آموزش بیمار

Patient education through portals plays a vital role in improving health outcomes of patients. Therefore, this systematic review aimed to investigate the effects of using patient portals on patient education.

This systematic review was conducted by searching keywords in the title, abstract, and keywords of the studies indexed in scientific databases including Embase, Web of Science, Scopus, and PubMed on March 4, 2024, without any time limitations. The method of data analysis was qualitative.  Data was extracted and the synthesized and results were presented qualitatively.

Eleven studies were finally included. The educational interventions focused on four aspects: self-management, self-care, knowledge improvement, and disease management. Educational approaches were classified into seven categories including text messages, video messages, image messages, e-mail, frequently asked questions, links to educational resources, and YouTube videos. Text messaging was the most common educational approach for delivering educational content through portals. Most (Four) studies dealt with the design of portals for cardiovascular diseases which indicated the effective role of portals for educating this group of patients.

This review showed that educational interventions through patient portals could improve the quality of life related to health, improve knowledge, and facilitate communication with healthcare providers by providing patient self-care recommendations.

The increasing incidence of chronic kidney disease around the world highlights the need for more attention and appropriate actions to enhance therapeutic outcomes and improve patients’ quality of life. This study aimed to evaluate the efficacy of a program to promote medication adherence among hemodialysis patients using the Capability, Opportunity, and Motivation-Behavior (COM-B) model.

The present study was a quasi-experimental interventional study conducted on 140 chronic kidney patients referred to the Dialysis ward of Imam Reza Hospital (Kermanshah, Iran) divided into two groups of 70 patients as intervention and control during 2021. The program was developed by conducting a needs assessment based on the COM-B model and evaluating it in two stages, before and three months after the implementation. Data were collected by a questionnaire based on the COM-B model and analyzed using the SPSS software (version 16).

After the implementation of the program, the components of capability and medication adherence behavior had a significantly higher average rank in the intervention group. The effect sizes of the intervention components, including capability, opportunity, motivation, and medication adherence behavior, were calculated to be 0.69, 0.19, 0.23, and 0.43, respectively.

Considering the effect sizes of each component, especially behavior, it seems that the developed program based on the COM-B model has enough efficiency and that the employed model is effective for developing programs to promote medication adherence.

Since patient education is a sustainable strategy to reduce health risks and increase patients' quality of life, identifying the factors influencing this process will be helpful. The aim of this study was to determine the factors that inhibit and facilitate patient education from the viewpoint of nurses in charge of education.

In this cross-sectional descriptive study was done on 36 nurses who were responsible for Patients education of shahid mohammadi hospital in 2019. Researcher-made questionnaire including demographic characteristics, facilitators and inhibitors. Scientific validity was determined through content validation method. To determine the scientific reliability of the instrument, re-test was used, which had a correlation coefficient of 93%. The questions were adjusted with a three-point Likert scale and the data were analyzed using SPSS 21 software and descriptive statistical tests.

The most important facilitators were special points for patient education for nurses (75%), allocation of special time for patient education (66.7%), patient participation in planning and implementation of education (63.9%) respectively. The most important restrictions included lack of knowledge and skills to recognize the patient's learning needs (75%), lack of trainer time (75%), lack of physical and mental fitness of the patient (58.3%), inability to communicate properly with the patient and his family (56.35%). The least important facilitator was the presentation of seminars on the teaching strategies, and the least important deterrent was the "gender difference between the educator and the patient."

Considering the multiplicity of facilitators and inhibitors of patient education, considering the opinions of executives and Beneficiaries in designing the education process can be helpful.

Foot ulcer is one of the greatest complications of diabetes. If there is no effective pressure reduction in the ulcer, healing may be delayed. In this regard, the use of offloading methods for the prevention and treatment of foot ulcers in diabetic patients is known as a common therapeutic approach. Since evidence-based recommendations should be considered for the use of the above methods, we decided to provide applicable guidelines in this area by localizing the recommendations and localizing the IWGDF practical guide.

In this study, the adoption of the international evidence-based clinical guidelines on the offloading interventions to prevent and heal diabetic foot ulcers was carried out using the ADAPTE methodology  in  a working group consisting of orthopedic, physical medicine and rehabilitation specialists was performed during three stages of set up, adoption, and finalization. AGREEII tool was used to evaluate the quality of the selected clinical guidelines. Also, in order to reach a consensus for the relevant recommendations, three Delphi rounds and one face-to-face meeting were used.

