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1.
Rev Lat Am Enfermagem ; 28: e3322, 2020 Sep 07.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-32901766

RESUMO

OBJECTIVE: to develop and validate an educational technology for individuals living with the human immunodeficiency virus. METHOD: a methodological study, for the elaboration of educational material. The educational needs, content selection, and illustrations were defined from interviews with the target population. Afterward, we carried the writing, the material layout elaboration, and assembly and, subsequently, it was validated by specialists. The content validation was established from the Level Content Validity Index higher than 0.8. RESULTS: the educational material was prepared for adults living with the human immunodeficiency virus, with a focus on health promotion and quality of life, and was prepared in five volumes. The validation was made by 22 multi-professional judges selected according to the criteria established in the study. All items were evaluated as relevant by the judges and the average obtained with the index was 0.97. CONCLUSION: the booklet has been validated in terms of content, language, and appearance by experts in the field. We believe that through this technology it is possible to contribute to the health literacy and empowerment of individuals living with the human immunodeficiency virus, strengthening their autonomy.


Assuntos
Infecções por HIV , Qualidade de Vida , Adulto , Promoção da Saúde , Humanos , Folhetos , Inquéritos e Questionários
2.
J Anesth Hist ; 6(3): 156-157, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32921486

RESUMO

J.Y. Simpson of Edinburgh, Scotland discovered chloroform anesthesia in November 1847. During this time, W.T.G. Morton's agents had been collecting royalties for the use of ether across much of the United States. After reading about the advantages of chloroform as cited in C.T. Jackson's writings in the Boston Daily Atlas, S.F. Gladwin, a dentist in Lowell, Massachusetts, who had been reluctant to pay any ether royalties, demonstrated his independence and opportunism in swiftly adopting chloroform in his practice and publicizing its use through local advertisements.


Assuntos
Publicidade/história , Anestesia Dentária/história , Anestésicos Inalatórios/história , Clorofórmio/história , História do Século XIX , Humanos , Massachusetts , Folhetos/história
3.
Rev Infirm ; 69(260-261): 39-40, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32600596

RESUMO

The nurse, a frontline player in therapeutic education. The ageing of the population and the growing number of people with chronic diseases is resulting in a significant need for therapeutic patient education (TPE). Nurses, by virtue of their training and their missions, are frontline players in the implementation of TPE, as demonstrated by the different perspectives of a student nurse and his practice placement tutor with the development of an educational booklet on the theme of "diet and diabetes".


Assuntos
Diabetes Mellitus/enfermagem , Relações Enfermeiro-Paciente , Educação de Pacientes como Assunto , Estudantes de Enfermagem/psicologia , Dieta , Humanos , Folhetos
4.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32636237

RESUMO

OBJECTIVE: The Centers for Disease Control and Prevention recommend testing for Chlamydia trachomatis in sexually active female patients <25 years old using nucleic-acid amplification tests (NAAT) from a vaginal swab. Our providers were typically testing using the less sensitive urine NAATs. We aimed to increase the percentage of urogenital C trachomatis NAATs performed by using vaginal swabs in adolescent female patients ages 10 through 20 years from 1.4% to 25%. METHODS: We implemented 3 interventions at 3 pediatric practices over 12 months including education, process standardization, and cross-training. We used statistical process control to analyze the effect of interventions on our primary outcome: the percentage of urogenital C trachomatis tests performed with a vaginal swab. Our balance measure was the total number of urogenital C trachomatis tests. RESULTS: There were 818 urogenital C trachomatis tests performed: 289 before and 529 after the first intervention. Of urogenital C trachomatis tests in the preintervention time period, 1.4% were performed by using vaginal swabs. We surpassed our aim of 25% 6 weeks after the first intervention. We noted sustained improvement after the second intervention, with an average of 68.3% of tests performed by using vaginal swabs for the remaining postintervention period. There was no difference in the overall number of urogenital C trachomatis tests pre- and postintervention. CONCLUSIONS: Using quality improvement methodology and implementing easily replicable interventions, we significantly and sustainably increased use of vaginal swabs. The interventions standardizing processes were associated with a higher impact than the educational intervention.


