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The number of patients with dementia admitted to hospitals is increasing. However, the care and treatment of these patients tends to be suboptimal. A response to this is a widespread implementation of educational initiatives. Nevertheless, the effect of such initiatives is questioned. The aim of this study was to investigate the impact of a dementia education intervention by examining the self-reported outcomes of general hospital staff and exploring the staff’s experiences of these outcomes. An explanatory sequential mixed-methods design framed the study method. The quantitative data collection included repeated questionnaires: pre-intervention ( n = 849), one month post-intervention ( n = 618), and five months post-intervention ( n = 468) followed by a qualitative data collection using interviews ( n = 16). The GRAMMS guideline was followed. The integration of the quantitative and qualitative results suggests that the impact of the education intervention can be ascribed to the interdisciplinary focus, which facilitated a comprehensive commitment to creating careful solutions for patients with dementia. A prioritization of person over task seems to be assisted by an improved interdisciplinary cooperation initiated by the inclusion of all employed staff at the hospital in a dementia education intervention.

Introduction Heart failure is a progressive condition affecting 6.2 million Americans. The use of palliative and supportive care for symptom management and improved quality of life is recommended for persons with heart failure. However, 91% of nurses believe they need further training to have palliative care conversations. The purpose of this pilot education intervention was to determine if providing nurses with education on the timing and content of palliative care conversations would improve their perceived skill and knowledge. Methods This was a pilot study of an online educational intervention. Data were electronically collected from 13 participants using validated questionnaires delivered via Qualtrics. Participants completed a demographic survey and End-of-Life Professional Caregiver Survey (EPCS) before and after completing an online, asynchronous education module. Results Mean scores were higher on all posttest measures. Independent samples t-tests revealed statistically significant differences on the Effective Care Delivery (ECD) scale ( t[32] = −2, p = .05) and total EPCS scale scores ( t[32] = −2.2, p = .03) from pre- to posttest. Conclusion Scores increased on all dimensions pretest to posttest with statistically significant differences in ECD and total scores. Providing asynchronous online education on timing and content of palliative care conversations to nurses caring for people with heart failure is a feasible and effective way to improve perceived knowledge and skill of palliative care conversations.

Background and aim The European Association of Palliative Care recommends that family carers need education on the progression of dementia. This systematic review aimed to explore whether interventions incorporating education regarding the progressive nature of dementia increased carers’ understanding of dementia and improved mental health and burden. Method MEDLINE, PsycINFO and CINAHL were searched to April 2018. Randomised controlled trials with samples of family carers of someone with dementia were eligible. Included interventions involved a component aimed to increase the carer’s understanding of the progression of dementia. Outcomes of interest included: knowledge of dementia, depression, burden and pre-death grief. Results Searches identified 3221 unique citations of which 11 studies were eligible for review. Interventions ranged from 4 to 16 sessions of which 1 to 3 sessions focused on the progression of dementia. Knowledge: Two studies evaluated carers’ knowledge of dementia. One found no difference between the trial arms immediately after the intervention or three months later. The second found a significant intervention effect at the end of the intervention but not at three-month follow-up. Depression: Seven studies evaluated intervention effects on depression. Meta-analysis of three trials showed significant differences in mean follow-up scores favouring intervention over control. The remaining four studies did not show differences in depression between intervention and control groups. Burden: Nine studies evaluated burden and were examined in two meta-analyses (mean scores at follow-up and mean change scores from baseline to follow-up), neither of which found a benefit for intervention over control. Using the grading of recommendations assessment, development and evaluation system, we judged the quality of evidence to be very low for depression and low for burden, knowledge and pre-death grief, reducing our confidence in any of the effect estimates. Conclusion The evidence was not sufficient to support or refute the effectiveness of education on progression of dementia on carers’ knowledge and mental health.

A growing body of work suggests that teaching college students a contextual understanding of difference-that students' different experiences in college are the result of participating in different contexts before college-can improve the academic performance of first-generation students (i.e., students whose parents do not have 4-year college degrees). However, only one empirical study, using an in-person panel format, has demonstrated the benefits of this intervention approach. In the present research, we conduct two studies to test the effectiveness of a new difference-education intervention administered online to individual students. In both studies, first-year students read senior students' and recent graduates' stories about how they adjusted to college. In the difference-education condition, stories conveyed a contextual understanding of difference. We found that the online intervention effectively taught students a contextual understanding of difference and closed the social class achievement gap by increasing first-generation students' psychological empowerment and, thereby, end-of-second-year grades.

