Knowledge Of Chronic Disease Research Articles

AB045. Chronic disease knowledge among migrant workers in Singapore

Background: Chronic disease knowledge can influence an individual’s ability to effectively prevent and manage metabolic diseases such as diabetes, hypertension, and hyperlipidemia. Migrant workers in Singapore, an under-resourced population with high levels of undiagnosed chronic disease, may benefit from chronic disease education and outreach efforts. This exploratory pilot study examines the distribution of chronic disease knowledge amongst migrant workers in Singapore by using a convenience sample of individuals visiting a migrant worker healthcare center.

Health Education Through a Campaign and mHealth to Enhance Knowledge and Quality of Life Among Patients With Chronic Kidney Disease in Bangladesh: Protocol for a Randomized Controlled Trial.

BackgroundDespite the growing burden of chronic kidney disease (CKD), disease knowledge and understanding are still lacking, especially in Bangladesh.ObjectiveThe aim of this study was to evaluate the outcome of a health education intervention in order to enhance knowledge, health-related quality of life (QOL), and motivation regarding healthy lifestyles among rural and periurban adults suffering from CKD.MethodsA parallel-group (1:1) randomized controlled trial is ongoing in the Mirzapur subdistrict, Bangladesh, where two groups of patients with CKD are being compared. Patients aged 18 years and over with CKD (stages 1-3) were enrolled in November 2020. Patients were randomly allocated into either the intervention group (n=63) or the control group (n=63). The control group received usual treatment, while the intervention group received health education through a CKD campaign facilitated by a nephrologist and via mHealth (ie, periodic mobile phone calls) from community health workers. Both groups were followed up for a period of 6 months. The primary endpoint is patients’ increased knowledge measured using the Chronic Kidney Disease Knowledge Questionnaire. The secondary endpoints are improved QOL measured using the standardized EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire as well as improvements in the levels of blood pressure, BMI, serum creatinine, fasting blood sugar, hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen, and albumin to creatinine ratio.ResultsEnrollment of participants began in November 2020; the intervention and follow-up were completed in May 2021. We enrolled 126 patients in the study. Patients’ mean ages were 57.97 (SD 15.03) years in the control group and 57.32 (SD 14.37) years in the intervention group. There were 45 out of 63 (71%) females in the control group and 38 out of 63 (60%) females in the intervention group. In addition, there were 38 out of 63 (60%) literate patients in the control group and 33 out of 63 (52%) literate patients in the intervention group.ConclusionsIt is expected that a combined approach, incorporating both a CKD campaign and mHealth, for health education may be an effective tool for increasing knowledge and improving QOL among patients with CKD.Trial RegistrationClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831International Registered Report Identifier (IRRID)DERR1-10.2196/30191

Effects of Nutritional Interventions on Cardiovascular Disease Health Outcomes in Aboriginal and Torres Strait Islander Australians: A Scoping Review

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.

Knowledge of chronic obstructive pulmonary disease, presence of chronic respiratory symptoms and use of spirometry among the Spanish population: CONOCEPOC 2019 study

ObjectiveThe aim of this study was to analyze current data on the population's level of knowledge about COPD and to evaluate certain diagnostic interventions, such as the use of spirometry. Material and methodsAn epidemiological, observational, cross-sectional study by telephone interview, with random dialing of landline telephone numbers, was conducted in November 2019, in a nationally representative sample of adults over 40 years of age. ResultsFrom a total of 51,079 telephone calls, a total of 1920 individuals responded. Mean age was 61.9 years and 31.6% were men. Overall, 19.4% were current smokers and 13.4% reported respiratory disease (5% reported COPD). In total, 27.9% had spontaneous knowledge of COPD, which is a relative increase from the 17% observed in 2011. The most frequent information channel was the media (35.5%), with a significant presence of social networks and the Internet (25.7%). Almost one fifth (18.1%) had chronic respiratory symptoms. Of these, 59.3% had requested medical care, and 66.2% had undergone spirometry. Spirometry was performed less frequently in subjects treated in primary care compared to respiratory medicine departments (51.9% versus 79.1%; P < .001). ConclusionsKnowledge of COPD is still scarce, and strategies are needed to increase awareness and the importance of assessing respiratory symptoms and increased use of spirometry.

