Project TitleA pilot scheme forpatient-centre education for CVDs : education for cardiac patients to enhance abetter understanding SummaryMy project is a pilot scheme for patient-centre education programme forpatients with Cardiovascular diseases in Bangkok Hospital. The overall goal ofthe project is to enhance a better understanding of cardiovascular-relatedknowledge and to increase patients’ adherence to self-management stronglyinfluencing the reduced risk of cardiovascular events and the increasedeffectiveness of medical treatment and the enhanced health-related quality oflife. It will do this by 20 patients with CVDs were enrolled into single-blindrandomized controlled trial. Patients randomly allocated to either theintervention group receiving the patients-centre education programme or thecontrolled group receiving the traditional patient education programme. The statisticsanalysis will be conducted to evaluate the effectiveness of patient-centreeducation programme. Background According to the World Health Statistics,Cardiovascular Diseases (CVDs) are the major cause of mortality in Thailand,leading to the economic loss of 280 billion in Thai Baht. Approximately 77% ofre-hospitalisations for CVDs were transferred to the emergency department and25 % of readmitted patients needed a critical care bed. Lack of patient education programmes for CVDs was considered as a significant factoraccounting for the high numbers ofreadmission CVDs patients (Laothavorn et al, 2010, Srisuk etal, 2014).
Patient education is an essential step to enhance apatient understanding of diseases, treatment and health-related lifestyleself-management (Alm-Roijer et al, 2006; Boyde et al, 2011; Brown et al, 2011;Ghisi et al, 2014; Kayaniyil et al, 2009). Further, health-related knowledgeand motivation correlate closely to the concept of self-management andadherence to recommended health regimens and prescribed medications(Bodenheimer, 2002; Campbell, 2016) potentially leading to a better healthmaintenance and thelow risk of subsequent Cardiovascular events and mortality in the long term.Additionally, the presence of carers and their support has been regarded as avital resource for patients with CVDs to manage their lifestyle. (Arestedt, 2013; Sacco, 2014; Srisuk et al, 2014) As consequence of having inadequate knowledge and lack of motivation,patients tend to be associated with health-compromisingbehaviours and to ignorehealth-promoting suggestion (Goossens et al, 2013) producing adetrimental effect on patients’ health and well-being.
However, patienteducation programme has not been developed to be systematic procedures.Informed in verbal and unstructured way, cardiac patients face a difficulty ofcomprehending and retaining medical knowledge (Goossens et al, 2013) Given that this research focuses on patientsexperiencing difficulties in education for CVDs, developing patient educationis vitally important for cardiac patients in order to promote healthy behaviours,nutritional eating plan, physical activities and cardiovascular-relatedself-management and reduce the risk of cardiovascular events. Statement ofproblemLack of patient education for Cardiovascular Diseasesin Thailand result in the inadequacy of health-related knowledge andself-management and the reduction of the effectiveness of health treatment. Main objectiveThe primary objective of the project is to develop andevaluate patient-centre education programme for CVDs implemented in heart centreof Bangkok Hospital in order for cardiac patients to consult and collaboratewith health providers to tailor intervention to suit their requirement therebypositively affecting adherence to self-tailored health-related intervention. Objective1. Establisha cooperation for the patient-centre education programme with healthcareproviders and patients in heart centre of Bangkok Hospital.2. Developappropriate health educational materials that satisfy patients’ expectation andfacilitate the comprehension and the retention of cardiovascular-relatedinformation 3.
Recruitpatients with CVDs and screen them and recruit healthcare providers to beeducators in a pilot scheme for patient-centre education programme for CVDs.4. Conducta single-blind randomized controlled trial for patients with CVDs 5. Evaluatethe effectiveness of patient-centre education programme.
Participants& rolesParticipants . Projectcoordinator : communicating with Heart Centre staff and Healthcare providers;with IT staff and healthcare providers; patients; allocating voluntaryparticipants randomly by using statistics tools; analyzing, evaluating andinterpreting data 2. Heart Centrestaff : granting approval; giving feedback and recommendation; facilitating tocomplete project in every aspect of the development process, 3. Healthcareproviders: granting approval; giving feedback and recommendation; providing,answering about cardiovascular-related information and healthy recommendation;educate both the intervention group and the controlled group, giving an advice,collaborate with individual patient and their family to tailor suitableintervention programme; conducting a follow-up process4. IT staff:creating and managing a website for health professionals and patients toquestion and answer about health-related information.5. Data collector: conducting a survey6. Patients in theintervention group : filling out a questionnaire, making a decision afterlistening all necessary information about the study and giving a sign consent,enrolling in trial; being educated about cardiovascular-related knowledge andself-management, consult about his/her current situation, problems,constraints, requirement and expectation and collaborate with healthcareproviders to tailor his/her own suitable intervention programme; receiving afollow-up process.
7.Patients in thecontrolled group : filling out a questionnaire, making a decision afterlistening all necessary information about the study and giving a sign consent,enrolling in trial; receiving a follow-up process. Project implementationplan Objective Action Description Rationale Participants & Roles 1. Establish a cooperation for the patient education programme with healthcare providers and patients in heart centre of Bangkok Hospital.
1.Devise a pilot scheme for developing and evaluating the patient-centre education programme 2. Approach to Heart Centre at Hospital 3. Have a conference with relevant healthcare providers to receive feedback and recommendation. 4. Revise the pilot scheme and re-propose to health professionals involved in this project in order to receive approval This plan is a collaborative effort involving a great number of stakeholders and have to be approved from healthcare providers in heart centre of Bangkok hospital, thus thorough preparation is required to be done in order to ensure that the pilot scheme is correct and complete in every detail. If rejected, the pilot scheme will be modified.
