Nurses play a central role in preparing patients for discharge. Diabetes affects one-third of all hospitalized patients, with readmission rates 20% higher for patients with diabetes. Low health literacy affects patients' ability to understand education provided during a hospitalization, especially in diabetic patients who are required to perform complex self-care activities. The rehabilitation nurses within the practicum site struggled to provide adequate diabetes education, leading to patients' readmissions and frequent calls to the nursing unit post discharge. The purpose of this project was to educate nurses on an inpatient unit about survival skills and teach-back approaches to improve inpatient diabetes education. Orem's self-care nursing deficit theory guided the project. Nursing literature provided current evidence-based practice guidelines on diabetes education for the staff education program. An expert panel was used to evaluate the effectiveness of the project in improving rehabilitation nurses' knowledge, skills, and ability to administer patient education to diabetic patients using the teach-back method. All 6 expert panel members agreed that the in-service content was relevant to the environment and would improve the nurses' ability to deliver diabetic education on the rehabilitation unit using the teach-back method. Current knowledge of diabetes education practices and strategies to overcome low health literacy can bring positive social change and improve nursing practice by advancing the nurses' ability to provide inpatient diabetes education.

The induction of labor is medically indicated for many conditions in which delivering the baby outweighs the risk of continuing the pregnancy. Patients admitted for the induction of labor require adequate information to actively participate in decision making that affects their plan of care. The purpose of this quality improvement project was to improve the quality of healthcare delivery and promote patient engagement by providing consistent education using a teaching tool. The project question addressed the impact of a labor-induction teaching tool on improving patient education, participation, and overall satisfaction. The Plan-Do-Study-Act (PDSA) model was used to plan, implement, and evaluate the labor-induction teaching tool in a 9-room labor and delivery unit that averages approximately 1,500 births per year. The teaching tool content was obtained from existing patient education information from the organization's resource library. The nurses piloted the teaching tool for all patients admitted for the induction of labor for 3 weeks. Patient comments supported the use of the teaching tool to improve knowledge, increase participation in decision making, and enhance overall satisfaction. The nurses voluntarily completed an online survey that indicated the teaching tool was easy to use, positively impacted workflow, and supported informed choice. Patient charts were audited and showed a 94% compliance with documentation of education. The success of the teaching tool in improving patient education and decision-making capacity supports the development of other teaching tools, encourages patient and family-centered care, and improves the delivery of quality care.

Background and aims: Despite living with a gluten-free diet (GFD) Swedish women with coeliac disease (CD) report a lower level of well-being than women without the disease and than men with the disease. The aims of this thesis were to describe the life experience of being a woman living with CD (I) and to assess the effects of patient education (PE) with problem based learning (PBL) on psychological well-being (II) and gastrointestinal symptoms (III). Subjects and methods: In total 106 women, > 20 years, with confirmed CD, who had been treated with a GFD for a minimum of five years were randomized (II&III) to one of two groups: either to the intervention group (n=54) that underwent a ten-session educational program, called ‘Coeliac School’, with PBL, or to a control group (n=52) that received information regarding CD, which was sent to their home on a regular basis. Assessments: Well-being (II & III) (the Psychological General Well-Being index and the Gastrointestinal Symptom Rating Scale) was assessed at baseline and after 10 weeks in all patients and after 6 months in the intervention group. Individual interviews (I) were carried out with purposefully selected women (n=15) before the start of the‘Coeliac School’. Result: The qualitative study showed that CD can influence women’s lives in different ways. A desire for a normalised life-world was described. Three conditions necessary to achieve a normalised life-world were described as: being secure, being in control and being seen and included. After ten weeks of education, participants in the “Coeliac school” reported a significant improvement in psychological well-being (p=0.001) and gastrointestinal symptoms (p=0.013). The controls did not improve significantly. However, at baseline the controls, for reasons which were not apparent, and despite randomization, expressed significantly better psychological well-being and fewer gastrointestinal symptoms than women in the intervention group. Six months after completion of the PE program some of its positive effect had decreased. Conclusions: A PE with PBL can help women with CD to benefit from a greater degree of well-being. It is important to offer PE to those women who fail to achieve a normalised lifeworld. However, intervention methods need to be refined in order to provide a more pronounced long-term effect.

