Self-Efficacy and Educational Interventions in Heart Failure: A review of the Literature

Purpose: The purpose of this study was to conduct a systematic review of the literature to better understand how to structure educational interventions for heart failure patients to improve their self-efficacy for self-care behaviors. Methods: A computer search of the literature from 1966 through May 2009 was conducted, yielding 84 manuscripts. All manuscripts were reviewed in relation to the search criteria, resulting in 12 articles that were evaluated. Results: Each of the reviewed studies utilized an intervention plus education to improve self-efficacy. Self-efficacy was a primary outcome for seven of the studies, and a secondary outcome for five on the studies in this literature search. Both short and long-term interventions can improve self-efficacy demonstrating that the duration of the intervention can vary and still be successful. Conclusion: Existing evidence suggests that it is not the amount of education (number of sessions/length of sessions) that improves self-efficacy, but some other factor or factors that remain unknown at present. Education delivery costs, flexibility, and the ability to more easily integrate new discoveries need to be explored. Interventions that include components specifically geared toward increasing self-efficacy for self-care in patients with heart failure are needed. Learning activities need to be incorporated into patient education programs in order to provide practice time that may result in behavior changes. The opportunity to practice self-care behaviors within the context of the education provided to those with heart failure, along with ongoing support, needs to be explored in future studies

Impact of an Aging Simulation Game on Pharmacy Students’ Empathy for Older Adults

Objective. To evaluate changes in empathy and perceptions as well as game experiences among student pharmacists participating in an aging simulation game. Methods. First-year student pharmacists participated in an aging simulation game. Changes were measured pre/post-activity using the Kiersma-Chen Empathy Scale (KCES) and Jefferson Scale of Empathy – Health Professions Scale (JSE-HPS) for empathy and the Aging Simulation Experience Survey (ASES) for perceptions of older adults’ experiences and game experiences. Wilcoxon signed rank tests were used to determine changes. Results. One hundred fifty-six student pharmacists completed the instruments. Empathy using the KCES and JSE-HPS improved significantly. Of the 13 items in the ASES, 9 significantly improved. Conclusion. Simulation games may help students overcome challenges demonstrating empathy and positive attitudes toward elderly patients. Read More: http://www.ajpe.org/doi/abs/10.5688/ajpe7956

A Qualitative Analysis of Coronary Heart Disease Patients’ Views of Dietary Adherence and of Web-Based and Mobile-Based Nutrition Tools

Purpose: Dietary adherence can be challenging for patients with coronary heart disease (CHD), as they may require multiple dietary changes. Choosing appropriate food items may be difficult or take extensive amounts of time without the aid of technology. The objective of this project was to (1) examine the dietary challenges faced by patients with CHD, (2) examine methods of coping with dietary challenges, (3) explore the feasibility of a web-based food decision support system, and (4) explore the feasibility of a mobile-based food decision support system. Methods: Food for the Heart (FFH), a website-based food decision support system, and Mobile Magic Lens (MML), a mobile-based system, were developed to aid in daily dietary choices. Three CHD patient focus groups were conducted and focused on CHD-associated dietary changes as well as the FFH and MML prototypes. A total of 20 CHD patients and 7 informal caregivers participated. Qualitative, content analysis was performed to find themes grounded in the responses. Results: Five predominant themes emerged: 1) decreasing carbohydrate intake and portion control are common dietary challenges, 2) clinician and social support makes dietary adherence easier, 3) FFH could make meal-planning and dietary adherence less complicated, 4) MML could save time and assist with healthy choices, and 5) additional features need to be added to make both tools more comprehensive. Conclusions: FFH and MML may be tools that CHD patients would value in making food choices and adhering to dietary recommendations, especially if additional features are added to assist patients with changes

Development of a Unique Student Pharmacist Internship in a Primary Care Provider System

