Patient-centered Education Research Articles

How Patient-Centered is Education and Counseling of Patients on Oral Anticancer Therapy? A Multicenter Cross-sectional study

Background: In the last years, there has been an exponential increase in the number of oral anticancer therapies (OACT). However, no research has yet been conducted on the current quality of patient-centered care (PCC) for patients on OACT in Belgium. Moreover, there was no valid and reliable instrument available to assess PCC tailored to the context of OACT. Therefore, we developed and validated a new patient-reported experience measure (PREM), named the CONTACT-Patient-Centered Care Questionnaire (CONTACT-PCCQ).
 Aim: The aim of this study was to gain insight in the quality of PCC for patients on OACT using the CONTACT-PCCQ. It was examined which areas of patient-centered education and counseling are currently being performed adequately, according to patients, and which areas require improvement.
 Methods: This was a multicenter cross-sectional study. Patients were recruited in 11 hospitals in Belgium. They completed the CONTACT-PCCQ online or on paper. The CONTACT-PCCQ consists of 86 items, which all represent a key element (KE) in patient-centered education and counseling for patients on OACT. The items are divided into seven subscales: A1) medication counselling at the start of OACT, A2) follow-up of OACT, B) communication style, C) counseling by hospital treatment team, D) counseling by primary care healthcare professionals, E) psychosocial support, and F) involvement of family and friends. Patients were asked to indicate how they experienced the performance of each KE on a 5-point Likert rating scale. The answer options were dichotomized into ‘performed’ and ‘not performed’. Subsequently, the degree of performance of each item was defined by calculating the proportion of patients that indicated that the item was performed. On subscale-level, mean total scores were calculated.
 Findings: In total, 266 patients completed the CONTACT-PCCQ. Subscale C ‘Commitment and cooperation between healthcare professionals’, concerning care coordination in the hospital, had the highest mean subscale score. The lowest score was obtained on subscale D ‘Involvement of primary care’. The degree of performance of all items ranged from 22% to 95%. Items regarding specific topics in patient education (e.g., what do to in case of vomiting, which food to avoid during treatment) and adherence monitoring scored low. Low scores were also obtained on the items about the involvement of the community pharmacist and homecare nurse - in contrast to the items regarding the general practitioner. Some other items, e.g., regarding information about vaccinations and palliative care, were also scored low by patients. In general, KEs on communication style (e.g. HCPs left enough opportunity to ask questions, HCPs took sufficient time for a proper conversation) received high scores.
 Discussion and conclusion: This study gave insight in the overall quality of patient-centered education and counselling for patients on OACT. Three gaps in PCC were uncovered: unmet patient information needs due to shortcomings in patient education, inadequate adherence monitoring, and lacking collaboration with community pharmacists and home care nurses. These results enable hospitals and policy makers to set priorities in care quality improvement for patients on OACT.

Practice patterns, role and impact of advanced practice nurses in stroke care: A mixed-methods systematic review.

To undertake a systematic review of the practice patterns and roles of advanced practice nurses (APNs) in inpatient and outpatient stroke-care services; and to evaluate the impact of APN-led inpatient and outpatient stroke-care services on clinical and patient-reported outcomes. A mixed-methods systematic review. A systematic search was conducted across six electronic databases for primary studies. Data were synthesised using a convergent integrated approach. DATA SOURCES (INCLUDE SEARCH DATES) *FOR REVIEWS ONLY: A systematic search was conducted across PubMed, CINAHL, Cochrane Library, Embase, PsycInfo and ProQuest Dissertations & Theses Global, for primary studies published between the inception of the databases and 3 November 2022. Findings based on the 18 included primary studies indicate that the APNs' roles have been implemented across the continuum of stroke care, including pre-intervention care, inpatient care and post-discharge care. Practicing at an advanced level, the APNs engaged in clinical, operational and educational undertakings across services and disciplines. Positive clinical and patient-reported outcomes have been attributed to their practice. The review highlights the critical role of APNs in improving stroke care, especially in the pre-intervention phase. Their clinical expertise, patient-centered approach and collaboration can transform stroke care. Integrating APNs into stroke care teams is essential for better management and outcomes in light of the increasing stroke burden. Healthcare institutions should integrate APNs to enhance pre-intervention stroke care, improve diagnostic accuracy and expedite treatment. APNs can prioritise patient-centric care, including assessments, coordination and education. Medication reconciliation, timely rehabilitation referrals and lifestyle modifications for secondary stroke prevention are crucial. Implementing advanced practice nursing frameworks ensures successful APN integration, leading to improved stroke care and better patient outcomes in response to the growing stroke burden. What problem did the study address? Poor clarity of the role of advanced practice nurses among patients, physicians, healthcare professionals, health policymakers and nurses. What were the main findings? Advanced practice nurses practise across the continuum of stroke care, mainly in pre-intervention care which takes place before initiating treatment, inpatient care and post-discharge care. The implementation of the advanced practice nurse role in stroke care has contributed positively to clinical and patient-reported outcomes. Where and on whom will the research have an impact? Insights from the review are envisioned to inform healthcare policymakers and leaders in the implementation and evaluation of the APN role in stroke care. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. No Patient or Public Contribution. TRIAL AND PROTOCOL REGISTRATION: https://figshare.com/ndownloader/files/41606781; Registered on Open Science Framework osf.io/dav8j.

