The effect of Teach-back method education on the control of asthma and family care pressure of patients in Iran / El efecto de la educación del método Teach-back en el control del asma y la carga del cuidado familiar de los pacientes en Irán / O efeito da educação do método Teach-back no controle da asma e a carga do cuidado familiar dos pacientes no Irã

Objective. To investigate the effect of teach-back education on patient asthma control and family care pressure of patients with asthma. Methods. The present study is a clinical trial and the study population was patients referred to Shahid Faghihi and Shahid Motahhari clinics in Shiraz, Iran. 58 patients with asthma and their caregivers were randomly assigned to the intervention and control groups, for a total of 29 subjects in each group. In the intervention group: the teach-back method was delivered individually to the patient and his or her primary caregiver in three sessions of approximately 60 minutes at one-day intervals. each session included presentations, practical techniques and a booklet. In this study, patients and caregivers in the control group were not trained. Before the intervention, 4 and 8 weeks after the intervention, asthma control test and spirometry test were performed to evaluate asthma control; Also, before the intervention and 8 weeks after the intervention, Zarit test was performed to evaluate the care burden. Results. The findings of repeated measures tests showed that, compared to the control group, the intervention group obtained a greater increase in the vital capacity index (p=0.028) and in the disease control score (p=0.001), as well as a reduction in the burden of care on family members (p<0.001). Conclusion. The present study showed that teaching asthma related topics to the patient and her caregiver along with the follow-up and supervision of the nurse improves the asthma control of the patient and also reduces the caregiver pressure.

Objetivo. Investigar el efecto de la educación con el método teach-back sobre el control del asma y la carga del cuidado familiar de estos pacientes. Métodos. Ensayo clínico cuya población de estudio fueron los pacientes remitidos a las clínicas Shahid Faghihi y Shahid Motahhari en Shiraz, Irán. Se asignaron aleatoriamente 58 pacientes con asma y sus cuidadores a los grupos de intervención y control, con un total de 29 díadas en cada grupo. Las personas del grupo de intervención recibieron formación con el método teach-back que se impartió individualmente al paciente y a su cuidador principal en tres sesiones de aproximadamente 60 minutos en tres días consecutivos. Cada sesión incluía presentaciones, técnicas prácticas y un folleto. Los pacientes y cuidadores del grupo de control no recibieron formación. Antes de la intervención y a las 4 y 8 semanas después de la misma, se aplicaron las escalas de control del asma y la de Zarit para evaluación de la carga del cuidado y, además se practicó una espirometría. Resultados. Las pruebas de medidas repetidas entre los grupos de estudio mostraron que, comparando con el grupo control, el grupo de intervención obtuvo mayor aumento del índice de capacidad vital (p=0.028) y del puntaje de control de la enfermedad (p=0.001), además, se redujo la carga del cuidado en los familiares (p<0.001). Conclusión. El presente estudio mostró que con la enseñanza de temas relacionados con el asma al paciente y a su cuidador, junto con el seguimiento y la supervisión de la enfermera, se mejora el control del asma en el paciente y también se reduce la carga del cuidador.

Objetivo. Investigar o efeito da educação com o método teach-back sobre o controle da asma e a carga do cuidado familiar destes pacientes. Métodos. Ensaio clínico no qual a população de estudo foram os pacientes enviados às clínicas Shahid Faghihi e Shahid Motahhari em Shiraz, Irã. 58 pacientes com asma e seus cuidadores foram designados aleatoriamente aos grupos de intervenção e controle, com um total de 29 díade em cada grupo. As pessoas do grupo da intervenção receberam formação com o método teach-back que se transmitiu individualmente ao paciente e ao seu cuidador principal em três sessões de aproximadamente 60 minutos em três dias consecutivos. Cada sessão incluía apresentações, técnicas práticas e um folheto. Os pacientes e cuidadores do grupo de controle não receberam formação. Antes da intervenção e às 4 e 8 semanas depois dela, se aplicaram as escalas de controle da asma e a de Zarit para avaliação da carga do cuidado e, além disso se praticou uma espirometria. Resultados. As provas de medidas repetidas entre os grupos de estudo mostraram que, comparando com o grupo de controle, o grupo de intervenção obteve maior aumento do índice de capacidade vital (p=0.028) e da pontuação de controle da doença (p=0.001), ademais de que se reduziu a carga do cuidado nos familiares (p<0.001). Conclusão. O presente estudo mostrou que o ensino de temas relacionados com a asma ao paciente e ao seu cuidador, junto com o seguimento e a supervisão da enfermeira, se melhora o controle da asma no paciente e também se reduz a carga do cuidador.

