Patients' expectations and experiences of provided surgery-related patient education : A descriptive longitudinal study

Funding Information: The authors thank Guðný Bergóra Tryggvadóttir, specialist at the Social Science Research Institute at the University of Iceland for providing statistical support, nurses at the Landspítali University Hospital and at Akureyri Hospital who participated in data collection and the participants who provided valuable information about themselves. Funding Information: The study was funded by the University of Iceland Science Fund, the Landspitali University Hospital Science Fund and the Icelandic Nurses' Association Science Fund Publisher Copyright: © 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.Aims: The aim of this study was to explore the educational expectations and experiences of surgical patients. Design: Prospective, longitudinal, descriptive and two-centre study. Data were collected with questionnaires at the hospital and 6 weeks and 6 months postsurgery. Methods: Patients undergoing elective surgery and hospitalized overnight from January to July 2016 answered questions about the content of received pre-operative and pre-discharge education, topics they wanted more information on, sources of information, satisfaction with and usefulness of the information and if their recovery was as expected. Results: Patients (N = 697, 49% male, mean age 64.1 [SD 12.6] years) perceived the provided education as useful and satisfactory but less so after discharge. Most common topics which they expected more education about were postoperative complications, pain management, fatigue, lack of stamina and expected recovery time. Most patients received information through face-to-face teaching (79.7%) and in writing (78.4%). Expectations on recovery were related to patients' satisfaction with the education and how useful they evaluated it.Peer reviewe

The effect of a short educational intervention on the use of urinary catheters: a prospective cohort study.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesTo assess the effectiveness of implementation of evidence-based recommendations to reduce catheter-associated urinary tract infections (CAUTIs).Prospective cohort study, conducted in 2010-12, with a before and after design.A major referral university hospital.Data were collected before (n = 244) and 1 year after (n = 255) the intervention for patients who received urinary catheters.The intervention comprised two elements: (i) aligning doctors' and nurses' knowledge of indications for the use of catheters and (ii) an educational effort consisting of three 30- to 45-minute sessions on evidence-based practice regarding catheter usage for nursing personnel on 17 medical and surgical wards.The main outcome measures were the proportion of (i) admitted patients receiving urinary catheters during hospitalization, (ii) catheters inserted without indication, (iii) inpatient days with catheter and (iv) the incidence of CAUTIs per 1000 catheter days. Secondary outcome measures were the proportion of (i) catheter days without appropriate indication and (ii) patients discharged with a catheter.There was a reduction in the proportion of inpatient days with a catheter, from 44% to 41% (P = 0.006). There was also a reduction in the proportion of catheter days without appropriate indication (P < 0.001) and patients discharged with a catheter (P = 0.029). The majority of catheters were inserted outside the study wards.A short educational intervention was feasible and resulted in significant practice improvements in catheter usage but no reduction of CAUTIs. Other measures than CAUTI may be more sensitive to detecting important practice changes.Icelandic Nurses' Association Research Fund Landspitali University Hospital Research Fund Ministry of Welfare in Icelan

Аутстаффинг, прекаризация и лизинг персонала как инструменты повышения эффективности его использования на предприятии (на примере КУП «Петриковский райжилкомхоз»)

To access publisher's full text version of this article click on the hyperlink at the bottom of the pagePatient education in connection with hip replacement is intended to prepare patients for surgery, discharge and postoperative recovery. Patients experience symptoms and emotions due to disease or upcoming surgery which can affect how their knowledge expectations are fulfilled.To describe the differences between received and expected knowledge in patients undergoing elective hip replacement in three Nordic countries, and to analyse how these differences are related to patients' characteristics, preoperative symptoms and emotions.A descriptive, prospective survey with two data collection points; before admission and at hospital discharge after surgery.Two Finnish, three Icelandic and two Swedish hospitals.The population consisted of patients on a waiting list for hip replacement. Of the consecutively included patients, 320 answered questionnaires both before admission and at discharge and were included in the study. The mean age of the patients was 64 years, and 55% were women.Structured questionnaires were used; the knowledge expectations of hospital patients scale and self-reported scales for symptoms and emotions before admission and received knowledge of hospital patients scale at discharge. Fulfilment of knowledge expectation was assessed by calculating the difference between received and expected knowledge with a paired sample t-test. A multiple stepwise regression model was used to explain the variance of fulfilled knowledge expectations.Patients expected more knowledge than they received (p<0.001) and 77% of them had unfulfilled knowledge expectations. Patients with a higher level of education were more likely to have unfulfilled knowledge expectations. A higher level of education was also related to a greater difference between received and expected knowledge. The difference was more correlated with patients' emotions than their symptoms. A depressive state was the major predictor of the variance in the difference between received and expected knowledge.In order to better support patients by education it is necessary to assess their emotional state, educational level and knowledge expectations before surgery

