Pamphlet Group Research Articles

Anxiety and Self-care Behavior in Patients Undergoing Head and Neck Radiotherapy: Effect of Print and Multimedia Health Materials

Background: Patients undergoing radiotherapy require training through educational media due to the specific nature of this therapeutic modality. Aim: The aim of this study was to compare the efficiency of multimedia and print educational tools in anxiety and self-care behaviors among patients undergoing radiotherapy. Method: This randomized clinical trial was conducted on 60 patients referring to the radiotherapy centers of Mashhad, Iran, in 2016. Based on the treatment centers, the patients were randomly assigned into two groups of Group 1 and 2 provided by a 20-minute multimedia training session and three pamphlets, respectively. The patients’ anxiety was assessed in two stages, namely before the intervention and prior to the initiation of the first radiotherapy session, using the State-Trait Anxiety Inventory. Neil's Self-care Inventory was completed at the end of the first, third, and fifth weeks of treatment for assessing self-care behaviors. Results: The mean ages of the multimedia and pamphlet groups were 52.2±1.4 and 50.6±1.4, respectively. Paired t-test showed a significant decrease in the mean anxiety score of the pamphlet group (37.8±3.0) after the intervention, compared to that in the multimedia group (40.0±2.3) (P=0.009). Furthermore, the multimedia group had significantly higher self-care behavior scores, compared to the pamphlet group, in the first (P=0.003), third (P=0.01) and fifth weeks of treatment (P<0.001). Implications for Practice: Educational multimedia tools can have a more effective contribution in maintaining self-care behaviors. Given the reduction of anxiety in the pamphlet group, it is important to consider the rate and flow of transferring information in radiotherapy training to reduce anxiety among patients.

Psychological effects of belonging to a Facebook weight management group in overweight and obese adults: Results of a randomised controlled trial.

This study was conducted to test whether the weight outcomes in an online social networking group were mediated by changes to psychological outcome measures in overweight and obese individuals, following a weight management programme delivered via Facebook. The data analysed in this study were collected during a three-armed, randomised, controlled clinical weight management trial conducted with overweight and obese adults over 24weeks. Two intervention groups were given the same weight management programme: one within a Facebook group, along with peer support from other group members (the Facebook Group); the other group received the same programme in a pamphlet (the Pamphlet Group). A Control Group was given standard care. The primary outcome was weight; secondary outcomes included the following domains from self-reported questionnaires: energy intake and expenditure; psychological health, social relationships, physical health, quality of life, depression, anxiety, stress, health anxiety, happiness, as well as Facebook Group participants' opinion of this group. The Facebook Group experienced a reduction in their baseline weight measurement by week 24, significantly compared to the Control Group (p=.016). The Facebook Group recorded a significant increase in the psychological health domain during the trial (at week 12) relative to their baseline measurement, and significant compared to the Control Group (p=.022). Mediation analysis indicated a statistical trend, but not statistical significance, for psychological health as a mediator to weight loss in the Facebook Group. While both intervention groups showed significant changes in psychological outcome measures, the Facebook Group was the only group to experience statistically significant weight loss by the end of the 24weeks. Therefore, an examination of other psychological and/or behavioural outcome measures undertaken in larger studies in the future may help to identify significant mediators to improved weight loss outcomes in online social networking groups.

Comparison of the Effect of Toothbrushing Education Via Video, Lecture and Pamphlet on the Dental Plaque Index of 12-Year-Old Children.

The aim of this study was to compare the effect of different modes of toothbrushing education (lecture, video and pamphlet) on the dental plaque index (PI) of adolescents. The cluster randomized intervention was performed on 128 participants aged 12 years, who were allocated into four groups based on the type of intervention. Group 1: no intervention; and groups 2, 3, 4: education via lecture, video, and pamphlet, respectively (n = 32). Their plaque index was measured at the baseline, 24 h and two months later. Data were analyzed by repeated measures analysis of variance (ANOVA), one-way ANOVA, independent and paired t-test. The plaque indices of groups 2, 3, 4 at 24 h (p values < 0.001) and two months (p values < 0.001) showed a significant reduction when compared to the baseline. The lowest PI score was observed in the pamphlet, video and lecture groups at 24 h, respectively. After 2 months, the lowest score of PI was measured in lecture, video and pamphlet groups, respectively; however, these differences were non-significant. Therefore, toothbrushing education via lecture, video and pamphlet reduced the dental plaque index with the same effectiveness.

