Component Of Patient Education Research Articles

Abstract PO5-20-05: The FOR ME (Fostering Opportunities in Research through Messaging and Education) study: Using multiple qualitative methods to develop a culturally sensitive narrative intervention to promote equity in clinical trials

Abstract Background: Black women are more likely to present with advanced stage disease and to die following a breast cancer (BC) diagnosis compared to women from other racial/ethnic groups. In 2020, only 7.2% of enrollees in clinical trials that led to the approval of 3 novel drugs for breast cancer were Black. While there are many contributing factors to this inequity (i.e., tumor biology, social and structural health determinants, racial injustice, and differential access to and utilization of high-quality mammography, diagnostics, and therapies), persistent underrepresentation of Black patients in cancer clinical trials (CTs) slows scientific advancements. Objective: The aim of this study is to develop, optimize, and test a narrative decision aid intervention (web-based video) for Black women diagnosed with BC to promote shared decision making and CT participation. The first aim is to conduct multiple qualitative methods with multi-level stakeholders to identify barriers, facilitators, and intervention priorities that would assist Black breast cancer patients to make informed decisions about participating in clinical trials. The second aim is to create a culturally sensitive, narrative intervention designed to support decision making and motivate Black breast cancer patients to participate in clinical trials. Aim 3 will then pilot a study to determine acceptability of the intervention among patients and assess whether it increases clinical trial participation in a safety net oncology practice. Methods: Guided by community-based participatory research approaches, we used multiple qualitative methods (key informant interviews (KIIs) and story circles) to identify barriers and facilitators that support decision-making and CT participation. The KIIs, completed in-person, via phone, or video conferencing, were recorded and professionally transcribed. The research team used thematic analysis and inductive coding approaches. Next, interviews and focus groups will invite feedback on the educational/motivational content of the intervention and will be used to develop a culturally sensitive script and story boards. A video production company will produce the narrative intervention. Finally, focus groups and interviews with participant cohorts will provide feedback on the completed intervention. Black women diagnosed with BC will view the intervention in an oncology clinic. Using a pretest/posttest design, we will analyze the acceptability of the intervention and its effect on intention to participate in clinical trials. We will then conduct a quasi-experimental study in a safety net oncology practice to determine whether the rate of clinical trial participation among Black breast cancer patients increases following implementation of the intervention as a standard component of new patient education. Progress: Recruitment started in July 2022 and currently 30 of 30 interviews with patients are completed, 20 of 20 interviews with clinical stakeholders (oncologists and clinical trial staff) are completed, and 14 of 20 interviews with advocates and community partners are completed. Data collection and the analysis of the interviews and story circles is ongoing. Citation Format: Neha Hippalgaonkar, Ryan Nguyen, Leslie Carnahan, Vida Henderson, Tigist Mersha, Eliza Cohn, Kauthar Salum, Ana Williams, Lolita Coleman, Beulah Brent, AnneMarie Murphy, Paris Thomas, Paramjeet Khosla, Kent Hoskins. The FOR ME (Fostering Opportunities in Research through Messaging and Education) study: Using multiple qualitative methods to develop a culturally sensitive narrative intervention to promote equity in clinical trials [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-20-05.

Understanding Treatment Anxiety and Utility of Mixed Media Educational Tools in Radiation Oncology Consultation: A Qualitative Study

