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Cancer-related patient education: an overview of the last decade of evaluation and research.

PURPOSE/OBJECTIVES: To provide an overview of cancer-related patient-education research to determine future research needs. DATA SOURCES: A literature search of peer-reviewed articles from 1989-1999. Databases that were searched included Medline, CINAHL, HealthStar, ERIC, CancerLit, and PubMed. DATA SYNTHESIS: 176 articles were analyzed and synthesized into narrative form. CONCLUSIONS: Patients with cancer want and benefit from information, especially when making treatment decisions. Education helps patients manage side effects and improves adherence. Literacy is an important factor in materials development. The efficacy of computer-assisted learning, audio and video programs, and telephone interventions is supported in a variety of patient groups. Pain education can improve pain control, but the impact on fatigue has not been well researched. IMPLICATIONS FOR NURSING PRACTICE: Patient education is an important component of nursing care. Research has confirmed its impact in many areas but questions still remain.

Communications Media↗

The computer-literate nurse.

This study investigated the perceptions of nursing educators concerning the amount and kinds of computer training that should occur in the nursing degree program. Data were collected in two phases: a semi-structured interview of experts in the application of the computer to nursing and a random sample of nursing educators in 2-year and 4-year nursing degree programs. The panel of experts identified objectives within each of seven domains: programming and algorithms, skills in computer usage, major uses and applications, limitations of computers, personal and social aspects, and relevant values and attitudes. The responses of this panel were used to generate an universe of computer literacy objectives. The sample of nursing educators then identified a subset of objectives within the universe that they felt nursing students should master in order to be computer literate. The survey found that nursing educators desire graduates of nursing degree programs to understand how a computer works and to develop skills in using application programs. They do not expect nursing graduates to acquire programming skills, however, they do expect the graduates to acquire skills in using the computer as a tool in nursing. These skills include using a word processor for writing nursing care plans, using computer-aided instruction as a learning tool, using a hospital computer information system, using a computerized library database, and using software for statistical computations.

Computer Literacy↗

Recipes and nutrition education.

Since the beginning of the science of nutrition in the 1800s, nutritionists have been concerned about the use of recipes in nutrition programs. Although research indicates that recipes may be most used by those with a high school education and with food preparation experiences, recipes appear to be valuable in providing many forms of food and nutrition information to individuals with varying education levels. Factors that should be considered in selecting recipes are: clients' nutritional and dietary status, money, equipment, literacy, information and knowledge, and life-style. Subsequently, evaluation is needed to document impact on clients' food habits and to justify the approach in nutrition education programs. This project reviewed procedures used by nutritionists to assess clientele needs and evaluated the tools they use in education programs. Although it focused on recipes, the same information could have been obtained for handouts, posters, slide series, comic books, storybooks, and demonstrations. Research is needed in nutrition education to identify standards for the use of tools, such as recipes, and to study their impact on improving dietary adequacy of clientele. Such standards should be tested within a theoretical framework so that they will be useful in other situations.

Cooking↗

Leveraging Pharmacy Education through a Train-the-Trainer Model to Enhance Breast Cancer Literacy in Rural Communities.

Rural versus urban communities experience disproportionate challenges in breast cancer outcomes, with higher breast cancer mortality and later stage disease presentation, despite similar diagnosis rates. These disparities are driven by structural barriers, including rural hospital closures, transportation difficulties, and limited access to oncology specialists. This study evaluated a train-the-trainer program designed to equip PharmD students located at a pharmacy school in a rural county in South Carolina with breast cancer education training, leveraging the pharmacists' position as accessible healthcare professionals in rural communities. Training focused on breast cancer risk factors, prevention, screening, genetics, staging, and treatment options. Effectiveness was measured through pre- and post-workshop confidence surveys and knowledge assessments. Results showed significant improvement in student confidence across educational domains, with average scores increasing from 6.30 to 8.59 (p&#x2009;<&#x2009;0.0001). Understanding of screening guidelines (mean difference: 4.30; p-value:&#x2009;<&#x2009;.0001) and target therapy options showed the greatest improvement (mean difference: 3.65; p-value:&#x2009;<&#x2009;.0001), while knowledge of BRCA gene inheritance showed the smallest change (mean difference: 0.369; p-value: ns), suggesting some pre-existing awareness but limited understanding of its clinical applications. Overall, this pilot program demonstrates how pharmacy education can address healthcare disparities in rural communities. By preparing pharmacists to deliver accurate breast cancer education and to increase rural patient agency, this model creates a sustainable approach to improving health literacy in medically underserved areas. Future research could further expand this model to include diverse healthcare professionals and incorporate long-term impact assessments in community settings.