COVID-19 AWARENESS IN OUR COMMUNITY

Purpose: Coronaviruses (CoV) are enveloped, positively stranded RNA viruses. Our study aims to understand the level of knowledge, behavior and awareness of COVID-19 in our society.Material and Methods: Our study with a cross-sectional research design was planned as a survey study. The questionnaire consists of three sections and 33 questions. Our study was carried out between November 2020 and February 2021 and involved 200 people.Results: 67% of the participants are women. 93.5% are in the 19-25 age group. 93.5% of the participants are single and 81.5% are university students. While 77% of the participants smoked, 92% did not have chronic diseases. There was no significant correlation between the age, gender, marital status, occupation, education, presence of chronic disease and smoking and knowledge score of the participants (p&gt;0.05). Almost all of the questions measuring the level of knowledge were answered correctly over 80%. The lowest correct answer is 55%, and "The COVID-19 is not severe in all people. In elderly and/or patients with chronic diseases, the disease may be severe." It is seen that the change in the frequency and duration of handwashing due to the pandemic of the participants is more than 50%. More than 90% said they changed the frequency of going out andusually were reluctant to enter busy places.65.5% stated that they took measures to strengthen their immune system, 74% wanted to get the COVID-19 vaccine and 52% believed that the outbreak could be successfully contained.Conclusion: In our study, more than 90% of the participants were university students who were in the 18-29 age group. Therefore, it would not be right to generalize our study results to society. We think that our results reflect the COVID-19 level of knowledge and attitudes/behaviors of university students in a cross-sectional way. We think that the COVID-19 level of knowledge is sufficient among university students.

Psychological Impact and their Associated Factors of COVID-19 Pandemic among Nurses of a Metropolitan City of Central Nepal

Introduction: COVID-19 poses a great challenge to the global health system. The nurses worked in COVID ward and fever clinic act as gatekeepers to the health care system in the public health response to COVID-19 epidemic. The consequences of lockdown, quarantine of COVID-19 pandemic has not only caused physical sufferings but also affected the mental health of the nurses around the globe. This study aimed to assess psychological impact and associated factors of COVID 19 pandemic among nurses working in different level of hospital at Bharatpur Municipality Chitwan, Nepal.&#x0D; Methods: A cross-sectional descriptive study was conducted among 150 nurses working in different hospitals of Bharatpur Municipality. Non-probability Purposive Sampling Technique was used and Data was collected via online survey using Google Form questionnaire. COVID-19 peritraumatic distress index (CPDI) questionnaire was used to find out psychological impact. Statistical analysis of data was done using SPSS version 20.&#x0D; Results: Total of 150 nurses were involved in the study where 99.3% were female, 45.3% in the age group of 26-35 years, mean age 27.22±6.612 years, 87.2% bachelor in nursing. Mild to moderate peritraumatic distress was found in 47.33% and 16% of respondents found to have severe distress level. Chi-square test showed that respondents level of knowledge (p=0.003) and presence of chronic disease (p=0.007) was statistically significant with level of distress.&#x0D; Conclusions: Majority of the nurses had some form of psychological distress. Study highlights the need for counseling for distress and mental health during COVID-19 pandemic. A focus on improving mental wellbeing of nurses should be immediately initiated.

Knowledge of Chronic Kidney Disease Among the Population of Saudi Arabia Evaluated Using a Validated Questionnaire: A Cross-Sectional Study.