Dementia is a leading cause of death and disability in Australia. This research evaluated dementia knowledge and educational needs among the Australian health workforce. An online version of the validated Dementia Knowledge Assessment Scale (DKAS) was administered with a random sample of 234 health professionals across eight Australian states. Respondents provided additional self-report data concerning dementia experiences, educational needs, and demographic information. Dementia knowledge deficiencies were identified concerning risk factors, prevalent typologies of the condition, and cognitive symptoms. Prior university education and dementia-specific training were predictive of significantly higher knowledge scores. Self-reported dementia education needs included nonpharmaceutical interventions for the behavioral and psychological symptoms and best-evidence care provision. Knowledge deficiencies among health workers suggest patients with dementia may not be receiving consistent, best-evidence care in Australia. The research findings will support the development of a targeted online dementia education intervention that aims to improve health worker knowledge and patient care.

Education is needed for enhanced capacity of acute hospitals to provide dementia care. A nonrandomized controlled, repeated-measures design was used to evaluate a dementia education program delivered to an intervention group (IG, n = 468), compared to a wait-listed group (n = 277), representing separate sites of a multisite hospital. Participants completed self-efficacy for dementia and satisfaction measures and provided written descriptions of dementia care collected at baseline, postintervention (IG only), and at 8-week follow-up. Oral narratives were gathered from IG participants 8 weeks postintervention. The IG demonstrated significant improvement in self-efficacy scores from baseline to immediately postintervention ( P < .001), sustained at 8 weeks. There were no changes from baseline to 8 weeks postintervention evident in the wait-listed group ( P = .21). Intervention group participants described positive impacts including implementation of person-centered care approaches. Implementation of dementia care education programs throughout hospital settings is promising for the enhancement of dementia care.

Objective: While driveway run-over incidents continue to be a cause of serious injury and deaths among young children in Australia, few empirically evaluated educational interventions have been developed which address these incidents. Addressing this gap, this study describes the development and evaluation of a paper-based driveway safety intervention targeting caregivers of children aged 5 years or younger. Design: Cross-sectional survey. Method and setting: Informed by previous research, the intervention targeted key caregiver safety behaviours that address driveway risks. To assess the impact of the intervention, 137 Queensland (Australia) caregivers (95.0% women; mean age = 34.97 years) were recruited. After receiving the intervention, changes to a number of outcomes such as caregiver risk perception, safety knowledge and behavioural intentions were measured. Results: Findings indicated that the intervention had increased general and specific situational risk awareness and safety knowledge among a substantial proportion of participants. Close to one-quarter of the sample strongly agreed that the intervention had increased these outcomes. In addition, 71.6% of the sample reported that they intended to make changes to their routine in and around the driveway, as a result of reading the intervention material and a further, quarter of the participants strongly agreed that the information provided would be a help both to themselves (26.5%) and other caregivers (33.8%) to keep their children safe in the driveway. Conclusion: While the educational intervention requires further validation, findings from this study suggest that intervention content and format increases driveway safety.

Introduction Despite an increasing and widespread understanding of the importance of quality improvement in healthcare, medical students and junior doctors receive variable training in improvement methods. The South West Foundation Doctor quality improvement programme attempted to equip junior doctors with the skills to develop and improve healthcare services. Methods A questionnaire-based evaluation was undertaken of a cohort of first-year doctors who took part in a 9-month quality improvement educational intervention. The study was conducted across a whole training region with some of the hospitals running the quality improvement educational intervention and one acting as the natural control cohort. A previously validated questionnaire was sent out at the start and end of their first year. Results In questions related to attitudes to all domains of quality improvement first-year doctors consider it an important part of their role as doctors to improve the quality of healthcare. However, they do not think they are equipped with the skills to do this improvement. During their first year as doctors, these self-reported skills increased dramatically in the hospitals that took part in the programme but not in the single hospital that did not run the programme. Conclusion First-year doctors consider improving the quality of healthcare to be an important part of their job. This can be contrasted to their self-reported skills related to quality improvement when they start their first year. In hospitals that run a structured, supported experiential quality improvement programme, these self-reported skills increase statistically significantly.

