Changes in menstrual symptoms and work productivity after checklist-based education for premenstrual syndrome: an 8-month follow-up of a single-arm study in Japan

BACKGROUND

Premenstrual syndrome (PMS) is prevalent among women of reproductive age, but most do not seek medical advice. We hypothesized that building PMS awareness could promote medical help-seeking for PMS and thus reduce menstrual symptoms and improve work productivity.

METHODS

In January 2020, women aged between 25 and 44 years, having paid work, and not currently consulting with an obstetrics and gynecology doctor (n = 3090) responded to the Menstrual Distress Questionnaire (MDQ), the Premenstrual Symptoms screening tool, and the World Health Organisation Health and Work Performance Questionnaire. In addition, they received checklist-based online education for PMS. Of 3090 participants, 2487 (80.5%) participated in a follow-up survey in September 2020. We conducted multiple logistic regression analyses and text analyses to explore factors that encouraged and discouraged medical help-seeking. We also evaluated changes in menstrual symptoms and work productivity, using generalized estimating equations with interactions between the severity of PMS, help-seeking, and time.

RESULTS

During the follow-up period, 4.9% of the participants (121/2487) sought medical help. Those having high annual income (adjusted odds ratio [aOR] = 2.07, 95% confidence interval [CI]: 1.21-3.53) and moderate-to-severe PMS (aOR = 2.27, 95% CI: 1.49-3.46) were more likely to have sought medical help. Those who did not seek medical help despite their moderate-to-severe PMS reported normalization of their symptoms (36%), time constraints (33%), and other reasons for not seeking medical help. Participants with moderate-to-severe PMS who had sought medical help showed a significant improvement of - 8.44 points (95% CI: - 14.73 to - 2.15 points) in intermenstrual MDQ scores during the follow-up period. However, there were no significant improvements in premenstrual and menstrual MDQ scores or absolute presenteeism.

CONCLUSION

Medical help-seeking alleviated intermenstrual symptoms in women with moderate-to-severe PMS, but only a small proportion of them sought medical help after PMS education. Further research should be conducted to benefit the majority of women who are reluctant to seek medical help, including the provision of self-care information.

TRIAL REGISTRATION

UMIN Clinical Trials Registry number: UMIN000038917.

Not all information is informative: An exploration of educational content on recycled potable water knowledge and acceptance

As drought and water shortages threaten access to safe water supplies globally, finding ways to increase public acceptance of recycled water has become increasingly important. Educational interventions have often been explored as a potential method to help overcome public distaste for recycled water. However, in past research, the effects of educational interventions have tended to be modest, leading to some skepticism over the ability of public information campaigns to truly increase acceptance. We propose that, at least in part, these modest effects of education may be driven by differences in the ability of some types of educational content to increase recycled water knowledge and subsequent acceptance (e.g., some content may be too complex for a lay audience or may be insufficient to adequately address the concerns that drive one's apprehension towards recycled water). Thus, we developed and tested an educational video split into four distinct areas of educational content related to potable water reuse: (1) need for recycled water, (2) approaches to implementing recycled water (e.g., through direct, indirect, or de-facto reuse), (3) purification technology, and (4) locations and testimonials of actual implementation. In two experiments (Ns = 711, 385), we found that content illustrating approaches to implementing recycled water and locations using it led to medium to large increases in knowledge and acceptance. These results imply that given limited time and resources, brief information about these topics may increase acceptance better than alternative information. Moreover, these results underscore a need to more carefully consider the content used in educational campaigns, as not all information is equally likely to produce desired effects.

The effect of educational intervention based on social support theory on the perceived stress caused by the covid-19 pandemic in patients with diabetes in hormozgan (2020-2021)

BACKGROUND

People with diabetes are more at risk of covid-19. Perceived social support plays an important role in maintaining people's health and reducing the negative effects of stress caused by the environment and society. The present study was designed and implemented with the purpose of determining the effect of educational intervention based on social support theory in reducing stress caused by the covid-19 pandemic in people with diabetes.

METHODS

The current investigation was an interventional and semi-experimental study conducted on 212 patients diagnosed with type 2 diabetes. Eligible participants were diabetic individuals capable of utilizing virtual platforms and not afflicted with COVID-19. Exclusion criteria encompassed unwillingness to continue study participation, absence from multiple training sessions, and development of a specific illness during the study period. Random allocation placed patients into either the control or intervention group. The intervention group received educational materials via WhatsApp, while the control group did not receive any intervention. The researcher administered a questionnaire to collect demographic information and assess perceived social support among the patients. Data analysis involved the use of chi-square tests, independent and paired t-tests, as well as ANCOVA.

RESULTS

This study revealed that the mean age of patients in the control and intervention groups was 46.35 ± 14.15 and 51.72 ± 11.57, respectively. Most of the diabetic patients in both groups were female, married, had a diploma, were housekeepers, and had an income between 2 and 5 million Tomans. According to the results obtained in all subscales of social support theory as well as the perceived stress score due to the corona pandemic after the educational intervention, a statistically significant difference was observed between the two groups (P < 0.05), so that the score of all subscales of social support theory in the intervention group was higher than the control group. But the perceived stress score caused by Corona in the intervention group was significantly lower than the control group.

CONCLUSION

The results of this study illustrate the noteworthy influence of social support training in lessening perceived stress among patients with diabetes during the COVID-19 pandemic. Consequently, healthcare providers are encouraged to integrate social support education programs into comprehensive care initiatives for diabetic patients, particularly during periods of heightened stress like the current coronavirus pandemic.

Effects of Interventions for Improving Awareness and Knowledge of Nonalcoholic Fatty Liver Disease Among Chinese Young Adults for Prevention of Liver Cancer-A Randomized Controlled Trial

Chinese young adults (CYA), who are at an increasing risk of developing nonalcoholic fatty liver disease (NAFLD), which in turn increases the risk of liver cancer, are an ideal target population to deliver educational interventions to improve their awareness and knowledge of NAFLD and consequently reduce their risk of developing NAFLD. The purpose of this study was to determine the efficacy of two interventions to improve awareness and knowledge of NAFLD among CYA for the prevention of liver cancer. Between May and July 2021, 1373 undergraduate students aged 18 to 25 years in one university in China completed a web-based, self-administered survey distributed through WeChat app. One week after completion of the baseline survey, all eligible participants were randomly assigned to a pamphlet, a video intervention, or no intervention (control group), with follow-up assessments immediately and 1-month post-intervention. The 7-page pamphlet or 6.5-min video had information on NAFLD. Self-assessments included NAFLD awareness, lean NAFLD awareness, and knowledge scores of NAFLD. About 26% of participants had NAFLD awareness at baseline. Compared with controls, participants in both interventions showed significant improvement of awareness of NAFLD (pamphlet, + 46.0%; video, + 44.3%; control, + 18.7%; OR [95% CI], 3.13 [2.19-4.47] and 2.84 [1.98-4.08]), awareness of lean NAFLD (pamphlet, + 41.2%; video, + 43.0%; control, + 14.5%; OR [95% CI], 2.84 [1.62-4.99] and 2.61 [1.50-4.54]), and knowledge score of NAFLD (pamphlet, + 64.2%; video, + 68.9%; control, - 1.0%; OR [95% CI], 1.62 [1.47-1.80] and 1.67 [1.50-1.86]) at immediately post-intervention. Delivering NAFLD education through a pamphlet or video intervention was effective in improving the awareness and knowledge of NAFLD among CYA.

Teaching lateral reading: Interventions to help people read like fact checkers

People need more support learning to evaluate the credibility of online information. This article reviews recent research on interventions designed to teach lateral reading, the strategy of leaving an unfamiliar website to search for information about a source's credibility via additional sources. Interventions that use diverse designs to teach lateral reading and target participants in elementary school through adulthood have shown evidence of improving participants' digital evaluations. These interventions suggest that targeted and explicit instruction in lateral reading can help people both assess credible information and identify misinformation. Still, much more work is needed in a wider range of contexts to probe the design elements, duration, and teacher education needed to support successful interventions.

Short report: Siblings of children with neurodevelopmental disorders, a phenomenological perspective on parental perception

BACKGROUND

Siblings, typically developing brothers and sisters of children with neurodevelopmental disorders (NDD), are at risk for long-term psychosocial difficulties.

OBJECTIVE

The present study aims at obtaining an in-depth insight on the lived experience of siblings of children with NDD through their parents' perspective.

METHODS

Seven mothers and three fathers who signed up their sibling children (12-15 years) to a peer-support intervention participated in a semi-structured videoconference interview according to the Interpretative Phenomenological Analysis (IPA) qualitative approach. Interviews were conducted by trained personnel and independently coded.

RESULTS

Thematic analysis highlighted three core themes and twelve sub-themes: "The complexity of the fraternal relationship" (three sub-themes), "Growing up with diversity" (six sub-themes), and "Me as a sibling" (three sub-themes).

CONCLUSIONS

The study provides insight on parents' perception of the lived experience of their sibling children, thus spreading awareness on the everyday difficulties families with a child with NDD may encounter.

WHAT THIS PAPER ADDS

The present study contributes to the scarce literature on the lived experience of siblings of children with NDD, and notably it is one of the few qualitative studies on the topic which makes use of an IPA interviewing style. This methodological choice allowed for an in-depth understanding of siblings' strengths and struggles as perceived by their own parents, and of how their brother/sister's condition impacted on their family role, socio-emotional development and personality. Recounting siblings' experiences contributes in spreading awareness on the everyday difficulties siblings and their families face when cohabitating with a child with NDD.

LOGAN-CV: A Prospective Study of a Multifaceted Intervention Targeting United States Clinicians to Improve Guideline-Based Management of Lipid-Lowering Therapy

INTRODUCTION

The 2018 American Heart Association (AHA)/American College of Cardiology (ACC)/Multisociety blood cholesterol guidelines recommend clinicians consider adding non-statin therapy for patients with very high-risk (VHR) atherosclerotic cardiovascular disease (ASCVD) and low-density lipoprotein cholesterol (LDL-C) ≥ 70 mg/dl while receiving maximally tolerated statins. However, according to a recent study, only 17.1% of patients with established ASCVD received appropriate lipid-lowering therapy (LLT) intensification. Here, we describe the design of a prospective, 12-month study (LOGAN-CV) evaluating a multifaceted site-level intervention to enhance clinicians' adherence to guidelines to improve LDL-C levels for patients with VHR ASCVD.

