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Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) presents significant challenges for affected children and adolescents, their social environment, and treating physicians, due to its profound impact on quality of life and the lack of causal therapeutic approaches. One crucial aspect of care that has been missing for these patients is comprehensive education for both them and their social circles., Objective: This study protocol aims to outline the goals, study design, execution, and evaluation of the subproject within the BAYNET FOR ME/CFS project. The focus is on developing online education programs for children and adolescents with ME/CFS, as well as for their parents, siblings, and school staff. These programs are designed to improve independent disease management, increase knowledge, and promote interaction with other affected individuals., Methods: In phase I, the group-based online education programs were developed by a multidisciplinary team based on the ModuS concept created by the Competence Network for Patient Education (KomPaS). These programs were then piloted and finalized. Phase II involved recruiting participants and implementing the finalized programs. Given the restricted physical and cognitive capacities of the affected individuals, the patient education programs were exclusively designed in a digital format to facilitate participation. In phase III, the programs will be evaluated for acceptance, completeness, and participant satisfaction. The qualitative assessment will focus on individual expectations and benefits derived from the training. Phase IV will further assess the programs in terms of improvements in disease knowledge, health-related quality of life, life satisfaction, and family burden., Results: The programs were developed, piloted, and finalized during phase I, which ran from December 2022 to May 2023. The pilot phase, from March to May 2023, led to adaptations in the program concept. In total, 8 patients and their parents, 5 siblings, and 59 school staff participated in the piloting. Adjustments were made to the format, content, duration, and schedule to better meet the needs of the affected individuals and their social circles. In phase II, participant recruitment for the patient education program took place from January to July 2023. The study successfully recruited 24 young patients with ME/CFS and their parents, along with 8 siblings and 51 school staff. Two program blocks for patients and parents and 2-3 blocks for siblings and school staff commenced in May 2023 and were completed within the same year. Phase III began after phase II and involves the evaluation of the programs, with the process expected to conclude by the end of 2024. Phase IV, planned for 2025-2026, will involve the rollout of the program to 150 children and their caretakers. This phase will focus on evaluating disease knowledge, health-related quality of life, life satisfaction, and family burden, as well as include longitudinal assessments., Conclusions: The data aim to support the development of a comprehensive, interprofessional care model for children and adolescents with ME/CFS., International Registered Report Identifier (irrid): DERR1-10.2196/54679., (©Franca Keicher, Julia Thomann, Jana Erlenwein, Mara Schottdorf, Nils Lennart Reiter, Nadine Patricia Scholz-Schwärzler, Barbara Vogel, Cordula Warlitz, Silvia Stojanov, Silvia Augustin, Lola Goldbrunner, Linda Schanz, Veronika Dodel, Charlotte Zipper, Nicole Schiweck, Robert Jaeschke, Milica Saramandic, Karolina Wiejaczka, Maria Eberhartinger, Kristina Dettmer, Daniel Bruno Ricardo Hattesohl, Stephanie Englbrecht, Uta Behrends, Juliane Spiegler. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 21.11.2024.)

Aims: Tailored education is recommended for cardiac patients, yet little is known about information needs in areas of the world where it is most needed. This study aims to assess (i) the measurement properties of the Information Needs in Cardiac Rehabilitation short version (INCR-S) scale and (ii) patient's information needs globally., Methods and Results: In this cross-sectional study, English, simplified Chinese, Portuguese, or Korean versions of the INCR-S were administered to in- or out-patients via Qualtrics (January 2022-November 2023). Members of the International Council of Cardiovascular Prevention and Rehabilitation community facilitated recruitment. Importance and knowledge sufficiency of 36 items were rated. Links to evidence-based lay education were provided where warranted. A total of 1601 patients from 19 middle- and high-income countries across the world participated. Structural validity was supported upon factor analysis, with five subscales extracted: symptom response/medication, heart diseases/diagnostic tests/treatments, exercise and return-to-life roles/programmes to support, risk factors, and healthy eating/psychosocial management. Cronbach's alpha was 0.97. Construct validity was supported through significantly higher knowledge sufficiency ratings for all items and information importance ratings for all subscales in cardiac rehabilitation (CR) enrolees vs. non-enrolees (all P < 0.001). All items were rated as very important-particularly regarding cardiac events, nutrition, exercise benefits, medications, symptom response, risk factor control, and CR-but more so in high-income countries in the Americas and Western Pacific. Knowledge sufficiency ranged from 30.0 to 67.4%, varying by region and income class. Ratings were highest for medications and lowest for support groups, resistance training, and alternative medicine., Conclusion: Identification of information needs using the valid and reliable INCR-S can inform educational approaches to optimize patients' health outcomes across the globe., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Rationale and Objectives: Under-awareness of Interventional Radiology (IR) care by the public has been reported. The aim of this study is to evaluate the impact of educational videos to facilitate better patient understanding during the informed consent process., Materials and Methods: Educational videos for six common IR procedures including chemoembolization, radioembolization, ablation, tunneled central venous catheter placement, port placement, and port removal were developed for educating patients in the pre-procedural setting. One hundred and eighty patients referred to a tertiary academic institution were randomly selected to participate, including 30 patients per procedure type. Anonymous seven question, five-point Likert-scale assessments were administered to the participants before and after engaging with the videos. The survey evaluated patients' perceived understanding of IR procedures and satisfaction with the videos as educational tools., Results: One hundred and eighty patients completed the survey. Comparing post-video to pre-video ratings, there was an increase in patients' understanding of the involved anatomy (4.5 vs 3.3; p < 0.01), understanding of procedure benefits (4.6 vs 3.7; p < 0.01), understanding of procedural risks (4.5 vs 3.3; p < 0.01), understanding of procedural alternatives (3.4 vs 2.7; p < 0.01), and overall procedural understanding (4.7 vs 3.4; p < 0.01). Additionally, patients had a positive impression of the videos with a mean overall satisfaction rating of the video-assisted explanation of 4.80., Conclusions: A patient-centric video-assisted informed consent for IR procedures enhances patients' understanding and results in high patient satisfaction., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Purpose: In the health-care system within hospitals, Taiwanese patients usually play the role of passively cooperating with health-care professionals. Therefore, patients rarely make their own treatment decisions. This study evaluated the level of patient education and patient satisfaction in relation to empowerment level in Taiwan., Methods: A cross-sectional survey by a self-administered structured questionnaire was carried out with 618 inpatients from the four hospitals. Statistical analyses were then conducted. Analysis of covariance and post-hoc comparison was used to compare differences between the level of patient empowerment, age, and education as covariates in the model., Results: This study found that 21.2% and 35.6% of participants were highly empowered and well empowered, respectively. Years of education is a significant covariate in the counselling domain of patient education. Even after controlling for age and education level, the counselling, answer question and justifying action, providing information scores remain significant for all levels after adjusting for the effects of degree of patient empowerment. Patients with higher empowerment also having more-sufficient patient education, indicating a tendency toward higher patient satisfaction. Patient education and counselling practices in Taiwan's clinical practice could be improved to enhance patient empowerment and ensure health-care systems are person-centred., Conclusion: To move more toward highly patient empowerment, we suggest that health-care professionals advocate a patient-empowerment approach and to provide more counselling related to patients' illnesses and possible treatments., Competing Interests: Declaration of competing interest All the authors disclose no conflict of interest in this work., (Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Purpose: To develop recommendations to support the range of patient education interventions relevant in the management of patients with subacromial pain syndrome (SAPS) in physical therapy., Materials and Methods: A 3-round modified Delphi consultation was used to obtain consensus agreement on the relevance of 12 preliminary recommendations. These were developed from a literature review and an expert consultation on general educational strategies and specific patient education interventions for the management of SAPS. The analysis assessed the rate of consensus on the relevance of these recommendations. Delphi panelists were rehabilitation professionals including physical ( n  = 21) and occupational therapists ( n  = 1) with SAPS experience, and patient-partners ( n  = 2) presenting shoulder pain., Results: The Delphi consultation resulted in 13 revised consensus recommendations. Six consensus recommendations addressed general educational strategies to facilitate patient education, including teaching methods and materials, and seven addressed specific educational interventions, including teaching symptom self-management and tailoring activities and participation. These recommendations were incorporated into a clinical decision-making tool to support the selection of the most relevant patient education interventions., Conclusion: The recommendations developed in this study are relevant to guide physical therapist's clinical decisions making regarding interventions using patient education for SAPS. They promote active engagement and empowerment of individuals with SAPS.