Expert patients leading activities on social justice: towards patient-centered education.

Social justice is recognized by reputable international organizations as a professional nursing value. However, there are serious doubts as to whether it is embodied in Catalan nursing education. To explore what nursing students take away from two teaching activities led by expert patients (one presentation and three expert patient illness narratives) on the topics of social justice, patient rights, and person-centered care. Qualitative study using a content analysis approach. The research plan included (1) think-pair-share activities (additional faculty-assisted presentation and three faculty-assisted, semi-structured scripted narratives); (2) paired reflections; (3) focus groups; and (4) content analysis of paired reflections and focus groups. Fourth-year nursing degree students at the Autonomous University of Barcelona (UAB), Spain. Convenience sampling was used. The UAB Research Ethics Committee did not deem it necessary to apply any specific measures. We fully explained to patients that they could decide what medical information they would share with the students that was relevant to their learning, and we provided students with guidelines about patient confidentiality, dignity, and respect. The students engaged in reflection about their education (recognizing that it had been centered on the professional and not the patient) and their relationship with the patient, in which they reproduced low-involvement patient care by modeling behaviors of their nurse educator. Moreover, they valued a person-centered care model with an emphasis on the emotional part but left out decision-making as an individual right of people. The think-pair-share activities were useful to spark self-reflection among students, who identified aspects to change in their own practice, and reflected about their own education process, both of which promote change.

Description of the mealtime of older adults with dementia in a long-term care facility: A video analysis

This study analyzed the mealtime structure of older adults with dementia in long-term care facilities. The study conducted video observations at 2 long-term care facilities with 10 residents and 24 staff members, resulting in 41 dyads. The average mealtime duration was 12.21 ± 5.16 minutes; the average time of a single intake was 0.21 ± 0.21 minutes; and the median of the eating interval was 0.17 minutes. The average verbal assistance time was 1.41 ± 1.31 minutes; the average verbal assistance frequency was short (23.92 ± 15.50 times). During mealtime, residents had an average of 5.00 ± 4.07 instances of failing to eat properly. The video analysis emphasized the necessity of implementing a mealtime assistance program that incorporates patient-centered education for the staff and ensures sufficient staffing to provide high-quality meals for residents in long-term care facilities.

Effect of teaching health-promoting behaviors on the care burden of family caregivers of hemodialysis patients: a four-group clinical trial

