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This longitudinal, descriptive study based on Bandura's self-efficacy theory (1977), examined the effects of educational activities on self-efficacy and of self-efficacy on functional ability in everyday activities in clients undergoing elective, primary, unilateral, total knee arthroplasty (TKA). Educational activities included: attending a joint replacement class and a physical therapy session, performing exercises, and reading educational materials. Other sources of client information were also discussed. Self efficacy was assessed regarding confidence in ability to perform activities required for discharge home. Cronbach's alpha for the self-efficacy scale was .94 (pre-education) and .81 (post-education). Functional ability in everyday activities was operationalized as length of hospital stay, discharge placement, and perceived health status. Perceived health status was assessed using the three-scale Western Ontario McMasters University Osteoarthritis Index (WOMAC). Cronbach's alpha was: pain .85, joint stiffness .76, and physical function .94 (preoperatively); and pain .86, joint stiffness .80, and physical function .94 (postoperatively).Evidence was collected from a convenience sample of 31 participants: (a) when the process of scheduling surgery began; (b) before surgery, after the client had opportunities to participate in educational activities, and (c) approximately six weeks after surgery. The orthopedic surgeon and professional staff reviewed instruments for validity. Five clients reviewed the questionnaires for understandability and readability. Data were analyzed using Pearson r correlation coefficients, independent samples t-tests, analyses of variance and chi-square tests. An alpha level of .05 was designated as significant.Higher self-efficacy scores were associated with more expected benefits, previous TKA, and greater pain relief. Lower self-efficacy scores correlated with greater improvement in self-efficacy. Shorter lengths of hospital stay were associated with greater joint stiffness reduction, younger age and previous TKA. Discharge home was associated with younger age and living with someone else. Participants that were "very sure" of the need for TKA exhibited higher self-efficacy scores than participants that were "unsure". Improved outcomes were not associated with any one type of educational activity.This study highlighted the need for further refinement of context sensitive self-efficacy instruments, more sophisticated means of assessing the impact of an increasing array of information sources and more longitudinal studies with larger sample sizes. / Department of Educational Leadership

Darbo aktualumas. Šiandien sveikatos mokymas tampa viena iš prioritetinių veiklos sričių slaugoje. Slaugytojas privalo suteikti pakankamai žinių ir informacijos, kad žmogus išmoktų tinkamai rūpintis savo sveikata bei išsiugdytų gebėjimus ją saugoti. Siekiant teigiamo sveikatos mokymo rezultato būtina analizuoti pacientų poreikius ir motyvus sveikatos mokymuisi. Darbo tikslas: nustatyti pacientų sveikatos mokymosi poreikį ir motyvus Kaišiadorių ligoninės Vidaus ligų ir Slaugos ir palaikomojo gydymo skyriuose. Realizuojant tyrimą buvo atlikta teorinė mokslinės literatūros analizė ir įvykdytas momentinis tyrimas, apklausiant raštu 301 pacientą iš Kaišiadorių ligoninės. Tyrimo rezultatams pateikti naudojami metodai: kiekybinė aprašomoji statistikos analizė. Tyrimo rezultatai: vertinant sveikatos mokymo ypatumus Kaišiadorių ligoninės Vidaus ligų ir Slaugos ir palaikomojo gydymo skyriuose galima teigti, kad pacientų mokymu, individualių užsiėmimų metu daugiausia užsiima slaugytojos. Slaugytojų mokymas, pacientų nuomone, įvertintas kaip geras. Analizuojant pacientų mokymo poreikį paaiškėjo, kad pacientai daugiausia žino apie galimas ligos komplikacijas ir reikalingas slaugos priemones. Statistiškai reikšmingai (p < 0,05) daugiau apie galimas ligos komplikacijas ir reikalingas slaugos priemones žino Slaugos ir palaikomojo gydymo skyriaus pacientai negu Vidaus ligų skyriaus pacientai. Analizuojant pacientų mokymosi poreikį išryškėjo, kad statistiškai reikšmingai (p < 0,05) vidaus... [toliau žr. visą tekstą] / The work topicality. Today, health education is one of the first-priority areas of nursing. Nurse must provide the necessary knowledge and information that a person learn to properly take care of his health, and develop the capacity of its saving. It is necessary to analyze the needs of patients and reasons for learning for a positive outcome of health education. The aim of this work. Identify health training needs and reasons from the point of view of patiens in the department of Internal Medicine, and Nursing and supportive care at Kaišiadoriai Hospital. Unlocking the study was carried out theoretical analysis of scientific literature and carried out a snapshot survey by interviewing 301 patients in writing of Kaišiadoriai hospital. Quantitative Descriptive Analysis method was used to present the study results. The survey results. Then the health education features in the department of Internal Medicine, and nursing and supportive care at Kaišiadoriai hospital were estimated, we can affirm that nurses are teaching patients more then anybody else. From the point of view of patients the nurses‘ teaching is high. The analysis of patients' training needs shows that the most patients are aware of the possible complications of the disease and preservative care. Statistically significant (p <0.05) patients in the department of nursing and supportive care know more about the possible complications of the disease and the preservatives... [to full text]

In an attempt to replicate and extend previous research, the present study conducted a brief psychoeducational intervention through community organisations designed to overcome methodological shortcomings of past studies. The two session intervention (one session with follow-up phone call) sought to establish if a brief community intervention was effective in both improving family members’ knowledge about schizophrenia and various other indicators linked to improved client functioning. People with schizophrenia and their family members (N = 50) were recruited into a controlled trial of a brief educational intervention. Clients and their corresponding key family members were randomly allocated to a treatment group or a wait-list control group. Measures included those reflecting knowledge about schizophrenia, expressed emotion, perceived coping ability, burden of care and distress. Analyses showed that knowledge increased significantly after the intervention and not after the control condition and was maintained at a nine-month follow-up. Family members’ and clients’ expressed emotion ratings significantly decreased from pre- to post-test with changes in total expressed emotion scores improving across treatment by over twice the magnitude compared to the control condition. All gains were maintained at the nine-month follow-up, with continuing improvement seen in family members’ intrusiveness ratings. A similar pattern of findings was reflected on other indices, with significant improvements in burden of care, coping and distress that were more a function of intervention than the control condition. All gains were maintained at the nine-month follow-up. Additionally, assessment of relapse rates at this follow-up interval indicated that no client had relapsed. Overall the results suggested that although knowledge increased as a result of education, the improvements in all indicators other than knowledge appeared to be due to education combined with some non-specific factors. These non-specific factors may have included expectancy effects, setting effects, sampling bias and other possibilities. These issues are considered in terms of implementation of brief programs in supportive community settings and in terms of future research.

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.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2005. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Michigan, 2006. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 66-80).

Thesis (M.S.)--University of Michigan, 2006. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 66-80).