METHODS

Clinicians from up to ten research sites are eligible if they care for adult patients with ASCVD. Interventions include educational modules, a cloud-based performance platform providing clinicians a tailored summary of their LDL-C management performance, newsletters, periodic peer-to-peer calls, and pre- and post-intervention surveys evaluating knowledge, attitudes, and beliefs around LDL-C management, with additional interventions for clinicians demonstrating a lower readiness to make treatment decisions based on guideline recommendations. Patients with VHR ASCVD, defined as having recent myocardial infarction and LDL-C ≥ 70 mg/dl despite statin treatment, will be included in the study. Patient data will be collected from electronic medical records from baseline (clinician enrollment) through the 12-month intervention. The study started in October 2022, with anticipated completion in March 2024.

PLANNED OUTCOMES

The change in proportion of patients with LDL-C < 70 mg/dl achieved at any time during the 12-month intervention (primary); LLT intensification, changes in guideline-aligned LDL-C testing and LLT titration over 12 months, and change in overall clinicians' knowledge, attitudes, and beliefs are key outcomes of interest. The LOGAN-CV study addresses a critical unmet need in LDL-C control in patients with VHR ASCVD and evaluates the effect of a multifaceted intervention targeting clinicians to improve their adherence to guidelines and consequently improve clinical outcomes for patients.

Effect of educational intervention on medication reconciliation practice of hospital pharmacists in a developing country - A non-randomised controlled trial

BACKGROUND

Medication reconciliation is an evidence-based practice that reduces medication-related harm to patients. This study evaluated the effect of educational intervention on medication reconciliation practice of pharmacists among ambulatory diabetes and hypertensive patients.

METHODS

A non-randomized clinical trial on medication reconciliation practice was carried out among 85 and 61 pharmacists at the intervention site and control site, respectively. Medication reconciliation was carried out among 334 (intervention-183; control-151) diabetes and/or hypertensive patients by the principal investigator to indirectly evaluate pharmacists' baseline medication reconciliation practice at both sites. A general educational intervention was carried out among intervention pharmacists. Medication reconciliation was carried out by the principal investigator among another cohort of 96 (intervention-46; control-50) and 90 (intervention-44; control-46) patients at three and six months postintervention, respectively, to indirectly assess pharmacists' postintervention medication reconciliation practice. Thereafter, a focused educational intervention was carried out among 15 of the intervention pharmacists. Three experts in clinical pharmacy analysed the medication reconciliation form filled by the 15 pharmacists after carrying out medication reconciliation on another cohort of 140 patients, after the focused intervention. Data was summarized with descriptive (frequency, percentage, mean ± standard deviation) and inferential (Pearson product-moment correlations analysis, independent-samples t-test and one-way ANOVA) statistics with level of significance set at p<0.05.

KEY FINDINGS

Baseline medication reconciliation practice was poor at both sites. Post-general educational intervention, medication discrepancy was significantly reduced by 42.8% at the intervention site (p<0.001). At the intervention site, a significant increase of 54.3% was observed in patients bringing their medication packs for clinic appointments making medication reconciliation easier (p=0.003), at 6-months postintervention. Thirty-five, 66 and 48 drug therapy problems were detected by 31 (43.1%), 33 (66.0%) and 32 (71.1%) intervention pharmacists at 1-, 3- and 6-month post-general educational intervention, respectively. Post-focused educational intervention, out of a total of 695 medications prescribed, 75 (10.8%) medication discrepancies were detected and resolved among 42 (30%) patients by the 15 pharmacists.

CONCLUSIONS

The educational interventions improved pharmacists' medication reconciliation practice at the intervention site. It is expected that this research would help create awareness on medication reconciliation among pharmacists in developing countries, with a view to reducing medication-related patient harm.

Effectiveness of an educational intervention to promote psychosocial well-being of school-going adolescents in Sri Lanka

BACKGROUND

One-fifth of the Sri Lankan population consists of adolescents, with 71% of them schooling. An extreme need exists in the country for the introduction of evidence-based interventions for the psychosocial well-being of adolescents. The present study assessed the effectiveness of an educational intervention to promote the psychosocial well-being of school-going adolescents in grade nine in Western Province, Sri Lanka.

MATERIALS AND METHODS

A quasi-experimental study was conducted among grade nine students in Western Province in 2019. Panadura Medical Officer of Health (MOH) area was selected as the interventional area (IA), and Kelaniya MOH area was identified as the control area (CA). Teachers at schools in the IA received training on psychosocial health promotion of adolescents. They delivered the activity-based educational intervention package to the grade nine students as 20-min classroom sessions for three months. Pre- and post-intervention assessments of attitudes and practices related to the psychosocial well-being of adolescents were conducted using an interviewer-administered questionnaire. Categorical data were compared using Chi-Square or Fisher's exact test. Mann-Whitney U test was applied to determine the difference between the medians of the pre-and post-intervention scores on attitude and practices for psychosocial well-being.

RESULTS

A total of 1040 grade nine students were enrolled. There was a statistically significant increase in median score on attitudes [81.8 (IQR:75.5-85.5) to 82.3(IQR:78.6-87.2] and practices [81.7(IQR: 76.1-85.7) to 83.1(IQR: 79.1-86.9)] in the IA while there was no significant difference in the CA. The proportion of bullied adolescents in the past 30 days reduced significantly from 14.8% (n = 38) to 7.9% (n = 20) in IA(p = .03), whereas there was a slight reduction from 17.1% (n = 44) to 11.3% (n = 26) in CA (p = .17).

CONCLUSIONS

The present psychosocial intervention is effective in improving the psychosocial well-being of school adolescents, though long-term effectiveness was not assessed. It is recommended to utilise study findings in deciding to introduce the present intervention to basic and in-service teacher training packages and school curricula with necessary modifications.

A Study on the effect of lifestyle educational intervention based on the theory of planned behavior on promoting quality of life of middle-aged women

The present study aimed to determine the effect of lifestyle educational intervention based on the theory of planned behavior on promoting the quality of life of middle-aged women. The present quasi-experimental study examined 80 middle-aged women and randomly divided them into two groups (intervention and control). Data collection tools included the demographic information questionnaire, the Health Promoting Lifestyle Profile-II (HPLP-II), the 12-Item Short-Form Health Survey (SF-12), and the author-developed questionnaire based on constructs of the theory of planned behavior. Data were collected via WhatsApp twice (before and three months after the educational intervention). Five 45-minute training sessions were held for the intervention group and a 60-minute session for a family member regarding physical activity and spiritual growth over two months via WhatsApp. Data were analyzed using SPSS, and the results were considered significant at a statistical level (p < .05). The implementation of the educational intervention significantly increased the mean scores of quality of life, physical activity and spiritual growth, knowledge regarding physical activity and spiritual growth, attitude toward physical activity and spiritual growth, subjective norms toward spiritual growth, perceived behavioral control for physical activity, and behavioral intention to perform physical activity and spiritual growth in the intervention group in comparison with the control group. The educational intervention, which was designed based on constructs of the theory of planned behavior, was influential in promoting the lifestyles and quality of life of middle-aged women. Therefore, it is suggested to use the educational program of the present study in addition to other middle-age health care.

Development and validation of a predictive model for the diagnosis of rheumatic heart disease in low-income countries based on two cross-sectional studies

Objectives

We developed a questionnaire-based risk-scoring system to identify children at risk for rheumatic heart disease (RHD) in rural India. The resulting predictive model was validated in Nepal, in a population with a similar demographic profile to rural India.

Methods

The study involved 8646 students (mean age 13.0 years, 46% boys) from 20 middle and high schools in the West Midnapore district of India. The survey asked questions about the presence of different signs and symptoms of RHD. Students with possible RHD who experienced sore throat and joint pain were offered an echocardiogram to screen for RHD. Their findings were compared with randomly selected students without these symptoms. The data were analyzed to develop a predictive model for identifying RHD.

Results

Based on our univariate analyses, seven variables were used for building a predictive model. A four-variable model (joint pain plus sore throat, female sex, shortness of breath, and palpitations) best predicted the risk of RHD with a C-statistic of 0.854. A six-point scoring system developed from the model was validated among similarly aged children in Nepal.

Conclusions

A simple questionnaire-based predictive instrument could identify children at higher risk for this disease in low-income countries where RHD remains prevalent. Echocardiography could then be used in these high-risk children to detect RHD in its early stages. This may support a strategy for more effective secondary prophylaxis of RHD.

Impact of an educational intervention for advanced cancer patients referred for early phase clinical trials

A 2017 service evaluation identified a lack of information and knowledge among patients who were referred on to early phase oncology clinical trials (Hood, 2020). An educational booklet was developed to improve patients' knowledge and experience. To build upon this work, a patient co-designed website was developed. This study examined the impact, if any, of a patient co-designed educational intervention within the clinical pathway for patients who are referred for an early phase oncology clinical trial at an experimental cancer medicine centre (ECMC).

AIMS

1. To understand the experiences of patients who have been referred to an ECMC for an early phase clinical trial pre- and post-intervention. 2. To investigate if the intervention reduced anxiety levels in newly referred patients.

METHOD

A convergent mixed-methods design was used in this study, to collect quantitative and qualitative data in parallel.

OUTCOMES

This study examined the experiences of advanced cancer patients who attended their initial research outpatient appointment to discuss the possibility of taking part in an early phase clinical trial and the impact of an educational resource.

The Effects of an Educational Intervention on Exercise Advice Behaviors of Thai Oncology Nurses

OBJECTIVE

To evaluate an educational intervention based on the Theory of Planned Behavior to increase oncology nurses' exercise advice behaviors.

METHODS

A single-group, quasi-experimental repeated measures design study was used with 124 oncology nurses in a Thai cancer institute. The educational intervention included preeducation self-directed activities for 1 hour, a 2-hour group education session, and posteducation outreach contact 1 week later. The outcome measures, including the Theory of Planned Behavior constructs, exercise knowledge, and self-reported exercise prescription behaviors, were collected at three time points: Time 1 (2 weeks preintervention), Time 2 (immediately preintervention), and Time 3 (2 weeks after the intervention).

