Development of Efficacy-Enhanced Heart Failure Rehabilitation Patient Education Materials for Health Behavior Change

Background: Patient education materials (PEMs) are often used in health education programs to empower patients to self-manage their disease for better health outcomes. Heart failure (HF) patients wanted more information about self-management and educational materials that were easy to understand. Programs with self-efficacy as the core component have proven to be effective in improving patients’ self-management. Purpose: To develop practical, efficacy-enhanced, tailored HF rehabilitation PEMs that satisfy our clients to drive long-lasting behavior change and evaluate the materials’ quality (readability, understandability, actionability, and acceptability). Methods: Exploratory mixed methods study involving: i) semi-structured interviews; ii) evaluation of the PEMs; iii) revision and reevaluation of the PEMs; iv) publication. An appointed panel of experts evaluates content accuracy, understandability, and actionability. The Patient Education Material Assessment Tool assesses content understandability and actionability. The content read ability was assessed using Flesch Kincaid Calculator. Clients’ acceptability was assessed using Educational Material Acceptability tool. Results: The newly developed PEMs have good understandability, actionability, readability, and acceptance. Discussion: Patient-centered PEMs have good acceptance and satisfaction among clients. However, the effectiveness of tailored efficacy-enhanced PEMs for behavior changes needs further evaluation. Translation to Health Education Practice: All stakeholders should be included in developing PEM

Analysing practice for prosthetic restoration among Major lower Limb Amputees with diabetes:from Northern Borneo Perspective

Diabetes is high in the agenda of public health issues with significant prevalence of diabetic-related amputations. Prosthetic restoration post-amputation is imperative to reduce disability, but its success is influenced by several factors. This study analysed the practice, and the determining factors affecting prosthetic restoration among major lower limb amputees with diabetes in Sabah. Methods: Retrospective cross-sectional study among 65 major lower limb amputees with diabetes referred for rehabilitation medicine services at Queen Elizabeth Hospital from0 1st January 2015 to 31st December 2017. Demographics data, pre-morbid diseases, levels of amputation and practice on prosthetic restoration (suitability for restoration, duration from prosthetic application to restoration, funding issue) are primary evaluated factors. Results: Forty-nine, fifteen and one amputees had below knee amputation, above knee amputation and hip disarticulation respectively. Forty-three amputees (66.2%) were deemed suitable for prosthetic restoration but only 27 were prosthetically restored, with mean duration from prosthetic application to restoration of 5.92±2.189 months. Having additional pre-morbid diseases did not reduced the likelihood of suitability for prosthetic restoration compared to those only with diabetes (p=0.082). Funding issue is the key factor affecting prosthetic restoration with higher likelihood for restoration among those eligible through governmental agencies funding (p=0.027). Conclusion: In Sabah, low rate of suitability for prosthetic restoration is observed among major lower limb amputees with diabetes. A larger study is warranted to investigate causes of such low rate of suitability for prosthetic restoration among this specific population in the effort to reduce public health burden from major lower limb amputation-related disability