Objectives:The Cycling against Hip Pain programme is a 6-week exercise and education treatment pathway for people with hip osteoarthritis. Preliminary results of the Cycling against Hip Pain programme found significant improvements in clinical and patient-reported outcome measures for patients referred from primary care. This article evaluates the effectiveness of the changes made to the pathway in a quality improvement replication programme.Methods:The replicated Cycling against Hip Pain programme was delivered between February 2018 and September 2019 in a region of England with a high percentage of adults aged over 65 years. All participants were referred from the orthopaedic outpatient department of the funding hospital (secondary care). The programme was delivered at a local leisure centre and combined 30 min of education on osteoarthritis with 30 min of progressive static cycling, once a week for 6 weeks.Results:The participants on the replicated Cycling against Hip Pain programme did not differ from the original cohort in terms of age or pre-programme weight, however, presented with worse hip symptoms at baseline. Consistent with the findings from the original cohort, participants demonstrated significant improvements to their Oxford Hip Score, 30-s chair stand performance, Timed Up and Go score, Hip Osteoarthritis Outcome Score function and pain, EQ5D health rating, EQ5D-5L score and pain at rest and on weight bearing. In addition, participants reported an increase in knowledge, confidence and motivation to exercise.Conclusion:A 6-week cycling and education intervention for the treatment of hip osteoarthritis provided benefits to function, pain and quality of life for patients referred from secondary care. These results are consistent with findings from patients who were referred from primary care and further support the potential of the pathway in the conservative management of hip osteoarthritis.

Background: This study explores the relationship between education for inpatient diabetes providers and the utilization of insulin order sets, inpatient glucometrics, and length of stay in a large health care system. Methods: The study included patients with and without the diagnosis of diabetes. An education campaign included provider-directed diabetes education administered via online learning modules and in-person presentations by trained individuals. Relationships among provider-attended diabetes education, order set usage, and inpatient glucometrics (hypo- and hyperglycemia) were analyzed, as well as length of stay. Results: Insulin use knowledge scores for all providers averaged 52%, and improved significantly to 93% ( P < .001) by the end of the education intervention period. Likewise utilization of electronic basal-bolus order sets increased from a baseline of 20% for patients receiving insulin to 86% within 6 weeks ( P < .01) of introduction of order sets. During the study, the incidence of hypoglycemia and hyperglycemia declined from 1.47% to 1.27% and from 23.21% to 17.80%, respectively. However, these improvements were not sustained beyond the completion of the education campaign. Conclusions: Education of diabetes health care providers was provided in a large, multihospital system through the use of online learning modules. Adoption of standardized insulin order sets was associated with an improvement in glucometrics. This educational and quality initiative resulted in overall improvements in insulin knowledge, adherence to recommended order sets, inpatient glucometrics, and patient length of stay. These improvements were not sustained, reinforcing the need for repeated educational interventions for those involved in providing inpatient diabetes care.

Stress ulcer prophylaxis (SUP) with acid suppressive therapy is often inappropriately prescribed in the intensive care setting. Acid suppressive therapy, including proton pump inhibitors and histamine-2 receptor antagonists, has been associated with adverse effects, including increased risk of nosocomial infections. Reduction in the rate of inappropriate use of SUP may mitigate the risk of medication adverse effects and unnecessary health care costs. Our interdisciplinary team executed a bundled quality improvement initiative to reduce inappropriate use of SUP in the ICU, which included ( a) developing evidence-based clinical practice guidelines for use of SUP, ( b) implementing these clinical guidelines with an education intervention targeting ICU health care providers, and ( c) determining provider attitudes regarding SUP use before and after implementation of the bundled initiative. Within 1 month following implementation, inappropriate SUP (per patient hospital day) decreased from 19% to 6.6% ( P = .002). Our multidisciplinary bundled quality improvement initiative reduced inappropriate use of SUP. The program was successfully integrated into the pharmacists’ workflow, thus yielding a sustainable impact on SUP use.

Rationale Many stroke patients and their partners report long-term negative consequences of stroke on their health-related quality of life. Adequate self-management abilities may help manage the consequences of the stroke, but it is unknown what specific intervention might be effective to enhance self-management abilities of stroke patients and their partners. Aim The study aims to investigate the effectiveness of a 10-week group self-management intervention addressing proactive coping strategies compared with a group education intervention in stroke patients and their partners. Design The study is a multicenter randomized controlled trial. A total of 106 stroke patients with, if applicable, their partners are randomly assigned to the self-management intervention or the education intervention within each of the 10 participating hospitals and rehabilitation centers. The main inclusion criteria are a symptomatic stroke at least six-weeks ago, living at home, and reporting at least two participation restrictions on the Utrecht Scale for Evaluation of Rehabilitation-Participation's restriction scale. Measurements are performed at baseline, immediately after intervention, three-months, and nine-months postintervention. Study outcomes Primary outcome measures are stroke patients' and partners' proactive coping competencies (Proactive Competence Inventory) and societal participation (Utrecht Scale for Evaluation of Rehabilitation-Participation's restriction scale). Discussion If effective, the results of this study will enable stroke patients and their partners to deal better with the lasting consequences of stroke. In the context of the growing number of people returning home after stroke, a large number of people may profit from this intervention.