Anxiety and adjustment disorders are prevalent in cancer patients, especially at the initiation of treatment, which may be alleviated by improved communication at initial consultation. The purpose of this study is to explore patients' needs in how radiation consultation may improve treatment-related anxiety and the role of multimedia visual tools. Eight patients previously treated with partial or whole breast irradiation at our institution were interviewed in a semi-structured manner at a median of 1.54 months (range 0.13 - 12.42) after they completed radiation. Interview questions included expectations prior to consultation, experience of consultation and treatment, and the role of augmented reality or multimedia tools. Two independent reviewers performed an inductive, thematic analysis to generate themes and subthemes (inter-rater reliability = 0.79). Four main themes were identified in thematic analysis: information expectations, anxiety, personalized education, and visual aids. Patients described preconceptions of radiation, desire for greater volume of information, importance of repetition from providers, benefit of seeing treatment set-up during simulation, and frustrations with the breath-holding process. Anxiety was related to fear of the unknown, difficulty remembering information when anxious, difficulty asking questions, and ambiguity of information worth worrying about. Patients expressed a desire for personalized education, including accounting for prior health conditions, varying health literacy, preference for individualized presentations, and minimizing extraneous input from those not on the healthcare team. Patients desired visuals during consultation, favored 3D technology over 2D mediums, acknowledged differences in learning style, and preferred an interactive component of patient education done in conjunction with visual tools. While verbal consultation process provides valuable education regarding radiation treatment, patients continue to experience anxiety attributed to fear of the unknown. Augmenting the standard initial consultation with interactive visual aids, particularly in the form of a 3D medium, may enhance the patient experience at time of consultation. The results of this study will inform the development of a patient educational tool and clinical study named Curie therapy User eXperience (CurieUx) to be used during radiation oncology consultations.

Opioid-Sparing Strategies in Arthroscopic Surgery

Background: Opioid overprescription is a problem in orthopaedic surgery. Arthroscopic surgery, given its minimally invasive nature, represents an opportunity to minimize opioid prescription and consumption by using effective pain management adjuncts. Thus, the primary question posed in this study was which noninvasive pain management modalities can effectively manage pain and reduce opioid intake after arthroscopic surgery. Methods: The databases PubMed, MEDLINE, EMBASE, Scopus, and Web of Science were searched on August 10, 2022. Randomized controlled trials (RCTs) evaluating noninvasive pain management strategies in arthroscopy patients were evaluated. Eligible studies were selected through a systematic screening process. Meta-analysis was performed for pain scores and opioid consumption at time points which had sufficient data available. Results: Twenty-one RCTs were included, with a total of 2,148 patients undergoing shoulder, knee, and hip arthroscopy. Meta-analysis comparing nonopioid, oral analgesic regimens, with or without patient education components, with the standard of care or placebo demonstrated no difference in pain scores at 24 hours, 4 to 7 days, or 14 days postoperatively. Nonopioid regimens also resulted in significantly lower opioid consumption in the first 24 hours postoperatively (mean difference, −37.02 mg oral morphine equivalents, 95% confidence interval, −74.01 to −0.03). Transcutaneous electrical nerve stimulation (TENS), cryotherapy, and zolpidem were also found to effectively manage pain and reduce opioid use in a limited number of studies. Conclusions: A range of noninvasive pain management strategies exist to manage pain and reduce opioid use after arthroscopic procedures. The strongest evidence base supports the use of multimodal nonopioid oral analgesics, with some studies incorporating patient education components. Some evidence supports the efficacy of TENS, cryotherapy, and nonbenzodiazepine sleeping aids. Direction from governing bodies is an important next step to incorporate these adjuncts into routine clinical practice to manage pain and reduce the amount of opioids prescribed and consumed after arthroscopic surgery. Level of Evidence: Level II, systematic review and meta-analysis of RCTs. See Instructions for Authors for a complete description of the levels of evidence.

The FOR ME (Fostering Opportunities in Research through Messaging and Education) study: Developing a culturally sensitive narrative intervention to promote equity in clinical trials.