Background: Patient education plays a crucial role in improving the quality of life for patients with heart failure. As artificial intelligence continues to advance, new chatbots are emerging as valuable tools across various aspects of life. One prominent example is ChatGPT, a widely used chatbot among the public. Our study aims to evaluate the readability of ChatGPT answers for common patients' questions about heart failure., Methods: We performed a comparative analysis between ChatGPT responses and existing heart failure educational materials from top US cardiology institutes. Validated readability calculators were employed to assess and compare the reading difficulty and grade level of the materials. Furthermore, blind assessment using The Patient Education Materials Assessment Tool (PEMAT) was done by four advanced heart failure attendings to evaluate the readability and actionability of each resource., Results: Our study revealed that responses generated by ChatGPT were longer and more challenging to read compared to other materials. Additionally, these responses were written at a higher educational level (undergraduate and 9-10th grade), similar to those from the Heart Failure Society of America. Despite achieving a competitive PEMAT readability score (75 %), surpassing the American Heart Association score (68 %), ChatGPT's actionability score was the lowest (66.7 %) among all materials included in our study., Conclusion: Despite its current limitations, artificial intelligence chatbots has the potential to revolutionize the field of patient education especially given theirs ongoing improvements. However, further research is necessary to ensure the integrity and reliability of these chatbots before endorsing them as reliable resources for patient education., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: Pain and anxiety are common complications in burn patients, significantly impacting treatment effectiveness and overall patient well-being. Peer counseling, a form of patient education provided by individuals with shared experiences, may hold potential to alleviate this pain and anxiety. This study seeks to investigate the effectiveness of patient-centered education through peer counseling on background pain and state anxiety levels in these patients., Methods: A two-arm, parallel, randomized, controlled trial design was employed. A total of 86 participants were randomly allocated to one of two groups: control and intervention groups. State anxiety and background pain levels were assessed using the Spielberger State Anxiety Inventory (STAI) and Visual Analogue Scale (VAS), respectively, before and after intervention. Statistical analyses, including Chi-square test, Fisher's exact test, independent t-test, and paired t-test, were employed to analyze the data., Results: The intervention significantly reduced pain and anxiety in the intervention group compared to baseline (p < .001). There was no significant difference between the control and intervention groups in baseline levels, but there was a significant difference after the intervention (p < .001)., Conclusion: This study demonstrates the efficacy of patient-centered education through peer counseling in reducing background pain and state anxiety levels in burn patients. Compared to standard education, peer counseling led to a more pronounced reduction in both pain and anxiety, suggesting its potential as a valuable nonpharmaceutical intervention to improve patient well-being during burn recovery., Practice Implications: Based on our findings, we recommend that healthcare providers consider implementing peer-based education programs in burn care settings., Competing Interests: Declaration of Competing Interest The funding organization was not involved in the study's design, data collection, analyses, interpretation, manuscript preparation, or the decision to publish the results., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Background: Artificial intelligence (AI) and large language models (LLMs) transform how patients inform themselves. LLMs offer potential as educational tools, but their quality depends upon the information generated. Current literature examining AI as an informational tool in dermatology has been limited in evaluating AI's multifaceted roles and diversity of opinions. Here, we evaluate LLMs as a patient-educational tool for Mohs micrographic surgery (MMS) in and out of the clinic utilizing an international expert panel., Methods: The most common patient MMS questions were extracted from Google and transposed into two LLMs and Google's search engine. 15 MMS surgeons evaluated the generated responses, examining their appropriateness as a patient-facing informational platform, sufficiency of response in a clinical environment, and accuracy of content generated. Validated scales were employed to assess the comprehensibility of each response., Results: The majority of reviewers deemed all LLM responses appropriate. 75% of responses were rated as mostly accurate or higher. ChatGPT had the highest mean accuracy. The majority of the panel deemed 33% of responses sufficient for clinical practice. The mean comprehensibility scores for all platforms indicated a required 10th-grade reading level., Conclusions: LLM-generated responses were rated as appropriate patient informational sources and mostly accurate in their content. However, these platforms may not provide sufficient information to function in a clinical environment, and complex comprehensibility may represent a barrier to utilization. As the popularity of these platforms increases, it is important for dermatologists to be aware of these limitations., (© 2024 The Author(s). International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Background/objectives: Carbohydrate counting is recommended to improve glycemic control in type 1 diabetes (T1D), but the most effective educational methods are unclear. Despite its benefits, many individuals struggle with mastering carbohydrate counting, leading to inconsistent use and suboptimal glycemic outcomes. This study aimed to compare the effectiveness of two group-based programs with individual dietary counseling (standard care) for glycemic control., Methods: The trial was a randomized, controlled, open-label, parallel-group design. Adults with T1D on multiple daily insulin injections (MDIs) and with glycated hemoglobin A1c (HbA1c) 53-97 mmol/mol were randomly assigned (1:1:1) to basic (BCC), advanced carbohydrate counting (ACC), or standard care. Primary outcomes were the changes in HbA1c or mean amplitude of glycemic excursions (MAGEs) in BCC and ACC versus standard care after six months. Equivalence testing was performed to compare BCC and ACC., Results: Between November 2018 and August 2021, 63 participants were randomly assigned to BCC (N = 20), ACC (N = 21), or standard care (N = 22). After 6 months, HbA1c changed by -2 mmol/mol (95% CI -5 to 0 [-0.2%, -0.5 to 0]) in BCC, -4 mmol/mol (-6 to -1 [-0.4%, -0.6 to -0.1]) in ACC, and -3 mmol/mol (-6 to 0 [-0.3%, -0.6 to 0]) in standard care. The estimated difference in HbA1c compared to standard care was 1 mmol/mol (-3 to 5 [0.1%, -0.3 to 0.5]); p = 0.663 for BCC and -1 mmol/mol (-4 to 3 [-0.1%, -0.4 to 0.3]); p = 0.779 for ACC. For MAGEs, changes were -0.3 mmol/L (-1.5 to 0.8) in BCC, -0.0 mmol/L (-1.2 to 1.1) in ACC, and -0.7 mmol/L (-1.8 to 0.4) in standard care, with differences of 0.4 mmol/L (-1.1 to 1.9); p = 0.590 for BCC and 0.7 mmol/L (-0.8 to 2.1); p = 0.360 for ACC versus standard care. An equivalence in effect between BCC and ACC was found for HbA1c, but not for MAGEs., Conclusions: Group-based education in BCC and ACC did not demonstrate a clear advantage over individualized dietary counseling for overall glycemic control in adults with T1D. Healthcare providers should consider flexible, patient-centered strategies that allow individuals to choose the format that best suits their learning preferences when selecting the most suitable dietary educational approach.

Introduction. Home hemodialysis is an effective therapeutic option for patients with chronic kidney disease. As highlighted in the literature, its management requires good self-care abilities from the patient and adequate support for self-care from the caregiver. Therefore, the development of educational programs plays a fundamental role in patient care. Aim. The goal of this study is to map the educational programs aimed at caregivers and patients undergoing home hemodialysis treatment, in order to identify gaps in the literature regarding this focus. Methods. A Scoping Review was conducted following the Joanna Briggs Institute guidelines. Potentially relevant articles were identified through a selection process on major databases (PubMed, Scopus, CINAHL, EMBASE, Web of Science, and Google Scholar), without applying any time limits. Results. The educational programs available in the literature for home hemodialysis patients focus on both clinical and psychological aspects; training through a "practical" approach is the most commonly used strategy. Discussion and conclusions. The review highlights the crucial role that a multidisciplinary and multidimensional educational approach can provide to home hemodialysis patients. It is necessary to optimize educational strategies for this population to improve patient outcomes., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)

Background: Patients with cancer and an underlying autoimmune disease who are considering immune checkpoint blockers (ICBs) need to know about the benefits and risks of severe immune-related adverse events and flares of the autoimmune condition., Objective: This study aims to develop and alpha test an educational website for patients with cancer., Methods: Learning topics, images, and website architecture (including flow and requirements) were developed and iteratively reviewed by members of a community scientist program, a patient advisory group, and content experts. Alpha testing was performed, measuring the site's usability using the Suitability Assessment of Materials and its acceptability using the Ottawa Acceptability Measure., Results: The website included a home page; general information about ICBs; comprehensive modules on the benefits and risks of ICBs for patients with cancer and preexisting autoimmune diseases; general wellness information; and features such as a quiz, additional resources, and a glossary. For the alpha testing, 9 users assessed the newly developed website. Patient reviewers (n=5) had rheumatoid arthritis, Crohn disease, Sjogren syndrome, or vasculitis. Health care provider reviewers (n=4) were medical oncologists or rheumatologists. The median Suitability Assessment of Materials rating was 75 (IQR 70-79; range 0-100) for patients versus 66 (IQR 57-72; range 0-100) for providers (scores ≥70 indicate no substantial changes needed). Recommendations for improvement, mostly involving navigation and accessibility, were addressed. All participants expressed that the website was acceptable and balanced in terms of discussion of benefits and harms. Because half (2/4, 50%) of the providers suggested we increase the amount of information, we extended the content on the impact of having an autoimmune disease when considering ICB treatment, the probability of flares, and the management of flares in this context., Conclusions: The feedback led to minor revisions to enhance readability, navigation, and accessibility, ensuring the website's suitability as a decision-making aid. The newly developed website could become a supporting tool to facilitate patient-physician discussion regarding ICBs., (©Maria A Lopez-Olivo, Maria E Suarez-Almazor, Gabrielle F Duhon, McKenna Cherry, Huifang Lu, Cassandra Calabrese, Mehmet Altan, Hussain Tawbi, Alexa Meara, Clifton O Bingham, Adi Diab, Viola B Leal, Robert J Volk. Originally published in JMIR Cancer (https://cancer.jmir.org), 25.10.2024.)