IntroductionPublic knowledge and awareness regarding chronic kidney disease (CKD) is an important factor influencing the successful implementation of CKD prevention and screening programs. To the best of our knowledge, there are no studies conducted among the Saudi population to explore the public knowledge of CKD using a validated questionnaire. Hence, we explored the knowledge of CKD among the population of the Kingdom of Saudi using a validated questionnaire to determine the level of knowledge regarding CKD as well as the predictors of CKD knowledge.Materials and MethodsThis was a cross-sectional online survey study conducted between 12 January 2020 and 11 February 2021. A structured study questionnaire in the GoogleTM platform, with socio-demographic variables and questions assessing CKD knowledge, was used to collect data. A snowball sampling technique was used to recruit participants.ResultsA total of 983 people accessed the survey and 951 provided a complete response. Respondents belonging to the age group 41–55 years, having masters or PhD level education, having monthly income >15,000 SR, married, doing >150 minutes/week physical activity had significantly higher kidney disease knowledge. There were significant differences in the mean kidney disease knowledge total score between participants with and without: a history of kidney disease (5.63, df = 895, p<0.001), diabetes mellitus (2.34, df = 949, p = 0.019), hypertension (3.25, df = 949, p = 0.001), and family history of kidney failure (4.60, df = 949, p<0.001).ConclusionThe study revealed a lack of awareness among the Saudi population regarding knowledge about CKD. However, a significantly higher level of knowledge prevailed among respondents from higher educational and higher economic backgrounds. Those with risk factors for CKD also held a greater knowledge about the disease.

Translation, Adaptation, and Validation of Chronic Kidney Disease Self-Management and Knowledge Instruments for People at Pre-Dialysis Stage in the Arab World.

Knowledge is critical for self- management, however there are no measures available in Arabic to effectively assess knowledge and self-management for chronic kidney disease (CKD). The aim of this study was to translate, culturally adapt, and validate Chronic Kidney Disease Self-Management Instrument-29 (CKD-SM-29) and Kidney Disease Knowledge survey (KiKs) for use by Arabic-speaking health professionals and patients. The study was carried out in two phases: translation and cultural adaptation, and validation. Instruments were translated from English to Arabic then adapted and validated using 203 pre-dialysis CKD patients. Face validity and internal consistency were demonstrated for Arabic versions of CKD-SM-29 and KiKs. Cronbach's α for the CKD-SM-29 was .91 for KiKS was .78. Test-retest revealed good stability over a 1-week period. Intra Class Correlation coefficient for CKD-SM-29 was .90 and was .78 for KiKS. Convergent and discriminative validity were also demonstrated for the translated instruments. The validity and reliability of the Arabic CKD-SM-29 and KiKs were demonstrated. The translated instruments are culturally adapted and will support care of patients with CKD in Arabic-speaking countries.

POS-314 People’s knowledge of Chronic Kidney Disease of Unknown Etiology in Sri Lanka