CONCLUSION

Results indicated a statistically significant increase in scores after the intervention for all outcomes, including the Theory of Planned Behavior constructs (overall P value <.001), exercise knowledge (β = 2.99, P < .001), and exercise prescription behaviors: asking (odds ratio [OR] = 12.98, P < .001), assessing (OR = 6.20, P < .001), referring (OR = 4.10, P < .001), and writing exercise advice (OR = 11.52, P < .001). Additionally, verbal counseling behavior was performed by all participants, and therefore, the odds for verbal counseling were not reported. Structural equation modeling analysis demonstrated that attitudes and perceived behavioral control explained 41% of the variance in exercise advice intention. Perceived behavioral control and intention also explained 20% of the variance in self-reported exercise advice behaviors.

IMPLICATIONS FOR NURSING PRACTICE

Attitudinal and perceived behavioral control constructs should be a focus of attention to improve health care professionals' exercise advice behaviors. More focused research is required to examine whether patients engage in and follow the exercise advice provided by oncology nurses.

Educational training to improve opioid overdose response among health center staff: a quality improvement initiative

BACKGROUND

There were seven opioid overdoses in this New York City (NYC) federally qualified health center from December 2018 through February 2019, reflecting the rising rate of overdose deaths in NYC overall at the time. In response to these overdoses, we sought to increase the readiness of health center staff to recognize and respond to opioid overdoses and decrease stigmatizing attitudes around opioid use disorder (OUD).

METHODS

An hour-long training focusing on opioid overdose response was administered to clinical and non-clinical staff of all levels at the health center. This training included didactic education on topics such as the overdose epidemic, stigma around OUD, and opioid overdose response, as well as discussion. A structured assessment was administered immediately before and following the training to evaluate change in knowledge and attitudes. Additionally, participants completed a feedback survey immediately after the training to assess acceptability. Paired t-tests and analysis of variance tests were used to assess changes in pre- and post-test scores.

RESULTS

Over 76% of the health center staff participated in the training (N = 310). There were large and significant increases in mean knowledge and attitudinal scores from pre- to post-test (p < .001 and p < .001, respectively). While there was no significant effect of profession on attitudinal change scores, profession did have a significant effect on knowledge change scores, with administrative staff, non-clinical support staff, other healthcare staff, and therapists learning significantly more than providers (p < .001). The training had high acceptability among participants from diverse departments and levels.

CONCLUSIONS

An interactive educational training increased staff's knowledge and readiness to respond to an overdose as well as improved attitudes toward individuals living with OUD.

TRIAL REGISTRATION

This project was undertaken as a quality improvement initiative at the health center and as such was not formally supervised by the Institutional Review Board per their policies. Further, per the guidelines of the International Committee of Medical Journal Editors, registration is not necessary for clinical trials whose sole purpose is to assess an intervention's effect on providers.

Improvement of oral health knowledge and behavior of diabetic patients: an interventional study using the social media

BACKGROUND

Diabetic patients are not often aware of relationship between diabetes mellitus (DM) and periodontal diseases, and the researchers recommend further knowledge enhancement of diabetic patients in this regard. This study aimed to enhance oral health knowledge of diabetic adults via an educational intervention.

METHODS

In this interventional study, three private offices of endocrinologists specialized in treatment of DM were selected for the recruitment of participants. In total, 120 diabetic adults (40 from each office) took part in an educational intervention in three groups (patients from each office made up one group): (I) physician-aid, (II) researcher-aid, and (III) social media. In group (I), participants received educational materials (brochure and CD) from their endocrinologist, in group (II) participants received educational materials from researcher. Group (III) joining an educational group in WhatsApp for 3 months. A self-reported standard questionnaire was filled out by the patients before, and after the intervention to assess oral health knowledge. Data were analyzed by SPSS version 21 using independent t-test, Mann-Whitney test, Chi-square test, and ANCOVA.

RESULTS

The mean oral health knowledge score increased in all three groups after the educational interventions (P < 0.001); the highest increase occurred in the social media group. Toothbrushing twice daily or more had the greatest improvement in the physician-aid group compared with the other two groups (P < 0.001). The greatest improvement in dental flossing once daily or more occurred in the social media group (P = 0.01). The mean level of the hemoglobin A1c (HbA1c) decreased in all three groups, but not significantly (P = 0.83).

CONCLUSION

The results showed that educational interventions enhance oral health knowledge, and improve the behavior of diabetic adults. The education via the social media can be an efficient method for knowledge enhancement of diabetic patients.

Effect of an educational intervention based on the theory of planned behavior on improving medication adherence in patients with multiple sclerosis treated with injectable disease-modifying drugs: randomized controlled trial

BACKGROUND

Adherence to prescribed treatment in chronic diseases, as occurs in multiple sclerosis (MS), is a critical factor for a successful therapeutic response. This study aimed to investigate the effect of educational program based on Theory of Planned Behavior (TPB) on treatment adherence in patients with multiple sclerosis (MS) receiving injectable immunomodulatory drugs.

METHODS

The present study is an educational randomized controlled trial research that was conducted on 100 patients with MS who had gone to MS clinic in Tehran city (Iran). The samples were randomly assigned to the intervention (N = 50) and control groups (N = 50). Data collection instrument was a researcher-made questionnaire based on TPB. Then, educational program was performed for the intervention group through four educational sessions. After three months, data collection was repeated for the two groups and data were analyzed.

RESULTS

The knowledge and performance of the intervention group on treatment adherence drugs increased from 56.25 ± 20.3 to 78.31 ± 15.57 and 56.22 ± 5.76 to 71.62 ± 12.01 after the education respectively (p < 0.001). The mean of construct of TPB in the intervention group also increased after the intervention (p < 0.05).

CONCLUSION

Applying the TPB model proved is very effective in developing an educational program for patients with MS, to enhance treatment adherence drugs. Besides such programs, follow-up education for controlling and monitoring are highly recommended.

TRIAL REGISTRATION

This trial has been registered at Iranian Registry of Clinical Trials, IRCT20210808052109N1. Prospectively registered at 12-Aug-2021, (12/8/2021) available at: URL: https://en.irct.ir/trial/57994.

Evaluating the effect of educational intervention based on the health belief model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls

INTRODUCTION

A healthy lifestyle can reduce the rate and symptoms of premenstrual syndrome. Thus, the present study evaluates the effect of educational intervention based on the Health Belief Model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls.

METHODS

This quasi-experimental study was conducted on 80 first-grade high school girls. They were divided into two intervention and control groups (40 people in each group). The data collection tools included the participants' demographic information questionnaire, premenstrual symptoms screening tool, and a researcher-made questionnaire based on the constructs of the health belief model about PMS and the behaviors reducing its symptoms. Data were collected in two phases (before and three months after the educational intervention) via WhatsApp. Educational sessions were held in the form of four 45-min sessions for intervention group subjects regarding PMS and the behaviors that reduce its symptoms during one month via WhatsApp.

RESULTS

According to the results of this study, the mean scores of knowledge about PMS and health belief model constructs (including perceived susceptibility), perceived severity, perceived benefits, perceived self-efficacy, cues to action, lifestyle/behaviors that reduce PMS symptoms) and the percentage of people who did not have PMS symptoms or had a mild type of PMS increased significantly after implementing the educational intervention in the intervention group compared to before the intervention and compared to the control group. Also, the perceived barriers construct score PMS decreased significantly.

CONCLUSIONS

The health belief model education focused on a healthy lifestyle was effective in reducing PMS symptoms. It is recommended to use the educational intervention designed in this study, along with other health care in schools and during puberty as an easy, low-cost, and effective intervention.

Effect of an educational intervention on the knowledge, attitudes, and practices of healthcare workers at King Hussein Cancer Center towards predatory publishers

AIMS

We explored the effect of an educational intervention on the knowledge, attitudes, and practices of healthcare workers (HCWs) towards predatory publishing.

METHODS

A retrospective pre-post quasi experimental design was implemented on HCWs within King Hussein Cancer Center (KHCC). Following a 60-min educational lecture, a self-administered questionnaire was completed by participants. Pre- and post-intervention scores for familiarity, knowledge, practices, and attitudes were compared using the paired sample t-test. Multivariate linear regression was used to identify predictors of mean differences (MD) of knowledge scores.

RESULTS

A total of 121 respondents completed the questionnaire. The majority of participants demonstrated underwhelming awareness of predatory publishing and average levels of knowledge of their characteristics. Furthermore, respondents did not take the necessary precautions to avoid predatory publishers. The intervention (i.e. the educational lecture) improved familiarity (MD: 13.4; 95%CI: 12.4 - 14.4; p-value < .001), knowledge of predatory journal's characteristics (MD: 12.9; 95%CI: 11.1 - 14.8; p-value < .001), awareness and perceived compliance to preventive measures (MD: 7.7; 95%CI: 6.7 - 8.6; p-value < .001), and positively influenced attitudes towards open access and safe publishing (MD: 0.8; 95%CI: 0.2 - 1.5; p-value = 0.012). Females had significantly lower familiarity scores (p-value = 0.002). Moreover, those who had published in open access journals, received at least one predatory e-mail, or had more than 5 published original articles had significantly higher familiarity and knowledge scores (all p-value < 0.001).

CONCLUSIONS

An educational lecture proved effective in improving awareness of KHCC's HCW's to predatory publishers. Nonetheless, the mediocrity of pre-intervention scores raises concerns on effectiveness of the predatory covert practices.

Effect of educational intervention programme on the health-related quality of life (HRQOL) of individuals with type 2 diabetes mellitus in South-East, Nigeria

BACKGROUND

Diabetes is one of the most important chronic diseases that have a great impact on health as people with diabetes are constantly being reminded of their disease daily; they have to eat carefully, exercise, and test their blood glucose. They often feel challenged by their disease because of its day-to-day management demands and these affect their quality of life. The study aimed at determining the effect of an educational intervention program on the quality of life of Individuals with type 2 Diabetes Mellitus in South East, Nigeria.

METHODS

A quasi-experimental controlled study involving three hundred and eighty-two (382) type 2 DM persons recruited from the tertiary health institutions in South East, Nigeria, and randomly assigned to intervention and control groups respectively. Data was collected from the diabetic clinics of the health institutions using the SF - 36 questionnaires. Pretest data collection was done, and thereafter, education on self-care was given to the intervention group. After a 6months follow-up, post-test data were collected from both groups. Analysis was done using an Independent t-test, Analysis of Covariance (ANCOVA), Paired Samples Test, and Spearman rank order correlation at 0.05 alpha level.

