Pretest-posttest Intervention Study Research Articles

Educating undergraduate students on malaria: results from a pragmatic pre-test post-test intervention study

Background: To tackle the major public health problem of malaria, India has launched the National Vector borne Diseases Programme. Various strategies of this programme strongly depend on community’s knowledge and participation. However, there is a deficiency in evidence on the same from India.Methods: A single-group pre-test post-test study was carried out among consenting adult students of hotel management in Mangalore, India using a self-administered pre-tested questionnaire with an innovative scoring scheme. Following pre-test, an interactive audio-visual health education session was delivered. The intervention, which was prepared after reviewing the latest guidelines, incorporated many pictures and diagrams. The session covered aetiology, transmission, diagnosis and treatment aspects as well as personal, household and community level measures for prevention and control. Thereafter, post-test was administered.Results: 91 out of 120 students approached agreed to participate in the study. 4 out of these were lost at post-test yielding an overall response rate of 72.5%. The final participants’ mean age was 20.43 years (SD 1.12 years); 69% were male and all had completed 10+2 education. The median pre-test score was 8.4 points with inter-quartile range from 6.5-9.75; the median post-test score was 9.68 points with inter-quartile range from 7.76–11.1. Wilcoxon signed-ranks test yielded a p value of 0.001365 which was highly significant.Conclusions: Pending the conduct of better-designed intervention evaluation studies, this study provides a good starting point for designing pragmatic and scalable health education interventions against malaria.

Managing Changes in Condition in the SNF with a Rectal Administration Catheter to Prevent ED and Hospital Utilization (S729)

•Verbalize understanding that rectal hydration and medication administration is an effective alternative to parenteral or hypodermoclysis therapy.•Incorporate new understanding/skills that can help drive nursing efficiency and patient outcomes.•Incorporate understanding in the use of oral medications on hand to quickly address symptoms via the rectal route. Options to treat a patient’s change in condition when the oral route is compromised in the SNF setting are limited. Parenteral or hypodermoclysis administration of fluids and medication is possible; however, these methods have limitations, and require alternate forms of medications that can be costly. Delays in obtaining orders, equipment and supplies has the potential to increase emergency department (ED) and/or hospital utilization. The aim of this QI project was to look at the feasibility of the intervention to facilitate safe, easy, comfortable and effective enteral hydration and medication delivery via the rectal route, and the ability to treat changes in a patient’s condition while decreasing the need for parenteral therapy and ED or hospital utilization. A Pretest-posttest intervention study design was used to evaluate 11 clinical use cases of a specialized rectal administration catheter to treat patient changes in condition in four SNFs over a 2-month period between November and December 2016. Ten participants (100%) completed the study with 11 total use cases. Hydration was effective in all 11 use cases, with all participants tolerating the intervention without signs of discomfort or expulsion of fluids. Nine of the 11 (81%) use cases facilitated successful management of the patients’ condition at the facility. In two use cases, participants had ‘Do Not Hospitalize’ orders on the chart. For the remaining nine use cases, ED or hospital transfer would have been necessary if unmanageable in the SNF. Of these nine use cases, seven (78%) were able to avoid ED and/or hospital utilization through successful management of the condition. The other two participants (18%) needed acute care intervention. In all use cases the catheter provided a safe, easy, and comfortable alternative to provide hydration and medication administration compared to parenteral and previous enteral delivery options. Additionally, the SNFs were able to reduce the need for ED or hospital utilization.

Evaluation of an Education and Training Program to Prevent and Manage Patients' Violence in a Mental Health Setting: A Pretest-Posttest Intervention Study.

Workplace violence can lead to serious consequences for victims, organizations, and society. Most workplace violence prevention programs aim to train staff to better recognize and safely manage at-risk situations. The Omega education and training program was developed in Canada in 1999, and has since been used to teach healthcare and mental health workers the skills needed to effectively intervene in situations of aggression. The present study was designed to assess the impact of Omega on employee psychological distress, confidence in coping, and perceived exposure to violence. This program was offered to 105 employees in a psychiatric hospital in Montreal, Canada. Eighty-nine of them accepted to participate. Questionnaires were completed before the training, after a short period of time (M = 109 days) and at follow-up (M = 441 days). Repeated-measures ANOVAs and Cohen’s d effect sizes were calculated. Results demonstrated statistically significant improvements in short-term and follow-up posttest scores of psychological distress, confidence in coping, and in levels of exposure to violence. This study is one of very few to demonstrate the positive impact of this training program. Further research is needed to understand how to improve the effectiveness of the program, especially among participants resistant to change.

An intimate partner violence informational program in a hospital fracture clinic: a pre-test post-test intervention study.