TPS6653 Background: Black women are more likely to die from breast cancer than women of any other race/ethnicity. Contributing factors to this inequity include structural and socioeconomic determinants of health, differential access to novel therapies, tumor biology and comorbidities. In 2020, only 7.2% of enrollees in clinical trials that led to approval of 3 novel drugs for breast cancer were Black. Underrepresentation of patients from racial/ethnic minority groups in clinical trials is a contributing factor to health disparities. The first aim of this study is to conduct multiple qualitative methods with multi-level stakeholders to identify barriers, facilitators, and intervention priorities that would assist Black breast cancer patients to make informed decisions about participating in clinical trials. Secondly, we aim to create a culturally sensitive, narrative intervention designed to support decision making and motivate Black breast cancer patients to participate in clinical trials. Aim 3 will pilot a study to determine acceptability of the intervention among patients and assess whether it increases clinical trial participation in a safety net oncology practice. Methods: Community-based participatory research approaches are guiding our research methodologies. First, we are conducting interviews and story circles with Black women with breast cancer, community partners and advocates, and oncologists and clinical trials office staff. These interviews will identify themes to inform intervention content. Next, interviews and focus groups will invite feedback on the educational/motivational content of the intervention and will be used to develop a culturally sensitive script and storyboards. A video production company will produce the narrative intervention. Finally, focus groups and interviews with participant cohorts will provide feedback on the completed intervention. Black women diagnosed with breast cancer will view the intervention in an oncology clinic. Using a pretest/posttest design, we will analyze the acceptability of the intervention and its effect on intention to participate in clinical trials. We will then conduct a quasi-experimental study in a safety net oncology practice to determine whether the rate of clinical trial participation among Black breast cancer patients increases following implementation of the intervention as a standard component of new patient education. Recruitment started in July 2022, and currently, 14 of 30 interviews with patients are completed. Aim 1 interviews with patients, oncologists, clinical trial staff, and advocates are expected to finish by April 2023, and results will be presented.

YouTube as a Source of Patient Information for Cubital Tunnel Syndrome: An Analysis of Video Reliability, Quality, and Content.

This study seeks to examine the reliability, quality, and content of YouTube videos on cubital tunnel syndrome, on which there is presently a paucity of information. The top 50 unique YouTube videos by relevance resulting from the Boolean search term "cubital tunnel + cubital tunnel syndrome" were identified, with video properties for analysis including source, upload date, duration, views, and comments. Content was assessed using the Journal of American Medical Association (JAMA) criteria, the Global Quality Score (GQS), and a "Cubital Tunnel-Specific Score" (CTSS). The average video saw 72 108 ± 199 362 views, with videos produced by allied (nonphysician) health professionals demonstrating the highest mean views (111 789 ± 294 471 views). Videos demonstrated low mean JAMA scores (2.4/4 ± 0.7), GQS (2.8/5 ± 1.3), and CTSS (7.5/21 ± 4.3), with academic and nonacademic physician videos demonstrating significantly greater mean GQS and CTSS scores when compared with videos by allied health professionals. Positive independent predictors for GQS included academic sources (β = 1.871), nonacademic physician sources (β = 1.651), and video duration (β = 0.102), which were likewise positive predictors for CTSS (β = 4.553, 4.639, 0.374). Content relating to surgical techniques or approaches for cubital tunnel decompression had the greatest CTSS scores (11.2 [4.2]). YouTube is a source of highly accessible information on cubital tunnel syndrome, although the average video presents generally poor and inadequate information. Directing patients toward higher quality video resources can be a meaningful component of patient education.

Abstract B047: The For Me (Fostering Opportunities in Research through Messaging and Education) study: Developing a culturally sensitive narrative intervention to promote equity in clinical trials