IntroductionChronic kidney disease could have a profound effect on the life of patients and family caregivers. The caregivers’ care burden increases as the disease progresses. Interventions reducing care burden should be investigated. Educational interventions could affect family caregivers’ care burden among hemodialysis patients. However, most studies and interventions have focused on caregivers. Therefore, this study aims to compare the effect of teaching Health-promoting behaviors on the care burden of family caregivers of hemodialysis patients.Materials and methodsThis trial was conducted using a pretest-posttest design and follow-up after one month. Hemodialysis patients and their family caregivers were selected using convenience sampling method. In total, 124 patient-caregiver pairs were divided into four groups of patient-centered education, caregiver-centered education, Patient and caregiver education and control by block randomization (15 blocks of 8 members and 1 block of 4 members) (n = 31 pairs per group). The intervention (teaching health-promoting behaviors) was performed in 8 sessions using the teach-back method, except for the control. The data were collected by patient and caregiver demographic forms and Novak and Guest care burden inventory as well as following the treatment regimen in three stages (before, immediately after and one month after the intervention). Demographic variables were compared among the four groups using ANOVA, Kruskal-Wallis and Chi-square test. The intragroup comparison of the main variables was made using the repeated measures ANOVA with modified LSD post hoc test. The intergroup comparison was made by one-way ANOVA with LSD post hoc test.ResultsOut of 124 caregivers participating in the study, 68 (54.8%) were female. Also, out of 124 patients participating in the study, 86 (69.4%) were male. The mean age of the caregivers and patients was 39.2 ± 11.31 and 54.23 ± 14.20 years old, respectively. There was a statistically significant difference in the mean total care burden scores of the pre-test and post-test between the four groups (p < 0.001). The total care burden decreased in patient-centered, caregiver-centered and Patient and caregiver education groups. However, this reduction in the caregiver-centered and Patient and caregiver education groups was significantly higher than the patient-centered education group (p < 0.001).ConclusionThe results revealed teaching health-promoting behaviors reduced care burden. Moreover, caregiver-centered approach could reduce care burden more than patient-centered approach. Therefore, this could be used as a supportive method to improve the health of patients and caregivers.Trial registration number (TRN)IRCT20090522001930N4.Date of registration2021-11-12.

Knowledge and unmet needs of patients with atrial fibrillation in China: a nationwide cross-sectional survey

Abstract Background Knowledge about the disease and treatment options is necessary for active patient engagement in shared decision-making, which is essential for ’patient-centered’ atrial fibrillation (AF) management. Purpose To evaluate the knowledge level and identify unmet needs of patients with AF in China. Methods A nationwide cross-sectional survey was conducted using online or paper questionnaires between May and August 2022. Adult AF outpatients or inpatients in China were eligible for participation. The questionnaires included items on knowledge regarding AF, treatment options, risk factors, AF treatment practice, and AF patients’ unmet needs. Results This survey included 2,002 patients with AF [mean age 68.62±13.45, 1,040 (52%) men] from 55 centers across 17 provinces in China. Most patients (66.18%) had knowledge scores of &amp;lt; 4 (an 8-item disease knowledge scale, the score ranged from 0 [worst] to 8 [best]), which is a poor knowledge level. Approximately half of the patients did not know that "AF can cause blood clots which can lead to stroke (cerebral infarction)." The proportion of patients who knew about oral anticoagulants, cardiac rhythm/heart rate control drugs, and catheter ablation were 85.96%, 81.37%, and 41.36%, respectively. However, only 79.52%, 72.08%, and 16.18% of patients received these respective treatments. Moreover, only 51.46% of patients were satisfied or very satisfied with their treatments. The improvement in life quality, prevention and treatment of complications, and symptom control were the three most important aspects for patients when choosing treatments. The impact of AF on daily activities, sleep, emotions, and memory were reported by 80.77%, 63.54%, 52.80%, and 66.18% patients, respectively. Most patients with AF recognized hypertension (87.50%) and diabetes mellitus (50.33%) as risk factors, but few recognized obesity and excessive alcohol intake. Overall, 93.56% of patients obtained AF knowledge from physicians. They expect the source of knowledge to include regular community education(61.29%), as well as digital tools(58.74%) between physicians and patients. Furthermore, 90.86% of patients considered involvement in treatment decisions necessary. Conclusions This study reveals that the knowledge level of patients with AF in China regarding the disease and treatment options is insufficient, and there remain unmet needs for AF management. Thus, more patient-centered education through multiple channels is required to improve patients' involvement in treatment decisions.

Appendectomy Pain Medication Prescribing Variation inthe U.S. Military Health System.

