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Byrd JN, Huynh KA, Cho HE, Chung KC. Improving Perioperative Preparation for Patients Undergoing Surgical Treatment for Distal Radius Fractures. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4995. [PMID: 37360230 PMCID: PMC10287137 DOI: 10.1097/gox.0000000000004995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/23/2023] [Indexed: 06/28/2023]
Abstract
We aimed to review common patient concerns after surgical repair of distal radius fracture (DRF) to identify potential interventions to improve the gap between expectation and education for DRF patients. Methods We conducted a retrospective cohort study of 100 consecutive patients who underwent surgical repair of DRF at a level I trauma center. Patient-initiated communication notes were reviewed with thematic analysis to identify the common reasons patients required additional information. We used the Patient Education Materials Assessment Tool to score the available educational resources for DRF patients for the understandability and actionability of the educational materials provided to the patients. Results Of 165 patient communication episodes, 88.5% occurred postoperatively. The most common concerns were pain (30, 15.4%) and surgical site changes (24, 12.3%). Most communications (171, 83.4%) were resolved with patient education through instruction or reassurance. The reviewed materials did not address pain or surgical site changes. No reviewed materials provided actionable steps patients could take to facilitate recovery. Conclusions Pain management and normal wound healing were the most common surgical concerns of DRF patients. We identify opportunities to improve expectation-setting in online materials and during face-to-face education to create a more patient-centered perioperative experience.
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Affiliation(s)
- Jacqueline N. Byrd
- From the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Mich
- Department of Surgery, University of Texas Southwestern Medical School, Dallas, Tex
| | - Kristine A. Huynh
- From the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Mich
- Department of Plastic Surgery, University of Texas Southwestern Medical School, Dallas, Tex
| | - Hoyune E. Cho
- From the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Mich
- Department of Plastic Surgery, University of California, Irvine, School of Medicine, Orange, Calif
| | - Kevin C. Chung
- From the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Mich
- Department of Surgery, University of Texas Southwestern Medical School, Dallas, Tex
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2
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Koivisto JM, Saarinen I, Kaipia A, Puukka P, Kivinen K, Laine KM, Haavisto E. Patient education in relation to informational needs and postoperative complications in surgical patients. Int J Qual Health Care 2020; 32:35-40. [PMID: 31016323 DOI: 10.1093/intqhc/mzz032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/31/2019] [Accepted: 03/01/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To study surgical patients' informational expectations and the level of received knowledge at the time of hospital discharge. To examine if there is an association with postoperative complications and the patient´s level of received knowledge. DESIGN Comparative descriptive design. SETTING The data on patients admitted for non-cardiac surgery were collected in three phases during an eight-month period. PARTICIPANTS 258 in-ward non-cardiac general surgery and orthopedic surgery adult patients. INTERVENTIONS Questionnaires before admission (knowledge expectations) and at discharge (received knowledge). A telephone interview 30 days after discharge. MAIN OUTCOME MEASURES Received knowledge (as much or more / less) compared to expectations, and its association with post-discharge complications. RESULTS There were differences between patient groups in their perception of receiving enough knowledge and they were connected to gender (male vs. female OR 2.67, 95% CI 1.55-4.60, P = 0.0004) and procedure (elective orthopedic implant surgery vs. elective minor orthopedic and hand surgery: OR 3.25, 95% CI 1.72-6.17, P = 0.0003). Patients who received less knowledge than expected had more postoperative complications than those who received sufficient (as much or more than expected) information. CONCLUSIONS Patients differ in terms of informational needs, and preoperative education prepares the patient for the information provided postoperatively. Patient education may have an influence on recovery from surgery.
