Browsing by Subject "Patient education"
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Item Communicating Critical Information to Cancer Survivors: an Assessment of Survivorship Care Plans in Use in Diverse Healthcare Settings(Springer, 2021) Lyson, Helena C.; Haggstrom, David; Bentz, Michael; Obeng-Gyasi, Samilia; Dixit, Niharika; Sarkar, Urmimala; Medicine, School of MedicinePurpose: Survivorship care plans (SCPs) serve to communicate critical information needed for cancer survivors’ long-term follow-up care. The extent to which SCPs are tailored to meet the specific needs of underserved patient populations is understudied. To fill this gap, this study aimed to assess the content and communication appropriateness of SCPs collected from diverse health care settings. Methods: We analyzed collected SCPs (n=16) for concordance with Institute of Medicine (IOM) recommendations for SCP content and for communication appropriateness using the Suitability Assessment of Materials (SAM) instrument. Results: All plans failed to incorporate all IOM criteria, with the majority of plans (n=11) incorporating less than 60% of recommended content. The average reading grade level of all the plans was 14, and only one plan received a superior rating for cultural appropriateness. Conclusion: There is significant variation in the format and content of SCPs used in diverse hospital settings and most plans are not written at an appropriate reading grade level nor tailored for underserved and/or minority patient populations. Implications for Cancer Survivors: Co-designing SCPs with diverse patient populations is crucial to ensure that these documents are meeting the needs and preferences of all cancer survivors.Item Decision-making for prenatal genetic screening: how will pregnant women navigate a growing number of aneuploidy and carrier screening options?(Springer Nature, 2021-12-04) Farrell, Ruth M.; Pierce, Madelyn; Collart, Christina; Yao, Meng; Coleridge, Marissa; Chien, Edward K.; Rose, Susannah S.; Lintel, Mary; Perni, Uma; Tucker Edmonds, Brownsyne; Obstetrics and Gynecology, School of MedicineBackground: Prenatal genetic screens, including carrier screening (CS) and aneuploidy screening (AS), comprise an important component of reproductive healthcare delivery. Clinical practice guidelines emphasize the importance of informed decision-making and patient's preferences regarding the use of these screens. Yet, it is unclear how to achieve this ideal as prenatal genetic screening options rapidly become more complex and increasingly available to patients. With increased complexity and availability of reproductive testing options, decision-support strategies are critical to prepare patients to consider AS and/or CS. Methods: A self-administered survey evaluated knowledge and decision-making preferences for expanded carrier (CS) and aneuploidy (AS) prenatal screening. The survey was administered to participants before their first prenatal visit to assess baseline decision-making needs and preference at the initiation of prenatal care. Analysis was approached as a descriptive process. Results: Participants had similar familiarity with the concepts associated with AS compared to CS; mean knowledge scores for CS was 0.59 [possible range 0.00 to 1.00] and 0.55 for AS. Participants reported preferences to learn about a range of conditions, including those with severe or mild impact, childhood-onset, and adult-onset. Decision-making preference with respect to learning about the associated disease phenotypes for the contained on AS and CS panel shifted with the complexity of the panel, with a greater preference to learn about conditions post-test compared pre-test education as panels increased from 5 to 100 conditions. Conclusion: Patients' baseline knowledge of prenatal genetic screens coupled with evolving decision-making preferences presents challenges for the delivery of prenatal genetic screens. This calls for the development and implementation of innovative approaches to support pregnant patients' decision-making commensurate with advances in prenatal genomics.Item An Evaluation of the Effectiveness of a Prearteriogram Teaching Program: An Exploratory Study(1977-12) Johnson, Claudia DilleAn exploratory study was conducted in order to identify what information patients have and/or want to have about an arteriogram prior to the procedure being performed, and to evaluate the effectiveness of a prearteriogram teaching program in providing this information. The final sample consisted of nine adult patients who were hospitalized and scheduled for arteriography (except for cerebral arteriograms). Data were collected over a two-and-a-half month period utilizing a prearteriogram and a postarteriogram questionnaire. Subjects were contacted prior to the arteriogram and asked to complete part of the prearteriogram questionnaire. The Singer Caramate (Model SP-2) was then used to present the prearteriogram teaching program (a cassette tape recording with accompanying slides) to the subjects. The program. provided the subjects with information about the arteriogram, including preparation for the procedure, how the procedure was performed, and postprocedural care. The subjects then completed the remainder of the prearteriogram questionnaire. Within 48 hours of the completion of the arteriogram the subjects were again contacted and asked to complete the postarteriogram questionnaire. Results of this study indicated that these subjects had very little, if any, information about the arteriogram prior to the procedure being performed, but that they did desire information about the preparation for the test, the procedure itself, and postprocedural care. Most of the subjects in the study indicated that they acquired information about the arteriogram from the