Humans↗

Environmental management of asthma at top-ranked U.S. managed care organizations.

We evaluated the status of nationally top-ranked managed care organizations' (MCOs) asthma disease management programs to identify "best practices" in the environmental treatment and control of asthma. Application materials were developed and mailed to the top 34 managed care organizations, as determined by the ranked results from the October 1998 edition of US News and World Report. Based on the results of a staff and panel review, five applicants were selected for site visitation. The results of the site visits determined two finalists and three runners-up. We recommend that MCOs integrate population and community-based strategies and seek an emphasis on prevention. We encourage collaborations with other organizations and agencies. We endorse home visitation to assess environmental factors and also support use of telephonic case management. We think that smoking cessation programs should be coordinated with asthma management. We consider it important to use alternative forms of communication such as the Internet. And we find that it is important to be mindful of language, culture, and literacy.

Asthma↗

Speaking of women's 'nameless misery': the everyday construction of depression in Australian women's magazines.

In this article we examine the tensions between current Australian depression policy directions and lay beliefs about depression as constructed and circulated through popular media at a time when mental health education discourses are also promoting 'depression literacy' [Parslow & Jorm, 2002. Medical Journal of Australia, 177(7), 117-121]. Drawing upon research into articles on depression published in two women's magazines before and after the promulgation of the National Action Plan for Depression [Commonwealth Department of Health and Aged Care, 2000. National action plan for depression. Canberra: Commonwealth Department of Health and Aged Care-Mental Health and Special Programs Branch] we identify the cultural context of certain lay beliefs about depression as articulated through personal and celebrity stories, advice columns and resource links. The depression literacy literature privileges biomedical and psychological expertise in explaining depression and promoting help-seeking behaviour. In contrast, the magazine discourses foreground an individualising discourse of depression as a problem of self-management while also referring to biomedical expertise. They emphasise women's abilities to manage difficult life events and to build informal supportive relationships, which reinforces dominant notions of feminine identity as concerned with balancing competing gender demands. We critique the national policy on depression literacy as taking insufficient account of women's belief structures, which leads, for example, to a limited analysis of stigma. We also critique policy for not engaging sufficiently with the gendered nature of depression and its relation to social inequities, something the magazines replicate.

Attitude to Health↗

A new way for surgical education--development and evaluation of a computer-based training module.

Computer-based training (CBT) programs teach the material of a specific field and at the same time offer various ways of objectively assessing the knowledge gained. The interactive use of multi-media components such as text, graphics, animation, sound, digital slide shows, and videos as well as quizzes can theoretically facilitate the learning process. The aim of this study was the development and evaluation of a CBT-program by surgeons for student training. Using SuperCard, a teaching module for Distal Radius Fracture (DRF) was developed, which contains detailed clinical information. Video clips and vivid animations combine theoretical knowledge with practical experience. Fourth-year medical students (n = 103) were tested after using the module for 90 min. Other students (n = 47) served as the control group. In a 90 min lecture, DRF was discussed. CBT gained in all evaluated criteria (distinctiveness, detailed description, presentation of materials, structure, motivation for learning, time saved learning and memory retention) 15-20% better scores than the lecture. Although 82% of the students stated that their experience with computers was limited or insufficient, 100% found the use of CBT systems useful in student teaching. Most of them suggested the use of such programs as a method of exam preparation/self study (90%) or as a supplement to a lecture (40%). Based on these evaluations, CBT modules are an appropriate future teaching and learning system that is well accepted. In conclusion, the results of this study show that CBT-programs could be a valuable supplement to medical education. In addition, further development of CBT-programs and their use as information systems for surgical residency programs at universities can be suggested.

