Use of interactive iBooks for patient education in otology

Use of an educational video with mobile technology for the informed consent process: A randomised controlled trial on patients undergoing surgery for an impacted lower third molar

The purpose of this study was to determine whether audiovisual presentation of consent information would significantly improve patients' postoperative recall of risks and complications regarding surgical removal of impacted lower third molars compared to the presentation of traditional written consent information. A randomised controlled study on 59 patients undergoing third molar removal was conducted. Patients in the intervention group (n = 30) viewed an educational video on risks and complications related to surgery using mobile tablets. Control-group patients (n = 29) received written information of the risks and complications. Patients' postoperative recall of potential risks for dysesthesia of the lower lip and tongue, infection, and bleeding along with surgical complications of facial oedema, trismus, and pain were assessed using true-false tests. The effect of audiovisual information on postoperative recall of the risks and complications was determined by comparing accuracy scores between the intervention group and control group using the independent t-test. The intervention group was found to have significantly better recall scores of the potential risks and complications, due to much higher accuracy in their recall of bleeding and dysesthesia of the lower lip and/or tongue, compared to the control group [mean (SD) 4.70 (0.94) vs 3.76 (1.50), p = 0.003]. The use of an educational video played on mobile tablets rather than a written pamphlet may lead to better understanding of the informed consent process in patients.

Evaluation of Patient's Knowledge of Prevention and Treatment of Burn Injuries

Background

Burn injuries are amongst the most devastating causes of trauma worldwide. Preventive measures can be of great value in decreasing burn incidents. Increasing the knowledge and education of patients is a crucial step in this process.

Methods

In this prospective cross-sectional study, we evaluated 82 patients with burn injuries who were divided into two groups randomly during the 2018 to 2019 at Shahid Motahari Hospital, Tehran, Iran. The first group received an e-Book, and the second group a paperback booklet to read before visiting their primary care. Besides, both groups received a questionnaire on their knowledge of burn injuries and prevention before and after the visit. The e-Book and paperback booklet included basic information about burn injuries and preventive measures. We compared the questionnaire results in both groups before and after reading the e-book and booklet using a paired t-test analysis.

Results

There was a significant improvement in self-reported knowledge of burn prevention (P < 0.05; CI: 95%). Subjects receiving the eBook performed significantly had better post-survey (P < .01, 95% CI), despite equivalent pre-survey scores compared to those receiving the booklet.

Conclusion

Increased use of interactive educational modalities, such as an e-book, can benefit patients with knowledge of their disease and improve the quality of care. These modalities may increase compliance with the physician's recommendations regarding their disease states and treatments.

Cystic Fibrosis: A Pocket Guide

In 2010, an iPad app titled 'A Patient's Guide to Cystic Fibrosis' was developed for use by Cystic Fibrosis (CF) clinical nurse specialists during a patient's annual review. Feedback from pseudo-CF patients and NHS staff including CF clinical nurse specialists and respiratory consultants about the appearance, usability and content of the app and iPad interface, and the appropriateness of the app for CF patients was positive. The visual images, animations and interactive elements of the app were sufficient in providing an engaging experience for the user. The app was deemed suitable for patients and set a foundation for the development of comprehensive and interactive CF patient information learning tools. Since 2010, the prevalence and popularity of iPad apps in healthcare have soared and apps now have the capability to include more interactive touch-based experiences with digital content such as 3D models. The original iPad app was re-developed as an Apple iBook and an Android app titled 'Cystic Fibrosis: A Pocket Guide'. This paper describes the design, development and feedback on the original iPad app and its subsequent variants, and concludes with reflections from the specialist CF nurses, who have continued to use pocket guide over 10 years.

The tinnitus patient information pack: usefulness in intrusive tinnitus

PURPOSE

The purpose of this paper is to determine a tinnitus patient information pack's (TPIP) usefulness in patients suffering with tinnitus with respect to their need for further tinnitus retraining therapy (TRT) and in reducing TRT cancellations and non-attenders.

DESIGN/METHODOLOGY/APPROACH

The paper consists of prospective case series in a district general hospital ENT out-patient department.

FINDINGS

Patients with tinnitus-related symptoms constitute around 2 per cent of the ENT OPD workload at the West Middlesex Hospital, Chelsea & Westminster NHS Trust, London, i.e., 365 patients with intrusive tinnitus were referred by the ENT surgeon for TRT; 56/365 patients (15.3 per cent) failed to attend and 60 (16.4 per cent) cancelled their appointments. The following year, a TPIP was administered to all tinnitus sufferers, despite the affliction's intrusiveness, and told to contact the audiology department if they felt that TRT was required, which resulted in 43/233 patients (18.5 per cent) over a one-year period self-referring for TRT; 2/233 (0.9 per cent) did not attend, and 1/233 (0.4 per cent) were cancelled appointments.

PRACTICAL IMPLICATIONS

The patient-focussed TPIP acts as an initial therapy for the tinnitus sufferer by providing reassurance and self-therapy. This results in patients who are less likely to seek TRT, leading to more efficient clinical resource usage (p<0.01).

