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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
411

Patientundervisningens betydelse vid en förändrad livsstil för personer med diabetes mellitus typ 2 : En litteraturöversikt / The importance of patient education in a changedlifestyle for people with type 2 diabetes mellitus : A literature review

Rosberg, Johanna, Bomberhult, Hanna January 2019 (has links)
Bakgrund: Diabetes mellitus typ 2 är en sjukdom som blir allt vanligare. Personer som diagnostiserats med sjukdomen behöver bryta gamla rutiner och tillämpa livsstilsförändringar som är anpassade för sjukdomen. För att kunna genomföra dessa livsstilsförändringar krävs kunskap om diabetes mellitus typ 2. Hälso- och sjukvårdspersonalen har ett stort ansvar att ge personerna relevant och personcentrerad patientundervisning för att livsstilsförändringar ska kunna ske.Syfte: Att beskriva vad personer med diabetes mellitus typ 2 upplever främjar och hindrar livsstilsförändringar. Metod: En litteraturöversikt med kvalitativ design och ett induktivt förhållningssätt gjordes. Resultat: Det framkom att bra bemötande och personcentrerad patientundervisning av hälso- och sjukvårdspersonal genererade god självhantering och motivation till livsstilsförändringar hos personerna med diabetes mellitus typ 2. Bristande kunskap om sjukdomen på grund av otillfredsställande patientundervisning ledde till osäkerhet om behandlingen, och oro över att göra fel hindrade personerna att utföra livsstilsförändringar. Slutsats: En personcentrerad patientundervisning är nyckeln till goda livsstilsförändringar för personer med diabetes mellitus typ 2. När personerna får individanpassad undervisning genererar det god kunskap om sjukdomen som förbättrar personernas genomförande av livsstilsförändringar. / Background: Type 2 diabetes mellitus is an increasingly common disease. People diagnosed with type 2 diabetes mellitus need to break old routines and apply lifestyle changes that are appropriate for the disease. To be able to implement these lifestyle changes, knowledge of type 2 diabetes mellitus is required. The healthcare staff have a huge responsibility to give the persons relevant and person-centred patient education, so that lifestyle changes can take place. Purpose: to describe what people with diabetes mellitus type 2 experience promote and prevent lifestyle changes.Method: A literature review with qualitative design and an inductive approach was made. Result: It emerged that a good encounter and person-centred patient education of healthcare professionals generated good self-management and motivation for lifestyle changes in the persons with type 2 diabetes mellitus. Lack of knowledge about the disease due to unsatisfactory patient education led to uncertainty about the treatment, and concerns about wrongdoing prevented people from lifestyle changes. Conclusion: A person-centred patient education is the key to good lifestyle changes for people with type 2 diabetes mellitus. When the individuals receive individualized education, it generates good knowledge of the disease that improves the self-management and performance of lifestyle changes.
412

Tecnologia educativa de cuidados para o pós-operatório da cirurgia de revascularização miocárdica: uma ferramenta para o paciente e família / Educational technology for postoperative care after CABG: a tool for patients and family.