The identification of CKDu in its early stages is crucial for the patients more than for the health providers as it helps to prevent them from further complications and progression into severe stages of the disease. Studies on the estimates of people’s knowledge of CKDu and their ability to identify the disease early and seek treatment are unknown in Sri Lanka. Knowledge is measured in this study comprises information acquired from authoritative sources such as the local health department. The items of knowledge displayed in posters and educational sessions were used to construct the questionnaire of 67 knowledge items. The study used a descriptive, cross-sectional design to identify patients’ knowledge and at-risk behaviors in the Medirigiriya DS division in Polonnaruwa District. The randomly obtained sample of 200 families was from 12 agricultural settlements in six Grama Niladhari (GN) divisions. A team of seven research assistants and the author conducted qualitative research, and 200 semi-structured interviews. The interviews were conducted with the chief householder or their spouse, who gave their verbal consent. The interviews were conducted in Sinhalese and translated into English. The questionnaire data were computer entered and analyzed in SPSS. Textual data were analyzed in the Atlas/Ti program for textual data analysis. The mean knowledge score was 36.1 (S.D 7.76) for 178 families which, when converted to a percentage, was 42.3%. The CKDu knowledge scores increased as the age of patients increased (P 0.05). It shows that older patients were more knowledgeable of CKDu. The total knowledge score and socioeconomic status are significantly correlated (r.191 at the 0.05 level -two-tail test). Knowledge was lower among the old, less educated, low-income families and paddy farmers who owned paddy land less than 1 acre. Almost every interviewee was aware that a blood test should be done to identify CKDu. None of the respondents correctly answered all the 67 items of the knowledge questionnaire. 28.5% (n = 57) of the participants answered 42 to 50 questions correct, 35% (n=71) respondents answered 39 to 41 answers correct, and 34% (n=68) answered 8 to 32 questions correct. Furthermore, 86% (n =172) of the participants knew that the kidneys make urine, 64.5% (n=129) knew that kidneys clean blood, but only 17.5% (n=35) knew kidneys help regulate blood sugar, 15.5% (n=31) knew that kidneys help regulate blood pressure and breakdown proteins in the blood. Most participants did not know that CKDu can help prevent its progression into severe stages if identified in the initial stages. 72.5% (n=145) believed that identifying CKDu in a person is like getting a death certificate, but 90.5% (n=181) viewed that medications could slow down the disease's progression. Therefore, well over 90% of CKDu patients attend hospitals and clinics to get medications. Despite the high prevalence of CKDu among middle-aged rice paddy farmers, most respondents in the endemic areas knew very little about the disease, its causation, and treatment. The findings show that more community programs are needed to educate the people in the lower income groups, the rice paddy farmers, agricultural laborers, and older people. Implementing CKDu educational programs, measuring their effectiveness and efficacy should be a priority.

Anxiety and depression symptoms in older adults during coronavirus disease 2019 pandemic: A community-based cross-sectional study.

Objectives:The coronavirus disease 2019 pandemic has caused high morbidity and mortality in older adults over the world. Because the coronavirus disease 2019 pandemic greatly affects older adults who have a preexisting health condition, they are generally susceptible to a high incidence of severe symptoms of anxiety and depression. Therefore, we aimed to assess the prevalence of anxiety and depression symptoms in older adults during the coronavirus disease 2019 pandemic.Methods:Community-based cross-sectional study was completed in August 2020. Standardized and pretested General Anxiety Disorder–7 and Geriatric Depression Scale were used to screen the symptoms of anxiety and depression, respectively. Data were entered into EpiData (version 4.3.2) and transferred to SPSS (version 24) for further analysis. Bivariate and multivariate logistic regression analyses were carried out to determine the significantly associated variables with a 95% confidence interval at p < 0.05.Results:Of the total older adults interviewed, 68.7% had developed symptoms of anxiety and 59.9% had symptoms of depression during the coronavirus disease 2019 pandemic. Female participants, having a chronic disease and poor knowledge of the coronavirus disease 2019 pandemic, were significantly associated with anxiety symptoms. Age category of 81 to 90 and above 90, lack of social support, and having a chronic disease were significantly associated with symptoms of depression.Conclusion:The symptoms of anxiety and depression among older adults in the North Shoa Zone during coronavirus disease 2019 were higher than before the coronavirus disease 2019 happened. The results were evidence points for developing a psychological intervention to tackle the older adults’ mental health needs in the community during and after the coronavirus disease 2019 pandemic.

Knowledge and Practices towards Prevention and Early Detection of Chronic Kidney Disease and Associated Factors among Hypertensive Patients in Gondar Town, North West Ethiopia.