Background: Patient education is a crucial strategy for promoting prevention and diabetes self-management since glycemic control achievement involves taking medications, medical nutrition therapy, physical exercise, and behavior changes. However, patient education programs are still barely implemented in low- and middle-income countries. This trial aims to investigate whether a lifestyle education intervention added to physical exercising is superior to sole physical exercising regarding functional capacity, disease-related knowledge, health behaviors, cardiometabolic health parameters, quality of life, depression, and diet quality in individuals with prediabetes or diabetes., Methods: Multicenter double-blinded randomized controlled trial with two parallel arms involving 12-week intervention and 6-month follow-up. The eligible individuals (≥ 18 years, living with prediabetes or diabetes, literate, no clinical decompensation and/or physical and/or mental limitations that contraindicate physical exercising, written physician permission for exercise, no cognitive impairment, no vision limitations for reading, no confirmed diagnosis of unstable coronary disease or heart failure, no pacemaker and/or implantable cardioverter-defibrillator, no complex ventricular arrhythmias, no intermittent claudication, no recent cardiovascular event or cardiac surgery, and no currently enrolled in a structured exercise program) were recruited from two Brazilian cities and randomized to either (1) an Exercise and Lifestyle Education Program (ExLE) or (2) an Exercise Program (Ex), which can be delivered on-site or remotely based on the participants' internet access and technology literacy. The primary outcomes will be changes in functional capacity and disease-related knowledge. The secondary outcomes will involve changes in health behaviors (health literacy, physical activity level, exercise self-efficacy, and medication adherence) and cardiometabolic health parameters (glycemic control, anthropometric measures, and cardiac autonomic control). Program adherence, satisfaction with the program, diabetes-related morbidity, and changes in quality of life, depression, and diet quality will be the tertiary outcomes. Assessments will occur at baseline, post-intervention, and after 6-month follow-up., Discussion: If superior effectiveness of ExLE compared to Ex program to improve the outcomes measures is found, this program could be delivered broadly in the Brazilian health system, especially in the primary care facilities where most individuals living with prediabetes and diabetes in our country are assisted., Trial Registration: ClinicalTrials.gov, NCT03914924 . Registered on April 16, 2019., (© 2024. The Author(s).)

Introduction: Patients seek support from online resources when facing a troubling urologic cancer diagnosis. Physician-written resources exceed the recommended 6-8th grade reading level, creating confusion and driving patients towards unregulated online materials like AI chatbots. We aim to compare the readability and quality of patient education on ChatGPT against Epic and Urology Care Foundation (UCF)., Materials and Methods: We analyzed prostate, bladder, and kidney cancer content from ChatGPT, Epic, and UCF. We further studied readability-adjusted responses using specific AI prompting (ChatGPT-a) and Epic material designated as Easy to Read. Blinded reviewers completed descriptive textual analysis, readability analysis via six validated formulas, and quality analysis via DISCERN, PEMAT, and Likert tools., Results: Epic met the recommended grade level, while UCF and ChatGPT exceeded it (5.81 vs. 8.44 vs. 12.16, p < 0.001). ChatGPT text was longer with more complex wording (p < 0.001). Quality was fair for Epic, good for UCF, and excellent for ChatGPT (49.5 vs. 61.67 vs. 64.33). Actionability was overall poor but particularly lowest (37%) for Epic. On qualitative analysis, Epic lagged on all quality measures. When adjusted for user education level (ChatGPT-a and Epic Easy to Read), readability improved (7.50 and 3.53), but only ChatGPT-a retained high quality., Conclusions: Online urologic oncology patient materials largely exceed the average American's literacy level and often lack real-world utility for patients. Our ChatGPT-a model indicates that AI technology can improve accessibility and usefulness. With development, a healthcare-specific AI program may help providers create content that is accessible and personalized to improve shared decision-making for urology patients.

Purpose: This study was conducted to determine the effect of providing preprocedural education to patients undergoing coronary angiography on their vital signs., Design: The study was a randomized controlled experimental study with a pretest/post-test control group design., Methods: The study was conducted in the Cardiology Service of a hospital in Eskişehir between November 2021 and April 2022. Power analysis identified that it was appropriate to include 79 individuals in the experimental group, 79 individuals in the control group, and a total of 158 individuals. The experimental group was trained using the "Structured Education Manual" prepared by the researchers., Findings: The education had an influence on the stabilization of vital signs after the procedure compared to preprocedure. When the comparison of vital signs before and after the education was analyzed, systolic blood pressure and diastolic blood pressure differed significantly between 11 measurements in both groups (P < .05). The systolic and diastolic blood pressure of the experimental group measured before the procedure was higher than their other measurements after the procedure. Heart rate, respiratory rate, and saturation value in both groups displayed a statistically significant difference between 11 measurements (P < .05). In the experimental group, heart rate and respiratory rate before the procedure were higher than the postprocedure measurements. The saturation value of the experimental group at 150 minutes after the procedure was higher than the other measurements., Conclusions: Education given to patients before undergoing a coronary angiography procedure had a positive effect on the patients' vital signs. It is recommended that patients undergoing a coronary angiography procedure be provided with audio-visual training by nurses before the procedure., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The American Society of PeriAnesthesia Nurses. All rights reserved.)