Gentil, Luana Llagostera Sillano 18 November 2013 (has links)
Introdução: Sabe-se que pacientes e famílias beneficiam-se de orientações educativas no período de pós-operatório de revascularização miocárdica. Deste modo, desenvolver uma ferramenta de ensino para ser utilizado neste período contribui para o melhor conhecimento sobre o autocuidado no domicílio, otimiza a recuperação e diminui o estresse destes indivíduos comum nesta etapa. Existem diversas ferramentas de ensino utilizadas para a orientação do paciente/família antes da alta hospitalar, entretanto, no Brasil, a produção de materiais fundamentados com orientações fidedignas e significativas, com a participação da população alvo, de expertise na área de cardiologia e com rigor metodológico para a construção destas ferramentas, ainda representa uma lacuna na produção do conhecimento. Objetivos: O objetivo geral desta pesquisa foi elaborar uma ferramenta educativa que auxilie no autocuidado de paciente revascularizado e família após a alta hospitalar e os específicos foram sistematizar, identificar, estruturar o conteúdo da ferramenta educativa e validar a adequação da linguagem, conteúdo e ilustrações da mesma com a participação de paciente/familiares e peritos em cardiologia. Método: Trata-se de um estudo de abordagem metodológica que contou com a participação de 35 pacientes/famílias e oito peritos na primeira fase e na terceira fase oito pacientes/famílias e peritos. Estes foram representados por enfermeiros, cardiologista clínico, fisioterapeuta, nutricionista, farmacêutico clínico, psicólogo. A construção se deu em três diferentes fases: na primeira organizou-se o conteúdo da cartilha mediante a revisão da literatura, a coleta de informações entre o grupo de paciente/família e entre os peritos em cardiologia; na segunda se deu a construção da ferramenta educativa piloto baseada nos dados da fase anterior, tendo como base as informações coletadas e sistematizadas pelos princípios teóricos de Orem e organizadas pelo referencial metodológico de Pasquali; a terceira fase consistiu da apresentação da ferramenta educativa piloto aos pacientes/familiares e peritos em cardiologia para validação do conteúdo, linguagem e ilustrações com a utilização de um instrumento desenvolvido para este fim. Após conclusão desta etapa foram realizadas a construção da ferramenta educativa aperfeiçoada, a diagramação e a impressão da versão final. Resultados: Os itens que foram frequentemente identificados para inclusão na ferramenta se referem ao uso correto dos medicamentos e as alternativas para conter os gastos com estes, cuidados com a alimentação, com a dieta e com o uso de bebidas alcoólicas, realização de atividades físicas e atividades de vida diária, cuidados com a ferida operatória, identificação de intercorrências e direcionamento à serviços de saúdes, retorno à consulta médica e orientações sobre adaptação psicológica e enfrentamento das dificuldades no pós-operatório. Conclusão: A construção e validação da ferramenta educativa focada no autocuidado, poderá ser útil em pesquisas futuras para aumentar as estratégias de enfrentamento dos pacientes/famílias e otimizar o planejamento da alta pelos profissionais da saúde. / Introduction: It is well known that patients and families benefit from educational orientations while recovering from coronary artery bypass graft surgery (CABG). Therefore, developing a teaching tool to be used during this period contributes to a better understanding of self-care at home, optimizes recovery, and decreases stress, a symptom common to these individuals at this stage. There are several teaching tools used to guide the patient/ family prior to discharge. However, in Brazil, the production of materials based on reliable guidelines, with the participation of the target population and experts in cardiology, and adequate methodology still represents a gap in knowledge production. Objectives: The general objective of this research was to develop an educational tool to assist in the self-care of patients undergoing CABG and their families after discharge. Specific objetives were to systematize, identify, and structurize the content of an educational tool and validate the appropriateness of language, content and illustrations, with the participation of patients/families and experts in cardiology. Method: This is a study of methodological approach that included the participation of 35 patients/families and eight experts in the first phase, and eight patients/families and experts in the third phase. The experts were represented by nurses, clinical cardiologists, physiotherapist, dietician, clinical pharmacist, and a psychologist. The construction took place in three different phases: in the first phase the contents of the booklet were organized through a review of the literature and collection of information from the group of patients/families and among experts in cardiology; in the second phase an educational pilot tool was constructed based on data from the previous phase, with the information collected and systematized by the theoretical principles of Orem and organized by the methodological framework of Pasquali; the third phase consisted of the presentation of the pilot educational tool for patients/families and experts in cardiology for validation of content, language and graphics, using a tool developed for this purpose. This led to the construction of an improved educational tool with a revised layout, and the final version was printed. Results: The items that were frequently identified for inclusion in the tool refer to the correct use of medications and alternatives to contain spending on these, nutritional care, use of alcohol, physical activities and activities of daily living, wound care, identifying and targeting the complications of home health services, return to medical consultation, and guidance on psychological adjustment and coping difficulties postoperatively. Conclusions: The construction and validation of an educational tool focused on self-care may be useful in future research to increase the coping strategies of patients/ families and optimize discharge planning by health professionals.
413