Promoting health literacy through the teach back method among Iranian health ambassadors: A randomized controlled trial / Promoting health literacy through the teach back method among Iranian health ambassadors: A randomized controlled trial / Promoção da alfabetização em saúde mediante o método teach-back entre os embaixadores da saúde iranianos: Un ensaio controlado aleatório

Objective. Describe the effect the teach back method on promoting the health literacy of health ambassadors in Urmia County in 2020. Methods. In the present quasi-experiment, 200 persons over 14 years old participated. They were divided into two research groups, a control (n=100) and an intervention (n=100). The sampling method was simple randomization and the data collection instrument was a questionnaire comprised of demographic information and health literacy (HELIA). The educational intervention took 4 sessions each 45 minutes in length following the teach back method. The questionnaire-based data were collected once before the intervention and once again three months after the intervention. Results. The present findings showed that 54% of the control group and 50% of the intervention group had a good or very good level of health literacy before the intervention(p>0.05). However, after the intervention, 52% of the control and 78% of the intervention group had a good or very good level of health literacy. The present findings revealed that the mean scores of health literacy dimensions (access to information, reading, understanding, appraisal, decision-making) and the overall health literacy score were significantly higher in the intervention group than the control (after the intervention). Wilcoxon's test results showed that the mean difference of the overall health literacy scores and the dimensions before and after the intervention were statistically significant (p<0.001). Conclusion. In the light of the present findings, we can conclude that participatory methods and the teach back method can improve health literacy, acquire reliable information and adopt healthy behaviors.

Objetivo. Describir el efecto del método teach-back en la promoción de la alfabetización en salud de los embajadores de la salud en el condado de Urmia, Irán en 2020. Métodos. En el presente estudio cuasiexperimental participaron 200 personas mayores de 14 años. Mediante muestreo de aleatorización simple se asignaron los grupos de investigación: de control (n=100) y de intervención (n=100). Se empleó un instrumento para la recogida de datos que contenía información demográfica y el instrumento Health Literacy for Iranian Adults -HELIA-. La intervención educativa consistió en 4 sesiones de 45 minutos, siguiendo el método teach- back. Los datos basados en el cuestionario se recogieron antes de la intervención y tres meses después de la misma. Resultados. Los hallazgos mostraron que el 54% del grupo de control y el 50% del grupo de intervención tenían un nivel bueno o muy bueno de conocimientos sobre alfabetización en salud antes de la intervención (p>0.05). Sin embargo, después de la intervención, el 52% del grupo de control y el 78% del grupo de intervención tenían un nivel bueno o muy bueno de conocimientos sanitarios. Los presentes resultados revelaron que las puntuaciones medias de las dimensiones de la alfabetización en salud acceso a la información, lectura, comprensión, valoración, toma de decisiones y de la puntuación global fueron significativamente mayores en el grupo de intervención que en el de control a los 3 meses después de la intervención. Finalmente, los resultados de la prueba de Wilcoxon mostraron que la diferencia media de las puntuaciones de la alfabetización en salud y de las dimensiones antes y después de la intervención eran estadísticamente significativas (p<0.001). Conclusión. A la luz de los resultados, se pudo concluir que la aplicación del método teach-back puede mejorar los conocimientos sobre la alfabetización en salud, además de ayudar a adquirir información fiable y a adoptar comportamientos saludables.

