Traditional nurse instruction versus 2 session nurse instruction plus DVD for teaching ostomy care: a multisite randomized controlled trial.

PURPOSE: This randomized controlled trial compared 2 methods of ostomy care instruction to determine their effect on patients' knowledge, skills, and confidence related to postoperative ostomy care. SUBJECTS AND SETTING: Eighty-eight adults with newly created ostomies were randomly assigned to 1 of 2 groups. Of the 88 enrolled patients, 68 completed the study: 10 patients were discharged from the hospital prior to completion of the study interventions; 10 others were withdrawn because they no longer met study inclusion criteria. The remaining subjects, who were equally split between men and women, ranged in age from 23 to 84 years. There were 23 colostomy and 45 ileostomy patients in our sample. The study setting was 2 acute care hospitals within a large tertiary health care system in the midwestern United States. METHODS: We used a posttest-only experimental design to compare 2 methods of postoperative ostomy education. Traditional education comprised 3 WOC nurse-led instruction sessions and the experimental intervention comprised 2 nurse-led instruction sessions plus DVD instruction that could be accessed in between nurse-led sessions. All patients received one-on-one instruction from certified WOC nurse at their bedside. Patients completed a written test of ostomy knowledge, a self-care skills demonstration, and a Visual Analog Scale rating their confidence with ostomy self-care. RESULTS: There were no significant differences between the 2 teaching methods or type of ostomy with regard to knowledge of ostomy care (F3,64 5 1.308, P 5 0.28), ostomy care skills (F3,64 5 0.163, P 5 0.92), or confidence in performing ostomy self-care (F3,64 5 0.629, P 5 0.59). Differences between the study groups' self-reported learning style, education level, age, room type, and gender also did not significantly impact their knowledge, skills, or confidence. CONCLUSION: When teaching first-time ostomy patients postoperative self-care, a Nurse Instruction plus DVD method is as effective as Nurse Instruction alone.

Keratoconjunctivitis sicca associated with administration of etodolac in dogs: 211 cases (1992-2002).

OBJECTIVE: To characterize features and response to treatment of keratoconjunctivitis sicca (KCS) associated with oral administration of etodolac in dogs. DESIGN: Retrospective case series. SAMPLE POPULATION: 65 cases obtained from a survey of veterinary ophthalmologists (group A) and 146 cases reported to Fort Dodge Animal Health (group B). PROCEDURES: Data analyzed included breed, sex, age, weight, dose and duration of etodolac administration, results of Schirmer tear test at the time of diagnosis and last follow-up, treatments, and response to treatments. Groups A and B were analyzed separately by use of forward stepwise logistic regression models developed to predict probability of complete remission or clinical improvement as a function of several variables. RESULTS: Most dogs developed severe KCS (84 eyes of 50 dogs [group A]; 111 eyes of 62 dogs [group B]). Resolution of KCS occurred in 7 of 65 (A) and 23 of 146 (B) dogs. No response to treatment was observed in 26 of 65 (A) and 27 of 146 (B) dogs. Fifty-one (A) and 52 (B) dogs had records that were sufficiently complete to use in models. In group B, dogs with etodolac treatment intervals < 6 months prior to the onset of KCS were 4.2 times as likely to have remission as were dogs with treatment intervals > or = 6 months. CONCLUSIONS AND CLINICAL RELEVANCE: Shorter duration of etodolac administration (< 6 months) was associated with improved outcome in 1 population of dogs. Monitoring of tear production should be considered prior to and during administration of etodolac in dogs.