Effectiveness of yoga and educational intervention on disability, anxiety, depression, and pain in people with CLBP: A randomized controlled trial

ObjectiveThe current study investigates the effects of an 8-week yoga program with educational intervention compared with an informational pamphlet on disability, anxiety, depression, and pain, in people affected by chronic low back pain (CLBP). MethodsThirty individuals (age 34.2 ± 4.52 yrs) with CLBP were randomly assigned into a Yoga Group (YG, n = 15) and a Pamphlet Group (PG, n = 15). The YG participated in an 8-week (2 days per week) yoga program which included education on spine anatomy/biomechanics and the management of CLBP. Main outcome measuresMonitoring response to intervention, the Oswestry Low Back Pain Disability Questionnaire (ODI-I), Zung self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS) and Numeric Rating Scale for Pain (NRS 0–10) were used to collect data. ResultsAfter intervention, the YG showed a significant decrease (p < 0.05) in the mean score in all assessed variables when compared with baseline data. In addition, statistically significant (p < 0.05) differences were observed among groups at the end of intervention in depression, anxiety, and pain, but not in disability. ConclusionsThe yoga program and education together appear to be effective in reducing depression and anxiety, which can affect perception of pain.

Online, game-based education for melanoma recognition: A pilot study

ObjectiveTo evaluate the effectiveness of a game-based learning (GBL) intervention, Tapamole, in improving recognition of the features of melanoma (MM) compared to a written education intervention. MethodsTapamole, an online education intervention, was developed using GBL. Participants were voluntarily recruited from the Dermatology waiting room and randomized to three groups: game, pamphlet, and no intervention. Participants completed a pre-intervention survey, post-intervention survey, and test on MM recognition. Clustered binary data equations were used to calculate sensitivity, specificity, and accuracy for each group and GEE model with log link was used to compare measures between groups. ResultsSixty participants were recruited. The sensitivity for MM recognition in the game group was 100% compared to 95% for the pamphlet group. The specificity (40.8% vs 53.3%) and accuracy (60.6% vs 67.2%) of the game and pamphlet groups were similar. Participants in the game group reported higher enjoyment than those in the pamphlet group. ConclusionGBL was as effective as the written intervention in identifying features of MM. Practice implicationsWith increasing use of the Internet for health information, it is critical to have effective online education interventions. GBL education tools are effective, enjoyable, and should be used to improve MM patient education.

Assessing effective methods to educate caregivers on fever in children aimed at reducing input to the paediatric emergency department

Introduction: Many paediatric emergency departments face a significant proportion of non-urgent attendances, leading to problems for both patients and healthcare systems. Our primary aim was to compare the effectiveness of pamphlet versus video in educating caregivers regarding fever management in children. Our secondary aim was to assess caregivers’ sentiments towards these methods. Methods: A randomized controlled trial was conducted with 50 participants over a four-week period (May–June 2015) in the KK Hospital Paediatric Emergency Department. The control group was exposed to the standard pamphlet available in the KK Hospital Paediatric Emergency Department, which provided basic information on fever management. The intervention group watched a video produced by our team, containing similar content. The same five-question questionnaire assessing fever management knowledge was issued to participants before and immediately following exposure to intervention. Results: The pamphlet group had a mean pre-intervention score=2.8 (out of five), post-intervention score=3.84, amounting to an improvement of 1.04. The video group had a mean pre-intervention score=2.56, post-intervention score=4.12, giving an improvement of 1.36. The study was powered at 80%, with calculated p-value=0.111, hence the results were statistically insignificant. Both groups had increased self-reported awareness post-exposure, found the intervention useful, would rely on it for future management and would recommend it to others. Conclusion: While the sample size was limited, this study demonstrates the potential that both pamphlet and video interventions have in educating caregivers, as participants reported favourable sentiments towards the methods. It would be worthwhile to conduct the study on a larger scale to yield statistically significant results.