Objetivo. Descrever o efeito do método teach-back na promoção da alfabetização em saúde dos embaixadores da saúde no condado de Urmia, Irã em 2020. Métodos. No presente estudo quase-experimental participaram 200 pessoas maiores de 14 anos. Mediante amostragem de aleatória simples foram designados aos grupos de investigação: de controle (n=100) e de intervenção (n=100). Se empregou um instrumento para o recolhimento de dados que continha informação demográfica e o instrumento Health Literacy for Iranian Adults -HELIA-. A intervenção educativa consistiu em 4 sessões de 45 minutos, seguindo o método teach- back. Os dados baseados no questionário se recolheram antes da intervenção e três meses depois dela. Resultados. As descobertas mostraram que 54% do grupo de controle e 50% do grupo de intervenção tinham um nível bom ou muito bom de conhecimentos sobre alfabetização em saúde antes da intervenção (p>0.05). Porém, depois da intervenção, 52% do grupo de controle e 78% do grupo de intervenção tinham um nível bom ou muito bom de conhecimentos sanitários. Os presentes resultados revelaram que as pontuações médias das dimensões da alfabetização em saúde acesso à informação, leitura, compreensão, valoração, toma de decisões e da pontuação global foram significativamente maiores no grupo de intervenção que no de controle aos 3 meses depois da intervenção. Finalmente, os resultados da prova de Wilcoxon mostraram que a diferença média das pontuações da alfabetização em saúde e das dimensões antes e depois da intervenção eram estatisticamente significativas (p<0.001). Conclusão. À luz dos resultados, se pôde concluir que a aplicação do método teach-back pode melhorar os conhecimentos sobre a alfabetização em saúde, além de ajudar a adquirir informação confiável e a adotar comportamentos saudáveis.

Application of video education combined with Teach-back in implant restoration treatment of patients with chronic periodontitis / 中国实用护理杂志

Objective:To explore the application effect of video education combined with Teach-back in the treatment of patients with chronic periodontitis.Methods:Using non-simultaneous experimental research methods, From January to August in 2019, 41 patients with chronic periodontitis who underwent implant restoration in Shanghai Tenth People′s Hospital was selected by convenience sampling method as the control group, and implemented routine oral health education. From September 2019 to May 2020, 42 patients with chronic periodontitis who underwent implant restoration in Shanghai Tenth People′s Hospital were the observation group, and implemented video education combined with Teach-back. Compare the two groups of oral health care self-efficacy, periodontal clinical indicators, and the incidence of peri-implant mucositis.Results:Comparing 6 months and 12 months after implant restoration, the total scores of oral health self-efficacy and regular oral visits, correct brushing, and balanced diet in the observation group were 66.31 ± 4.32 and 67.19 ± 4.65, 22.04 ± 1.35 and 21.69 ± 1.82, 21.73 ± 1.65 and 22.64 ± 1.82, 22.54 ± 1.62 and 22.86 ± 1.74 respectively, which were higher than the control group 53.93 ± 4.78 and 54.09 ± 5.67, 17.02 ± 2.58 and 17.43 ± 2.16, 17.65 ± 1.74 and 18.54 ± 2.36, 19.14 ± 2.13 and 18.12 ± 2.58, the difference between the two groups at the two time points were statistically significant ( t values were 6.52-12.39, all P<0.05). And the PLI, mSBI, and PIS scores of the observation group were 0.80 ± 0.17 and 0.75 ± 0.14, 0.79 ± 0.19 and 0.81 ± 0.18, 2.08 ± 0.45 and 2.10 ± 0.53, respectively, which were lower than the control group 0.92 ± 0.19 and 0.99 ± 0.21, 1.03 ± 0.17 and 1.16 ± 0.21, 2.45 ± 0.68 and 2.62 ± 0.61, the difference between the two groups at the two time points were statistically significant ( t values were 2.93-8.16, all P<0.05). 12 months after, the incidence of mucositis around implants in the observation group was 7.14%(3/42), which was lower than 26.83%(11/41)in the control group ( χ2=5.73, P<0.05). Conclusions:Video education combined with Teach-back can improve the self-efficacy of oral health care during implant restoration treatment in patients with chronic periodontitis, improve oral health care behavior, thereby improving the periodontal condition around the implant and reducing the incidence of mucositis.

