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One way clinical nurse specialists (CNS) influence nursing practice and share professional expertise is by making presentations. This article presents strategies that clinical nurse specialists can use to enhance the effectiveness of oral presentations. Included are tips for analyzing the audience, developing content and materials, selecting presentation methods, and delivering an effective presentation.
Women often have questions related to menopause and hormone replacement therapy (HRT). A brochure entitled Understanding Menopause and Beyond was developed to address these issues. The purpose of this study was (a) to formally evaluate the relevance and utility of a brochure in understanding menopause and related health concerns and (b) to describe women's information needs at menopause. This descriptive study was conducted using a self-administered survey with a convenience sample of 200 pre-, peri-, and postmenopausal women attending a cancer screening center. On the basis of survey results, the topics most likely to be discussed with a health care provider were the risks and benefits of HRT and bone mineral density testing. The topics most frequently cited in the brochure that women previously did not know or understand were the questions to ask and the information to share with a health care provider and the risk factors for osteoporosis. The most important and informative sections of the brochure were those describing the risk factors for osteoporosis, the questions to ask and the information to share with a health care provider, and the risks and benefits of HRT. It was concluded that women have information needs regarding menopause not only related to the potential cancer risks, but also about related health issues such as osteoporosis, cardiovascular health, and emotional health. Furthermore, a targeted brochure can be effective in addressing these information needs. Oncology nurses who provide cancer screening and education services frequently receive questions about the safety and efficacy of HRT and other questions related to menopause. They therefore are uniquely qualified to address these concerns with their patients.
The purpose of this pilot study was to explore the effectiveness of a pain education program to overcome patient-related barriers in managing cancer pain for Taiwanese home care patients with cancer. The pain education program was developed based on previous studies of Taiwanese patient-related barriers to cancer pain management. The Barriers Questionnaire-Taiwan form, the Brief Pain Inventory, the Medication Adherence Questionnaire, and a demographic questionnaire were used for data collection. The sample consisted of 18 patients in the experimental group and 19 patients in the control group. Descriptive statistics, tests, and paired tests were used to analyze the data. Results of this study revealed that patients who received the pain educational program had significantly greater reduction in Barriers Questionnaire-Taiwan form scores and more improvement in medication adherence compared with patients who did not participate in the program. When compared to pretest scores, patients scores after receiving the pain education intervention showed significant improvement on the Barriers Questionnaire-Taiwan form, medication adherence, pain intensity, and pain interference. The results of this study support the effectiveness of the pain education program on overcoming the barriers to cancer pain management for Taiwanese home care patients with cancer.
While most nurses recognize the educational needs of their patients, time has become a major deterrent to optimal teaching. This is especially true in critical care, where patients are being transferred earlier or directly discharged. Written information which is available to the patient at home can help to bridge this gap. Because "ready made" materials are limited and often costly, this article will discuss the steps of creating printed materials tailored to your patients' needs.
In an effort to comply with the Patient Self-Determination Act hospitals have scurried to develop patient education emphasizing patients' rights to accept or refuse medical treatments and to complete Advance Directives available in their state. Despite efforts at patient and family education, nurses report family difficulty in making end-of-life decisions because they have not fully clarified their values with regard to life-sustaining treatments, making decisions in crisis situations difficult. A brochure that discusses life-sustaining treatments along with Advance Directives is needed to help families understand this information before they reach a critical situation where anxiety makes decision-making difficult. The critical care nurse, clinical nurse specialist, or manager can initiate a multidisciplinary task force to coordinate the development of a brochure used to increase community awareness. The purpose of this article is to help staff develop a brochure that can address these issues.
This article describes a study that found much of the written patient information materials used during home visits may be too difficult for patients and caregivers to read and comprehend. A discussion of literacy and suggestions for selecting, developing, and analyzing health education and information materials that are easy-to-read and culturally appropriate are provided.
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In the current health care system, written patient education tools are important. Well-written and easy-to-understand materials are essential to assist the patient in recovery and increasing compliance. The purpose of patient education is to provide the patient with the knowledge needed for self-care. This article discusses strategies to design effective written patient education material.
OBJECTIVE: Motor vehicle collisions are a leading cause of death and disability in pregnant women. The purpose of this study was to examine current restraint practices by pregnant women. Additionally, the beliefs and knowledge of pregnant women about restraint laws and effectiveness were studied. METHODS: From May of 1997 to January of 1998, women were surveyed at initial prenatal visit at four obstetrical clinics. Data collected included age, gravida, ethnicity, educational level attained, payor source, restraint use, and knowledge of effectiveness of restraint use. RESULTS: A total of 807 women completed surveys. Most always wore restraints before pregnancy, but increased restraint use during pregnancy (79% vs. 86%, chi2, p = 0.02). Only 52% used restraints properly. Significantly fewer women believed restraints were beneficial to mother and fetus in late pregnancy compared with early pregnancy. Only 21% of women were educated on proper restraint use during pregnancy. Comparison by payor mix showed no difference in use or education received. CONCLUSIONS: Most women use restraints and continue to do so during pregnancy, but they use them improperly. Pregnant women are familiar with mandatory restraint laws but are less informed about restraint use in pregnancy. Few women receive education from health care providers about proper restraint use. This study highlights the need for aggressive educational efforts to improve car restraint use in pregnant women, thereby reduce maternal and fetal injury and death.
