Structured Education Intervention Research Articles

Kenyan adults with type 2 diabetes mellitus (T2DM) increase diabetic knowledge and self-efficacy and decrease hemoglobina1c levels post-educational program.

Literature supports the relationship between increased diabetic knowledge and improved health outcomes among individuals with Type II diabetes mellitus (T2DM). In Kenya, knowledge gaps within the at-risk population still exist about the symptoms, complications, and management strategies of T2DM, making it challenging to achieve the required personal and community health levels. The project's objective was to determine whether a structured educational intervention for patients in Eldoret, Kenya, would increase diabetic knowledge and self-efficacy and reduce HbA1c levels. We utilized an experimental study with a convenience sample of 143 participants systematically grouped into control and experimental. The experimental group only received a structured educational intervention based on the health belief model. Pre- and post-intervention data for diabetic knowledge, self-efficacy, and HbA1c were analyzed using the independent T and ANOVA tests. We observed significant between-group differences for diabetic knowledge (t (116) = 7.22, p<0.001), self-efficacy t (96)=5.323, p<0.001; and HbA1c level t (121) =-2.87, p =.003. We also observed significant within-group differences for diabetic knowledge, t (12.6), p<0.001); self-efficacy t (5.32), p<.001); and HbA1c, t (4.4), p<0.001, in the experimental group only. This study reveals the effect of a structured education intervention in increasing diabetic knowledge and self-efficacy while reducing HbA1c levels in T2DM patients in Eldoret, Kenya.

Effects of a comprehensive structured patient education intervention on disease-related knowledge and behaviour change among people living with type 2 diabetes in the Philippines.

Addressing the ongoing needs of individuals with diabetes, particularly in low- and middle-income countries like the Philippines, requires a focus on regular follow-ups with healthcare teams, adherence to healthy behaviors, and effective patient education to prevent long-term complications. The aim of this study was to ascertain the impact of a comprehensive educational program for those living with diabetes in the Philippines. In a prospective study, a convenience sample of patients living with diabetes attending a cardiac rehabilitation or an outpatient diabetes clinic in the Philippines received a 12-week education intervention. Participants completed surveys at pre- and post-intervention assessing disease-related knowledge, health literacy, dietary habits, and tobacco use. Physical activity was measured by steps taken per day using wearable devices and by self-report of minutes of moderate or vigorous-intensity exercise per week. Satisfaction with the educational materials was also evaluated by a survey composed of Likert-type scale and open-ended questions. Descriptive statistics, paired t-tests or chi-square were used for data analysis. Overall, 184 individuals living with diabetes type 2 (mean age = 54.4 ± 12.4, 32% female) completed both assessments. There was significant improvement in disease-related knowledge (p < 0.001), daily steps measured by a wearable device and self-reported minutes of moderate/vigorous-intensity exercise (p < 0.001), and the number of fruit and vegetable servings consumed per day (p = 0.001). No significant changes were observed in health literacy levels. One participant stopped using tobacco at post-education. Educational materials were highly satisfactory to participants. Lack of time, family responsibilities, and poor internet access were the main barriers to learning reported by participants. Suggestions to improve the education provided included assessment of information needs at the start of the education, having short summaries about the topics, follow-ups post-intervention, and inviting family members to sessions. Results of this study demonstrated the positive effects a comprehensive structured patient education intervention on disease-related knowledge and behaviour changes among people living with type 2 diabetes in the Philippines.

S1783 Effectiveness of a Structured Education Intervention in Improving GERD Symptom Reassessment and Reducing Long-term PPI Use in an Underserved Population

S1783 Effectiveness of a Structured Education Intervention in Improving GERD Symptom Reassessment and Reducing Long-term PPI Use in an Underserved Population

Preliminary Effects of a Structured Educational Program in Cardiac Patients at Different Stages of Enrollment in Cardiovascular Rehabilitation.