The IWGDF 2015 clinical guide was selected. The quality score of this guideline based on AGREEII tool in each of the 6 areas was more than 70% and varied between 81.3% and 100% with good quality. The IWGDF guideline for offloading interventions for the prevention and treatment of diabetic foot ulcers included 13 recommendations.

In IWGDF guideline, a total of 13 recommendations regarding foot wear and offloading interventions in the prevention and treatment of foot ulcers in patients with diabetes in accordance with the health care system of our country were adapted.

Chronic diseases are among the most challenging health issues in the world. Although no definitive treatment has been found for such diseases, electronic health strategies can dramatically reduce their complications by enhancing patientschr('39') awareness and monitoring their treatment. The main objective of this study was to design an education-based follow-up system for cardiac patients based on mHealth.

This research was an applied-developmental one. To determine the data elements, a questionnaire was developed and needs assessment was conducted with the faculty members at University of Mazandaran and 2 health system specialists. The data were analyzed using descriptive statistics and after identifying the entities, the conceptual model of the system was designed and implemented based on the Unified Modeling Language (UML). The questionnaire was finally provided to 30 cardiac patients to assess its usability and user satisfaction. The data were analyzed using descriptive statistics with SPSS Software (version 16).

Some modifications were made to the system based on end users’ opinions and ultimately the system was developed with 7 parts including interaction with physician, remote visit, training, notification of medication intake, prescription, follow-up monitoring of patients, and communication with the emergency ward. The final evaluation of usability and user satisfaction showed that users rated the program with a mean score of 7.17 out of 9 at a good level.

Given that users evaluated the system as good, it can provide effective interaction between physician and patient and monitor patient care along with ongoing training to improve the treatment process.

This study aimed to examine the effects of preoperative preparation of patients and family caregivers on outcomes after coronary artery bypass graft surgery (CABG).

Preoperative preparation can improve patients’ experience of surgery and hospitalization. However, there is limited data about how preoperative preparation affects postoperative outcomes following CABG.

This non-randomized clinical trial was conducted on ninety pairs of patient/ caregiver in the time period from July to November 2018. The participants were purposively selected and non-randomly allocated to either control or experimental group. The intervention was performed one day after admission and the day before CABG in the form of an educational video, an intensive care unit tour, and an educational booklet. In both groups, on the third day after surgery, patients' delirium was assessed in the ICU and family caregivers were asked to complete a family satisfaction questionnaire. Patients and their family caregivers in both groups completed a hospital anxiety and depression questionnaire (HADS) on the first and seventh days after surgery and before discharge. Data were analyzed in SPSS version 16.0 using descriptive and inferential statistics. 

After intervention, the mean score of patients’ anxiety and depression in the intervention group was significantly less than the control group (P=0.03). After intervention, the mean score of anxiety and depression among family caregivers in the control and experimental groups were not significantly different (P=0.11). Family caregivers’ satisfaction of experimental group was significantly higher than the control group in both healthcare providers’ performance dimension (P=0.01) and comfort dimension (P=0.027). Moreover, the groups did not significantly differ from each other regarding delirium incidence (P=0.6) and length of stay in the intensive care unit (P=0.21).

Considering that the preparation of the patient and family caregiver on the day before CABG can reduce patients' anxiety and depression and increase the satisfaction of the family caregiver, it is recommended to use this intervention for patients and family caregivers before CABG.

Colonoscopy is the most important diagnostic and therapeutic method for colorectal diseases. Patients' satisfaction with such aggressive procedures is an important criterion for assessing the quality of health care. The purpose of this study was to determine the effect of compilation education through video tutorials and visual aids on satisfaction in patients undergoing colonoscopy.

This quasi-experimental study was performed on 180 outpatient colonoscopy candidates referred to Imam Khomeini Hospital in Urmia in 2018. The participants were selected by convenience sampling method and they were randomly assigned to control and intervention groups. Training videos and educational charts on colonoscopy before colonoscopy and on colonoscopy day were screened for the candidates of the colonoscopy, and the additional information and patient questions were provided. Patients' satisfaction after intervention was assessed by GHAA-9 questionnaire. SPSS software version 16 was utilized and descriptive and inferential methods were used for data analysis.

The mean score of satisfaction was 46.07 ± 5.03 in the intervention group and 24.72 ± 7.94 in the control group. The independent t-test results showed that there was a significant difference between the two groups after the intervention (p <0.0001).

The combination of education through educational videos and video cards significantly increased patient satisfaction, therefore the colonoscopy unit staff are recommended to improve the quality of care and patient satisfaction by using such methods.

