Abstract
Changes in health care delivery in the United States of America due to economic pressures have required nurses to develop innovative instructional materials for educating patients and families. Educational materials such as videotapes, specifically designed to provide information and promote active participation in treatment decisions, can be effective tools for empowering patients. A comprehensive analysis in 1988 concluded that the concept of 'video modelling' or 'behavioural modelling' offered the greatest benefit of videotaped presentations. The purpose of this integrative literature review was to examine the concept of video modelling and its applications in clinical practice. A computer search of the electronic databases of Medline and CINHAL between 1990 and 1999 produced a total of 40 research studies on video instruction for patients. Based on criteria for inclusion, 18 research studies involving video modelling were reviewed and three major uses were identified: (1) assisting decision making regarding treatment options; (2) reducing pre-procedural anxiety and improving coping skills; and (3) teaching self-care practices. The studies reviewed included a variety of research designs, clinical settings, and patient populations. Despite these differences, several benefits to the use of video modelling were found. Patients who viewed videotapes regarding treatment options had a greater understanding of the risks and benefits of those choices and were more apt to be active participants in decision making. Collective results of the studies focusing on stress and coping revealed that preparatory videotapes using video modelling could have a positive effect on reducing anxiety and physiological arousal during stressful procedures. With self-care practices, several of the studies found that there was an increase in desired behaviours in people whose educational programmes included video modelling. The use of video modelling has potential benefits for clinical practice in facilitating knowledge acquisition, reducing preparatory anxiety, and improving self-care. Nurses must become more actively involved in evaluating various teaching approaches used with patients to enhance practice and outcomes.
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