Assuntos
Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Técnicas de Amplificação de Ácido Nucleico/métodos , Pediatras/educação , Padrões de Prática Médica/tendências , Vagina/microbiologia , Esfregaço Vaginal/tendências , Adolescente , Criança , Infecções por Chlamydia/epidemiologia , Feminino , Humanos , Massachusetts/epidemiologia , Técnicas de Amplificação de Ácido Nucleico/estatística & dados numéricos , Folhetos , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/estatística & dados numéricos , Utilização de Procedimentos e Técnicas/tendências , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade , Comportamento Sexual , Adulto Jovem
5.
PLoS One ; 15(6): e0232867, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497049

RESUMO

INTRODUCTION: The Neglected Tropical Diseases Roadmap of the WHO set targets for potential elimination as a "public health problem" for the period 2012-2020 in multiple countries in Africa, with the aim of global elimination of schistosomiasis as a "public health problem" by 2025. AIM: The purpose of the study was to estimate the cost from a provider's perspective of the Department of Health's Schistosomiasis Mass Drug Administration (MDA) in Ugu District, KwaZulu-Natal in 2012, with a view to project the costs for the entire KwaZulu Natal Province. METHODS: A total of 491 public schools and 16 independent schools in Ugu District, a predominantly rural district in KwaZulu-Natal with a total of 218 242 learners, were included in the schistosomiasis control programme. They were randomly selected from schools situated below an altitude of 300 meters, where schistosomiasis is endemic. A retrospective costing study was conducted using the provider's perspective to cost. Cost data were collected by reviewing existing records including financial statements, invoices, receipts, transport log books, equipment inventories, and information from personnel payroll, existing budget, and the staff diaries. RESULTS: A total of 15571 children were treated in 2012, resulting in a total cost of the MDA programme of ZAR 2 137 143 and a unit cost of ZAR 137. The three main cost components were Medication Costs (37%), Human Resources Cost (36%) and Capital items (16%). The total cost for treating all eligible pupils in KwaZulu-Natal will be ZAR 149 031 888. However, should the capital cost be excluded, then the unit cost will be ZAR 112 per patient and this will translate to a total cost of ZAR 121 836 288. CONCLUSIONS: Low coverage exacerbates the cost of the programme and makes a decision to support such a programme difficult. However, a normative costing study based on the integration of the programme within the Department of Health should be conducted.


Assuntos
Anti-Helmínticos/economia , Custos Diretos de Serviços/estatística & dados numéricos , Administração Massiva de Medicamentos/economia , Praziquantel/economia , Esquistossomose/tratamento farmacológico , Serviços de Saúde Escolar/economia , Adolescente , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/uso terapêutico , Gastos de Capital/estatística & dados numéricos , Criança , Custos de Medicamentos/estatística & dados numéricos , Doenças Endêmicas/economia , Doenças Endêmicas/prevenção & controle , Feminino , Humanos , Masculino , Folhetos , Praziquantel/administração & dosagem , Praziquantel/uso terapêutico , Estudos Retrospectivos , População Rural , Amostragem , Esquistossomose/economia , Esquistossomose/epidemiologia , África do Sul/epidemiologia
6.
Rev. esp. nutr. comunitaria ; 26(2): 0-0, abr.-jun. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-194452