ORIGINALITY/VALUE

The data suggest that all tinnitus sufferers presenting to ENT clinics could be handed a TPIP and empowered with the decision whether they require further intervention.

Tablet-Based Patient Education Regarding Human Papillomavirus Vaccination in Colposcopy Clinic

OBJECTIVE

The aim of this study was to use an electronic tablet-based education module to increase patient knowledge about human papillomavirus (HPV).

METHODS

Patients presenting to an academic colposcopy clinic were first queried as to whether they had been infected with HPV. A quality improvement project was then conducted using a 4-question pretest assessing baseline knowledge about HPV and cancer, followed by a tablet-based education module and a 5-question posttest.

RESULTS

Between June 2017 and January 2018, 119 patients participated in the tablet education. At their initial visit, only 50 (42.0%) of patients were aware that they had an HPV infection; however, medical records revealed that 74 women (62.2%) were presenting with a documented HPV infection. After the tablet education, 95% of women identified cervical cancer as a problem that can be caused by HPV, as compared with 88.2% in the pretest (p = .046). Knowledge of head and neck cancer as a disease that can be caused by HPV increased from 10.9% to 80.7% (p < .001). More patients answered that they "definitely" or "probably" would consider the vaccine for a child in their family: 108 (95.6%) pretest vs. 112 (99.1%) posttest (p = .046). The activities were ranked as "extremely" or "very" helpful by 93.3% of patients.

CONCLUSIONS

Patients presenting to colposcopy clinic are not well educated regarding the connection between an abnormal Pap test, HPV infection, and certain cancers. Tablet-based education improves patient knowledge of HPV-associated cancers in an outpatient clinic setting.

OCULUS study: Virtual reality-based education in daily clinical practice

BACKGROUND

Atrial fibrillation (AF) is associated with high risk of stroke and other thromboembolic complications. The OCULUS study aimed to evaluate the effectiveness of the three-dimensional (3D) movie in teaching patients about the consequences of AF and pharmacological stroke prevention.

METHODS

The study was based on a questionnaire and included 100 consecutive patients (38% women, 62% with AF history). Using the oculus glasses and a smartphone, a 3D movie describing the risk of stroke in AF was shown. Similar questions were asked immediately after, 1 week and 1 year after the projection.

RESULTS

Before the projection 22/100 (22.0%) declared stroke a consequence of AF, while immediately after 83/100 (83.0%) (p < 0.0001) patients declared this consequence. Seven days after, stroke as AF consequence was chosen by 74/94 (78.7%) vs. 22/94 (23.4%) when compared to the baseline knowledge; p < 0.0001, a similar trend was also observed in 1-year follow-up (64/90 [71.1%] vs. 21/90 [23.3%]; p < 0.0001). Before the projection 88.3% (83/94) patients responded, that drugs may reduce the risk of stroke, and after 1 week the number of patients increased to (94/94 [100%]; p = 0.001). After 1 year 87/90 (96.7%) answered that drugs may diminish the risk of stroke (p = 0.02 in comparison to the baseline survey 78/90 [86.7%]). Use of oral anticoagulation to reduce the risk of stroke was initially chosen by 66/94 (70.2%), by 90/94 (95.7%; p < 0.0001) 7 days after and by 83/90 (92.2%; p < 0.0001) 1 year after.

CONCLUSIONS

3D movie is an effective tool in transferring knowledge about the consequences of AF and the pivotal role of oral anticoagulation in stroke prevention.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03104231. Registered on 28 March 2017.

Linguistic Validation of Interactive Educational Interventions in Neurologic Trauma

BACKGROUND

Neurological surgeons oftentimes educate patients and their families on complex medical conditions and treatment options. Time constraints and varied linguistic and cultural backgrounds limit the amount of information that can be disbursed. In this study, we assessed the linguistic validity of interactive educational interventions in non-English-speaking patients with traumatic brain injury (TBI) and concussion and their families.

METHODS

A total of 273 English-, Spanish-, Korean-, and Vietnamese-speaking neurotrauma patients (n =124) and family members (n =149) completed a presurvey to evaluate their incipient understanding, interacted with an iPad-based iBook (Apple) on concussion or TBI in their native language, completed a postsurvey to gauge changes in understanding, and then consulted with their neurosurgeon.

RESULTS

All participants (124 patients and 149 family members) had significantly increased (95% confidence interval [CI], P < 0.01) postsurvey scores (average pre-iBook score, 2.810; average post-iBook score, 4.109), regardless of native language or cultural background. Caucasian participants scored significantly higher than the combination of all ethnicities on both the baseline survey (95% CI, P < 0.01) and the post-iBook survey (95% CI, P < 0.01), and Asian participants scored significantly lower (95% CI, P < 0.05) than the combination regardless of similar baseline scores.

CONCLUSIONS

Interactive iBook-based interventions on concussion and TBI can increase participants' comprehension, improve their comfort with their medical condition and the follow-up care, and enhance communication with their physicians. These findings are linguistically valid irrespective of the participants' native language or cultural background.