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PubMed2004

Knowledge of oral cancer, distress and screening intentions: longer term effects of a patient information leaflet.

Study aim was to determine the influence of a patient information leaflet (PIL) on mouth cancer to improve knowledge, reduce distress and increase intention to accept a mouth screen over a 2-month period. The design was a randomised controlled trial. Two dental practices in the northwest of England participated. Standardised multi-item scales of the three outcome measures were employed. The PIL was given to a randomised intervention group of patients in waiting room. Single sheet questionnaire was completed by both groups of patients at baseline in waiting room (immediately following leaflet administration in intervention arm of study). Repeat questionnaire completion at 8 weeks by all patients through postal system. Mann-Whitney U-tests comparing outcome variables between patients with and without access to the leaflet at baseline and 8 weeks were performed. Multiple logistic regression was used to predict re-reading of the leaflet at home. Useable replies were received from 317 patients (60% response rate). All measures showed some benefit of immediate exposure to the leaflet at follow up. Older patients, less initial knowledge, and self-reported smoking positively predicted the re-reading of the leaflet. The introduction of a mouth cancer PIL into dental practice may help to inform patients about oral cancer, moderate distress and encourage acceptance of an oral health screen.

Age Factors↗
PubMed2004

The impact of describing clinical trial treatments as new or standard.

Concern has been expressed over a possible widespread belief amongst patients in trials, that a new treatment is better than the standard, despite the lack of evidence of such superiority. A sample of the general public (N = 130) read a leaflet describing a hypothetical trial comparing two similar treatments for either arthritis or back-pain. Half read that both treatments were standard and generally available; half that one was new and available only within the trial. Participants rated any preference for one or the other treatment, gave written reasons, and indicated their willingness to enter the randomized trial. Fifteen participants subsequently talked through their answers. Most participants expressed no preference for either treatment when both were described as standard. When one was new more people with the arthritis (but not the back-pain) scenario expressed a preference (chi2 = 5.44, P = 0.031). Importantly, this was not more likely to be for the new treatment. Rationally, those who preferred a freely available treatment were less likely to participate in the trial (chi2 = 23.3, P < 0.001). The mere description of a trial treatment as new was insufficient to engender a preference for it over a standard treatment, although it may contribute to preference under certain additional circumstances.

Adolescent↗
PubMed2004

We are the experts: people with asthma talk about their medicine information needs.

People with chronic illness are being encouraged to become more involved in their care. For this, they need to be well informed about their medicines, and more written medicines information is becoming available. However, there is little data about its effectiveness and impact. This study examined the patient perspective of medicines information through focus groups of people with asthma. Most participants actively sought medicines information from a variety of professional and lay sources. There were some positive experiences but many examples of partial or total information failure. Individualised information was valued and medicine leaflets were generally seen as less helpful than face-to-face advice. Some felt strongly that patients with long experience should be involved in the development of medicine information leaflets. We conclude that medicine information leaflets do not currently meet the needs of users and that people who take medicines should be involved in their development and testing.

Adolescent↗
PubMed2004

Decision analysis for newly diagnosed hypertensive patients: a qualitative investigation.

This study adopted a qualitative approach to explore patients' views on the usefulness of a decision analytic decision aid (DA). Semi-structured interviews were conducted with 15 newly diagnosed hypertensive patients who had been recruited for a factorial randomised controlled trial of two decision aids. Issues investigated included respondents' attitudes to information, their views on the nature of their relationship with their general practitioner (GP) (paternalistic, shared or consumerist), the ease of use and potential wider application of the computerised decision aid and its influence upon their decision-making about whether or not to begin anti-hypertensive treatment. Views on the decision aid were favourable. For the majority, the decision aid appeared to confirm and/or clarify their stated preferences towards medicine-taking. Occasionally it could provoke a major shift in a respondent's attitude to medicine-taking, while in a few it had no discernible effect. While views on the decision aid were favourable, it was difficult to determine whether this was due to the individualised cardiovascular risk information it provided or the decision analytic process itself.

Aged↗
PubMed2004

Effectiveness of a perimenopausal health education intervention for mid-life women in northern Taiwan (#MS03-21-LW).

The purpose of this quasi-experimental research was to assess the effectiveness of a perimenopausal health education intervention for mid-life women in northern Taiwan. The health education intervention included a health education brochure, one-on-one teaching. One hundred seventy-nine women were in the intervention group and 174 women were in the control group. Education effectiveness was assessed by participants' scores on four questionnaires at the beginning of the study and 3 months after initial recruitment. Both groups of women were compared on changes in their scores on health knowledge, level of perceived uncertainty, health behaviors and perceived perimenopausal disturbances. The intervention group had significantly reduced scores on perimenopausal disturbances (P < 0.005) and reported increase practice of healthy behaviors (P < 0.001) compared to the control group. However, a significant decrease of perceived uncertainty was only found in the subgroup of women recruited from the Chinese medicine clinic of the control group (t = 2.22; d.f. = 58; P < 0.05). Chinese medicine physicians assess patients based on a philosophical approach that treats all symptoms holistically. This may have helped reduce patient uncertainty.