This quasi-experimental study investigated the preliminary effects of a structured education intervention in a pooled sample of cardiovascular rehabilitation (CR) patients in Brazil. Recently enrolled (RE) and long-term enrolled (LTE) patients attended 12 weekly education sessions in addition to three weekly exercise sessions. Patients completed surveys assessing disease-related knowledge, physical activity, food intake, self-efficacy, and health literacy. Functional capacity was assessed by the 6-minutes walking test. All outcomes were assessed at pre-,post-CR, and 6-months follow-up. Bonferroni correction was applied. In total, 69 (69.7%) patients completed all three assessments. There were significant improvements in knowledge pre-to post-test in both subgroups (p < 0.001), and in functional capacity (p ≤ 0.001) and food intake (p ≤ 0.001) pre-to post-test in the RE subgroup. Post-test knowledge was correlated to physical activity, functional capacity and health literacy. This preliminary study suggests the importance of structured education for CR patients. A larger study using a randomized controlled design is needed to determine efficacy.

Application of TELSA structured education program in adults with type 1 diabetes mellitus

Objective: To evaluate the effect of TELSA structured education program in adults with type 1 diabetes mellitus (T1DM) in China. Methods: From January 2019 to January 2020, 64 adult T1DM patients who met the standard of entry and had the intention to participate in TELSA structured education program were selected from the outpatient of type 1 diabetes comprehensive management in the Second Xiangya Hospital as intervention group. A total of 64 patients matched by age and sex were enrolled as the control group. During the program, the intervention group lost 3 cases and the control group lost 4 cases. Finally, there were 61 effective samples in the intervention group and 60 effective samples in the control group. The patients in the control group were given face-to-face education by a T1DM educator for about 2 hours. The patients in the intervention group were intervened according to TELSA structured education program. The level of glycosylated hemoglobin, the frequency of hypoglycemia, self-management ability and quality of life were evaluated before intervention, 6 months after intervention and 12 months after intervention. Results: The ages of the intervention group and the control group were 30.0(22.0,43.5) and 29.5(22.3,42.5) (P>0.05), and the proportions of males were 47.54%(29 cases) and 45.00%(27 cases), respectively (P>0.05). There were interaction effects (P<0.05) on the level of glycosylated hemoglobin, self-management ability and quality of life in the two groups. At 6 and 12 months after intervention of TELSA structured education program, the level of glycosylated hemoglobin in the intervention group decreased from the baseline level (7.87±1.45)% to (7.23±1.06)% and (7.28±0.93)%, respectively, which was significantly lower than that in the control group at 6 months (7.72±1.20)% and at 12 months(7.76±1.24)% (all P<0.05). After TELSA structured education intervention, the scores of self-management scale for adult type 1 diabetes mellitus (SMOD-CA) in the intervention group showed an upward trend (P<0.001), and the scores of diabetes-specific quality of life scale (A-DQOL) showed a downward trend (P<0.001). In contrast, there was no statistically significant difference in the trend of scores in the control group (P=0.853 and 0.227). The comparison between groups at different time points showed that at 6 and 12 months after the intervention, the SMOD-CA scores of the patients in the intervention group were higher than those in the control group (P<0.001), and the A-DQOL scores were lower than those in the control group (P<0.001). Conclusions: The TELSA structured education program can effectively ameliorate glycemic control, with the improvement of self-management ability and quality of life in adult T1DM patients.