Background Chronic kidney disease is a global health problem with serious adverse effects, including kidney failure, cardiovascular disease, and premature death. Improving awareness and practice on the impact, prevention, and early detection of chronic kidney disease will reduce the significant economic and public health burden. Methods A cross-sectional study was conducted to determine knowledge and practice towards prevention and early detection of chronic kidney disease and its associated factors among hypertensive patients in Gondar town in 2019. The study included hypertensive patients visiting health institutions from February to March 2019. Data was collected using a semistructured questionnaire and individuals who fulfilled our inclusion criteria were selected using a systemic random sampling technique. Epi Info software version 7 was used for data entry, and SPSS version 20 was used for descriptive and logistic regression analysis. Result Out of a total of 442 participants, 434 completed the questionnaire, with a response rate of 98.1%. Of the total, 298 (68.7%) had good knowledge of chronic kidney disease with a mean knowledge score of 8.78 ± 2.80 and 210 (48.4%) had good practice with mean practice score of 6.58 ± 1.61. Educational status, residence, and duration of hypertension were significantly associated with the knowledge and practice scores of the participants in the multivariate logistic regression analysis. Conclusion More than half of the participants had good knowledge about chronic kidney disease and its risk factors. However, the level of preventive practice among participants was low. The educational status, residence, and duration of hypertension were significantly associated variables with knowledge and practice scores in multivariate logistic regression.

Validation of the Australian version of the Chronic Kidney Disease Self-Management instrument.

The aim of this study is to evaluate the validity and reliability of the modified Chronic Kidney Disease Self-Management instrument in an English-speaking population. There is growing evidence that self-management behaviours can improve outcomes for people with chronic kidney disease. However, there are few suitable instruments available. The study was cross sectional, with a test-retest protocol. Adults with chronic kidney disease attending a primary health care between June and December 2015 completed the Chronic Kidney Disease Self-Management instrument. Construct validity was determined using exploratory factor analysis, internal consistency and test-retest reliability using Cronbach's α and intraclass correlation. For convergent validity, the relationships between knowledge, self-efficacy and self-management were investigated. The Australian version of the Chronic Kidney Disease Self-Management instrument has 17 items grouped into four factors: self-integration, seeking social support, adherence to lifestyle modification and problem solving. The instrument demonstrated good reliability. Self-efficacy was positively correlated with self-management scores, although there was no correlation between chronic kidney disease knowledge and self-management. The Australian version of the Chronic Kidney Disease Self-Management instrument was found to be a valid and reliable patient-reported outcome measure. It can be used in clinical practice to support self-management, as well as future research.

Building Clinical Nutrition Capacity in Lao PDR: A Novel Clinical Nutrition Educational Model to Provide Interventions to Treat Malnutrition and Non-Communicable Diseases

Abstract Objectives Malnutrition is the number one health priority in Lao PDR where 36% of children under the age of five are stunted and 27% are underweight. Compounded by escalating rates of diabetes and non-communicable diseases, hospital-based nutrition interventions are needed. A partnership between OHSU and the Lao Ministry of Health is working to fill the gap in knowledge and application by providing clinical nutrition education to health care providers. Methods A clinical nutrition needs assessment was conducted in early 2016 and informed the design of a 1000-hour, evidenced-based applied clinical dietetics certificate program for health professionals. Aligning with the 2015 International Dietitian Education Program (IDE) standards, the curriculum was adapted to be culturally relevant and appropriate. Semi-structured interviews, open-ended questions, and pre-and post-tests were used to evaluate the program. Results As of January 2020, 32 clinicians have successfully completed the program. At matriculation, the mean pre-test score was 43% and 50% of students could not calculate BMI or waist-to-hip ratio, determine individual energy, nutrient and fluid requirements, provide individualized medical nutrition therapy, or manage severe acute malnutrition. The mean final exam score was 84% with greatest improvements in malnutrition (+94%) and chronic disease (+62%) knowledge and application. Upon completion, 98% of students successfully met IDE competency standards, conducted nutrition-focused physical exams, administered culturally appropriate nutrition interventions, and provided nutrition education to medical teams at provincial hospitals. Conclusions Providing hands-on training on nutrition assessment, differential diagnosis, and treatment plan design and implementation enables health care providers in Lao PDR to better treat patients with malnutrition and non-communicable diseases that are prevalent within this developing country. This educational curriculum may serve as a model for other developing countries. Funding Sources OHSU Global-SE Asia, OHSU Graduate Programs of Human Nutrition and the Vejdusit Foundation