Comparison of Two Methods of Direct and Indirect Education on Osteoporosis Preventive Behaviors among Female Students

Background Osteoporosis is the most common metabolic bone disease that decreases bone mass, causes destruction and eventually friability. This disease is preventable, and because adolescent females are the high-risk population, teaching this age group is of the utmost importance. The aim of this study was to compare the effects of the two educational methods (Lecture and Pamphlet) on osteoporosis preventive behaviors among female students. Materials and Methods: This was a randomized clinical trial (RCT). To collect data, demographic questionnaire, food frequency questionnaire (FFQ), and physical activity questionnaire were used. Subjects were 205 seventh-grade girls who were selected by multistage random method and allocated in two experimental (Lecture = 68, Pamphlet = 67) and 70 for control group. In the Lecture group, there were 5 sessions of training, each of which lasted 60 minutes. In the Pamphlet group, only educational pamphlets were given, and no interventions were performed in the control group. Data were analyzed through statistical software SPSS version 21.0. Descriptive statistics, chi-square tests, t-test and ANOVA were applied to analyze the data. Results: The mean age of the students was 13 + 0.856 years old and there was no difference in terms of demographic variables between intervention and control groups. The results identified the mean scores of physical activity behaviors significantly improved two mounts after the intervention in the lecture group (P=0.001).While, the men scores of the pamphlet group had no significant changes after two months, but the differences of the both group compared to the control group were significant. Considering the significant decreased in the control group (P= 001). The mean scores of calcium intake in the two lecture and pamphlet groups significantly increased (P<0.001), while, as it was expected no significant changes in the control group after the intervention. Conclusion: The osteoporosis preventive behaviors intervention improved the preventive behaviors of the participants. The results showed the effectiveness of education in both Pamphlet and Lecture group, because calcium intake and physical activity were significantly increased compared to pre-intervention and the control group.

Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study.

Colorectal cancer (CRC) screening is a cost-effective prevention and control strategy. However, the promotion of CRC screening for older adults may be difficult because reading CRC prevention information may evoke embarrassment, fear, and anxiety towards the screening procedure and cancer diagnosis. This study aims to (1) examine the effects of three promotional materials for CRC screening on the attitudes toward CRC screening tests (screening interest, screening effectiveness, and trust in the screening results) and cancer fear, and (2) to explore the interaction effect of cancer fear with screening effectiveness and trust in the screening results on screening interest of the three screening tests (fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy) among Chinese older adults. A total of 114 community-dwelling older adults were asked to look at the corresponding promotional materials (pamphlet, cartoon, and video) of one of the three study groups. The pamphlet and video represent convention strategies and the cartoon represents an innovative strategy. No significant difference was observed in the screening interest and cancer fear across groups. FOBT was the most preferred screening modality. The video group has a large proportion agreed screening effectiveness of flexible sigmoidoscopy than pamphlet and cartoon groups and trusted in the screening results for FOBT and flexible sigmoidoscopy than the pamphlet group. Logistic regression results showed that the effect of trust in the screening results on screening interest for colonoscopy was greater among participants with higher cancer fear than those with lower cancer fear level. In conclusion, the three promotional groups had produced similar results in their attitudes toward CRC screening and cancer fear. The use of cartoons may be a comparable approach with conventional methods in the promotion of CRC screening. Additional components that can arouse fear and boost response efficacy simultaneously might also be useful for the effective promotion of colonoscopy among Chinese older adults.

Effects of a weight management program delivered by social media on weight and metabolic syndrome risk factors in overweight and obese adults: A randomised controlled trial.

