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Educational care path for the endoscopic patient.

Complex healthcare systems make it increasingly difficult for healthcare providers to coordinate patient care throughout the healthcare continuum. In order for patients to actively participate in their care, we need to develop tools that include them in this process. Our Short Stay (endoscopy) staff observed that pre-procedure patient teaching materials from area physician offices did not reflect consistent information. After meeting with several physicians and their office staff, our unit decided to use a Care Path tool designed for healthcare providers and adapt relevant areas for patients' use. Keeping in mind that patient satisfaction is an important focus for healthcare facilities, we successfully redesigned our unit's informational pamphlet into an educational tool resembling a Care Path to be used by our patients in their preparation and education for an endoscopic procedure.

Critical Pathways↗

Fever education: does it reduce parent fever anxiety?

OBJECTIVE: The aims of the study were to determine the following: 1) if a fever education program (interactive or written) reduces parent fever anxiety; 2) if an interactive fever program was more effective as a teaching style than standard written material alone; and 3) if a fever program increases parent fever home management and reduces return emergency department (ED) visits. METHOD: A quasiexperimental, pretest and post-test pilot study examining parental fever anxiety was conducted at The Children's Hospital of Philadelphia. Eligible participants consisted of 87 parents and their children, aged 3 months to 5 years presenting with fever >38.4 degrees C, and without coexisting serious illness. RESULTS: Both the interactive fever education program and the standard written fever pamphlet were equally effective as teaching methods. Data revealed a 30% reduction in fever anxiety rated as moderate-severe on arrival to none-low post-fever education, increased parent fever home management skills with correct use of thermometer and antipyretics, and reduced unnecessary return ED visits. CONCLUSION: Parents in the acute and nonacute care setting may benefit from an interactive fever education program that includes the definition and benefit of fever, the correct use of a thermometer, fever home management skills, and appropriate fever telephone follow-up.

Adult↗

Preparing readable patient education handouts.

Printed health educational materials, such as patient information handouts, booklets, pamphlets, and information sheets are among the most common and extensively used teaching tools (Rankin & Stallings, 1996). In this article, the author reports (1) the readability of patient information handouts developed by the nursing division and (2) the effect on the patient-teaching task force members of instruction on the readability of patient information handouts at a 79-bed community hospital in Southern Ontario.

Educational Status↗

The effects of a direct-mail informational campaign on attitudes of industrial managers toward the mentally retarded population.

This study attempted to determine the effects of a direct-mail campaign on the attitudes of managers and presidents of industries toward the mentally retarded. The participants in the study were 99 managers and presidents selected from a total population of 4290 within the State of Alabama, USA. Random sampling techniques were utilized to select and assign managers and presidents into an experimental group (n = 50) and a control group (n = 49), giving a total usable sample size of 99. The size of this sample was adequate to insure that, in 19 out of 20 cases, the sample mean was within 0.50 points of the population mean on the response scale according to Elliot (1980). The pre-test of the attitude scale was administered to the experimental and control groups by mail. A post-test was administered to the control and experimental groups one week after the mailing of the final pamphlet. The major finding of this study revealed positive attitude gains from pre-test to post-test for the experimental group following the direct-mail campaign. No significant difference was noted for the control group from pre-test and post-test. Pre-test scores of the experimental and control groups were not significantly different; however, post-test scores between these groups were significantly different. The results of this research contribute further information on a direct-mail approach for changing attitudes of managers and presidents of industries toward mentally retarded persons.

Alabama↗

Pap smear brochures, misogyny and language: a discourse analysis and feminist critique.

Text from a public health brochure on pap smears was analysed with particular reference to ways in which the language used conveys particular messages about women and their bodies. In the text, 'humans' were found to be excluded as such. Both the pap smear service provider and the women who are the recipients of this service--and at whom such brochures are targeted--are objectified and their characteristics of human existence (i.e. ontological capacities) were restricted. The language of the pamphlet invokes an image for women associated with vaginal (penile penetrative) sex. The discourse also is found to be didactic, biomedical and written in the voice of the service provider. Further, the encounter of pap smear events is contextualized as procedural such that not only is the woman 'done to' in the process of having a cervical smear test but the woman's and provider's experiences of the encounter are silenced. It is concluded that the texts may be viewed as misogynist and that such texts do not take account of the complexity of women's decisions to 'submit to' or comply with cervical cancer screening.