:Background:Many organizations have conducted Intimate Partner Violence (IPV) informational campaigns, but the extent to which such cost-effective, simple changes to the clinic environment can improve patient perceptions about IPV is largely unknown. Our primary objective was to determine how an IPV informational program affects patients’ perceptions about discussing IPV in a fracture clinic setting. Methods:We conducted a pre-post intervention study to evaluate the impacts of an IPV informational program on patients’ perceptions and willingness to discuss IPV in an orthopaedic fracture clinic setting. During the intervention phase, there were posters and brochures in each bed area and several places in the waiting area, and the surgeons received a button to wear on their lab coat stating their openness to discuss IPV and a set of instructions on how to ask patients about IPV and refer them to resources. Results:A total of 160 patients (80 pre-intervention and 80 post-intervention) have participated in this study. Overall perception of the clinic as an open place in which to discuss IPV did not change as a result of the informational program compared to the control setting. However, more patients exposed to posters and information about IPV believed the clinic staff possessed resources to help IPV victims compared to the control group; however, this difference did not reach statistical significance (62% vs. 53%, respectively, p=0.29).Conclusions:Passive interventions may serve an adjunctive role in facilitating active interventions in a clinic environment, but should not be considered in isolation as an effective approach.

Rate, risk factors and assessment of a counselling intervention for antenatal depression by public health nurses in an Israeli ultra-orthodox community.

To investigate the rate of and risk factors for perinatal depression in an Israeli ultra-orthodox Jewish community and assess the contribution of antenatal nursing intervention to reducing symptoms of postpartum depression. Perinatal depression is recognized globally as a common complication of pregnancy and childbirth, with negative effects on the mother, infant and family. Among Jewish ultra-orthodox women both religion and childbearing play major roles. Single-group pretest-posttest intervention study. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. One-hundred-sixty women attending a mother-child healthcare clinic during December 2011-January 2013 completed the Edinburgh Postnatal Depression Scale prenatally and 148 (92·5%) repeated the survey 6weeks postpartum. Nurses were trained to screen and offer non-directive supportive counselling intervention. Risk factors for antenatal depressive symptoms were analysed using multivariable logistic regression and analysis of changes in score was performed by 2-way analysis of variance. Nineteen participants (11·9%) scored ≥10 on the Edinburgh Postnatal Depression Scale antenatally. Nurses provided intervention for 40 women. Postpartum, only one participant scored ≥10. The decrease in Edinburgh score was greater for those whose antenatal score was ≥10. Although the rate of antenatal depressive symptoms was similar to that in other studies, postpartum symptoms may have been underreported, possible due to culturally-related reticence. This underscores the importance of understanding the context in which the service is offered and the sensitivities of particular groups. The findings indicate that antenatal nursing intervention is a potentially protective measure for perinatal emotional well-being.

Telemonitoring is acceptable amongst community dwelling older Australians with chronic conditions

Telemonitoring is an innovative model of care being implemented to address thegrowing burden of chronic and complex disease. This paper explores the perceptions of community dwelling older people withchronic and complex conditions towards a general practice nurse-led telemonitoring interven-tion. A pre-test post-test intervention study was conducted with consumer surveys adminis-tered before and after the intervention. The telemonitoring intervention consisted of a periodof home monitoring during which daily vital signs and symptoms were transmitted to the generalpractice nurse. 21 participants completed both pre and post-test surveys. There was a significant dif-ference between pre and post ratings on the survey item ‘‘the use of telemonitoring equipmentseems difficult to me’’ (p = 0.013), and ‘‘telemonitoring will be a standard way of health caredelivery in the future’’ (p = 0.032). Approximately half of the participants reported that tele-monitoring provided them with a sense of security and peace of mind, assisted them to managetheir health, in addition to improving their confidence in managing their care. Most participants felt more involved and expressed that daily monitoring helped them to understand changes intheir condition. Telemonitoring is acceptable to Australian community dwelling older persons withchronic conditions. Prior experience with computers and technology may not be a meditatingfactor in acceptability. The use of telemonitoring not only provided important physiological infor-mation to health professionals but also has the potential to empower older people by allowingthem to better understand their own health.