Patient education is one of the main standards of quality of nursing care. Educational programs play a pivotal role in enhancing the knowledge of nursing students in this regard. The present study aimed to assess the effect of role-play training on the knowledge of nursing students regarding patient education. This quasi-experimental study was conducted on 74 nursing students at Iran University of Medical Sciences in Tehran, Iran. The participants were selected via census sampling and randomly divided into the experimental and control groups. Patient education contents were introduced in the control group based on routine university methods, while in the experimental group, the intervention was performed based on role-playing. The knowledge of students regarding patient education was evaluated using a researcher-made knowledge measurement questionnaire in the experimental and control groups. The results indicated that role-play training improved the knowledge of the students regarding patient education. Moreover, the mean score of the knowledge of the students in the experimental group (63.85%) was higher compared to the control group (46.41%), and the difference in this regard was considered statistically significant (P<0.001). According to the results, role-play training could influence the knowledge of nursing students regarding patient education. Therefore, it is recommended that role-playing be used in more than one semester using other active teaching methods in student educational programs.

Educating health to patients is a patient-centered process based on needs expressed by both the physician and the patient in order to make a collaborative and conscious decision over the disease. Surveying and analyzing the research fields in this area and discovering the relationships between the expressions used in this paper can provide researchers and scholars with useful information. Therefore, this paper aims at analyzing the article contents related to the area of health education for the patients through thematic mapping and hierarchical clustering methods. The current research is of descriptive-analytical type and has dealt with analyzing texts’ contents with a hierarchical clustering approach. Searching the phrase “Health Education” and filtering the search with “Patient Education” as well as the “Major Topics” helped us extract the entire data on PubMed database (1964 to 2014). Analysis and clustering of data were done using software such as SPSS20 and Ravar PreMap. Findings: Producing scientific articles on health education for the patients has showed an increasing trend. Regarding the hierarchical clustering, noted thematic areas included health education, drug consumption pathology, nurses, communication skills, health promotional behaviors, adaptability and mental health, health literacy, and preventive behaviors. The thematic clusters formed have structural relationships as they exploit similarity measurement method and the distance between descriptors. The majority of researchers noticed psychological and therapeutic aspects in health education area.

Patient education is one of the most important factors for the provision of patients and their familie's rights at health centers. Some of the benefits of patient education include: Increasing the level of health literacy, developing self-care skills in chronic diseases, increasing knowledge about conditions, improving the quality of care and helping the patient to achieve more self-sufficiency and reducing health care costs. Medical Librarians can help health professionals and nurses to promote community health by identifying useful information as well as writing them in plain language. This paper reports an experience about creating a nongovernmental center for the provision and dissemination of easy-to-read materials. It is hoped that launching and supporting such centers, in addition to promoting community health, will guarantee the patient's rights to access high quality and authentic health educational resources. This can also provide a field for the participation of various health groups and the activities of graduates of the above fields.

Patient education is one of the important aspects of nursing care and key roles of nurses. In this context, recognizing its barriers can greatly influence on the process of improving the quality of patient education. The aim of this study was to investigate the barriers to patient education from the viewpoint of nurses in Iran.
Material & In this review study, research articles related to barriers of patient education from the viewpoint of nurses were searched in Persian and English languages and without time limitation in these databases: PubMed, ISI, ERIC, Science Direct, Scopus, Proquest, Google Scholar, MagIran, SID, IranDoc and IranMedex. Doing research in Iran was the main inclusion criterion. After evaluating entry criteria and quality of the articles, 24 articles were analyzed.
A wide range of barriers were presented in studies. After the categorization, five main areas were identified: 1) Barriers related to nurses: Lack of time due to workload of nursing staffing; 2) Barriers related to patients: the patient's unfavorable physical and psychic status; 3) Management barriers: lack of manager's support; 4) Organizational obstacles: the inappropriateness of nurse-patients ratio; 5) Environmental barriers: lack of cooperation of the medical team members to implement educational programs.
Most of the barriers to patient education are those of related to nurses. To improve the status of patient education, it is essential for managers to encourage nurses in this important task by adopting measures such as increasing in nursing staffing, allocating sufficient funds and proper supervision.