Background Early diagnosis of dementia within primary care is important to allow access to support. However, dementia remains under-detected in general practice. Aim This work aimed to develop and evaluate an educational intervention for primary care promoting person-centred responses to people experiencing cognitive decline. Method A prototype educational intervention was pilot tested and refined; the final version of the educational intervention was then evaluated in four volunteer practices. A questionnaire was administered pre- and post-training to 94 practice staff to assess knowledge and attitudes to dementia. The responses of general practitioners (who make diagnostic, referral and treatment decisions) were compared with those from other staff who do not have such roles. Findings Post-training, there were statistically significant improvements in understanding of person-centred care for people with dementia; attitudes to early diagnosis; awareness of non-cognitive dementia symptoms; and awareness of the role that non-clinical staff may have in recognising dementia. Conclusions A dementia education intervention for primary care which fosters person-centred attitudes can involve all members of a primary care team. Further research is needed to ascertain if improvements in knowledge and attitudes translate into improved practice.

A heterosexual male reflects on his complex personal/intellectual journey as an investigator on a sexual assault resistance education intervention that trains women to resist sexual assault. Along the way, the author has confronted and worked through criticisms of the sexual assault resistance education program, his view of the everyday social world has changed radically and, perhaps most surprising, he has dealt with his own hurt feelings. Ultimately, his experiences have further strengthened his already strong commitment to stopping rape.

Patients with heart failure (HF) who have been discharged from a home care agency are a particularly vulnerable group at risk for poor outcomes and high rehositalization rates. The primary aim of this experimental study was to determine the efficacy of a telemonitoring and self-care education intervention in reducing hospitalization and improving quality of life and patient’s knowledge of HF after home care discharge. Ninety-three participants completed the study. The primary outcome of 90-day post–home care discharge hospitalization was significantly reduced in the intervention group compared to controls (9 vs. 18, p - .046). HF knowledge ( p = .013) and QOL ( p = .004) were significantly increased in intervention group patients in comparison to control group patients’ at the study endpoint.

Purpose The purpose of this pilot study was to assess the effectiveness, feasibility, and acceptability of a short-duration, culturally tailored, community-based diabetes self- management program (CTCDSP) for Korean immigrants with type 2 diabetes delivered at a non-clinic-affiliated community center. Methods Forty-one Korean adults with type 2 diabetes participated in a 2-session CTCDSP delivered by a bilingual nurse practitioner at a Korean community center. Outcome measures included biological, behavioral, and general health well-being; diabetes knowledge; and self-efficacy assessed at baseline, post-education, and 3-month follow-up. Repeated-measures analyses of variance were used to explore mean differences in outcomes across the 3 assessment points. Results From baseline to 3-month follow-up assessment, participants exhibited significant improvement on several physiological and behavioral measures. Mean levels of hemoglobin A1c and waist circumference decreased, whereas high-density lipoprotein levels increased. Additionally, participants reported an increase in weekly feet checks, and there was a trend increase in participants’ reported frequency of exercise activities. The feasibility of the CTCDSP was established, and participant satisfaction with the program was high. Conclusions A short-duration CTCDSP may be an effective, feasible, and favorably received approach to improving diabetes outcomes in Korean and potentially other underserved ethnic minority immigrants who have limited access to mainstream clinic-based diabetes self-management programs.

Many transplant candidates have concerns about living donation.To determine whether a structured educational session increased eligible kidney transplant candidates' pursuit of living donation.Eligible transplant candidates were randomized to standard of care (n = 50) or to the educational intervention (n = 50), which included both written materials and a 2-hour education session. The primary outcome was having a living donor contact the transplant program to express interest in donation for a patient, and a secondary outcome was the candidates' preference for treatment of end-stage renal disease; both outcomes were determined at 3 months after enrollment.Of the 100 patients randomized, 4 in the intervention group and 2 in the standard of care group had a living donor contact the program (P = .45). Within-group changes in treatment preference from baseline were seen in the education intervention group (P = .02), but not in the standard of care group (P = .37).This educational intervention did not increase the likelihood of a potential donor contacting the transplant program, compared with standard care. However, patients who received the educational intervention were more likely to change their treatment preference to living donation at study completion. Research investigating other methods of increasing living transplant rates is urgently required.