Developing a Health Game to Prepare Preschool Children for Anesthesia: Formative Study Using a Child-Centered Approach

Background: Every year, millions of children undergo medical procedures that require anesthesia. Fear and anxiety are common among young children undergoing such procedures and can interfere with the child's recovery and well-being. Relaxation, distraction, and education are methods that can be used to prepare children and help them cope with fear and anxiety, and serious games may be a suitable medium for these purposes. User-centered design emphasizes the involvement of end users during the development and testing of products, but involving young, preschool children may be challenging.Objective: One objective of this study was to describe the development and usability of a computer-based educational health game intended for preschool children to prepare them for upcoming anesthesia. A further objective was to describe the lessons learned from using a child-centered approach with the young target group.Methods: A formative mixed methods child (user)-centered study design was used to develop and test the usability of the game. Preschool children (4-6 years old) informed the game design through playful workshops (n=26), and usability testing was conducted through game-playing and interviews (n=16). Data were collected in Iceland and Finland with video-recorded direct observation and interviews, as well as children's drawings, and analyzed with content analysis and descriptive statistics.Results: The children shared their knowledge and ideas about hospitals, different emotions, and their preferences concerning game elements. Testing revealed the high usability of the game and provided important information that was used to modify the game before publishing and that will be used in its further development.Conclusions: Preschool children can inform game design through playful workshops about health-related subjects that they are not necessarily familiar with but that are relevant for them. The game's usability was improved with the participation of the target group, and the game is now ready for clinical testing.</p

Developing a Health Game to Prepare Preschool Children for Anesthesia : Formative Study Using a Child-Centered Approach

Funding Information: The authors acknowledge generous funding from the Icelandic Technology Development Fund; the Children’s Welfare Fund; SUMARGJÖF - the Friends of Children Society; and the Remembrance Fund of the Icelandic Landspitali Hospital, Iceland. Publisher Copyright: © Brynja Ingadottir, Elina Laitonen, Adalheidur Stefansdottir, Anna Olafia Sigurdardottir, Berglind Brynjolfsdottir, Heidi Parisod, Johanna Nyman, Karitas Gunnarsdottir, Katrín Jónsdóttir, Sanna Salanterä, Anni Pakarinen.Background: Every year, millions of children undergo medical procedures that require anesthesia. Fear and anxiety are common among young children undergoing such procedures and can interfere with the child’s recovery and well-being. Relaxation, distraction, and education are methods that can be used to prepare children and help them cope with fear and anxiety, and serious games may be a suitable medium for these purposes. User-centered design emphasizes the involvement of end users during the development and testing of products, but involving young, preschool children may be challenging. Objective: One objective of this study was to describe the development and usability of a computer-based educational health game intended for preschool children to prepare them for upcoming anesthesia. A further objective was to describe the lessons learned from using a child-centered approach with the young target group. Methods: A formative mixed methods child (user)-centered study design was used to develop and test the usability of the game. Preschool children (4-6 years old) informed the game design through playful workshops (n=26), and usability testing was conducted through game-playing and interviews (n=16). Data were collected in Iceland and Finland with video-recorded direct observation and interviews, as well as children’s drawings, and analyzed with content analysis and descriptive statistics. Results: The children shared their knowledge and ideas about hospitals, different emotions, and their preferences concerning game elements. Testing revealed the high usability of the game and provided important information that was used to modify the game before publishing and that will be used in its further development. Conclusions: Preschool children can inform game design through playful workshops about health-related subjects that they are not necessarily familiar with but that are relevant for them. The game’s usability was improved with the participation of the target group, and the game is now ready for clinical testing.Peer reviewe

Analysis of graduating nursing students’ moral courage in six European countries

Background: Moral courage is defined as courage to act according to one's own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses' career.Aim: To analyse graduating nursing students' moral courage and the factors associated with it in six European countries.Research design: A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with a single question (visual analogue scale 0-100), the questionnaire also covered several background variables.Participants and research context: The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students' moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires.Ethical considerations: Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent.Results: The mean of graduating nursing students' self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0-100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students' moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves.Discussion and conclusions: In all countries, the graduating nursing students' moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research.</p