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Affiliation(s)
| | | | - Antti Kaipia
- Hospital District of Satakunta.,Department of Urology, University of Tampere
| | - Pauli Puukka
- Department of Nursing Science, University of Turku
| | | | | | - Elina Haavisto
- Hospital District of Satakunta.,Department of Nursing Science, University of Turku
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3
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Leino-Kilpi H, Inkeroinen S, Cabrera E, Charalambous A, Fatkulina N, Katajisto J, Sigurðardóttir ÁK, Sourtzi P, Suhonen R, Zabalegui A, Valkeapää K. Instruments for Patient Education: Psychometric Evaluation of the Expected Knowledge (EKhp) and the Received Knowledge of Hospital Patients (RKhp). J Multidiscip Healthc 2020; 13:1481-1505. [PMID: 33204098 PMCID: PMC7667700 DOI: 10.2147/jmdh.s271043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/28/2020] [Indexed: 02/01/2023] Open
Abstract
Purpose In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients’ expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial). Patients and Methods The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language experts. International data collection was performed in 2009–2012 with a total sample of 1,595 orthopedic patients. Orthopedic patients were selected due to the increase in their numbers, and need for educational activities. Here we report the psychometrics of the instruments for potential international use and future development. Results Content validities were confirmed by each participating country. Confirmatory factor analyses supported the original theoretical, six-dimensional structure of the instruments. For some subscales, however, there is a need for further clarification. The summative factors, based on the dimensions, have a satisfactory internal consistency. The results support the use of the instruments in patient education in orthopedic nursing, and preferably also in other fields of surgical nursing care. Conclusion EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted.
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Affiliation(s)
- Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Saija Inkeroinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Esther Cabrera
- School of Health Sciences, TecnoCampus, University Pompeu Fabra, Barcelona, Spain.,Department of Care Management and Social Work, Sechenov University, Moscow, Russia
| | - Andreas Charalambous
- Department of Nursing Science, University of Turku, Turku, Finland.,Nursing Department, Cyprus University of Technology, Limassol, Cyprus
| | - Natalja Fatkulina
- Department of Nursing, Klaipeda University, Klaipėda, Lithuania.,Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Árún K Sigurðardóttir
- School of Health Sciences, University of Akureyri, Akureyri, Iceland.,Akureyri Hospital, Akureyri, Iceland
| | - Panayota Sourtzi
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,Welfare Division, City of Turku, Turku, Finland
| | - Adelaida Zabalegui
- Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Kirsi Valkeapää
- Department of Nursing Science, University of Turku, Turku, Finland.,Human Performance Division, Finnish Defense Research Agency, Järvenpää, Finland
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4
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Ingemann C, Hansen NF, Hansen NL, Jensen K, Larsen CVL, Chatwood S. Patient experience studies in the circumpolar region: a scoping review. BMJ Open 2020; 10:e042973. [PMID: 33020108 PMCID: PMC7537463 DOI: 10.1136/bmjopen-2020-042973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Patient experiences with health systems constitute a crucial pillar of quality care. Across the Arctic, patients' interactions with the healthcare system are influenced by challenges of access, historical inequities and social determinants. This scoping review sought to describe the range and nature of peer-reviewed literature on patient experience studies conducted within the circumpolar region. DESIGN In a partnership between Danish/Greenlandic, Canadian and American research teams, a scoping review of published research exploring patient experiences in circumpolar regions was undertaken. DATA SOURCES Seven electronic databases were queried: MEDLINE, Embase, Scopus, 'Global Health 1910 to 2019 Week 11', CINAHL, PsycINFO and SveMed+. ELIGIBILITY CRITERIA Articles were eligible for inclusion if they (a) took place in the circumpolar region, (b) reported patients' perspective and (c) were focussed primarily on patient experiences with care, rather than satisfaction with treatment outcome. DATA EXTRACTION AND SYNTHESIS Title and abstract screening, full-text review and data extraction was conducted by four researchers. Bibliometric information such as publication date and country of origin was extracted, as was information regarding study design and whether or not the article contained results relevant to the themes of Indigenous values, rural and remote context, telehealth and climate change. Two researchers then synthesised and characterised results relevant to these themes. RESULTS Of the 2824 articles initially found through systematic searches in seven databases, 96 articles were included for data extraction. Findings from the review included unique features related to Indigenous values, rural and remote health, telehealth and climate change. CONCLUSIONS The review findings provide an overview of patient experiences measures used in circumpolar nations. These findings can be used to inform health system improvement based on patient needs in the circumpolar context, as well as in other regions that share common features. This work can be further contextualized through Indigenous methodologies such as sharing circles and community based participatory methods.