Background: Hypertension is the leading cause of mortality among Guyanese between the ages of 45 and 64 years and is inversely related to wealth and education. This pilot study aims to determine 1) the feasibility of a pharmacy-based clinic, 2) the prevalence of elevated blood pressure and 3) the outcome of follow-up of those with elevated blood pressure. Methods: Participants were recruited based on a convenience sample. Adults with or without a previous diagnosis of hypertension were included. Screening, education and patient counselling were provided. Participants with elevated blood pressure readings were contacted 1 month after the initial visit for a follow-up. Results: Twenty-two subjects between the ages of 27 and 78 years participated: 32% (7 of 22) were found to have elevated blood pressure readings, and 71% (5 of 7) of those with high blood pressure readings visited a physician within 1 month of the screening. Of those prescribed antihypertensive medications, 71% (5 of 7) reported low adherence to their medication. Conclusion: The methods developed in this study advanced knowledge on the effective management of hypertension in a developing country. One-third of participants were found to have elevated blood pressure. Among those with elevated blood pressure, most followed up with a physician and were diagnosed with hypertension. Pharmacists and pharmacies can play a pivotal role in providing education and improving drug therapy adherence. The need for pharmacy interventions is heightened in areas where access to physicians is scarce. This pilot study illustrates that a pharmacy-based screening and education intervention is indeed feasible.

There is an expectation that all occupational therapists will be evidence-based practitioners. This paper reports on an education intervention that has helped therapists working in clinical practice to respond to the challenges posed by evidence-based practice. The intervention was developed for a group of clinicians who had already undertaken an evidence-based practice course. The aim was to enable them to apply evidence-based practice skills to their practice settings. The intervention, which used the problem of evidence-tinged practice as a focus, is described and the ten commandments generated by the clinicians involved are presented for others as a potentially useful tool.

Purpose: This study was to explore the effect of preventive health education intervention in the knowledge, attitude, practice of betel nut chewing, and self-efficacy of anti-betel nut chewing for adolescent students. Methods One hundred eighty-six indigenous samples were recruited, and divided into experimental and control groups. The experimental group underwent fourteen-week classes regarding the prevention of betel nut chewing. Both groups took post-tests immediately after intervention in order to evaluate the instant effect of the teaching program. The follow-up (post-post-test) evaluated the instant improvement at the 28th week (14 weeks after the end of the class). Results There was no difference in knowledge of the hazards of betel nut chewing among pre-tests, post-tests, and post-post-test in the experimental group. The attitude, practice of betel nut chewing and self-efficacy of anti-betel nut chewing aspects was significantly different among pre-tests, post-tests, and post-post-test after intervention. There was a significantly immediate and instant improvement after health education intervention. Conclusion Health education enables students to better resist the use of betel nuts. This study confirmed the importance of health education programs in dealing with the health risks of betel nut chewing for the risk group Students.

Hand hygiene adherence needs to be increased and sustained in order to prevent and reduce healthcare associated infections. We implemented an educational intervention and observed the adherence of healthcare workers, patients and visitors over 24 hour periods at four observation points. For healthcare workers a total of 2,294 opportunities were observed and for patients and visitors, a total of 597 opportunities were observed. Healthcare worker adherence increased following the introduction of the educational intervention, with 53.0% (282/532) adherence at baseline (observation point 1), and was sustained varying between 67.7% and 70.8% in the post-intervention points ( p=0.0007). The greatest increase in adherence was observed between baseline and the observation point 2. Adherence varied according to type of opportunity ( p

Objectives: Support for goal-setting and attainment is a frequent component of social work interventions aimed at fostering client growth. This study investigated goal-setting and attainment in the Michigan Supported Education Research Project, an intervention that provides support for adults with psychiatric disabilities to engage in postsecondary education. Method: An experimental design with three conditions was used and data was collected at five time points. The sample included 397 adults. Results: Results indicate increased complexity of goal statements over time. Goals became more specific for those in the treatment conditions and for those who were high participants. Multivariate models found that selecting school as the most important goal was a significant factor in predicting later enrollment. Conclusions: Interventions can influence the goals that are set by individuals. Because of its importance to social work practice, researchers and practitioners should pay more explicit attention to goal-setting.

BASED on previous work from the USA, a five lesson smoking education plan was developed and used with Secondary 1 pupils (aged 12-13 years) in three schools. A survey by anonymous questionnaire six months after the intervention showed that, among pre-test non-smokers, 27 claimed to be smokers (7.3%) in the intervention schools compared with 11 (16.7%) in a control school (p