scholarly journals Effect of PreAnaesThesia Computerized Health (PATCH) Assessment on Duration of Nurse—Patient Consultation and Patient Experience: A Pilot Trial

2020 ◽  
Vol 17 (14) ◽  
pp. 4972 ◽  
Author(s):  
Tarig Osman ◽  
Eileen Lew ◽  
Elaine Lum ◽  
Jennifer Chew ◽  
Rajive Dabas ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Standard Care ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Health Assessment ◽  
Self Assessment ◽  
Care Nurse ◽  
Face To Face ◽  
Care Groups ◽  
Patient Consultation

Preanaesthesia health assessment is gradually transitioning from paper-based, face-to-face assessment to digitized assessment, self-administered by the patient. This transition could potentially optimize the various goals of assessment, notably facilitating the efficient collection of the patient’s health information. We have previously developed and validated a tablet application (PreAnaesThesia Computerized Health assessment application or “PATCH”) for patients to conduct preanaesthesia self-assessment. In a randomized controlled trial, we sought to compare the duration of nurse–patient consultation and patient satisfaction between patients who underwent PATCH self-assessment vs. standard care nurse-led assessment. Fifty-two elective surgical patients were randomized to complete either PATCH assessment or standard care nurse-led assessment at an outpatient preoperative clinic. The duration of nurse–patient consultation was subsequently noted for all patients who also completed a satisfaction survey. The mean (SD) nurse–patient consultation times in the PATCH and standard care groups were comparable, at 11.5 (3.6) min and 12.2 (2.9) min, respectively (p = 0.703). Overall satisfaction scores were also comparable, at 23.9 and 27.0 respectively (p = 0.451) for the PATCH and standard nurse assessment groups. Favorable perceptions of PATCH among users ranged between 41.7% and 79.2%. In conclusion, PATCH self-assessment can feasibly be introduced into current practice with comparable nurse–patient consultation times and patient satisfaction.

scholarly journals Use of Tablet Video for Delivery of Neonatal Discharge Instructions to First-Time Parents

2021 ◽  
Vol 53 (2) ◽  
pp. 145-147
Author(s):  
Kristine L. Cece ◽  
Jane E. Chargot ◽  
Micheleen Hashikawa ◽  
Melissa A. Plegue ◽  
Katherine J. Gold
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Satisfaction ◽  
Controlled Trial ◽  
Patient Perceptions ◽  
Discharge Instructions ◽  
Face To Face ◽  
Randomized Controlled ◽  
Use Of Technology ◽  
Video Group ◽  
First Time

Background and Objectives: While video discharge instructions have been shown to improve retention of information and patient satisfaction, data are limited regarding patient perceptions of video tools. Methods: We conducted a randomized controlled trial to assess self-rated comprehension and overall satisfaction with video versus face-to-face neonatal discharge instructions in first-time mothers. Results: Video instructions were no different from face-to-face instructions, though there was a nonsignificant increase in confidence in caring for their newborn in the video group. Conclusions: Broader use of technology may allow for a more standardized approach to patient education and improve efficiency for clinicians, without compromising patient satisfaction and confidence in caring for themselves and their dependents.

Adding an app-based intervention to the Cognitive Behavioral Analysis System of Psychotherapy (CBASP): Concept and Feasibility in a Pilot Routine Clinical Trial (Preprint)

2021 ◽  
Author(s):  
Anna-Lena Netter ◽  
Ina Beintner ◽  
Eva-Lotta Brakemeier
Keyword(s):  
User Satisfaction ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Cognitive Behavioral ◽  
Added Value ◽  
Behavioral Analysis ◽  
Situational Analysis ◽  
Face To Face ◽  
Analysis System