Adult↗
PubMed1994

Long-waiting outpatients: target audience for health education.

The study examines the meaning of waiting time in an outpatient department. Attention is payed to the activities of the patients and companions during the waiting time, the potential for health education programmes during the waiting time and the form such a health education programme should take. The setting was the King Khalid University Hospital Outpatient Department, Riyadh, Saudi Arabia. The study sample was selected by a systematic random sample approach of one in every 10 patients or companions visiting the clinic in a period of 2 weeks. The results showed an average waiting time of 148 min with a standard deviation of 11 min. Patients currently engage in reading, sleeping or talking during long waiting time. However, they showed a preference for health education programmes for specific diseases such as heart disease, diabetes mellitus and bowel diseases during the waiting time. Leaflets were favoured to be the most preferred mode for disseminating such information. A sizeable proportion of patients also wanted religious programmes included. We conclude that education programmes for preferred specific health topics at outpatient clinic services would be of potential benefit to patients' overall health.

Adolescent↗
PubMedDate not supplied

Effects of an information booklet on well-being of hospital patients.

Although informational booklets are being used increasingly in Dutch hospitals, little is known of their effects and the conditions for optimal use. Various aspects of the use and effects of a specially developed information booklet were investigated in two surgical wards of a general hospital. The booklet gave information about ward procedures, operative routines, narcosis, and psychosocial care possibilities. Both before and after introduction of the booklet we gathered data on the satisfaction, knowledge, and emotional state of patients on the two wards and their perception of the care climate. Patients on the control ward received just the booklet. On the experimental ward staff nurses were trained in nondirective therapeutic skills, and measurements were repeated on both wards after this intervention. In a third manipulation on the experimental ward, some of the patients had a supportive and informative talk with a trained nurse. Although patients appreciated and read the booklet better than a general hospital leaflet, the results show that the booklet and other supporting measures had no effect on the patients' perception of their well-being.

Consumer Behavior↗
PubMedDate not supplied

Evaluation of a self-teaching program.

A self-teaching booklet on hypertension was evaluated in two populations: clients attending public health screening clinics and inpatients at a Veterans Administration hospital. Participants were randomized into an education or a control group. Evaluation consisted of measuring knowledge gained from the booklet immediately after reading it and retention of key concepts two weeks later. Men did better than women, and VA education participants did better than VA controls. No differences were detected between the public health education and control groups or the combined VA and public health) education and control groups. The self-teaching booklet alone did not appear to yield a measurable amount of new knowledge. Health professionals, when educating patients and evaluating programs, should consider combinations of educational methods when using self-teaching programs.

Adult↗
PubMed1997

Readability of patient information booklets for women with breast cancer.

Providing accurate information, in both verbal and written formats, is seen as an important component of patient care. For individuals diagnosed with cancer, acquiring information may be a particularly pertinent issue in terms of coping with the disease. Numerous information booklets are available for people with cancer which aim to provide information on various aspects of care and treatment. This British study examined the readability of 50 information booklets available to women with breast cancer using the SMOG and Flesch reading tests. Generally the information booklets were found to have a high reading age, arguably not suitable for the majority of the United Kingdom (UK) population. This study has implications for health care professionals who provide written information as a supplement or substitute for verbal information.

Breast Neoplasms↗
PubMed1998

Information booklets about cancer: factors influencing patient satisfaction and utilization.

Providing patients with adequate information is an important component of care. This exploratory study investigated factors influencing patient satisfaction with and utilization of information booklets. The research was conducted in two stages. In stage 1, five commonly used cancer information booklets were reviewed by 36 Australian patients who were either receiving chemotherapy or had just completed treatment. Data were collected on patient satisfaction with, preference for and utilization of information booklets. In addition data were collected on variables identified in the literature as potentially influencing patient satisfaction, including patient characteristics, presentation and readability of booklets, and the timing of provision. A high level of satisfaction was found for all five information booklets, although a clear preference for one particular booklet emerged. The most notable feature of this booklet was its readability level (grade 8); in contrast the other booklets were written at levels equivalent to grades 11-12. Stage 2 focused on the side effects of patient information preference style on their satisfaction and recall of information presented in two booklets in the course of their treatment. No differences were found between patients who seek information and those who avoid it. The findings of this study suggest that patients' information needs may be better met if information booklets are written in plain English, and presented to patients prior to treatment. Future studies incorporating a larger sample of patients and greater selection and variety of information booklets are required to further determine if patient characteristics and features of booklet presentation influence patient satisfaction and preference.