Post-appendectomy opioid prescription practices may vary widely across and within health care systems. Although guidelines encourage conservative opioid prescribing and prescribing of non-opioid pain medications, the variation of prescribing practices and the probability of opioid refill remain unknown in the U.S. Military Health System. This retrospective observational cohort study evaluated medical data of 11,713 patients who received an appendectomy in the Military Health System between January 2016 and June 2021. Linear-mixed and generalized linear-mixed models evaluated the relationships between patient-, care-, and system-level factors and the two primary outcomes; the morphine equivalent dose (MED) at hospital discharge; and the probability of 30-day opioid prescription refill. Sensitivity analyses repeated the generalized linear-mixed model predicting the probability of opioid (re)fill after an appendectomy, but with inclusion of the full sample, including patients who had not received a discharge opioid prescription (e.g., 0 mg MED). Discharge MED was twice the recommended guidance and was not associated with opioid refill. Higher discharge MED was associated with opioid/non-opioid combination prescription (+38 mg) relative to opioid-only, lack of non-opioid prescribing at discharge (+6 mg), care received before a Defense Health Agency opioid safety policy was released (+61 mg), documented nicotine dependence (+8 mg), and pre-appendectomy opioid prescription (+5 mg) (all P < .01). Opioid refill was more likely for patients with complicated appendicitis (OR = 1.34; P < .01); patients assigned female (OR = 1.25, P < .01); those with a documented mental health diagnosis (OR = 1.32, P = .03), an antidepressant prescription (OR = 1.84, P < .001), or both (OR = 1.54, P < .001); and patients with documented nicotine dependence (OR = 1.53, P < .001). Opioid refill was less likely for patients who received care after the Defense Health Agency policy was released (OR = 0.71, P < .001), were opioid naive (OR = 0.54, P < .001), or were Asian or Pacific Islander (relative to white patients, OR = 0.68, P = .04). Results from the sensitivity analyses were similar to the main analysis, aside from two exceptions. The probability of refill no longer differed by race and ethnicity or mental health condition only. Individual prescriber practices shifted with new guidelines, but potentially unwarranted variation in opioid prescribing dose remained. Future studies may benefit from evaluating patients' experiences with pain management, satisfaction, and patient-centered education after appendectomy within the context of opioid prescribing practices, amount of medications used, and refill probability. Such could pave a way for standardized patient-centered procedures that both decrease unwarranted prescribing pattern variability and optimize pain management regimens.

Providing Patient-Centric Education in Type 2 Diabetes and CKD: The “YOU” Project™

Providing Patient-Centric Education in Type 2 Diabetes and CKD: The “YOU” Project™

Translation, Cultural Adaptation, and Validation of a Korean Version of the Information Needs in Cardiac Rehabilitation Scale.

: To translate and culturally adapt the Information Needs in Cardiac Rehabilitation (INCR) questionnaire into Korean and perform psychometric validation. : The original English version of the INCR, in which patients are asked to rate the importance of 55 topics, was translated into Korean (INCR-K) and culturally adapted. The INCR-K was tested on 101 cardiac rehabilitation (CR) participants at Kangwon National University Hospital and Seoul National University Bundang Hospital in Korea. Structural validity was assessed using principal component analysis, and Cronbach's alpha of the areas was computed. Criterion validity was assessed by comparing information needs according to CR duration and knowledge sufficiency according to receipt of education. Half of the participants were randomly selected for 1 month of re-testing to assess their responsiveness. : Following cognitive debriefing, the number of items was reduced to 41 and ratings were added to assess participants' sufficient knowledge of each item. The INCR-K structure comprised eight areas, each with sufficient internal consistency (Cronbach's alpha>0.7). Criterion validity was supported by significant differences in mean INCR-K scores based on CR duration and knowledge sufficiency ratings according to receipt of education (p<0.05). Information needs and knowledge sufficiency ratings increased after 1 month of CR, thus supporting responsiveness (p<0.05). : The INCR-K demonstrated adequate face, content, cross-cultural, structural, and criterion validities, internal consistency, and responsiveness. Information needs changed with CR, such that multiple assessments of information needs may be warranted as rehabilitation progresses to facilitate patient-centered education.

Fatty Liver Education Promotes Physical Activity in Vulnerable Groups, Including Those With Unhealthy Alcohol Use

Fatty liver disease (FLD), alcohol-associated and metabolically associated, often coexists. Increase in physical activity is associated with metabolic health and decreased FLD. We aimed to identify factors associated with physical activity and its improvement following FLD education in a racially diverse, vulnerable population. From February 19, 2020 to December 30, 2022, 314 adults with FLD at safety-net hepatology clinics in San Francisco were surveyed at baseline, immediately after FLD education, and at 6-month follow-up. After collecting clinical and sociodemographic data, logistic regression (adjusted for age, sex, and race/ethnicity) assessed factors associated with physical activity at baseline and its improvement following education. Participant characteristics in those without vs with any physical activity were median age 49 vs 55 years, 64% vs 56% female, 66% vs 53% Hispanic race/ethnicity, 75% vs 55% obese, and 30% vs 22% consumed heavy alcohol, respectively. On multivariable analysis, older age was the only significant factor associated with physical activity at baseline (relative risk ratio 1.37 per decade increase, 95% confidence interval [CI] 1.07-1.75). Hispanic (vs non-Hispanic) participants had a significantly higher odds of improvement in physical activity (vs no change) 6 months after education (odds ratio 2.36, 95% CI 1.27-4.39). Among those with suboptimal or no physical activity at baseline, participants who consumed heavy alcohol (vs no drinking) had a significantly higher likelihood of achieving optimal physical activity following education (relative risk ratio 1.98, 95% CI 1.05-3.74). Despite social and structural barriers, FLD education increased uptake of physical activity in vulnerable populations, especially among Hispanic individuals and those consuming heavy alcohol. Implementation of patient-centered education is important for FLD management.