Abstract Background: Black women are more likely to die from breast cancer than women from any other race/ethnicity. Contributing factors to this inequity include tumor biology, comorbidities, socioeconomic determinants such as poverty, culture, and social injustice, and differential access to and utilization of novel therapies. In 2020, only 7.2% of enrollees in clinical trials that led to approval of 3 novel drugs for breast cancer were Black. Underrepresentation of patients from racial/ethnic minority groups in cancer clinical trials is a barrier to achieving health equity and results in a lack of scientific advancement and comprehensive understanding of the safety, efficacy, effectiveness, and biological heterogeneity of treatment effect. Objective: To develop, optimize and pilot test a narrative decision aid intervention (web-based video) that is culturally sensitive, grounded in a multi-level theoretical framework, and informed by in-depth qualitative research that can be implemented in safety net oncology practices and will support decision making among Black breast cancer patients related to clinical trial participation. Specific Aims: Aim 1) Conduct multiple qualitative methods with multi-level stakeholders to identify barriers, facilitating factors and intervention priorities to support decision making and motivate Black breast cancer patients to participate in clinical trials. Aim 2) Create a culturally-sensitive, narrative intervention designed to support decision making and motivate Black breast cancer patients to participate in clinical trials. Aim 3) Determine acceptability among patients and conduct a pilot study to determine whether the intervention increases clinical trials participation in a safety net oncology practice. Study Design: Interviews with members of the target audience, community partners, oncologists, and clinical trials office staff from a safety net hospital will identify salient themes to inform intervention content. Community-based participatory research approaches will guide research methodology. Interviews, focus groups, and story circles with participant cohorts will elicit input and feedback on the educational/motivational content informed by qualitative data and will be used to develop a script and storyboards that are culturally sensitive. A video production company will produce the narrative intervention. Focus groups and interviews with participant cohorts will provide iterative feedback on the completed intervention. Black patients currently diagnosed with breast cancer will view the intervention in an Oncology clinic. Using a pretest/posttest design, we will analyze acceptability of the intervention and its effect on intention to participate in clinical trials. We will then conduct a quasi-experimental study in a safety net oncology practice to determine whether the rate of clinical trials participation among Black breast cancer patients increases following implementation of the intervention as a standard component of new patient education. Study recruitment will begin July 2022. Citation Format: Vida Henderson, Leslie Carnahan, Ryan Nguyen, Pam Khosla, AnneMarie Murphy, Beulah Brent, Kent Hoskins. The For Me (Fostering Opportunities in Research through Messaging and Education) study: Developing a culturally sensitive narrative intervention to promote equity in clinical trials [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B047.

Incorporation of occupational based intervention into joint protection education for individuals with thumb carpometacarpal osteoarthritis: A case series

BackgroundTo our knowledge, the use of occupational performance in education on joint protection techniques has not been studied for individuals with thumb carpometacarpal (CMC) osteoarthritis. PurposeThis case series was designed to investigate if occupation-based instruction inside the clinic was useful and found satisfactory as an educational tool for individuals with thumb CMC joint arthritis. MethodsThree participants with thumb CMC joint osteoarthritis performed washing, rinsing, and drying a dish, moving a pot and pan, maneuvering a laundry basket, and pouring from a pitcher during joint protection education in the therapy clinic with a skilled hand therapist in addition to routine treatment. Satisfaction with this intervention was assessed via a 3-question satisfaction survey. Pain with activity and function via the Thumb Disability Examination were assessed at baseline and a 4week follow up. ResultsPatients in this study expressed satisfaction with the inclusion of the performance of occupations in their joint protection education in the clinic. Pain with activity improved by an average of 1.7/10 on a 10-point Numeric Pain Rating Scale and function improved by an average of 10.04 on the Thumb Disability Examination. ConclusionsAlthough no causal relationships can be assumed in this study, hand therapists should consider adding occupation-based intervention as a component of patient education on joint protection for individuals with thumb CMC joint osteoarthritis.

Surgical Site Infection (SSI) Surveillance Program for Mastectomy in the Department of Surgery of the University of the Philippines-Philippine General Hospital