Application research of teach-back in mouth-opening training of patients with nasopharyngeal carcinoma / 中国实用护理杂志

Objective@#To investigate the effect of teach-back on the compliance of mouth-opening training in patients with nasopharyngeal carcinoma after radiotherapy.@*Methods@#Eighty patients with nasopharyngeal carcinoma in the First Affiliated Hospital of Gannan Medical University were selected. They were divided into intervention group and control group according to the random number table method. The intervention group used the teach-back method for health education, and the control group used conventional methods for health education. The knowledge mastery of mouth-opening training, the degree of compliance with mouth-opening training and the difficulty of mouth opening were compared between the two groups.@*Results@#Within 1 week of the intervention group, the complete mastery rate, partial mastery rate, and unmastered rate was 77.5% (31/40), 17.5% (7/40), and 5.0% (2/40), respectively, within 2 weeks, that was 97.5% (39/40), 2.5% (1/40), 0. Within 1 week of the control group was 65.0% (26/40), 10.0% (4/40), 25.0% (10/40), respectively, within 2 weeks, that was 75.0% (30/40), 20.0% (8/40), and 5.0% (2/40). The knowledge mastery of mouth-opening training in the intervention group was higher than that in the control group within 1 week and 2 weeks, and the difference between the two groups was statistically significant (χ2=6.590, 8.618, P<0.05). At the end of radiotherapy, the complete compliance rate, partial compliance rate, and non-compliance rate of the intervention group was 90.0% (36/40), 10.0% (4/40), 0, respectively. After 3 months of radiotherapy, the rate was 75.0% (30/40), 22.5% (9/40), 2.5% (1/40). At the end of 6 months of radiotherapy, the rate was 60.0% (24/40),30.0% (12/40) and 10.0% (4/40). At the end of the radiotherapy, the control group was 70.0% (28/40), 20.0% (8/40), and 10.0% (4/40), respectively. After 3 months of radiotherapy, the rate was 40.0% (16/40), 45.0% (18/40) and 15.0% (6/40). After 6 months of radiotherapy, the rate was 20.0% (4/40), 40.0% (16/40), and 40.0% (16/40). The compliance of the intervention group at the end of radiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy was higher than that of the control group, and the difference between the two groups was statistically significant (χ2=5.986, 10.615, 15.771, P<0.05 or 0.01). In the intervention group, the incidence of Ⅰ degree, Ⅱ degree, Ⅲ degree and Ⅳ degree difficulty of mouth opening after 6 months of radiotherapy was 10.0% (4/40), 5.0% (2/40), 0, 0, respectively, and the control group was 15.0% (6/40), 15.0% (6/40), 2.5% (1/40), 2.5% (1/40), the incidence of difficulty of mouth opening of the intervention group was lower than that of the control group, and the difference between the two groups was statistically significant (Z=15.737, P<0.01).@*Conclusions@#Teach-back can effectively improve the mastery of patients′ mouth-opening training knowledge and the compliance of mouth-opening training, which is beneficial to reduce the incidence of mouth-opening difficulties in patients with nasopharyngeal carcinoma. It is worthy of clinical promotion.

Application of teach-back method on blood glucosed and compliance for patients′ gestational diabetes mellitus / 中国实用护理杂志

Objective@#To explore the effects of teach-back on health education for patients′ gestational diabetes mellitus.@*Methods@#A total of 90 pregnant women with gestational diabetes mellitus from obstetrics outpatient were recruited and randomly assigned to either case or control group. The case and control groups received the same treatment and health education, the only difference was teach-back method in the case group,to compare blood glucose, compliance and outcome of pregnancy.@*Results@#After the intervention, fasting blood glucose (FPG), 2h postprandial blood glucose (2h-ppg) and glycosylated hemoglobin (HbA1c) in the case group were respectively (4.75±0.30) mmol/L, (5.69±0.74) mmol/L, (5.15±0.28)%, control group were respectively (5.01±0.30) mmol/L, (6.15±0.70) mmol/L, (5.68±0.33)%. The difference was statistically between the two groups (t=-4.631、-3.019、-8.020, P<0.05 or 0.01). The treatment compliance rate, gestational hypertension, hyperhydramnios, cesarean section and macrosomia rate in the case group were respectively 93.2% (41/44), 6.8% (3/44), 11.4% (5/44), 13.6% (6/44), 2.3% (1/44), control group were respectively 81.4% (35/43), 23.3% (10/43), 30.2% (13/43), 32.6% (14/43), 14.0% (6/43), the difference was statistically between the two groups (U=570.000, χ2=4.398-5.775, P<0.01 or 0.05).@*Conclusion@#Teach-back method is methodis a good health method and to reduce glucose level and improve Compliance of therapy. It is worthy of promotion.