BACKGROUND The Cognitive Behavioral Analysis System of Psychotherapy (CBASP), developed specifically for the treatment of persistent depressive disorder (PDD), is an empirically supported treatment. However, given the high rates of non-response and relapse, there is need for optimization. Studies suggest that outcomes can be improved by increasing the treatment dose, e.g., by constant online-based application of therapy strategies between sessions. The highly structured nature of CBASP encourages augmenting it with online interventions, which are of increasing importance for mental health care. OBJECTIVE We developed the app-based intervention "CBASPath", which is designed to be used in addition to face-to-face CBASP therapy in terms of blended therapy. CBASPath offers eight sequential modules with interactive exercises to facilitate additional engagement with the therapy content and a separate exercise to conduct situational analyses within the app at any time. METHODS CBASPath was tested in an open pilot study as part of routine outpatient CBASP treatment. Participating patients (n=13) were asked to report their usage patterns and blended use (integrated use of app as part of therapy sessions) at three assessment points over the 6-month test period and to rate the usability, quality, and their satisfaction with CBASPath. RESULTS Results of the pilot trial show that 12 participants used CBASPath as a blended tool during their therapy and maintained this throughout the study period. Overall, they reported good usability and quality ratings along with high user satisfaction. All participants showed favourable engagement with CBASPath, but with frequency of use differing widely among participants and assessment points. The situational analysis was used by all participants, while the number of completed modules ranged between 1 and 7. All participants reported blended use, although the frequency of integration in face-to-face sessions varied widely. CONCLUSIONS Our findings suggest that a digital augmentation of the complex and highly interactive CBASP therapy in the form of blended therapy with CBASPath is feasible in routine outpatient care. Therapeutic guidance might contribute to the high adherence and increase patients’ self-management. Few adjustments within the app could facilitate higher user engagement. A randomized controlled trial to investigate the efficacy and the added value of this blended approach is now needed. In the long term, CBASPath could help optimize PDD treatment and reduce relapse by intensifying therapy and providing long-term patient support through the app. CLINICALTRIAL No Registration due to pilot character of the study.

scholarly journals Digital Training for Non-Specialist Health Workers to Deliver a Brief Psychological Treatment for Depression in Primary Care in India: Findings from a Randomized Pilot Study

2020 ◽  
Vol 17 (17) ◽  
pp. 6368 ◽  
Author(s):  
Shital S. Muke ◽  
Deepak Tugnawat ◽  
Udita Joshi ◽  
Aditya Anand ◽  
Azaz Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Large Scale ◽  
Training Programs ◽  
Health Workers ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Course Content ◽  
Face To Face ◽  
Digital Training

Introduction: Task sharing holds promise for scaling up depression care in countries such as India, yet requires training large numbers of non-specialist health workers. This pilot trial evaluated the feasibility and acceptability of a digital program for training non-specialist health workers to deliver a brief psychological treatment for depression. Methods: Participants were non-specialist health workers recruited from primary care facilities in Sehore, a rural district in Madhya Pradesh, India. A three-arm randomized controlled trial design was used, comparing digital training alone (DGT) to digital training with remote support (DGT+), and conventional face-to-face training. The primary outcome was the feasibility and acceptability of digital training programs. Preliminary effectiveness was explored as changes in competency outcomes, assessed using a self-reported measure covering the specific knowledge and skills required to deliver the brief psychological treatment for depression. Outcomes were collected at pre-training and post-training. Results: Of 42 non-specialist health workers randomized to the training programs, 36 including 10 (72%) in face-to-face, 12 (86%) in DGT, and 14 (100%) in DGT+ arms started the training. Among these participants, 27 (64%) completed the training, with 8 (57%) in face-to-face, 8 (57%) in DGT, and 11 (79%) in DGT+. The addition of remote telephone support appeared to improve completion rates for DGT+ participants. The competency outcome improved across all groups, with no significant between-group differences. However, face-to-face and DGT+ participants showed greater improvement compared to DGT alone. There were numerous technical challenges with the digital training program such as poor connectivity, smartphone app not loading, and difficulty navigating the course content—issues that were further emphasized in follow-up focus group discussions with participants. Feedback and recommendations collected from participants informed further modifications and refinements to the training programs in preparation for a forthcoming large-scale effectiveness trial. Conclusions: This study adds to mounting efforts aimed at leveraging digital technology to increase the availability of evidence-based mental health services in primary care settings in low-resource settings.