Knowledge expectations of surgical orthopaedic patients: a European survey

Ageing population entails a growing international problem of osteoarthritis. Best practices for education of these patients are lacking. This study focused on empowering education in Northern (Finland, Iceland, Lithuania and Sweden) and Southern Europe (Cyprus, Greece and Spain). The aim was to analyse associations between expected knowledge and background factors. The data were collected from European arthroplasty patients with the Knowledge Expectations of hospital patients- scale, (KE(hp) - scale), including bio-physiological, functional, experiential, ethical, social and financial dimensions. Patients had essential bio-physiological and functional knowledge expectations. Women expected more than men, employed less than retired, unemployed or who worked at home. Generally, patients in Northern countries expected more than in Southern countries. However, highest expectations were found in Sweden and Greece, lowest in Spain and Cyprus. There are differences in knowledge expectations based on patients' backgrounds. Development of common standards in European patient education needs further research

To discipline a "dog": the essential structure of mastering diabetes

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldIn this article we describe the findings of a study in which the essential structure of mastering diabetes was explored from the patient's viewpoint, emphasizing the lived experience of adhering and not adhering to a complex treatment regimen for diabetes

Impact of technology-based patient education on modifiable cardiovascular risk factors of people with coronary heart disease: A systematic review.

To access publisher's full text version of this article click on the hyperlink belowObjective: To collect evidence on what types of technology and content are most effective in helping people with coronary heart disease (CHD) to change their modifiable cardiovascular risk factors. Methods: A literature search was performed to find relevant studies published between 1 January 2008 and 31 December 2018 in PubMed, CINAHL, PROQUEST and Scopus databases. Selected outcomes were risk factors (exercise, diet, blood pressure, blood sugar, cholesterol, body mass index, tobacco use). The quality of the studies was evaluated according to Joanna Briggs Institute Reviewers Manual Checklists for risk for bias, TIDieR for quality of interventions, and PRISMA statement for presenting results. Results: Eighteen quantitative (17 RCT´s and one quasi-experimental) studies were included. Patient education delivered through telephone, text messaging, webpages, and smartphone applications resulted in significant changes in some risk factors of people with CHD. Sufficient descriptions of the content and intervention methods were lacking. Conclusion: Patient education delivered with technology can help people with CHD to modify their risk factors. There is a need for better descriptions of the content and delivery of educational interventions in studies. Practice implications: Patient education needs to be delivered with technological solutions that best support the multidimensional needs of CHD patients. Keywords: Cardiac rehabilitation; Coronary heart disease; Lifestyle changes; Patient education; Risk factors; Secondary prevention; Telehealth; e-health

Self-reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross-sectional study

Aims There are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio-economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio-economic factors were associated with patient-reported outcome measures (PROMs). Methods and results In this cross-sectional survey, PROMs were measured with seven validated instruments, as follows: self-care (the 12-item European Heart Failure Self-Care Behaviour scale), HF-related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care-Patients evaluation), health status (EQ-5D visual analogue scale), health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale). Additional data were collected on access and use of health care, household income, demographics, and clinical status. The patients (n = 124, mean age 73 +/- 14.9, 69% male) self-care was low for exercising (53%) and weight monitoring (50%) but optimal for taking medication (100%). HF-specific knowledge was high (correct answers 12 out of 15), but only 38% knew what to do when symptoms worsened suddenly. Patients sense of security was high (amp;gt;70% had a mean score of 5 or 6, scale 1-6). The most common symptom was tiredness (82%); 12% reported symptoms of anxiety, and 18% had symptoms of depression. Patients rated their overall health (EQ-5D) on average at 65.5 (scale 0-100), and 33% had poor or very bad HRQoL. The monthly income per household was amp;lt;sic3900 for 84% of the patients. A total of 22% had difficulties making appointments with a general practitioner (GP), and 5% had no GP. On average, patients paid for six health care-related items, and amp;gt;90% paid for medications, primary care, and visits to hospital and private clinics out of their own pocket. The cost of health care had changed for 71% of the patients since the 2008 economic crisis, and increased out-of-pocket costs were most often explained by a greater need for health care services and medication expenses. There was no significant difference in PROMs related to changes in out-of-pocket expenses after the crisis, income, or whether patients lived alone or with others. Conclusions This Icelandic patient population reported similar health-related outcomes as have been previously reported in international studies. This study indicates that even after a financial crisis, most of the patients have managed to prioritize and protect their health even though a large proportion of patients have a low income, use many health care resources, and have insufficient access to care. It is imperative that access and affordable health care services are secured for this vulnerable patient population.Funding Agencies|Landspitali University Hospital Research Fund, Landspitali, National University Hospital of Iceland; Icelandic Nurses Association Research Fund; Maria Finnsdottir Research Fund; Heart Failure Association of the ESC Nursing Training Fellowship</p