Application of Teach-back health education model in patients after percutaneous coronary intervention / 中国实用护理杂志

Objective@#To explore the effect of Teach-back health education model on health education for patients after percutaneous coronary intervention (PCI).@*Methods@#Eighty patients after PCI operation in cardiology were selected, 40 patients selected from February to March as control group and 40 patients selected from April to May as observation group according to the time of admission in 2018. The control group used the routine health education method, based on this, the observation group used the "Teach-back" health education model to healthy educate patients. Three months after the intervention, the results of body mass index (BMI), triglycerides, total cholesterol, low-density lipoprotein, Seattle angina questionnaire (SAQ), and Morisky questionnaire were evaluated.@*Results@#After 3 months of intervention, the triglyceride, total cholesterol, and low-density lipoprotein in the observation group were (1.35±0.43), (3.99±0.57), and (2.32±0.24) mmol/L, which were lower than the control group (1.63±0.38), (4.31±0.73), (2.61±0.28) mmol/L, the difference between the two groups was statistically significant (t=3.082, 2.717, 5.048, P<0.01 or 0.05). After 3 months of intervention, evaluate the SAQ score of the observation group, the degree of physical limitation, the stability of angina pectoris, the degree of angina pectoris, the satisfaction of treatment, and the disease cognition were respectively (76.16±5.03), (88.75±14.92), and (84.25±12.17), (84.76±5.11), (82.79±9.64) points, which were higher than the control group (68.94±9.80), (80.63±17.44), (76.25±12.34), (70.80±7.00), (70.50±13.85) points, the differences were statistically significant (t=-4.145, Z=-5.848--2.166, P < 0.05). After 3 months of intervention, the Morisky questionnaires of the observation group and the control group were (2.43±0.78) and (3.80±0.41) points, and the difference was statistically significant (Z=-6.848, P<0.05).@*Conclusion@#The application of Teach-back health education model to patients after PCI has a good effect.

Application of teach-back method on blood glucosed and compliance for patients′ gestational diabetes mellitus / 中国实用护理杂志

Objective To explore the effects of teach-back on health education for patients′gestational diabetes mellitus. Methods A total of 90 pregnant women with gestational diabetes mellitus from obstetrics outpatient were recruited and randomly assigned to either case or control group. The case and control groups received the same treatment and health education, the only difference was teach-back method in the case group,to compare blood glucose, compliance and outcome of pregnancy. Results After the intervention, fasting blood glucose (FPG), 2h postprandial blood glucose (2h- ppg) and glycosylated hemoglobin (HbA1c) in the case group were respectively (4.75 ± 0.30) mmol/L, (5.69 ± 0.74) mmol/L, (5.15±0.28)%,control group were respectively (5.01±0.30) mmol/L, (6.15±0.70) mmol/L, (5.68± 0.33)% . The difference was statistically between the two groups (t=-4.631、-3.019、-8.020, P<0.05 or 0.01). The treatment compliance rate, gestational hypertension, hyperhydramnios, cesarean section and macrosomia rate in the case group were respectively 93.2% (41/44), 6.8% (3/44), 11.4% (5/44), 13.6% (6/44), 2.3% (1/44),control group were respectively 81.4% (35/43), 23.3% (10/43), 30.2% (13/43), 32.6% (14/43), 14.0% (6/43),the difference was statistically between the two groups ( U=570.000, χ2 =4.398-5.775, P<0.01 or 0.05). Conclusion Teach-back method is methodis a good health method and to reduce glucose level and improve Compliance of therapy. It is worthy of promotion.

