Long-term benefits of education by emergency care nurses at discharge of patients with atrial fibrillation.

INTRODUCTION AND OBJECTIVE: Health education improves the prognosis of many diseases. A previous study in patients with atrial fibrillation (AF) showed that an educational intervention by nurses at discharge from the emergency room (ER) decreased AF-related complications at 3-month follow-up. Our objective was to determine whether this intervention had a long-term effect. PATIENTS AND METHODS: A prospective study assessed the outcomes of an intervention carried out upon discharge from the ER. Patients with a diagnosis of AF were randomized into two groups: the intervention group and the control group. The intervention consisted of a basic explanation about the arrhythmia and its treatment, precautions and warning signs, a training to take their pulse, and an individualized informational leaflet. At one year of follow-up, the clinical records for all participants were reviewed. The primary variable was the combined endpoint of AF-related or treatment-related complications and death. RESULTS: The study included 240 patients (116 intervention and 124 control), mean age 76.1±10.9years. The primary variable was significantly lower in the intervention group (31.9% vs 48.4%; p=0.005). CONCLUSION: Education by ER nurses at patient discharge helped to decrease AF-related complications at one year of follow-up.

[Chronically-ill patients in emergency care: degree of understanding and agreement with the person accompanying them regarding their possible clinical course]. / Enfermos crónicos en urgencias: grado de conocimiento y concordancia con el acompañante respecto a sus posibilidades evolutivas.

BACKGROUND AND OBJECTIVE: Among patients with chronic diseases attending emergency department (ED), to analyze the level of knowledge of the patient and their companion about the patient's illness. To determine the factors associated to patient's and companion's knowledge and the level of concordance among them. MATERIAL AND METHODS: Patients' demographic and clinical characteristics were recorded. A structured interview was performed to patients and companions. Three dependent variables were considered: the patients' good or bad knowledge about the outcome of their chronic disease; the companions' good or bad knowledge about the outcome of their relatives' chronic disease; and the level of concordance (respect to good knowledge) among them. RESULTS: We included 191 patients; 81% of them subjectively considered themselves to be well informed, but only 54% of patients had objectively a good knowledge, and this fact was only associated with age < or = 70 y-o (P<,001). Instead, up to 79% of companions had objectively a good knowledge about patients' disease (P<.001 respect to patients), which was associated with to have an illness different from chronic pneumopathy (p<0,05) and a previous admission as inhospital (P=,01). Concordance between patient and companion was seen in a 49%, and was associated with age < or =70 y-o (P<.001) and companion filling that patient is well-informed (P<.05). CONCLUSIONS: Among patients with chronic diseases attending ED, a poor knowledge about their disease's characteristics and outcome is seen, as well as about the chance of making a living will. A better level of knowledge is detected among companions. The concordance in the level of knowledge among patients and companions is only seen in a half of interviewed people.

Enfermos crónicos en urgencias: grado de conocimiento y concordancia con el acompañante respecto a sus posibilidades evolutivas / Chronically-ill patients in emergency care: degree of understanding and agreement with respect to their accompanying evolutionary possibilities

Fundamentos y objetivo: Analizar el grado de conocimiento del paciente que acude a urgencias respecto a la enfermedad crónica que presenta, el de su acompañante, los factores asociados a un buen conocimiento y el grado de concordancia entre paciente y acompañante. Material y método: Se recogieron las características clínico-epidemiológicas de los pacientes; se realizó una encuesta a pacientes y acompañantes y se analizó si alguna variable clínico-epidemiológica o de opinión se asociaba al buen conocimiento o a la concordancia entre ambos. Resultados: Se incluyó a 191 pacientes. El 54% tenía objetivamente un buen conocimiento, que contrastaba con el 81% que se autoconsideraba subjetivamente bien informado (p<0,001). Sólo una edad ≤70 años se asoció a un buen conocimiento (p<0,001). El 79% de acompañantes tenía un buen conocimiento (p<0,001 respecto a pacientes), hecho que se asoció a que el paciente presentase una enfermedad diferente de la neumopatía (p<0,05) y hubiese ingresado previamente (p=0,01). La concordancia entre paciente y acompañante fue del 49% y se asoció a una edad del paciente ≤70 años (p<0,001) y a que el familiar considerara al paciente bien informado (p<0,05). Conclusiones: Los pacientes afectados de enfermedades crónicas que consultan en urgencias tienen una deficiente información acerca de las características y posibilidades evolutivas de su enfermedad. Existe un mejor conocimiento por parte de los acompañantes, aunque en la mitad de casos existen discrepancias entre ambos (AU)

Background and objective: Among patients with chronic diseases attending emergency department (ED), to analyze the level of knowledge of the patient and their companion about the patient's illness. To determine the factors associated to patient's and companion's knowledge and the level of concordance among them. Material and methods: Patients’ demographic and clinical characteristics were recorded. A structured interview was performed to patients and companions. Three dependent variables were considered: the patients’ good or bad knowledge about the outcome of their chronic disease; the companions’ good or bad knowledge about the outcome of their relatives’ chronic disease; and the level of concordance (respect to good knowledge) among them. Results: We included 191 patients; 81% of them subjectively considered themselves to be well informed, but only 54% of patients had objectively a good knowledge, and this fact was only associated with age ≤70 y-o (P<,001). Instead, up to 79% of companions had objectively a good knowledge about patients’ disease (P<.001 respect to patients), which was associated with to have an illness different from chronic pneumopathy (p<0,05) and a previous admission as in hospital (P=,01). Concordance between patient and companion was seen in a 49%, and was associated with age ≤70 y-o (P<.001) and companion filling that patient is well-informed (P<.05).Conclusions: Among patients with chronic diseases attending ED, a poor knowledge about their disease's characteristics and outcome is seen, as well as about the chance of making a living will. A better level of knowledge is detected among companions. The concordance in the level of knowledge among patients and companions is only seen in a half of interviewed people (AU)