Informed Consent in Obstetric Anesthesia: The Effect of the Amount, Timing and Modality of Information on Patient Satisfaction

Hicks, Michelle, B. 12 1900 (has links)
Using mainly quantitative methods of evaluation, as well as patient comment assessment, this study evaluated whether changing the current informed consent process for labor epidural analgesia to a longer, more informational process resulted in a more satisfied patient. Satisfaction with the labor epidural informed consent process was evaluated using a questionnaire that was mailed and also available online. Half of the patient population was given a written labor epidural risk/benefit document at their 36-week obstetric check up. All patients received the standard informed consent. Survey responses were evaluated based on three independent variables dealing with the modality, timing, amount of informed consent information and one dependent variable, whether the patient's expectations of the epidural were met, which is equated with satisfaction. Patients in this study clearly indicated that they want detailed risk/benefit information on epidural analgesia earlier in their pregnancy. A meaningfully larger percentage of patients who received the written risk/benefit document were satisfied with the epidural process as compared to those who did not receive the document.
414

Nyckeln till följsamhet : Metoder för att främja följsamheten vid läkemedelsbehandling hos patienter med cardiovaskulär sjukdom

Andersson, Linda, Nordenberg, Sara January 2013 (has links)
Patienter med cardiovaskulär sjukdom kräver i många fall en livslång medicinering där följsamheten till den medicinska behandlingen ofta brister. Följden blir ett lidande för individen med ett försämrat hälsotillstånd. Sjuksköterskans ansvarsområde innefattar att förmedla evidensbaserad kunskap till sina patienter. Syftet är därför att belysa metoder till ökad följsamhet genom sjuksköterskans pedagogiska roll i samband med läkemedels behandling vid cardiovaskulär sjukdom. Vetenskapliga artiklar är sökta via databaserna Cinahl och PubMed. Vidare är artiklarna granskade och sammanställda i resultatet. Att främja medicinsk följsamhet är en utmaning i vården. Genom undervisning blir patienten delaktig i sin vård vilket leder till att beslut kan tas som grundas på kunskap, information och rådgivning. Resultatet visar att flertalet studier framhåller att det motiverande samtalet (MI) är en effektiv metod för att öka följsamheten vid läkemedelsanvändning. Sjuksköterskan vill att den enskilda patienten har en aktiv roll i sin vård och behandling, och vill hjälpa patienten till att se sin egen kapacitet och resurser. För att uppnå ett samarbete mellan patient och sjuksköterska krävs att båda parterna är medvetna om maktförhållandet som finns sinsemellan, och låta det bli till en fördel till lärande och inte ett lärohinder. I diskussionen lyfts de olika områden som identifierats i resultatet. Områdena medicinsk följsamhet, patientundervisning, motiverande samtal och empowerment knyts samman. / Program: Sjuksköterskeutbildning
415

Education thérapeutique du patient asthmatique bilingue français-créole en Guadeloupe : Quels outils, quel impact ? / Therapeutic Patient Education of the asthmatic bilingual French-Creole patients in Guadeloupe : what tools, what impact?