Patient Education Practices and Preferences of Interprofessional Radiation Oncology Providers

Patient understanding of radiotherapy (RT) processes and data regarding optimal approaches to patient education (PE) within radiation oncology (RO) are limited. Our objective was to evaluate PE practices and preferences of interprofessional RO providers to inform recommendations for delivering inclusive, accessible, and patient-centered education. An anonymous 17-item online survey, approved by an ethics review board, was administered to all members of the Radiation Oncology Education Collaborative Study Group (ROECSG) between 10/5/22 to 11/23/22. Respondent demographics, provider practices/preferences, and institutional practices were collected. Qualitative items explored key strategies, challenges, and desired resources for PE. Descriptive statistics summarized survey responses. Fisher's exact test compared PE practices by provider role and PE timing. Thematic analysis was used for qualitative responses. A total of 123 ROECSG members, including RO attendings (64%), RO trainees (21%), medical physicists (7%), physician assistants/nurses (2%), and radiation therapists (2%), completed the survey (31% response rate). Most practiced in an academic setting (86%) in North America (82%). The most common PE resources used were custom created institution-specific (61%) and electronic health system generated materials (38%). PE was delivered primarily by one-on-one teaching (72%), paper handouts (69%), and organizational websites (21%) (e.g., RTanswers.org). Almost half (41%) reported that PE practices differed based on type of clinical encounter, for example paper handouts for in-person visits and multimedia for virtual visits. The majority (86%) stated that their institution has disease site-specific PE materials, with nearly all having breast cancer materials (91%). Only 58% reported access to non-English PE materials. RO attendings/trainees were more likely than other team members to deliver PE at consultation (98% vs 71%, p = 0.03). PE practices amongst radiation oncologists differed according to the timing along the RT care path (consultation vs simulation vs first fraction, respectively): one-on-one teaching: 89% vs 49% vs 56%, p<0.01 and paper handouts: 69% vs 28% vs 16%, p<0.01. Key PE strategies included incorporating multimedia resources, personalizing delivery, and repetition at multiple timepoints by the interprofessional team. Limited time, inadequate administrative support, and lack of customized resources were identified as challenges in PE delivery. Interprofessional RO providers engage in PE, with most utilizing institution-specific materials. PE practices differ according to the type of clinical encounter and timing in the RT care path. Increased adoption of multimedia materials and partnerships with patients to tailor PE resources based on language, learning styles, and cultural preferences are needed to foster high-quality, patient-centered PE delivery.

A conceptual framework for asthma self-management in Ecuadorian children and adolescents: A qualitative study

Asthma symptoms can be controlled through proper self-management, medication adherence, and avoidance of triggers, thus avoiding high costs for multiple hospitalizations, emergency or outpatient visits. This article seeks to develop a conceptual framework of the factors that influence asthma self-management in a pediatric population living in the Andean urban area of Cuenca-Ecuador. A phenomenological study was carried out (February-April 2021) in 10 children and adolescents from 7 to 17 years old with asthma attending public and private hospitals. In-depth interviews were applied using open questions created after reviewing the literature. Factors influencing asthma self-management include individual (attitudes, self-education, seeking medical attention, managing crisis triggers) and environmental (health system, school/family support). The interviews were audio-recorded, transcribed, and analyzed by two independent researchers. Our results show that the pediatric population identifies individual and environmental influences that affect asthma self-management, with age and socioeconomic status moderating the influential factors. The participants described the beliefs, attitudes, practices, perceptions, and specific experiences in the family, school, and health system contexts as relevant to comply with asthma self-management. In addition, problems or barriers that hinder the self-management of the disease, mainly related to adherence to treatment, were identified. In conclusion, our analysis highlights the need to empower the pediatric population in asthma self-management. When delivering patient-centered education for effective asthma management, future interventions must consider children´s age and socioeconomic status influences in individual and environmental factors.