Adolescent↗
PubMed1997

The discursive formation of health. A study of printed health education material used in primary care.

This study analyses printed educational material on cholesterol, food and health-related lifestyle changes used in primary care in southern Sweden. Two theoretically grounded perspectives are used: orientation of knowledge and rhetoric. According to the first one, the material contained many examples of abstract and detailed knowledge, such as tables of energy contents, and a little less of action-oriented and detailed knowledge, such as food recipes. We also found a few examples of comprehensive, abstract knowledge, such as theoretic explanations. Action-oriented and comprehensive knowledge, relating health to-lifestyle, were rare. The rhetoric style of the material was generally dominated by plain facts, without any identified voice (i.e. sender) or any emotional orientation. Overall, information was not related to 'the voice of the life-world' but to 'the voice of medicine', and it was in character more general than specific.

Books↗
PubMed1998

Finnish physicians' attitudes towards preconsultation information: menopausal treatment practices as an example.

The purpose of this study was to investigate Finnish physicians' attitudes towards consumer groups provision of information about physicians' treatment practices, using menopause as a specific example. A questionnaire to be used to make a public brochure listing physicians by their menopausal and postmenopausal treatment practice was sent by consumer organizations to 812 physicians [gynecologists and general practitioners (GPs)] in 1995, after contacting the physicians' associations for support for this activity. The gynecological association had a negative attitude towards the study while that of the GPs' association was more favorable. The response rate was 38% (n = 307). Only 5% of the physicians who got the questionnaire wanted to participate in the planned brochure and only 21% of those responding considered preconsultation information a good idea. The most common reasons for not wanting to participate were that preconsultation information is medically unfeasible and that it would be incompatible with physician's current working practice. Approaches other than public brochures about physicians' treatment patterns are needed if we want to increase patients' participation in decision-making.

Adult↗
PubMed1999

A Dutch 'Poststroke Guide': distribution and use.

Stroke patients and caregivers have a substantial need for information. The Dutch 'Poststroke Guide' was written in an attempt to meet this need. The study investigates the distribution of this guide among stroke patients, caregivers, and stroke providers. Stroke patients and caregivers who ordered a copy of the first edition received a questionnaire to evaluate the guide and to provide information about personal characteristics. Nearly one-third of the guides finds its way directly to stroke patients and/or caregivers and more than two-thirds goes to providers. Since providers are calling stroke patients' attention to the guide to an increasing extent, the information for caregivers ought to be improved. Mainly young, slightly disabled male stroke patients with healthy caregivers returned the questionnaire. Both stroke patients and caregivers read the guide thoroughly; it clearly meets their need for information. In the future, distribution will have to be less selective.

Aged↗
PubMed1999

The impact of tailored interventions on a community health center population.

We conducted a 4-year randomized study in a community health center that serves primarily low income Blacks in Durham, North Carolina. Patients (1318 at baseline) were assigned randomly to one of three study groups: provider prompting intervention alone, provider prompting and tailored print materials or the previous group and tailored telephone counseling. The purpose of the study was to determine whether increasingly intensive, tailored print and telephone interventions also were increasingly effective in promoting adherence to mammograms, Pap tests and overall cancer screening compliance. Thus, the combination of tailored print interventions (print and telephone) should have been more effective than the provider prompting intervention alone, or the print intervention and prompting combination. This is one of the few studies to examine a measure of overall cancer screening compliance and to assess the benefit of combinations of tailored interventions in promoting adherence to cancer screening. Patients gave extremely high ratings to the interventions. At the bivariate level, we found a significant effect of the most intensive group (provider prompting intervention, tailored print communications and tailored telephone counseling) on Pap test compliance (P = 0.05) and borderline significance at the multivariate level (P = 0.06) as well on overall screening compliance (P = 0.06). There was not a significant effect on mammography, probably because a majority of the patients were receiving regular mammograms. We also found some important subgroup differences. For example, a larger proportion of women reported Pap tests in the tailored print and counseling group when they believed the materials were 'meant for me.' These results show that a combination of tailored interventions may have potential for reaching the women who have too often been labeled the 'hard to reach.'

Adolescent↗
PubMed2003

Print versus website physical activity programs: a randomized trial.