Application of Teach- back health education model in patients after percutaneous coronary intervention / 中国实用护理杂志

Objective To explore the effect of Teach-back health education model on health education for patients after percutaneous coronary intervention (PCI). Methods Eighty patients after PCI operation in cardiology were selected, 40 patients selected from February to March as control group and 40 patients selected from April to May as observation group according to the time of admission in 2018. The control group used the routine health education method, based on this, the observation group used the"Teach-back"health education model to healthy educate patients. Three months after the intervention, the results of body mass index (BMI), triglycerides, total cholesterol, low-density lipoprotein, Seattle angina questionnaire (SAQ), and Morisky questionnaire were evaluated. Results After 3 months of intervention, the triglyceride, total cholesterol, and low-density lipoprotein in the observation group were (1.35±0.43), (3.99±0.57), and (2.32±0.24) mmol/L, which were lower than the control group (1.63±0.38), (4.31 ± 0.73), (2.61 ± 0.28) mmol/L, the difference between the two groups was statistically significant (t=3.082, 2.717, 5.048, P<0.01 or 0.05). After 3 months of intervention, evaluate the SAQ score of the observation group, the degree of physical limitation, the stability of angina pectoris, the degree of angina pectoris, the satisfaction of treatment, and the disease cognition were respectively (76.16±5.03), (88.75± 14.92), and (84.25±12.17), (84.76±5.11), (82.79±9.64) points, which were higher than the control group (68.94 ± 9.80), (80.63 ± 17.44), (76.25 ± 12.34), (70.80 ± 7.00), (70.50 ± 13.85) points, the differences were statistically significant (t=-4.145, Z=-5.848--2.166, P < 0.05). After 3 months of intervention, the Morisky questionnaires of the observation group and the control group were (2.43±0.78) and (3.80±0.41) points, and the difference was statistically significant (Z=-6.848, P<0.05). Conclusion The application of Teach-back health education model to patients after PCI has a good effect.

Evaluating effectiveness of patient counseling, teach back versus standard method

Background: The aim of the study was to assess memory retention of new prescription education by comparing Teach back method and standard counseling method. And also to evaluate association of age, sex, drug use in past and education in memory retention.Methods: A prospective experimental study was carried out for a period of six months. Eligible subjects visiting pulmonary medicine outpatient department were screened and grouped into standard groups and teach back group. Patients in the standard group are taught eight counseling points about the drugs by one way dialogue method and asked at the end if there are any questions. while patients in the teach back method builds on the standard method by asking three open ended questions to recall what was taught and correcting any misunderstandings by two way dialogue method.Results: The demographic information (age, sex, education, current prescription use) are collected from both groups. The post counseling score is assessed by evaluator using a scoring sheet. Scores were analyzed using Mann Whitney U test Teach back group shows statistically significant (p value = 0.0001) increase in score compared to standard group. The mean value of teach back scoring is 6.28 while that of standard is 4.44.Conclusions: All the demographic parameters (Age, sex, drug use in past three months and education) do not show any significant association with scoring and memory retention (p value >0.05 for chi square test). The group that received teach-back method of counseling showed a significant improvement in patient knowledge and memory retention.

The role of video-based education combined with teach-back method in improving health literacy and blood pressure control of elderly patients with hypertension / 现代临床护理

Objective To explore the effect of video-based education and teach-back method on health literacy and blood pressure control of elderly patients with hypertension. Methods 50 elderly hypertensive patients hospitalized in our hospital during May and December 2016 were enrolled as control group and anther 50 elderly hypertensive patients hospitalized in our hospital during January and May 2017 were assigned as the experimental group.On the basis of routine health education as in the control group,the experimental group was educated by video-based education combined with teach-back method.The health literacy and blood pressure control level of the two groups were compared before and after intervention. Result After intervention,the level of health literacy of the experimental group was significantly better than that of the control group,and the level of blood pressure control was significantly better than that of the control group as well (P<0.001 and P<0.05). Conclusions Video-based education combined with teach-backmethod is an effective way for health education.It has good effect on improving health literacy and blood pressure control level of elderly patients with hypertension.

Areview of the applicability of the health education model of the teach-back method / 中国实用护理杂志

Teach-back method is a new research topic of health education in recent years, which has been widely applied in the field of health education in foreign countries, and has achieved good effect. Relevant reports of the method use were also reported in China.These reports show that this method can significantly improve the compliance of patients, and improve the rehabilitation effect. This paper will detail from the definition, implementing methods, advantages and application status at home and abroad of Teach-back method.The aim is to enhance the familiarity of the method in Health education professionals and let it will be better to use to work in public service.