RESULTS

The control group indicated significantly higher mean HRQOL scores in most domains of the HRQOL before intervention (t = -1.927 to -6.072, p < 0.05). However, 6 months after the intervention, the mean HRQOL scores of the intervention group increased significantly in all the domains of HRQOL (p < 0.05) with an effect size of 0.14 (Eta squared). A comparison of the two groups shows a statistically significant difference (64.72 ± 10.96 vs. 58.85 ± 15.23; t = 4.349. p = 0.001) after the intervention. Age was inversely correlated with some domains of HRQOL; as age increases, HRQOL decreases in those domains. Gender had no significant influence on HRQOL.

CONCLUSION

Educational intervention was effective in improving HRQOL in individuals with type 2 DM. Hence, it is recommended for inclusion in all diabetes care plans.

"I Was Here First, Why Did They Go Before Me": Examining Patients'Perceptions of Priority in a Psychometric Study of Emergency Department Triage

INTRODUCTION

Unrealistic patient expectations for wait times can lead to poor satisfaction. This study's dual purpose was: (1) to address disparities between patients' perceived priority level and the Emergency Severity Index (ESI) assigned by emergency room triage nurses; and (2) to evaluate validity and reliability of using the Patient Perception of Priority to be Seen Survey (PPPSS) to investigate patient expectations for emergency department urgency.

METHODS

A two-group pretest-posttest quasi-experimental approach compared patient urgency opinions to nurse urgency ratings with and without a scripted educational intervention. This tested how closely patient perceptions were related to triage nurse ratings.

RESULTS

Reliability for the PPPSS was acceptable (reliability = 0.75). Patients who were rated lower urgency on the ESI by triage nurses tended to self-report higher urgency (rho = -0.44, P < .01). Attitudes were more consistent in the posttest patient group who were exposed to the scripted verbal description of emergency department procedures (χ² (1, N = 352) = 8.09, P < .01). Patients who disagreed with emergency nurse scores tended to be younger on average (eg, < 40 years old; rho = 0.69, P < .01). Male identified patients tended to be rated both by nurses and themselves as higher urgency (beta = 0.18, P = .02).

DISCUSSION

We recommend the PPPSS for nurses and researchers to quickly assess patient expectations. Additionally, promoting patient understanding through a scripted educational strategy about the ESI system may also result in improvements in communication between patients and nurses.

Effect of an educational intervention for telephone triage nurses on out-of-hours attendance: a pragmatic randomized controlled study

BACKGROUND

Telephone triage has been established in many countries as a response to the challenge of non-urgent use of out-of-hours primary care services. However, limited evidence is available regarding the effect of training interventions on clinicians' telephone consultation skills and patient outcomes.

METHODS

This was a pragmatic randomized controlled educational intervention for telephone triage nurses in 59 Norwegian out-of-hours general practitioners' (GPs) cooperatives, serving 59% of the Norwegian population. Computer-generated randomization was performed at the level of out-of-hours GP cooperatives, stratified by the population size. Thirty-two out-of-hours GP cooperatives were randomized to intervention. One cooperative did not accept the invitation to participate in the educational programme, leaving 31 cooperatives in the intervention group. The intervention comprised a 90-minute e-learning course and 90-minute group discussion about respiratory tract infections (RTIs), telephone communication skills and local practices. We aimed to assess the effect of the intervention on out-of-hours attendance and describe the distribution of RTIs between out-of-hours GP cooperatives and list-holding GPs. The outcome was the difference in the number of doctor's consultations per 1000 inhabitants between the intervention and control groups during the winter months before and after the intervention. A negative binomial regression model was used for the statistical analyses. The model was adjusted for the number of nurses who had participated in the e-learning course, the population size and patients' age groups, with the out-of-hours GP cooperatives defined as clusters.

RESULTS

The regression showed that the intervention did not change the number of consultations for RTIs between the two groups of out-of-hours GP cooperatives (incidence rate ratio 0.99, 95% confidence interval 0.91-1.07). The winter season's out-of-hours patient population was younger and had a higher proportion of RTIs than the patient population in the list-holding GP offices. Laryngitis, sore throat, and pneumonia were the most common diagnoses during the out-of-hours primary care service.

CONCLUSIONS

The intervention did not influence the out-of-hours attendance. This finding may be due to the intervention's limited scope and the intention-to-treat design. Changing a population's out-of-hours attendance is complicated and needs to be targeted at several organizational levels.

The effect of educational intervention in the prevention of cardiovascular diseases in patients with hypertension with application of health belief model: A quasi-experimental study

Background

The best methods for preventing and controlling cardiovascular diseases are preventive behaviours.

Aim

The purpose of the current study is to ascertain how educational intervention affects cardiovascular disease prevention.

Methods

The current investigation is a quasi-experimental study conducted in Shiraz, Iran, in the year 2022, focusing on 200 hypertension patients (by sample random sampling) that were divided into two groups: a control group consisting of 100 participants (63 males and 37 females) and an intervention group also consisting of 100 participants (58 males and 42 females). The data collection instrument comprises inquiries pertaining to demographic factors as well as constructs of the health belief model (HBM) and preventive behaviours for cardiovascular diseases. The participants in both groups completed the questionnaire prior to and three months after the intervention. The intervention group underwent a total of six training sessions, each lasting 55 min.

Results

The results showed that after the intervention, the intervention group showed a significant increase in all cues of the HBM model except for the perceived barriers. Following a period of three months subsequent to the educational intervention, the experimental group also exhibited a notable reduction in blood pressure in comparison to the control group.

Conclusion

The findings of the study indicate that the utilisation of the HBM demonstrated positive outcomes in facilitating the promotion of cardiovascular disease prevention among patients diagnosed with hypertension. The promotion of health among individuals with high blood pressure can be both beneficial and feasible. Moreover, this particular model can be utilised as a comprehensive framework for the development, execution, and evaluation of advantageous and effective healthcare initiatives.

The effect of educational intervention on self-care behavior in hypertensive older people: Applying the health belief model

BACKGROUND

Hypertension is a worldwide health issue. Increasing aging has given rise to the prevalence of this problem. Disease management using educational intervention based on theoretical frameworks is effective for influencing self-care behavior. The goal of this study is to investigate the effects of educational intervention on self-care behaviors that influence hypertension control among the elderly population during 2020 based on the health belief model.

MATERIALS AND METHODS

A quasi-experimental study was conducted on rural older people in Ardestan, Iran. Assessments were done before and after three educational intervention sessions with a control group. The random sampling has done on 99 hypertensive elderly people in two rural centers of Ardestan from 2019 to 2020. Awareness variables, components of the health belief model, and blood pressure were assessed before and three months after the intervention. Data analysis was done using descriptive and analytical statistics.

RESULTS

The study groups did not differ significantly in terms of the variables studied at the beginning of the study. After three months, the variables of awareness, self-care, and perceived sensitivity constructs, perceived severity, perceived benefits, and guide to action showed a significant rise in the experimental group compared to the control group. In addition, the effectiveness of educational intervention significantly increased self-care behavior in the experimental group.

CONCLUSIONS

Educational intervention based on the health belief model can be effective to reduce the barriers of self-care behaviors. In order to have a lasting change in behavior, the use of behavioral change patterns that ecologically take into account interpersonal, organizational, and social factors is suggested too.

Impact of education on the knowledge, attitude and practice of disposal of expired and unused medications among pharmacy students

OBJECTIVE

To assess the impact of education among pharmacy students on their level of knowledge, attitude and practices in the disposal of expired and unused medications.

MATERIALS AND METHODS

A pre-test post-test study without control group was conducted in which a total of 573 students pursuing Bachelor of Pharmacy and Doctor of Pharmacy programmes were enrolled. The impact of education provided was analysed with the aid of a previously validated KAP questionnaire. Data on KAP was analysed using SPSS software 24.0.

RESULTS AND DISCUSSION

The knowledge, attitude and practice of the total students improved from 74.17±17.063 to 91.06±11.87, 75.92±19.26 to 91.73±12.318 and 43.11±22.77 to 82.06±16.149 respectively. The improvement with respect to knowledge and attitude was significantly high among Doctor of Pharmacy students when compared to Bachelor of Pharmacy, with P value<0.001 for both domains.

CONCLUSION

The present study concludes on the effectiveness of educational intervention in generating a positive impact on the student population with respective to adequate disposal practices to be followed for unused and expired medications.

An internet-based educational intervention for mothers targeting preschoolers' weight management promotion (PWMP): a pilot study

BACKGROUND

The prevalence of overweight and obesity among children has raised public health concerns. This study aimed to design and evaluate a behaviour change intervention program to promote weight management among Tehranian preschoolers.

METHODS

The PRECEDE-PROCEED model is one of the most popular models in health education used to develop and evaluate most educational interventions. In this one-group pre and post-pilot study, 13 mothers of preschoolers were recruited from preschools in Tehran (the capital of Iran), in August 2020. Mothers received a six-week educational intervention, including text messages and educational videos via WhatsApp, to increase their self-efficacy to overcome barriers changing their children's lifestyle. Mothers reported preschoolers' height and weight to assess Body Mass Index and filled out the Food Frequency Questionnaire, the Persian version of the children's health-related quality of life questionnaire, and demographic features. The "Children's physical activity and sedentary behaviors checklist," newly designed by the researchers, was also filled out by mothers. These behaviors were measured according to the minutes that children were involved in these activities in a day, and the days they spent in a week for them. All variables were measured at baseline, immediately after the intervention and three months later. Data analysis was performed using SPSS IBM statistics version 22. Friedman test was used to evaluate changes over time.

RESULTS

The findings demonstrated that the mean BMI z-score stayed steady between baseline, immediately after the intervention and after three months (P = 0.60). Besides, after three months, the intervention programme led to a decrease in soft drink consumption (P = 0.001), and an increase in parental perception of their child's general health (P = 0.05), the parental concern regarding their child's emotional and physical health (P = 0.002) and minutes of physical activity per day (P = 0.02). However, fruit intake decreased (P = 0.01), and simple sugar, such as cube, increased (P = 0.03).