scholarly journals A Pilot Randomized Controlled Trial of Smoking Cessation in an Outpatient Respirology Clinic

2015 ◽  
Vol 22 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Smita Pakhale ◽  
Justine Baron ◽  
Michael A Armstrong ◽  
Avanti Garde ◽  
Robert D Reid ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Standard Care ◽  
Smoking Status ◽  
Controlled Trial ◽  
Retention Rates ◽  
Face To Face ◽  
Quit Rate ◽  
Intervention Adherence ◽  
To Receive

OBJECTIVE: To assess the feasibility and potential effectiveness of a modified version of the Ottawa Model for Smoking Cessation in an outpatient respirology clinic.METHODS: Adult tobacco smokers attending the respirology clinic and willing to choose a quit date within one month of enrollment were randomly assigned to receive standard care or the intervention. Standard care participants received smoking cessation advice, a brochure and a prescription for smoking cessation medication if requested. Intervention participants received a $110 voucher to purchase smoking cessation pharmacotherapy and were registered to an automated calling system. Answers to automated calls determined which participants required nurse telephone counselling. Feasibility indicators included recruitment and retention rates, and intervention adherence. The effectiveness indicator was self-reported smoking status at 26 to 52 weeks.RESULTS: Forty-nine (54.4%) of 90 eligible smokers were randomly assigned to the intervention (n=23) or control (n=26) group. Self-reported smoking status at 26 to 52 weeks was available for 32 (65.3%) participants. The quit rate for intervention participants was 18.2% compared with 7.7% for controls (OR2.36 [95% CI 0.39 to 14.15]).CONCLUSION: It would be feasible to evaluate this intervention in a larger trial. Alternatives to face-to-face follow-up at the clinic are recommended.

scholarly journals Comparing the Impact of an Implicit Learning Approach With Standard Care on Recovery of Mobility Following Stroke: Protocol for a Pilot Cluster Randomized Controlled Trial

10.2196/14222 ◽  
2019 ◽  
Vol 8 (11) ◽  
pp. e14222
Author(s):  
Louise Johnson ◽  
Jane Burridge ◽  
Sara Demain ◽  
Sean Ewings
Keyword(s):  
Implicit Learning ◽  
Stroke Rehabilitation ◽  
Standard Care ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Learning Approach ◽  
Postural Adjustment ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
The Impact

Background Although implicit and explicit learning approaches have been well investigated in healthy populations, there is less evidence regarding the relative benefits of each approach in clinical practice. Studies in stroke typically investigate single elements of an implicit learning approach (ILA; eg, reduced quantity feedback or an external focus of attention) within controlled environments. These studies predominantly evaluate performance, with few measuring this over time (ie, learning). The relevance and transferability of current research evidence into stroke rehabilitation is therefore limited. Objective The objective of this study was to compare the ILA with standard care in the acute phase following stroke, to generate data and insights to inform the design of a definitive trial, and to understand patient and therapist perceptions of the ILA. Methods This is a multicenter, assessor-blind, cluster randomized controlled pilot trial with nested qualitative evaluation. Stroke units (clusters) will be randomized to either ILA (intervention) or standard care (control) arms. Therapy teams at the intervention sites will be trained in the ILA and provided with an intervention manual. Those at the control sites will have minimal input from the research team, other than for data collection. Consent will be provided at the individual participant level. Once enrolled, participants will receive rehabilitation that focuses on lower limb recovery, using the designated approach. Measures will be taken at baseline, every 2 weeks until the point of discharge from hospital, and at 3 months post stroke onset. Measures include the Fugl Meyer Assessment (motor leg subsection), modified Rivermead Mobility Index, Swedish Postural Adjustment in Stroke Scale, and achievement of mobility milestones. Fidelity of the treatment approach will be monitored using observational video analysis. Focus groups and interviews will be used to gain insight into the perceptions of trial participants and clinical teams. Results The first site opened to recruitment in February 2019. The opening of a further 5 sites will be staggered throughout 2019. Results are expected in early 2021. Conclusions The findings from this mixed methods pilot study will be used to inform the design of a definitive study, comparing the ILA with standard care in acute stroke rehabilitation. Trial Registration ClinicalTrials.gov NCT03792126; https://clinicaltrials.gov/ct2/show/NCT03792126 International Registered Report Identifier (IRRID) DERR1-10.2196/14222

