Patient education and counseling
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of two formats of informed consent on knowledge amongst persons with advanced HIV disease in a clinical trial of didanosine.
To determine subjects' perception of the purpose of informed consent, 113 subjects were recruited from a dose-controlled clinical trial of didanosine (ddI). Subjects were surveyed regarding how they made decisions regarding their medical care in general, about how they obtained information about this trial in particular, and several aspects of the informed consent procedure. Subjects were then randomly allocated to receive information about the trial by either a written only format or a written and verbal format 1 week before commencement of the trial. ⋯ We found that the provision of information by written mode alone, or written and verbal modes were both associated with significant increases in knowledge levels and that there was a significant interaction in the degree of change between the two methods, with the written plus verbal method showing the most improvement over time. There was an interaction between degree of improvement in knowledge of didanosine in subjects who received written information versus those who received written and verbal knowledge and time (pre- versus post-consent) and a significant main effect for time. All subjects were relatively well-informed about the drug and stated that specialist and general medical practitioners were their major source of knowledge for all aspects of their HIV health care.
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Review Comparative Study
Contraception in The Netherlands: the low abortion rate explained.
This article gives a review of the main factors that are related to the low abortion rate in the Netherlands. Attention is payed to figures on abortion and the use of contraceptive methods since the beginning of the 1960s up to the end of the 1980s. ⋯ A reduction of unwanted pregnancies has been accomplished through successful strategies for the prevention of teenage pregnancy (including sex education, open discussions on sexuality in mass media, educational campaigns and low barrier services) as well as through wide acceptance of sterilization. The Dutch experience with family planning shows the following characteristics: a strong wish to reduce reliance on abortion, ongoing sexual and contraceptive education related to the actual experiences of the target groups, and low barrier family planning services.
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Comparative Study Controlled Clinical Trial
The effects of a personal versus a factual approach videotape on the level of preoperative anxiety of same day surgery patients.
The literature which evaluates the effects of different health education techniques demonstrates that approaches that are more personal and relevant to the learner are more effective than traditional didactic learning methods. In particular, such findings have been found with regard to decreasing anxiety levels of hospital patients. However, not many of these studies have used the medium of videotape, and studies evaluating the effects of this medium are rare. ⋯ It was hypothesized that those patients who viewed the personal approach video would have lower levels of preoperative anxiety than those who viewed the factual approach video. Multiple regression and analysis of variance (ANOVA) techniques indicated that gender was the most significant predictor of preoperative anxiety in this study. Recommendations for future research are offered.
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Randomized Controlled Trial Comparative Study Clinical Trial
Group treatment for pain and discomfort.
Rheumatic patients very often suffer from chronic pain and impairment and show psychological reactions as a consequence of their physical condition. These reactions may vary from psychophysiological symptoms to anger, anxiety, or depression. ⋯ Treatment effects in different diagnostic groups were compared to each other, supporting the assumption that pain reduction is greatest in low back pain and least in ankylosing spondylitis. Subjects with inflammatory rheumatic diseases showed some improvement in self-reported physical complaints and in their feelings of well-being.
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As many as 10-20% of pediatric patients in this country have a chronic illness. This number will likely increase. Unfortunately, there has not been a parallel growth in physicians acquiring knowledge and skills in patient education. ⋯ The discussion focuses on the barriers to patient education and why it has not been a more integral part of caring for chronically ill children and their families. The solutions to this problem are complex but must include the willingness of health care professionals to welcome patients and their families as partners in the process. In addition, there is a need for change in the medical education system so that patient education is taught as a continuum, beginning with principles and theory and concluding with application to patient care.