CONCLUSION

Results from this study are promising but should be interpreted with caution and should be replicated on a larger scale and compared with a control group to evaluate whether effects are maintained in a larger sample.

Effectiveness of letters to patients with or without Cochrane blogshots on 10-year cardiovascular risk change among women in menopausal transition: 6-month three-arm randomized controlled trial

BACKGROUND

Health information and patient education on lifestyle changes may have a positive effect on the prevention of many chronic conditions, especially cardiovascular diseases (CVDs). We performed a parallel, three-arm randomized controlled trial (RCT) of 6-month educational intervention in a form of letters containing a reminder of the participant's CVD risk with or without Cochrane blogshots to reduce CVD risk among women aged 45-65 with one or more known CVD risk factors.

METHODS

The control group received a letter about their CVD risk at the beginning of the trial. The intervention groups received the initial letter about their CVD risk and remainder letters about their CVD risk every 2 months, with or without Cochrane blogshots: (1) effect of calcium in the prevention of high blood pressure, (2) effect of reducing saturated fat acids in eating habits, and (3) effects of green and black tea in CVD prevention. The primary outcome was CVD risk reduction calculated as the difference between the baseline and 6-month score for a 10-year risk of fatal CVD according to the ACC/AHA guidelines.

RESULTS

After both interventions, CVD risk reduction was significantly higher compared to the control group (P < 0.001, Kruskal-Wallis H test). The number of participants who decreased their CV risk was 29% (20/70) in the control group, 69% (48/70) in the group receiving the reminder letters, and 70% (49/70) in the group receiving the reminder letters and blogshots. The number needed to treat to achieve risk reduction was 2.41 (95% CI = 1.77 to 3.78) for letters with a CVD risk reminder and 2.50 (1.81 to 4.03) for letters with a reminder and a blogshot. The group receiving reminder letters with Cochrane blogshots had a significant change in the category of CVD risk, mainly from high to moderate and from moderate to low CVD risk category.

CONCLUSIONS

A simple and inexpensive intervention method in a form of letters reminding women about their CVD risk with or without providing additional health information in the form of Cochrane blogshots about interventions for important CVD risk factors may be effective in CVD management and could be considered by primary care providers.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04601558. Retrospectively registered on October 19, 2020.

The effect of stigmatization education on the social distancing of nursing students toward patients with a diagnosis of schizophrenia

PURPOSE

To assess the effect of a program designed to reduce nursing students' social distancing from individuals diagnosed with schizophrenia.

METHOD

This experimental study was designed using a pretest, a posttest, and a control group. All participants were nursing students, of which 25 were included in the intervention group and 23 were placed in the control group. A 13-week program was offered to the intervention group. The measuring instruments consisted of a personal information form and the Social Distance Scale. Data were analyzed using the two-way repeated measures analysis of variance.

FINDINGS

A significant difference was found between the two groups.

CONCLUSION

The Education Program on Stigmatization in Schizophrenia is an effective intervention that reduces the social distance of nursing students from individuals diagnosed with schizophrenia.

Effectiveness of educational intervention on reducing oxidative stress caused by occupational stress in nurses: A health promotion approach

BACKGROUND

Nursing is one of the most stressful occupations. Educational intervention regarding stress management can play an important role in reducing occupational stress among nurses The present study aimed to determine the effectiveness of educational intervention on reducing oxidative stress caused by occupational stress in nurses: A health promotion approach in a hospital in western Iran.

MATERIALS AND METHODS

The present interventional study was performed in 2019 among 92 nurses working at the Kosar Hospital located in the city of Sanandaj in the country of Iran. Occupational stress was evaluated using the Osipow Occupational Stress Questionnaire. Oxidative stress was measured by taking blood samples and measuring the enzymatic activity of superoxide dismutase (SOD), malondialdehyde, and catalase (CAT) using SOD, malondialdehyde (MDA), and CAT kits. Educational intervention was carried out in the second stage. Three months after the intervention, data were taken again.

RESULTS

The results of the present study indicated that there was a significant difference in occupational stress between before and after the educational intervention (P < 0.05). A significant reduction in MDA (P = 0.038) and SOD (P = 0.048) was observed after educational intervention, but this was not the case for CAT (P = 0.592). There was no significant correlation between occupational stress with oxidative stress parameters before and after the educational intervention (P < 0.05). No significant difference in occupational stress was observed between men and women. Among the oxidative stress parameters under evaluation, MDA was higher among men compared to women and this was statistically significant.

CONCLUSIONS

Educational intervention regarding occupational stress is effective in reducing oxidative stress among nurses. The group meetings teach stress management to the participants and enable them to better manage their stress by utilizing their own capabilities. Thus, attention to this issue is vital in maintaining the mental and physical health of nurses and, in turn, improves the quality of care rendered.

The impact of a breast cancer educational intervention in Ghanaian high schools

Introduction

Globally breast cancer is the leading cause of cancer with an estimated 2.3 million new cases and 685,000 deaths in 2020. Late presentation is the hallmark of breast cancer in Ghana for which ignorance and fear are the major reasons fuelled largely by myths and misconceptions. Breast cancer awareness and education needs to start early to bring about a change in knowledge, attitude and practices. However, Breast cancer awareness activities in Ghana have usually targeted adult women.

This study assessed the impact of breast cancer education among adolescent high school girls in Ghana.

Methodology

A pre- post-test quasi experimental study was conducted at two senior high schools. A self-administered pre-educational questionnaire was followed by an educational intervention consisting of a drama, PowerPoint lecture, question and answer session and distribution of breast cancer information leaflets. After 3 months the same questionnaire was administered as a post-education test to assess the impact of the educational intervention. The total score for each domain was categorised into adequate knowledge > 50% and inadequate knowledge < 50%.

Results

The number of participants in the pre-test and post-test were 1043 and 1274; the median ages [IQR] were 16.0 [15.0–17.0] for both the pre and post-test students. General knowledge on breast cancer at pre-education (29.1%) improved to 72.5% (p < 0.001). Knowledge on signs and symptoms improved from 33.1 to 55% (p < 0.001); knowledge on risk factors improved from 55.3 to 79.2% (p < 0.001), and knowledge on breast self-examination and screening improved from 9.8 to 22.2% (p < 0.001). The overall performance of the students improved from 17.2 to 59.4% (p < 0.001).

Conclusion

There is inadequate knowledge about breast cancer and self-examination among senior high school girls in Ghana. Our breast cancer educational intervention was effective in improving general knowledge of breast cancer, risk factors, signs and symptoms and breast self-examination. The overall knowledge base improved from 17.2 to 59.4% 3 months post intervention, accompanied by an increase in the reported practice of breast self-examination and a greater belief that breast cancer is curable. This study has demonstrated the need for a school breast cancer educational program and that breast cancer education in high schools is effective.

Educational intervention program based on health belief model and neck pain prevention behaviors in school teachers in Tehran

Background

Prevention of musculoskeletal disorders as one of the most common occupational health problems among the working population in both developed and developing countries is an important necessity and priority. The aim of this study was to evaluate the effectiveness of an educational intervention program based on the Health Belief Model (HBM) to increase awareness, perceived sensitivity, perceived severity, perceived benefits, and self-efficacy in adopting neck health-promoting behaviors in school teachers.

Methods

The present study was a quasi-experimental of the randomized clinical trial that was conducted for 6 months (December 2020 to July 2021). Participants were 146 junior high school teachers were selected from 26 schools through random sampling and divided into two groups of intervention and control. The data collection instrument was the self-design questionnaire and was completed in three points of time (before, immediately, and 3 months after the intervention). The data were analyzed by software version 24 SPSS.

Results

The results showed that awareness, perceived sensitivity, perceived severity, perceived benefits and barriers, and self-efficacy in adopting neck health-promoting behaviors in the intervention group increased in two points of time (immediately after the intervention and 3 months of follow-up) (P <  0.05).

Conclusion

Designing and implementing an educational intervention based on HBM could affect in adopting neck health-promoting behaviors among teachers.

Trial registration

IRCT20210301050542N1, 16/03/2021 first registration has been approved in Iranian Registry of Clinical Trials at (16/03/2021).

Professionals´ readiness for change to knowledge-based palliative care at nursing homes: a qualitative follow-up study after an educational intervention

Background

There has been a global increase in the number of people who are dying of old age. This development implies a need for good palliative care among older persons at the end of life. Here nursing homes have an important role to play. However, the principles of palliative care have not been sufficiently applied in nursing homes, and there is a need to increase the implementation of palliative care in these settings. Therefore the project named Implementation of Knowledge-Based Palliative Care in Nursing Homes (the KUPA project, to use its Swedish acronym) was started as a contribution to filling this knowledge gap. The aim of the present study was to investigate the professionals’ experiences of readiness for change to knowledge-based palliative care at nursing homes after the educational intervention within the KUPA project.

Methods

The focus group method was used to interview 39 health-care professionals with the aid of semistructured questions based on the Organizational Readiness for Change theoretical framework. Six focus groups were formed at six nursing homes in two counties in southern Sweden. The groups included different types of professionals: assistant nurses, nurses, occupational therapists, physiotherapists and social workers. The analysis was conducted with an abductive approach and included deductive and inductive content analysis.

Results

The analysis revealed one overarching theme: hopeful readiness for change in palliative care despite remaining barriers. The main categories were increased knowledge facilitating development, enhanced team spirit, uncertainty about future plans connected with hopeful readiness and remaining organizational barriers.

Conclusions

This study adds knowledge and understanding concerning professionals’ readiness for change palliative care in nursing homes and shows how ready nursing home settings undertake these changes in practice. The Organizational Readiness for Change theory proved suitable for application in nursing homes to assess the professionals’ experiences and to evaluate educational interventions regardless of the organization’s readiness for change.

Trial registration

ClinicalTrials NCT02708498, first registration 15/03/2016.

An educational intervention to facilitate appropriate subspecialty referrals: a study assessing resident communication skills

BACKGROUND

Our goal was to improve pediatric residents' advanced communication skills in the setting of referral to address the entrustable professional activity of subspecialty referral identified by the American Board of Pediatrics. To accomplish this aim, we created a referral and consultation curriculum to teach and assess core communication skills in subspecialty referral involving an adolescent with syncope, an anxiety-provoking symptom that is rarely associated with serious pathology.