While medical technology, intervention, and treatment continue to advance, patients often find themselves involved in an increasingly complex healthcare system . Because of this, many patients lack access to the knowledge to facilitate successful navigation or participation in healthcare systems to their best advantage. Patient Ill education that provides experiential information has been shown to reduce anxiety levels and increase patient health outcomes and compliance with medical instructions or recommendations. Given the demonstrated effectiveness of experiential instruction in patient education, Model-Centered Instruction (MCI) has the potential to be an effective instructional design for patient education because it affords the learner experience with systems or models in the presence of instructional augmentation. While MCI design theory is well-documented, it has not been widely implemented and tested at the instructional product level.

Problématique : En tant que pratique pluridisciplinaire et interprofessionnelle, l'éducation thérapeutique du patient (ETP) invite à l'intervention d'acteurs divers, professionnels de santé et non soignants. L'implication des patients dans l'animation des séances d'ETP est devenue une réalité qui recouvre du fait social. Objectif : Cette recherche qualitative vise à caractériser l'intervention du patient éducateur (PE) dans les séances d'ETP. Méthode : empruntant à la théorie ancrée, nous avons réalisé une étude sur des situations convoquant 10 pathologies (hémophilie, VIH/sida, insuffisance rénale, Mici, diabète, polyarthrite rhumatoïde, insomnie chronique, aphasie, mucoviscidose et BPCO) par analyse de documents, observations non participantes et entretiens semi‐directifs. La validation des résultats selon un principe de saturation théorique nous a permis de proposer une théorisation de la figure du patient éducateur. Résultats : le PE se caractérise à travers dix catégories regroupées en trois familles : éléments constitutifs de son intervention (profil, motivation, recrutement, rapport à l’éthique), éléments structurants (compétences,collaboration) et éléments consécutifs (modalités et finalité de l’intervention, apport spécifiques, devenir). Discussion : le PE est porteur de « compétences de l’éprouvé » issus d’un travail réflexif sur ses savoirs expérientiels. Son intervention est complémentaire de celles des autres acteurs de l’ETP, questionne une collaboration interprofessionnelle et s’envisage sous l’angle de la complexité et d’éco‐système. Conclusion : l’intervention des PE constitue une expression de la démocratie en santé. Son opérationnalisation qui reste à développer plaide en faveur du passage vers une mobilisation de démopraxie en santé. / Background : As a pluridisciplanary and interprofessionnal practice, the therapeutic patient education (TPE) requires various actor's, intervention, health professionnals and non health professionals....

The aim of this study was to document and explore the perceived role of nurses and their attitudes and beliefs when providing health promotion strategies and health education for hospitalised people who have diabetes mellitus (diabetes). As part of the exploratory, descriptive study key steps undertaken included : 1/. Determining the strategies the nurses currently use to provide health promotion and health education to patients; 2/. Documenting of the role nurses play in referring people to diabetes educators; 3/. and 3/. Determining the extent to which nurses feel able to fulfil the roles of health promotion and health education. The study reported in this thesis was conducted in Western Sydney within a socially, culturally and economically diverse population. Study participants were nurses working in medical or surgical wards. The study reveals that nurses require support from all levels of the healthcare system. Additionally, all levels of the healthcare system need to work together to investigate, implement and evaluate new models of care that are responsive to the dynamic state of the contemporary health care systems. / Master of Nursing (Hons)

Globally the diabetes epidemic is a major health challenge. Associated with the diagnosis of diabetes is the morbidity and premature mortality stemming from the complications of the disease. It was identified that approximately 50% of clients who attended a diabetes centre in an outer western metropolitan region of Sydney were not completing diabetes education. A strategy employed to overcome this was the introduction of a 2 ½ hour group diabetes education program called the Ongoing Education System (OES), for persons with Type 2 diabetes, that enabled completion of education at this one session. However, debate occurred among health professionals at the Wentworth Diabetes Service (WDS) as to the effectiveness of the OES as compared to the traditional individual education sessions. (one-on-one education). The purpose of this study was to compare the outcomes of two modes of diabetes education for completing education for clients with Type 2 diabetes , namely individual education (Treatment A) and the OES group education (Treatment B). The findings overall revealed no difference in the outcomes of participants who received individual education and those who received the OES at completion of education as well as at 6 and 12 month post education. A secondary finding of this study was the significant influence gender and age exerted on the outcomes of the education programs. One significant implication from the findings for both the person diagnosed with Type 2 diabetes and the health care organisation is that the OES provides a cost effective alternative to individual education that encourages clients to complete diabetes education thereby enabling the person to achieve an optimal quality of life. In addition this study provides research evidence for the benefit of current practice in diabetes education. / Doctor of Philosophy (PhD)