Background. Mastectomy is a common surgical procedure done worldwide. Surgical site infection (SSI) is a common healthcare-associated infection. Mastectomy SSIs are frequently under-reported.
 Objectives. The study aimed to determine the incidence of SSI among mastectomy cases of the Department of Surgery, University of the Philippines – Philippine General Hospital (UP-PGH) during one year of full implementation of the Surgical Site Infection Surveillance Program and evaluate the program’s surveillance follow-up rate.
 Methods. This study was an observational practice audit research that included all adult patients who underwent a mastectomy in UP-PGH from January 1, 2018, to January 31, 2019, when the SSI Surveillance Program was fully implemented. SSI was monitored and assessed during the patient’s hospital stay, on the day of hospital discharge, and at 30 days (± 2 days) after surgery, either during an outpatient visit or via phone call by a nurse navigator. SSI frequency for mastectomy was computed both during the in-hospital stay and at 30 days after surgery. Surveillance follow-up rate, defined as the proportion of patients who could follow-up up to 30 days after surgery, was determined.
 Results. The 30-day SSI rate for mastectomy was 6.8% (19/279). All 279 patients were followed up to 30 days after surgery. Of the 279 patients, 277 (99.3%) were through clinic visits, one was through phone calls, and one was still admitted to the hospital.
 Conclusion. Full implementation of the SSI Surveillance Program for mastectomy in UP-PGH for one year showed a higher SSI rate than in published international literature. The program had a complete 30-day patient follow-up, contributing to more accurate SSI reporting. Implementing an SSI surveillance program with standardized protocols, dedicated personnel, patient education component, and the analysis of the information derived from such programs can improve an institution's quality of surgical care.

Effectiveness of Peri-Discharge Complex Interventions for Reducing 30-Day Readmissions among COPD Patients: Overview of Systematic Reviews and Network Meta-Analysis.

Background:An overview of systematic reviews(SRs) and network meta-analysis(NMA) were conducted to evaluate the comparative effectiveness of peri-discharge complex interventions for reducing 30-day readmissions among chronic obstructive pulmonary disease(COPD) patients.Methods:Five databases were searched for SRs of randomized controlled trials(RCTs). An additional search was conducted for updated RCTs from database inception until Jun 2020. Pooled effect of peri-discharge complex interventions was assessed using random-effect pairwise meta-analyses. Comparative effectiveness across different peri-discharge complex interventions was evaluated using NMA.Results:Nine SRs and 11 eligible RCTs(n = 1,422) assessing eight different peri-discharge complex interventions were included. For reducing 30-day all-cause readmissions, pairwise meta-analysis showed no significant difference between peri-discharge complex interventions and usual care, while NMA indicated no significant differences among different peri-discharge complex interventions as well as usual care. For reducing 30-day COPD-related readmissions, peri-discharge complex interventions were significantly more effective than usual care (pooled RR = 0.45, 95% CI:0.24–0.84).Conclusions:Peri-discharge complex interventions may not differ from usual care in reducing 30-day all-cause readmissions among COPD patients but some are more effective for lowering 30-day COPD-related readmission. Thus, complex intervention comprising core components of patient education, self-management, patient-centred discharge instructions, and telephone follow up may be considered for implementation, but further evaluation is warranted.

Effect of Pharmacist Interventions on Medication Adherence to Capecitabine in Cancer Patients: A Systematic Review

Oral chemotherapy poses challenges regarding patient medication adherence. Pharmacists play a vital role in supporting medication adherence to achieve the effectiveness of therapy. This review aimed to evaluate the impact of pharmacist interventions on medication adherence in patients with cancer taking capecitabine. The literature was systematically reviewed using Scopus, ScienceDirect, Sage Journal, Springer Link, PubMed, and Google Scholar. Key text words included “adherence, pharmacist intervention, capecitabine, oral chemotherapy, and cancer.” We collected original articles published from January 2010 to June 2021 in English that reported pharmacist interventions to enhance capecitabine adherence in adult patients with cancer and assessed adherence rates pre- and post-intervention. Two independent researchers extracted data relevant to inclusion criteria and determined the methodological quality of studies using the Joanna Briggs Institute Critical Appraisal Checklist Tools. A total of 4179 articles were retrieved, of which five were eligible for review. The most common pharmacist intervention strategy was a combination of patient education, with oral and written information provided. Components of patient education were the characteristics of capecitabine, including its mechanism of action, side effects, and their management; current therapeutic regimen; importance of adherence; and risk of non-adherence. Pharmacist interventions provide beneficial impacts on medication adherence, beliefs about medication, and tolerability of side effects. The findings suggest that pharmacist interventions support medication adherence improvement and highlight the role of pharmacist interventions in pharmaceutical oncology care services. Further studies are necessary to assess pharmacist interventions’ long-term effects and clinical outcomes.