Background: Effective pain management following discharge is critical for postoperative recovery, with pain self-efficacy serving as a crucial component in this process. Patient education plays a key role in enhancing self-efficacy. Among various educational modalities, a growing body of evidence supports the efficacy of video-based methods., Local Problem: A lack of evidence-based pain education programs for patients undergoing elective orthopedic surgery was identified at an urban academic hospital on the East Coast of the United States. This quality improvement project aimed to develop and assess a video-based pain education program, focusing on pain self-efficacy and self-reported preparedness among adult patients prescribed opioids for postsurgical pain., Methods: This project adopted a pretest-posttest design, utilizing the knowledge-to-action framework. Data collection spanned 3 months. Among the 69 patients screened for eligibility, 13 participants were included in the analysis. The primary intervention consisted of a 15-minute educational video covering essential pain management aspects. Following the intervention, pain self-efficacy and self-reported preparedness were evaluated using the Pain Self-Efficacy Questionnaire and a five-point Likert scale, respectively., Results: Median (IQR) scores on the Pain Self-Efficacy Questionnaire increased significantly from 20 (16) to 32 (14) (p < .01). Mean (SD) scores for patients' self-reported preparedness also increased from 21.92 (6.53) to 31.85 (2.41) (p < .01). All participants reported being satisfied or very satisfied with the educational intervention., Conclusion: Video-based education is a time-efficient and cost-effective approach. Healthcare providers can consider integrating video education to enhance pain self-efficacy in the postoperative phase, thus enhancing postsurgical pain outcomes and overall recovery experience., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: The aim of this study is to prospectively evaluate whether individual and group Therapeutic Patient Education (TPE) can reduce the need to intensify treatment of diabetes and hypertension in newly diagnosed type 2 diabetic patients., Methods: A total of 937 patients were recruited and followed-up for 42.7 ± 21.5 months. TPE was a structured comprehensive education delivered by trained nurses: 322 patients received individual TPE (ITPE), 291 underwent group TPE (GTPE), and 324 were in Usual Care (UC). The primary endpoints were intensification of diabetes treatment and intensification of hypertension treatment., Results: The rate of diabetes treatment intensification was 40.1% in patients receiving ITPE, 47.8% in patients undergoing GTPE, and 64.2% in patients in UC (p < 0.001). The rate of hypertension treatment intensification was 24.2% in patients following ITPE, 31.3% in patients receiving GTPE, and 41.0% in patients in UC (p < 0.001). Multivariate analysis showed that both ITPE and GTPE were associated with reduced intensification of diabetes (ITPE: HR:0.51; 95% IC:0.40-0.64; p < 0.001 - GTPE: HR:0.46; 95% IC:0.44-0.70; p < 0.001) and hypertension medication (ITPE: HR:0.45; 95% IC:0.34-0.61; p < 0.001 - GTPE: HR:0.49; 95% IC:0.38-0.65; p < 0.001). The association was independent of age, sex, BMI, HbA1c, and presence of hypertension at baseline., Conclusions: TPE, delivered as both individual and group sessions, represents an effective tool to reduce the need to intensify treatment of both diabetes and hypertension. Therefore, it can ensure better control of diabetes and hypertension with fewer medications. This could reduce adverse effects and costs and improve quality of life and medication taking in patients with type 2 diabetes., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Approximately 6.7 million American adults are living with heart failure (HF). Current therapies are geared toward preventing progression and managing symptoms, as there is no cure. Multiple studies have shown the benefit of including palliative care (PC) in patients with HF to improve symptoms and quality of life. Heart failure guidelines recommend the inclusion of PC in therapy, but referrals are often delayed. A previous pilot project demonstrated increased involvement of PC when targeted education was given to patients with HF., Objective: Educate patients with HF on PC and examine the impact on PC consults, readmission, mortality, intensive care unit (ICU) transfers and evaluate sustainability of the intervention., Methods: Patients (n = 124) admitted to an academic hospital with a diagnosis of HF were asked to view an educational module on PC. Patients who completed the module were placed in the intervention group (n = 39). Patients who declined were placed in the usual care group (n = 38). The number of PC consults, re-admissions, mortality, and transfers to the ICU were compared among participants and those who declined. Results were compared to previous pilot project., Results: Eleven patients in the intervention group (IG) requested a PC consult vs one in the usual care group (UCG) ( P = .006). There was no statistically significant difference in readmissions, mortality, or ICU transfers between groups., Conclusions: This sustainable project again demonstrated education on PC increases utilization of PC but does not statistically impact mortality, re-admissions, or transfers to higher levels of care., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The aim of the study is to assess the readability of online patient education materials (PEMs) for congenital hand differences., Methods: The top 10 online, English-language PEMs for 10 conditions (polydactyly, syndactyly, trigger finger/thumb, clinodactyly, camptodactyly, symbrachydactyly, thumb hypoplasia, radial dysplasia, reduction defect, and amniotic band syndrome) were compiled and categorized by source and country. Readability was assessed using 5 tools: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook Index (SMOG). To account for the potential effect of each condition's name in the aforementioned formulas, the analysis was repeated after replacing the name with a monosyllabic word/s., Results: The mean readability scores of the 100 PEMs were FRES 56.3, where the target was ≥80, FKGL 8.8, GFI 11.5, CLI 10.9, and SMOG 8.6, and the median grade score was 9.8, where the target grade was ≤6.9. Following adjustment, all readability scores improved significantly ( P < .001). Postadjustment scores were FRES 63.8, FKGL 7.8, GFI 10.7, CLI 9.1, and SMOG 8.0, and the median grade score was 8.6. Only 1 webpage met the target level using all tools. Two-sample t test for country of publication (the United States and the United Kingdom) demonstrated that PEMs originating from the United Kingdom were easier to read using the preadjustment CLI ( P = .009) and median grade metrics ( P = .048). A 1-way analysis of variance revealed no influence of condition or source on readability., Conclusion: Most online PEMs for congenital hand differences are written above the recommended reading level of sixth grade, even when adjusted for the effect of the condition's name., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Urodynamic testing is an invasive procedure that causes pain and anxiety. Patient education is an evidence-based nursing intervention that relieves pain and anxiety and increases patient satisfaction., Aims: This study was carried out to compare the effects of different education methods utilized before a urodynamic testing procedure on patients' pain, anxiety, readiness for the procedure, and satisfaction., Methods: The study is a randomized controlled clinical trial. Participants (n = 80) were randomly assigned to four groups. While patients in the control group were provided with routine clinical information, patients in the intervention group were given education with brochures, videos, and brochure-supported videos. The research data were collected by using a Data Collection Form with items about participants' descriptive characteristics, the Visual Analog Scale, and the State Anxiety Inventory., Results: It was determined that pain expectation before urodynamics and the severity of pain during urodynamics were lower in intervention groups than in the control group. Pain expectation before urodynamics was lower in the brochure-supported video education group than in the brochure education group. Anxiety levels were lower and satisfaction levels were higher in the video education and brochure-supported video education groups than in the control and brochure education groups., Conclusions: Of the methods utilized, it was determined that the most effective one was brochure-supported video education as it affected all parameters positively., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: Depression and anxiety are common comorbidities in patients undergoing coronary artery bypass grafting (CABG), with potential adverse effects on surgical outcomes. Effective interventions to reduce depression and anxiety in these patients are therefore warranted. This study investigated the effectiveness of peer-based video education compared to conventional video education in reducing perioperative depression and anxiety in CABG patients., Design: A three-arm, parallel, randomized, controlled trial design was employed., Methods: A total of 114 participants were randomly assigned to 1 of 3 groups (n = 38 per group): standard education (control), conventional video education, and peer-based video education. State anxiety levels were measured using the Spielberger State Anxiety Questionnaire at 1 day before surgery (baseline), 1 hour before surgery, and 4 weeks after surgery. Depression levels were measured using the Beck Depression Inventory Short-Form at baseline and 4 weeks after surgery. Statistical analyses, including χ 2 , Fisher's exact test, one-way analysis of variance, and repeated-measures analysis of variance, were applied to analyze the collected data., Findings: Both peer-based and conventional video education groups demonstrated lower preoperative anxiety levels compared to the control group. However, only the peer-based video education group exhibited a statistically significant difference (P < .05). Four weeks after surgery, anxiety and depression levels decreased in all participants compared to baseline, with no statistically significant differences among the three groups., Conclusions: Our findings suggest that peer-based video education is more effective in controlling preoperative anxiety in patients undergoing CABG than conventional video education and standard education. Moreover, video-based education, whether conventional or peer-based, appears to be as effective as standard education in reducing anxiety and depression 4 weeks after CABG surgery. Further research is warranted to investigate the influence of content and presentation methods on patient outcomes and explore the potential long-term benefits of video-based education in promoting patient care., Competing Interests: Declaration of Competing Interest None to report., (Copyright © 2024 The American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Introduction: Therapeutic nutrition plays an imperative role during a patient's hospital course. There is a tremendous body of literature that emphasizes the systematic delivery of information regarding hospital nutrition diets. A major component of delivering healthcare information is the principle of providing quality healthcare information, but this has not yet been investigated on hospital nutrition diets. This study aimed to evaluate the comprehension and readability of patient education materials regarding therapeutic hospital diets., Methodology: The methodology employed the use of publicly available questions regarding hospital nutrition diets and categorized them per Rothwell's Classification of Questions. Additionally, the questions were extracted online and have an associated digital article linked to the question. These articles underwent analysis for readability scores., Results: This study's findings reveal that most hospital diets do not meet the recommended grade-reading levels., Conclusions: This underscores the need for healthcare providers to enhance patient education regarding hospital diets. The prevalence of "Fact" questions showcases the importance of clearly explaining diets and dietary restrictions to patients.

Background: Using Patient Reported Outcome Measures (PROMs) in clinical settings can improve patient outcomes by enhancing communication between patient and provider. There has been significant improvements in the development of PROMs, their implementation in routine patient clinical care, training physicians and other healthcare providers to interpret the PROMs results to identify any issues reported by the patient, and to use the PROMs results to provide or modify the treatment., Main Body: Despite the increased use of PROMs, the lack of PROM completion by patients is a major concern in the optimal use of PROMs. Studies have shown several reasons why patients do not complete PROMs and one of the reasons is their lack of understanding of the significance of PROMs and their utility in their clinical care. While examining the various strategies that can be used to improve the uptake of PROM completion by patients, educating patients about the use of PROMs has been recommended. There is less evidence on how patients are trained or educated about PROMs. It may also be possible that the patient education strategies are not reported in the publications. This brings up the question of evaluation of the educational strategies used., Conclusion: Our symposium at the 2023 ISOQOL conference brought together a range of experiences and learning around patient-centered PROMs educational activities used in the Netherlands, Canada, and the UK. This commentary is aimed to describe the lay of the land about educational activities around the use of PROMs in clinical care for patients, recognizing the gaps, and posing questions to be considered by the research and clinical community., (© 2024. The Author(s).)