This thesis explores the issue of men's access to chronic illness self management programs from a social constructionist perspective. A combination of research methodologies was used; a quantitative analysis to confirm gender differences in levels and patterns of service use; a qualitative analysis to gain an increased understanding of the factors affecting men's access; and a trial to test the application of the research findings. The clients and services of Arthritis Victoria were chosen as the setting for this research. The quantitative analyses were conducted on contingency tables and odds ratios and confirmed that men were under-represented as service users. The analyses also identified gender differences in patterns of service use. The qualitative analysis was based on a series of in-depth, semi-structured interviews. It was undertaken from a grounded theory approach to allow for the development of theoretical explanations grounded in the data. It was found that men's decisions to access chronic illness self management programs were strongly influenced by dominant social constructions of masculinity which constrained help-seeking and health management behaviour. However, the restrictive influence of hegemonic masculinity was progressively undermined by the increasing severity of the chronic condition until a crisis point was reached in terms of the severity of the condition or its impact on lifestyle. This resulted in a reformulation or rejection of hegemonic masculinity. The described conceptual framework was consistent for men from diverse social groupings, although it appeared less prominent in both younger and older men, suggesting that dominant social constructions of masculinity have the greatest influence on health decisions during the middle stage of adulthood when work and family obligations are greatest. The thesis findings informed the development of some guiding principles for reviewing the structure and delivery of chronic illness self management services for men. The guiding principles will have direct application in the planning of Arthritis Victoria programs, and implications for other chronic illness self management programs in Australia, and also in Western countries with a similar health and sociocultural setting to Australia.

"May 2002" / Includes bibliographical references (leaves 267-289) / xvii, 290, [69] leaves : ill., plates ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Depts. of Public Health and General Practice, 2002

<p>Patienter upplever ofta att den information de får är felaktig. Felaktig på så sätt att det är för lite, för mycket, ingen alls, given vid fel tidpunkt, för komplicerad och given på ett fackspråk med många krångliga ord som patienten inte förstår. Syftet med den här litteraturstudien var att belysa vilket informationsbehov patienter med cancer kan ha. Studien baserades på 20 vetenskapliga artiklar och resultatet visar att de flesta patienter med cancer vill ha all tillgänglig information om såväl diagnos som behandling och även veta vilka valmöjligheter som finns. Det finns dock vissa som endast vill ha begränsad information varför det är viktigt att utvärdera varje patients informationsbehov. Välinformerade patienter upplever minskad oro och ångest och får en känsla av att ha kontroll över sin komplexa situation. Därför är det viktigt för sjuksköterskan att ha kunskap om behovet av information och de betydelsefulla faktorer som kan förändra och tillfredställa detta behov hos patienter. Genom att ge patientundervisning större utrymme i sjuksköterskeutbildningen, och göra sjuksköterskor mer uppmärksamma på ny forskning kan patienters situation underlättas ytterligare i framtiden.</p> / <p>Patients often<strong> </strong>experience that the information they are given is wrong. Wrong in the consideration of too little, to much, none at all, given at the wrong time, too complicated or in a difficult technical language that they do not understand. The purpose of this study was to illuminate what information needs patients with cancer may have. The study was based on 20 scientific articles and shows that most patients with cancer want to have all available information regarding both diagnosis and treatment including the available choices. However, there are some who only want limited information; therefore it is important to evaluate each patient's information needs. Well-informed patients experience less anxiety and distress and get a sense of control over their complex situation. It is therefore important for the nurse to have knowledge of the need for information and the important factors that can alter and satisfy the needs of patients. By providing patient education more space in the education of nurses, and make nurses more aware of new research, the patients' situation can in the future be further improved.</p>