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Affiliation(s)
- Christine Ingemann
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
- Institute of Nursing and Health Sciences, University of Greenland, Nuuk, Greenland
| | | | - Nanna Lund Hansen
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
| | - Kennedy Jensen
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
- Institute of Nursing and Health Sciences, University of Greenland, Nuuk, Greenland
| | - Susan Chatwood
- University of Alberta School of Public Health, Edmonton, Alberta, Canada
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5
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Ingadottir B, Thylén I, Ulin K, Jaarsma T. Patients are expecting to learn more: A longitudinal study of patients with heart failure undergoing device implantation. PATIENT EDUCATION AND COUNSELING 2020; 103:1382-1389. [PMID: 32122674 DOI: 10.1016/j.pec.2020.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the educational expectations and experiences of patients with heart failure in relation to device implantation. METHODS In this longitudinal study, patients at six Swedish and Icelandic hospitals answered instruments about their knowledge expectations, before the device implantation, and about the knowledge they had received at two weeks, six months and 12 months after the procedure. Predictors for fulfillment of knowledge expectations were assessed with linear mixed model analysis. RESULTS Patients (N = 133, mean age 69.8 (±9.7) years, 80 % men) had high knowledge expectations, which for 83 % of them were unfulfilled. Predictors for fulfillment of knowledge expectations were access to knowledge from healthcare professionals (β 0.74, 95 % CI: 0.42-1.10), educational level (β -0.30, 95 % CI: -0.52 to -0.07) and knowledge expectations (β -1.03, 95 % CI: -1.30 to -0.80). Healthcare professionals were the main information source (89 %), 74 % of patients received written information, and 19 % had used the Internet. CONCLUSIONS Patients receive less knowledge than they expect, and individual factors and communication with healthcare professionals are related to their experience. Face-to-face is the most common method of delivering education. PRACTICE IMPLICATIONS Healthcare professionals should assess patients' expectations for information and consider implementing more diversity in their educational practices.
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Affiliation(s)
- Brynja Ingadottir
- Faculty of Nursing, School of Health Sciences, Univeresity of Iceland, Reykjavik, Iceland; Landspitali, the National University Hospital of Iceland, Reykjavik, Iceland.
| | - Ingela Thylén
- Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kerstin Ulin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, Geriatrics and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Julius Center, University Medical Center, Utrecht, the Netherlands
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6
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Jette DU, Hunter SJ, Burkett L, Langham B, Logerstedt DS, Piuzzi NS, Poirier NM, Radach LJL, Ritter JE, Scalzitti DA, Stevens-Lapsley JE, Tompkins J, Zeni Jr J. Physical Therapist Management of Total Knee Arthroplasty. Phys Ther 2020; 100:1603-1631. [PMID: 32542403 PMCID: PMC7462050 DOI: 10.1093/ptj/pzaa099] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/24/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022]
Abstract
A clinical practice guideline on total knee arthroplasty was developed by an American Physical Therapy (APTA) volunteer guideline development group that consisted of physical therapists, an orthopedic surgeon, a nurse, and a consumer. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches to management of total knee arthroplasty.
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Affiliation(s)
- Diane U Jette
- FAPTA, MGH, Institute of Health Professions, Boston, Massachusetts
| | | | - Lynn Burkett
- ONC, National Association of Orthopaedic Nurses (NAON), Wyomissing, Pennsylvania
| | - Bud Langham
- Home Health and Hospice Services, Encompass Health, Birmingham, Alabama
| | - David S Logerstedt
- Department of Physical Therapy, University of the Sciences, Philadelphia, Pennsylvania
| | - Nicolas S Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Noreen M Poirier
- Department of Orthopedics and Rehabilitation, University of Wisconsin (UW) Health, Madison, Wisconsin
| | - Linda J L Radach
- Consumers United for Evidence Based Healthcare, Lake Forest Park, Washington
| | - Jennifer E Ritter
- Department of Rehabilitation Services/Physical Therapy, University of Pittsburgh Medical Center (UPMC) St Margaret Hospital/Catholic Relief Services, Pittsburgh, Pennsylvania
| | - David A Scalzitti
- OCS, School of Medicine and Health Sciences, George Washington University, Washington, DC
| | - Jennifer E Stevens-Lapsley
- Department of Physical Medicine and Rehabilitation, University of Colorado at Denver & Health Sciences Center, Denver, Colorado
| | - James Tompkins
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, Arizona
| | - Joseph Zeni Jr
- Department of Physical Therapy, University of Delaware, Newark, Delaware
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7
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Nors TB, Sestoft B, Dreyer P. Patients' Perspectives on Relatives in the Perioperative Setting: A Danish Study. AORN J 2020; 111:e1-e11. [DOI: 10.1002/aorn.12941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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8