Gotin, Jacques 27 February 2015 (has links)
Cette étude a pour missions essentielles de comprendre et d’expliquer comment le passage d’une langue à une autre voire le mélange des deux codes langagiers qui se côtoient au sein de la population de la Guadeloupe, département français d’outre-mer, le français et le créole, peuvent, dans le cadre des échanges médicaux éducatifs, influencer la compréhension des mécanismes de la maladie par le patient, son acceptation et sa gestion.La justification de cette étude tient du constat que la prévalence de cette maladie chronique en Guadeloupe, l’asthme bronchique, est relativement importante, que la prise en charge reste perfectible malgré les recommandations de bonnes pratiques édictées par les sociétés savantes, et que certains patients ont du mal à comprendre les termes utilisés en français par leur médecin lors de l’annonce du diagnostic, ainsi que par les éducateurs chargés de leur apporter les outils de bonne gestion de cette maladie, ce qui n’est pas sans incidents en termes de morbidité et de mortalité.L’auteur décompose sa recherche autour de cinq grands thèmes :- La description du territoire d’étude, sur le plan géographico-climatique, historico-économique, sanitaire et social, la naissance d’une ère culturelle nouvelle générant une langue partagée par plus de 95% de la population et transmise au sein des familles et dans la communauté.- La présentation de l’éducation thérapeutique, démarche considérée par la communauté scientifique comme essentielle pour améliorer la prise en charge du patient et l’autogestion de la maladie, les plans gouvernementaux successifs traitant de cette matière.- L’état des connaissances sur l’asthme bronchique en France, dans le monde et en Guadeloupe plus particulièrement.- L’impact de la langue créole dans le processus de compréhension de la maladie à travers la relation soignant-soigné, et ses conséquences chez les natifs bilingues en termes d’acquisitions des outils d’autogestion en comparaison à l’utilisation du français.- La formulation de propositions de contextualisation didactique, tant en termes de formation des professionnels de santé par la préconisation de l’utilisation de la langue créole, par l’adaptation des outils psychopédagogiques au contexte local, que d’encouragement du patient à utiliser sa langue maternelle dans l’expression de ses ressentis.La recherche montre que la langue créole, utilisée autant au cours de la consultation par le médecin traitant et par le malade que pendant les séances d’éducation thérapeutique par les éducateurs et le public, influence les indicateurs de gestion de cette maladie.En conclusion, l’auteur défend l’hypothèse selon laquelle l’utilisation de la langue créole dans les échanges médicaux éducatifs chez les adolescents asthmatiques bilingues français-créole favoriserait la compréhension des mécanismes de la maladie asthmatique, la prise de conscience de sa gravité et la nécessité de se soigner pour éviter les complications, corollaire d’une bonne qualité de vie. / In Guadeloupe, a French Overseas Territory, the population uses French and Creole linguistic codes. The main goals of this thesis are to understand and to explain how a better use of French and Creole, within the framework of educational medical exchanges, can improve the understanding of the mechanisms of the disease by the patient, its acceptance and its management.The bronchial asthma is a chronic disease, which affects an important part of the Guadeloupian population. In spite of the recommendations promulgated by the medical scholars, the care of the patients can be improved in Guadeloupe. Certain patients have difficulty understanding the terms used in French by their doctor during the announcement of the diagnosis, as well as by the educators in charge of bringing them the tools of good management of this disease what is not without incidents in terms of morbidity and mortality.The author elaborates his research around five main themes:- The thorough description of the space studied in this thesis; the geography of the land, the history of the population, the impact of the economic; the presentation of the social and health care infrastructures; and furthermore the birth of a new cultural era generating a language shared by more than 95 % of the population and passed on within families and communities.- The presentation of the therapeutic education, the approach considered by the scientific community as essential to improve the management of the patient and the self-management of the disease, the successive governmental plans dealing with this subject.- The state of the knowledge on the bronchial asthma in France, in the world and in Guadeloupe more particularly.- The impact of the Creole language in the process of understanding of the disease within the healthcare relationships and its consequences at the bilingual natives in terms of acquisitions of the tools of self-management in comparison to the use of French.- The formulation of proposals of didactic contextualization regarding the training of the healthcare professionals; the recommendation to the healthcare workers to use the Creole language; the adaptation of the psycho-pedagogical tools to the local context; the encouragement to the patients to use their native language in the expression of their feelings.- Researches show that the Creole language used during the consultation by the regular doctor, but also during the educational sessions therapeutics by the educators influence the indicators of management of this disease. In conclusion, the author defends the hypothesis according to which, the use of the Creole language in the educational medical exchanges at the bilingual asthmatic teenagers French-Creole would favor the understanding of the mechanisms of the asthmatic disease, the awareness of its gravity and the necessity of looking after oneself to avoid the complications, corollary of a good quality of life.
416

Eficácia da educação conscientizadora no controle da hipertensão arterial sistêmica.