One of the major needs of patients is receiving clear and sufficient information and the first step for nurses in undertaking this task is establishing an educational relationship with patients. Improving communication with patient causes empowerment in obtaining information and identifying patient’s problems by using engagement and active listening, and as a result identifying the problems more accurately. The current study is conducted with the goal of examining the barriers to educating and establishing relationship with patient from the point of view of nurses in the hospitals of Jiroft city in the year 2015.
In this descriptive analysis study, 200 employed nurses in the hospitals of.... City was selected by census. The information gathering tools in this research has been the assessment questionnaire of barriers to educating and establishing communication. The data has been analyzed by using version 16 of SPSS software and Descriptive Statistical Test (Abundance Distribution, Mean, and Standard Deviation) and inferential statistics (Independent t-test, ANOVA, Pearson product-moment correlation coefficient).
The results showed that job features, with the mean and standard deviation of 3.896± 0.628, was identified as the most important factor in the communication barriers with patient. Also from the aspect of educational barriers, environment factors with the mean of 4.036±0.543 were identified as the most important factor. Although by increasing educational barriers the relationship barrier has also increased, however a meaningful relationship between the two groups of educational barriers and communicational barriers was not observed.
considering the results it seems that job features comparing to other barriers are of the most important environment barriers, and it is of the major challenges in establishing educational relationship. Therefore, the clinical managers and planners can facilitate the necessary conditions for patient education by increasing the participation of nurses, make an effort to attract more partnership with nurses and facilitate the required conditions for educating the patients.

Use of media education has been noted to control the problems of patients with chronic diseases by health professional staffs in recent decades. This study aimed to determine the effect of the movie- based education on sleep quality in patients with bronchial asthma.
This randomized clinical trial was conducted on patients with bronchial asthma referred to a clinical office in Borojen city, Iran. Fifty one eligible patients were conventionally selected but were randomly allocated to either the intervention group or the control group using block randomization. One patient in control group was excluded because of hospitalization. Education about sleep was provided for intervention group through showing a 15 minutes film which could be simply read by computer, DVD player and cell phone. In addition to demographic information, patient's sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Data were collected one week before and one month after intervention. Collected data were analyzed through statistical software of SPSS, version 21, using central tendency and dispersion indices as well as statistical testes including Chi square test, independent sample test, Fisher exact test, Mann-Whitney U and Wilcoxon test that P The results showed no statistically significant differences in the total quality of sleep and its dimensions in the test and control groups before the intervention (p>0.05). There was observed a significant difference by the total score of sleep quality and dimensions of subjective sleep quality, sleep disturbances and sleep latency in both groups post intervention (p=0.001). There was, however, observed no statistically significant differences in the scores of dimensions such as sleep duration, sleep efficiency, use of sleep medication and day time dysfunction between the test and control groups after intervention(p>0.05).
The movie-based education could improve the quality of sleep in patients with bronchial asthma. The further studies were suggested to examine its effectiveness in patients with other chronic diseases due to the ease of its implementation. If the results of this study would confirm, this method may be considered as a way to teach the patient to self-care at home

The development of nursing curriculum to develop the skills and the professional tasks by using the proper training is necessary for planning. Learning based on nursing models and theories is an original strategy in nursing education. This study aimed to clarify participant's experiences about patient education curriculum.
This study was part of a qualitative study using Glasser grounded theory approach in 2014. To explore experiences and understanding of nursing students, lecturers, and clinical tutors, in-depth and semi-structural interviews about patient education was used to gather the data. Data analysis conducted simultaneously by data gathering. The extracted codes were categorized into three main themes with several subthemes.
Three main themes were extracted including ‘the role of professional patient education’, ‘application of nursing theory in clinical practice’, and ‘integrated curriculum course’.
This study recommends the application of Orem nursing model for managing and organizing the patient education curriculum. This may be an applicable guidance for developing nursing curriculum.

Currently, patient education has been considered in medical centers. Clinical provision, which is one of the legal tools with training-support dimensions, can evaluate the consistency between the implemented procedures and the planned ones. This study aimed to evaluate the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision.
This longitudinal, embedded study was conducted during 2013-2015 in three stages of designing, implementation, and evaluation of the supervision program using randomized convenience sampling on 786 monitoring units (medical records of patients being discharged) at Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. In the designing stage, the checklists for supervision of recording patient education and consistency of patient perception with the recorded trainings and the patient satisfaction questionnaire were designed and their valididty and reliability were established. In the implementation stage, structure of the monitoring program was designed with the cooperation of eight supervisors. During 12 months, 2333 checklists and questionnaires were completed at the time of hospital discharge in the evaluation stage. Data analysis was performed in SPSS, version 18, using One-way ANOVA.
After 12 months of embedded evaluation, the mean score of recording patient education was 88.5±21.75, and the mean scores of patient satisfaction with the training process and consistency between patients’ perception and the recorded trainings were 47.17±21.48 and 73±25.13, respectively. The mean scores of recording patient training and consistency between patients’ perception and the recorded trainings had an increasing trend (P The results of clinical supervision during the study were indicative of gradual improvement in recording training programs and patient perception, while patient satisfaction was decreased. Therefore, implementation and evaluation of patient training programs in healthcare centers is recommended.

