), amount of practice (weeks, days/week, times/day), continued practice; all time points - anxiety (Hospital Anxiety and Depression Scale), AQLQ (Asthma Quality of Life Questionnaire). RESULTS: No group differences in baseline expectancy. Statistically significant results (P < 0.05) indicated that at follow-up, F2FB participants perceived greater need for a physiotherapist than DVD and booklet participants (3.43 (0.87) versus 2.15 (1.26)). F2FB participants reported greater enjoyment of core techniques (such as stomach breathing: 7.42 (1.67) versus 6.13 (1.99) (DVD and booklet)). Fewer F2FB participants reported problems due to doubts (24 (22.9%) versus 90 (54.2%)). F2FB participants completed more practice sessions (75.01 (46.38) versus 48.56 (44.71)). Amount of practice was not significantly related to quality of life. In the DVD and booklet arm, greater confidence in breathing retraining ability explained 3.9% of variance in quality of life at 12 months. CONCLUSION: Adults with asthma receiving breathing retraining face-to-face report greater enjoyment and undertaking more practice than those receiving a DVD and booklet. Greater confidence in ability to do breathing retraining is associated with improved QoL.


Assuntos
Asma/fisiopatologia , Asma/reabilitação , Terapia por Exercício/métodos , Qualidade de Vida , Terapia Respiratória/métodos , Adulto , Ansiedade , Asma/psicologia , Feminino , Seguimentos , Humanos , Masculino , Folhetos , Fatores de Tempo , Resultado do Tratamento
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