Resistance Training Reduces Force Tremor and Improves Manual Dexterity in Older Individuals With Essential Tremor

ABSTRACTAlthough symptoms of Essential Tremor (ET) are typically controlled with medication, it is of interest to explore additional therapies to assist with functionality. The purpose of this study was to determine if a generalized upper limb resistance training (RT) program improves manual dexterity and reduces force tremor in older individuals with ET. Ten Essential Tremor and 9 controls were recruited into a dual group, pretest–posttest intervention study. Participants performed 6 weeks of upper-limb RT, and battery of manual dexterity and isometric force tremor assessments were performed before and after the RT to determine the benefits of the program. The six-week, high-load, RT program produced strength increases in each limb for the ET and healthy older group. These changes in strength aligned with improvements in manual dexterity and tremor—most notably for the ET group. The least affected limb and the most affected limb exhibited similar improvements in functional assessments of manual dexterity, whereas reductions in force tremor amplitude following the RT program were restricted to the most affected limb of the ET group. These findings suggest that generalized upper limb RT program has the potential to improve aspects of manual dexterity and reduce force tremor in older ET patients.

Benefit of Pelvic Floor Muscle Therapy in Improving Sexual Function in Women With Stress Urinary Incontinence: A Pretest–Posttest Intervention Study

Very few data are available on the effect of pelvic floor muscle training on sexual function in incontinent women. The authors used the Female Sexual Function Index to assess the effect of pelvic floor muscle training on female sexual function. Participants included women with stress urinary incontinence, without overactive bladder symptoms, who completed a 3-month pelvic floor muscle training. All patients completed the Female Sexual Function Index and the International Consultation on Incontinence Questionnaire–Short Form at baseline and at the 3-month follow-up. Thirty-four patients completed all of the questionnaires; 64.7% patients were referred with stress urinary incontinence without sexual disorders, while 35.3% complained of stress urinary incontinence and sexual symptoms. The International Consultation on Incontinence Questionnaire–Short Form score significantly decreased after 3 months of pelvic floor muscle training (p =.01). The Female Sexual Function Index score significantly improved after pelvic floor muscle training even in women with sexual disorders (12.5 ± 9.5 vs. 29.7 ± 3.7; p <.001). This study showed that pelvic floor muscle training may improve female sexual function in women with pure stress urinary incontinence.

The effectiveness of an e-learning program on pediatric medication safety for undergraduate students: A pretest–post-test intervention study

Safe medication management is a major competency taught in the nursing curriculum. However, administering pediatric medications is considered a common clinical stressor for Taiwanese students. A supplemental e-learning program that helps students fill the gap between basic nursing skills and pediatric knowledge on medication safety was developed. To evaluate the effectiveness of an e-learning program to increase pediatric medication management among students who take pediatric nursing courses. This intervention study used a historical comparison design. A university in Northern Taiwan. A total of 349 undergraduate nursing students who took pediatric nursing courses participated. Eighty students in the comparison group received regular pediatric courses, including the lectures and clinical practicum; 269 students in the intervention group received an e-learning program, in addition to the standard pediatric courses. Between February 2011 and July 2012 pediatric medication management, including pediatric medication knowledge and calculation ability, was measured at the beginning of the first class, at the completion of the lectures, and at the completion of the clinical practicum. The program was evaluated qualitatively and quantitatively. The intervention group had significantly higher pediatric medication management scores at completion of the lecture course and at the completion of the clinical practicum than the comparison group based on the first day of the lecture course, after adjusting for age, nursing program, and having graduated from a junior college in nursing. Overall, the students appreciated the program that included various teaching modalities content that related to the administration of medication. Using an e-learning program on pediatric medication management is an effective learning method in addition to sitting in a regular lecture course. The different emphases in each module, provided by experienced instructors, enabled the students to be more aware of their role in pediatric medication safety.

Resistance Training Can Improve Fine Manual Dexterity in Essential Tremor Patients: A Preliminary Study

Sequeira G, Keogh JW, Kavanagh JJ. Resistance training can improve fine manual dexterity in essential tremor patients: a preliminary study. ObjectiveTo determine if a short-term resistance training (RT) program of the upper limb can improve strength, fine manual dexterity, and quality of life in individuals with essential tremor (ET). DesignSingle group, dual pretest-posttest intervention study. SettingGeneral community. ParticipantsParticipants (N=6; mean age ± SD, 74±7y) clinically diagnosed as having ET (mean years diagnosed ± SD, 19±7y) were recruited into the study. InterventionA 6-week RT program involving unilateral dumbbell bicep curls, wrist flexion, and wrist extension exercises twice a week. Main Outcome MeasuresUpper limb strength determined from five-repetition maximum; fine manual dexterity determined from the Purdue Pegboard Test (PPT) for the hand of the most affected limb, the hand of the least affected limb, both hands, and a bilateral assembly task; and quality of life determined from the Medical Outcomes Study 36-Item Short-Form Health Survey and the ET specific Quality of Life in Essential Tremor questionnaire. ResultsThe RT program resulted in significant increases in 4 of the 6 upper limb strength measures. Significant improvements in the PPT were observed for the single hand components of this test. PPT performance improved immediately after RT when using the most affected limb, but these changes took longer to be observed for the least affected limb. ConclusionsOverall, fine manual dexterity improved in ET patients after a simple RT program. The findings of this preliminary study provide clear evidence that RT is worthy of further investigation as a therapy for improving functionality in ET patients.