Cesarino, Cláudia Bernardi 12 June 2006 (has links)
Made available in DSpace on 2016-01-26T12:51:50Z (GMT). No. of bitstreams: 1 claudiacesarino_tese.pdf: 741624 bytes, checksum: a99caea6b41c2eedb4b7976075598132 (MD5) Previous issue date: 2006-06-12 / Introduction: The patients compliance as well as an adequate blood pressure control are the major challenges in the treatment of hypertension. Objective: The purpose of this study was to observe the efficacy of an education program carried out by the nurse by means of a conscious pedagogical methodology in the blood pressure control, in the treatment compliance with a non-pharmacological therapy as well as in the frequency to examinations in the hypertension service. Casuistics and Method: Two groups of hypertensive individual were studied: the control group that attended the hypertension routine service; and the study group that besides the service took part in educational activities based on Paulo Freire s pedagogical methodology carried out by the nurse. Blood pressure was indirecty measured in both groups, biweekly; the control group was let off after examinations, and the study group referred to the educational activities. These were held during 12 months, in a total of 23 meetings, and at-home visits were accomplished for both groups after 24 months of the education program starting period. Total cholesterol and fractions (HDL, LDL, VLDL), triglycerides, ghycemia, sodium-potassium at the last 24-hour urine tests were collected, quarterly. Results: It was observed that the blood pressure was around normal level in the study group; the body mass index values, tryglicerides and urine-sodium were lowered. Some changes in the non-pharmacological therapy was also observed such as: a better understanding about the disease, smoking was quitted and the frequency in physical activities. There were no significant changes in both groups in relation to ethylism and other metabolic parameters. At-home visits, the study group showed adequate blood pressure control in 95.69%, where as the control group, 34.8% (p<0.05). There was a significant difference between the two groups in relation to the frequency to the examinations in the hypertension service since no patients of the study group abandoned the follow-up, whereas 21.70% of the control group did (p<0.05). Conclusion: This education program has got the study group patients aware in relation to the treatment since it was taken seriously and better results were showed such as: adequate blood pressure control; the examination compliance in the hypertension service as well as the non-pharmacological therapy. Therefore, this study is likely to contribute to further changes in hypertensive patient s education. / O maior desafio da hipertensão arterial é a adesão dos pacientes ao tratamento e o controle da pressão arterial. Objetivo: Este estudo teve o objetivo de verificar a eficácia de um programa educativo, realizado pelo enfermeiro, empregando a metodologia pedagógica conscientizadora no controle da pressão arterial, na adesão ao tratamento não farmacológico e na assiduidade nos retornos a consulta no ambulatório de hipertensão arterial. Casuística e Método: Foram estudados dois grupos de hipertensos: o grupo controle, que participou do atendimento de rotina do ambulatório e o grupo estudo, que além dos cuidados convencionais, participou das atividades educativas realizadas pelo enfermeiro seguindo a metodologia pedagógica de Paulo Freire. Foi realizada medida indireta da pressão arterial quinzenalmente de ambos os grupos, sendo o grupo controle dispensado após verificações e o grupo estudo encaminhado para as atividades educativas. Estas ocorreram em um período de 12 meses, no total de 23 encontros, sendo que após 24 meses do início do programa educativo, foram realizadas visitas domiciliares em ambos os grupos. Foram coletadas amostras de sangue para exames de colesterol total e frações (HDL, LDL, VLDL), triglicérides, glicemia, sódio e potássio na urina de 24 horas trimestralmente. Resultados: Verificou-se que no grupo estudo a pressão arterial ficou em níveis desejáveis, com queda nos valores do Índice de Massa Corpórea, triglicerídeos e sódio urinário. Demontraram-se também, neste grupo modificações no tratamento não farmacológico, tais como: maior compreensão sobre a doença, abandono do hábito de fumar e a prática de exercício físico. Não houve modificações significativas nos dois grupos com relação ao consumo de bebida alcoólica e aos demais parâmetros metabólicos. Nas visitas domiciliares verificou-se que o grupo estudo apresentou 95,6% com a pressão arterial controlada e o grupo controle 34,8% (p< 0,05). Houve diferença significante entre os dois grupos quanto a assiduidade no ambulatório de hipertensão arterial, já que não ocorreu abandono entre os pacientes do grupo estudo, enquanto 21,7% do grupo controle abandonaram o atendimento ambulatorial (p<0.05). Conclusões: Constatou-se que o programa educativo utilizado com o grupo de estudo levou o paciente a assumir com maior seriedade o tratamento, trazendo melhores resultados no que concerne aos valores pressóricos, na assiduidade às consultas ao ambulatório de hipertensão arterial e na adesão ao tratamento não farmacológico quando comparadas ao grupo controle. Deste modo, esta pesquisa tem muito a contribuir para uma prática transformadora na educação dos hipertensos.
417