Patient education is one of the important aspects of nursing care and is among nursing key roles in delivery of health services.
This study aimed to determine the barriers to patient education from nurse's viewpoint employed in educational hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd.
This study was a cross-sectional and descriptiveanalytical study in which 162 nursing personnel were selected by stratified-random sampling method. In order to perform the sampling according to the population of each hospital, the numbers of samples were determined. Data were collected with a two-part questionnaire. First part contained personal and demographic information such as age, sex, marital status, education and working experience. The second part included 19 questions on patient education barriers which evaluated four domains of working conditions, management, nursing attitude and training skills. The data were analyzed by descriptive statistics and chi-square statistical test. Answers were designed based on a Likert scale from low to average and high impact with scores of 1-3, respectively. In management domain, the scores ranged from 6 to 18. Scores less than 10 showed "low impact", 10 to 14 "average impact" and more than 14 "high impact". In the domain of ​​working conditions, similar scores were obtained. The findings displayed that nurse's attitude ranged from 2 to 6 scores. Scores less than 3 showed "low impact", 3-4.5 "average impact" and more than 4.5 "high impact". In domain of training skills, scores ranged from 5 to 15. Scores less than 8 indicated "low impact", 8 to 11.5 "average impact" and more than 11.5 "high impact". The data were analyzed with descriptive statistics and chi-square. The study was approved by the Ethics Committee of Health Faculty, Shahid Sadoughi University of Medical Sciences in Yazd.
In this study, 149 of the 162 questionnaires were answered indicating92% response rate. The data showed that 45.2% of male nurses and 47.3% of female nurses blamed working condition barriers with highest impact on the implementation of patient education. Moreover, 45.8% of single and 47.5% of married nurses had the same opinion. Chi-square test found no significant relationship between the variables of age, sex, working experience, employment status, marital status, and educational level with patient education barriers (P≥0.05).
The data showed that 31.5% of nurses believed that barriers related to management had the greatest impact on the implementation of patient education followed by 47.7% barriers to working condition, 2.7% attitude of nurses and 14.1% training skills. Chi-square test showed a significant correlation between the domains of working condition and type of hospital (P=0.048). Working condition was proved as the most important factor. Management was the second factor followed by training skills as the third. Finally, ​​attitude of nurses was identified as the least important patient education barrier.
The results of the present study revealed three factors with highest impact as education barriers in nurse's opinion; high working load (74.5%), insufficient nursing stuff in wards (71.8%) and nursing shifts in a row (70.4%) in working condition domain. The study population reported three factors with lowest impact; training as a specific task assigned for doctors (54.4%), lack of nurses ‘self-confidence for training (43.5%) and not delivering the trainings to patients (40.3%).
In attention to that the domain of nurses working conditions had the greatest impact on the education of the patients, it is recommended that official authorities to maintain nursing resource in hospitals and reduce their workload and provide facilities and conditions for educational programs to encourage nurses to consider this important issue.

Hemodialysis patients require effective education to improve their quality of life. Flexible educational strategy via internet (computer) is essential
The aim of this study was to compare the effects of multimedia based education and traditional methods on life quality of hemodialysis patients
In this quasi- experimental study, all of the patients (n=62) who referred to four hemodialysis centers in Tabriz City from May to Sept 2013 were divided randomly in tow groups, intervention and control. Quality of short life questionnaire (Sf-36) were completed before and three months after the educational program. The intervention group navigated their way through the Research Development Hemodialysis and Essentials Care Application using laptop during their hemodialysis. The control group received the same content in the traditional way (face to face education & pamphlet). Data were analyzed by conducting the independent- and the paired samples t, the Chi-square, and ANOVA tests
There were no statistically significant difference between the study groups in pre- and post-education life quality mean scores, but inter group comparison findings showed that all post-education quality of life scales mean scores had changed statistically in both the intervention and control groups except Apperception general health scale (p>0/05)
The Hemodialysis and Essentials Care application based education can improve patients’ life quality as well as traditional method. This application could be used to facilitate the patient education process to improve their life style