METHODS

We utilized blended multimodal educational interventions to improve resident communication skills in referral of patients. Trainees participated in 1) an interactive online module on syncope focusing on "red-flag" symptoms that would warrant a subspecialty cardiology referral and 2) a 4-h intervention with Standardized Parents (SPs), focusing on the case-based application of communication skills. Communication skills were assessed by two pre- and post- Objective Structured Clinical Examination encounters of patients with syncope, with an SP evaluation using a 20-item checklist. Analysis was performed with Sign test and McNemar's test. Trainees provided feedback on a Critical Incident Questionnaire, which was analyzed qualitatively.

RESULTS

Sixty-four residents participated. There was an overall improvement in communication skills based on SP scores (82.7 ± 10.9% to 91.7 ± 5.0%, p < 0.001), and 13/20 items demonstrated significant improvement post-intervention. Residents' improved performance enabled them to address patient/family emotions, explain referral logistics, and clarify concerns to agree on a plan.

CONCLUSIONS

By participating in this curriculum, residents' communication skills improved immediately post-intervention. Further research is needed to assess if this intervention improves patient care by providing residents with enduring skills to judiciously manage the referral process.

Educational intervention in triage with the Swedish triage scale RETTS©, with focus on specialist nurse students in ambulance and emergency care - A cross-sectional study

AIM

To determine the reliability of application of the RETTS© triage scale after an educational intervention using paper-based scenarios in emergency care education.

BACKGROUND

Knowledge about and education in triage are important factors in triagescale implementation. Presenting students with a large number of triage scenarios is a common part of triage education.

METHODS

In this prospective cross-sectional study at two universities students undergoing education in emergency care used RETTS© to assess triage level in 46 paper-based scenarios.

RESULTS

57 students in the study made 2590 final triage decisions. Fleiss Kappa for final triage was 0.411 which is in the lower range of moderate agreement. In 25 of 46 (53.4%) scenarios, final triage levels did not agree about whether the case was stable or unstable.

CONCLUSION/IMPLICATIONS

Application of the RETTS© triage scale after an educational intervention with paper-based simulation in emergency care education resulted in moderate agreement about the final levels of triage.

Efficacy of capacity building educational interventions in the management of obstetric complications: A systematic review

BACKGROUND

Delay in the diagnosis and management of obstetric complications lead to raised mortality rate. This can be curtailed by appropriate implementation of the educational intervention among the health-care providers. Hence, this review aimed to identify the literature evidence of the efficacy of various educational interventions training in the management of obstetric complications.

MATERIALS AND METHODS

We searched PUBMED, Web of Science, SCOPUS, Google Scholar, Cochrane, and maternity care databases with studies published from 2011 to 2021 for identifying studies related to this educational intervention review using MeSH terms and free terms. The search process was also done on the websites of the World Health Organization and the reproductive health library in the English language. From the 1823 abstracts reviewed, 16 studies were included (15 quasi-experimental, 01 randomized clinical trial, and 01 exploratory research design). We identified studies that included skill assessment of nurses, midwives, auxilliary nurse-midwives (ANMs), medical students, interns, and doctors after implementing various educational interventions.

RESULTS

According to the findings of this literature, achieving enhanced nursing management of obstetric complications has been developed. Especially, it suggests through better nursing training and education and also by providing sufficient resources, time, and coordination with obstetric specialists, nurses and midwives will be able to implement their care roles, which include proper diagnosis, appropriate intervention, advanced care, client education, and psychological support. The efficacy of each educational intervention varies and depends on the participants' understanding, interest, and the advancement of the teaching-learning method used.

CONCLUSION

This systematic review reveals abroad and logical move towards the evaluation of various educational interventions in the field of obstetric complications. Among all the educational interventions implemented, mobile application, and simulation-based training play a major role in improving the knowledge and skills of health-care providers in the management of obstetric complications.

Effect of the e-flipped learning approach on the knowledge, attitudes, and perceived behaviour of medical educators

Objectives

Using the Kirkpatrick evaluation model, investigate the effect of the e-flipped learning approach on the knowledge, attitudes, and perceived behaviour of medical educators.

Results

This interventional study was conducted on 140 eligible medical educators at Shiraz University of Medical Sciences (SUMS) from 2019 to 2021. A researcher-made questionnaire was developed to assess the impact of the course on three levels of reaction, knowledge, and perceived behaviour using the Kirkpatrick evaluation model. According to the findings, the average reaction and knowledge scores are higher than the desired level, but the perceived behaviour score is slightly lower than the desired level. The e-flipped learning approach can improve medical educators’ knowledge, attitude, and behaviour regarding online teaching.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06119-8.

The effectiveness of spiritual intelligence educational interventions for nurses and nursing students: A systematic review and meta-analysis

AIM

To synthesize the best available research evidence regarding the effectiveness of spiritual intelligence educational interventions on spiritual intelligence and professional outcomes in nurses and nursing students.

BACKGROUND

Spiritual intelligence is a form of intelligence with which individuals can deal with a crisis, alter situations, solve problems and achieve goals through a set of capacities and abilities. Possessing spiritual intelligence contributes to professional practice and competence in the workplace and has been seen to be beneficial for nurses and nursing students. Nursing interventions to teach and increase understanding of spiritual intelligence have been explored in the literature, but the effectiveness of spiritual intelligence training for nurses and nursing students remains uncertain.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

A three-step systematized search of sixteen electronic English and Persian databases was conducted to identify randomized and non-randomized trials published in English and Persian from January 2000 to November 2021.

METHODS

The methodological quality of eligible studies was undertaken by two independent reviewers using the Medical Education Research Study Quality Instrument. Meta-analyses were undertaken where appropriate using STATA v16.

RESULTS

Seven studies involving 512 participants were included. Pooled results demonstrated that those who received the educational intervention had significantly higher spiritual intelligence scores at 2 weeks (MD 13.38, 95 % CI: 5.76, 20.99) and one month follow up (MD 20.03, 95% CI: 6.61, 33.45) compared with those who did not. No difference in spiritual intelligence scores was observed among those who received spiritual intelligence education or life skills training (MD 7.52, 95 % CI -1.78, 16.82). Significantly higher communication skills (MD 5.41, 95 % CI: 2.16, 8.66), job satisfaction (MD; 11.30, 95 % CI: 8.63, 13.97) and spiritual care competence (MD; 28.55, 95 % CI: 26.08, 31.02) and decrease in overall stress (MD; 10.30, 95 % CI: 6.84, 13.76) among those who received the educational interventions were reported at the one-month follow-up. Significantly higher job satisfaction levels were also reported at 2-month follow-up among those who received the educational interventions (MD; 16, 95 % CI: 11.06, 20.94).

CONCLUSIONS

The evidence from this review demonstrates that spiritual intelligence educational interventions have a positive effect on spiritual intelligence and professional outcomes in nurses and nursing students. We noted that the outcomes in the studies included were mostly measured at one-month follow-up and with subjective measures. Longer trials with objective measures are required to provide higher levels of evidence. The results of this review are largely based on single trials and were limited in terms of the number of outcomes. Conducting further trials is warranted to identify the influence of such education on various professional outcomes in nursing practice.

TWEETABLE ABSTRACT

Systematic review and meta-analysis shows spiritual intelligence educational interventions have a positive effect on nurses' and nursing students' spiritual intelligence, work-related stress and professional practice.

An innovative strategy for nursing training on standard and transmission-based precautions in primary health care: A randomized controlled trial

BACKGROUND

Strategies to improve adherence to standard and transmission-based precautions are essential to reduce the risk of health care-associated infections. This study aims to evaluate the effectiveness of an educational strategy on precautions among nursing staff in primary health care settings.

METHODS

A randomized nonblinded controlled trial was conducted with 100 nursing staff working in 28 primary health care units. Groups were allocated randomly. The intervention group received a WebQuest educational strategy: a guided, creative method designed to engage participants in developing learning tasks, organized in 5 dimensions. The control group did not receive any training. Knowledge and self-reported adherence were assessed at 3 time points in the intervention group and at 2 time points in the control group. Data analyses were performed using Pearson's chi-square or Fisher's exact for categorical data, and Mann-Whitney and Repeated Measures analysis of variance for quantitative data.

RESULTS

A higher level of knowledge was identified in the postintervention for the dimensions of risk assessment, hand hygiene, and mask use and cough etiquette (all P values P < .05). The self-reported adherence increased in intervention (P = .008) and control groups (P = .005). The differences decreased after 6 months.

CONCLUSIONS

The educational intervention increased the knowledge and self-reported adherence to standard and transmission-based precautions.

Effects of an educational intervention on nursing students' attitudes towards gypsy women: A non-randomized controlled trial

BACKGROUND

The cultural differences between health professionals and patients, together with the ethnocentric opinions that some health professionals sometimes hold, generate prejudice and negatively influence the experiences of these groups, for example, the Gypsy population.

METHODS

We set up a quasi-experimental study to test the efficacy of an educational intervention among 40 nursing students in Spain based on the use of positive references in order to improve the students' attitude towards gypsy women receiving health care. Analysis of comparison of means and correlation analysis were carried out according to the type of variable compared.

RESULTS

The score in all the items that make up the Prejudicial Attitude Scale (PAT) decreased after the test, which demonstrated that their attitudes had become less prejudiced. The Stereotype Content Model (SCM), the perception of the outgroup and the stereotypes regarding the Roma population as "trustworthy" all improved showing a statistically significant difference between the periods (pre and post educational intervention).

CONCLUSION

Nursing educators have the opportunity, through theoretical and practical exposure to positive references, to explore the students' experience and perceptions, analyze interventions and change their perceptions of threat, thus contributing to a more inclusive group identity.

The effect of peer education based on Pender's health promotion model on quality of life, stress management and self-efficacy of patients with multiple sclerosis: a randomized controlled clinical trial

Background

As a chronic, disabling disease, multiple sclerosis (MS) has challenged healthcare systems in many ways. MS adversely affects patients’ quality of life and self-efficacy and results in psychological stress. The present study was conducted to investigate the effect of peer education based on Pender’s health promotion model on the quality of life, stress management, and self-efficacy of patients with MS in the south of Iran.