IntroductionThe aim of this project was to evaluate the effectiveness of using social media to augment the delivery of, and provide support for, a weight management program delivered to overweight and obese individuals during a twenty four week intervention.MethodsParticipants randomly divided into either one of two intervention groups or a control group. The two intervention groups were instructed to follow identical weight-management program. One group received the program within a Facebook group, along with a support network with the group, and the other intervention group received the same program in a booklet. The control group was given standard care. Participants’ weight and other metabolic syndrome risk factors were measured at baseline and at weeks 6, 12, 18 and 24.ResultsThe Facebook Group reported a 4.8% reduction in initial weight, significant compared to the CG only (p = 0.01), as well as numerically greater improvements in body mass index, waist circumference, fat mass, lean mass, and energy intake compared to the Pamphlet Group and the Control Group.ConclusionsThese results demonstrate the potential of social media to assist overweight and obese individuals with respect to dietary and physical activity modifications for weight management, and justify further research into the inclusion of social media in clinical weight management programs. It is anticipated that social media will provide an invaluable resource for health professionals, as a low maintenance vehicle for communicating with patients, as well as a source of social support and information sharing for individuals undergoing lifestyle modifications.

Comparing Written and Planned Training On Anxiety among Patients Undergoing Orthopedic Surgery

Introduction and objectives: The prevalence of preoperative state anxiety is an unavoidable complication. Aside from its type and scope, the surgical operation is considered as a severe stressful situation for patients. Considering the importance of reducing the state anxiety in patients undergoing surgery, there are different methods, one of which is patient education; therefore the aim of the current study was compare the effect of written and planned training on the state anxiety among patients undergoing orthopedic surgery.Method: In this study, 81 patients candidate for orthopedic surgery were selected using convenience sampling and were randomly divided into 3 groups, including planned training, pamphlet and control groups. All patients answered 20 questions-State-Traits Anxiety Inventory (STAI) Questionnaire the day before surgery and the intervention was later carried out in the planned training and pamphlet groups. Then the effect of preoperative state anxiety was re-evaluated about half an hour after training in three groups. For data analysis, in addition to mean and standard deviation, independent t-test and ANOVA were used in Spss16.Results: The results of comparing pre- and post-training mean score of the state anxiety in three groups showed that the mean score of state anxiety reached from 50.41 to 41.03, 52.41 to 44.37 and 45.04 to 50.56 in planned, pamphlet and control groups, respectively. ANOVA test showed that there is a significant difference in this comparison. The results of Tukey's test also revealed that the mean score of state anxiety in the planned and pamphlet groups was lower significantly than the control group (p&lt;0.05).Conclusion: Based on research findings, the planned training method was more effective in decreasing state anxiety among patients compared to the pamphlet group before orthopedic surgery. Therefore, considering the fact that nurses play an important role in examining and relieving the state anxiety among patients and spend more time with patients undergoing surgery compared with other members of the healthcare team, therefore, the planned training method must be considered to ensure effective support to reduce the preoperative state anxiety among patients.

The Effect of Written Information on Recall of Surgical Risks of Carpal Tunnel Release Surgery: A Randomized Controlled Study.

Written information has been thought to help patients recall surgical risks discussed during the informed consent process, but has not been assessed for carpal tunnel release, a procedure with the rare but serious risk of complex regional pain syndrome. The authors' objective was to determine whether providing a pamphlet would improve patients' ability to remember the risks of surgery. Sixty patients seen for carpal tunnel release were included in this prospective, single-blind, randomized study. Patients received either a written pamphlet of the risks of surgery or no additional information following a standardized consultation. Two weeks after the initial consultation, patients were contacted to assess their risk recall and whether they had read about the operation from any source. There was no difference in terms of the number of risks recalled between pamphlet (1.33 ± 1.21) or control groups (1.45 ± 1.22; p = 0.73). Recall of infection was better in the pamphlet group (p < 0.05). No patients remembered complex regional pain syndrome. There was no difference in the proportion of people who read additional information about carpal tunnel release surgery between the pamphlet (34.8 percent) and control groups (21.4 percent; p = 0.39), but reading about carpal tunnel release surgery was associated with improved recall (2.45 ± 1.13 versus 0.77 ± 0.91; p < 0.01). Reading about surgery improved risk recall, but providing this information in the form of a pamphlet did not, nor did it affect patients' ability to recall the risk of complex regional pain syndrome. These results demonstrate that surgeons should implement additional measures to improve comprehension of surgical risks. Therapeutic, I.