Health Literacy and Intercultural Competence Training.

Intercultural competence (ICC) and health literacy (HL) are vital components of patient education. The purpose of this study was to determine if an educational intervention that combined ICC and HL was effective at changing second-year nursing students' self-efficacy, beliefs, and knowledge. A total of 157 second-year nursing students in two different programs participated in pre- and post-surveys consisting of the Transcultural Self-Efficacy Tool and Health Literacy Beliefs and Knowledge survey. Students attended a two-part lecture with a moderated panel on ICC and health literacy and began clinical fieldwork. Results were analyzed using Wilcoxon signed-rank test and Pearson correlation. There was a statistically significant difference in all ICC subscales after an educational intervention and clinical fieldwork (cognitive z = 7.681, p < .001; practical z = 7.319, p < .001; affective z = 6.533, p < .001). HL knowledge and belief measures showed statistically significant difference after the intervention (z = 3.037, p < .001). There was a statistically significant correlation between intercultural self-efficacy and HL beliefs (Pearson's r = .486, p < .001). Self-efficacy in ICC and beliefs and knowledge in HL increased over time for nursing students, indicating that it may be beneficial to train students about these two constructs simultaneously. [HLRP: Health Literacy Research and Practice. 2021;5(4):e283–e286.]

Non-operative Management of Anterior Knee Pain: Patient Education

Purpose of ReviewAnterior knee pain is a multifactorial, often chronic condition, which can lead to long-term pain and disability. The purpose of this review is to examine the latest research on patient education for anterior knee pain. We will focus on how we might use patient education to increase the adoption of other efficacious treatment modalities and offer some suggestions for content and form of effective patient education.Recent FindingsNew research suggests that patient education, alone, or in combination with targeted exercise therapy, can be effective in reducing pain and improving function in patients with patellofemoral pain. Addressing non-physical or psychological factors may also be an important component of patient education in many patients with chronic pain. Incorporation of new technologies into patient education, such as those available online, or through phone- or tablet-based apps, is likely to be helpful in the future, as we move more towards connecting with patients virtually.SummaryPatient education has been shown to be effective in decreasing pain and improving activity in patients with patellofemoral pain. Patient education should be individualized to the patient, focus on the latest effective treatments, and emphasize those treatments that can be self-managed by the patient. Emphasis should also be placed on patient understanding of risk factors and patterns of movement that may lead to, or exacerbate, anterior knee pain. Future research should continue to further characterize the elements of patient education that offer the most efficient treatment benefit.

Communication Strategies to Improve Medication Adherence: A Systematic Review of Literature

Less than optimal medication adherence is a persisting issue among many patient groups, resulting in poorer health outcomes along with increased strain on financial and time resources. However, communication strategies employed by clinicians may offer a simple, cost-effective method for improving medication adherence and health outcomes. We conducted a review of literature that rendered search results from seven databases, resulting in 1,513 abstracts. A final sample of 44 studies was included to compare the effectiveness of communication-based adherence strategies among various health conditions. After reviewing the full text of included studies, we organized communication strategies into four categories: patient reminders, collaborative communication, patient education, and counseling strategies. Although all of the strategies indicated some level of success, studies examining patient education components showed the most promise both in generalizability and results. This review’s results indicate that a need remains for quantitative research examining the effectiveness of these strategies to increase medical adherence.

Interventions to improve uptake of urate-lowering therapy in patients with gout: a systematic review.