Introduction: Traditionally, surgical procedures are explained through consultations between the surgeon and the patient to ensure informed consent. Patient education enhances engagement and knowledge, aiding informed decision-making. This study aimed to assess the effect of an educational video on preoperative patient knowledge and satisfaction in the context of total knee arthroplasty (TKA) as an adjunct to the consent process., Methods: A prospective randomized controlled study involving 100 patients in dedicated elective orthopedic units in UK-based hospitals was conducted. After consultation with a dedicated knee surgeon and a preoperative education day for TKA run by dedicated orthopedic nurse specialists, patients were randomized into one of two limbs (video vs no video) at a 1:1 ratio. The treatment group (video group) was shown a video about the principles and steps of the procedure, including the recovery time. Following this, a 10-point knowledge test was completed, and patients rated their satisfaction with the preoperative education on a scale of 0-10., Results: Patients in the video limb group had a significantly greater mean knowledge score and greater satisfaction with preoperative education than patients who did not view the video. The video group (n = 49) had a mean knowledge score of 8.73 +/- 0.159 compared to 7.68 +/- 0.281 for the nonvideo limb (n = 50) (p < 0.05). The video group had a mean satisfaction score of 9.00 +/- 0.123 compared to 8.40 +/- 0.121 for the nonvideo limb group (p < 0.05)., Conclusion: Video-assisted consent in total knee arthroplasty improves preoperative knowledge and patient satisfaction when used as an adjunct in the consent process. A simple, standardized video, either pre- or post-consultation could reinforce information that the patient receives in a simple effective manner, allowing for true informed consent., (© 2024. The Author(s).)

Aims: To explore the effect of early initiation of self-management based on multidisciplinary education in heart failure (HF) patients., Methods: HF patients in the Cardiology Department of Beijing Hospital were consecutively enrolled from June 2022 to February 2023. In-hospital HF patients from June 2022 to October 2022 were divided into the control group, and HF patients from November 2022 to February 2023 were divided into the cardiac rehabilitation (CR) group. A series of self-management education sessions with cardiologists, pharmacologists, nutritionists, and nurses was initiated early in the CR group. Continuous strengthening education was provided during the 3 months of discharge. Patients in the control group only received education twice during hospitalization. Minnesota Living with Heart Failure Questionnaire (MLHFQ), Pittsburgh sleep quality index (PSQI), anxiety Self-rating anxiety scale (SAS), and Self-rating depression scale (SDS) were compared between the two groups. Major cardiovascular adverse events (MACEs) were recorded during follow-up., Results: A total of 91 HF patients were enrolled. There were 44 patients in the CR group and 47 in the control group. Compared with before the program, the MLHFQ and SAS scores significantly decreased at 3 months after discharge in both groups. PSQI also showed mild improvement without significant differences in both groups. Furthermore, SDS showed a significant increase in the CR group but within the normal range. MACE occurrences did not show a significant difference., Conclusion: Early initiation of self-management program based on multidisciplinary education may help improve quality of life, sleep quality, and reduce anxiety for hospitalized HF patients., (© 2024. The Author(s).)

This quality improvement project implemented a standardized chemotherapy class for newly diagnosed patients receiving oncology care at an urban ambulatory oncology center. Results showed high scores on patient satisfaction qu.

Aims: To evaluate a self-administered digital education resource for patients after a heart attack (adapted simplified Chinese version of Cardiac College™) on secondary prevention knowledge and health behaviour change outcomes., Methods and Results: Chinese immigrants recovering from a heart attack were recruited from cardiac rehabilitation programmes at four metropolitan tertiary hospitals. Participants provided access to Cardiac College™ (adapted simplified Chinese version), a self-learning secondary prevention virtual education resource over 4 weeks. The web-based resources include 9 booklets and 10 pre-recorded video education sessions. Assessments included health literacy, secondary prevention knowledge, self-management behaviours, self-reported physical activity, and a heart-healthy diet. Satisfaction, acceptability, and engagement were also assessed.From 81 patients screened, 67 were recruited, and 64 (95.5%) completed the study. The participants' mean age was 67.2 ± 8.1 years old, 81.2% were males, and the majority had no English proficiency (65.6%). Following the intervention, significant improvements were observed for secondary prevention knowledge overall and in all subdomains, with the most improvement occurring in medical, exercise, and psychological domains (P < 0.001). Dietary and self-management behaviours also improved significantly (P < 0.05). According to participants, the educational materials were engaging (100%), and the content was adequate (68.8%); however, 26.6% found the information overwhelming. Overall, 46.9% were highly satisfied with the resources., Conclusion: A self-learning virtual patient-education package improved secondary prevention knowledge and self-care behaviour in Chinese immigrants after a heart attack. The culturally adapted version of Cardiac College™ offers an alternative education model where bilingual staff or translated resources are limited., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Online patient education materials (PEMs) on lymphedema surgery were assessed for quality, readability, and content. A total of 37 PEMs were identified, primarily authored by academic/medical organizations. Readability scores indicated materials were difficult to read, with an average Flesch-Kincaid Grade Level of 10.4. PEM Assessment Tools showed acceptable understandability (72.3%) but poor actionability (28.5%). PEMs often lacked information on surgical risks, postoperative care, and long-term follow-up. Simplifying language and adding visual aids could improve PEM effectiveness., (© 2024 Wiley Periodicals LLC.)

This study is a randomized controlled interventional study aimed to determine the effect of preoperative brochure-assisted education on surgical fear and anxiety in patients scheduled for septorhinoplasty surgery. The study was conducted between May 2022 and February 2023 in the Otorhinolaryngology services and clinics of a training and research hospital in the southern region of Turkey. The study included 61 patients, with 29 in the education group and 32 in the control group. All patients received routine nursing care before surgery, with the education group receiving additional education through an informative brochure. The data were collected using the "Personal Information Form", "Surgical Fear Questionnaire", and "Surgical Anxiety Questionnaire". There was no significant difference in the mean scores of surgical fear between the groups on the morning of the surgery (p > 0.05). However, a significant difference was found in the mean scores of surgical anxiety between the groups (p < 0.05). In conclusion, patients in the education group who received preoperative brochure-assisted education had lower anxiety compared with the control group., (© 2024 John Wiley & Sons Australia, Ltd.)

Background: ChatGPT is becoming very popular as an information source for the public. The adequacy of ChatGPT generated patient counseling material has not yet been extensively assessed., Methods: ChatGPT was presented with perioperative counseling and complication questions regarding five different procedure, and accuracy of responses was assessed. The chat was then asked to present an explanation of each procedure, and quality of the responses were compared to online educational material., Results: ChatGPT responses were comprehensive when discussing counseling points commonly discussed by a provider prior to a procedure. Responses to questions on surgical complications were less accurate and comprehensive. In comparison to online educational material, ChatGPT scored at or above the median SAM and PEMAT scores for all procedures., Conclusions: ChatGPT did well addressing basic counseling points during the perioperative period, although it did not perform as well when addressing surgical complications. Chat response quality was comparable to currently available online educational material., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: We sought to identify (1) what types of information US adults with rheumatic and musculoskeletal diseases (RMD) perceive as most important to know about their disease, and (2) what functions they would use in an RMD-specific smartphone app., Methods: Nominal groups with patients with RMD were conducted using online tools to generate a list of needed educational topics. Based on nominal group results, a survey with final educational items was administered online, along with questions about desired functions of a smartphone app for RMD and wearable use, to patients within a large community rheumatology practice-based research network and the PatientSpot registry. Chi-square tests and multivariate regression models were used to determine differences in priorities between groups of respondents with rheumatic inflammatory conditions (RICs) and osteoarthritis (OA), and possible associations., Results: At least 80% of respondents considered finding a rheumatologist, understanding tests and medications, and quickly recognizing and communicating symptoms to doctors as extremely important educational topics. The highest-ranked topic for both RIC and OA groups was "knowing when the medication is not working." The app functions that most respondents considered useful were viewing laboratory results, recording symptoms to share with their rheumatology provider, and recording symptoms (eg, pain, fatigue) or disease flares for health tracking over time. Approximately one-third of respondents owned and regularly used a wearable activity tracker., Conclusion: People with RMD prioritized information about laboratory test results, medications, and disease and symptom monitoring, which can be used to create educational and digital tools that support patients during their disease journey., (Copyright © 2024 by the Journal of Rheumatology.)