prearteriogram teaching program, and that this program was helpful to them in preparing them for the arteriogram. The majority of the subjects also recommended that future patients scheduled for arteriograms be given this informati.on by presenting the program to them prior to the procedure. Thus, the investigator postulated that the presentation of information in an audio-visual program prior to an arteriogram is an effective means of providing information about the procedure to patients.Item Group education program for hypertension control(Wiley, 2020-11) Meredith, Ashley H.; Schmelz, Andrew N.; Dawkins, Emily; Carter, Amy; Medicine, School of MedicineHypertension continues to be a health crisis, with multiple approaches attempting to define best practices for management. The objective of our hypertension group education program is to improve patient health outcomes through engaging a multidisciplinary health professional team. A 6-hour group curriculum was created with a focus on nutrition, lifestyle, and medication approaches to hypertension management, while incorporating personally identified behavior change goals and barriers. Outcomes were tracked pre-program, at program completion, and 6 and 12 months post-program completion. Program participants demonstrated immediate and sustained improvements in blood pressure readings and attainment of personal behavior change goals. Group hypertension education classes are an effective way to care for patients. Additional healthcare resources should be dedicated to creating and evaluating educational delivery models that are sustainable and provide results over time, including financial implications to the health system.Item The health-related uses and gratifications of YouTube: Motive, cognitive involvement, online activity, and sense of empowerment(2015-07) Park, Daniel Youngjoon; Goering, Elizabeth M.; White-Mills, Kim D.; Brann, MariaThe purpose of this study was to examine the relationships among motives for health-related YouTube use, cognitive involvement with health information on YouTube, post-exposure online activity, and sense of empowerment regarding health and health care. As a result of the analysis of data from 263 participants, social utility, convenient information-seeking, habit-passing time, and exciting entertainment motives were identified as four motives for health-related YouTube use. Social utility and convenient information-seeking motives were positively related to cognitive involvement and cognitive involvement was positively related to perceived control. Social utility motive was negatively related to perceived competence, whereas convenient information-seeking motive was positively related to perceived competence. Habit-passing time motive was negatively related to goal internalization, whereas convenient information-seeking and exciting entertainment motives were positively related to goal internalization. The findings from this study imply that YouTube could be a useful health communication media for health professionals and organizations to use for empowering users in coping with health-related concerns.Item Improving Patient-Centered Communication about Sudden Unexpected Death in Epilepsy through Computerized Clinical Decision Support(Thieme, 2021) Grout, Randall W.; Buchhalter, Jeffrey; Patel, Anup D.; Brin, Amy; Clark, Ann A.; Holmay, Mary; Story, Tyler J.; Downs, Stephen M.; Pediatrics, School of MedicineBackground: Sudden unexpected death in epilepsy (SUDEP) is a rare but fatal risk that patients, parents, and professional societies clearly recommend discussing with patients and families. However, this conversation does not routinely happen. Objectives: This pilot study aimed to demonstrate whether computerized decision support could increase patient communication about SUDEP. Methods: A prospective before-and-after study of the effect of computerized decision support on delivery of SUDEP counseling. The intervention was a screening, alerting, education, and follow-up SUDEP module for an existing computerized decision support system (the Child Health Improvement through Computer Automation [CHICA]) in five urban pediatric primary care clinics. Families of children with epilepsy were contacted by telephone before and after implementation to assess if the clinician discussed SUDEP at their respective encounters. Results: The CHICA-SUDEP module screened 7,154 children age 0 to 21 years for seizures over 7 months; 108 (1.5%) reported epilepsy. We interviewed 101 families after primary care encounters (75 before and 26 after implementation) over 9 months. After starting CHICA-SUDEP, the number of caregivers who reported discussing SUDEP with their child's clinician more than doubled from 21% (16/75) to 46% (12/26; p = 0.03), and when the parent recalled who brought up the topic, 80% of the time it was the clinician. The differences between timing and sampling methodologies of before and after intervention cohorts could have led to potential sampling and recall bias. Conclusion: Clinician-family discussions about SUDEP significantly increased in pediatric primary care clinics after introducing a systematic, computerized screening and decision support module. These tools demonstrate potential for increasing patient-centered education about SUDEP, as well as incorporating other guideline-recommended algorithms into primary and subspecialty cares.Item Increasing Readiness for Early Integrated Palliative Oncology Care: Development and Initial Evaluation of the EMPOWER 2 Intervention(Elsevier, 2021) Perry, Laura M.; Sartor, Oliver; Malhotra, Sonia; Alonzi, Sarah; Kim, Seowoo; Voss, Hallie M.; Rogers, James L.; Robinson, William; Harris, Kendra; Shank, Jessica; Morrison, David G.; Lewson, Ashley B.; Fuloria, Jyotsna; Miele, Lucio; Lewis, Brian; Mossman, Brenna; Hoerger, Michael; Psychology, School