Discharge information needs and symptom distress after abdominal aortic surgery.

The purpose of this study was to describe the discharge information needs and symptom distress of people after abdominal aortic reconstructive surgery. Interviews (N = 51) were conducted prior to, and 4 weeks after, hospital discharge. People indicated that the most important information to help them manage their care after discharge related to the recognition, prevention and management of complications. Broken sleep and incisional pain were the most distressful of symptoms prior to hospital discharge, whereas fatigue and broken sleep were most distressful once home. These results may assist nurses to understand the discharge information needs and symptom distress of people recovering from aortic reconstructive surgery and the importance of discharge education to help people to manage their care once home.

Symptom distress, anxiety, depression, and discharge information needs after peripheral arterial bypass.

The purpose of this study was to describe the symptom distress, anxiety, depression, and discharge information needs of patients after peripheral arterial bypass surgery. Patients (n = 38) were interviewed before and after hospital discharge. The symptoms of incisional pain and broken sleep, as measured by Visual Analogue Scales, were the most distressing symptoms experienced before and after discharge. Patients reported low levels of anxiety and depression as measured by the Profile of Mood States. A moderate amount of information, assessed by the Patient Learning Need Scale, was perceived by patients to be important to help manage their care after discharge. The most important information related to the recognition, prevention, and management of complications. The findings contribute to an understanding of discharge information needs after peripheral arterial bypass and emphasizes the importance of patient education to facilitate transition to the home.

New approaches to addressing information needs in local public health agencies.

For local Public Health agencies to be fully responsive to community needs, staff must have ready access to up-to-date and accurate information. During the last several years, the Hamilton-Wentworth Department of Public Health Services (DPHS), a Teaching Health Unit affiliated with McMaster University, has been developing new information services including establishment of a specialized library on site; education sessions on the use of information stored in this library and in the Hamilton-Wentworth Health Library Network; innovative approaches to tailoring information services to staff needs including on-site access to on-line literature databases; and establishment of a group to retrieve and report community health data. In the initial three years of operation, surveys of Hamilton-Wentworth staff and a comparison health unit (Niagara) revealed that staff most frequently sought information from managers and support staff, as well as from personal books, articles and journals. Over half (57%) of the Hamilton-Wentworth staff reported use of the DPHS library, whereas 28% of Niagara Regional Health Unit staff reported use of their library. Other information services, for example, bibliographic indexes on population health, were less frequently used. Plans to increase their use are discussed.

The Patient Learning Needs Scale: reliability and validity.

The article describes the development and initial psychometric evaluation of an instrument to measure patients' perceptions of learning needs at time of discharge from hospital to home. Evaluation of the Patient Learning Needs Scale was based on responses of 301 adults hospitalized with a medical or surgical illness. Factor analysis isolated seven subscales: medications, activities of living, feelings related to condition, community and follow-up, treatment and complications, enhancing quality of life and skin care. These seven factors accounted for 56.1% of the variance. Cronbach's alpha for the 50-item scale was 0.95.

Factors influencing patients' informational needs at time of hospital discharge.

The relationship between patients' perceived informational needs and selected sociodemographic and illness-related variables were examined in a sample of 301 adult medical and surgical patients preparing for discharge from an acute care setting. Marital status, living arrangements and chronicity of illness had no influence on the importance of informational needs as measured by the Patient Learning Need Scale (PLNS). More informational needs were identified by females than males, and those with malignant as opposed to benign disease. Length of time spent in the hospital, number of discharge medications, and patient perception of the influence of the illness on life were positively correlated with informational needs at the time of discharge.

A critical appraisal of the efficacy of continuing medical education.

To determine the efficacy of continuing medical education (CME), we collected 248 original articles describing studies of CME interventions. These articles were reviewed for applicability and scientific credibility by applying preset methodological criteria. Thirteen percent of articles described randomized trials, but only 7% of all articles and 20% of randomized trials assessed the impact of CME on patient outcomes. Seven articles met all our criteria and were reviewed in detail. These studies provide convincing evidence that CME can improve physician behaviors. However, only three of these methodologically sound studies assessed patient outcomes and only one demonstrated any improvement in outcomes.