Effects of Video- and Pamphlet-based Patient Educations on Anxiety and Satisfaction Among Candidates for Gastroscopy

Background: Endoscopy is a diagnostic tool, which causes its candidates different levels of anxiety. Anxiety can reduce patients’ tolerance and cooperation and increase the likelihood of endoscopy-related complications. One strategy to alleviate anxiety is patient education. However, previous studies reported conflicting findings about the most appropriate patient education method. Objectives: This study aimed at examining the effects of video- and pamphlet-based patient educations on anxiety and satisfaction among candidates for gastroscopy. Methods: This quasi-experimental study was conducted on 90 patients referred to the endoscopy unit of Valiasr hospital in Birjand city, Iran. The patients were selected through convenience sampling method and randomly allocated to a video, pamphlet, or control group. Data were collected using a demographic questionnaire, a researcher-made questionnaire for satisfaction assessment, and the Spielberger’s state-trait anxiety inventory. One day before gastroscopy, the participants completed the demographic questionnaire and Spielberger’s state-trait anxiety inventory. Then, educations were provided to them. In the day of their gastroscopy, their anxiety was reassessed both two to three hours before and immediately after the procedure. Collected data were entered into the SPSS software version 15. As all study variables had normal distribution, the data were analyzed by performing the one-way analysis of variance, the Tukey’s post hoc, the paired- and independent-sample t test, the chi-square, and Fisher’s exact tests at a significance level of less than 0.05. Results: The groups did not differ significantly from each other regarding the pretest and posttest values of total, state, and trait anxiety. However, the level of patient satisfaction in the video group was significantly greater than the control and pamphlet groups (P < 0.05). Moreover, patient satisfaction was not significantly correlated with patients’ demographic characteristics. Conclusions: Video-based patient education can improve patient satisfaction among candidates for gastroscopy.

Feasibility of Two Educational Methods for Teaching New Mothers: A Pilot Study.

BackgroundPrinted health educational materials are commonly issued to prepare patients for hospital discharge. Teaching methods that engage multiple senses have been shown to positively affect learning outcomes, suggesting that paper materials may not be the most effective approach when educating new mothers. In addition, many written patient educational materials do not meet national health literacy guidelines. Videos that stimulate visual and auditory senses provide an alternative, potentially more effective, strategy for delivering health information. The acceptability of these methods, as perceived by nurses executing patient education initiatives, is important for determining the most appropriate strategy.ObjectiveThe purpose of this study was to determine the feasibility of 2 educational methods for teaching new mothers how to care for themselves and their infants after hospital discharge. Feasibility was measured by adequate enrollment, acceptability of the intervention to patients and nurses, and initial efficacy.MethodsNew mothers (n=98) on a Mother-Baby Unit received health information focused on self-care and infant care delivered as either simple printed materials or YouTube videos on an iPad. Mothers completed a pretest, post-test, and an acceptability survey. Following completion of the initiative, nurses who participated in delivering the health education using one of these 2 methods were asked to complete a survey to determine their satisfaction with and confidence in using the materials.ResultsMothers, on average, were 26 years old; 72% had a high school education; and 41% were African American. The improvement in knowledge scores was significantly higher for the iPad group (8.6% vs 4.4%, P=.02) compared to the pamphlet group. Group (B=4.81, P=.36) and time (B=6.12, P<.001) significantly affected scores, while no significant interaction effect was observed (B=5.69, P=.09). There were no significant differences in responses between the groups (all P values >.05). The nurses had a mean age of 44.3 years (SD 13.9) and had, on average, 16.6 years of experience (SD 13.8). The nurses felt confident and satisfied administering both educational modalities.ConclusionsThe pamphlet and iPad were identified as feasible and acceptable modalities for educating new mothers about self-care and infant care, though the iPad was more effective in improving knowledge. Understanding the acceptability of different teaching methods to patient educators is important for successful delivery of informational materials at discharge.