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Buus AAØ, Hejlsen OK, Dorisdatter Bjørnes C, Laugesen B. Experiences of pre- and postoperative information among patients undergoing knee arthroplasty: a systematic review and narrative synthesis. Disabil Rehabil 2019; 43:150-162. [PMID: 31106616 DOI: 10.1080/09638288.2019.1615997] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose: The aim of this review was to identify and synthesize knowledge of how patients undergoing knee arthroplasty experience pre- and postoperative information provided by healthcare professionals.Materials and methods: A systematic review and narrative synthesis was conducted in accordance with Popay et al.'s guidelines which involve 1) developing a preliminary synthesis; 2) exploring relationships; and 3) assessing the robustness of the synthesis. Qualitative and quantitative studies were considered for inclusion, and a systematic, extensive search was conducted in scientific databases.Results: A total of 31 studies were included in this review. The analysis resulted in five synthesized themes: 1) Support in the decision to undergo surgery; 2) Confidence versus uncertainty in the preparation for surgery; 3) Prerequisites for feeling secure before discharge; 4) Struggling through rehabilitation at home; and 5) Unmet expectations and endeavoring to accept realities.Conclusions: The findings illustrate the complexities of patients' experiences of information from healthcare professionals and its significance for how they manage challenges throughout the surgical care pathway. Information from healthcare professionals influences patients' knowledge, skills and confidence in the journey through knee arthroplasty. Therefore, it is important that healthcare professionals recognize patients' support requirements and adapt information to their individual needs.Implications for rehabilitationHealthcare professionals should encourage more dialog with patients and adapt information to their individual circumstances and needs throughout the surgical care pathway.It is important that healthcare professionals provide ongoing information and repeat information throughout the entire surgical care pathway in order to facilitate predictability and improve patients' ability to comprehend and assimilate information.Improved access to information and advice from healthcare professionals following knee arthroplasty will offer patients reassurance and increase their confidence in managing postoperatively at home.Patients who require enhanced information and guidance from healthcare professionals need to be identified in order to support their progress and achieve the best possible postoperative outcomes.
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Affiliation(s)
| | - Ole Kristian Hejlsen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Britt Laugesen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
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9
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Abstract
Total knee replacement (TKR) surgery has been found to achieve positive outcomes for many patients such as reduced pain and increased function. However, some patients experience suboptimal outcomes including falls, readmission to hospital, and reduced functional performance. Preparation for discharge after TKR surgery is often defined related to pain control, walking, knee function, and ability to climb stairs. These measures may not fully encompass aspects of recovery that impact patients' readiness for discharge after surgery. The purpose of this article is to review discharge readiness following TKR surgery and discuss factors that are known to impact preparedness for discharge.
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10
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Klemetti S, Ingadottir B, Katajisto J, Lemonidou C, Papastavrou E, Valkeapää K, Zabalegui A, Leino-Kilpi H. Skills and Practices of European Orthopedic Nurses in Empowering Patient Education. Res Theory Nurs Pract 2018; 32:382-399. [DOI: 10.1891/1541-6577.32.4.382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: This study provides an overview of the self-defined skills and practices of European orthopedic nurses in empowering patient education. Nurses themselves have highlighted the necessity to enhance their own skills, but possibilities for further education have been limited. Methods: The data (n = 317 nurses) from a structured survey were collected during the years 2009–2012 in seven European countries with an EPNURSE—questionnaire (Empowering Patient Education from the point of view of Nurses). Results: Nurses considered patient education as an important part of their work and evaluated their own skills as good. However, their patient education practices were based more on practices on their ward and their own experience than on further education or evidence-based knowledge. On the other hand, lack of time for patient education and experienced overload were the major barriers experienced by nurses. Implications for Practice: Further education of orthopedic nurses in empowering evidence-based patient education is highly needed. Nurse leaders need to acknowledge the strong need for supporting nurses within clinical practice, improve their evidence-based knowledge and support practices that prioritize patient education within the hospital environment. Further international collaboration in nursing research and health-care organizations is desirable to reach these patient educational goals in clinical nursing practice.