RESUMO

FUNDAMENTOS: Hablar de equidad de género requiere de abordar estereotipos perjudiciales, donde a menudo se perpetúan a través de la publicidad. El objetivo del estudio fue explorar la construcción y reproducción de estereotipos de género presentes en la publicidad gráfica a través de folletos promocionales en las principales cadenas de supermercados de la Ciudad Autónoma de Buenos Aires (CABA), Argentina. MÉTODOS: Se desarrolló una metodología cualitativa usando análisis documental y muestreo intencional. Se recolectaron folletos de 8 principales cadenas de supermercados de la CABA durante 3 meses (960 páginas de folletos). RESULTADOS: Los hallazgos indican que existen marcados estereotipos de género en las publicidades impresas donde se representó a las mujeres en roles pasivos y tradicionales como madre-cuidadora y ama de casa; esta tendencia se vio asimismo en publicidades orientadas a la población infantil. La representación de hombres fue con actividades diferenciales y roles activos. Se observaron representaciones vinculadas a la mujer madre, cuidadora y ama de casa y al modelo de familia tradicional en torno a aspectos alimentarios. CONCLUSIONES: Se concluye que en las publicidades gráficas a través de folletos promocionales existen estereotipos de género sexistas, sin observar una evolución positiva hacia otros patrones de género, inclusión y diversidad


BACKGROUND: Talking about gender equity recquires facing stereotypes counterproductive, often perpetuated through publicity. The objective of the study was to explore the construction and reproduction of gender stereotypes present in graphic advertising through promotional brochures in the main supermarket chains in Buenos Aires (CABA), Argentina. METHODS: A qualitative methodology was developed, usingdocumentary analysis and intentional sampling. Promotional brochures were gathered from 8 supermarket chains of the CABA, along three consecutive months (960 pages). RESULTS: The findings of this study indicate that there are noticeable gender stereotypes in print advertisements (brochures), where women were represented in passive and traditional roles as mother-caregiver and housewife, a trend which was also seen in advertisements aimed at children. Representation of men included differential activities and more active roles. Representations related to the woman mother, caregiver and housewife and the traditional family model regarding food aspects were observed. CONCLUSIONS: It is concluded that there are sexist gender stereotypes in graphic advertising through promotional brochures, without any positive evolution towards other gender patterns, inclusion and diversity


Assuntos
Humanos , Estereotipagem de Gênero , Folhetos , Rotulagem de Produtos/estatística & dados numéricos , Rotulagem de Produtos/normas , Publicidade/normas , Argentina , Mulheres , Sexismo , Identidade de Gênero
8.
PLoS One ; 15(3): e0229849, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32187610

RESUMO

BACKGROUND: Whiplash-associated disorders have been the subject of much attention in the scientific literature and remain a major public health problem. OBJECTIVE: Measure the impact of a validated information booklet on the fear-avoidance beliefs of emergency physicians and their approach to management regarding the treatment of whiplash-associated disorders. METHODS: A prospective cluster randomized controlled study conducted with a sample of emergency medicine physicians. Fear-avoidance beliefs were measured using The Whiplash Belief Questionnaire (WBQ) and Fear-Avoidance Beliefs Questionnaire (FABQ). We assessed the approach to management based on the prescription of pharmacological and non-pharmacological treatments based on the advice given to patients. The validated information booklet was the French version of The Whiplash Book. A set of questionnaires was sent to participants pre- and post-intervention. The experimental intervention was the provision of The Whiplash Book. The control arm did not receive any training or information. RESULTS: Mean fears and beliefs scores on inclusion were high: WBQ = 19.09 (± 4.06); physical activity FABQ = 11.45 (± 4.73); work FABQ = 13.85 (± 6.70). Improvement in fear-avoidance beliefs scores being greater in the intervention group was further confirmed by the variation in WBQ (-20 [-32; -6] vs. -6 [-16; 9]; p = 0.06), physical activity FABQ (-70 [-86; -50] vs. -15 [-40; 11]; p < 0.001), and work FABQ (-40 [-71; 0] vs. 0 [-31; 50]; p = 0.02). The emergency physicians' initial approach to management was not consistent with current guidelines. Reading the French version of The Whiplash Book could contribute to changing their approach to management in several areas on intra-group analysis. CONCLUSION: The French version of The Whiplash Book positively influenced fear-avoidance beliefs among emergency physicians.