Objective: While graphics are commonly used by clinicians to communicate information to patients, the impact of using visual media on surgical patients is not understood. This review seeks to understand the current landscape of research analyzing impact of using visual aids to communicate with patients undergoing surgery, as well as gaps in the present literature., Design: A comprehensive literature search was performed across 4 databases. Search terms included: visual aids, diagrams, graphics, surgery, patient education, informed consent, and decision making. Inclusion criteria were (i) full-text, peer-reviewed articles in English; (ii) evaluation of a nonelectronic visual aid(s); and (iii) surgical patient population., Results: There were 1402 articles identified; 21 met study criteria. Fifteen were randomized control trials and 6 were prospective cohort studies. Visual media assessed comprised of diagrams as informed consent adjuncts (n = 6), graphics for shared decision-making conversations (n = 3), other preoperative educational graphics (n = 8), and postoperative educational materials (n = 4). There was statistically significant improvement in patient comprehension, with an increase in objective knowledge recall (7.8%-29.6%) using illustrated educational materials (n = 10 of 15). Other studies noted increased satisfaction (n = 4 of 6), improvement in shared decision-making (n = 2 of 4), and reduction in patient anxiety (n = 3 of 6). For behavioral outcomes, visual aids improved postoperative medication compliance (n = 2) and lowered postoperative analgesia requirements (n = 2)., Conclusions: The use of visual aids to enhance the surgical patient experience is promising in improving knowledge retention, satisfaction, and reducing anxiety. Future studies ought to consider visual aid format, and readability, as well as patient language, race, and healthcare literacy., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Purpose: This study assesses readability, suitability, and accountability of online uveitis patient education materials (PEMs)., Methods: Two uveitis specialists reviewed the top 10 websites on Google for keyword "uveitis," with a PubMed review control. Readability was assessed using an online calculator, suitability using the Suitability Assessment of Materials (SAM) tool, and accountability using JAMA benchmarks., Results: The mean SAM score was 21.05, indicating that websites were on average adequately suitable to educate patients. WebMD Uveitis website scored the highest at 25.5, while allaboutvision.org scored the lowest at 18.0. The average Flesch Reading Ease (FRE) score was 44.0 (95% CI: 34.2, 53.8). The average reading grade score was 11.0 (95% CI: 9.4, 12.6). WebMD Uveitis page scored highest on readability. The average accountability score among sites was 2.36 out of 4., Conclusions: Uveitis websites are only adequately suitable as PEMs, and all are above the recommended reading level. Uveitis specialists should advise patients on quality of online PEMs.

Introduction: Health literacy is the ability of individuals to use basic health information and services to make well-informed decisions. Low health literacy among surgical patients has been associated with nonadherence to preoperative and/or discharge instructions as well as poor comprehension of surgery. It likely poses as a barrier to patients considering foregut surgery which requires an understanding of different treatment options and specific diet instructions. The objective of this study was to assess and compare the readability of online patient education materials (PEM) for foregut surgery., Methods: Using Google, the terms "anti-reflux surgery, "GERD surgery," and "foregut surgery" were searched and a total of 30 webpages from universities and national organizations were selected. The readability of the text was assessed with seven instruments: Flesch Reading Ease formula (FRE), Gunning Fog (GF), Flesch-Kincaid Grade Level (FKGL), Coleman Liau Index (CL), Simple Measure of Gobbledygook (SMOG), Automated Readability Index (ARI), and Linsear Write Formula (LWF). Mean readability scores were calculated with standard deviations. We performed a qualitative analysis gathering characteristics such as, type of information (preoperative or postoperative), organization, use of multimedia, inclusion of a version in another language., Results: The overall average readability of the top PEM for foregut surgery was 12th grade. There was only one resource at the recommended sixth grade reading level. Nearly half of PEM included some form of multimedia., Conclusions: The American Medical Association and National Institute of Health have recommended that PEMs to be written at the 5th-6th grade level. The majority of online PEM for foregut surgery is above the recommended reading level. This may be a barrier for patients seeking foregut surgery. Surgeons should be aware of the potential gaps in understanding of their patients to help them make informed decisions and improve overall health outcomes., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: YouTube®, attracts billions of monthly viewers, including those seeking health-related content. However, the quality standards of information are highly variable. The study aimed to evaluate the educational merit of YouTube® concerning pacemakers, focusing on quality and reliability for educating both patients and physicians., Methods: The term "pacemaker" was searched on YouTube®. Following the application of exclusion criteria based on video language, duration, and minimum view count, a total of 71 videos were analyzed. Quality was assessed using the Global Quality Score (GQS), while reliability was evaluated using the modified DISCERN (mDISCERN) score. Data and metrics available regarding the channel and the specific video were obtained. The Kolmogorov-Smirnov test was employed to assess data normality, and the Mann-Whitney U test was utilized to determine statistical significance., Results: Youtube videos on cardiac pacemakers proved to be of moderate quality, with an average GQS score of 3.10, and of moderate reliability, indicated by a mean mDISCERN score of 3.08. Higher scores were reported for videos of more than five minute duration, the ones that were targeted at physicians, and the videos with higher view ratios. The presence of a board-certified MD yielded statistically greater mean GQS, but not mDISCERN score. No statistical difference was observed based on the number of likes., Conclusion: In conclusion, while YouTube® offers significant education opportunities, there is a clear need for enhanced oversight and quality control. Healthcare providers should guide patients towards valid resources and consider collaborating with platforms to develop content standards., Competing Interests: Declaration of competing interest The authors have nothing to disclose., (Copyright © 2024. Published by Elsevier B.V.)

Background: Chat Generative Pre-trained Transformer (ChatGPT) is a language model that may have the potential to revolutionize health care. The study purpose was to test whether ChatGPT could be used to create educational brochures about kidney transplant tailored for three target audiences: caregivers, teens and children., Methods: Using a list of 25 educational topics, standardized prompts were employed to ensure content consistency in ChatGPT generation. An expert panel assessed the accuracy of the content by rating agreement on a Likert scale (1 = <25 % agreement; and 5 = 100 % agreement). The understandability, actionability and readability of the brochures were assessed using the Patient Education Materials Assessment Tool for printable materials (PEMAT-P) and standard readability scales. A caregiver and patient reviewed and provided written feedback., Results: We found mean understandability scores of 69 %, 66 %, and 73 % for caregiver, teen, and child brochures respectively, with 90.7 % of the ChatGPT generated brochures scoring 40 % on the actionability scale. Generated caregiver and teen materials achieved readability levels of grades 9-14, while child-specific brochures achieved readability levels of grades 6-11. Brochures were formatted appropriately but lacked depth., Conclusion: ChatGPT demonstrates potential for rapidly generating patient education materials; however, challenges remain in ensuring content specificity. We share the lessons learned to assist other healthcare providers with using this technology., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background and Purpose: Fatigue is a common and disabling symptom in multiple sclerosis (MS). Educational interventions have shown potential to reduce fatigue. The aim was to systematically review the current best evidence on patient education programmes for MS-related fatigue., Methods: This was a systematic review and meta-analysis following Cochrane methodology. A systematic search was conducted in eight databases (September 2023). Moreover, reference lists and trial registers were searched and experts in the field were contacted. Randomized controlled trials were included evaluating patient education programmes for people with MS with the primary aim of reducing fatigue., Results: In total, 1176 studies were identified and assessed by two independent reviewers; 15 studies (1473 participants) were included. All interventions provided information and education about different aspects of MS-related fatigue with different forms of application, some with components of psychological interventions. Amongst those, the most frequently applied were cognitive behavioural therapy (n = 5) and energy-conservation-based approaches (n = 4). Studies differed considerably concerning mode of intervention delivery, number of participants and length of follow-up. Interventions reduced fatigue severity (eight studies, n = 878, standardized mean difference -0.28; 95% confidence interval -0.53 to -0.03; low certainty) and fatigue impact (nine studies, n = 824, standardized mean difference -0.21; 95% confidence interval -0.42 to 0.00; moderate certainty) directly after the intervention. Mixed results were found for long-term effects on fatigue, for secondary endpoints (depressive symptoms, quality of life, coping) and for subgroup analyses., Conclusion: Educational interventions for people with MS-related fatigue may be effective in reducing fatigue in the short term. More research is needed on long-term effects and the importance of specific intervention components, delivery and context., (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Introduction: The aim was to determine the effect of arteriovenous fistula (AVF) care training given to hemodialysis (HD) patients on the self-care behaviors of patients., Methods: The randomized controlled experimental study was conducted in the HD unit. The study was carried out with a total of 66 patients. Patients in the intervention group were trained using the AVF Care Education Book for 4 weeks. The study data were collected using the scale for evaluating self-care behaviors related to AVF in HD patients (ASBHD-AVF). Shapiro-Wilk and Kolmogorov-Smirnov tests, independent t-tests, and ANOVA were used in the SPSS 25.0 package program., Results: As a result of the research, it was determined that the average ASBHD-AVF score of the patients in the trained intervention group increased from 54.52 ± 7.41 to 73.77 ± 3.05 (p <0.05). The mean ASBHD-AVF score of the patients in the control group increased from 56.14 ± 4.51 to 58.14 ± 5.93 (p >0.05). When the difference between the two groups was examined, it was determined that the average ASBHD-AVF score of the patients in the intervention group was statistically significantly higher than the control group (p <0.05)., Conclusion: AVF care education given to HD patients improves patients' self-care behaviors. Improved fistula self-care behaviors of patients will contribute to the healthy functioning of the AVF and the effective HD treatment of patients., (© 2024 International Society for Apheresis and Japanese Society for Apheresis.)