Attitude to Health↗

An evaluation of managing and educating patients on the risk of glucocorticoid-induced osteoporosis.

OBJECTIVE: To assess the impact of risk management activities on patient risk of glucocorticoid-induced osteoporosis. METHODS: Ninety-six adult patients taking chronic glucocorticoid therapy in 15 community pharmacies. Patients in the control group received usual and customary care. Patients in the treatment pharmacies received education and an educational pamphlet about the risks of glucocorticoid-induced osteoporosis. In addition, the treatment group pharmacists monitored the patients' drug therapy, to identify and address drug-related problems. Data including the glucocorticoid taken by the patient, medications, and osteoporosis risk factors were collected at baseline and after 9 months of monitoring, via Web-based survey completed in the pharmacy. Using an intent to treat approach, the pre-post frequency changes were compared with contrasts for presence of bisphosphonate therapy, presence of estrogen therapy, presence of calcium supplement, discussion of glucocorticoid-induced osteoporosis risk, discussion of bone density test, presence of bone mineral density test, reported inactivity, and reported low calcium diet. RESULTS: The contrast was significant in favor of the treatment pharmacies for the frequency of patients taking a calcium supplement (Control [-6.9%] vs. Treatment [17.1%], P < 0.05). No other contrast was significant. CONCLUSIONS: Community pharmacists are capable of increasing calcium supplementation among patients at risk for glucocorticoid-induced osteoporosis. Pharmacists who educate at-risk patients can impact the self-care of these patients.

Adult↗

Public health nursing interventions to improve the use of a health service: using a pilot study to guide research.

This article demonstrates how a pilot study can provide useful direction for a research project. In planning a study to improve the use of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program for Medicaid-eligible children, we tested our research methods and interventions (mailed pamphlets, telephone calls, home visits) on a small scale (N = 100) prior to implementing a large-scale (N greater than 2000) project. The issues and obstacles included obtaining cooperation from many agencies involved in administering the Medicaid program, addressing informed consent, assessing feasibility of methods for random sampling and random assignment, identifying sources of Medicaid data, designing and assessing validity and reliability of research tools, and testing the feasibility of implementing interventions in the field. Our experience may be particularly helpful for public health nurses who plan to investigate approaches to improve the use of services in federally mandated health programs where cooperation from federal, state, and local agencies is required.

Adolescent↗

Relieving parental anxiety a booklet for parents of an infant in NICU.

The transfer of a sick newborn infant to a Newborn Intensive Care Unit evokes an acute emotional crisis for the parents. In order to help the family master this crisis, the authors have developed a parent booklet entitled, "A Sign of Hope." This pamphlet introduces the parents to Newborn Intensive Care even before the transfer of the baby to the regional hospital. By merely changing a few words, telephone numbers, and maps, this brochure can be adapted for use at most Level II or III Newborn Special Care Units.

Anxiety↗

Oral cancer educational materials for the general public: 1998.

OBJECTIVES: Previous studies have shown that US adults are not well informed about oral cancers and only 15 percent ever have had an oral cancer examination. This study sought to determine the quantity and adequacy of educational materials designed to inform or educate US adults about risks for, and signs and symptoms of, oral cancer and the need for an oral cancer examination. METHODS: Letters requesting copies of oral cancer educational materials produced by the organization or agency--leaflets, fact sheets, pamphlets, videos, posters--were sent to 172 national and state organizations or agencies. To determine the adequacy of the items, a previously developed, tested, and used form based on current science was adapted for this study. In addition, the SMOG index was used to determine readability for printed items. RESULTS: Seventy-seven percent or 132 of the selected organizations responded to queries. A total of 59 items were received that focused on or included the topic of oral cancer. Twenty of these 59 items focused specifically on oral cancer; the balance, on other topics, but mentioned oral cancer. The readability ranged from sixth to 13th grade. CONCLUSIONS: This study demonstrates a dearth of educational materials about oral and pharyngeal cancers; most are written at too high a grade level for the general public. These findings may help to explain why the public is so uninformed about these neoplasms.