Effect of nutritional education through lecture and pamphlet methods on breakfast consumption behavior among primary school girls in Ahvaz

Purpose and Background: Nutrition is an important factor in the health and educational success of students. Breakfast is a main meal and skipping it would constitute a significant reason for pre- school children’s academic failure as well as pre-school children’s growth disorders. This study aims to compare the effects of lecture and pamphlet educational methods on the knowledge, attitude, and performance of the 4th and 5th grade primary school girls in Ahvaz regarding their breakfast consumption behavior. Methodology: The three group intervention method was implemented. The 165 students selected for the study were classified into three groups (55 students in each group), namely, Intervention Group 1 (lecture), Intervention Group 2 (pamphlet), and Control Group. First, the research questionnaires comprising 15 questions on knowledge domain, 12 questions on attitude, and 11 questions on performance were completed. Four educational sessions were held for the intervention groups within two weeks. After three months, the second phase questionnaires were completed. The obtained data were subsequently analyzed through SPSS 16. Findings: The mean knowledge scores obtained before and after intervention in the three groups were as follows: - Lecture Group: Before: 21; After: 27.9 - Pamphlet Group: Before: 21.7; After: 25.6 - Control Group: Before: 43.5; After: 42.9 The mean knowledge, attitude, and performance scores in the lecture and pamphlet groups were significantly greater than those in the control group (P>0.0001). Upon intervention, these scores were significantly greater in the lecture group as compared with the pamphlet group (P>0.0001).

Using new technologies to promote weight management: a randomised controlled trial study protocol.

BackgroundOver the last three decades, overweight and obesity and the associated health consequences have become global public health priorities. Methods that have been tried to address this problem have not had the desired impact, suggesting that other approaches need to be considered. One of the lessons learned throughout these attempts is that permanent weight loss requires sustained dietary and lifestyle changes, yet adherence to weight management programs has often been noted as one of the biggest challenges. This trial aims to address this issue by examining whether social media, as a potential health promotion tool, will improve adherence to a weight management program. To test the effectiveness of this measure, the designated program will be delivered via the popular social networking site Facebook, and compared to a standard delivery method that provides exactly the same content but which is communicated through a pamphlet. The trial will be conducted over a period of twelve weeks, with a twelve week follow-up. Although weight loss is expected, this study will specifically investigate the effectiveness of social media as a program delivery method. The program utilised will be one that has already been proven to achieve weight loss, namely The CSIRO Total Wellbeing Diet.Methods/designThis project will be conducted as a 3-arm randomised controlled trial. One hundred and twenty participants will be recruited from the Perth community, and will be randomly assigned to one of the following three groups: the Facebook group, the pamphlet group, or a control group. The Facebook Group will receive the weight management program delivered via a closed group in Facebook, the Pamphlet Group will be given the same weight management program presented in a booklet, and the Control Group will follow the Australian Dietary Guidelines and the National Physical Activity Guidelines for Adults as usual care. Change in weight, body composition and waist circumference will be initial indicators of adherence to the program. Secondary outcome measures will be blood glucose, insulin, blood pressure, arterial stiffness, physical activity, eating behaviour, mental well-being (stress, anxiety, and depression), social support, self-control, self-efficacy, Facebook activity, and program evaluation.DiscussionIt is expected that this trial will support the use of social media - a source of social support and information sharing - as a delivery method for weight management programs, enhancing the reduction in weight expected from dietary and physical activity changes. Facebook is a popular, easy to access and cost-effective online platform that can be used to assist the formation of social groups, and could be translated into health promotion practice relatively easily. It is anticipated in the context of the predicted findings that social media will provide an invaluable resource for health professionals and patients alike.Trial registrationAustralian New Zealand Clinical Trials Register (ANZCTR): ACTRN12614000536662. Date registered: 21 May 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1849-4) contains supplementary material, which is available to authorized users.