Effect of teach-back on the cognition of osteoporosis in diabetic patients / 中国实用护理杂志

Objective To explore the effect of teach-back on the health education of osteoporosis knowledge in diabetic patients. Methods A total of 152 cases of diabetic patients hospitalized in endocrinology department, the Second Affiliated Hospital of Xi′an Jiaotong University were recruited. The study subjects were divided into control group and experimental group according to the admission date, 76 cases in each group respectively. Intervention was conducted using a unified set of publicity materials and slides of osteoporosis knowledge. The routine health education was applied in the control group, and the experimental group was carried out the teach-back health education. The effect of health education was evaluated by the Osteoporosis Knowledge Test (OKT) before intervention, 1 day after intervention, and 3 months after intervention. Results Before intervention, the OKT score of two groups were not statistically different (t=0.071, P=0.943). The OKT score of the control group was (19.21±3.91) points for 1 day after intervention and (16.95 ± 4.14) points for 3 months after intervention. The OKT score of the experimental group was (21.61 ± 2.59) points for 1 day after intervention and (20.54 ± 3.09) points for 3 months after intervention. After intervention, the OKT score of the experimental group was higher than that of the control group, and the results were statistically different (t=4.455, 6.057,P<0.01). Repeated measures analysis of variance revealed that there were significant differences in OKT score between the two groups (P<0.01). Conclusion Teach-back health education is more beneficial for diabetic patients to understand and remember the knowledge of osteoporosis and is worth further research and application.

Application of Teach back mission pattern in health literacy education of elderly patients with metabolic syndrome / 中国实用护理杂志

Objective To investigate the effect of Teach-back mission pattern in the education of elderly patients with metabolic syndrome.Methods A total of 110 elderly patients with metabolic syndrome who were admitted to the hospital from October 2015 to September 2017 were selected as study subjects and randomly divided into observation group and control group with 55 cases each by random digits table method.The control group was given traditional health education,and the observation group was given Teach-back missionary model.After 6 months of follow-up,the health literacy levels of the two groups before and after intervention were measured using the Scale on Health Literacy for Patients with Chronic Disease.The systolic blood pressure (SBP),diastolic blood pressure (DBP),body mass index (BMI),waist circumference (WC),fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),triglyceride (TG),and total cholesterol (TC) levels were compared before and after the intervention of the two groups of patients.Results The cases of loss of contact and withdrawal were removed.In the follow-up period of 6 months,52 patients and 49 patients in the observation group and the control group completed the study.The scores of the observation group's information acquisition ability,exchange interaction ability,improvement of health willingness,and economic support willingness were (27.18 ±4.15),(29.63 ± 4.56),(14.63 ± 2.07),(7.85 ± 1.23) points,respectively.All were significantly higher than the control group (23.96 ± 3.83),(26.34 ± 3.87),(13.04 ± 1.56),(6.91 ± 0.93) points,and the difference was statistically significant (t =3.898-4.339,all P＜ 0.05).During follow-up of 6 months,the awareness rate of disease knowledge and the compliance rate of health behaviors in the observation group were 92.31％(48/52) and 69.39％(34/49),respectively,which were significantly higher than those in the control group,86.54％ (45/52) and 63.27％ (31/49).The difference was statistically significant (x2=8.677,7.336,P＜ 0.01).During follow-up of 6 months,SBP,DBP,BMI,and WC in the observation group were (135.73 ±8.53) mmHg(1 mmHg=0.133 kPa),(85.69 ± 8.74) mmHg,(23.76 ± 1.91) kg/m2,(87.13 ± 6.45) cm,respectively,those in the control group were (141.79±7.24) mmHg,(89.45±8.37) mmHg,(24.98 ± 2.03) kg/m2,and (90.13 ± 6.74) cm,respectively,,and the difference was statistically significant (t =2.206-3.831,P＜ 0.05).The FPG,HbA1c,TG,and TC in the observation group were (6.57 ± 0.91) mmol/L,(5.85 ±1.03)％,(1.71 ± 0.68) mmol/L,and (4.67 ± 0.68) mmol/L,respectively,which were significantly lower than those of the control group.The control group values were (7.24 ± 1.03) mmol/L,(6.46 ± 1.14)％,(1.98 ±0.63) mmol/L,(4.98 ± 0.72) mmol/L.The difference was statistically significant (t =2.167-3.469,P ＜0.05).Conclusions The Teach-back mission pattern can significantly improve the level of health literacy in elderly patients with metabolic syndrome,improve their physical and metabolic indicators,and has important implications for preventing and treating various chronic diseases and improving life quality.

