Category Archives: Patient Education as Topic

Patient and family stroke education

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Cheng, Ho Y, Sek YChair, and Janita PChau. “The effectiveness of psychosocial interventions for stroke family caregivers and stroke survivors: A systematic review and meta-analysis.” Patient education and counseling 95.1 (2014):30-44.

Cameron, Vanessa. “Best practices for stroke patient and family education in the acute care setting: a literature review.” Medsurg nursing 22.1 (2013):51-5, 64.

Shyu, Yea-Ing L, et al. “A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers.” Journal of clinical nursing 17.18 (2008):2497-2508.

Cameron, Jill I, and Monique A MGignac. “‘Timing It Right’: a conceptual framework for addressing the support needs of family caregivers to stroke survivors from the hospital to the home.” Patient education and counseling 70.3 (2008):305-314.

O’Farrell, B, and D Evans. The continuum of care: the process and development of a nursing model for stroke education. Axone 20.1 (1998):16-18.

Olson, DaiWai, et al. Transition of care for acute stroke and myocardial infarction patients: from hospitalization to rehabilitation, recovery, and secondary prevention. Evidence report/technology assessment 202 (2011):1-197.

Hafsteinsdottir, T B, et al. “Educational needs of patients with a stroke and their caregivers: a systematic review of the literature.” Patient education and counseling 85.1 (2011):14-25.

Reviewed and updated 4/21/2014 ldt

What patient education interventions are used in the preoperative care of patients?

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A search of Joanna Briggs Institute and PubMed identified the following references.
The PubMed search included terms for these concepts: preoperative period, pain, psychology, adults, patient education.

From Joanna Briggs:

Cabilan C, et al.  Prehabilitation for surgical patients: a systematic review protocol. 2013.
This is protocol for a systematic review, but in the background information, it references several papers on presurgical interventions specifically concerning the outcome of pain.

Stern C.  Knowledge retention from preoperative patient information.  2005 (updated 2010).
This systematic review references several studies investigating usefulness of preoperative education on outcomes such as pain.

From PubMed:
(“Preoperative care”[mesh] OR “preoperative period”[mesh]) AND pain AND (psychology OR anxiety OR fear) AND adults AND patient education

This search may include references cited in the Joanna Briggs reviews.  It also includes a systematic review on outcomes of preoperative patient education in surgical setting:
Ronco M, et al.  Patient education outcomes in surgery: a systematic review from 2004 to 2010.  Int J Evid Based Healthc. 2012 Dec;10(4):309-23.

What evidence is published on timing and appropriateness of education for patients in the intensive care unit?

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Results below are from a search of PubMed and CINAHL for these concepts:

  • patient education
  • intensive care
  • English language limit
  • time/timing

PubMed:  “Patient Education as Topic”[MAJR] AND “intensive care”[mesh] AND english[lang]

CINAHL:  (MH “Intensive Care Units”) AND (MM “Patient Education+”) AND ( (time OR timing) )   This search focuses on papers that discuss some aspect of timing as it relates to patient education.  Removing the (time OR timing) part of the search will retrieve some additional papers discussing aspects, such as education for transition from ICU to general unit.

The PubMed search results are more general.  The references below discuss general aspects of patient education in the ICU.  Other references in the search results discuss patient education in specific situations, such as with patients on ventilators:

Häggström M, Asplund K, Kristiansen L.  How can nurses facilitate patient’s transitions from intensive care?: a grounded theory of nursing.  Intensive Crit Care Nurs. 2012 Aug;28(4):224-33

Scott A.  Managing anxiety in ICU patients: the role of pre-operative information provision.   Nursing in Critical Care (NURS CRIT CARE), 2004 Mar-Apr; 9 (2): 72-9.

Clark BJ, Moss M. Secondary prevention in the intensive care unit: does intensive care unit admission represent a “teachable moment?”. Crit Care Med. 2011 Jun;39(6):1500-6.

What are some studies on managing and mandatory patient discharge?

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Braet A. Weltens C. Vleugels A. Effectiveness of discharge interventions from hospital to home to reduce readmissions: a systematic review. . Joanna Briggs Institute EBP Database.