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11
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Does intervention improve the outcomes of patients after total knee replacement surgery? Int J Orthop Trauma Nurs 2018; 31:26-31. [DOI: 10.1016/j.ijotn.2018.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/07/2018] [Accepted: 08/13/2018] [Indexed: 01/27/2023]
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12
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Effect of an e-Learning Tool on Expectations and Satisfaction Following Total Knee Arthroplasty: A Randomized Controlled Trial. J Arthroplasty 2018; 33:2153-2158. [PMID: 29555496 DOI: 10.1016/j.arth.2018.02.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/31/2018] [Accepted: 02/07/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Orthopedic surgeons recognize patient expectations of total knee arthroplasty (TKA) can be managed through education. E-learning is the application of educational technology. The objective of this study was to evaluate whether an e-learning tool could affect whether patients' expectations were met and they were satisfied 1 year following TKA. METHODS Patients with osteoarthritis from the London Health Sciences Centre, Canada, were randomly assigned to either a control group (n = 207) receiving standard patient education or an intervention group (n = 209) using the e-learning tool in addition to the standard. We used a web-based system with permuted block sizes, stratified by surgeon and first or second TKA. Preoperative measures were completed following the patients' preadmission clinic visit. Postoperative patient-reported outcome measures were completed at 6 weeks, 3 months, and 1 year after TKA. One year after TKA, risk difference was used to determine between-group differences for patient satisfaction and expectations being met. RESULTS One year postoperatively, the risk that expectations of patients were not met was 21.8% in the control group and 21.4% in the intervention group for an adjusted risk difference of 1.3% (95% confidence interval, -7.8% to 10.4%, P = .78). The proportion of patients satisfied with their TKA at 1 year postoperative was 78.6% in the intervention and 78.2% in the control groups. CONCLUSION There was no between-group difference at 1 year between intervention and control groups for either the risk that expectations of patients were not met or the proportion of patients who were dissatisfied with their TKA.
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13
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Palese A, Gonella S, Fontanive A, Guarnier A, Barelli P, Zambiasi P, Allegrini E, Bazoli L, Casson P, Marin M, Padovan M, Picogna M, Taddia P, Salmaso D, Chiari P, Frison T, Marognolli O, Canzan F, Ambrosi E, Saiani L. The degree of satisfaction of in-hospital medical patients with nursing care and predictors of dissatisfaction: findings from a secondary analysis. Scand J Caring Sci 2017; 31:768-778. [DOI: 10.1111/scs.12396] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 09/09/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Alvisa Palese
- Department of Medical and Biological Sciences; Udine University; Udine Italy
| | - Silvia Gonella
- Department of Internal Medicine; Azienda Ospedaliero Universitaria Città della Salute e della Scienza; Turin Italy
| | - Anna Fontanive
- Department of Medical and Biological Sciences; Udine University; Udine Italy
| | - Annamaria Guarnier
- Azienda per i Servizi Sanitari Trento; National Health Service Trust; Trento Italy
| | - Paolo Barelli
- Azienda per i Servizi Sanitari Trento; National Health Service Trust; Trento Italy
| | - Paola Zambiasi
- Azienda per i Servizi Sanitari Trento; National Health Service Trust; Trento Italy
| | - Elisabetta Allegrini
- Azienda Ospedaliera Universitaria Integrata Verona; National Health Service Trust; Verona Italy
| | - Letizia Bazoli
- Fondazione Poliambulanza; National Health Service Trust; Brescia Italy
| | - Paola Casson
- Azienda Unità Sanitaria Locale n. 9; National Health Service Trust; Treviso Italy
| | - Meri Marin
- Azienda per i Servizi Sanitari n. 2 “Isontina”; National Health Service Trust; Gorizia Italy
| | - Marisa Padovan
- Azienda Unità Sanitaria Locale n. 6; National Health Service Trust; Vicenza Italy
| | - Michele Picogna
- Azienda per i Servizi Sanitari n.4 “Medio Friuli”; National Health Service Trust; Udine Italy
| | - Patrizia Taddia
- Istituto Ortopedico Rizzoli; National Health Service Trust; Bologna Italy
| | | | | | - Tiziana Frison
- Azienda Ospedaliero-Universitaria; National Health Service Trust; Padua Italy
| | - Oliva Marognolli
- Azienda Ospedaliera Universitaria Integrata Verona; National Health Service Trust; Verona Italy
| | - Federica Canzan
- Department of Public Health and Community Medicine; Verona University; Verona Italy
| | - Elisa Ambrosi
- Department of Public Health and Community Medicine; Verona University; Verona Italy
| | - Luisa Saiani
- Department of Public Health and Community Medicine; Verona University; Verona Italy
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14