Controlling Hypertension through Education and Coaching in Kidney Disease (CHECK-D): protocol of a cluster randomised controlled trial

IntroductionChronic kidney disease (CKD) affects 30 million Americans. Early management focused on blood pressure (BP) control decreases cardiovascular morbidity and mortality. Less than 40% of patients with CKD achieve recommended...

How patient-centered is education and counseling of patients treated with oral anticancer drugs? A multicenter cross-sectional study

ObjectiveIn this multicenter cross-sectional study, the quality of patient-centered education and counseling for patients treated with oral anticancer drugs was examined. MethodsThe CONTACT-Patient-Centered Care Questionnaire was administered to 266 patients, recruited in 11 Flemish hospitals. The questionnaire consists of 80 items, each evaluating the degree of performance of a key element in patient-centered education and counseling. ResultsIn total, 15 key elements were seriously underperformed (degree of performance < 50%). Elements regarding adherence monitoring, specific topics in patient education, and involvement of the community pharmacist and home care nurse received a very low score. Only six key elements were systematically performed (degree of performance ≥ 90%), among which the elements on communication style and involvement of the general practitioner. ConclusionThis study uncovered three major gaps in patient-centered education and counseling of patients on oral anticancer drugs: unmet patient information needs due to shortcomings in patient education, inadequate adherence monitoring, and lacking collaboration with community pharmacists and home care nurses. Practice implicationsThis study highlights the need for interdisciplinary and patient-centered education and counseling of patients using OACD, including all key stakeholders: physicians, nurses, hospital pharmacists, general practitioners, community pharmacist and home care nurses.

Improving Transitional Care for Older Adults: Results of a Patient-Centred Quality Improvement Intervention.

The objective of this study was to evaluate the implementation and outcomes of a quality improvement intervention for older adults discharged from hospital to home, that used a patient-centred discharge education tool called the Patient-Centered Discharge Plan (PCAP). We conducted a pre-post evaluation of PCAP implementation among patients 65 years and older and discharged home from an acute medical or geriatric admission at two general hospitals. Two patient cohorts, PRE and POST, were analysed using administrative data (n = 3,309) and post-discharge structured interviews in a subset of patients (n = 326). Outcomes were 90-day readmissions and return emergency department (ED) visits, and transition experiences (10-item scale). The PCAP was provided to 20 per cent of 1,683 patients. Transition experience scores increased from PRE to POST at both hospitals (adjusted beta 1.3; 95% CI: 0.8, 1.7), and return ED visits declined in one of the two hospitals (adjusted decline 1.3%; 95% CI: -3.7, 6.2). In conclusion, dedicated resources are needed to support future PCAP implementation.

Nursing Interventions in the Perioperative Pathway of the Patient with Breast Cancer: A Scoping Review.

The decrease in average hospitalisation time and the increase in outpatient surgery in some types of breast cancer represent gains for the reduction of the negative impact of hospitalisation in women with breast cancer but are also a challenge for the organisation of nursing care to prepare women for surgery, reduce anxiety about the interventions, and ensure continuity of care in the postoperative period. The aim of this study is to identify nursing interventions present in the care provided to patients with breast cancer during the perioperative period. A scoping review was the method chosen to answer the research question: What are the specialised nursing interventions in the perioperative pathway of the patient with breast cancer? Inclusion and exclusion criteria were defined for the articles that were identified in the CINAHL and MEDLINE databases; later, additional sources were identified from the list of bibliographic references for each selected study. The final bibliographical sample consisted of seven articles, which allowed the identification of three key moments of nursing interventions in the perioperative period of patients with breast cancer: the preoperative consultation, the reception of the patient in the operating room, and the postoperative consultation. Factors such as psychological, emotional, and spiritual support, communication and patient-centred care, health education and surgical safety, and the definition of a perioperative pathway for these patients contribute significantly to patients' satisfaction and the improvement of their quality of life. The results of this study make it possible to establish recommendations for practise and for research, increasing the range of nurses' actions.

Nephrologists’ Perspectives on Home Dialysis Utilization: A National Survey From Israel

Nephrologists’ Perspectives on Home Dialysis Utilization: A National Survey From Israel

Diabetes and Cancer Co-management Education: Leveraging the Patient Activated Learning System (PALS) for Patients with Breast Cancer.