Yifan Xue MBBS MPH. Patient: Discharge from Hospital. [Recommended Practices]

Domingo G. Johnson P. Reyes F. Thompson F. Shortridge- Baggett L. Effectiveness of structured discharge process in reducing hospital readmission of adult patients with community acquired pneumonia: A systematic review. [Systematic Review]

Hall WA ; Carty EM. Managing the early discharge experience: taking control. Journal of Advanced Nursing, 1993 Apr; 18(4): 574-82

Mandatory checklists at discharge may have the potential to prevent readmissions. Critical care medicine 2010 vol:38 iss:4 pg:1226

Campagna V. News from CCMC. Managing patient throughput: case managers contribute to successful discharge planning. Care management [1531-037X] yr:2007 vol:13 iss:3 pg:20

Reviewed JKN 4/14

Discharge instructions for the palliative care or hospice patient

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Handouts for patients or family members are available through MedlinePlus.
At the bottom of the Palliative Care and Hospice care pages there are links to patient handouts.

Actual instructions will vary by patient, and specific sets of instructions might also be available through the Krames materials on EMR. You might try a keyword search for palliative in the Krames tool to see what it retrieves.

Nothing in CINAHL or PubMed searches really addressed what to cover in discharge instructions with patients going to palliative care or hospice.
Searched with combinations of these concepts: (Palliative care or hospice), (discharge instructions or patient education

For patients with coronary artery disease, does patient education affect lifestyle/behavior or patient satisfaction?

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Many of the papers describe multi-faceted interventions that include patient education as one component.

Cardiac Rehabilitation: Interventions. In: Joanna Briggs JBI+Connect. Updated September 2, 2014.

Arch Gerontol Geriatr. 2008; 46 (2): 227-44
In this trial of 173 patients age ≥ 65 years and post CABG randomized to a multi-faceted intervention by a multidisciplinary team of professionals and which included education or usual care, the intervention group was more likely to engage in physical activity

Schadewaldt V, et al. Nurse-led clinics as an effective service for cardiac patients: results from a systematic review.  Int J Evid Based Healthc. 2011 Sep;9(3):199-214.
Review of seven randomized studies on nurse-led clinics, but the major intervention was patient education and behavior counseling.   Clinics were associated with limited effects on behaviors, such as smoking cessation and diet adherence.

PubMed search:  (“coronary artery disease” OR coronary artery bypass) AND (rehabilitation OR “secondary prevention”) AND patient education AND (behavior OR lifestyle OR satisfaction) AND (clinical trial OR randomized)
Other clinical trials on patient education interventions. To see quasi-experimental studies, change modify the search above replacing the terms for study type with these terms:  (comparative study OR before and after study OR pilot) or remove all terms for the study methodology from the search.

CINAHL search:  (cornoary artery disease OR corornary artery bypass) AND patient education AND (rehabilitation OR “secondary prevention”) AND (satisfaction OR lifestyle OR behavior)
Identified papers, such as Barnason S, et al. A comparison of patient teaching outcomes among postoperative coronary artery bypass graft (CABG) patients. Prog Cardiovasc Nurs. 1995; 10(4): 11-20.
While this is an older study, it does reference a tool for measuring patient satisfaction that might be useful.

Reviewed by John Nemeth 4/14

Does patient education for cardiac rehabilitation patients affect mortality (all-cause or CV-related), cardiovascular morbidity, revascularization, or hospitalization?

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•    DynaMed.  Coronary Artery Disease.  Use the navigation pane on the left side of the page to select Treatment>Counseling.  Cites this systematic review.

Cochrane Database Syst Rev. 2011 Dec 7;(12):CD008895.  Brown JP, et al.  Patient education in the management of coronary heart disease.

Reviews 13 RCTs of educational interventions in over 68,000 CAD patients.  Interventions used various methods.  Results for effect on health-related quality of life were inconsistent.  No statistically significant evidence for reduction of mortality, cardiac morbidity, revascularization, or hospitalization.  Educational interventions varied in format.  See the review for descriptions of individual interventions.

•    Joanna Briggs JBI+Connect.  Cardiac Rehabilitation: Interventions

JBI also cites the Brown (2011) review above, as well as:

Kummel M, et al. Effects of an intervention on health behaviors of older coronary artery bypass (CAB) patients. Arch Gerontol Geriatr. 2008; 46 (2): 227-44
RCT of 117 patients randomized to usual care or an intervention consisting of multiple sessions of health counseling, guidance, and adjustment education.  Intervention positively impacted physical activity and functional abilities.  No evaluation of effect on mortality or morbidity.

Reviewed by John Nemeth 4/14