Adult↗

Use of technology to facilitate language skills in school-age children.

Technology offers numerous possibilities for facilitating language and literacy skills in school-age children and adolescents. Narrative skills can be addressed by the use of specialized programs as well as generic word processing software. Writing skills can be targeted due to the variety of possibilities for input as well as options for supporting spelling and syntax. Reading skills might be improved by the use of programs that focus on decoding, as well as hypertext tools that highlight the use of text patterns or signals.

Auditory Perception↗

The scorecard on globalization 1980-2000: its consequences for economic and social well-being.

The era of globalization has brought substantially less progress than was achieved in the preceding 20 years. This study by the Center for Economic and Policy Research concludes that the data provide no evidence that the policies associated with globalization have improved outcomes for developing countries, and its findings challenge economists and policymakers who cite globalization as an engine of growth while pressing for policies that strengthen the trend. The study also served as a backdrop to the release of the United Nations Development Program's Human Development Report on July 11, 2001. Using standard measures of economic growth, health outcomes, education, and literacy, the CEPR study compares the progress achieved during the period preceding globalization, 1960-80, with the period from 1980 to 2000, which was characterized by the reduction of tariff and nontariff barriers to trade, the removal of restrictions on international investment flows, and increasing intervention by the International Monetary Fund and World Bank on a wide range of economic and policy issues. While the evidence presented here does not prove that the policies associated with globalization were responsible for the deterioration in economic performance, it does present a very strong prima facie case that some structural and policy changes implemented during the last two decades are at least partly responsible for these declines.

Adult↗

Training programs in school consultation.

The need to train psychiatrists in school consultation is important to approach mental health and psychosocial concerns from the broad perspective of addressing barriers to learning and promoting healthy development. There is a major national impetus to improve academic achievement and literacy, which can be amplified by addressing the social, emotional, and mental health needs of children and youth. Training in school consultation allows the psychiatrist to better understand a critical institution in each child's life and also provides technical assistance and training to school personnel, which facilitates networking between programs and individuals involved in or interested in school mental health. Each of the described programs approaches consultation from a specific focus that varies in time commitment, placement options, and frequency and order of didactic presentations. There is no conclusive available evidence as to which program is most effective, since such evaluation depends on the overall goals of the consultation program itself.

Adolescent↗

Baccalaureate nursing faculty performance of nursing computer literacy skills and curriculum integration of these skills through teaching practice.

This article describes a cross-sectional survey research study designed to collect data from nurse educators regarding their self-reported competence in the performance of 60 nursing computer literacy skills, as well as self-reported levels of integration of these skills, through teaching practice, into the curricula of their respective baccalaureate nursing programs. Data were received from 184 respondents representing 18 publicly funded, National League for Nursing-accredited, college and university generic baccalaureate degree programs in the New England region of the United States. Study findings revealed that 21 of the 60 skills were being performed "well" or "very well" as reported by 50% or more of respondents, while in the area of curriculum integration through teaching practice, only 3 of the 60 skills were being integrated into teaching practice either "moderately" or "extensively" as reported by 50% or more of respondents. Another major finding of this research study strongly suggested that faculty who have the ability to perform requisite nursing computer literacy skills comfortably are more likely to integrate these skills into the curriculum through their teaching practices (r = .76; p<.01). This article concludes with a discussion of the implications of the study findings for nursing education.

Computer Literacy↗

Curricular trends in accredited generic baccalaureate nursing programs across the United States.

Rapid technological advances in health care delivery, changes in health care financing, and the increasing number of elderly in the American population have resulted in dramatic alterations in the nature and scope of health care, the needs of health care consumers, and the practice of nursing. A descriptive research study was conducted with 113 respondents from accredited generic baccalaureate nursing programs across the continental United States and the Virgin Islands to determine the presence or absence of current health care emphases and essential nursing knowledge and skills in professional nurse education curricula. Findings revealed that, with few exceptions (e.g., computer literacy, economics, legal issues), content addressing current health care emphases and essential knowledge was integrated within one or more required courses in most nursing curricula. Differences were noted in the teaching strategies used by different types of nursing programs and in different locations.

Clinical Competence↗

Editorial.

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Culture↗