Methods

The present study was a randomized controlled clinical trial. A total of 90 patients were divided into group A intervention group 45 patients) and group B (control group 45 patients). The intervention was peer education based on Pender’s health promotion model. Data were collected using the MS Quality of Life Scale, the Self-efficacy Scale, and the Stress Management Scale. Data analyses were conducted using SPSS version 22. To analyze the data, we used descriptive statistics. Thus, inferential statistics applied included Chi-square, independent-samples t-test, and Repeated measures (ANOVA). The significance level was considered p < 0.05.

Results

The quality of life, self-efficacy, and stress management mean scores of the intervention group as measured immediately and 3 months after intervention were significant (p < 0.05). As for the control group, however, the difference was not significant.

Conclusion

Peer education based on Pender’s health promotion model improves patients’ quality of life, stress management, and self-efficacy with multiple sclerosis. Nursing managers and health system policymakers can use this educational approach for patients with other chronic diseases to enhance their quality of life and self-efficacy.

Trial registration

Iranian Registry of Clinical Trials: IRCT registration number: IRCT20190917044802N3.

The Impact of an Inpatient Pancreatitis Service and Educational Intervention Program on the Outcome of Acute Pancreatitis

BACKGROUND

We introduced an inpatient pancreatitis consultative service aimed to 1) provide guideline-based recommendations to acute pancreatitis inpatients and 2) educate inpatient teams on best practices for acute pancreatitis management. We assessed the impact of pancreatitis service on acute pancreatitis outcomes.

METHODS

Inpatients with acute pancreatitis (2008-2018) were included in this cohort study. Primary outcomes included length of stay and refeeding time. The educational intervention was a guideline-based decision support tool, reinforced at hospital-wide educational forums. In Part A (n = 965), we compared outcomes pre-service (2008-2010) to post-service (2012-2018), excluding 2011, when the pancreatitis service was introduced. In Part B (n = 720, 2012-2018), we divided patients into 2 groups based on if co-managed with the pancreatitis service, and compared outcomes, including subgroup analysis based on severity, focusing on mild acute pancreatitis.

RESULTS

In Part A, for mild acute pancreatitis, length of stay (111 vs 88.4 h, P = .001), refeeding time (61.8 vs 47.4 h, P = .002), and infections (10.0% vs 1.87%, P < .001) were significantly improved after the pancreatitis service was introduced, with multivariable analysis showing reduced length of stay (odds ratio 0.83; 95% confidence interval, 0.82-0.84; P < .001) and refeeding time (odds ratio 0.75; 95% confidence interval, 0.74-0.77; P < .001). In Part B, for mild acute pancreatitis, refeeding time (44.2 vs 50.3 h, P = .123) and infections (5.58% vs 4.70%, P = .80) were similar in patients cared for without and with the service. Length of stay was higher in the pancreatitis service group (93.3 vs 81.2 h, P = .05), as they saw more gallstone acute pancreatitis patients who had greater length of stay and magnetic resonance cholangiopancreatography. In the post-service period, a majority of patients with moderate/severe acute pancreatitis and nearly all intensive care unit admits received care from the pancreatitis service.

CONCLUSIONS

Implementation of an inpatient pancreatitis service was associated with improved outcomes in mild acute pancreatitis. Guideline-based educational interventions have a beneficial impact on management of mild acute pancreatitis by admitting teams even without pancreatitis consultation.

Nursing staff confidence and knowledge when caring for people with self-harm injuries: a service improvement study

The knowledge and confidence of nursing staff can impact re-harming rates of patients with self-harm injury. This service improvement study sought to address the knowledge, confidence and practice issues for staff nurses and healthcare assistants (HCAs) caring for patients who had presented to the emergency department (ED) with self-harm injury. The knowledge and confidence of nursing staff was reported using Likert-style questionnaires in a longitudinal study, framed within one Plan, Do, Study, Act (PDSA) cycle. Attitudes and challenges to patient care were also sought to inform future practice. The findings, based on the responses of 10 nurses and 5 HCAs, showed an increase in knowledge and confidence among both staff groups following the education session. Of the 15 who participated, 5 provided feedback to a reflective questionnaire to assess their views 30 days after the intervention. Quantitative data revealed a perception in an increase in the standard of care. The study found that both knowledge and confidence in supporting individuals presenting with self-harm in the ED improved at 30 days post-educational intervention. The numbers in the study were small and challenge transferability, however, service improvement theory is concerned with identifying measures of success rather than statistical reliability.

Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in Bangladesh: a pre-post quasi-experimental study

BACKGROUND

Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of an educational intervention program on breast cancer knowledge and the practice of breast self-examination among young female students of a university in Bangladesh.

METHODS

A quasi-experimental (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar's tests and paired sampled t-tests were performed to investigate the differences between pre- and post-test stages.

RESULTS

A total of 400 female university students aged 18-26 years were included in the sample. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational intervention. The significant differences were measured in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99 ± 1.05 vs. 6.35 ± 1.15; p < 0.001), risk factors (3.35 ± 1.19 vs. 7.56 ± 1.04; p < 0.001), treatment (1.79 ± 0.90 vs. 4.63 ± 0.84; p < 0.001), prevention (3.82 ± 1.32 vs. 7.14 ± 1.03; p < 0.001), screening of breast cancer (1.82 ± 0.55 vs. 3.98 ± 0.71; p < 0.001) and process of BSE (1.57 ± 1.86 vs. 3.94 ± 0.93; p < 0.001). Likewise, a significant percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8%; p < 0.001).

CONCLUSIONS

Study findings confirm that the study population had inadequate awareness and knowledge at baseline which was improved significantly after educational intervention. A nationwide roll-out with community-based interventions is recommended for the female population in both rural and urban areas.

Effects of an educational intervention to strengthen humanistic practice on haemodialysis nurses' caring attitudes and behaviours and quality of working life: a cluster randomised controlled trial

Background

Nurses are trained to establish a trusting relationship with patients to create an environment promoting patients’ quality of life. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices may emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead to a deterioration of quality of life and, ultimately, of health status. For nurses, it may cause a deterioration of the work environment and, in turn, of quality of working life. Based on Watson’s Theory of Human Caring, we developed a brief educational intervention for haemodialysis nurses to strengthen their humanistic practice in the aim of improving the nurse-patient relationship and nurse quality of working life.. The intervention was tested by way of an experimental design.

Methods

One hundred and one haemodialysis nurses, recruited in ten hospitals in French-speaking Switzerland, were randomised into an experimental group that received the intervention and a control group. The nurse-patient relationship was measured with the Caring Nurse-Patient Interaction Scale (EIIP-70) and nurse quality of life at work was measured with the Quality of Work Life Questionnaire at four time points: pre-intervention, intervention completion, and six-month and one-year follow-ups. Random intercept regression analysis was used to evaluate change over time in the two variables under study.

Results

The intervention appeared to reinforce nurse attitudes and behaviours geared to a more humanistic practice. The effect seemed to fade over time but, 1 year post-intervention, six dimensions of the nurse-patient relationship (hope, sensibility, helping relationship, expression of emotions, problem solving, teaching) scored above baseline. Nurse quality of working life, too, seemed positively impacted. The cultural dimension of nurse quality of working life, that is, the degree to which everyday work activities attune with personal and cultural values, seemed positively impacted, as well, with improvement stable throughout the year following the intervention.

Conclusions

Results support a positive effect of the intervention over both the short term and the medium-to-long term. A brief intervention of the sort may constitute an effective means to improve the nurse-patient relationship by preventing or reducing dehumanising practices.

Trial registration

NCT03283891.

Application of the PRECEDE -PROCEED model in prevention of brucellosis focused on livestock vaccination process

BACKGROUND

This article reports the steps of an educational intervention, which is designed to change livestock breeders' preventive behavior in terms of vaccinating their livestock against brucellosis. The study has been conducted in a rural area in a country with the second highest brucellosis prevalence in the world.

METHODS

In a quasi-experimental study and applying PRECEDE-PROCEED model, 45 livestock breeders were trained through basket method, accompanied with constructive feedback from researchers and peers and a brief interactive lecture at the end. The livestock breeders' awareness, attitude and practice level in the intervention group was compared with those of other 45 livestock breeders in a control group, 1 and 6 months after the intervention. According to the results of the Rose Bengal tests (RBTs), as a rapid and simple screening test, the presence or absence of Brucella antibodies in the animals' serum was investigated.

RESULTS

Immediately and 1 month after the intervention, the mean scores of knowledge, awareness and practice of livestock breeders in the intervention group were significantly higher. Six months after the intervention, the results of the RBTs were positive in more livestock in the intervention group compared to the animals in the control group. The positive result of RBT after educational intervention, in livestock whose test results were negative immediately before intervention, accompanying the results of observation indicating a good general condition of livestock was considered as a probable evidence of the success of the educational intervention.

CONCLUSION

The model-driven educational intervention could significantly increase livestock breeders' awareness, attitude and practice regarding prevention of brucellosis and vaccination of their livestock against brucellosis; however, a period of non-continuous reinforcement and gradual reduction of the number of the reinforcements by health educator workers is recommended in order to increase the maintenance of the learnt behavior.

TRIAL REGISTRATION

Conducting this study was registered at Iranian Registry of Clinical Trials ( IRCT20180304038945N1 ). Registered 24 December 2018. The proposal was registered before enrollment of the first participant.

Ergonomic risk factors and musculoskeletal disorders in bank staff: an interventional follow-up study in Iran

Background

Long-term use of computer in a static mode may cause musculoskeletal disorders (MSDs) in bank staff. Considering the high number of bank employees in different countries, such as Iran, the risk factors of these disorders should be investigated in order to implement interventions required to reduce the risk factors. This study aimed to examine the risk factors of MSDs using the Rapid Office Strain Assessment (ROSA) method and to perform an ergonomic intervention program with banking staff in Iran.

Methods

This interventional study was conducted on 277 bank employees in Iran. Subjects were randomly divided into three groups, including a control group (without any intervention), an educational intervention (EI) group, and a group receiving both educational and physical intervention (EPI). Before and after the intervention, the ROSA method and Nordic questionnaire were used to assess the risk factors of MSDs in office jobs and to investigate the prevalence of MSDs. Data were collected 2 weeks before and 9 months following the intervention.