BackgroundGout treatment is suboptimal despite available therapy, with low levels of initiation and persistence of urate-lowering therapy (ULT) in many patients.AimTo identify all interventions that have attempted to improve the uptake of ULT and analyse the clinical outcomes.Design & settingA systematic review of international articles published in English.MethodA systematic search was conducted through MEDLINE, Embase, CINAHL Plus, and Scopus databases to identify all studies on relevant interventions for gout. Interventions were included if they aimed to address patient adherence with serum urate (SU) level as an outcome. This included patient education, practitioner monitoring, medication titration, SU monitoring, and ongoing patient engagement and follow-up. Follow-up studies to original interventions and those with only an abstract available were included.ResultsTwenty articles met the inclusion criteria, describing outcomes of 18 interventions conducted in primary care settings: six nurse-led, five pharmacist-led, and seven multidisciplinary, multifaceted interventions. Improvement in SU levels was observed in all interventions. Nurse-led interventions were effective at empowering patients as they addressed illness perceptions and provided education, advice, and telephone follow-up. Pharmacist-led interventions primarily aimed to monitor patients, alter medication dosage, and provide automated telephone follow-up. Various multifaceted programmes involving a range of providers resulted in increased sustained use of urate-lowering medication.ConclusionA nurse-led approach focusing on patient understanding about gout is the most effective in achieving improved patient adherence, and lowered SU levels among patients. An intervention should include patient education and follow-up components.

Educating students to educate patients.

Editors’ note: An important part of a health professional's role in a patient‐centred approach is to help patients and clients understand their health, illnesses and long‐term conditions in order to participate actively in their own care. To be an effective educator requires learning and practising a specific set of communication skills. Health professionals need to be able to assess the health literacy of their patients and to tailor the discussion of information to the appropriate level. The authors of this toolbox article have significant experience in facilitating health professional students’ learning to educate. They describe three components of effective patient education and how skills may be developed through experiential learning with simulated patients. These components are: assessment of the educational needs of the patient; delivery of education tailored for each patient; and evaluation of patient learning. Challenges in this area of practice and strategies to overcome these challenges are discussed, including adequate preparation for simulated patients and ensuring the authenticity of their roles, as well as how to ensure that all students are engaged in learning.

Improving the Pathway to Discharge

The current health care paradigm requires a more efficient discharge of patients. Nurses are challenged to have patients ready for discharge earlier without sacrificing the quality of patient preparation and education. On our mother-baby unit, patient education and discharge components were unnecessarily delayed until the day of discharge. To improve the efficacy and effectiveness of the discharge process on the mother-baby unit. Examples of evidence include survey responses from staff indicating issues that affected discharge efficiency, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data on discharge, and analysis of discharge data. A literature search indicates that the retention of information by patients is better retained when presented throughout the patient’s stay rather than at the time of discharge only. On the basis of this survey feedback and the evidence found in the literature, this problem-based intervention included the creation of the Pathway to Discharge tool. This innovative tool placed discharge tasks at timed intervals throughout the patient's stay to maximize patient education and better prepare the patient for going home. The pathway was initiated immediately after birth in the labor and delivery unit and concluded at the time of discharge. The pathway was broken down into five time frames and identified key care components to complete during that time. Use of this new discharge tool involved the patient in the process by encouraging ownership of the activities required to leave the hospital. Updated instructional videos were placed on tablets (iPads) for a more effective way to provide discharge instructions. Implementation of the Pathway to Discharge showed an increase in the number of discharges that occurred before 12:00 p.m. and the number of discharge elements completed before the day of discharge. Nurse satisfaction with the discharge process and “discharge info” on the HCAPHS survey improved with the intervention. This clinical nurse–led innovation demonstrated improvement in the discharge process on a mother-baby unit. By finding a more efficient and effective way to prepare new mothers for discharge, patients felt more satisfied with their discharge instructions and were discharged in a more timely manner.

