Patient Knowledge Of Disease Research Articles

PICTOGRAM-BASED INFORMATION LEAFLET IN PATIENTS WITH PSORIASIS

Objective: The objective of the study was to evaluate the impact of an information leaflet on the knowledge of disease in patients with psoriasis. Methods: A total of 50 patients with psoriasis on different treatment regimens were selected in the study. The pre- and post-test design (quasi-experimental design) was conducted for user testing of information leaflets (Baker Able design) which covered risk factors, signs and symptoms, and treatment options. The knowledge of psoriasis was assessed before and after the administration of the information leaflet and was compared using paired t-test. Results: At the follow-up interview, it was observed that patients were well informed about their skin disease but had less awareness about the risk factors and methods to cope with the disease. The overall user-testing knowledge assessment mean scores were observed to have significantly improved with p<0.001 after the introduction of the leaflet. Conclusion: The overall user opinion regarding the content of the leaflets was good. This study shows that an information leaflet given to patients with psoriasis can significantly improve their knowledge of the disease.

Integrating Adolescents and Young Adults into Adult-Centered Care for IBD.

Planned healthcare transition, initiated in pediatric care, is a gradual process aimed at fostering the adolescent patient's disease knowledge and skills with the ultimate objective of preparing patients and families for adult-centered care. The process is critical in inflammatory bowel diseases (IBD) where there is an increased risk of non-adherence, hospitalizations, and emergency department use as young adult patients graduate from pediatric to adult-centered care. While evidence for healthcare transition in IBD is mounting, important gaps remain in the understanding of this process from the perspective of the adult gastroenterologist. This paper summarizes what is known about healthcare transition in IBD and explores the unanswered questions-a conceptual and methodological framework for transition interventions, relevant outcomes that define successful transition, and key stakeholder perspectives. For the adult gastroenterologist managing the young adult patient population, this paper presents the paradigm of "care integration"-a process of ongoing, multi-modality support for the patient, initiated in the adult care setting, with the goal of improving self-management skills and active participation in medical decision-making.

Impact of a pharmacotherapy plan to improve adherence for patients with type-2 diabetes and hypertension in a Chilean hospital.

Non-adherence to prescribed treatment is a principle cause of treatment failure in patients with chronic diseases, such as type 2 diabetes mellitus (T2DM) and hypertension. Improved patient monitoring and education have been shown to improve adherence and clinical outcomes. This study evaluates the impact of a pharmacotherapy optimization plan centered on patient education that was implemented at a hospital in Arauco, Chile. A prospective study was conducted using 50 randomly selected patients diagnosed with both T2DM and hypertension. Each patient participated in three successive interview sessions over 6 months. At each session, the following variables were evaluated by a pharmacist: blood pressure, HbA1c, adherence to prescribed medication, and patient knowledge of disease. Significant decreases were observed for HbA1c (<0.001), and SBP (<0.001), with stronger and more significant decreases observed for females. Patient adherence to prescribed medication also improved, but not significantly. The number of patients with full knowledge of their diseases increased significantly (p < 0.001) from 10 to 66%. This study suggests that the incorporation of a pharmacotherapeutic optimization plan for patients with chronic diseases can have a positive impact on the control of chronic diseases, such as T2DM and hypertension.

Application of family nursing intervention strategy among patients with hepatocirrhosis ascites

Objective To study the implementation effects of family nursing intervention strategies among patients with hepatocirrhosis ascites .Methods A total of 100 cases of patients and pairing families , according to the discharge order , were randomly divided into intervention group and control group with 50 cases in each group .The patients in control group and their family members were followed the routine discharge guidance, while the patients in intervention group and their family members were based on the family nursing intervention strategy , which were discharged through the process of regular telephone follow-up and home visits . After six months, the medical compliance behaviors , the awareness rate of knowledge after healing and complications between the control group and the intervention group were compared by telephone follow -up, home visits and outpatient reviews .Results Totals of 92%intervention group patients followed the correct medication and the rate of disease knowledge about hepatocirrhosis ascites was 96% among intervention group of patients and their family members , which were significantly higher than the control group . The incidence of gastrointestinal hemorrhage and hepatic encephalopathy among intervention group were 10% and 12%, respectively , which were significantly lower than the control group .There were significant differences between two groups （χ2 =12.705, 16.000, 5.263, 4.883, respectively;P〈0.05）.Conclusions The proper family nursing intervention strategy that helps to exert the effect of family members and enhance their social support can also improve the disease knowledge of patients and their relatives .Besides, it increases the medical compliance behaviors and decreases the incidence of complications . Key words: Hepatocirrhosis ascites; Health education; Medical compliance behavior; Family nursing intervention