Objective: A Virtual Patient Tour (VPT) was developed to inform cardiac surgery patients about their hospitalization from the admission to their postoperative stay on the ward. The objective of our study was to assess the feasibility and acceptability of this VPT following the framework of the Virtual Reality Clinical Outcomes Research Experts Committee., Methods: In this single-centre cross-sectional study, adult patients admitted to the hospital for elective cardiac surgery were included. Acceptability, usability, and tolerability were measured by the validated questionnaires Unified Theory of Acceptance and Use of Technology (acceptability), System Usability Scale (usability), and Virtual Reality Sickness Questionnaire (tolerability). Descriptive statistics were used for the analysis., Results: Twenty-eight participants used the VPT. Results showed high acceptability (mean 16.7 ± 1.5), acceptable usability (mean 86.7 ± 9.3), and high tolerability (sickness score, median 7.1 % [0-17.1 %])., Conclusion: The use of the VPT is a feasible and promising technique. The next step is to optimize the content and technique of the VPT based on the suggestions of the participants., Practice Implications: We recommend incorporating the VPT into preoperative patient education in addition to the routine information in cardiac surgery patients., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Educating patients regarding surgery is an important aspect of the preoperative process. It helps individuals answer their queries, reduce anxiety, and improve overall satisfaction with the surgical experience., Objective: To compare patients' expectations with their real-perioperative surgical experiences. Also, to evaluate the effectiveness of preoperative education and, thus, improve the doctor-patient relationship., Methodology: Through consecutive sampling, 65 adult patients were selected from the ENT department of Khyber Teaching Hospital. Preoperative education was provided to all the subjects using a 25-point pro-forma, and their queries were addressed. Postoperatively, all participants were interviewed regarding their expectations and real perioperative surgical experiences. The gaps were noted, and participants were asked about their preferences for addressing such gaps in future interactions. Postoperatively, patients were asked to give comments on how a certain part of preoperative education could have been better delivered., Results: Among the 65 patients, 28 (43.1%) were male, and 37 (56.9%) were female. The majority (38.5%) had a primary/secondary school education. Eight (12.3%) patients had ear surgery, 19 (29.2%) had nose surgery, and 38 (58.5%) had throat surgery. Almost 39 (60%) patients had preoperative fear/anxiety. After preoperative education, 17 (26.2%) patients experienced perioperative fear/anxiety, which was a significant reduction (p = 0.001). Preoperative anxiety was greater in females (M: F = 8:13, p = 0.00), while perioperative anxiety was comparable among both genders after patient education (M: F = 5:12, p = 0.18). The greatest dissatisfaction was noted regarding the surgical schedule (33.8%), range of motion (16.9%), deep breathing exercises (13.8%), and preoperative fasting (12.3%). Most importantly, patients' comments were noted, when they were asked to suggest a better way to educate preoperatively in their respective area of dissatisfaction. Patients appreciated detailed explanations with practical demonstrations for range of motion exercises. One patient complained about no clear instructions on postoperative resumption of snuff., Conclusion: Preoperative patient education should be a two-way process involving active participation and continuous feedback. By educating patients properly through a multidisciplinary approach, healthcare providers can further enhance patient satisfaction, alleviate anxiety, and improve the overall quality of care., (© 2024. The Author(s).)

Background: We queried ChatGPT (OpenAI) and Google Assistant about amblyopia and compared their answers with the keywords found on the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) website, specifically the section on amblyopia. Out of the 26 keywords chosen from the website, ChatGPT included 11 (42%) in its responses, while Google included 8 (31%)., Objective: Our study investigated the adherence of ChatGPT-3.5 and Google Assistant to the guidelines of the AAPOS for patient education on amblyopia., Methods: ChatGPT-3.5 was used. The four questions taken from the AAPOS website, specifically its glossary section for amblyopia, are as follows: (1) What is amblyopia? (2) What causes amblyopia? (3) How is amblyopia treated? (4) What happens if amblyopia is untreated? Approved and selected by ophthalmologists (GW and DL), the keywords from AAPOS were words or phrases that deemed significant for the education of patients with amblyopia. The "Flesch-Kincaid Grade Level" formula, approved by the US Department of Education, was used to evaluate the reading comprehension level for the responses from ChatGPT, Google Assistant, and AAPOS., Results: In their responses, ChatGPT did not mention the term "ophthalmologist," whereas Google Assistant and AAPOS both mentioned the term once and twice, respectively. ChatGPT did, however, use the term "eye doctors" once. According to the Flesch-Kincaid test, the average reading level of AAPOS was 11.4 (SD 2.1; the lowest level) while that of Google was 13.1 (SD 4.8; the highest required reading level), also showing the greatest variation in grade level in its responses. ChatGPT's answers, on average, scored 12.4 (SD 1.1) grade level. They were all similar in terms of difficulty level in reading. For the keywords, out of the 4 responses, ChatGPT used 42% (11/26) of the keywords, whereas Google Assistant used 31% (8/26)., Conclusions: ChatGPT trains on texts and phrases and generates new sentences, while Google Assistant automatically copies website links. As ophthalmologists, we should consider including "see an ophthalmologist" on our websites and journals. While ChatGPT is here to stay, we, as physicians, need to monitor its answers., (©Gloria Wu, David A Lee, Weichen Zhao, Adrial Wong, Rohan Jhangiani, Sri Kurniawan. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 15.08.2024.)

Background: Artificial intelligence (AI) chatbots, such as ChatGPT, have made significant progress. These chatbots, particularly popular among health care professionals and patients, are transforming patient education and disease experience with personalized information. Accurate, timely patient education is crucial for informed decision-making, especially regarding prostate-specific antigen screening and treatment options. However, the accuracy and reliability of AI chatbots' medical information must be rigorously evaluated. Studies testing ChatGPT's knowledge of prostate cancer are emerging, but there is a need for ongoing evaluation to ensure the quality and safety of information provided to patients., Objective: This study aims to evaluate the quality, accuracy, and readability of ChatGPT-4's responses to common prostate cancer questions posed by patients., Methods: Overall, 8 questions were formulated with an inductive approach based on information topics in peer-reviewed literature and Google Trends data. Adapted versions of the Patient Education Materials Assessment Tool for AI (PEMAT-AI), Global Quality Score, and DISCERN-AI tools were used by 4 independent reviewers to assess the quality of the AI responses. The 8 AI outputs were judged by 7 expert urologists, using an assessment framework developed to assess accuracy, safety, appropriateness, actionability, and effectiveness. The AI responses' readability was assessed using established algorithms (Flesch Reading Ease score, Gunning Fog Index, Flesch-Kincaid Grade Level, The Coleman-Liau Index, and Simple Measure of Gobbledygook [SMOG] Index). A brief tool (Reference Assessment AI [REF-AI]) was developed to analyze the references provided by AI outputs, assessing for reference hallucination, relevance, and quality of references., Results: The PEMAT-AI understandability score was very good (mean 79.44%, SD 10.44%), the DISCERN-AI rating was scored as "good" quality (mean 13.88, SD 0.93), and the Global Quality Score was high (mean 4.46/5, SD 0.50). Natural Language Assessment Tool for AI had pooled mean accuracy of 3.96 (SD 0.91), safety of 4.32 (SD 0.86), appropriateness of 4.45 (SD 0.81), actionability of 4.05 (SD 1.15), and effectiveness of 4.09 (SD 0.98). The readability algorithm consensus was "difficult to read" (Flesch Reading Ease score mean 45.97, SD 8.69; Gunning Fog Index mean 14.55, SD 4.79), averaging an 11th-grade reading level, equivalent to 15- to 17-year-olds (Flesch-Kincaid Grade Level mean 12.12, SD 4.34; The Coleman-Liau Index mean 12.75, SD 1.98; SMOG Index mean 11.06, SD 3.20). REF-AI identified 2 reference hallucinations, while the majority (28/30, 93%) of references appropriately supplemented the text. Most references (26/30, 86%) were from reputable government organizations, while a handful were direct citations from scientific literature., Conclusions: Our analysis found that ChatGPT-4 provides generally good responses to common prostate cancer queries, making it a potentially valuable tool for patient education in prostate cancer care. Objective quality assessment tools indicated that the natural language processing outputs were generally reliable and appropriate, but there is room for improvement., (©Damien Gibson, Stuart Jackson, Ramesh Shanmugasundaram, Ishith Seth, Adrian Siu, Nariman Ahmadi, Jonathan Kam, Nicholas Mehan, Ruban Thanigasalam, Nicola Jeffery, Manish I Patel, Scott Leslie. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 14.08.2024.)