Assuntos
Medo/psicologia , Médicos/psicologia , Traumatismos em Chicotada , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Folhetos , Estudos Prospectivos , Inquéritos e Questionários , Traumatismos em Chicotada/psicologia , Traumatismos em Chicotada/reabilitação
9.
Support Care Cancer ; 28(11): 5419-5427, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32146546

RESUMO

PURPOSE: International and national studies have shown unmet information needs regarding nutrition in breast cancer patients. An intervention study has examined the question of the extent to which a fact sheet on the topic of nutrition is suitable to cover the need for information of breast cancer patients. METHOD: The fact sheet with basic information on nutrition was distributed in 21 intervention breast care centres in 2017. The use of the fact sheets was evaluated in a quasi-experimental design as part of the annual breast cancer patients' survey of the University of Cologne. The breast cancer patients considered were being treated with primary breast carcinoma in a hospital in North Rhine-Westphalia. A multilevel analysis was carried out in order to quantify the effect of the intervention. RESULTS: Unmet information needs are experienced more by younger and non-native German-speaking patients. With regard to education, patients without a graduation and a high grade of education express more unmet information needs. The multilevel analysis showed that patients who were treated at an intervention site and therefore possibly received the fact sheet have a significantly higher chance of their information needs being met (OR = 1.45; p ≤ 0.05). CONCLUSION: The intervention study showed that a fact sheet with basic information on nutrition is a possible instrument to satisfy the information needs of breast cancer patients and therefore reduce unmet information needs regarding nutrition. This intervention study is a pragmatic example on how to reduce unmet information needs among breast cancer patients in Germany.


Assuntos
Neoplasias da Mama/terapia , Dieta , Necessidades e Demandas de Serviços de Saúde , Folhetos , Educação de Pacientes como Assunto , Acesso à Informação , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/dietoterapia , Neoplasias da Mama/epidemiologia , Feminino , Alemanha/epidemiologia , Necessidades e Demandas de Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/normas , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Hospitais , Humanos , Pessoa de Meia-Idade , Estado Nutricional , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/organização & administração , Educação de Pacientes como Assunto/normas , Avaliação de Programas e Projetos de Saúde , Recomendações Nutricionais , Inquéritos e Questionários , Adulto Jovem
10.
Afr J Prim Health Care Fam Med ; 12(1): e1-e7, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32129654

RESUMO

BACKGROUND: Hypertension is a global health burden affecting developed and developing countries, and South Africa is no exception. AIM: This article aims to highlight the language and content used in health education on hypertension in primary healthcare (PHC) by health promoters and in pamphlets. METHODS: The study design was quantitative descriptive. The population comprised a purposive selected sample of 12 health promoters in 12 PHC clinics and 50 pamphlets relating to health education on hypertension. An audio recorder was used to record health education provided by health promoters. Quantitative content analysis and frequency distribution was used to analyse the data. RESULTS: The health promoters used various South African languages mixed with English (code switching). Patients were taught about lifestyle modifications and encouraged to adhere to management therapy. The switching in language usage may affect the understanding of those who do not speak the local language and that may explain the reason for lack of hypertension-suited life modification required by health education. CONCLUSION: It is important that heath education on hypertension should be standardised so that the content of health education in clinic A is similar to that in clinic B. Information contained in pamphlets should be summarised and standardised to the content presented by health promoters.


Assuntos
Promoção da Saúde/organização & administração , Hipertensão/prevenção & controle , Idioma , Educação de Pacientes como Assunto , Atenção Primária à Saúde/organização & administração , Países em Desenvolvimento , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Folhetos , África do Sul/epidemiologia
11.
BJOG ; 127(7): 886-896, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32034849