Study the Effect of Planned and Writing Training on the Anxiety of Patients Undergoing Orthopedic Surgery

Surgery process is a diagnostic and therapeutic process in many diseases which increases the psychological and physiological reactions in some patients, that among them, anxiety and depression are considered as the most significant complications resulted from surgery. Given the importance of reducing anxiety in patients undergoing surgery, various methods are used for this purpose, which patient training is one of them. The study was aimed to study the effect of planned and writing training on the anxiety of patients undergoing orthopedic surgery. In this study, 81 patients scheduled for orthopedic surgery were selected by convenience sampling method, and then randomly divided into 3 groups of planned, pamphlet and control. All patients filled out Spielberger’s 40-question anxiety questionnaire on the day before surgery, and then intervention was done in two planned and pamphlet groups. Then the patient’s anxiety was re-evaluated in three groups about a half hour before surgery after training. In addition to calculating the mean, standard deviation, independent t test and variance were used with software Spss16 to analyze the data. Comparison of the mean anxiety scores before and after training in the three showed that the mean of total anxiety score is reached from 93.37 to 81.37in planned group, from 99.74 to 88.07 in pamphlet group and from 85.63 to 96.33in control group. Using analysis of variance for comparing the three groups shows a significant difference. The results of Tukey test showed that the patients’ mean anxiety score in planned and pamphlet groups was significantly lower than that in control group patients (P<0.05). Based on the findings, planned training had a more effect on patients’ anxiety reduction in compared to pamphlet group before orthopedic surgery. Therefore, since nurses have an important role in investigating and relieving anxiety and take more time with patients undergoing surgery than other members of therapeutic team, they must consider the planned training methods to support their patients more to reduce preoperative anxiety.

Effect of an educational program on attitudes towards deceased organ donation.

Organ shortage for transplantation remains a serious global issue. We assessed the effects of an educational program on changing attitudes of medical students towards deceased organ donation. We conducted a non-randomized trial involving medical students who had not previously signed a donor card. Third-year medical students (n=86, program group) received an information pamphlet followed by a 60-min classroom lecture by a transplant physician who was himself a kidney transplant recipient and finally another information pamphlet containing a donor card. First-year students (n=87, control group) received the same two pamphlets only. The primary outcome was signing a donor card. The secondary outcomes included willingness to sign a donor card, willingness to donate organs, family discussion about deceased organ donation, and knowledge. Outcomes were measured by questionnaires before and after the intervention. A higher proportion of students of the program group signed a donor card than the pamphlet group (8.1% vs. 0%, respectively). After propensity score adjustment, the program was associated with higher proportion of willingness to sign a donor card (91.9% vs. 73.6%; adjusted proportion ratio 1.28 [95% CI 1.11-1.48]), family discussion (18.6% vs. 6.9%; 2.85 [1.15-7.03]), and increased knowledge. There were no significant differences between the two groups in willingness to donate organs after brain death (64.0% vs. 60.9%; 1.12 [0.90-1.40]) and cardiac death (77.9% vs. 71.3%; 1.11 [0.93-1.33]). The educational program delivered by a transplant physician and a recipient may alter the attitudes of medical students towards deceased organ donation.

Randomized Controlled Trial of Adjunctive Social Media for More Effective Contraceptive Counseling

INTRODUCTION: The objective of this study was to determine whether social media, specifically a Facebook page, is an effective tool for improving contraceptive knowledge. METHODS: English-speaking women 18–45 years old receiving care in an urban academic center obstetrics–gynecology clinic were invited to participate in a randomized trial of standard contraceptive education+pamphlet compared with standard contraceptive education+Facebook information for contraception counseling. Contraceptive knowledge was evaluated pre- and postintervention by the Contraceptive Knowledge Inventory. We evaluated the effect of the intervention by raw score or percent increase in Contraceptive Knowledge Inventory score, patient satisfaction with counseling method, and contraceptive preference postintervention. All analyses were stratified by age group. RESULTS: Median raw Contraceptive Knowledge Inventory score postintervention was significantly higher in the Facebook (n=69) compared with the pamphlet group (n=74) across all age groups (all P≤.02) as was percent increase in Contraceptive Knowledge Inventory score (all P<.05). Patient satisfaction with counseling method was significantly higher in the Facebook group across all ages (all P≤.01). Patient contraceptive preference for long-acting reversible contraceptives (LARC; intrauterine device or implant) postintervention was significantly greater in the Facebook compared with the pamphlet group (57% compared with 35%, P=.01). Among women currently using no or barrier contraception, patient preference for implant postintervention was significantly greater in the Facebook compared with the pamphlet group (26% compared with 5%, P=.02), although when analysis was extended to include an implant or intrauterine device, LARC was nonsignificantly higher in the Facebook compared with pamphlet group (48% compared with 33%, P=.19). CONCLUSION: Social media as an adjunct to traditional in-office counseling is a powerful tool that improves patient contraceptive knowledge and increases patient preference for LARC.

