An innovative state-of-the-art health storytelling technique for better management of type 2 diabetes

BackgroundType 2 diabetes (T2D) is a chronic lifelong disease that requires long-term prevention and management strategies in a community setting. A health story is a novel technique that may be used as an effective tool for better prevention and management of T2D.ObjectiveThe main objective of this study is to develop a story to be used as a social health technique based on contemporary scientific knowledge that may be used at a community level for better communication and management of T2D.MethodsA community–academic partnership was formed with a not-for-profit Nutrition Education, Awareness, and Training (NEAT) organization in Khyber Pakhtunkhwa, Pakistan. We agreed to develop a story that may be used as a health and nutrition education communication tool for better management of patients with T2D. The following phases were followed during the story creation process: (1) the theory phase, (2) the modeling phase, and (3) the evaluation phase. Raters evaluated the story to determine its literary and scientific quality, comprehensiveness, and T2D specificity.ResultsThe title of the story translated into English is “The Story of Diabetes—The Story of Success.” It is text based and contains 86 pages in the local language, “Pashto,” with an English translation. The story is divided into five chapters and describes the initial diagnosis, fear associated with the disease, issues related to referral to certified practitioners, the importance of a balanced diet, and related lifestyle habits. After story evaluation, the raters suggested its literary and scientific quality, comprehensiveness, and T2D specificity (Pearson correlation scores of >0.8).ConclusionThis unique story was created for T2D and found to be of significant quality in terms of its literary and scientific quality, as well as its comprehensiveness and diabetes specificity. As a result, it may be suggested that it can be used in subsequent studies to improve T2D management among adult patients

Data_Sheet_3_An innovative state-of-the-art health storytelling technique for better management of type 2 diabetes.PDF

BackgroundType 2 diabetes (T2D) is a chronic lifelong disease that requires long-term prevention and management strategies in a community setting. A health story is a novel technique that may be used as an effective tool for better prevention and management of T2D.ObjectiveThe main objective of this study is to develop a story to be used as a social health technique based on contemporary scientific knowledge that may be used at a community level for better communication and management of T2D.MethodsA community–academic partnership was formed with a not-for-profit Nutrition Education, Awareness, and Training (NEAT) organization in Khyber Pakhtunkhwa, Pakistan. We agreed to develop a story that may be used as a health and nutrition education communication tool for better management of patients with T2D. The following phases were followed during the story creation process: (1) the theory phase, (2) the modeling phase, and (3) the evaluation phase. Raters evaluated the story to determine its literary and scientific quality, comprehensiveness, and T2D specificity.ResultsThe title of the story translated into English is “The Story of Diabetes—The Story of Success.” It is text based and contains 86 pages in the local language, “Pashto,” with an English translation. The story is divided into five chapters and describes the initial diagnosis, fear associated with the disease, issues related to referral to certified practitioners, the importance of a balanced diet, and related lifestyle habits. After story evaluation, the raters suggested its literary and scientific quality, comprehensiveness, and T2D specificity (Pearson correlation scores of >0.8).ConclusionThis unique story was created for T2D and found to be of significant quality in terms of its literary and scientific quality, as well as its comprehensiveness and diabetes specificity. As a result, it may be suggested that it can be used in subsequent studies to improve T2D management among adult patients.</p

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research