scholarly journals Comparing the Impact of an Implicit Learning Approach With Standard Care on Recovery of Mobility Following Stroke: Protocol for a Pilot Cluster Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Louise Johnson ◽  
Jane Burridge ◽  
Sara Demain ◽  
Sean Ewings
Keyword(s):  
Implicit Learning ◽  
Stroke Rehabilitation ◽  
Standard Care ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Learning Approach ◽  
Postural Adjustment ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
The Impact

BACKGROUND Although implicit and explicit learning approaches have been well investigated in healthy populations, there is less evidence regarding the relative benefits of each approach in clinical practice. Studies in stroke typically investigate single elements of an implicit learning approach (ILA; eg, reduced quantity feedback or an external focus of attention) within controlled environments. These studies predominantly evaluate performance, with few measuring this over time (ie, learning). The relevance and transferability of current research evidence into stroke rehabilitation is therefore limited. OBJECTIVE The objective of this study was to compare the ILA with standard care in the acute phase following stroke, to generate data and insights to inform the design of a definitive trial, and to understand patient and therapist perceptions of the ILA. METHODS This is a multicenter, assessor-blind, cluster randomized controlled pilot trial with nested qualitative evaluation. Stroke units (clusters) will be randomized to either ILA (intervention) or standard care (control) arms. Therapy teams at the intervention sites will be trained in the ILA and provided with an intervention manual. Those at the control sites will have minimal input from the research team, other than for data collection. Consent will be provided at the individual participant level. Once enrolled, participants will receive rehabilitation that focuses on lower limb recovery, using the designated approach. Measures will be taken at baseline, every 2 weeks until the point of discharge from hospital, and at 3 months post stroke onset. Measures include the Fugl Meyer Assessment (motor leg subsection), modified Rivermead Mobility Index, Swedish Postural Adjustment in Stroke Scale, and achievement of mobility milestones. Fidelity of the treatment approach will be monitored using observational video analysis. Focus groups and interviews will be used to gain insight into the perceptions of trial participants and clinical teams. RESULTS The first site opened to recruitment in February 2019. The opening of a further 5 sites will be staggered throughout 2019. Results are expected in early 2021. CONCLUSIONS The findings from this mixed methods pilot study will be used to inform the design of a definitive study, comparing the ILA with standard care in acute stroke rehabilitation. CLINICALTRIAL ClinicalTrials.gov NCT03792126; https://clinicaltrials.gov/ct2/show/NCT03792126 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14222

scholarly journals Continuous noninvasive hemoglobin monitoring estimates timing for detecting anemia better than clinicians: A randomized controlled trial

2019 ◽  
Author(s):  
Bo Tang ◽  
Xuerong Yu ◽  
Li Xu ◽  
Afang Zhu ◽  
Yuelun Zhang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Standard Care ◽  
Controlled Trial ◽  
Care Group ◽  
Exact Test ◽  
Randomized Controlled ◽  
Care Groups ◽  
Transfusion Volume ◽  
Better Than