IMPACT OF PATIENT COUNSELING ON HEALTH KNOWLEDGE AND MEDICATION ADHERENCE IN ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

Objective: This study evaluated the impact of clinical pharmacist-led intervention in health knowledge and medication adherence of Asthma and chronic obstructive pulmonary disease (COPD) patients.&#x0D; Methods: Questionnaires were designed to assess Health knowledge for Asthma and COPD separately. Medication adherence was measured by using the Morisky Medication Adherence Scale-8. Pre-counseling patient responses were recorded. Patient counseling was given regarding the disease condition, medications, and medication use at baseline visit. Patient responses were re-measured upon follow-up visit. The data extracted were tabulated, statistically analyzed and the results were obtained.&#x0D; Results: A total of 141 patients completed the study. Before counseling, the mean (±standard deviation) of knowledge and adherence levels were found to be 8.51±3.36 and 5.01±2.11, respectively. After counseling, they increased up to 12.72±2.16 for knowledge (p&lt;0.0001) and 6.60±1.35 (p&lt;0.0001) for medication adherence. The majority of subjects had about 11–30% increase in knowledge as well as medication adherence. Male patients were more adherent to their medication regime than females.&#x0D; Conclusion: The study demonstrates the positive impact of education and counseling provided by a clinical pharmacist in achieving better therapeutic outcomes – through improvement in medication adherence and health knowledge. In conclusion, continuous education programs and patient counseling should be conducted for chronic diseases to reiterate the importance of medication adherence and, in turn, prevent recurrences, arrest disease progression, minimize hospitalization, and ultimately improve quality of life.

Knowledge, Attitude and Practice of Lebanese Community Pharmacists toward Chronic Obstructive Pulmonary Disease

Inclusion of a pharmacist showed that pharmacy-led patient education can positively impact treatment outcome, chronic obstructive pulmonary disease (COPD) knowledge, medication adherence, quality of life, significant reduction in hospital admission rates, and emergency department visits. The objectives were to assess the degree of COPD knowledge in Lebanese community pharmacists as well as their attitudes and practice toward disease management. Between January and May 2018, a cross-sectional survey enrolled 709 Lebanese community pharmacists. A committee was created to build up the questionnaire; it was composed of two physicians (one infectious disease specialist and one pulmonologist) and eight pharmacists, with long expertise in community and hospital pharmacy. It comprised 12 questions assessing knowledge, 12 questions for attitude, and 13 questions for practice. Higher attitude (β = 0.56) and higher practice (β = 0.41) were associated with higher knowledge score. Higher knowledge (β = 0.10) and practice (β = 0.16) scores as well as female gender (β = 0.60) were significantly associated with higher attitude scores. Higher knowledge (β = 0.13) and higher attitude (β = 0.19) showed significant association with higher practice scores. Female gender (β = -0.94), however, was significantly associated with decreased practice score. Our study highlights the importance of assessing the capabilities of pharmacists of achieving their support role in COPD patients. In order to improve community pharmacists’ knowledge of COPD, ultimately improving patient outcomes, further education is crucial.

Co-Developed Indigenous Educational Materials for Chronic Kidney Disease: A Scoping Review.