BACKGROUND: Patient Decision Support (PDS) tools assist patients in using medical evidence to make choices consistent that are with their values and in using evidence about consequences of medical alternatives. OBJECTIVE: To evaluate a PDS intervention for perimenopausal hormone replacement therapy. We assessed the impact of the PDS on (1) consistency between the decision to take estrogen replacement therapy (ERT) or progesterone/estrogen replacement therapy (PERT) and the expected utility of treatment and (2) likelihood to take ERT and PERT pre- and postintervention. DESIGN: Content of the PDS was standardized. Randomized trial of three intensities of intervention: (1) brochure; (2) lecture/discussion; and (3) active decision support. SUBJECTS: Participants were perimenopausal community volunteers between the ages of 40 and 65 (n = 248). MEASURES: (1) Consistent with values (correlation between expected utility (EU) and likelihood of taking hormones); and (2) Likelihood to take hormone replacement therapy. RESULTS: (1) The brochure group was less consistent with the decision analytic model than the lecture/discussion and active decision support groups. (2) Influence on decisions: PDS tools increased the number of women certain about whether or not to take hormones. There were no differences among experimental groups. Of 99 women uncertain about ERT pre-PDS, 65% changed. Twenty-one (32%) decided against ERT and 44 (68%) decided for ERT. (3) More intensive interventions produced modest gains in a normative direction. CONCLUSIONS: PDSs using any of 3 formats reduce uncertainty and assist women to make informed decisions. Increased consistency with decision analytic models appears to be driven by better estimates of likelihood of outcomes.
BACKGROUND: Back surgery rates are rapidly rising in the United States. This surgery is usually elective, so patient preferences are important in the treatment decision. OBJECTIVES: The objective of this study was to determine the impact on outcomes and surgical choices of an interactive, diagnosis-specific videodisk program for informing patients about treatment choices. RESEARCH DESIGN: This was a randomized, controlled trial at 2 sites comparing the interactive video plus a booklet with the booklet alone. SUBJECTS: Elective surgery candidates (n = 393) included 171 patients with herniated disks, 110 with spinal stenosis, and 112 with other diagnoses. MEASURES: Mailed questionnaires were used to assess outcomes and satisfaction; surgery rates were determined by questionnaires and automated records. RESULTS: Symptom and functional outcomes at 3 months and 1 year were similar between study groups. The overall surgery rate was 22% lower in the videodisk group (26% versus 33%, P = 0.08). Among patients with herniated disks, those in the video group underwent significantly less surgery (32% versus 47%, P = 0.05 by Kaplan-Meier test). Among patients with spinal stenosis, surgery rates in the video group were higher (39% for the video group, 29% for the booklet group; P = 0.4). There was little effect on patient satisfaction, but patients in the video group felt better informed. CONCLUSIONS: The program appears to facilitate decision making and may help to ensure informed consent. For patients with herniated disks, it reduced the surgery rate without diminishing patient outcomes. Its impact on costs of care depends on the proportion of patients with various diagnoses and on local surgery rates.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
BACKGROUND: Smoking cessation of patients with cancer can improve treatment efficacy and survival. OBJECTIVE: To determine whether a motivational interviewing intervention increased successful smoking cessation attempts of patients with cancer attending a South Australian public hospital, as compared with usual care. METHODS: A randomized controlled trial was used to study 137 patients with mixed cancer sites, including 74 intervention patients and 63 control patients. The motivational interviewing intervention was delivered over a 3-month period. The intervention included a visit with a smoking cessation counselor, provision of smoking cessation booklets, nicotine replacement therapy, family advice to quit, and an in-person or telephone follow-up conversation. RESULTS: At the 6-month follow-up visit, an intention-to-treat analysis found no difference in biochemically confirmed 3-month prevalence quit rates between the intervention (5%) and control (6%) groups. A sensitivity analysis using more lenient criteria indicated quit rates of 29% for the intervention group and 18% for the control group (p = .32). The predictors of smoking cessation at 6 months for all the patients included a smoking-related cancer site, more cessation attempts in the year before enrollment in the study, and no radiation therapy. CONCLUSIONS: Future efforts to improve smoking cessation in this patient group might focus on the delivery of more direct methods for encouraging spouse cessation and support to the patient in quitting, and the use of bupropion (Zyban) as an adjunct to cessation for this heavy smoking patient group.
The Institute of Medicine report Responsible Research: A Systems Approach to Protecting Research Participants noted that research participants require educational materials and ongoing interactions with investigators and healthcare professionals to have sufficient information to make a choice and be empowered to ask questions regarding their research participation. One of the ethical principles outlined in the Belmont Report, Respect for Persons, provided the framework for developing a brochure for research participants specific to the Department of Veterans Affairs (VA). The intent was to provide veterans and their families information about research in the VA and a list of basic questions to guide them through the complex decision making about their rights as research participants.
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