Abstract Background Hemoglobin measurement is important for transfusion decision-making. Pulse CO-Oximetry provides real-time continuous hemoglobin (SpHb) monitoring. The triage role of SpHb trends based on hemoglobin measurements was investigated. Methods In this diagnostic randomized controlled trial, 69 patients undergoing spine or cytoreductive surgery were randomly enrolled into SpHb-monitoring and standard-care groups. Diagnostic blood samples were drawn for CO-oximetry Hb (CoOxHb) when the SpHb decreased by 1 g/dl or at the clinician’s discretion in the standard-care group. The positive predictive value (PPV) was defined as the ability to detect a decrease in CoOxHb > 1 g/dl or a CoOxHb < 10 g/dl; the PPVs were compared using Fisher’s exact test. The SpHb and trend accuracies were calculated. The transfusion units and postoperative hemoglobin levels were compared. Results The PPV of a decrease in CoOxHb > 1 g/dl was 93.3% in the SpHb group vs 54.5% without SpHb monitoring (p = 0.002). The PPV of CoOxHb < 10 g/dl was 86.7% vs. 50.0% for these groups (p = 0.015). The CoOxHb was never < 7 g/dl with SpHb monitoring. Sixty SpHb–CoOxHb data pairs and 28 delta pairs (ΔSpHb-ΔCoOxHb) were collected. The bias, precision and limits of agreement were -0.29, 1.03 and -2.30 to 1.72 g/dl, respectively. When ΔSpHb and ΔCoOxHb were > 1 g/dl, the concordance rate for changes in hemoglobin reached 100%. The delta pairs revealed a positive correlation [ΔSpHb = 0.49 * ΔCoOxHb - 0.13; r = 0.69, 95% confidence interval (0.53, 0.82)]. No significant differences were found in the transfusion volume or postoperative anemia state. Conclusions The SpHb trend tracked changes in hemoglobin satisfactorily during surgery and more accurately estimated the appropriate timing for invasive hemoglobin measurements than the clinicians. Trial Registration ChiCTR1800016290, Date of registration 24 May 2018.

Physician Offered Prayer and Patient Satisfaction

2005 ◽  
Vol 35 (2) ◽  
pp. 161-170 ◽  
Author(s):  
Joshua R. Mann ◽  
Scott McKay ◽  
Damon Daniels ◽  
C. Scott Lamar ◽  
Patricia W. Witherspoon ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Usual Care ◽  
Controlled Trial ◽  
Randomized Study ◽  
Pilot Trial ◽  
Future Research ◽  
Patient Encounter ◽  
Number Of Patients ◽  
Physician Patient ◽  
The Impact

Objective: While there is ongoing debate about the role of physician-offered prayer during the physician-patient encounter, many physicians feel inclined to include prayer in their practices. This randomized-controlled trial evaluated patients' acceptance of physician-offered prayer in a family practice setting, and the impact of physician-offered prayer on patient satisfaction with the physician-patient encounter. Method: Subjects were 137 patients in an urban, largely African American, Southeastern family medicine practice who were randomized to receive usual care plus an offer of physician-led prayer or usual care alone. Satisfaction surveys were administered following the clinical encounter. The outcomes of interest were the rate of acceptance of physician-offered prayer and the impact of the prayer offer on patient satisfaction. Personal characteristics and satisfaction scores for patients accepting prayer were compared to those for patients declining prayer. Results: Over 90% of patients accepted the offer of prayer. The offer of prayer had no significant impact on patient satisfaction scores. The number of patients declining prayer was too low to permit comparison of prayer decliners with acceptors. Conclusions: This small pilot trial demonstrated that patient responses to spiritual interventions by physicians can be evaluated using randomized study designs. A large majority of patients accepted an offer of physician-led prayer, but no significant short-term impact on patient satisfaction was detected. Future research with larger sample sizes and more diverse patient populations should evaluate the effects of physician-offered prayer on the physician-patient relationship. Difficulties in conducting such research are discussed.

scholarly journals The effects of a personalized smartphone application on bowel preparation quality: A randomized controlled trial (Preprint)

2020 ◽  
Author(s):  
Quirine Eunice Wennie van der Zander ◽  
Ankie Reumkens ◽  
Bas van de Valk ◽  
Bjorn Winkens ◽  
Ad AM Masclee ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Bowel Preparation ◽  
Controlled Trial ◽  
Smartphone Application ◽  
Control Group ◽  
Right Colon ◽  
Face To Face ◽  
Written Information ◽  
Significant Difference ◽  
The Right