Oral health knowledge and dental utilization among Hispanic adults in Iowa

Patino, Daisy 01 December 2015 (has links)
Objectives: To determine oral health literacy levels among Hispanic adults living in Iowa, and assess the relationship between oral health literacy and dental utilization. Methods: This cross-sectional study included a convenience sample of self-identifying Hispanic/Latino adults. Participants were recruited via mass email, word of mouth, and from faith-based organizations that provided church services in Spanish. Participants were recruited from urban and rural communities in Central and Eastern Iowa. Participants were asked to complete a questionnaire, in either English or Spanish, that contained questions pertaining to: oral health literacy, dental utilization, acculturation, language proficiency, demographic information, country of origin, number of years living in the United States, and preferences pertaining to the characteristics of their dental providers (e.g. importance of dentist to be able to speak Spanish). Oral health literacy was assessed using the Comprehensive Measure of Oral Health Knowledge (Macek and colleagues). Oral health knowledge levels were categorized as low (0-14) or high (15-23). Dental utilization was defined as visiting a dental provider within the past 12 months or more than 12 months ago. Bivariate analyses were conducted using the Chi-square test with oral health knowledge and dental utilization being the two main outcome variables. Multiple logistic regression models were created to identify the variables related to low oral health knowledge irregular dental utilization. Statistical significance was set as p<0.05. IRB approval was obtained prior to conducting the study. Results: Three hundred thirty-eight participants completed the questionnaire. Sixty-seven percent of participants (n=228) completed the questionnaire in Spanish. The mean oral health knowledge score was 14 (low knowledge =51% vs. high knowledge = 49%). Thirty-five percent reported visiting the dentist <12 months ago. Bivariate analyses revealed that the following respondents were more likely to have low oral health knowledge (p<0.05): being older (i.e. 55-71 years of age), male, self-reporting low health literacy, having less than a high-school education, earning ≤$25,000, not having dental insurance, having low acculturation, being born outside of the United States, preferring a dental provider who speaks Spanish, perceiving one’s oral health to be fair/poor/or not knowing the status of one’s oral health, seeking dental care someplace other than a private dental office, and being more likely to seek care for a problem related visit rather than routine care. Having low oral health knowledge was statistically significantly associated visiting a dentist >12 months ago. Many other variables were also associated (p<;0.05) with infrequent dental utilization: low health literacy, being male, having <12th grade degree or a high school diploma, earning ≤$25,000, not having dental insurance, having low acculturation, reporting fewer years living in the United States, preferring a dental provider who speaks Spanish, perceiving one’s oral health to be fair/poor/or not knowing the status of one’s oral health, and seeking dental care someplace other than a private dental office. Final logistic regression analyses indicated that having less than a 12th grade education, lack of dental insurance, and a preference for receiving care from a Spanish speaking dental provider were associated with low oral health literacy. Furthermore, final logistic regression results predicting irregular dental utilization demonstrated that the following variables were statistically significant: being male, earning ≤$25,000 per year, not having dental insurance and having a history of tooth decay. Conclusion: Dental utilization and oral health knowledge appear to be associated. Patients with low oral health literacy may be less likely to utilize dental care, thus decreasing the opportunity to increase dental knowledge. Dental teams should recognize which patients are more likely to have low oral health literacy and provide dental education in patients’ preferred language.
418

Influences of Provider-Patient Communication on Health Literacy and Public Policy Relevant Outcomes