RESUMO

OBJECTIVES: To test whether providing psychological self-help materials would significantly lower the incidence of post-traumatic stress disorder (PTSD) at 6-12 weeks postnatally. DESIGN: Open-label randomised controlled trial, with blinded outcome assessment. SETTING: Community midwifery services in two National Health Service (NHS) trusts in the North West. SAMPLE: A cohort of 2419 women receiving normal NHS postnatal care. METHODS: Midwives screened women for traumatic birth experience; 678 women who screened positively (28.1%) were randomly allocated to self-help with usual care (n = 336) or to usual care alone (n = 342). The self-help materials were a leaflet and online film designed to prevent the development of PTSD after trauma exposure through explaining how to manage early psychological responses. MAIN OUTCOME MEASURE: The primary outcome was a composite of diagnostic and subdiagnostic PTSD at 6-12 weeks postnatally using the gold-standard Clinician-Administered PTSD Scale (CAPS-5) interview. RESULTS: Of the 678 women correctly randomised plus the nine women randomised in error, 478 (70.5%) were followed up. Diagnostic or subdiagnostic PTSD rates at follow-up did not differ between groups who received self-help (26.7%, 65/243) or usual care alone (26.2%, 64/244) (intention-to-treat analysis: RR 1.02, 95% CI 0.68-1.53). Findings remained consistent in the per-protocol analysis (RR 1.04, 95% CI 0.85-1.27). Women viewed the materials very positively. There were no adverse effects. Health economic micro-costing indicated implementation would be very low cost. CONCLUSIONS: Many women experience a traumatic birth and risk developing PTSD, but self-help strategies without professional support are insufficient and should not be routinely introduced. TWEETABLE ABSTRACT: Self-help information alone does not reduce the number of women developing PTSD after a traumatic childbirth.


Assuntos
Intervenção Baseada em Internet , Complicações do Trabalho de Parto , Folhetos , Parto/psicologia , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos , Adulto , Erros de Diagnóstico/prevenção & controle , Feminino , Humanos , Tocologia/métodos , Complicações do Trabalho de Parto/diagnóstico , Complicações do Trabalho de Parto/prevenção & controle , Complicações do Trabalho de Parto/psicologia , Gravidez , Técnicas Psicológicas , Autogestão/métodos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/psicologia , Resultado do Tratamento
12.
REME rev. min. enferm ; 24: e1315, fev.2020. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1125478

RESUMO

RESUMO Objetivo: construir e validar uma cartilha educativa para a sala de apoio à amamentação. Métodos: estudo metodológico realizado em três etapas: levantamento bibliográfico, elaboração do material educativo e validação por juízes especialistas. A estrutura do material quanto à sequência das informações, design, ilustrações, cores e diagramação foi feita por profissional especializado. Resultados: a produção final resultou na cartilha intitulada: "Voltei a trabalhar, como vou amamentar?". Participaram da validação nove juízes especialistas na área, avaliando os aspectos: "conteúdo" e "exatidão científica" validados a partir do cálculo do IVC, com média de 0,81, seguindo corte indicado pela literatura considerando esses itens validados para "aparência". Considerou-se nível de concordância entre os especialistas variando entre 86,8 e 97,6%, sendo o mínimo estabelecido de 75%, validando esse aspecto. Conclusão: o objetivo de construir e validar uma tecnologia educativa voltada para a sala de amamentação, pioneira neste enfoque específico, foi alcançado.


RESUMEN Objetivo: construir y validar un folleto educativo para la sala de apoyo a la lactancia materna. Métodos: estudio metodológico realizado en tres etapas: encuesta bibliográfica, preparación de material educativo y validación por jueces expertos. La estructura del material, en cuanto a la secuencia de información, diseño, ilustraciones, colores y diagramación, fue realizada por un profesional especializado. Resultados: la producción final resultó en el folleto titulado: "He vuelto a trabajar, ¿cómo haré para amamantar?". Nueve jueces expertos en el área participaron en la validación, evaluando los aspectos: "contenido" y "precisión científica" validados a partir del cálculo del IVC, con un promedio de 0.81, siguiendo el corte indicado por la literatura considerando estos elementos validados para "apariencia". Se consideró que el nivel de acuerdo entre expertos variaba entre 86.8 y 97.6%, con un mínimo establecido de 75%, validando este aspecto. Conclusión: se logró el objetivo de construir y validar una tecnología educativa dirigida a la sala de lactancia, pionera en este enfoque específico.