Background:Canadian Indigenous populations experience significantly more chronic kidney disease (CKD) than the general population. Indigenous people who live in rural and remote areas may also have difficulty accessing both information and care for their CKD. Informed decision making about treatment options for advancing kidney disease may be delayed, which can result in poor health outcomes and decreased quality of life. Moreover, Indigenous people may experience marginalization within Western health care systems.Objective:The objective of this scoping review is to identify culturally appropriate and co-developed Indigenous educational tools that will ultimately support CKD learning and end-stage kidney treatment decision making.Design:Scoping ReviewSetting:Databases included Embase, CINAHL, Medline (OVID), ERIC, and the Canadian Agency for Drugs and Technology Gray Matters.Study Participants:Community-based Indigenous patients, families, health care workers, and community members.Methods:We systematically reviewed the literature to explore the availability of co-developed Indigenous educational tools and material for CKD treatment options. Titles, abstracts, and full texts were reviewed independently by 2 reviewers with disagreements resolved through a third. All aspects of this project, including searching the databases were done in consultation with an Indigenous Elder.Results:Only one retrieved article identified a comprehensive CKD tool co-developed by researchers, health care providers, and an Indigenous community. Three themes emerged from the scoping review that may inform characteristics of co-developed tools: cultural appropriateness; appraisal of utility and effectiveness and; content informed by co-development of traditional and Western chronic disease knowledge.Limitations:Consistent with scoping review methodology, the methodological quality of included studies was not assessed. In addition, it was difficult to synthesize the findings from the research and gray literature.Conclusion:Little is known about the co-development of Indigenous educational tools for CKD. Further in-depth understanding is required about how to best engage with Indigenous communities, specifically to co-develop contextualized CKD tools that are acceptable to Indigenous people.Trial registration: Not applicable as this review described secondary data.

Novel educational and goal-setting tool to improve knowledge of chronic kidney disease among liver transplant recipients: A pilot study.

IntroductionLiver transplant (LT) recipients have limited understanding of post-transplant chronic kidney disease (CKD) despite an excellent pre-existing framework of transplant care. This pilot study examined the efficacy and feasibility of a tailored educational and goal-setting tool in improving CKD knowledge among LT recipients with early-stage CKD.MethodsIn this prospective cohort study, we administered the CKD educational and goal-setting tool to 81 LT recipients between 7/1/2016 and 12/31/2017. We excluded patients with simultaneous liver-kidney transplantation, eGFR<30 ml/min, non-English speaking, on hemodialysis or listed for kidney transplantation. The pre- and post-education knowledge scores were compared using a paired t-test. Linear regression was used to assess the independent predictors of change in knowledge score.ResultsMean age was 56.3 years, 69.1% were males, 85.2% were Caucasians and mean eGFR was 61.2 ± 20.0 ml/min. The CKD educational and goal-setting tool improved the CKD knowledge scores among LT recipients (pre: 71.8 ± 16.6%, post: 83.3 ± 10.4%; p<0.001). In an adjusted model (r2 = 0.75), those with lower pre-education knowledge scores had the most improvement in their post-education knowledge scores (β = -83.2; p<0.001). Two-thirds stated their most important self-management goal and reported motivation to follow this goal. Time spent for the CKD education was approximately 15 minutes.ConclusionsA simple LT-specific patient educational and goal-setting tool effectively improved CKD knowledge. Implementation of this tailored intervention will improve CKD awareness and may promote goal-setting in the target population.

Effectiveness of avatar-based technology in patient education for improving chronic disease knowledge and self-care behavior: a systematic review.

