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Aims and Objectives: To evaluate the effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction with the information and materials received by patients undergoing cardiac catheterisation., Background: Cardiac catheterisation is one of the most anxiety-provoking invasive procedures for patients. However, informational education using multimedia to inform patients undergoing cardiac catheterisation has not been extensively explored., Design: A randomised experimental design with three-cohort prospective comparisons., Methods: In total, 123 consecutive patients were randomly assigned to one of three groups: regular education; (group 1), accessibility-enhanced multimedia informational education (group 2) and instructional digital videodisc education (group 3). Anxiety was measured with Spielberger's State Anxiety Inventory, which was administered at four time intervals: before education (T0), immediately after education (T1), before cardiac catheterisation (T2) and one day after cardiac catheterisation (T3). A satisfaction questionnaire was administrated one day after cardiac catheterisation. Data were collected from May 2009-September 2010 and analysed using descriptive statistics, chi-squared tests, one-way analysis of variance, Scheffe's post hoc test and generalised estimating equations., Results: All patients experienced moderate anxiety at T0 to low anxiety at T3. Accessibility-enhanced multimedia informational education patients had significantly lower anxiety levels and felt the most satisfied with the information and materials received compared with patients in groups 1 and 3. A statistically significant difference in anxiety levels was only found at T2 among the three groups (p = 0·004)., Conclusions: The findings demonstrate that the accessibility-enhanced multimedia informational education was the most effective informational educational module for informing patients about their upcoming cardiac catheterisation, to reduce anxiety and improve satisfaction with the information and materials received compared with the regular education and instructional digital videodisc education., Relevance to Clinical Practice: As the accessibility-enhanced multimedia informational education reduced patient anxiety and improved satisfaction with the information and materials received, it can be adapted to complement patient education in future regular cardiac care., (© 2013 John Wiley & Sons Ltd.)

Background: Most smokers in developing countries begin smoking before age 18, and smoking prevalence is rising among adolescents. School personnel represent a target group for tobacco-control efforts because they interact daily with students, are role models for students, teach about tobacco-use prevention in school curricula, and implement school tobacco-control policies. The prevalence of teenage smoking has been examined in numerous studies, but few have focused on the influence of school personnel and the characteristics of school personnel who enforce school nonsmoking policy. The purpose of this study was to determine the factors associated with junior high school personnel advising students to quit smoking. Methods: School personnel (N = 7129) were recruited by cluster sampling from 60 junior high schools in Taiwan; of these, 5280 voluntarily returned self-administered, anonymous questionnaires (response rate = 74.06%) in 2004. Results: Most personnel (70%) had advised students to quit smoking. School personnel who were older, male, responsible for teaching health, smokers, with positive attitude against tobacco, or with more knowledge of tobacco hazards were more likely to advise students to quit smoking. Personnel with more interest in and access to tobacco-related materials were more likely to advise students to quit smoking. Personnel who had received tobacco-prevention training were 2.41 times more likely to persuade students to quit smoking after adjusting for other factors. However, only half of the participants had ever had access to educational materials about tobacco use, and 8% had ever received training to prevent tobacco use. Conclusions: To reduce youth smoking prevalence, school tobacco-control programs should support tobacco-prevention training for school personnel. (Contains 5 tables.)

Introduction: Parental smoking has been identified as the major source of children's exposure to environmental tobacco smoke (ETS). Therefore, parental involvement is critical in ETS exposure prevention programs. This study examined the effects of a parent-child interactive program on reducing children's exposure to ETS at home and enhancing parents' and children's prevention strategies.Methods: A clustered randomized controlled trial was administered to 75 families of school-aged children from six primary schools in New Taipei City, Taiwan. Families in the intervention group received a parent-child interactive intervention, and parents in the control group received written materials on tobacco hazards. Data on children's exposure and the prevention of children's exposure to ETS at home were obtained at baseline, 8-week, and 20-week or 6-month assessments.Results: The percentage of children with urine cotinine levels greater than or equal to 6 ng/ml was significantly lower in the intervention group than it was in the control group at both the 8-week and 6-month assessments. The intervention significantly reduced parental smoking in the presence of children and increased parents' prevention of children's ETS exposure and children's ETS avoidance behavior from the baseline to the 20-week assessment.Conclusions: This is a preliminary study design aimed at creating a program for reducing children's ETS exposure at home. Further research to produce evidence supporting the application of the parent-child interactive program in primary schools is suggested. The theoretical basis of the intervention design can serve as a reference for nursing education and the design of health education programs. [ABSTRACT FROM AUTHOR]