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Nies YH, Islahudin F, Chong WW, Abdullah N, Ismail F, Ahmad Bustamam RS, Wong YF, Saladina JJ, Mohamed Shah N. Treatment decision-making among breast cancer patients in Malaysia. Patient Prefer Adherence 2017; 11:1767-1777. [PMID: 29081652 PMCID: PMC5652923 DOI: 10.2147/ppa.s143611] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study investigated breast cancer patients' involvement level in the treatment decision-making process and the concordance between patients' and physician's perspectives in decision-making. PARTICIPANTS AND METHODS A cross-sectional study was conducted involving physicians and newly diagnosed breast cancer patients from three public/teaching hospitals in Malaysia. The Control Preference Scale (CPS) was administered to patients and physicians, and the Krantz Health Opinion Survey (KHOS) was completed by the patients alone. Binary logistic regression was used to determine the association between sociodemographic characteristics, the patients' involvement in treatment decision-making, and patients' preference for behavioral involvement and information related to their disease. RESULTS The majority of patients preferred to share decision-making with their physicians (47.5%), while the second largest group preferred being passive (42.6%) and a small number preferred being active (9.8%). However, the physicians perceived that the majority of patients preferred active decision-making (56.9%), followed by those who desired shared decision-making (32.8%), and those who preferred passive decision-making (10.3%). The overall concordance was 26.5% (54 of 204 patient-physician dyads). The median of preference for information score and behavioral involvement score was 4 (interquartile range [IQR] =3-5) and 2 (IQR =2-3), respectively. In univariate analysis, the ethnicity and educational qualification of patients were significantly associated with the patients' preferred role in the process of treatment decision-making and the patients' preference for information seeking (p>0.05). However, only educational qualification (p=0.004) was significantly associated with patients' preference for information seeking in multivariate analysis. CONCLUSION Physicians failed to understand patients' perspectives and preferences in treatment decision-making. The concordance between physicians' perception and patients' perception was quite low as the physicians perceived that more than half of the patients were active in treatment decision-making. In actuality, more than half of patients perceived that they shared decision-making with their physicians.
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Affiliation(s)
| | | | | | | | - Fuad Ismail
- Department of Radiotherapy and Oncology, Universiti Kebangsaan Malaysia Medical Centre
| | | | - Yoke Fui Wong
- Department of Radiotherapy and Oncology, National Cancer Institute, Putrajaya, Malaysia
| | | | - Noraida Mohamed Shah
- Faculty of Pharmacy
- Correspondence: Noraida Mohamed Shah, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia, Tel +60 3 9289 8038, Fax +60 3 2698 3271, Email
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Nepomuceno E, Silveira RCDCP, Dessotte CAM, Furuya RK, Arantes EDC, Cunha DCPTD, Dantas RAS. Instruments used in the assessment of expectation toward a spine surgery: an integrative review. Rev Esc Enferm USP 2016; 50:658-666. [PMID: 27680053 DOI: 10.1590/s0080-623420160000500017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/23/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify and describe the instruments used to assess patients' expectations toward spine surgery. METHOD An integrative review was carried out in the databases PubMed, CINAHL, LILACS and PsycINFO. RESULTS A total of 4,402 publications were identified, of which 25 met the selection criteria. Of the studies selected, only three used tools that had confirmed validity and reliability to be applied; in five studies, clinical scores were used, and were modified for the assessment of patients' expectations, and in 17 studies the researchers developed scales without an adequate description of the method used for their development and validation. CONCLUSION The assessment of patients' expectations has been methodologically conducted in different ways. Until the completion of this integrative review, only two valid and reliable instruments had been used in three of the selected studies. OBJETIVO Identificar e descrever os instrumentos usados para avaliar a expectativa dos pacientes diante do tratamento cirúrgico da coluna vertebral. MÉTODO Revisão Integrativa realizada nas bases de dados PubMed, CINAHL, LILACS e PsycINFO. RESULTADOS Identificamos 4.402 publicações, das quais 25 atenderam aos critérios de seleção. Dos estudos selecionados, apenas em três os autores utilizaram instrumentos que possuíam validade e confiabilidade confirmadas para serem aplicados; em cinco estudos foram utilizados escores clínicos, modificados para a avaliação das expectativas dos pacientes, e em dezessete os pesquisadores elaboraram escalas sem adequada descrição do método usado para o seu desenvolvimento e validação. CONCLUSÃO A avaliação das expectativas dos pacientes tem sido metodologicamente conduzida de diferentes maneiras. Até a finalização desta revisão integrativa, apenas dois instrumentos, válidos e confiáveis, haviam sido utilizados em três dos estudos selecionados.