Breaking bad news: doctors' skills in communicating with patients / Dando más notícias: a habilidade dos médicos em se comunicar com os pacientes

ABSTRACT CONTEXT AND OBJECTIVE: Breaking bad news is one of doctors' duties and it requires them to have some skills, given that this situation is difficult and distressful for patients and their families. Moreover, it is also an uncomfortable condition for doctors. The aim of this study was to evaluate doctors' capacity to break bad news, ascertain which specialties are best prepared for doing this and assess the importance of including this topic within undergraduate courses. DESIGN AND SETTING: Observational cross-sectional quantitative study conducted at a university hospital in Belo Horizonte (MG), Brazil. METHODS: This study used a questionnaire based on the SPIKES protocol, which was answered by 121 doctors at this university hospital. This questionnaire investigated their attitudes, posture, behavior and fears relating to breaking bad news. RESULTS: The majority of the doctors did not have problems regarding the concept of bad news. Nevertheless, their abilities diverged depending on the stage of the protocol and on their specialty and length of time since graduation. Generally, doctors who had graduated more than ten years before this survey felt more comfortable and confident, and thus transmitted the bad news in a better conducted manner. CONCLUSION: Much needs to be improved regarding this technique. Therefore, inclusion of this topic in undergraduate courses is necessary and proposals should be put forward and verified.

RESUMO CONTEXTO E OBJETIVO: Dar más notícias, além de dever do médico, requer certas habilidades de sua parte, por se tratar de situação difícil e angustiante para o paciente e seus familiares, assim como desconfortável para os profissionais da saúde. O objetivo deste estudo é avaliar a capacidade dos médicos em dar más notícias, assim como as especialidades mais preparadas e a importância da inclusão do tema para a graduação. TIPO DE ESTUDO E LOCAL: Estudo observacional, transversal, quantitativo, realizado em hospital universitário de Belo Horizonte, Minas Gerais, Brasil. MÉTODOS: Este estudo utilizou de questionário baseado no protocolo SPIKES que foi respondido por 121 médicos deste hospital universitário. O questionário investigou suas atitudes, posturas, modos e medos em relação a dar más notícias. RESULTADOS: A maioria dos médicos não teve problemas quanto ao conceito de más notícias, contudo, as habilidades divergiram dependendo da etapa do protocolo, assim como quanto a especialidade e tempo de formado. De modo geral, os médicos formados há mais de 10 anos se sentem mais confortáveis e confiantes, e transmitem tal informação de maneira mais bem conduzida. CONCLUSÃO: Muito se tem a aprimorar em relação a essa técnica. Desse modo, a inclusão do tema durante a graduação é necessária e propostas devem ser sugeridas e averiguadas.

Health Literacy ‐ Enhancing Physician Skills

The scope of health literacy demanded of the present day health services user is broad. Enhancing physician skills consists of improving on 6 things : Recognise and assist patients with low literacy to overcome their information handling problems ; Improve usability of health information ; Improve the usability of health services ; Build knowledge to improve health decision making ; Advocate for health literacy in your organisation ; and Learn more about health literacy.

Health Literacy ‐ Asking the Right Questions & Broad Concepts

The ability to make informed health decisions is a complex process. Knowing when to consult a healthcare professional, understanding one's medical condition and learning how to take medicines correctly require that health information can be accessed, processed and applied effectively by the individual. These statements underpin the concept of "health literacy" which may be defined as the degree to which people have the ability to find, understand, act and communicate health information to make informed health decisions. To communicate at a level that helps patients to make use of health information, there is a need for the healthcare professional to first be able to identify and understand the patient's health literacy by considering age, gender, cultural background, education level, thoughts and behaviours associated with the topic under discussion, and perceived benefits and barriers towards the topic. Five strategies can then be applied for improving that patient's understanding and self management of his or her medical condition: (1) Assess patients' health literacy using open-ended questions; (2) Speak in plain language; (3) Limit the number of teaching points; (4) Use visual aids, and (5) Incorporate the 'teach-back' method to ensure patient understanding.