A Quasi-Experiment on the Effectiveness of Cardiac Rehabilitation in Quality of Life of Cardiac Patients with the Caregivers’ Involvement

Introduction: Coronary Heart Disease can result in impaired quality of life which can inhibit an early recovery with successful outcomes for cardiac patients. Objective: To investigate the effect of a structured cardiac education and early intervention cardiac rehabilitation program on quality of life in cardiac patients involving caregivers. Method: A quasi experimental study with a purposive sampling was carried out where 132 acute coronary syndrome patients hospitalized for treatment were recruited and allocated to the experiment and control group with and without caregivers. A structured educational intervention and cardiac rehabilitation was initiated for the experimental group with and without caregivers. The outcome was measured using the World Health Organization Quality Of Life-BREF (WHOQOL-BREF) instrument.Results: Data was measured with repeated measures ANOVA between baseline, discharge and follow-up between the intervention and control group with p&lt;0.05 There was a statistically significant difference in QOL in both the groups with and without caregivers in the following domains: psychological health (F=3.784, p=0.002); social relationship (F=4.267, p=0.000) and environment (F=3.578, p=0.004). There was not a statistically significant difference between both the groups in the physical health domain (F=1.316, p=0.266).Conclusion: The results indicated that a structured cardiac educational intervention and cardiac rehabilitation with the involvement of the caregivers have significant effects on the quality of life of cardiac patients. The findings provide useful evidence to improve health outcomes of acute coronary syndrome patients involving the caregivers.

Improvement of Parent\u2019s awareness, knowledge, perception, and acceptability of human papillomavirus vaccination after a structured-educational intervention

BackgroundRegardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11–13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability.MethodsWe conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention.ResultsA total of 506 parents participated. Before receiving the structured-educational intervention, parents’ awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p < 0.001). HPV vaccine’s acceptability increased from 74.3 to 87.4% (p < 0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r = 0.32 to 0.53, p < 0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine’s acceptability with OR 1.90 (95%CI:1.40–2.57) and OR 1.31(95%CI,1.05–1.63), respectively.ConclusionsA structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability.

An automated structured education intervention based on a smartphone app in Chinese patients with type 1 diabetes: a protocol for a single-blinded randomized controlled trial

BackgroundAlthough evidence had demonstrated the effectiveness of smartphone apps in diabetes care, the majority of apps had been developed for type 2 diabetes mellitus (T2DM) patients and targeted at populations outside of China. The effects of applying a smartphone app with structured education on glycemic control in type 1 diabetes mellitus (T1DM) are unclear. A digital, culturally tailored structured education program was developed in a smartphone app (Yi tang yun qiao) to provide an automated, individualized education program aimed at improving self-management skills in patients with T1DM in China. This trial aims to investigate the effectiveness of this smartphone app among Chinese T1DM patients.Methods and analysisThis single-blinded, 24-week, parallel-group randomized controlled trial of a smartphone app versus routine care will be conducted in Changsha, China. We plan to recruit 138 patients with T1DM who will be randomly allocated into the intervention group (automated, individualized education through an app) or routine care group. The intervention will last for 24 weeks. The primary outcome will be the change in glycated hemoglobin (HbA1c) from baseline to week 24. The secondary outcomes will include time in range, fasting blood glucose, levels of serum triglycerides and cholesterol, blood pressure, body mass index, quality of life, diabetes self-care activities, diabetes self-efficacy, depression, anxiety, and patient satisfaction. Adverse events will be formally documented. Data analysis will be conducted using the intention-to-treat principle with appropriate univariate and multivariate methods. Missing data will be imputed with a multiple imputation method under the “missing at random” assumption.DiscussionThis trial will investigate the effectiveness of an app-based automated structured education intervention for Chinese patients with T1DM. If the intervention is effective, this study will provide a strategy that satisfies the need for effective lifelong diabetes care to reduce the disease burden and related complications resulting from T1DM.Trial registrationClinicalTrials.gov NCT04016987. Registered on 29 October 2019.

Development and Evaluation of a Pediatric Epilepsy Training Program for First Level Providers in Zambia.