Adult↗

A critical review of Australian cancer organizations' public education material.

Because of the potential benefits of primary prevention and early detection of cancer, a considerable proportion of the efforts of State cancer organizations has been directed towards public educational programs. The study aimed to determine the level of agreement in the messages contained in the written educational material of the State and Territory cancer organizations in Australia. Pamphlets and brochures dealing with primary and secondary prevention of breast, cervical, skin and bowel cancers were obtained. The materials were compared on a number of dimensions: the characteristics of people who are at increased risk of contracting the cancer, how to avoid the cancer through primary prevention, how and when to screen in the case of secondary prevention, and action to be taken if a sign or symptom indicative of cancer is discovered. The study found a lack of agreement in the messages of the State cancer organizations. Some hypotheses are suggested to explain the discrepancies. In addition, some suggestions for remedying this situation are provided.

Australia↗

Ineffective recruitment strategies for screening mammography: letterbox drops and invitations for friends.

To test the effectiveness of two interventions to encourage women to attend for mammographic screening, four randomised trials of letterbox drops were conducted. Leaflets about the screening service (n = 3984) were distributed to households within defined areas. Attendance from the 79 streets where a drop was made was compared with attendance from 78 control streets before and after the drop. No major effects were found either within each trial or across trials. In the second intervention, 69 women who attended the service were offered invitations for two friends. An additional 21 attenders were approached with the offer of an incentive to recruit friends. Invitations included an explanatory letter with an appointment time, a pamphlet and a contact phone number. The final response rate was only 7% and an incentive of an instant scratch lottery ticket for the original attender did not improve the response. Thus we identified two interventions with no major effect in recruiting women to mammographic screening.

Australia↗

Venereal disease education and a selected group of American college students.

Education is considered to be an important factor in the control and possible eradication of venereal diseases. A study was undertaken to discover what effect education had had on a selected group of university students so as to determine suitable avenues for future educational programmes. Many of the schools attended by the students had issued information on venereal diseases; most students considered that this information was useful. The study did not generally show a significant relationship between previous health education, current attitude and behaviour, and the contraction of venereal disease. However, the data did appear to reveal a correlation between the lack of education at junior high school and the acquisition of venereal disease. The university student health service, together with books and pamphlets made available outside the school of classroom, were regarded as being important in venereal disease education. These findings can help those planning venereal disease education for young adults.

Adolescent↗

Prenatal office practices regarding infant feeding choices.

The objective of this study was to determine the obstetric care providers' roles in breast-feeding promotion during prenatal care. A questionnaire addressing breast-feeding issues was sent to family practitioners (FP), obstetric-gynecologists (OB/GYN), and nurse midwives (NM) in Iowa, USA. All NM, 97% of FP, and 85% of OB/GYN reported asking infant feeding preference-usually only at the first prenatal visit. NM (73%) were most likely to provide extensive breast-feeding counseling. OB/GYN (68%) and FP physicians (90%) reported doing their own breast-feeding counseling. Breast examinations targeting future breast-feeding problems were done in 82% to 84% of patients. NM practices shared more information supportive of breast-feeding. Nearly all providers offered prenatal classes, but only 41% of FP offered breast-feeding classes. Free formula samples were available in 73% of FP, 54% of OB/GYN, and 36% NM offices. Pamphlets on formula feeding and also breast-feeding were readily available. Overall NM (64%) reported being strong breast-feeding advocates compared to only 13% of FP and 7% of OB/GYN. In conclusion, little promotion of breast-feeding occurs in most prenatal practice settings.

Bottle Feeding↗

Intimate partner violence resource materials: assessment of information distribution.