Supporting rural and remote area nurses to utilise and conduct research: An intervention study

Nurses are expected to embrace research and evidence-based practice but in rural/remote facilities it is particularly difficult to develop and utilise research skills. This collaborative study aimed to explore nurses' orientation to research and address known inhibitors to engagement with research in rural/remote north Queensland locations. The sample comprised nurses from two rural/remote areas within a regional health service. Methods A pre-test post-test intervention study with two levels of data collection: responses to Edmonton Research Orientation Scale administered 3 times to all nurses, and number of research proposals developed. This intervention comprised provision of face-to-face workshops, paper-based resources, and informal videoconference, email and telephone contact. Survey response rates varied from 56% to 34%. Two-thirds of respondents were over 40 years old; 75% were Registered Nurses. One quarter rated understanding of journal articles as poor or very poor and 50% rated their knowledge of research similarly. However, 50% said research had changed the way they practiced. Older nurses, nurses with tertiary qualifications and those with senior appointments had more positive orientation to research scores. Several locally relevant research proposals were developed from one site; two received internal funding for further development and implementation. The intervention also led to increased utilisation of library resources which has continued past this study's end. The variation in uptake between sites reinforces the need for locally targeted support. This study has gone beyond measuring research utilisation by including evaluation of support mechanisms to engage nurses in developing research proposals.

Transforming Attitudes of Nursing Students: Evaluating a Service-Learning Experience

Homelessness is a compelling social and public health issue. Nurse educators are challenged to better prepare graduates to serve this growing segment of the population. Clinical experiences with those experiencing homelessness allow students a better understanding of this population and may foster more compassionate care. This pretest-posttest intervention study examined nursing students' attitudes toward homelessness before and after participation in a service-learning clinical rotation with families experiencing homelessness. Twenty-three students enrolled in a public health nursing course at a small midwestern university participated in the research. The Attitudes Toward Homelessness Inventory was used to measure students' attitudes at the beginning and end of the course. Data analysis using descriptive statistics revealed significant differences in both global and specific attitudes toward people experiencing homelessness. These results suggest the clinical experiences positively influenced students' attitudes and support the value of integrating service-learning clinical opportunities with homeless individuals into nursing curricula.

Education Methods for Maintaining Nursing Competency in Low-Volume, High-Risk Procedures in the Rural Setting

Nurses practicing in the rural setting have faced a unique challenge in maintaining competency in low-volume, high-risk procedures. This study assessed the effectiveness of a focused, multifaceted educational intervention on the retention of nursing knowledge related to central venous access devices care and maintenance. A pretest-posttest intervention study design was used at a 58-bed rural healthcare facility in a Western state. This study demonstrates a statistically significant increase in functional nursing knowledge in the postintervention period.

Student nurses’ de-escalation of patient aggression: A pretest–posttest intervention study

Background Experts recommend staff training to prevent and manage aggressive situations involving patients or their relatives. However, in many countries this subject is not covered in pre-registration nursing education. In addition, the evidence regarding its impact on practical placements remains weak. Objective This study examines the influence of an aggression management training programme for nursing students on their performance in de-escalating aggressive patients. Design Pretest–posttest within-and-between-groups design. Setting A School of Nursing in Germany. Participants Convenience sample out of six classes of nursing students at differing educational levels (10th to 28th month of nursing education, n = 78, mean age = 22). Methods In a cross-sectional and longitudinal two groups before and after design nursing students encountered two scenarios (A or B) with simulation patients. After completing the training, each student was confronted with the unknown other scenario. De-escalation experts from three German-speaking countries evaluated 156 video scenes using the De-escalating Aggressive Behaviour Scale (DABS), not knowing whether the videos had been recorded before or after the training. Mean values and statistical significance tests were computed to compare the results. Results The performance levels of students who had been trained rose significantly from 2.74 to 3.65 as measured by the DABS on a 5-point Likert scale (Wilcoxon test p < .001). The trained students managed scenario A significantly better than the untrained students (untrained 2.50, trained 3.70; Mann–Whitney- U-test p < .001,). Similar results were found for scenario B (untrained 3.01, trained 3.61; Mann–Whitney- U-test p < .001). No significant differences were found in the pretest results irrespective the students’ age or duration of previous nursing education. Conclusions Aggression management training is able to improve nursing students’ performance in de-escalating aggressive behaviour. A maturation-effect on the de-escalating performance due to general nursing education or age is unlikely.