Introduction. The developing world continues to face challenges in closing the large treatment gap for epilepsy, due to a high burden of disease and few experienced providers to manage the condition. Children with epilepsy are susceptible to higher rates of developmental impairments and refractory disease due to delays or absence of appropriate management as a result. We demonstrated that a structured education intervention on pediatric epilepsy can improve knowledge, confidence, and impact clinical practice of first level providers in Zambia. Methods. Three first-level facilities across Zambia were included. After initial pilot versions and revisions, the final course was implemented at each site. Pre- and post-intervention knowledge and confidence assessments were performed. Additionally, chart reviews were conducted prior to intervention and 4 months after completion of training at each site to assess change on management. Results. Twenty-three of the original 24 participants from all 3 sites completed the training; 48% clinical officers, 43% nurses, 9% other expertise. Of the 15 concepts tested by knowledge assessment, 12 showed trends in improvement, 7 of which were significant (P < .05). Chart reviews demonstrated significant improvement in documentation of seizure description (P = .008), seizure frequency (P = .00), and possible causes of seizures/epilepsy (P = .034). Discussion. Key elements of success to this program included hands on clinical skills building and case-based teaching, development of a program with direct and ongoing input from the target audience, and inclusion of assessments to monitor impact on clinical practice. Future studies looking at health outcomes are necessary to determine sustained impact.

Epilepsy education in gliomas: engaging patients and caregivers to improve care.

Tumor-related epilepsy (TRE) is the most common cause of hospitalizations in patients with malignant gliomas leading to increased distress and decreased quality of life (QOL) for patients and caregivers. We sought to determine the feasibility of incorporating a structured TRE-specific education intervention into clinical practice while assessing effect on distress and TRE knowledge. We prospectively enrolled glioma patients and their caregivers on an IRB-approved study. Subjects underwent a pre-test to assess baseline knowledge regarding seizure management. A neuro-oncology provider guided subjects through a presentation focused on safety and home management of seizures. Seizure-related distress was measured before and after the educational intervention using a distress thermometer. A post-test was completed. At 2 and 6months, distress was re-assessed and post-tests were repeated. Subject satisfaction was assessed. Fifty subjects (23 patients, 27 caregivers) were enrolled. Median age was 59. Fifty-seven percent of patients had TRE. Median time to completion was 21.5min. Median baseline distress scores were 2/10 for patients and 5/10 for caregivers. Distress scores decreased by a mean of 1.5 points and TRE knowledge increased by 2 points for all subjects between the initial and 2-month visit. Ninety-eight percent of subjects strongly agreed that the education was helpful and informative. Caregivers reported more distress despite better baseline seizure knowledge than patients. Structured TRE education is feasible in patients with gliomas and their caregivers and may be effective in reducing distress. Further prospective studies are warranted to assess effects on hospitalizations, cost, and QOL.

Home-Based Education and Learning Program for Atrial Fibrillation: Rationale and Design of the HELP-AF Study

BackgroundAtrial fibrillation (AF) is a growing global epidemic, with its prevalence expected to significantly rise over coming decades. AF poses a substantial burden on health care systems, largely due to hospitalizations. Home-based clinical characterization has demonstrated improved outcomes in cardiac populations, but its impact on AF remains poorly defined. To test this hypothesis in AF, we developed the Home-Based Education and Learning Program for Patients With Atrial Fibrillation (HELP-AF) study. MethodsThe HELP-AF study is a prospective multicentre randomized controlled trial that will recruit 620 patients presenting to hospital emergency departments (EDs) with symptomatic AF (ANZCTR Registration: ACTRN12611000607976). Patients will be randomized to either the HELP-AF intervention or usual care. The intervention consists of 2 home visits by a nurse or pharmacist trained in the structured educational visiting (SEV) method. Patients in the control group will receive usual discharge follow-up care. ResultsThe primary endpoints are total unplanned hospital admissions and quality of life. Secondary endpoints include AF symptom severity and burden score; time to first hospital admission; total unplanned days in hospital; total AF-related hospital admissions (including atrial flutter); total cardiac and noncardiac hospital admissions; total AF- or atrial flutter-related; cardiac- and noncardiac-related ED presentations; and all-cause mortality. An economic evaluation will also be performed. Clinical endpoints will be adjudicated by independent blinded assessors. Follow-up will be at 24 months. ConclusionsThis study will assess the efficacy of a home-based structured patient-centred educational intervention in patients with AF.

