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Public perceptions of an appropriate donor card/brochure.

Donor card/brochures have not had a major impact on donation, though considerable resources have been invested in their development and distribution. One reason for this may be that they have not been evaluated by the people expected to sign them: the American public. A focus group format was used to develop a quantitative survey to assess the public's perception of an appropriate donor card/brochure. Several donor card/brochures were studied to compare and evaluate their effectiveness, content, format, and acceptance of the message. A donor card/brochure was designed that was based on the results of the survey: it included a business reply card for further evaluation. The newly developed donor card/brochure continues to be viewed positively by those returning business reply cards. Most have signed the card and discussed donation with family members.

Attitude to Health↗

Self-care guidelines: finding a common ground.

Pressure to reduce overall transplant costs is one of the factors which has led to earlier hospital discharge and increased patient management challenges in outpatient and home care settings. Earlier discharge often contributes to decreased opportunity to provide and ensure comprehension of critical patient and family education, resulting in challenges for home care clinicians who are committed not only to patient and environmental assessments, but to helping assure patient and family understanding of and compliance with critical posttransplant responsibilities and regimens. This article describes a transplant patient education tool that was developed for use with all types of solid organ transplant recipients discharged from multiple centers yet managed by a single home care organization. The tool provides patient education information that can be realistically reviewed and reinforced during the home visit. The resource focuses on key self-care issues to promote wellness and graft survival and help prevent adverse outcomes.

Home Care Services↗

Videotape-based decision aid for colon cancer screening. A randomized, controlled trial.

BACKGROUND: Rates of colon cancer screening in the United States are low, in part because of poor communication between patients and providers about the availability of effective screening options. OBJECTIVE: To test whether a decision aid consisting of an educational video, targeted brochure, and chart marker increased performance of colon cancer screening in primary care practices. DESIGN: Randomized, controlled trial. SETTING: Three community primary care practices in central North Carolina. PATIENTS: 1657 consecutive adult patients 50 to 75 years of age were contacted. Of these, 651 (39%) agreed to participate; 249 of the 651 participants (38%) were eligible. Eligible patients had no personal or family history of colon cancer and had not had fecal occult blood testing in the past year or flexible sigmoidoscopy, colonoscopy, or barium enema in the past 5 years. INTERVENTION: The 249 participants were randomly assigned to view an 11-minute video about colon cancer screening (intervention group) or a video about automobile safety (control group). After viewing the video, intervention group participants chose a color-coded educational brochure (based on stages of change) to indicate their degree of interest in screening. A chart marker of the same color was attached to their charts. Controls received a generic brochure on automobile safety, and no chart marker was attached. MEASUREMENTS: Frequency of screening test ordering as reported by participants and frequency of completion of screening tests as verified by chart review. RESULTS: Fecal occult blood testing or flexible sigmoidoscopy was ordered for 47.2% of intervention participants and 26.4% of controls (difference, 20.8 percentage points [95% CI, 8.6 to 32.9 percentage points]). Screening tests were completed by 36.8% of the intervention group and 22.6% of the control group (difference, 14.2 percentage points [CI, 3.0 to 25.4 percentage points]). CONCLUSION: A decision aid consisting of an educational video, brochure, and chart marker increased ordering and performance of colon cancer screening tests.

Aged↗

Patient education materials about the treatment of early-stage prostate cancer: a critical review.

BACKGROUND: To ensure that patients make informed medical decisions, patient education materials must communicate treatment risks and benefits. OBJECTIVE: To survey publicly available patient education materials and assess their suitability to support informed decision making in early-stage prostate cancer. DESIGN: Cross-sectional review of Internet, print, and multimedia sources. SETTING: University data analysis laboratory. MEASUREMENTS: The content of 44 materials that described all standard treatment options was reviewed. Top-rated documents underwent plain-language review. Total score on 54 content items and accuracy, balance, and plain-language evaluation was measured. RESULTS: 502 of 546 patient education materials did not describe all standard treatments (watchful waiting, surgery, radiation, and hormone therapy). Eighty percent of the 44 materials that addressed standard treatments and underwent content review described anatomy, physiology, stage, and grade of cancer. Half of the materials fully described radical prostatectomy and radiation therapy. One third of the materials included risks and benefits of each treatment; none explicitly compared outcomes of all treatments in a single summary. Information was accurate and balanced but did not include key content for informed consent. LIMITATIONS: The search was restricted to publicly available materials and did not include books or materials written in languages other than English. The accuracy, balance, and plain-language reviews were evaluated by 1 reviewer. The criteria reflect the authors' focus on informed decision making. Other aspects of health education may require a different evaluation template. CONCLUSIONS: Currently available patient education materials on early-stage prostate cancer treatment do not contain comprehensive information about the risks and benefits of each treatment. To assist patients and physicians in choosing among prostate cancer treatment options, a new generation of materials is needed.

CD-ROM↗

Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial.