Background & Aims: Liver cirrhosis affects 4.5 million adults in the United States (US). As more patients educate themselves online, we evaluated the accessibility, quality, understandability, accuracy, readability, and comprehensiveness (AQUA-RC) of online patient education materials for cirrhosis., Methods: Cross-sectional analysis using Google ® and YouTube ® on a cleared internet browser from 12 cities across the US. The authors independently reviewed the top 25 search results from each platform using search terms "liver cirrhosis" and "cirrhosis". Accessibility was evaluated from twelve cities in six regions across the US. We evaluated resource quality using the DISCERN score, understandability using the PEMAT score, readability using the Flesch-Kinkaid score, and accuracy/comprehensiveness using a list of author-generated criteria. AQUA-RC was compared between 1) academic websites (AW) vs. non-academic websites (NAW), and 2) websites vs. YouTube ® videos., Results: 28 websites and 25 videos were included. Accessibility was equal across all regions. Websites had higher average quality scores than videos, although this was not statistically significant (p = 0.84). Websites were more understandable than videos (p < 0.00001). Both websites and videos were 100% accurate. Readability for websites was higher than recommended standards. Websites were more comprehensive than videos (p = 0.02)., Conclusion: Online patient education materials for cirrhosis in the US are equally accessible, but readability and understandability are too complex. Websites are of greater quality, accuracy, and comprehensiveness than YouTube videos, which are often narrowly focused and targeted at the medical community rather than patients. Further efforts should be made to improve online patient education and expand content across platforms., (© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Objective: To examine the impact of standardized patient (SP) training on SPs' real-life healthcare encounters and explore whether SP training elements can be adapted to increase actual patients' understanding, communication and participation in a patient-centered care model., Methods: Data were collected from surveys and focus groups with standardized patients and a survey of primary care physicians. Findings were used to create an educational video with pre- and post-viewing surveys of patients' understanding of engagement strategies and plans to use them in future encounters., Results: SPs reported medical visits were more productive because of their ability to understand the visit's framework; crediting their SP training. Patients reported the video will help in planning future medical visits by providing information that increases their understanding of their role in the care process., Conclusions: SPs' understanding of the visit and its impact on knowledge, skills and affective domains can be transferred to patients in the form of specific strategies that enhance communication and patient participation during medical visits., Practice Implications: A brief educational intervention for patients using SPs' understanding of the medical visit may contribute to enhanced patient participation in future health care encounters and could increase patient engagement in patient-centered models of care., Competing Interests: Declaration of Competing Interest All authors are at are at the Frank H. Netter MD School of Medicine at Quinnipiac University. None of the 4 co-authors (Gabbriel Ceccolini, Mattel Rachel Kanevsky, Richard Feinn, Ingrid Philibert) declare any conflicts of interest or competing interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Artificial intelligence (AI) platforms such as ChatGPT and Bard are increasingly utilized to answer patient health care questions. We present the first study to blindly evaluate AI-generated responses to common endourology patient questions against official patient education materials. Methods: Thirty-two questions and answers spanning kidney stones, ureteral stents, benign prostatic hyperplasia (BPH), and upper tract urothelial carcinoma were extracted from official Urology Care Foundation (UCF) patient education documents. The same questions were input into ChatGPT 4.0 and Bard, limiting responses to within ±10% of the word count of the corresponding UCF response to ensure fair comparison. Six endourologists blindly evaluated responses from each platform using Likert scales for accuracy, clarity, comprehensiveness, and patient utility. Reviewers identified which response they believed was not AI generated. Finally, Flesch-Kincaid Reading Grade Level formulas assessed the readability of each platform response. Ratings were compared using analysis of variance (ANOVA) and chi-square tests. Results: ChatGPT responses were rated the highest across all categories, including accuracy, comprehensiveness, clarity, and patient utility, while UCF answers were consistently scored the lowest, all p  < 0.01. A subanalysis revealed that this trend was consistent across question categories (i.e., kidney stones, BPH, etc.). However, AI-generated responses were more likely to be classified at an advanced reading level, while UCF responses showed improved readability (college or higher reading level: ChatGPT = 100%, Bard = 66%, and UCF = 19%), p  < 0.001. When asked to identify which answer was not AI generated, 54.2% of responses indicated ChatGPT, 26.6% indicated Bard, and only 19.3% correctly identified it as the UCF response. Conclusions: In a blind evaluation, AI-generated responses from ChatGPT and Bard surpassed the quality of official patient education materials in endourology, suggesting that current AI platforms are already a reliable resource for basic urologic care information. AI-generated responses do, however, tend to require a higher reading level, which may limit their applicability to a broader audience.

Objective: Use of tele-technology for monitoring symptoms, functional parameters, and quality-of-life of people with asthma is essential. Delivering this information among patients is mandated for a better outcome and made possible via patient education (PE). This review aims to summarize the types of telerehabilitation modalities, dosage, and outcome measures used to assess the effectiveness of PE among people with asthma., Methods: We adopted a scoping review methodology. Thematic analysis was used to synthesize the data. The Preferred Reporting System for Meta-Analysis for Scoping Reviews (PRISMA-ScR) was followed during the review process., Results: PubMed, Embase, and Scopus were searched, with 34 studies meeting inclusion criteria. Results are presented in three themes: telerehabilitation platforms used to deliver PE among patients with asthma; content, duration, and frequency of the PE administered; and patient-reported outcome measures used to evaluate the effectiveness of PE., Conclusion: This scoping study detailed the types of telerehabilitation modalities, dosage, and outcome measures used to assess the effectiveness of PE in people with asthma. This review will be especially beneficial to those considering where additional research or implementation of telerehabilitation for asthma patients is required. The studies emphasized the involvement of several healthcare experts, emphasizing the significance of a multidisciplinary approach to efficient PE delivery and possible improvements in asthma management through telerehabilitation. Although a range of telerehabilitation platforms were generally accepted, hybrid models that integrate online and in-person sessions could further enhance patient satisfaction and quality-of-life. Comprehensive economic analyses are also required, and solving technology issues is essential to maximizing the efficacy of these initiatives.

Objective: The recommended readability of health education materials is at the sixth-grade level. Artificial intelligence (AI) large language models such as the newly released ChatGPT4 might facilitate the conversion of patient-education materials at scale. We sought to ascertain whether online otolaryngology education materials meet recommended reading levels and whether ChatGPT4 could rewrite these materials to the sixth-grade level. We also wished to ensure that converted materials were accurate and retained sufficient content., Methods: Seventy-one articles from patient educational materials published online by the American Academy of Otolaryngology-Head and Neck Surgery were selected. Articles were entered into ChatGPT4 with the prompt "translate this text to a sixth-grade reading level." Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL) were determined for each article before and after AI conversion. Each article and conversion were reviewed for factual inaccuracies, and each conversion was reviewed for content retention., Results: The 71 articles had an initial average FKGL of 11.03 and FRES of 46.79. After conversion by ChatGPT4, the average FKGL across all articles was 5.80 and FRES was 77.27. Converted materials provided enough detail for patient education with no factual errors., Discussion: We found that ChatGPT4 improved the reading accessibility of otolaryngology online patient education materials to recommended levels quickly and effectively., Implications for Practice: Physicians can determine whether their patient education materials exceed current recommended reading levels by using widely available measurement tools, and then apply AI dialogue platforms to modify materials to more accessible levels as needed., Level of Evidence: Level 5., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Purpose: Guidelines recommend that health-related information for patients should be written at or below the sixth-grade level. We sought to evaluate the readability level and quality of online patient education materials regarding epidural and spinal anesthesia., Methods: We evaluated webpages with content written specifically regarding either spinal or epidural anesthesia, identified using 11 relevant search terms, with seven commonly used readability formulas: Flesh-Kincaid Grade Level (FKGL), Gunning Fox Index (GFI), Coleman-Liau Index (CLI), Automated Readability Index (ARI), Simple Measure of Gobbledygook (SMOG), Flesch Reading Ease (FRE), and New Dale-Chall (NDC). Two evaluators assessed the quality of the reading materials using the Brief DISCERN tool., Results: We analyzed 261 webpages. The mean (standard deviation) readability scores were: FKGL = 8.8 (1.9), GFI = 11.2 (2.2), CLI = 10.3 (1.9), ARI = 8.1 (2.2), SMOG = 11.6 (1.6), FRE = 55.7 (10.8), and NDC = 5.4 (1.0). The mean grade level was higher than the recommended sixth-grade level when calculated with six of the seven readability formulas. The average Brief DISCERN score was 16.0., Conclusion: Readability levels of online patient education materials pertaining to epidural and spinal anesthesia are higher than recommended. When we evaluated the quality of the information using a validated tool, the materials were found to be just below the threshold of what is considered good quality. Authors of educational materials should provide not only readable but also good-quality information to enhance patient understanding., (© 2024. Canadian Anesthesiologists' Society.)