OBJECTIVE: To determine the educational impact of placing partner violence resource information in a medical setting. METHOD: A cross-sectional study with a structured interview. SETTING: Emergency department (ED) in an urban academic medical center. PARTICIPANTS: adult patients and visitors. INTERVENTIONS: Educational materials and community resource information. RESULTS: 51 patients and 71 visitors (N = 122) met the inclusion criteria and consented to enrollment during a 2-week study period. Of the participants, 71% were female and 29% were male. Sixty-five (53%) of the participants noticed the literature or cards. Ten (8%) read the materials. Seven (6%) retained a copy of the literature. Nineteen (16%) of the participants acknowledged knowing someone who could benefit from the information. Nine (7%) revealed that some of the information was new to them. CONCLUSIONS: Placing intimate partner violence resource pamphlets and cards in a medical setting is one means of educating the community and promoting violence prevention.

Adult↗

The effect of two nursing interventions on families of ICU patients.

Although much research has addressed family needs of ICU patients, only a few studies have examined interventions aimed at meeting these family needs. Therefore, the purpose of this study was to examine the effects of two interventions, a family information pamphlet and a family group session, on 60 family members of ICU patients. Results revealed no statistically significant differences between the family member groups on Critical Care Family Needs Inventory scores (p = .45), which assessed important needs, or State Trait Anxiety scores (p = .61). Consistent with previous research on families' needs, the majority of the needs identified as most important by all family members related to receiving information. Small sample sizes may have contributed to nonsignificant differences between family member groups, and study replication with larger sample sizes is recommended.

Clinical Nursing Research↗

Matching health messages to information-processing styles: need for cognition and mammography utilization.

The use of tailored health communications has become a favored technique for persuading individuals to engage in health behaviors, such as screening mammography. This experiment examined the impact of tailoring persuasive health communications to one aspect of individuals' information-processing styles, that of the need for cognition (NFC), the enjoyment of thinking deeply about issues. To determine whether messages matched to an individual's NFC are more influential than mismatched messages, 602 women who called the Cancer Information Service (CIS) of the National Cancer Institute were asked to participate in an experiment at the end of their service call. They were assigned randomly to receive 1 of 2 phone messages promoting mammography use and a similarly tailored pamphlet 1 month later. Messages matched to an individual's NFC were better at motivating mammography 6 months later among high-NFC women. After controlling for prior mammography utilization, age, worry, intentions, perceived norms, suggestions to get a mammogram, and marital status, the interaction between participant NFC and message type also approached statistical significance. The differential influence of these brief, tailored communications diminished after 12 months, however.

Adult↗

[Dengue prevention: focus on information].

The first three months of 2002 witnessed a dengue epidemic in the State of Rio de Janeiro. At that time, health authorities encouraged community participation in the elimination of vector breeding sites. For this campaign, a great quantity of information about the disease was extensively publicized in order to guide the population's preventive action. This paper analyzed the three pamphlets most widely distributed at that time in Rio de Janeiro city considering that this information contributed to the construction of disease representation and its prevention. It was observed that even though this information was provided repeatedly it must be revised.

Animals↗

Physicians promoting bicycle helmets for children: a randomized trial.

Head injury is the leading cause of death and serious morbidity in bicycle accidents. There is good evidence to recommend helmets, yet few children wear them. We evaluated helmet promotion in a randomized trial targeting children presenting to primary care settings for routine ambulatory care. The intervention consisted of physician counseling and take-home pamphlets. The study involved 339 families, 167 in the intervention group and 172 in the control group. In a follow-up telephone call, 2 to 3 weeks later, only 7.2% of the intervention group had purchased helmets, compared with 7.0% of the control group (chi 2 = 0.0056, P = .94). During the latter half of the study, bicycle safety received considerable media attention in Ottawa, and the provincial medical society sponsored a $5 discount campaign. Therefore both groups were subject to community "co-intervention." Nonetheless, we were surprised that physician counseling made no additional impact. Our results and the success of certain community programs suggest that physicians interested in helmet promotion would do better to participate in the design and implementation of multidisciplinary campaigns.

Adolescent↗