The Impact of in Intervention Program on Oral Cancer Awareness and Practice of Preventive Behaviors in High-Risk Indigenous Community in Sarawak, Malaysia

Background: Oral cancer is highly prevalent among indigenous people in Sarawak as this population lacks awareness and is known to practice high-risk habits. Aim: This study aimed to develop and evaluate the impact of an educational intervention to improve oral cancer awareness and practice of preventive behavior among high-risk indigenous communities in Sarawak, Malaysia. Methods: A quasi-experimental study was undertaken involving adults in a Bisaya community (with high risk habits) in Limbang, Sarawak. The intervention group received a structured, Health Beliefs Model (HBM) theory-based oral cancer education module, while the control group was exposed to the conventional oral cancer education method during Ministry of Health's community oral cancer and precancer screening program. Face-to-face interviews using a validated structured questionnaire were conducted to obtain baseline information prior to intervention and after one and three months. Descriptive and multivariate statistics were used for analyzing the data using SPSS software. Results: The overall response rate was 99.5%. The final sample comprised of 204 respondents (89 in the control group and 115 in the intervention group). At baseline, 75.1% of respondents had heard about oral cancer, however their in-depth knowledge on risk factors, signs and symptoms and prevention were lacking. The control group had better awareness than the intervention group. Smoking and alcohol drinking were more prevalent in the intervention group, whereas betel quid chewing and practice of mouth self-examination (MSE) were more evident in the control group. At 1-month and 3-month follow-up, there were significantly higher mean scores in all aspects of oral cancer awareness among respondents in the intervention group and these improved levels of awareness were maintained over a period of 1- and 3-months. There were higher proportion of smokers, alcohol drinkers and betel quid chewers in the intervention group who reported quitting their habits or reducing the number of cigarettes smoked per day, frequency of alcohol drinking and betel quid chewing than the control group. The respondents in the intervention group also had significant increase in uptake of MSE and higher proportions who performed it once a month. Conclusion: The structured HBM-based oral cancer health education intervention was shown to have significant impacts on oral cancer knowledge and awareness, cessation and reduction of risk habits and increased the uptake of MSE among respondents in the intervention group of this indigenous community. Therefore, the introduced structured health education intervention is recommended for other communities in Malaysia that practice the same oral cancer risk habits. Considering this indigenous community is of lower socioeconomic status (SES), the introduced intervention could also be extended to other lower SES groups in Malaysia.

P01.008 Feasibility of a structured tumor related epilepsy education intervention in adult gliomas

P01.008 Feasibility of a structured tumor related epilepsy education intervention in adult gliomas

Outcomes from a community-based hypertension educational programme: the West of Ireland Hypertension study.

Hypertension is a leading modifiable risk factor for premature cardiovascular disease. Research indicates a growing prevalence of hypertension among adults worldwide, with accompanying low levels of patient knowledge, and sub-optimal clinical management. This study aims to explore the impact of a structured hypertension educational intervention on patient knowledge, lifestyle behaviours and blood pressure control. An observational, prospective cohort design was selected. Participants were recruited through a public blood pressure screening event in a community-based setting. They were asked to complete a self-report questionnaire followed by an assessment of their blood pressure. Participants with high blood pressure were randomly assigned to either a control group or an intervention group. Those in the intervention group received an educational intervention on hypertension 4weeks later. Both groups were recalled 4months later for a repeat of the same initial assessment. Eighty-one participants with a mean age of 64years were included in this study. There were no significant differences in the baseline measures between the two groups. Significant improvements were found in the intervention group compared with the control group in levels of hypertension knowledge and awareness (p=<0.001), exercise levels (p=0.002) and weight (p=0.003). Participants who underwent the intervention showed a greater reduction in both systolic (SBP) and diastolic (DBP) blood pressure (SBP 158.8 to 141.6mmHg, p<0.0001 and DBP 84.7 to 77.7mmHg, p<0.001). Providing a tailored educational intervention can positively impact on hypertension knowledge, self-care management and control within community-based settings.