Introduction: Although public smoking restrictions have been implemented, children are still exposed to household smoking. Parental smoking is the main source of children’s exposure to secondhand smoke. This study was conducted to examine the factors associated with parents’ adoption of home smoking bans. Methods: A cross-sectional study was conducted using a self-administered questionnaire to collect data from 768 parents of school-aged children in Taiwan. The home smoking restriction status, parents’ perceptions of smoking in the presence of children and its influences, and parents’ sociodemographic characteristics were assessed. Hierarchical logistic regression analysis was used to determine the best-fit model. Results: More than 80% of the parents agreed with home smoking bans, whereas only approximately 26% of the parents actually restricted smoking at home completely. The crude odds ratios showed that parents who perceived the influence of parental smoking on children to be negative were more likely to adopt home smoking bans. Hierarchical logistic regression revealed factors associated with the adoption of home smoking bans, including a higher education level and older age of parents, a family composed of nonparent adults, and opposition to parental smoking in the presence of children. Conclusions: Children’s health is a major concern for parents considering home smoking bans. Helping parents clarify misunderstandings regarding parental smoking, emphasizing the adverse effects of children’s exposure to parental smoking, suggesting healthy substitutes for smoking, and providing effective strategies for maintaining a smoke-free home can motivate families to adopt home smoking bans. [ABSTRACT FROM PUBLISHER]

Most smokers in developing countries begin smoking before age 18, and smoking prevalence is rising among adolescents. School personnel represent a target group for tobacco-control efforts because they interact daily with students, are role models for students, teach about tobacco-use prevention in school curricula, and implement school tobacco-control policies. The prevalence of teenage smoking has been examined in numerous studies, but few have focused on the influence of school personnel and the characteristics of school personnel who enforce school nonsmoking policy. The purpose of this study was to determine the factors associated with junior high school personnel advising students to quit smoking. School personnel (N = 7129) were recruited by cluster sampling from 60 junior high schools in Taiwan; of these, 5280 voluntarily returned self-administered, anonymous questionnaires (response rate = 74.06%) in 2004. Most personnel (70%) had advised students to quit smoking. School personnel who were older, male, responsible for teaching health, smokers, with positive attitude against tobacco, or with more knowledge of tobacco hazards were more likely to advise students to quit smoking. Personnel with more interest in and access to tobacco-related materials were more likely to advise students to quit smoking. Personnel who had received tobacco-prevention training were 2.41 times more likely to persuade students to quit smoking after adjusting for other factors. However, only half of the participants had ever had access to educational materials about tobacco use, and 8% had ever received training to prevent tobacco use. To reduce youth smoking prevalence, school tobacco-control programs should support tobacco-prevention training for school personnel. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To develop and evaluate a Web-based, patient-orientated diabetic education management (POEM) system. Methods: The POEM system has been developed to extend hospital patient education by integrating patients’ medical care data into their education program components and presenting them on the Web. Since most patients are concerned about their medical care data, the POEM system can provide the incentives for patients to continuously and persistently log in and learn the required knowledge and skills, improving their clinical outcomes. A quasi-experimental method that uses control groups and pretests was used to evaluate the outcomes of the system intervention. We recruited patients with type-2 diabetes and alternatively assigned them to intervention and control groups. We compared laboratory test results including fasting blood glucose, HbA1c, total cholesterol, triglyceride (TG), and HDL between the two groups from the first visit through each follow-up visit. The study period progressed from September 2003 to May 2004 at the Metabolism Center of a medical teaching hospital in Taipei. Results: In this study, we recruited 274 participants: 134 (57% males and 43% females) in the intervention group and 140 (46% males and 54% females) in the control group. The patients’ laboratory test results from the first visit for fasting blood glucose, HbA1c, total cholesterol level, TG, and HDL in the intervention and control groups were respectively 187.54±77.10 and 189.99±73.49mg/dl, 9.03±2.79% and 8.95±2.23%, 193.29±47.93 and 202.52±58.45mg/dl, 152.48±70.85 and 157.37±74.88mg/dl, and 44.97±12.09 and 45.32±12.08mg/dl. There were three follow-up visits during the study period. We collected laboratory test results of the two groups through each of the following visits and analyzed them using ANCOVA. We discovered a significant difference in fasting blood glucose levels between intervention and control group as early as the first follow-up. At the second follow-up, both fasting blood glucose and HBA1c levels were significantly different between intervention and control group. At the third follow-up, there was a significant difference in fasting blood glucose, HBA1c, and total cholesterol between intervention and control group. We also monitored the number of logins for the patients in the intervention group during the follow-up period. The result showed the patients had consistently logged into the POEM system (about 8.5±3.7 logins per person per month after 3 months enrollment). Thus, the patients in the intervention group had better control of their fasting blood glucose, HbA1c and total cholesterol levels than those in the control group due to the assistance of the system. Conclusions: The POEM system can help patients control their glucose, HbA1c and total cholesterol levels to manage their diabetes, providing an easy and inexpensive way to extend hospital-based patient education services for community-based continuous patient education. [Copyright &y& Elsevier]