Cartwright-Vanzant, Rachel Carla 01 January 2017 (has links)
Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in the provider-patient-interaction linking health literacy and health outcomes. Quantitative and qualitative data were gathered from 47 registered nurses in south Florida using an online survey. These data were analyzed using descriptive statistics and a content analysis procedure. Descriptive statistics revealed that there is a lack of health literacy knowledge among nurses and nurses rarely or never use Knowles' communication techniques to relay health information to patients. By contrast, content analysis of qualitative data revealed that nurses have a basic understanding of the complexities of health literacy. No correlation existed between a nurse's knowledge of health literacy and the use of appropriate and varied communication techniques when the data sets were merged. This finding suggests that there may be another root cause of low health literacy that requires additional research to fully explore. The positive social change implications stemming from this study include recommendations to policy makers to encourages changes to existing law and policy that supports patient communication training to nurses in order to improve health outcomes for patients.
419

Adaptation of Heart Failure Education Materials for the Middle Eastern Population

Williams, Nadine A. 01 January 2019 (has links)
Cardiovascular disease, including heart failure, is the leading cause of death among male and female Middle Eastern Americans. In 2016, a medical center located in the northeastern region of the United States had an estimated 35% of heart failure patients readmitted within 30 days of discharge, 10% of these readmitted patients belonged to the local Middle Eastern community. The gap in nursing practice noted by nursing staff, patients, and their families was that the patient education materials on heart failure were not tailored to the cultural beliefs and customs of this high-risk population. The purpose of this project was to adapt the American Heart Association teaching tools on heart failure education to the Middle Eastern community to enhance compliance with treatment care plans, minimize days spent in the hospital, and decrease the readmission rates. The practice-focused question explored whether a team of experts could adapt heart failure education materials for the Middle Eastern community. An expert team met weekly to adapt the teaching materials to include information regarding effective communication techniques, adaptation to religious strictures, and modification of behavioral risks specific to Middle Eastern cultures. The information gathered was compiled and will be shared with the host medical facility. The positive social change resulting from this project might include improved culturally appropriate communication and support for the medical center's Middle Eastern population of heart failure patients, which may result in improved health outcomes.
420