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Affiliation(s)
- Eliane Nepomuceno
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação Interunidades, Ribeirão Preto, SP, Brazil
| | | | - Carina Aparecida Marosti Dessotte
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Geral e Especializada, Ribeirão Preto, SP, Brazil
| | | | - Eliana De Cássia Arantes
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação em Enfermagem Fundamental, Ribeirão Preto, SP, Brazil
| | | | - Rosana Aparecida Spadoti Dantas
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Geral e Especializada, Ribeirão Preto, SP, Brazil
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Pellinen T, Villberg J, Raappana M, Leino-Kilpi H, Kettunen T. Knowledge expectations of recently diagnosed patients with knee osteoarthritis. J Adv Nurs 2016; 72:2857-2868. [DOI: 10.1111/jan.13053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Tiina Pellinen
- Department of Health Sciences; University of Jyväskylä; Finland
| | - Jari Villberg
- Department of Health Sciences; University of Jyväskylä; Finland
| | | | - Helena Leino-Kilpi
- Department of Nursing Science; University of Turku; Finland
- Turku University Hospital; Turku Finland
| | - Tarja Kettunen
- Department of Health Sciences; University of Jyväskylä; Finland
- Central Finland Health Care District; Jyväskylä Finland
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Johansson Stark Å, Charalambous A, Istomina N, Salanterä S, Sigurdardottir AK, Sourtzi P, Valkeapää K, Zabalegui A, Bachrach-Lindström M. The quality of recovery on discharge from hospital, a comparison between patients undergoing hip and knee replacement - a European study. J Clin Nurs 2016; 25:2489-501. [DOI: 10.1111/jocn.13278] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Åsa Johansson Stark
- Department of Social and Welfare Studies; Linköping University; Norrköping Sweden
| | - Andreas Charalambous
- Cyprus University of Technology; Limassol Cyprus
- Department of Nursing Science; Turku University Hospital; University of Turku; Turku Finland
| | | | - Sanna Salanterä
- Department of Nursing Science; Turku University Hospital; University of Turku; Turku Finland
| | | | | | - Kirsi Valkeapää
- Department of Nursing Science; University of Turku; Turku Finland
- Lahti University of Applied Sciences; Lahti Finland
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18
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Orthopaedic patient education practice. Int J Orthop Trauma Nurs 2016; 21:39-48. [DOI: 10.1016/j.ijotn.2015.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 05/09/2015] [Accepted: 08/28/2015] [Indexed: 11/21/2022]
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Stark ÅJ, Salanterä S, Sigurdardottir AK, Valkeapää K, Bachrach-Lindström M. Spouse-related factors associated with quality of recovery of patients after hip or knee replacement - a Nordic perspective. Int J Orthop Trauma Nurs 2016; 23:32-46. [PMID: 27575874 DOI: 10.1016/j.ijotn.2016.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/09/2016] [Accepted: 03/14/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Today's shorter hospital stays mean that patients may need support from informal caregivers during their recovery period. The responsibility for providing this support shifts from the healthcare staff to their family members fairly early in the recovery process. Spousal caregivers are considered to be the primary caregivers as their relationship with the patient is more interdependent than that of other family members or caregivers. OBJECTIVES The aim was to describe spouse-related factors that were associated with patients' quality of recovery on discharge from hospital after elective hip or knee replacement. DESIGN The design was prospective, descriptive and comparative, with two measurements, before arthroplasty and on discharge. SETTINGS Two Finnish, three Icelandic and two Swedish university or community hospitals. PARTICIPANTS The sample consisted of spouses and patients. The inclusion criteria were as follows: age ≥18 years, ability to complete the questionnaires, and ability to understand Finnish/Icelandic/Swedish. The patients were asked to identify one family member. Spouses were those defining themselves as a wife, husband or cohabiting partner. Out of 463 spouses, 306 (66%) were included. The mean age of the included spouses was 64 years and 54% of them were females. METHODS Self-reported instruments were used on expected and received knowledge, access to knowledge, emotional state and quality of recovery. RESULTS If the spouses were or had been employed in healthcare or the social services, their partner had greater quality of recovery (p = 0.006). Spouses experiencing negative emotions had partners who experienced lower quality of recovery (p <0.001). Spouses who felt that nurses had enough time for them (p = 0.044) and explained matters concerning their family members' care and treatment (p = 0.011) had partners who experienced greater quality of recovery. CONCLUSIONS Spouses' emotional state played an important role in the patients' quality of recovery (QoR), with uncertainty and depressive state as the main predictors. The importance of nurses explaining matters sufficiently to spouses was emphasized, while spouses' fulfilment of knowledge expectations was not associated with patients' recovery.