BACKGROUND Adequate bowel preparation is essential for visualization of the colonic mucosa during colonoscopy. OBJECTIVE Aim of this study was to compare instructions provided via a personalized smartphone application with regular written instructions for bowel preparation in improving bowel preparation quality, and to evaluate patient satisfaction concerning the bowel preparation procedure. METHODS Eligible patients scheduled for an outpatient colonoscopy were randomized to the smartphone application or control group. Both groups received identical face-to-face education from a research physician including instructions about the colonoscopy procedure, diet restrictions, and intake of the laxative. In addition, the control group received written information, whereas the smartphone application group was instructed to use the smartphone application instead of the written information. All patients used bisacodyl and sodium picosulfate with magnesium citrate as laxative. Quality of bowel preparation was scored using the Boston Bowel Preparation Scale by blinded endoscopists. Patient satisfaction was measured by the patient satisfaction questionnaire-18 (PSQ-18). RESULTS In total 87 patients participated in the smartphone application group and 86 in the control group. The mean total Boston bowel preparation scale was significantly higher in the smartphone application group (8.3±0.9) compared to the control group (7.9±1.2, P=.03). The right colon showed a significantly higher bowel preparation score in the smartphone application group (2.7±0.5 vs 2.5±0.6, P=.04). General patient satisfaction was high for the smartphone application group (4.4±0.7), but showed no significant difference compared to the control group (4.3±0.8, P=.32). CONCLUSIONS Our personalized smartphone application significantly improved bowel preparation quality, in particular in the right colon, but does not further improve patient satisfaction compared to patients receiving regular written instructions. CLINICALTRIAL ClinicalTrials.gov NCT03677050; https://clinicaltrials.gov/ct2/show/NCT03677050

scholarly journals Continuous noninvasive hemoglobin monitoring estimates timing for detecting anemia better than clinicians: A randomized controlled trial

2019 ◽  
Author(s):  
Bo Tang ◽  
Xuerong Yu ◽  
Li Xu ◽  
Afang Zhu ◽  
Yuelun Zhang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Standard Care ◽  
Controlled Trial ◽  
Care Group ◽  
Exact Test ◽  
Randomized Controlled ◽  
Care Groups ◽  
Transfusion Volume ◽  
Better Than

Abstract Background Hemoglobin measurement is important for transfusion decision-making. Pulse CO-Oximetry provides real-time continuous hemoglobin (SpHb) monitoring. The triage role of SpHb trends based on hemoglobin measurements was investigated. Methods In this diagnostic randomized controlled trial, 69 patients undergoing spine or cytoreductive surgery were randomly enrolled into SpHb-monitoring and standard-care groups. Diagnostic blood samples were drawn for CO-oximetry Hb (CoOxHb) when the SpHb decreased by 1 g/dl or at the clinician’s discretion in the standard-care group. The positive predictive value (PPV) was defined as the ability to detect a decrease in CoOxHb > 1 g/dl or a CoOxHb < 10 g/dl; the PPVs were compared using Fisher’s exact test. The SpHb and trend accuracies were calculated. The transfusion units and postoperative hemoglobin levels were compared. Results The PPV of a decrease in CoOxHb > 1 g/dl was 93.3% in the SpHb group vs 54.5% without SpHb monitoring (p = 0.002). The PPV of CoOxHb < 10 g/dl was 86.7% vs. 50.0% for these groups (p = 0.015). The CoOxHb was never < 7 g/dl with SpHb monitoring. Sixty SpHb–CoOxHb data pairs and 28 delta pairs (ΔSpHb-ΔCoOxHb) were collected. The bias, precision and limits of agreement were -0.29, 1.03 and -2.30 to 1.72 g/dl, respectively. When ΔSpHb and ΔCoOxHb were > 1 g/dl, the concordance rate for changes in hemoglobin reached 100%. The delta pairs revealed a positive correlation [ΔSpHb = 0.49 * ΔCoOxHb - 0.13; r = 0.69, 95% confidence interval (0.53, 0.82)]. No significant differences were found in the transfusion volume or postoperative anemia state. Conclusions The SpHb trend tracked changes in hemoglobin satisfactorily during surgery and more accurately estimated the appropriate timing for invasive hemoglobin measurements than the clinicians. Trial Registration ChiCTR1800016290, Date of registration

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