BACKGROUND: Mediated physical activity interventions can reach large numbers of people at low cost. Programs delivered through the mail that target the stage of motivational readiness have been shown to increase activity. Communication technology (websites and e-mail) might provide a means for delivering similar programs. METHODS: Randomized trial conducted between August and October 2001. Participants included staff at an Australian university (n=655; mean age=43, standard deviation, 10 years). Participants were randomized to either an 8-week, stage-targeted print program (Print) or 8-week, stage-targeted website (Web) program. The main outcome was change in self-reported physical activity. RESULTS: There was no significant increase in total reported physical activity within or between groups when analyzed by intention to treat (F [1,653]=0.41, p=0.52). There was a significant increase in total physical activity reported by the Print participants who were inactive at baseline (t [1,173]=-2.21, p=0.04), and a significant decrease in the average time spent sitting on a weekday in the Web group (t [1,326]=2.2, p=0.03). CONCLUSIONS: There were no differences between the Print and Web program effects on reported physical activity. The Print group demonstrated slightly larger effects and a higher level of recognition of program materials.

Adult↗
PubMed2000

Can tailored interventions increase mammography use among HMO women?

BACKGROUND: Telephone counseling and tailored print communications have emerged as promising methods for promoting mammography screening. However, there has been little research testing, within the same randomized field trial, of the efficacy of these two methods compared to a high-quality usual care system for enhancing screening. This study addressed the question: Compared to usual care, is tailored telephone counseling more effective than tailored print materials for promoting mammography screening? DESIGN: Three-year randomized field trial. PARTICIPANTS: One thousand ninety-nine women aged 50 and older recruited from a health maintenance organization in North Carolina. INTERVENTION: Women were randomized to 1 of 3 groups: (1) usual care, (2) tailored print communications, and (3) tailored telephone counseling. MAIN OUTCOME: Adherence to mammography screening based on self-reports obtained during 1995, 1996, and 1997. RESULTS: Compared to usual care alone, telephone counseling promoted a significantly higher proportion of women having mammograms on schedule (71% vs 61%) than did tailored print (67% vs 61%) but only after the first year of intervention (during 1996). Furthermore, compared to usual care, telephone counseling was more effective than tailored print materials at promoting being on schedule with screening during 1996 and 1997 among women who were off-schedule during the previous year. CONCLUSIONS: The effects of the intervention were most pronounced after the first intervention. Compared to usual care, telephone counseling seemed particularly effective at promoting change among nonadherent women, the group for whom the intervention was developed. These results suggest that telephone counseling, rather than tailored print, might be the preferred first-line intervention for getting nonadherent women on schedule for mammography screening. Many questions would have to be answered about why the tailored print intervention was not more powerful. Nevertheless, it is clear that additional interventions will be needed to maintain women's adherence to mammography. Medical Subject Headings (MeSH): mammography screening, telephone counseling, tailored print communications, barriers.

Cost-Benefit Analysis↗
PubMed2000

[Impact of an information booklet on patient satisfaction in anesthesia].

OBJECTIVE: The aim of this study was to evaluate the satisfaction of adult surgical patients before and after an information booklet concerning anaesthetic techniques and complications, and postoperative management has been proposed during preanaesthetic visits. STUDY DESIGN: Survey. METHOD: Three surveys have been performed using an anonymous questionnaire of 25 items with graduated answers (very good, good, bad, very bad, no opinion) concerning patient satisfaction on structure, physician behavior, information and well being. As the results of the first two surveys were not significantly different, an information booklet was proposed to patients during preanaesthetic visits, then a third survey ("After") was realized. The results of this survey were compared to the combined results of the first two surveys ("Before"). RESULTS: In the "before" survey, 60 to 76% of the patients were satisfied (very good and good) of the information delivered during preanaesthetic visits. The proportion of patients satisfied of the information concerning anaesthetic techniques, transfusion and recovery were significantly higher in the "after" survey (P < 0.05). CONCLUSION: An information booklet on anaesthesia increases patient satisfaction on information provided during preanaesthetic visits.

Adult↗
PubMed1999

The suitability of United States Pharmacopoeia Dispensory Information psychotropic drug leaflets for urban patients with limited reading skills.

Although considerable research exist on the readability of patient education materials, few studies have focused on the efficacy of information drug leaflets used for psychopharmacology education of patients with limited reading skills. The purpose of this investigation was to evaluate the suitability of United States Pharmacopoeia Dispensary Information (USP-DI) drug leaflets (N = 42) for educating urban in-patients at a psychiatric unit using measurement criteria of the Suitability Assessment for Materials (SAM) instrument. The findings showed the USP-DI information drug leaflets were unsuitable as an educational tool for psychiatric in-patients with poor reading ability.

Drug Information Services↗