Explaining the causal links between illness management and symptom reduction: Development of an evidence-based patient education strategy

The Role of Science-Based Knowledge on the SARS-CoV-2 Virus in Reducing COVID-19-Induced Anxiety among Nurses

The COVID-19 infection has generated not only a risk of morbidity and mortality but also resulted in an enormous psychological impact on healthcare providers and the general public. This study aimed to evaluate the prevalence of anxiety and identify the role of protective factors. A two-part cross-sectional study was conducted, by means of an online questionnaire. Part 1 investigated 562 registered nurses, nursing students, and the general public. Participants were assessed for anxiety symptoms with the State-Trait-Anxiety Inventory. A one-way ANCOVA analysis revealed that nurses had the highest level of anxiety compared to the general public and students, with 26% of them reporting severe anxiety. To identify how anxiety can be mitigated, the Part 2 study was focused on registered nurses from Part 1. Multiple regression revealed that a higher level of science-based knowledge of COVID-19 and professional experience were associated with a lower level of anxiety among nurses. The findings suggest that nurses are a vulnerable population prone to anxiety symptoms resulting from the COVID-19 pandemic. Having a deeper science-based understanding of COVID-19 may protect nurses from anxiety. This study underlines the importance of deep evidence-based knowledge for health providers, which may be generalized to a possible future emergency disaster.

Knowledge and information credibility evaluation strategies regarding COVID-19: A cross-sectional study

BACKGROUND

The novel coronavirus disease (COVID-19) pandemic has not only caused significant challenges for health systems worldwide, but also fueled a surge in misinformation. Nurses as frontline health care providers should be equipped with the most accurate information on COVID-19.

PURPOSE

This study examines nurses' knowledge and strategies of information credibility sourcing.

METHOD

A cross-sectional survey among nurses and laypersons with no health care background. The questionnaire dealt with knowledge and ability assess credibility of COVID-19 information.

FINDINGS

Nurses' knowledge of COVID-19 preventative behaviors was significantly higher than that of laypersons; however, there was no difference in science-based knowledge of COVID-19. In contrast to laypersons, nurses in this study were better able to discern the credibility of health-related information about COVID-19 than laypersons. Yet they rarely used scientific criteria in evaluating conflicting information.

DISCUSSION

Given the importance of assessing the credibility of information, both information literacy skills and science-based knowledge about COVID-19 should be offered.

Glycemic control in adolescents with type 1 diabetes: Are computerized simulations effective learning tools?

OBJECTIVE

Type 1 diabetes mellitus (T1DM) in adolescent patients is often characterized by poor glycemic control. This study aimed at exploring the contribution of learning with computerized simulations to support: (a) mechanistic understanding of the biochemical processes related to diabetes; (b) diabetes self-management knowledge; and (c) glycemic control. We hypothesized that learning with such simulations might support adolescents in gaining a better understanding of the biochemical processes related to glucose regulation, and consequently improve their glycemic control.

METHODS

A prospective case-control study was conducted in 12- to 18-year-old adolescents with T1DM (n = 85) who were routinely treated at an outpatient diabetes clinic. While the control group (n = 45) received the routine face-to-face follow-up, the intervention group (n = 40) learned in addition with computerized simulations that were embedded in pedagogically supportive activities. Participants in both groups completed a set of questionnaires regarding sociodemographic characteristics, diabetes mechanistic reasoning and diabetes self-management. Clinical data and serum glycated hemoglobin (HbA1c) levels were gathered from medical records. All the data was collected at recruitment and 3 months later.

RESULTS

Analysis revealed improvement HbA1c levels in the intervention group (8.7% ± 1.7%) vs the controls (9.6% ± 1.6%) after 3 months (P < .05). Regression analysis showed that levels of diabetes mechanistic understanding and diabetes self-management knowledge, in addition to sociodemographic parameters, accounted for 31% of the HbA1c variance (P < .001).

CONCLUSION

These results suggest that learning with computerized simulations about biochemical processes can improve adolescents' adherence to medical recommendations and result in improved glycemic control. Implementing scientific learning into the hospital educational setting is discussed.

Can causal explanations about endothelial pathophysiology benefit patient education? A cluster randomized controlled trial in cardiac rehabilitation

OBJECTIVE

To examine whether explaining causal links among endothelial pathophysiology, cardiac risk factors, symptoms and health behaviors (termed causal information) enhances patients' depth of knowledge about cardiovascular disease self-management and their perceptions of the cardiac rehabilitation and secondary prevention (CRSP) program.

METHODS

Newly referred CRSP patients (N = 94) were cluster randomized to usual care (control; UC) or usual care with causal information (intervention; UC + CI). Depth of knowledge (factual vs. deep) was measured with an adapted cognitive-reasoning task. Patients' cardiovascular knowledge and beliefs about the efficacy of a CRSP program were assessed.

RESULTS

After controlling for education level, patients in UC + CI demonstrated deeper knowledge about cardiovascular management than did those in UC. The UC + CI group showed higher factual knowledge than their counterparts after covarying education, occupation status and BMI. The UC + CI group also rated the CRSP program as more credible than those in UC, after controlling for age. Deep knowledge mediated the relationship between group conditions and perceived credibility of CRSP.

CONCLUSION

Causal information can enhance the depth of patients' understanding of cardiovascular disease management and perceived treatment credibility of the CRSP program.

PRACTICE IMPLICATIONS

Explaining causal links may help improve patient education delivery and enhance patient engagement in CRSP.

Adherence to diabetes care: Knowledge of biochemical processes has a high impact on glycaemic control among adolescents with type 1 diabetes

AIM

To evaluate the impact of patients' understanding of biochemical processes involved in glucose regulation (causal-biochemical knowledge) and of diabetes self-management knowledge on adherence to treatment recommendations among adolescents with type 1 diabetes mellitus.

DESIGN

A cross-sectional study.

METHODS

Adolescents with type 1 diabetes mellitus, aged 12-18 years and able to read and write in Hebrew or in Arabic were eligible. Participants were recruited between August 2016 - January 2018 during routine visits to the Paediatric Diabetes Clinic; informed consent was obtained as customary. Patients completed sociodemographic, clinical and type 1 diabetes mellitus self-management and biochemical knowledge questionnaires. Adherence to treatment was assessed by patients' serum HbA1c levels, collected from medical records.

RESULTS

Ninety-seven patients participated in the study. Mean HbA1c levels were 9.2% (1.9%) and only 24 (24.7%) patients met the recommended HbA1c ≤ 7.5%. Lower HbA1c levels were strongly associated with higher family income, older age at diagnosis and with better type 1 diabetes mellitus self-management and causal-biochemical knowledge. A regression model showed that causal-biochemical knowledge contributed to the variance in HbA1c levels. Furthermore, causal-biochemical knowledge, but not self-management knowledge, was found to mediate the negative relationship between low family income and high HbA1c levels.

CONCLUSIONS

Causal-biochemical knowledge is a valuable component for the adherence to diabetes care and glycaemic control.

IMPACT

Our study suggests that causal knowledge is a valuable component that should be included in nursing and healthcare educational programmes for adolescents with type 1 diabetes mellitus.