Patient Education and Health-related Quality of Life

Total joint arthroplasty patients' perception of received knowledge of care

BACKGROUND

The education of orthopaedic patients is an essential component of nursing, because it has been shown to have a positive impact on outcomes of care and treatment.

PURPOSE

To describe total joint arthroplasty patients' perceptions of received knowledge on discharge.

DESIGN/METHOD

Patients (n = 123, mean age 68 years) undergoing total hip or knee arthroplasty self-administered a structured instrument, including 6 different dimensions of knowledge.

RESULTS

Patients perceived that they received most knowledge on the biophysiological dimension and least on the financial dimension. Patients' discharge destination and positive evaluation of hospitalization were related to their perceptions of the knowledge received.

DISCUSSION

Individually tailored education is needed to meet patients' educational needs. Nurses are responsible for ensuring that patients have enough knowledge even if they do not ask for this knowledge.

The effects of Internet or interactive computer-based patient education in the field of breast cancer: a systematic literature review

OBJECTIVE

The aim of this systematic review was to analyze what kind of Internet or interactive computer-based patient education programs have been developed and to analyze the effectiveness of these programs in the field of breast cancer patient education. Patient education for breast cancer patients is an important intervention to empower the patient. However, we know very little about the effects and potential of Internet-based patient education in the empowerment of breast cancer patients.

METHODS

Complete databases were searched covering the period from the beginning of each database to November 2008. Studies were included if they concerned patient education for breast cancer patients with Internet or interactive computer programs and were based on randomized controlled, on clinical trials or quasi-experimental studies.

RESULTS

We identified 14 articles involving 2374 participants. The design was randomized controlled trial in nine papers, in two papers clinical trial and in three quasi-experimental. Seven of the studies were randomized to experimental and control groups, in two papers participants were grouped by ethnic and racial differences and by mode of Internet use and three studies measured the same group pre- and post-tests after using a computer program. The interventions used were described as interactive computer or multimedia programs and use of the Internet. The methodological solutions of the studies varied. The effects of the studies were diverse except for knowledge-related issues. Internet or interactive computer-based patient education programs in the care of breast cancer patients may have positive effect increasing breast cancer knowledge.

CONCLUSION

The results suggest a positive relationship between the Internet or computer-based patient education program use and the knowledge level of patients with breast cancer but a diverse relationship between patient's participation and other outcome measures.

PRACTICE IMPLICATIONS

There is need to develop and research more Internet-based patient education.

A comparison of two educational interventions for the cognitive empowerment of ambulatory orthopaedic surgery patients

OBJECTIVE

The aim of this study was to compare the cognitive empowerment of ambulatory orthopaedic surgery patients when using Internet-based education (experiment) in contrast to face to face education conducted by a nurse (control).

METHODS

Elective ambulatory orthopaedic surgery patients were randomized to either an experiment group (n = 72) receiving Internet-based education, or to a control group (n = 75) receiving face-to-face education with a nurse. The data were collected at three different time points: before the preoperative education session, after preoperative education and 2 weeks after the operation. Three structured instruments were used: the Knowledge Test, the Sufficiency of Knowledge and the Orthopaedic Patient Knowledge Instrument.

RESULTS

Patients in both groups showed improvement in their knowledge. However, patients who received Internet-based education improved their knowledge level significantly more in the ethical (p = 0.005) and functional (p = 0.023) dimensions and also in total (p = 0.033) than those patients who underwent face-to-face education with a nurse. In addition, patients in the experiment group had higher scores in sufficiency of knowledge in the experiential (p = 0.050) and financial (p = 0.048) dimensions and, moreover, their scores in sufficiency of knowledge in the ethical dimension improved significantly more (p = 0.008) during the study period than patients in the control group.

CONCLUSION

Improvements in the patients' level and sufficiency of knowledge within both groups indicates an increase in patients' cognitive empowerment.

PRACTICE IMPLICATIONS

Internet-based education can be used in ambulatory orthopaedic surgery patient education for increasing patients' cognitive empowerment.

Ambulatory orthopaedic surgery patients’ knowledge expectations and perceptions of received knowledge

AIM

This paper is a report of a study to compare orthopaedic ambulatory surgery patients' knowledge expectations before admission and their perceptions of received knowledge 2 weeks after discharge.

BACKGROUND

Advances in technology and population ageing are driving up the number of ambulatory orthopaedic surgical procedures. Shorter hospital stays present a major challenge for patient education.

METHODS

A descriptive comparative cross-sectional study (pre- and post-test) design was adopted. The data were collected from 120 consecutive patients in 2004, using the Hospital Patient's Knowledge Expectations Scale and Hospital Patient's Received Knowledge Scale. All patients participated in a preoperative education session given by a nurse.

RESULTS

Patients expected more knowledge than they actually perceived that they received on all dimensions except the bio-physiological. They perceived that they received least knowledge about experiential, ethical, social and financial dimensions of knowledge. Knowledge expectations correlated with age and professional education. Perceptions of received knowledge correlated with earlier ambulatory surgery, and both expected knowledge and perceptions of received knowledge were related to the level of basic education.

CONCLUSION

Patients' knowledge expectations are greater than the knowledge they perceived that they receive, and they cannot become empowered if they lack important knowledge. Further research is needed to learn about meeting patients' knowledge expectations.