More than 70% of cancer patients have one or more comorbid conditions, and diabetes is one of the most common and burdensome comorbidities. However, existing patient-centered education materials often fail to acknowledge how to co-manage cancer and diabetes, leaving patients feeling overwhelmed and searching for guidance. Our team sought to fill this knowledge gap by using the Patient Activated Learning System (PALS), a patient-centered, publicly available platform, to generate patient-centered education materials about co-managing diabetes and cancer. Using insights from 15 patient interview transcripts, we developed eight reusable knowledge objects (RKOs) for a variety of common questions that patients have about co-managing diabetes and cancer. The RKOs were written in collaboration with researchers and clinicians and then peer reviewed by experts. The eight evidence-based RKOs have the potential to equip patients with the knowledge to support cancer and diabetes co-management. There are no existing patient-centered educational resources to help patients manage their diabetes during cancer treatments. We filled this gap by using the Patient Activated Learning System (PALS) to generate evidence-based, patient-facing educational information that was written by researchers and clinicians and peer reviewed by experts. This educational content will support cancer and diabetes co-management for patients.

Auditory perception in adult hearing aid users with and without auditory training - A comparative study

Background: Individuals with sensorineural hearing loss can regain some lost auditory function with the help of hearing aids, but it may be insufficient under non – optimal condition. Future research aspect lies in processing strategy and training to enhance effects of auditory training and rehabilitation of patients using hearing aids. So research is done to supplement the rehabilitation process with patient centric education, counseling and auditory training to help the listener compensate for loss of auditory signal and improve communication. Whether age-related hearing loss can be decreased by auditory training along with hearing aid is to be researched as it is not clear from previous scientific works whether the outcome is significantly better than those with hearing aid who have not received training. Aims and Objectives: The aim of the study was to determine the role of auditory training for improvement of auditory perception in aged patients with age-related sensorineural hearing loss using binaural hearing aid. Materials and Methods: This prospective observational study was conducted in Otorhinolaryngology department of Burdwan Medical College and Hospital, Burdwan, a rural based tertiary care hospital in Burdwan for 2 months from June 2022 to July 2022 and 50 aged patients with audiologically proven age related sensorineural hearing loss using hearing aid were included in this study after through history taking and meticulous clinical examination after getting institutional ethics committee clearance. Patients were divided in two groups, 25 in experimental group (with auditory training) and 25 in control group (without auditory training) and result was analyzed. Results: Formal auditory training was able to improve the central auditory skills of hearing aid users. Improvement was noted in an objective neurophysiologic correlate and perceived by patients, as revealed in a self-assessment questionnaire. Conclusion: Formal auditory training in adult hearing aid users promotes: Improvement in auditory skills for sound localization, memory for nonverbal sounds in sequence, auditory closure, and figure-to-ground for verbal sounds. Greater benefits with hearing aids in reverberant and noisy environments.

Gene therapy in sickle cell disease: Attitudes and informational needs of patients and caregivers.

Sickle cell disease (SCD) is an inherited blood disorder that results in serious morbidity and early mortality. Novel therapies for SCD, most notably genetic therapies (GTs) and HLA-mismatched donor hematopoietic cell transplantation, are in clinical trials. While potentially curative, these interventions are some of the most intensive treatments for SCD and are associated with serious and life-altering side effects, which may manifest several years after treatment. Little is known about knowledge, beliefs, and attitudes of individuals with SCD, or their caregivers, toward existing and these emerging therapies. Patients with SCD at least 13 years of age (n=66) and caregivers (n=38) were surveyed about knowledge, attitudes, and beliefs surrounding treatments for SCD. Only 4.8% felt "extremely knowledgeable" about GT for SCD while the majority (63.4%) reported little knowledge. Overall, health literacy was low among respondents. Most respondents had a neutral attitude regarding the safety of GT for SCD, and whether it was a good treatment for the disorder (56.7% and 58.6%, respectively). Only a few respondents endorsed the idea that GT was "unsafe" or "not a good treatment" (5.8% and 4.8%, respectively). There was an association between increasing knowledge about GT and agreement that it is safe (p=.012) and a good treatment for SCD (p=.031). Given that very few patients with SCD feel knowledgeable about GT and a majority have neutral feelings about the safety and utility of this new approach, culturally appropriate patient-centered education is urgently needed as these treatments get regulatory approval and proceed to the clinic.