Results

Before the intervention, the mean score of ROSA at workstations of all groups was above five with high risk. Nine months after the start of the intervention, there was a significant decrease in the mean ROSA score and its components in the two groups that received the intervention, which was statistically significant (P < 0.001). The results of the study of the prevalence of MSDs in the employees—before the intervention—indicate that the highest prevalence of MSDs in the control group was in areas of the neck (67.1%), back (64.4%), and lower back (63%). In the EI group, the highest prevalence of MSDs was in the neck (65.2%), lower back (61.6%), and back (60.7%) areas. In the EPI group, the discomfort areas were the neck (68.5%), shoulders (66.3%), and lower back (60.9%). Nine months after the intervention, there was a significant decrease in the prevalence of MSDs in the neck, shoulders, and lumbar regions of staff who received the intervention (P < 0.05).

Conclusion

Nine months after performing the interventions, there was a relative improvement in workstations and prevalence of MSDs in various areas within the bodies of the bank staff. This study showed that using the ROSA method is appropriate for assessing the risk factors of office work and that it can identify deficiencies in workstations. These defects can be addressed by designing and implementing an EI program together with physical interventions according to the components of the ROSA method.

The application of the theory of planned behavior to nutritional behaviors related to cardiovascular disease among the women

BACKGROUND

Nutritional factors have been identified as preventable risk factors for cardiovascular disease; this study aimed to investigate the application of the Theory of Planned Behavior (TPB) in nutritional behaviors related to cardiovascular diseases among the women in Fasa city, Fars province, Iran.

METHODS

The study was conducted in two stages. First, the factors affecting nutritional behaviors associated with cardiovascular disease on 350 women who were referred to Fasa urban health centers were determined based on the TPB. In the second stage, based on the results of a cross-sectional study, quasi-expeimental study was performed on 200 women covered by Fasa health centers. The questionnaire used for the study was a questionnaire based on TPB. The questionnaire was completed by the experimental and control groups before and three months after the intervention. Data were analyzed by SPSS software using logistic regression, paired t-test, independent sample t-test, and chi-square test. The level of significance is considered 0.05.

RESULT

The constructs of attitude, subjective norms, and perceived behavioral control (PBC) were predictors of nutritional behaviors associated with cardiovascular disease in women. The constructs predicted 41.6% of the behavior. The results showed that mean scores of attitude, subjective norms, PBC, intention, nutritional performance related to the cardiovascular disease before intervention were, respectively, 24.32, 14.20, 18.10, 13.37 and 16.28, and after the intervention, were, respectively, 42.32, 25.40, 33.72, 30.13 and 41.38. All the constructs except the attitude in the intervention group were significantly higher (p < 0.001) than the control group.

CONCLUSION

The results of the present study showed that the educational intervention based on the TPB would be consider an effective educational and promotinal strategy for the nutritional behaviors to prevent cardiovascular disease in women. Considering the role of mothers in providing family food baskets and the effect of their nutritional behaviors on family members, the education of this group can promote healthy eating behaviors in the community and family.

Promoting the adoption of behaviors to prevent osteoporosis using the health belief model integrated with health literacy: quasi-experimental intervention study

BACKGROUND

The health belief model (HBM) is effective in preventing osteoporosis and promoting health literacy (HL). In this regard, there are some critical points such as the role of HL in preventing osteoporosis, adoption of preventive behaviors, adoption of behaviors, including physical activity, and the role of health volunteers in transmitting health messages to the community. Considering the aforesaid points this study was performed among the health volunteers aimed to determine the effect of educational intervention based on integrated HBM with HL on walking and nutrition behaviors to prevent osteoporosis.

MATERIALS AND METHODS

In this quasi-experimental intervention study, 140 health volunteers (70 people in each of the two intervention and control groups) were enrolled in the study using multi-stage random sampling, in 2020. The members of the intervention group received e-learning through social media software, 4 times during 4 weeks (once a week) and were provided with educational booklets and pamphlets. Data collection tools included demographic and background questionnaires; standard questionnaire based on the HBM, awareness, and walking and nutrition behaviors to prevent osteoporosis; and HELIA questionnaire to measure HL. These questionnaires were completed in two stages, before and 3 months after the intervention. The educational intervention in this study was sent to the intervention group in 4 stages. The collected data were analyzed using proportional tests (paired t-test, Wilcoxon test, independent t-test, Mann-Whitney test) and SPSS software version 23.

RESULTS

The mean and standard deviation related to the score of adoption of nutrition behaviors at the beginning of the study in the intervention group was 5.398 ± 1.447, which changed to 8.446 ± 1.244 after 3 months, indicating a significant increase in the adoption of such behaviors (P = 0.009). In the control group, the mean and standard deviation of the scores of adoption of nutrition behaviors changed from 5.451 ± 1.222 to 6.003 ± 1.005, which was not statistically significant (P = 0.351). Also, the mean and standard deviation related to the scores of adoption of walking behavior at the beginning of the study in the intervention group was 8.956 ± 0.261, which changed to 13.457 ± 0.587 after 3 months, indicating a significant increase in the adoption of such behaviors (P < 0.001). In the control group, the mean and standard deviation related to the scores of the adoption of walking behavior changed from 8.848 ± 0.353 to 9.025 ± 0.545, which was not statistically significant (P = 0.211). Prior to the intervention, there was no significant difference between two groups regarding the variables of demographic and background, knowledge, all constructs of the model, HL, and adoption of walking and nutrition behaviors (P > 0.05). After the intervention, the comparison of the two groups showed that there was a significant change in the mean scores of awareness, all constructs of the model, HL, and adoption of preventive behaviors in the intervention group than the control group (P < 0.05).

CONCLUSION

The educational intervention based on an HBM integrated with HL was effective and acceptable in correcting and promoting walking and nutrition behaviors to prevent osteoporosis among health volunteers. Therefore, it can be said that the intervention implemented was in line with the developed model used.

Preparing student pharmacists to care for patients exposed to intimate partner violence

INTRODUCTION

Intimate partner violence (IPV) is a serious public health problem. Little is known about pharmacists' IPV knowledge and awareness. This study assessed student pharmacists' knowledge, attitudes, and awareness of IPV and examined the impact of a brief curricular unit on these factors.

METHODS

The Physician Readiness to Manage Intimate Partner Violence Survey was adapted for use with student pharmacists and administered at two pharmacy schools, one private (n = 88) and one public institution (n = 104). Students at one institution were exposed to a curricular unit on IPV tailored for pharmacy practice and completed a post-assessment.

RESULTS

Students at both institutions had low levels of IPV-related knowledge, answering <60% of items correctly. Students reported low levels of perceived knowledge and preparation. After exposure to the educational intervention (n = 60), knowledge scores increased on a matched post-assessment. Students across both institutions (n = 29) provided comments indicating that they believed IPV is an important issue, that this topic was novel and that pharmacists should address IPV, that pharmacists should be trained on IPV and a desire for training, and that there are barriers to addressing IPV in the pharmacy setting.

CONCLUSIONS

Preparing student pharmacists to care for patients exposed to IPV may improve patient outcomes and positively impact the lives of the patients they serve. A brief educational intervention improved students' knowledge about IPV and confidence in screening patients for IPV.

Development of A Nurse-Led Educational Intervention Program in Managing the Nutrition Impact Symptom Cluster in Patients with Nasopharyngeal Carcinoma following the Medical Research Council Framework

Objective:

This article aimed to report the experience of developing a complex nurse-led, theory-driven, and evidence-based educational intervention program intended to manage the nutrition impact symptom cluster experienced by patients with nasopharyngeal carcinoma (NPC) during radiotherapy, based on the Medical Research Council (MRC) framework.

Methods:

The “development” and “feasibility and piloting” phases of the MRC framework were used to guide the intervention development. The development phase included identifying the evidence base through a systematic review, exploring the relevant and guiding theory to enhance the effectiveness of the intervention and conducting a qualitative study to identify the intervention modelling. For the feasibility and piloting phase, we conducted a pilot study to examine the feasibility and estimate the effectiveness of the intervention.

Results:

The systematic review revealed that nurse-led educational interventions were used commonly for symptom cluster management, with promising effectiveness. The theoretical foundation was provided by the Theory of Unpleasant Symptoms, which indicates that an educational intervention can help patients to manage symptom cluster by influencing psychological, situational, and physiological factors. The qualitative study further provided contents of the intervention based on the perspectives of NPC patients and health professionals. The resulting program involves a nurse-led, family caregiver involvement, educational intervention with two sessions that uses a booklet as a medium. The pilot study found that conducting the educational intervention program was feasible and it also had some favorable effects on managing the nutrition impact symptom cluster in NPC patients.

Conclusions:

The MRC framework provided a strong structure with which to develop a complex intervention for nutrition impact symptom cluster management through a theory-driven and evidence-based approach. The evaluation of the intervention, the delivery process and the mediation mechanism of change using a rigorous randomized controlled trial design is recommended.

Effect of educational intervention on improvement of physical activities of middle-aged women

BACKGROUND

Regular physical activity has important health benefits for women. The present study aimed to investigate the effect of theory-based educational interventions on the improvement of physical activities of middle-aged women.

METHODS

This experimental study was conducted on 160 middle-aged women referred to Ahwaz health centers Iran in 2017 who were selected through the cluster sampling method. They were randomly divided into two groups: intervention (n = 80) and control (n = 80). The educational intervention for the experimental group consisted of 4 consultation and 4 follow-up sessions. The study outcomes included physical activity change, self-efficacy, decision-making balance, and the International Physical Activity Questionnaire, which were measured before the intervention and 2 months after that. The data were analyzed using the SPSS19 software as well as the Chi-square, independent t-test and paired t-test.

RESULTS

After the intervention, the mean scores of preparedness for change, decision-making balance, perceived self-efficacy, pre-thinking, thinking, preparation, practice and maintenance were significantly different in both the experimental and control groups (P value < 0.05). The t-test showed that after the educational intervention, the mean score of physical activity was significantly higher in the experimental group than in the control group (726.3 ± 201.6 and 339.8 ± 90.2, respectively) (P value < 0.001).

CONCLUSION

The findings of this study showed that the theory-based educational intervention was effective on the improvement of the middle-aged women's physical activities. Therefore, it is suggested that a theory-based educational program be designed and implemented in order to increase the physical activities of this group.