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International audience; We present the evolution of patient-centered care (PCC) and shared decision-making (SDM) in France since 2017, highlighting advantages and drawbacks of their implementation at the macro level. We then focus on several key policy and legislative milestones that are aimed to develop PCC and SDM. These milestones underline the importance of patient movements to support and fund the development of research and practice in the field. We shall conclude by presenting the growing research agenda and selected key topics. These key topics notably include the increase in both patient and healthcare professional trainings on PCC and SDM provided by healthcare users' and patients' representatives. PCC and SDM continue to be central preoccupations at the macro level, supported by public health policies and patients/healthcare users' actions. This overview, however, suggests that although implementation initiatives have increased since 2017, implementation remains scarce in routine clinical practice. Funding, not only for research projects, but for the implementation of PCC and SDM in real-life settings (e-decision aids, clinical guidelines integrating PCC/SDM, human resources dedicated to PCC/SDM, etc.) are needed to promote sustained adoption. More systematic training for both healthcare professionals and patients is also warranted for a true acculturation to occur.

Objective: Spacer and metered-dose inhaler use is widespread especially among pediatric population. In children, training in medication use is provided both for the family and the child. The aim of the present study was to investigate whether this training is well comprehended and which training method is more effective to achieve that goal. Methods: This study included patients presenting to our outpatient clinic who were in need of spacer and metered-dose inhaler use. The study subjects had an age range of 2-16 years. The patients were randomized into two groups. The first group was trained on metered-dose inhaler use by video demonstration. The second group was trained by applied verbal training. They asked to use spacer and metered-dose inhaler, and they were rated from 0 to 6, as in previous studies. Errors and deficiencies of use were re-explained. They were informed about their scores and were told that they would be rated again in the next follow-up appointment. They were asked again to use spacer and metered-dose inhaler and rated between 0 and 6 at the second-month control visit. Results: The intra-group analysis of the video group showed a significant difference between the first-month and second-month total scores (p

Objective: to evaluate the effectiveness of an educational program for teaching self-control skills for patients with rheumatoid arthritis (RA).Subjects and methods. Examinations were made in 85 patients: 38 of them underwent a training program for mastering self-control skills; 47 patients constituted a control group. The serum levels of rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide (anti-CCP) antibodies and DAS28 were determined at baseline and after 2 months.Results and discussion. After training in self-control skills, the study group showed a significant reduction of DAS28 on an average from 5.2±4.9 to 3.2±3.0 and in the number of tender and swollen joints, erythrocyte sedimentation rate (ESR), and the levels of CRP, RF, and anti-CCP antibodies. At the same time, the level of hemoglobin, the number of red and white blood cells did not change substantially. There was a decrease in ESR and CRP levels in the control group.Conclusion. Teaching the patients in self-control methods can reduce the activity of the inflammatory process.

Background Patients undergoing coronary artery bypass graft surgery (CABGS) may fail to adhere to their treatment regimen for many reasons. Among these, one of the most important reasons for nonadherence is the inadequate training of such patients or training using inappropriate methods. Objective This study aimed to compare the effect of gamification and teach-back training methods on adherence to a therapeutic regimen in patients after CABGS. Methods This randomized clinical trial was conducted on 123 patients undergoing CABGS in Tehran, Iran, in 2019. Training was provided to the teach-back group individually. In the gamification group, an app developed for the purpose was installed on each patient’s smartphone, with training given via this device. The control group received usual care, or routine training. Adherence to the therapeutic regimen was assessed using a questionnaire on adherence to a therapeutic regimen (physical activity and dietary regimen) and an adherence scale as a pretest and a 1-month posttest. Results One-way analysis of variance (ANOVA) for comparing the mean scores of teach-back and gamification training methods showed that the mean normalized scores for the dietary regimen (P Conclusions Based on the results of this study, the use of teach-back and gamification training approaches may be suggested for patients after CABGS to facilitate adherence to the therapeutic regimen. Trial Registration Iranian Registry of Clinical Trials IRCT20111203008286N8; https://en.irct.ir/trial/41507

BACKGROUND: Simulation has been associated with positive educational benefits in the training of healthcare professionals. It is unknown whether the use of simulation to supplement patient training for home hemodialysis (HHD) will assist in improving a patient's transition to home. We aim to assess the impact of simulation training on home visits, retraining and technique failure. METHODS: Since February 2013, patients training for HHD are required to dialyze independently in a dedicated training room (innovation room) which simulates a patient's home prior to graduation from the program. We performed a single-center retrospective, observational, cohort study comparing patients who completed training using the innovation room (n = 28) versus historical control (n = 21). The outcome measures were number of home visits, retraining visits and technique failure. RESULTS: Groups were matched for age, gender, race, body mass index and comorbidities. Compared with controls, significantly more cases had a permanent vascular access at the commencement of training (57.1 versus 28.6%, χ(2) P = 0.04). Cases spent a median of 2 days [IQR (1.75)] in the innovation room. Training duration was not statistically different between groups {cases: median 10.0 weeks [IQR (6.0)] versus controls: 11.0 [IQR (4.0)]}. Compared with controls, cases showed a trend towards needing less home visits with no difference in the number of re-training session or technique failure. CONCLUSIONS: Simulation-based teaching in NHHD training is associated with a trend to a reduction in the number of home visits but had no effect on the number of re-training sessions or proportion of patients with technique failure.

Background: The thought of having a surgery can be stressful for everyone. Providing the necessary information to the patient can help both the patient and the treatment team. This study was conducted to compare the effectiveness of face-to-face verbal training and educational pamphlets on the readiness of patients for undergoing non-emergency surgeries. Materials and Methods: The study was a before–after randomized clinical trial. 90 patients scheduled to undergo non-emergency surgery who referred to Shahrekord Ayatollah Kashani Hospital in 2013 were distributed randomly and gradually into two experimental groups (group of face-to-face verbal training and group of educational pamphlet) and one control group. Dependent variable of the study was pre-surgery readiness. Data analysis was carried out by using SPSS statistical software. Statistical analysis were analysis of variance (ANOVA) and correlation test. Results: Results showed that the mean scores of pre-surgery readiness in both interventional groups were significantly higher than that in the control group after the intervention (P < 0.05). However, there was no significant difference between the two experimental groups (P > 0.05). Conclusions: Each of the methods of face-to-face verbal education and using the pamphlet could be equally effective in improving the readiness of the patients undergoing surgery. Therefore, in environments where the health care providers are facing with the pressure of work and lack of sufficient time for face-to-face verbal training, suitable educational pamphlets can be used to provide the necessary information to patients and prepare them for surgery.