ABSTRACT Objective: to build and validate an educational booklet for the breastfeeding support room. Methods: methodological study carried out in three stages: bibliographic survey, preparation of educational material and validation by specialist referees. The material structure regarding the sequence of information, design, illustrations, colors and diagramming was made by a specialized professional. Results: the final production resulted in the booklet entitled: "I went back to work, how am I going to breastfeed?". Nine specialist referees in the area participated in the validation, evaluating the aspects: "content" and "scientific accuracy" validated from the CVI calculation, with an average of 0.81, following the cut indicated by the literature considering these items validated for "appearance". The level of agreement between specialist was considered to vary between 86.8 and 97.6%, with the minimum established being 75%, validating this aspect. Conclusion: the objective of building and validating an educational technology aimed at the breastfeeding room, pioneer in this specific focus, was achieved.


Assuntos
Humanos , Feminino , Gravidez , Aleitamento Materno , Saúde Materno-Infantil , Informação , Promoção da Saúde , Folhetos , Enfermagem Materno-Infantil , Tecnologia Educacional/educação
13.
BMC Med Inform Decis Mak ; 20(1): 35, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-32075636

RESUMO

BACKGROUND: Shared decision making (SDM) contributes to personalized decisions that fit the personal preferences of patients when choosing a treatment for a condition. However, older adults frequently face multiple chronic conditions (MCC). Therefore, implementing SDM requires special features. The aim of this paper is to describe the development of an intervention to improve SDM in older adults with MCC. METHODS: Following the Medical Research Council framework for developing complex interventions, the SDMMCC intervention was developed step-wise. Based on a literature review and empirical research in a co-creation process with end users, we developed training for geriatricians and a preparatory tool for older patients with MCC and informal caregivers. After assessing feasibility, the intervention was implemented in a pilot study (N = 108) in two outpatient geriatric clinics of an academic and a non-academic teaching hospital in Amsterdam, the Netherlands. RESULTS: Key elements of the training for geriatricians include developing skills to involve older adults with MCC and informal caregivers in SDM and following the six-step 'Dynamic model for SDM with frail older patients', as well as learning how to explore personal goals related to quality of life and how to form a partnership with the patient and the informal caregiver. Key elements of the preparatory tool for patients include an explicit invitation to participate in SDM, nomination that the patient's own knowledge is valuable, invitation to form a partnership with the geriatrician, encouragement to share information about daily and social functioning and exploration of possible goals. Furthermore, the invitation of informal caregivers to share their concerns was also a key element. CONCLUSIONS: Through a process of co-creation, both training for geriatricians and a preparatory tool for older adults and their informal caregivers were developed, tailored to the needs of the end users and based on the 'Dynamic model of SDM with frail older patients'.


Assuntos
Cuidadores , Tomada de Decisão Compartilhada , Idoso Fragilizado , Múltiplas Afecções Crônicas , Participação do Paciente , Idoso , Instituições de Assistência Ambulatorial , Geriatras/educação , Humanos , Países Baixos , Folhetos , Projetos Piloto
14.
J Med Libr Assoc ; 108(1): 113-117, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31897059

RESUMO

During the late nineteenth and early twentieth centuries, osteopathic information was circulated by way of pamphlets and postcards. Several osteopathic historical pamphlets and postcards from the D'Angelo Library collection have been researched and digitized in order to preserve these osteopathic artifacts and highlight their historical significance for the current profession.


Assuntos
Disseminação de Informação/métodos , Bibliotecas Médicas/organização & administração , Medicina Osteopática/história , Folhetos , História do Século XIX , História do Século XX , Humanos , Kansas , Cartões Postais como Assunto
15.
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
16.
Trials ; 20(1): 772, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881927