A study evaluating the effect of Educational Needs Assessment Tool (ENAT) focused patient education, on health outcomes in patients with Rheumatoid Arthritis: Protocol of an ongoing study

Aims and objectives: To evaluate the effectiveness of a patient education tool (the ENAT) on self efficacy, patient knowledge, health outcomes and its usability in practice. Background: The effectiveness and value of patient education in rheumatoid arthritis have been questioned. The ENAT was developed to help the nurses to provide more focused, individualized and relevant education. The psychometric properties of the ENAT have been assessed. Design: This study is a single blind randomized controlled trial using both quantitative and qualitative methodology. The primary outcome is patient self efficacy. Secondary outcomes are physical function, psychological status, pain levels, social interaction and patient knowledge of disease. Methods: 130 RA patients will be randomized into an experimental (EG) or control group (CG). The EG patients will complete the ENAT prior to seeing a Clinical Nurse Specialist (CNS) at weeks 0, 16 and 32. The CNS will use the ENAT as a template to meet patients perceived educational needs in addition to the usual care. The CG will receive their usual care from the CNS without the aid of the ENAT. To determine the ENAT’s usability, semi-structured quailtative interviews will take place with the practitioners and a sample of patients once they have completed the quantitative arm of the study. Results: The study commenced in April 2011 and the results are expected to be available after April 2013. Conclusions: It is hypothesized that nurses’ use of the ENAT will lead to increased patient self efficacy, and improved patient knowledge and health outcomes among the patients who used it. Furthermore, it is hypothesized that the ENAT will be easy for staff and patients to use. Relevance to clinical practice: The ENAT was developed to assess the perceived educational needs of patients with rheumatoid arthritis and thus help the nurses to provide more focused, individualised and relevant education.

Disease perception and awareness investigation of secondary osteoporosis in patients with chronic obstructive pulmonary in Urumqi

Objective To evaluate perception and awareness of disease knowledge in patients with chronic obstructive pulmonary disease (COPD) in rural area of Urumqi city.Methods A survey was made to collect 121 patients with chronic obstructive pulmonary disease in out-patient and hospitalization of Traditional Chinese Medicine Hospital of Xinjiang Medical University in 2011.Questionnaire data were coded and entered into Microsoft EpiDate by two persons independently,with SPSS 17.0 version statistical package was used for statistical analysis.Results Among 121 sampling subjects,104 participants completed the questionnaire qualifiedly.Among these patients,Male occupied 65.4％ (68/104),female occupied 34.6％ (36/104).Patients who know that post-menopausal women were easier to suffer osteoporosis totaled 42 cases (40.38％),patients who know that bedridden persons were easier to suffer osteoporosis totaled 42 cases (40.38％),patients who know that female was more likely to suffer than male totaled 65 cases (62.5％),who think the disease is related to the gender totaled 76 cases (73.08％),who think it is unlikely to develop osteoporosis after fracture healing totaled 13 cases (12.5％).Patients who do not think hat low back pain is the common manifestation of osteoporosis totaled 23 cases (22.12％),Patients who do not think hump and fracture are the common osteoporosis performance totaled 14 cases (13.46％) and 4 cases (3.85％) ; patients who know that osteoporosis is often accompanied by bone spurs totaled 33 cases (31.3％),patients who know that bone mineral density is a reasonable detection of osteoporosis totaled 62 cases (59.61％).Patients who know about alendronate phosphate (such as Fosamax,etc.) totaled 12 cases (11.76％),patients who know that commonly used TCM medicines for treating osteoporosis are Eucommia and Epimedium totaled 5 cases (4.90％).Conclusion COPD is prone to cause osteoporosis,but patients are lacking the awareness of osteoporosis. Key words: Urumqi; Chronic obstructive pulmonary disease; Osteoporosis; Awareness

The effect of educational intervention on the disease knowledge of diabetes mellitus patients

The prevention of diabetes and its complications is a challenge for the healthcare team. The aim of this study was to evaluate the effect of educational action on the disease knowledge of patients with type 2 diabetes. A randomized clinical trial was conducted with 62 patients registered in a service of reference in the treatment of hypertension in 2010. Data were collected through a questionnaire applied to the Intervention (IG) and Control (CG) groups at the beginning and at the end of the study. The IG participated in group educational activities, using problematization methodology. The results showed a significant increase in knowledge about diabetes in the patients of the IG, in all the topics (p<0.05). In the CG, some changes were observed in knowledge, however, these were fewer when compared with the IG. In conclusion, it was possible to increase disease knowledge through the performance of educational activities. Clinical trial identifier: RBR-58n26h.