Intervention to improve awareness of the risk factors for osteonecrosis of the jaw in patients under treatment with bisphosponates. Randomised clinical trial

PurposeTo evaluate the effectiveness of a health education programme on knowledge and reduction of the risk factors for bisphosphonate-related osteonecrosis of the jaw. MethodsAn experimental study control group without intervention was performed with 60 subjects who had started treatment with bisphosphonates in the University Hospital of León from October to December 2014. Patients in the experimental group received a structured education intervention in two sessions. The data was collected from a heteroadministered questionnaire at the beginning and at the end of the study period for both groups. ResultsThe educational intervention designed showed a significantly increased adherence to healthy behaviours related to oral hygiene such as mechanical control of plaque and the use of clorhexidine prior to invasive oral procedures. All subjects reported that they had not been advised to maintain a good level of oral health before starting treatment. After the intervention high percentages of recognition of early diagnostic measures starting from a baseline total ignorance of them were determined. No conclusive information about the use of removable dental prostheses, toxic habits or maintaining proper metabolic control in patients with diabetes mellitus was observed. ConclusionsImproving adherence to healthy behaviours related to oral health following the intervention, as well as their contribution to the early identification of warning signs of jaw osteonecrosis, stresses the importance of the use of health education as a tool in routine clinical practice.

Intervention to improve awareness of the risk factors for osteonecrosis of the jaw in patients under treatment with bisphosponates. Randomised clinical trial.

To evaluate the effectiveness of a health education programme on knowledge and reduction of the risk factors for bisphosphonate-related osteonecrosis of the jaw. An experimental study control group without intervention was performed with 60 subjects who had started treatment with bisphosphonates in the University Hospital of León from October to December 2014. Patients in the experimental group received a structured education intervention in two sessions. The data was collected from a heteroadministered questionnaire at the beginning and at the end of the study period for both groups. The educational intervention designed showed a significantly increased adherence to healthy behaviours related to oral hygiene such as mechanical control of plaque and the use of clorhexidine prior to invasive oral procedures. All subjects reported that they had not been advised to maintain a good level of oral health before starting treatment. After the intervention high percentages of recognition of early diagnostic measures starting from a baseline total ignorance of them were determined. No conclusive information about the use of removable dental prostheses, toxic habits or maintaining proper metabolic control in patients with diabetes mellitus was observed. Improving adherence to healthy behaviours related to oral health following the intervention, as well as their contribution to the early identification of warning signs of jaw osteonecrosis, stresses the importance of the use of health education as a tool in routine clinical practice.

Outcomes of a structured education intervention for Latinas concerning breast cancer and mammography

Objective: This study examined the utility of living room and church-based small group educational sessions on breast cancer and mammography, for under-served Latinas in North Carolina, USA. Design: Non-randomised, single arm design. Setting: A total of 329 self-selected Latinas participated in 31 small group educational classes in church and home locations in rural and urban settings, and underwent pre- and post-intervention testing of knowledge about breast cancer and mammography. Method: Participants completed educational surveys at baseline before intervention (329), immediately after intervention (329) and 3 months after intervention (223 participants). Results: Misconceptions still exist about breast cancer risk, prevalence and mammography use among Latinas, with the greatest knowledge deficit being in the domain of risk factors. Increases of knowledge were achieved when compared to baseline measures as a result of the interventions described in this paper, which were retained at 3 months re-testing. Many eligible women were not receiving mammograms due to financial barriers. Conclusions: Education sessions of the kind described in this paper are useful in enhancing retained knowledge in breast cancer education for US Latinas.