INNOVATIVE ASTHMA MANAGEMENT BY COMMUNITY PHARMACISTS IN AUSTRALIA

Kritikos, Vicky January 2007 (has links)
Doctor of Philosophy / Excerpt Chapter 2 - A review of the literature has revealed that asthma management practices in the Australian community are currently suboptimal resulting in significant morbidity and mortality. In adolescent asthma there are added challenges, with problems of self-image, denial and non-adherence to therapy where self-management skills assume a greater importance (Forero et al 1996, Price 1996, Brook and Tepper 1997, Buston and Wood 2000, Kyngäs et al 2000). In rural and remote areas in Australia, asthma management practices have been shown to be poorer and mortality rates from asthma are considerably higher compared to metropolitan areas (AIHW ACAM 2005, AIHW 2006). Limited access and chronic shortages of specialist services in rural areas are shifting the burden more and more towards the primary sector (AIHW 2006). It becomes paramount that people with asthma in rural settings become involved in self-management of their asthma and that community based health care providers be more proactive in facilitating these self-management behaviours by appropriate education and counselling. Health promotion activities, which are a broad range of activities including health education, have been acknowledged as having the potential to improve the health status of rural populations (National Rural Health Alliance 2002). Community pharmacy settings have been shown to be effective sites for the delivery of health promotion, screening and education programs (Anderson 2000, Elliott et al 2002, Cote et al 2003, Hourihan et al 2003, Watson et al 2003, Boyle et al 2004, Goode et al 2004, Paluck et al 2004, Sunderland et al 2004, Chambers et al 2005, Saini et al 2006). In the case of asthma, outreach programs have been shown to have beneficial effects in terms of reducing hospital admissions and emergency visits and improved asthma outcomes (Greineder et al 1995, Stout et al 1998, Kelly et al 2000, Legorreta et al 2000, Lin et al 2004). We proposed to extend the role of the community pharmacist beyond the traditional realm of the “pharmacy” into the community in rural Australia with the first asthma outreach programs designed for community pharmacy. The outreach programs were designed to include two health promotion strategies, the first targeting adolescents in high schools and the second targeting the general community. The project aimed firstly, to assess the feasibility of using community pharmacists to deliver two asthma outreach programs, one targeting adolescents and one for the wider community in a rural area and secondly, to assess the programs’ impact on adolescent asthma knowledge and requests for information at the community pharmacy. Excerpt Chapter 3 - Patient education is one of the six critical elements to successful long-term asthma management included in international and national asthma management guidelines, which have emphasised education as a process underpinning the understanding associated with appropriate medication use, the need for regular review, and self-management on the part of the person with asthma (Boulet et al 1999, National Asthma Council 2002, National Asthma Education and Prevention Program 2002, British Thoracic Society 2003, NHLBI/WHO 2005). The ongoing process of asthma education is considered necessary for helping people with asthma gain the knowledge, skills, confidence and motivation to control their own asthma. Since most health care professionals are key providers of asthma education, their knowledge of asthma and asthma management practices often needs to be updated through continuing education. This is to ensure that the education provided to the patient conforms to best practice guidelines. Moreover, health care professionals need to tailor this education to the patients’ needs and determine if the education provided results in an improvement in asthma knowledge. A review of the literature has revealed that a number of questionnaires have been developed that assess the asthma knowledge of parents of children with asthma (Parcel et al 1980, Fitzclarence and Henry 1990, Brook et al 1993, Moosa and Henley 1997, Ho et al 2003), adults with asthma (Wigal et al 1993, Allen and Jones 1998, Allen et al 2000, Bertolotti et al 2001), children with asthma (Parcel et al 1980, Wade et al 1997), or the general public (Grant et al 1999). However, the existing asthma knowledge questionnaires have several limitations. The only validated asthma knowledge questionnaire was developed in 1990 and hence, out of date with current asthma management guidelines (Fitzclarence and Henry 1990). The shortcomings of the other knowledge questionnaires relate to the lack of evidence of the validity (Wade et al 1997, Grant et al 1999, Bertolotti et al 2001), being outdated 81 with current concepts of asthma (Parcel et al 1980) or having been tested on small or inadequately characterised subject samples e.g. subject samples consisting of mainly middle class and well educated parents (Brook et al 1993, Wigal et al 1993, Moosa and Henley 1997, Allen and Jones 1998, Allen et al 2000, Ho et al 2003). Furthermore, most of the published asthma knowledge questionnaires have been designed to assess the asthma knowledge of the consumer (i.e. a lay person with asthma or a parent/carer of a person with asthma). There is no questionnaire specifically developed to assess the asthma knowledge of health care professionals, who are key providers of asthma education. It is hence important to have a reliable and validated instrument to be able to assess education needs and to measure the impact of training programs on asthma knowledge of health care professionals as well. An asthma knowledge questionnaire for health care professionals might also be used to gauge how successful dissemination and implementation of guidelines have been. Excerpt Chapter 4 - Asthma self-management education for adults that includes information about asthma and self-management, self-monitoring, a written action plan and regular medical review has been shown to be effective in improving asthma outcomes (Gibson et al 1999). These interventions have been delivered mostly in a hospital setting and have utilised individual and/or group formats. Fewer interventions have been delivered in a primary care setting, usually by qualified practice nurses and/or general practitioners or asthma educators and, to date, their success has not been established (Fay et al 2002, Gibson et al 2003). Community pharmacy provides a strategic venue for the provision of patient education about asthma. Traditionally, patient education provided by community pharmacists has been individualised. However, group education has been shown to be as effective as individualised education with the added benefits of being simpler, more cost effective and better received by patients and educators (Wilson et al 1993, Wilson 1997). While small group education has been shown to improve asthma outcomes (Snyder et al 1987, Bailey et al 1990, Wilson et al 1993, Yoon et al 1993, Allen et al 1995, Kotses et al 1995, Berg et al 1997, de Oliveira et al 1999, Marabini et al 2002), to date, no small-group asthma education provided by pharmacists in the community pharmacy setting has been implemented and evaluated.

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