361 Satisfaction With Provider Communication Is Associated With Perceived Disease Knowledge in Patients With Chronic Kidney Disease (CKD)

SATISFACTION WITH PROVIDER COMMUNICATION IS ASSOCIATED WITH PERCEIVED DISEASE KNOWLEDGE IN PATIENTS WITH CHRONIC KIDNEY DISEASE (CKD) Julie Wright, Kenneth Wallston, Svetlana Eden, Ayumi Shintani, T. Alp Ikizler, Kerri Cavanaugh. Vanderbilt University Medical Center, Nashville, TN USA Effective patient-provider communication is a crucial component of high quality patient care. Data are scarce regarding patient views of physician communication skills in the setting of pre-dialysis CKD care. Adult patients with non-dialysis dependent CKD (Stages 1-5) were enrolled from April-October 2009 during nephrology clinic visits. Patient satisfaction with provider communication was assessed using the Communication Assessment Tool (CAT), a validated scale for measuring patient perception of physician interpersonal and communication skills. Perceived knowledge was assessed by asking patients to rate their CKD knowledge on a scale from 1 (no knowledge) to 4 (a lot of knowledge) in nine areas and averaged to generate an overall perceived knowledge survey (PiKS) score. Associations between CAT and patient characteristics, including PiKS and a validated measure of objective CKD knowledge, were examined. Of 399 patients enrolled, the mean (SD) age was 57 (16) years. 53% were male, 83% Caucasian, and 77% had CKD Stage 3-5. The mean (SD) CAT and PiKS scores were 4.69 (0.51) and 2.56 (0.61), respectively. CAT was associated only with PiKS (Spearman correlation 0.15, p<0.0001) in unadjusted analysis. Patients of older age (OR 1.22 CI [1.11, 1.35]; p<0.0001 per 10 years), higher eGFR (1.03 [1.02, 1.04]; p<0.0001 per 5 ml/min/1.73m), and higher PiKS (2.15 [1.72, 2.68]; p<0.0001 per 1.0 increment increase) were likely to have higher odds of satisfaction with provider communication in adjusted analysis that also included sex, race, health literacy (REALM survey), income, number of provider visits, and objective knowledge. Adjusted analysis presented no evidence that objective knowledge was associated with CAT score. In addition to advancing age and higher eGFR, patients' perception of their disease specific knowledge may be an important component of their satisfaction with CKD care.

Canonical Correlation Analysis (CCA) of Imatinib Treatment (ImRx) Nonadherence (NA) with Associated Patient Variables (APVs) in Chronic Myeloid Leukemia (CML) - Results from the ADAGIO Study.