RESUMO

BACKGROUND: There has been little research to investigate whether the appearance of paper patient information leaflets (PILs) used to describe research studies to potential participants influences their decision to take part. Embedding a study within a trial (SWAT) is an efficient way of answering this type of methodological question. We included a randomised SWAT within a large cohort study, Outcome Monitoring after Cardiac Surgery (OMACS), to address this question. METHODS: Potential participants for the OMACS study were randomised to receive one of three PILs, which were identical in content but with varying formatting and use of colour: PIL A (enhanced format), PIL B (hybrid format) and PIL C (standard format). Consent to OMACS was the primary outcome. Consent rates using the three different PIL formats were collected and compared. Qualitative feedback on the different formats was obtained from a public and patient involvement (PPI) group. RESULTS: For the SWAT, 1517 PILs were sent to potential participants, of whom 640 (42%) consented to take part in OMACS. PIL B had the highest recruitment rate, with 45% of patients consenting to participation; 40% and 41% of patients consented to participation after receiving PILs A and C, respectively. Compared to PIL C, the consent rate was 4% higher with PIL B (45% versus 41%, 95% confidence interval (CI) -2% to + 10%, p = 0.16) and 1% lower with PIL A (40% versus 41%, 95% CI - 7% to + 5%, p = 0.72). CONCLUSIONS: Consent rates were similar for all three PIL formats. PIL B is being used for the remainder of the host study and will be used to inform the design of PILs for other research studies, as it was the preferred format of the PPI group. TRIAL REGISTRATION: International Clinical Trials Registry, ISRCTN90204321. Registered on 21 January 2015.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Apresentação de Dados , Folhetos , Participação do Paciente , Preferência do Paciente/estatística & dados numéricos , Seleção de Pacientes , Tomada de Decisões , Feminino , Humanos , Consentimento Livre e Esclarecido , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Participação do Paciente/métodos , Participação do Paciente/psicologia , Participação do Paciente/estatística & dados numéricos , Projetos de Pesquisa , Inquéritos e Questionários
17.
Clin Interv Aging ; 14: 2155-2162, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31849459

RESUMO

Introduction: The Stay Independent Brochure (SIB) is a widely used fall-risk self-assessment tool, which is part of the Stopping Elderly Accident, Deaths & Injuries (STEADI) program in the US. However, the validity and reliability of the SIB have not been established in an elderly Thai population. Objective: To construct a fall risk screening tool based on the SIB in a Thai elderly population and investigate its psychometric effect in a community context. Methods: A total of 480 elderly participants volunteered to take part in this study from the Nakhon Ratchasima province. In the first part of the study, the original version of the SIB was translated into Thai (total 12 questions) and adapted into a modified version (total 18 questions). The translated SIBs were cross-culturally adapted and tested for content validity, test-retest reliability, inter-rater reliability, construct validity and internal consistency. In the second part of the study, the psychometric properties of the translated SIBs were assessed using test-retest and inter-rater reliability and content and construct validity. Results: The SIBs had good content validity (IOC: 0.80 to 1.00), and the interclass correlation coefficient (ICC) of test-retest and inter-rater reliability was excellent for both SIB versions (ICC 0.89-0.95). The construct validity of 18 questions was tested by principal component factor analysis with varimax rotation and using factor loading greater than 0.4, and yielded 6 factors that explained 59.1% of the variance in fall risk (more than 12 questions). The coefficient alpha was higher than the usually recommended value of 0.70 for the total score of both SIB versions. The convergent validity between the TUG and BBS tests was statistically significant (p<0.001). Conclusion: Based on psychometric properties, it is recommended that the two Thai versions of the SIB are an appropriate initial screening tool for the multi-steps fall risk assessment algorithm in predicting falls in an elderly Thai community.


Assuntos
Acidentes por Quedas/prevenção & controle , Avaliação Geriátrica/métodos , Vida Independente , Folhetos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tailândia
19.
BMC Health Serv Res ; 19(1): 892, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31771571