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Affiliation(s)
- Åsa Johansson Stark
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
| | - Sanna Salanterä
- Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland
| | | | - Kirsi Valkeapää
- Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland; Lahti University of Applied Sciences, Lahti, Finland
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Ingadottir B, Thylén I, Jaarsma T. Knowledge expectations, self-care, and health complaints of heart failure patients scheduled for cardiac resynchronization therapy implantation. Patient Prefer Adherence 2015; 9:913-21. [PMID: 26170641 PMCID: PMC4494625 DOI: 10.2147/ppa.s83069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To describe what knowledge heart failure patients expect to acquire in relation to their upcoming cardiac resynchronization therapy (CRT) device implantation, to describe their self-care and health complaints, and to explore the relationship between knowledge expectations and self-care, health complaints, and background factors. PATIENTS AND METHODS Cross-sectional multicenter study with 104 patients scheduled for a first-time, elective CRT implantation in Swedish and Icelandic hospitals. Data were collected with the Knowledge Expectations of hospital patient Scale, European Heart Failure Self-care Behavior Scale, and Adjusted Postoperative Recovery Profile. RESULTS Patients expected most knowledge related to their disease and its treatment (median 4.0, interquartile range 0.13) and least on social issues (median 3.5, interquartile range 0.83). Their self-care was average (standardized mean 51.0±19.6) before the procedure. Patients had on average 8.2 (±4.7) health complaints and rated fatigue and sexual problems as the most severe. Age was independently associated with knowledge expectations (Expβ 0.049, P=0.033). CONCLUSION Heart failure patients waiting for a CRT device implantation have high expectations for multiple aspects of knowledge, including self-care issues, before their procedure. These expectations are similar to those of other surgical patients and they increase with age.
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Affiliation(s)
- Brynja Ingadottir
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
- Landspitali–The National University Hospital of Iceland, Reykjavik, Iceland
| | - Ingela Thylén
- Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Tiny Jaarsma
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
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Sigurdardottir AK, Leino-Kilpi H, Charalambous A, Katajisto J, Stark ÅJ, Sourtzi P, Zabalegui A, Valkeapää K. Fulfilment of knowledge expectations among family members of patients undergoing arthroplasty: a European perspective. Scand J Caring Sci 2015; 29:615-24. [PMID: 25648518 DOI: 10.1111/scs.12199] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/03/2014] [Indexed: 11/30/2022]
Abstract
In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach.
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Affiliation(s)
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Andreas Charalambous
- Department of Nursing Science, University of Turku, Turku, Finland.,Cyprus University of Technology, Limassol, Cyprus
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Åsa Johansson Stark
- Department of Social and Welfare Studies, Linköping University, Campus Norrköping, Sweden
| | | | | | - Kirsi Valkeapää
- Department of Nursing Science, University of Turku, Turku, Finland.,Lahti University of Applied Sciences, Lahti, Finland
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Fulfilment of knowledge expectations and emotional state among people undergoing hip replacement: A multi-national survey. Int J Nurs Stud 2014; 51:1491-9. [DOI: 10.1016/j.ijnurstu.2014.03.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 02/04/2014] [Accepted: 03/23/2014] [Indexed: 12/21/2022]
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