BACKGROUND. ImRx for CML is a long-term treatment potentially compromised by NA. Identifying APVs may assist in reducing NA and optimizing treatment outcomes.OBJECTIVE. To model the relationships between two NA measures and selected APVs using CCA, a multivariate analog of multiple regression to accommodate multiple criterion variables.DESIGN AND PATIENTS. Data subset from prospective, 90d observational, open-label, multicenter study. 169 evaluable pts on ImRx for minimum 30d at enrollment [1].MEASUREMENTS. NA at 90d vector: Basel Assessment of Adherence Scale for pts (pBAAS; 0/1 with 1=NA); and % of ImRx taken per pill count (%ImRx, subtracted from 100 to reflect NA). APVs at BL vector: age; months since CML diagnosis (mCML); months since ImRx initiation (mImRx); knowledge of CML disease, treatment, and ImRx (KCMLRx); and general health (SF-8).RESULTS. The criterion (dependent) vector of NA indicators included pBAAS and %ImRX. The predictor (independent) vector of APVs included: age, mCML, mImRx, KCMLRx, and SF-8. Two canonical correlations were generated: 0.389 (Bartlett Chi-squared=23.564, P=0.009) and 0.170 (Bartlett Chi-squared= 3.590, P=0.464); the second correlation was deleted due to nonsignificance from zero. The canonical loadings (or structure coefficients) for the retained model were: age 0.951, mCML 0.205, mImRx 0.145, SF-8 0.016, and KCMLRx -0.367. Redundancy analysis showed that 22.1% of variance in the predictor set was explained by variables within that set.CONCLUSIONS. The patient NA vector (composed of a binary assessment of NA per pBAAS 0/1 with 1=NA) and continuous quantification of % of ImRx not taken was related to the APV vector as follows: NA increased as patients were older, had been diagnosed with CML for a longer period of time, had been on imatinib treatment for a longer period time, and were in slightly better health at enrollment. These may be considered warning signs for NA for clinicians to consider in practice, given the long-term nature of ImRx. Importantly, better patient knowledge of disease and treatment, a clinically modifiable APV, was associated with a decrease in NA. The initial insights in patient NA with ImRX provided by these findings, though some are counterintuitive to the NA literature at large, must be studied further to better understand the dynamics of NA in the CML population.

The Relationship Between Health Literacy and Diabetes Knowledge and Readiness to Take Health Actions

The purpose of this study was to explore the relationship among health literacy, patients' readiness to take health actions, and diabetes knowledge among individuals with type 2 diabetes. Sixty-eight patients with type 2 diabetes receiving care in an academic general internal medicine clinic were administered the Rapid Estimate of Adult Literacy in Medicine (REALM) literacy instrument prior to completing the Diabetes Health Belief Model (DHBM) scale and Diabetes Knowledge Test (DKT). Multivariable linear regression was used to assess the association between REALM literacy level, DKT score, DHBM scale score, and most recent hemoglobin A1C level while controlling for other covariates of interest. After controlling for other covariates of interest, no significant association between DHBM scale score and REALM literacy level was found (P = .29). However, both DKT score and most recent hemoglobin A1Clevel were found to be significantly associated with patient literacy (P = .004 and P = .02, respectively). Based on the multivariable model, patients with less than a fourth-grade literacy level had 13% lower DKT scores (95% confidence interval [CI], -28% to -2%; P = .08) and 1.36% higher most recent hemoglobin A1Clevels (95% CI, 1.06% to 1.73%; P = .02) relative to those with a high school literacy level. Low health literacy is a problem faced by many patients that affects their ability to navigate the health care system and manage their chronic illnesses. While low health literacy was significantly associated with worse glycemic control and poorer disease knowledge in patients with type 2 diabetes, there was no significant relationship with their readiness to take action in disease management.

Telemedicine-assisted home support for patients with advanced chronic obstructive pulmonary disease: Preliminary results after nine-month follow-up

Eighteen well motivated patients with advanced chronic obstructive pulmonary disease, who had had at least four hospitalizations during the previous two years, were included in a home-based telemedicine study. A visiting nurse was equipped with a case containing a laptop computer and a number of medical devices, including an electrocardiogram recorder, spirometer, oximeter and blood pressure monitor. It also contained a videoconference camera, for realtime audiovisual connection with the hospital using the patient's TV set. A single ISDN line (128 kbit/s) was installed in each house before the study began. After nine months, there was a decrease in hospitalizations, emergency department visits and use of health services. The patient's disease knowledge and self-management also improved. It seems likely that adopting telemedicine in everyday clinical practice could substantially improve the care of chronically ill patients.

Disease Knowledge in Patients Attending a Diabetic Foot Clinic

Foot-specific patient education is an essential element of a health system diabetic foot program. Foot-specific patient education must be individualized, because of cognitive deficits in individuals with long-standing diabetes. Two hundred and two consecutive patients attending diabetic foot specialty clinics were asked to provide demographics and complete a 10-question multiple-choice questionnaire. All attended the clinics because of their high-risk status for the development of diabetic foot infection or ulcers. All received ongoing foot-specific patient education. In spite of this ongoing patient education program, only approximately 80% were able to respond appropriately to simple questions related to the care of their "at-risk" feet. This simple quality initiative reinforces the notion that patients with diabetes who are at risk for the development of diabetic foot ulcers should receive ongoing foot-specific patient education. This information needs to be constantly reinforced, as retention drops with time.