The development and validation of three videos designed to psychologically prepare patients for coronary bypass surgery

The effects of preference for information on consumers' online health information search behavior

BACKGROUND

Preference for information is a personality trait that affects people's tendency to seek information in health-related situations. Prior studies have focused primarily on investigating its impact on patient-provider communication and on the implications for designing information interventions that prepare patients for medical procedures. Few studies have examined its impact on general consumers' interactions with Web-based search engines for health information or the implications for designing more effective health information search systems.

OBJECTIVE

This study intends to fill this gap by investigating the impact of preference for information on the search behavior of general consumers seeking health information, their perceptions of search tasks (representing information needs), and user experience with search systems.

METHODS

Forty general consumers who had previously searched for health information online participated in the study in our usability lab. Preference for information was measured using Miller's Monitor-Blunter Style Scale (MBSS) and the Krantz Health Opinion Survey-Information Scale (KHOS-I). Each participant completed four simulated health information search tasks: two look-up (fact-finding) and two exploratory. Their behaviors while interacting with the search systems were automatically logged and ratings of their perceptions of tasks and user experience with the systems were collected using Likert-scale questionnaires.

RESULTS

The MBSS showed low reliability with the participants (Monitoring subscale: Cronbach alpha=.53; Blunting subscale: Cronbach alpha=.35). Thus, no further analyses were performed based on the scale. KHOS-I had sufficient reliability (Cronbach alpha=.77). Participants were classified into low- and high-preference groups based on their KHOS-I scores. The high-preference group submitted significantly shorter queries when completing the look-up tasks (P=.02). The high-preference group made a significantly higher percentage of parallel movements in query reformulation than did the low-preference group (P=.04), whereas the low-preference group made a significantly higher percentage of new concept movements than the high-preference group when completing the exploratory tasks (P=.01). The high-preference group found the exploratory tasks to be significantly more difficult (P=.05) and the systems to be less useful (P=.04) than did the low-preference group.

CONCLUSIONS

Preference for information has an impact on the search behavior of general consumers seeking health information. Those with a high preference were more likely to use more general queries when searching for specific factual information and to develop more complex mental representations of health concerns of an exploratory nature and try different combinations of concepts to explore these concerns. High-preference users were also more demanding on the system. Health information search systems should be tailored to fit individuals' information preferences.

Development and evaluation of a video program for presentation prior to elective cardiac surgery

BACKGROUND

: The objective of the present study was to develop and evaluate the effects of a preparatory videotape on endocrine stress responses of patients prior to cardiac surgery and to analyze patient acceptance of this video for preoperative preparation.

METHODS

: 101 male patients prior to elective cardiac surgery were enrolled into the study. On the day before surgery, patients were assigned to one of the following groups: group 1 (n = 51) saw a video with realistic information about the upcoming perioperative procedure, and group 2 (n = 50) saw a video of the same length without surgery-related information. Venous blood was sampled before and 15 min after the video presentation. On the second postoperative day, patients filled in a questionnaire concerning their experiences of having preoperatively watched the video.

RESULTS

: After viewing the video, blood levels of cortisol, adrenocorticotropic hormone (ACTH), beta-endorphin, prolactin, epinephrine and norepinephrine in patients of group 1 were not significantly different compared to values measured before the video presentation. In patients of group 2, blood levels of cortisol, ACTH, prolactin and norepinephrine were significantly lower after video presentation compared to values obtained before the video. Patients of group 1 (compared to group 2) were significantly more often of the opinion that the video had helped in the preparation for surgery, and that they would like to repeat this adjunct preoperative video preparation in another similar situation.

CONCLUSION

: We conclude from our results that (i); cardiac surgical patients prefer preoperatively an adjunct surgery-related video preparation to a non-specific video presentation, and that (ii); preoperative preparation with realistic information about the upcoming medical procedure in patients undergoing cardiac surgery does not lead to an increase in endocrine stress hormone levels.

Use of videotaped interventions in research

Evaluating conceptual and methodological issues are important considerations when developing a videotape for research intervention. The process of developing a videotape for research involves several critical steps to maintain scientific rigor during the project. Establishing content validity of the videotape script and maintaining scientific integrity while producing the videotape are key components. Issues such as copyright and intellectual property are important considerations. The use of videotape provides a consistent method of providing information to research subjects. Careful attention to the research process during each phase of development of the videotape will enhance the success of the project.

Measurement of preference for information in U.S. and Korean cardiac catheterization patients

Seeking information is a common coping strategy of patients facing a stressful event. Persons differ, however, in how much information they want to help them in their coping process. Research-based practice related to patients' preferences for information is hampered by the lack of reliable, valid, and clinically useful instruments to measure preference for information. Furthermore, it is imperative that researchers and clinicians understand preference for information in different cultures to reflect the diversity of the needs of patients in clinical practice. This study was designed to determine the reliability and validity of three measures of preference for information-the Miller Behavioral Style Scale (MBSS), the Krantz Health Opinion Survey-Information Subscale (KHOS-I), and the Preference for Information Scale-in 106 U.S. and Korean cardiac catheterization subjects. The MBSS and the KHOS-I were found to have fair-to-excellent reliability and fair-to-moderate convergent validity. The lack of a correlation of either of these two instruments with the Preference for Information Scale does not support convergent validity for that instrument.

Effects of preparatory videotapes on self-efficacy beliefs and recovery from coronary bypass surgery

This study evaluated the relative effects of three experimental videotapes that involved different approaches for preparing coronary artery bypass graft (CABG) patients for surgery and the inhospital recovery period. One of the tapes conveyed information via a health care expert only. The other two featured the same health care expert and also included clips of interviews with patient models. These latter two tapes differed in the extent to which they portrayed the recovery period as a steady, forward progression or as consisting of "ups and downs". Two hundred fifty-eight male CABG patients were randomly assigned to view one of the three videotapes on the evening prior to surgery or to a control condition. Overall, patients who viewed any of the videotapes felt significantly better prepared for the recovery period, reported higher self-efficacy for using the incentive spirometer and for speeding their recovery, performed more repetitions with their incentive spirometer each time they used it postoperatively, had shorter intensive care unit stays, and were released from the hospital more quickly than patients in the control condition. There was also evidence that patients' self-efficacy beliefs for speeding recovery directly mediated the effects of the videotapes on length of stay both in the intensive care unit and in the hospital.