RESUMO

BACKGROUND: Drug information leaflets (DILs) are written for patients and health care providers to show how to use the medications safely and effectively, in order to reach the required therapeutics outcomes. This comparative study was conducted to evaluate various DILs of non-steroidal anti-inflammatory drugs (NSAIDs) that are produced in Palestine, along with their imported equivalents. METHODS: Thirty-five DILs of NSAIDs were analyzed and evaluated in a cross-sectional comparative study. Thirty-one statements were obtained from literature and used; evaluation was performed on basis of both any presence or absence of these statements in the leaflets. 23 of the 31 statements that were available in both local and imported DILs were also evaluated in terms of total word-counts: the median (interquartile range) word-count for each statement was determined separately for the two groups and then compared. For the remaining 8 statements, this was not performed,either because they were not present in any leaflet, or because counting the number of words would not be meaningful. RESULTS: A total of 35 DILs for nine different active ingredients of NSAIDs were analyzed. In 97% of leaflets, "Instructions to convert medication into liquid forms" were missing and 94% did not provide any information about "Pharmacokinetics". 83% of DILs provided no information about "Mechanism of action" and 74% did not mention any reliable references. 66% of the analyzed inserts did not include any instruction about the possibility of a tablet splitting. And in 63%, the "Date of last revision" was missing. Further, "Duration of using" and "Inactive ingredients" were not found in 51% of leaflets. In terms of word-count, the related sections of the 23 selected criteria were expressed with more words by imported leaflets compared with the local ones, significant differences were found in 12 categories, the highest significance of > 42.4-fold difference was found in "Geriatric considerations" category whereas 1.4-fold difference was found in "Shelf life," being the lowest one. CONCLUSIONS: This study shows that local products provide less information than imported products, so we recommend that appropriate measurements be taken by both Palestinian authorities and manufacturers to improve both quantity and quality of local DILs.


Assuntos
Folhetos , Anti-Inflamatórios não Esteroides/uso terapêutico , Estudos Transversais , Humanos , Oriente Médio , Educação de Pacientes como Assunto/normas , Embalagem de Produtos , Publicações/normas
20.
BMC Public Health ; 19(1): 1519, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31727030

RESUMO

BACKGROUND: The NHS Health Check (NHSHC) is a national programme for the prevention of non-communicable diseases. Patients aged 40-74 without an existing cardiovascular-related condition should be invited quinquennially. Uptake is lower than anticipated. We assessed the impact on uptake of two new behaviourally-enhanced leaflets (with the current national leaflet as a control), enclosed with the invitation letter: the first trial on the leaflet. METHODS: A double-blind three-armed randomized controlled trial was conducted. The new leaflets were shorter (two pages, instead of four); one was loss-framed ('don't miss out') and the other was gain-framed ('make the most of life'). The participants were patients from 39 practices in Lewisham and 17 practices in NE Lincolnshire, who were allocated to interventions using a random-number generator and received one of the leaflets with their invitation letter from April-September 2018. The outcome measure was uptake of an NHSHC by November 2018. The trial was powered to detect a 2% effect. RESULTS: Uptake was 17.6% in the control condition (n = 3677), 17.4% in the loss-framed condition (n = 3664), and 18.2% in the gain-framed condition (n = 3697). Leaflet type was not a significant predictor of NHSHC uptake in a logistic regression that controlled for demographic variables, with GP practice as a random effect. Statistically significant predictors of uptake included location (higher uptake in Lewisham), age (increased age was associated with increased attendance) and sex (higher uptake in females). The Bayes Factor comparing the null to a hypothesis of differences between conditions was 416, which is extreme evidence in favour of the null hypothesis. CONCLUSION: There was no evidence for a meaningful effect of either a loss-framed or gain-framed behaviourally-informed leaflet type on uptake, which is surprising, given that behaviourally informed letters have improved uptake of NHSHCs. It is possible that people do not pay attention to leaflets that are enclosed with letters, or that the leaflet continues to support informed decision-making but this does not affect uptake. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03524131. Registered May 14, 2018. Retrospectively registered.


Assuntos
Ciências do Comportamento , Doenças Cardiovasculares/prevenção & controle , Promoção da Saúde/métodos , Folhetos , Aceitação pelo Paciente de Cuidados de Saúde , Educação de Pacientes como Assunto/métodos , Comunicação Persuasiva , Adulto , Fatores Etários , Idoso , Teorema de Bayes , Método Duplo-Cego , Inglaterra , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Medicina Estatal
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