BACKGROUND: Chronic low back pain is a common problem that has only modestly effective treatment options. OBJECTIVE: To determine whether yoga is more effective than conventional therapeutic exercise or a self-care book for patients with chronic low back pain. DESIGN: Randomized, controlled trial. SETTING: A nonprofit, integrated health care system. PATIENTS: 101 adults with chronic low back pain. INTERVENTION: 12-week sessions of yoga or conventional therapeutic exercise classes or a self-care book. MEASUREMENTS: Primary outcomes were back-related functional status (modified 24-point Roland Disability Scale) and "bothersomeness" of pain (11-point numerical scale). The primary time point was 12 weeks. Clinically significant change was considered to be 2.5 points on the functional status scale and 1.5 points on the bothersomeness scale. Secondary outcomes were days of restricted activity, general health status, and medication use. RESULTS: After adjustment for baseline values, back-related function in the yoga group was superior to the book and exercise groups at 12 weeks (yoga vs. book: mean difference, -3.4 [95% CI, -5.1 to - 1.6] [P < 0.001]; yoga vs. exercise: mean difference, -1.8 [CI, -3.5 to - 0.1] [P = 0.034]). No significant differences in symptom bothersomeness were found between any 2 groups at 12 weeks; at 26 weeks, the yoga group was superior to the book group with respect to this measure (mean difference, -2.2 [CI, -3.2 to - 1.2]; P < 0.001). At 26 weeks, back-related function in the yoga group was superior to the book group (mean difference, -3.6 [CI, -5.4 to - 1.8]; P < 0.001). LIMITATIONS: Participants in this study were followed for only 26 weeks after randomization. Only 1 instructor delivered each intervention. CONCLUSIONS: Yoga was more effective than a self-care book for improving function and reducing chronic low back pain, and the benefits persisted for at least several months.

Adult↗

Effect of a mailed brochure on appointment-keeping for screening colonoscopy: a randomized trial.

BACKGROUND: Even when primary care physicians have face-to-face discussions with patients before referring them for screening colonoscopy, patient nonadherence can be substantial. Often, primary care physicians lack sufficient time to educate patients and address their potential misconceptions and fears about this procedure. OBJECTIVE: To test whether an informational brochure sent to patients' home addresses after referral for screening colonoscopy would increase patient completion of the procedure. DESIGN: Randomized, controlled trial. SETTING: 2 general internal medicine practices affiliated with the University of Colorado Health Sciences Center. PATIENTS: 781 consecutive patients 50 years of age or older referred by their primary care physicians for screening colonoscopy. INTERVENTION: Patients were randomly assigned to receive usual care (control group) versus usual care plus an informational brochure (intervention group). The brochure was mailed within 10 days of referral for screening colonoscopy; it mentioned the name of the patient's primary care physician and encouraged patients to schedule a procedure. It also described colorectal cancer and polyps and the similar lifetime risks for colorectal cancer for men and women, colonoscopy and risk for perforation, the nature of bowel preparation for the procedure, and alternative screening tests. MEASUREMENTS: Rates of adherence to screening colonoscopy in the 2 study groups. RESULTS: The overall adherence rate was 11.7 percentage points (95% CI, 5.1 to 18.4 percentage points) greater in the intervention group than in the control group (70.7% vs. 59.0%). Older patients were more adherent than younger patients. Patients with low-income insurance plans, such as Medicaid, were less adherent despite being sent a brochure. LIMITATIONS: The small number of clinical practices and minority patients may limit generalizability. In addition, it was not possible to determine the degree to which adherence was influenced by a reminder to schedule a procedure versus detailed information about colonoscopy. CONCLUSIONS: An inexpensive mailed brochure is an effective way to increase patient adherence to primary care physician referral for screening colonoscopy.

Aged↗

Feet first. A commentary.

In 1989, the Board of Directors of the Professional Diabetes Academy, Pennsylvania Diabetes Academy endorsed the concept to revise Feet First, published in 1970, and gained the permission of the US Public Health Service to use the initial document as a base. With marked expansion, added color, nonreflective paper, and larger print, Feet First was published in 1991, and introduced to the podiatric profession during the Annual Meeting of the American Podiatric Medical Association in New York. The concept of need expressed by the late Glen W. McDonald, MD, and the late Seward P. Nyman, DPM, to see a melding of public health education and podiatric medicine has brought new meaning to the subject and provided an interdisciplinary approach to foot health education for the diabetic patient.

Diabetic Foot↗

Get SMART.

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Humans↗

Guidelines for producing patient information literature.

This article provides practical information on developing patient information literature. The step-by-step approach provided by the authors should be of use to nurses who are currently involved in producing such literature or who are looking at ways of effectively disseminating information to patients on specific topics.

Guidelines as Topic↗

Not so sweet charity.

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Attitude to Health↗

Patient-held oncology records.

Here, the author describes how an information booklet for oncology patients was developed. The booklet's positive reception suggests that the idea could be used in other settings.

Humans↗

Driving force.

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Accidents, Traffic↗

Research ethics.

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Ethics Committees↗