Adjunctive social media for more effective contraceptive counseling: a randomized controlled trial.

To determine whether social media, specifically Facebook, is an effective tool for improving contraceptive knowledge. English-speaking women aged 18-45 years receiving care at an urban academic center obstetrics and gynecology clinic were included and randomized to a trial of standard contraceptive education and pamphlet (n=74) compared with standard contraceptive education and Facebook (n=69) information for contraception counseling. Contraceptive knowledge was evaluated preintervention and postintervention by the Contraceptive Knowledge Inventory. We evaluated the effect of the intervention by raw score and percent increase in Contraceptive Knowledge Inventory score, participant satisfaction with counseling method, and contraceptive preference postintervention. All analyses were stratified by age group. The median raw postintervention Contraceptive Knowledge Inventory score was significantly higher in the Facebook compared with the pamphlet group (15 compared with 12, P<.001) as was percentage increase in the Contraceptive Knowledge Inventory score (36% compared with 12%, P<.001). Participant satisfaction with counseling method was significantly higher in the Facebook group (median 10 compared with 6, P<.001). Participant contraceptive preference for long-acting reversible contraceptives (LARCs; intrauterine device or implant) postintervention was significantly greater in the Facebook compared with the pamphlet group (57% compared with 35%, P=.01). Among women currently using none or barrier contraception, contraceptive preference for implants was significantly greater in the Facebook compared with the pamphlet group (26% compared with 5%, P=.02), although, when analysis was extended to include implant or intrauterine device, LARCs were not significantly higher in the Facebook compared with the pamphlet group (48% compared with 33%, P=.19). Social media as an adjunct to traditional in-office counseling improves patient contraceptive knowledge and increases patient preference for LARCs. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01994005.

Maternal Influenza Vaccination: Evaluation of a Patient-Centered Pamphlet Designed to Increase Uptake in Pregnancy

We developed and tested a theoretically-based pamphlet entitled 'Influenza in Pregnancy,' specifically designed to increase pregnant women's knowledge, reduce barriers to maternal vaccination, and subsequently improve vaccine uptake. A randomized control trial was conducted on pregnant women (n = 135) at three locations in Connecticut during the 2011-2012 season to evaluate the impact of the patient-centered pamphlet. The women were randomized to one of three groups: the pamphlet; pamphlet/benefit statement (vaccinating the pregnant woman also benefits the young infant); or control. A Chi square analysis compared the intervention with control using the primary outcome of vaccination. A secondary outcome of the perceptions of health beliefs of maternal vaccination were measured through General Linear Model/ANOVA model for repeated measures. Overall 66.9% (89/133) were vaccinated. Both the pamphlet group 72.9% (35/48) (χ² = 6.81, df = 1 p = .009), and the pamphlet/benefit statement group 86.1% (31/36) (χ² = 13.74, df = 1, p < .001), had significantly higher vaccine uptake than the control group 46.9% (23/49). The potential barrier, perception of vaccine safety (F = 4.973, df = 2, p < .01), and benefit of vaccination to mother and infant (F = 6.690, df = 2, p < .01) significantly improved for the intervention groups compared to control group. The pamphlet significantly increased the pregnant women's perceptions of the safety and benefit of the vaccine, and the overall uptake.