of ScienceContext: Early integrated palliative care improves quality of life, but palliative care programs are underutilized. Psychoeducational interventions explaining palliative care may increase patients' readiness for palliative care. Objectives: To 1) collaborate with stakeholders to develop the EMPOWER 2 intervention explaining palliative care, 2) examine acceptability, 3) evaluate feasibility and preliminary efficacy. Methods: The research was conducted at a North American cancer center and involved 21 stakeholders and 10 patient-participants. Investigators and stakeholders iteratively developed the intervention. Stakeholders rated acceptability of the final intervention. Investigators implemented a pre-post trial to examine the feasibility of recruiting 10 patients with metastatic cancer within one month and with a ≥50% consent rate. Preliminary efficacy outcomes were changes in palliative care knowledge and attitudes. Results: Using feedback from four stakeholder meetings, we developed a multimedia intervention tailored to three levels of health-literacy. The intervention provides knowledge and reassurance about the purpose and nature of palliative care, addressing cognitive and emotional barriers to utilization. Stakeholders rated the intervention and design process highly acceptable (3.78/4.00). The pilot met a priori feasibility criteria (10 patients enrolled in 14 days; 83.3% consent rate). The intervention increased palliative care knowledge by 83.1% and improved attitudes by 18.9 points on a 0 to 51 scale (Ps < 0.00001). Conclusions: This formative research outlines the development of a psychoeducational intervention about palliative care. The intervention is acceptable, feasible, and demonstrated promising pilot test results. This study will guide clinical teams in improving patients' readiness for palliative care and inform the forthcoming EMPOWER 3 randomized clinical trial.Item The Need for Patient-centered Education Among Patients Newly Diagnosed With a Pituitary Tumor(Endocrine Society, 2021-04-07) Donegan, Diane; Gowan, Tayler; Gruber, Rachel; Cottingham, Ann; Flanagan, Mindy; Erickson, Dana; Imperiale, Thomas F.; Medicine, School of MedicineObjectives: Brain tumors, including pituitary adenomas (PA), cause anxiety and distress, with a high unmet need for information correlating with increased anxiety. Condition-specific education may alleviate anxiety. We explored patients' experience around the diagnosis of a PA and piloted a patient education intervention to address peridiagnostic anxiety in adults diagnosed with PA. Methods: Anxiety, patient satisfaction, patient knowledge, and need for information were measured prior to, immediately after, and 1 month following the appointment in this multimethods study. A phone interview to explore patient diagnostic and intervention experiences was analyzed using qualitative methods. Results: A total of 17 patients participated in the study; 15 completed the interview. The baseline need for information was high. Disease-specific anxiety decreased, and patient knowledge and satisfaction increased significantly after the initial visit. Interview analysis identified 3 main themes: (1) the importance of communication; (2) the need for information; and (3) the impact of the diagnosis on patient experience. Conclusions: For patients with newly diagnosed PA, the diagnostic experience was associated with high levels of anxiety. Patients expressed a need for information. Information delivery reduced anxiety and had a positive impact on patient satisfaction. Practice implications: The study findings suggest a need for a streamlined diagnostic process with readily accessible information.Item Preprocedural Anxiety in Adults With Congenital Heart Disease: The PANIC Study(Elsevier, 2023-09-01) Cook, Stephen C.; Saidi, Arwa; Singh, Harsimran S.; Madder, Ryan D.; Cohen, Scott B.; Van Oosterhout, Stacie; Samuel, Bennet P.; Finn, Michael T. M.; Medicine, School of MedicineBackground: Preprocedural anxiety may have detrimental effects both cognitively and physiologically. Objectives: The objective of this study was to determine the association between state (situational) and trait (persistent in everyday life) anxiety and differences between the adult congenital heart disease (ACHD) and acquired heart disease populations. Methods: The State-Trait Anxiety Inventory and financial stress scale were administered to adults with acquired and CHD at 4 tertiary referral centers in the United States prior to cardiac catheterization. Student's t-test and least absolute shrinkage and selection operator regression analyses were used to assess differences in anxiety between groups and identify the optimal model of predictors of anxiety. Results: Of the 291 patients enrolled, those with CHD (n = 91) were younger (age 41.3 ± 16.3 years vs 64.7 ± 11.3 years, P < 0.001), underwent more cardiac surgeries (P < 0.001), and had higher levels of trait anxiety (t[171] = 2.62, P = 0.001, d = 0.33). There was no difference in state anxiety between groups (t[158.65] = 1.37, P = 0.17, d = 0.18). State anxiety was singularly associated with trait anxiety. Trait anxiety was negatively associated with age and positively associated with state anxiety and financial stress. Patients with CHD of great complexity were more trait (F[2,88] = 4.21, P = 0.02) and state anxious (F[2,87] = 4.59, P = 0.01), though with relatively small effect size. Conclusions: Trait anxiety levels are higher in the ACHD population and directly associated with state anxiety. Specialists caring for ACHD patients should not only recognize the frequency of trait anxiety but also high-risk subgroups that may benefit from psychological or social interventions to reduce preprocedural anxiety.