The objective of the review was to examine the effectiveness of patient education using avatar-based technology on knowledge and self-care behaviors in patients with chronic disease. Chronic disease is a major global problem. Patients with chronic disease who engage in self-care and self-management of their illnesses have better health outcomes and fewer hospitalizations and complications. Currently, information and communication technologies are used to support self-care and improve health outcomes. Within the body of literature, research into avatar-based technology for patient education is growing rapidly. To date, the evidence has not been systematically reviewed to determine the effectiveness of patient education using avatar-based technology on patients' knowledge and self-care behaviors in chronic disease. This review included studies of children and adults who have received avatar-based patient education interventions. The comparator was usual care or other forms of educational programs. The outcomes were knowledge, self-care behavior, self-efficacy, health-related quality of life, readmission and medication adherence. Experimental designs were eligible, including non-randomized controlled trials, and quasi-experimental, prospective and retrospective before and after studies. Seven databases, including MEDLINE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, ProQuest, Web of Science, Scopus and three other trial registries, including the World Health Organization (WHO), ClinicalTrials.gov and Australian New Zealand Clinical Trials Registry, were systematically searched for studies published between January 2005 and March 2017. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management Assessment and Review of Information (JBI SUMARI). Data extracted from papers included specific details about the interventions, populations, study methods and outcomes significant to the review question and specific objectives using the standardized data extraction tool from JBI SUMARI. Due to heterogeneity among the included studies, statistical pooling and meta-analysis were not possible. The results were tabulated, and the data narratively synthesized. Nine publications from eight studies were included in this review (n = 752). Three out of the eight studies were randomized controlled trials and five were non-randomized experimental studies. The overall quality of the included studies was moderate. There was a low risk of bias for the randomized controlled trial studies and moderate risk of bias for the quasi-experimental studies. Four of the eight studies showed that patients who participated in avatar-based education had a statistically significant improvement in knowledge (p < 0.05). Three studies showed improvement in behaviors and self-efficacy. Only three of eight studies examined health-related quality of life and adherence to medication, but the results were not statistically significant (p > 0.05). No studies identified the effectiveness of avatar-based patient education on readmission. Avatar-based technology in patient education can have a positive effect on a wide range of healthcare outcomes. The intervention can improve knowledge, self-care behaviors and self-efficacy in patients with chronic diseases. However, there is limited evidence of improvement in health-related quality of life and adherence to medication, and no available research on readmission.

Chronic Kidney Disease and Kidney Cancer Surgery: New Perspectives.

We sought to provide a contemporary understanding of chronic kidney disease and its relevance to kidney cancer surgery. Another purpose was to resolve points of discrepancy regarding the survival benefits of partial vs radical nephrectomy by critically evaluating the results of prospective and retrospective studies in the urological literature. We performed a comprehensive literature search for relevant articles listed in MEDLINE® from 2002 to 2018 using the key words radical nephrectomy, partial nephrectomy, glomerular filtration rate, kidney function and chronic kidney disease. We also assessed select review articles and society guidelines about chronic kidney disease pertinent to urology and nephrology. Complete evaluation of the potential consequences of chronic kidney disease involves assessment of the cause, the glomerular filtration rate level and the degree of albuminuria. Chronic kidney disease is commonly defined in the urological literature solely as a glomerular filtration rate less than 60 ml/minute/1.73 m2. This ignores the significance of the cause of chronic kidney disease, and the presence and degree of albuminuria. Although this glomerular filtration rate is relevant for preoperative assessment of patients who undergo surgery of kidney tumors, recent studies suggest that a glomerular filtration rate less than 45 ml/minute/1.73 m2 represents a more discerning postoperative prognostic threshold. Reported survival benefits of partial over radical nephrectomy in retrospective studies were likely influenced by selection bias. The lack of survival benefit in the partial nephrectomy cohort in the only randomized trial of partial vs radical nephrectomy was consistent with data demonstrating that patients in each study arm were at relatively low risk for mortality due to chronic kidney disease when accounting for the chronic kidney disease etiology and the postoperative glomerular filtration rate. The prognostic risk of chronic kidney disease in patients with kidney cancer is increased when the preoperative glomerular filtration rate is less than 60 ml/minute/1.73 m2 or the postoperative rate is less than 45 ml/minute/1.73 m2. Additional factors, including nonsurgical causes of chronic kidney disease and the degree of albuminuria, can also dramatically alter the consequences of chronic kidney disease after kidney cancer surgery. Urologists must have a comprehensive knowledge of chronic kidney disease to assess the risks and benefits of partial vs radical nephrectomy when managing tumors with increased complexity and/or oncologic aggressiveness.

262 Focused Educational Screening Improves Knowledge of Chronic Kidney Disease

262 Focused Educational Screening Improves Knowledge of Chronic Kidney Disease