Patient education in dental medicine: A review of the literature

In dental medicine, chronic diseases and chronic conditions (such as chronic periodontitis, temporomandibular disorders, chronic orofacial pain) justify patient education to self-care. This strategy of secondary or tertiary prevention, even if officially recognised, is still less known compared to health education, a form of primary prevention. The aim of the study was to make the point of recent studies devoted to patient education. Thus, the purpose of the study was to give an updated picture of patient education in odontology, describing, through an analysis of the international literature from 2006 to 2016, its characteristics and development. The main databases selected were: PubMed, EMBASE, CINAHL, Web of Sciences, DOSS, 302 articles published between 2006 and 2016 on patient education among which four RCTs and a case study were analysed because of their rigorous scientific quality. Patient education concerns chronic diseases and conditions also in the field of orthodontics. This limited number of studies, showed that patient education in odontology can bring real bio-clinic, cognitive, psychological and economic benefits to patients. Overall, it allows patients to better understand their illness and treatment and, thus, to improve their health behaviours and self-care techniques, which would reduce the treatment costs. Educational interventions in odontology should constitute a component of patient education in several chronic systemic diseases such as diabetes. It would be necessary to train future practitioners in this field and to develop a scientific research on this practice.

Patients Understanding of their Diagnosis and Treatment Plans During Discharge in Emergency Ward in a Tertiary Care Centre: A Qualitative Study

Many patients do not understand their emergency care plan or their discharge instructions. Patients should understand both the care that they received and their discharge instructions. Patients' knowledge of the diagnosis and treatment plan is an integral component of patient education. The objective of the study is to identify and describe the areas of patients' understanding and confusion about emergency care and discharge instructions at the BP Koirala Institute of Health Sciences, Dharan, Nepal. A qualitative study involving 426 patients discharged from the emergency unit of BPKIHS using a semi-structured questionnaire. Cases who are Leaving against medical advice, absconded cases and those patients who came just for vaccination are excluded from the study. The ethical approval for this study was received from the institutional review committee of B P Koirala Institute of Health Sciences, Dharan [Ref: IRC/0752/016]. There were 256 (60.1%) of men in this study. More than half of the participants reported not being able to read English. More than 90% of the respondents reported they could not read their prescription at all. While patient could point out their understanding of their diagnosis at discharge, most of them could not tell the names and the dosage of all the drugs prescribed to them at discharge. More than 95% of the patients could not tell the most common side effects of the drugs that they are prescribed. There is a need to further explore the factors influencing the understanding of the patients regarding their treatment plan. Interventions to understand the health literacy needs and ways to improve the health literacy of the patients are needed.

Advance Care Planning Education Sessions During Pulmonary Rehabilitation in Ireland.

This study aimed to investigate the practice of advance care planning (ACP) education within pulmonary rehabilitation programs (PRPs) in Ireland. All 27 PRPs in the Republic of Ireland were surveyed between May and September 2015, eliciting detailed quantitative and qualitative information about ACP education delivery. Data were analyzed using SPSS statistical software and content analysis. Twenty-two PRPs (82%) took part in the survey, with 86% (n = 19) of these being delivered in a hospital setting. Forty-five percent (n = 10) included ACP education of at least 20-min duration (n = 5) or as part of another session (n = 5). ACP topics discussed differed significantly across PRP sites. Sessions were delivered by respiratory nurses, physiotherapists, physicians, or palliative care physicians. Of the 12 sites currently not providing ACP education, almost half (n = 5) indicated a willingness to include this in the near future. Respondents identified enablers and barriers to ACP education, as well as staff education and service delivery gaps. Results demonstrate an overwhelmingly positive attitude toward ACP education. There is a need for ACP-specific education for all staff members involved in PRPs. Practical guidance on how to deliver this patient education component needs to be developed.

Exploring health literacy competencies towards patient education programme for Chinese-speaking healthcare professionals: a Delphi study

ObjectivesTo achieve consensus on a set of competencies in health literacy practice based on a literature review and expert consultation.SettingHospitals and community health centres in Taiwan.MethodA 2-stage modified Delphi study...