Cost-effectiveness of a pragmatic structured education intervention for the prevention of type 2 diabetes: economic evaluation of data from the Let's Prevent Diabetes cluster-randomised controlled trial

ObjectivesPrevention of type 2 diabetes mellitus (TD2M) is a priority for healthcare systems. We estimated the cost-effectiveness compared with standard care of a structured education programme (Let's Prevent) targeting lifestyle...

Enhancing Parental Self-management of Child’s Seizure Disorder by a Structured Educational Intervention: a Randomized Controlled Trial

Seizure disorder is a chronic paediatric condition which requires parental commitment to self-management to ensure quality of life for the child and the family. Hence this prospective, parallel group, randomized controlled clinical trial was planned to study whether structured education enhances parental self-management of their child’s seizure disorder. Sixty four parents of children, below 18 years of age, attending the Developmental Paediatrics and Child Neurology outpatient department, in a tertiary care centre in South India, who gave written informed consent were recruited into the study after institutional ethical committee approval was received. The department is located in a rural area and serves children with special needs who come from various parts of this state and the neighbouring states. The instrument used to assess efficacy of self-management was the Paediatric Epilepsy Self- Management Questionnaire (PEMSQ) (in the local language) after permission was obtained from the author. The first contact PEMSQ was administered on recruitment to the study by an independent assessor. The participants were randomized by permuted block randomization into two groups, the intervention group and the comparator group. Allocation was concealed from the assessor. After 72 hours the follow up PEMSQ was administered by the blinded assessor. The improvement in the follow up score compared to the first contact score was recorded and compared to find if there was a significant difference between the two groups. The nonparametric Wilcoxon Mann Whitney U test was used to compare the scores statistically using SPSS version 16. Our study showed significant improvement in the parental scores for self-management using the PEMSQ. There was also improvement in all the four PEMSQ sub-scalesi. Knowledge of seizure disorder, ii. commitment to adherence to treatment, iii. beliefs about efficacy of drugs, and iv. barriers to treatment Thus we conclude that there is a significant enhancement of parental self-management following the structured education given to the intervention group compared to the comparator group.

Evaluation of patient-reported outcomes data in structured diabetes education intervention: 2-year follow-up data of patient empowerment programme.

To examine the effects of a structured group-based education programme, patient empowerment programme (PEP), compared with usual care on 2-year changes in patient-reported outcomes (PRO) in patients with diabetes mellitus (DM). A prospective observational study of 715 patients (PEP/non-PEP: 390/325) was conducted to complete the baseline PRO survey and followed up for 2 years. Health-related quality of life (HRQOL) was measured using the short-form 12 at baseline and annually at two follow-up assessments, which yielded physical and mental component summary and SF-6D preference-based scores. Perceived control over diabetes and general health status were measured using the patient enablement instrument (PEI) and global rating scale (GRS) at follow-ups. When compared with non-PEP, PEP participants significantly reported improvement in health condition (GRS score > 0; 24.55 % vs 10.16 %; odds ratio = 2.502; P = 0.018) in 2 years and enabled the self-perceived control over diabetes (PEI score > 0; 72.20 % vs 38.40 %; odds ratio = 3.25; P < 0.001) in 1-year follow-up but no sustained effects in year 2 (52.65 % vs 39.04 %; odds ratio = 1.366; P = 0.265). There were no significant differences between PEP and non-PEP groups in the changes in quality of life scores (all P > 0.05) at 1 year. Although HRQOL scores deteriorated over 2-year period in both groups, PEP participants reported similar changes in HRQOL scores to that of non-PEP. PEP for DM patients preserved self-perceived disease control and health condition, whereas PEP participants perceived their HRQOL similar to that of non-PEP participants. Findings of PRO should be considered alongside clinical outcomes when evaluating the overall benefits of PEP.