Purpose: To describe a unique pharmacy intern program in a group of federally qualified health center (FQHC) outpatient primary care provider clinics. Summary: A pharmacy intern program was created at the North Central Nursing Clinics in Indiana, a group of four FQHC outpatient primary care provider facilities. Intern-performed tasks included: Prior authorization (PA) requests, medication assistance program (MAP) applications, sample procurement and inventory, and contraceptive devices for implantation inventory management. Interns interacted with clinic administration, nurse practitioners, and medical staff to complete their assigned responsibilities. Over a one-year period, the interns completed documentation on more than 2000 charts during a combined 12 h a week. Interns identified the interprofessional interactions as the most beneficial experience, while providers acknowledged no difference in the processing of paperwork during the transition of duties from pharmacy fellow to intern. Conclusion: This unique pharmacy intern program was successfully created and implemented in a primary care provider office, resulting in learning opportunities for pharmacy interns, as well as operational efficiencies to fellows, providers, and the organization

A Graduate Student Mentoring Program to Develop Interest in Research

Objective. To assess the impact of a graduate student mentoring program on student interest in research and postgraduate education and on graduate student confidence in mentoring. Methods. Undergraduate and pharmacy students (mentees) and graduate students (mentors) were matched and participated in the study, which required them to engage in at least 2 discussions regarding research and careers. Mentees completed a pre- and post-assessment of their perceptions of research, postgraduate training plans, and perceptions about mentors. Mentors completed a pre- and post-assessment of their perceptions about themselves as mentors and their confidence in mentoring. Results. Although there were no significant differences among the mentees’ perceptions of research or the mentors’ confidence in mentoring, qualitative analysis indicated that the mentees’ perceptions of research improved and that the mentors believed their mentoring skills improved. Conclusions. Based on the results of the qualitative analysis, implementing a graduate student mentoring program may help improve students’ perceptions of research and graduate students’ confidence in mentoring, which could increase student interest in postgraduate education and prepare mentors for future leadership roles

Educating Pharmacy Students to Improve Quality (EPIQ) in Colleges and Schools of Pharmacy

Objective. To assess course instructors’ and students’ perceptions of the Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) curriculum. Methods. Seven colleges and schools of pharmacy that were using the EPIQ program in their curricula agreed to participate in the study. Five of the 7 collected student retrospective pre- and post-intervention questionnaires. Changes in students’ perceptions were evaluated to assess their relationships with demographics and course variables. Instructors who implemented the EPIQ program at each of the 7 colleges and schools were also asked to complete a questionnaire. Results. Scores on all questionnaire items indicated improvement in students’ perceived knowledge of quality improvement. The university the students attended, completion of a class project, and length of coverage of material were significantly related to improvement in the students’ scores. Instructors at all colleges and schools felt the EPIQ curriculum was a strong program that fulfilled the criteria for quality improvement and medication error reduction education. Conclusion. The EPIQ program is a viable, turnkey option for colleges and schools of pharmacy to use in teaching students about quality improvement

Impact of a Health Literacy Assignment on Student Pharmacist Learning

BACKGROUND: The average American adult reads at the 8th grade level while most written health information materials, including medication guides, are written at the 12th grade level. To assist students with health literacy-sensitive communication, pharmacy schools should incorporate educational activities addressing health literacy competencies. OBJECTIVES: The objectives of this study were to evaluate the impact of a health literacy assignment on student pharmacists\u27 perceptions of: 1) learning about health literacy; 2) ability to write health literacy level-appropriate patient education material; and 3) the use of these skills in future pharmacy practice. METHODS: Third professional year student pharmacists were asked to rewrite a patient medication information sheet at the 5th grade reading level, altering it from the 12th grade level. Following assignment completion, students responded to a 4-item open-ended questionnaire on what they learned from the activity, what information components were the most difficult to rewrite and reason for the difficulty, key strategies to accomplish the assignment, and their perception of the impact this assignment had on their future practice. Content analysis of the reflections was performed using QSR NVivo to identify themes grounded in the students\u27 responses. RESULTS: Reflections were completed in 2009 (n = 159) and 2010 (n = 144), for a total of 303 completed reflections. Predominant themes included greater understanding about the challenges, importance, and methods of health literacy level-appropriate communication and greater awareness of the role of pharmacists in presenting information clearly to patients. CONCLUSIONS: Students indicated the activity increased their understanding of the complexity of patient information, the educational needs of patients, and the importance of providing information that is understandable. Student pharmacists learned methods of effective communication with patients and should be better prepared to communicate in a health literacy-level appropriate manner