1.Project coordinator: communicating with Heart Centre staff and Healthcare providers; 2. Heart Centre staff: granting approval, giving feedback and recommendation, facilitating to complete project in every aspect of the development process, 3.
Healthcare providers: granting approval, giving feedback and recommendation. 2.Develop appropriate health educational materials that satisfy patients’ expectation and facilitate the comprehension and the retention of cardiovascular-related information 5.Create a website to be an online health community for patient questioning and healthcare providers answering about health-related information managed by IT staff 6.
Develop the content of patient information leaflet by integrating the actual patients’ problem and expectation into Cardiovascular-related knowledge by using patient survey relating to the problem and needs of patient with CVDs. This plan aims to facilitate learning retention and enhance a better understanding of health-related knowledge. Thus, health educational materials which directly influencing the learning process must be accessible and affordable to all patients. Additionally, the content has to suit their needs, clarify misleading information and readability. This action need to be achieved through collaborating with multidisciplinary teams such as IT development, the outsourcing of printing. It is important for project coordinator to be able to communicate effectively and correctly, otherwise the problem of misunderstanding will arise unintentionally.
1. Project coordinator: communication with IT staff and healthcare providers 2.Heart Centre staff: granting approval, facilitating to complete project in every aspect of the development process. 3.Healthcare providers: providing, answering about cardiovascular-related information and healthy recommendation.
4.IT staff: creating and managing a website for health professionals and patients to question and answer about health-related information. 5.data collector: conducting a survey 3. Recruit patients with CVDs and screen them, recruit healthcare providers to participate in trial of patient-centre education programme for CVDs. 7. Initiate the screening process by establish the criteria and create a questionnaire.
8. Recruit healthcare providers and train them to be thoroughly familiar with cardiovascular-related knowledge and self-management in aspect of patient-centre education 9. Recruit participants – patient have to complete a questionnaire. -The eligibility criteria: people who are diagnosed as CVDs. -people who meet the criteria. -if they do not meet the eligibility criteria, they will be excluded.
10. Prior to provide written informed consent, Participants will be factually and described the study (risks, benefits, procedure). This stage has to deal with clinical trial, thus the right of patient is carefully exercised. Patients must be thoroughly informed the study to make a decision by themselves. A questionnaire is applied to Healthcare providers play crucial role in this project; therefore, it is vital to ensure that recruited healthcare providers have specialist knowledge and ability to communicate and articulate effectively which positively affect patients to fully comprehend all given information. 1. Project coordinator: communicating with healthcare providers, patients and heart centre staff. 2.
Heart Centre staff: granting approval, facilitating to complete project in every aspect of the development process. 3.Patients: recruiting, filling out a questionnaire, making a decision after listening all necessary information about the study and giving a sign consent, enrolling in trial, 4. Conduct randomized controlled trial to evaluate the effectiveness of patient-centre education intervention 11.Allocate patients randomly either to the intervention group of to the controlled group. 12. In both intervention group and controlled group, Patients will be educated about cardiovascular-related knowledge, self-management as a traditional patient education programme.
13.Patient in intervention group and their family consult and collaborate with healthcare providers about their current situation, problems, constraints, needs, expectation in order to tailor their own intervention. 14.
Both patient in intervention group and controlled group can choose any types of educational materials for study. This step entails comprehensive patient-centre education to progress the plan. Patients, patients’ family and healthcare providers are needed to actively participate and engage in this programme. Patients’ family are invited to participate in consulting because family member is identified as a significant factor to be a social support that can increase motivation and improve health behaviours and eating plan. Moreover, family member is a caregiver at home, they need to know all necessary information, especially for emergency aid. 1.Project Coordinator: communicating with healthcare providers and patients, allocating voluntary participants randomly by using statistics tools. 2.
Healthcare providers: educate both the intervention group and the controlled group, giving an advice, collaborate with individual patient and their family to tailor suitable intervention programme. 3.Patients in the intervention group: being educated about cardiovascular-related knowledge and self-management, consult about his/her current situation, problems, constraints, requirement and expectation and collaborate with healthcare providers to tailor his/her own suitable intervention programme.
5. Evaluate the effectiveness of patient-centre education programme by 17.In order to reinforce, motivate, empower and check their understanding and current situation, patients in the intervention group will be educated and counselled by phone-call fortnightly for 2 months and monthly for 4 months later 18. Collect and analyse data Data will be collected and analysed in order to evaluate the effectiveness of patient-centre education programme by comparing between the intervention group and controlled group. 1.Project coordinator: communicating with healthcare providers, analyzing, evaluating and interpreting data 2.
Healthcare providers: conducting a follow-up process: asking for a checklist, counselling, motivating and educating by telephone. 3.Patients in the intervention group: receiving a follow-up process. Resource Type of resource Description Detail-time/amount Physical resource · Meeting room for having conference with healthcare providers · Room for group-activities · Computer for data analyse · Printing 1 1 1 1 ICT resource · Access to university internet 100 hours Project budget · Snack for group member $100 Constraints& RisksConstraints 1.
The possibilitythat health professionals and staff at Heart Centre in Bangkok Hospital do notapprove this project.To combat thisconstraint, after having a discussion and receiving feedback and recommendationfrom them, the modified project proposal will be proposed to healthprofessionals and staff at Heart Center in Bangkok Hospital. 2.The possibilitythat members of patients’ family are not available to have a consultation withpatients and healthcare providers To combat thisconstraint, members of patients’ family can select either receiving aconsultation through telephone and all necessary patient information beingmailed or making an appointment to have a face-to-face consultation inhospital. Risks1.
Some patientsare affected by uncontrolled factors.To mitigateagainst the risk, healthcare providers will note a Reference ListReferencesBauman, A., Fardy,H., & Harris, P. (2018). Getting it right: why bother withpatient-centred care?. Mja.com.
au. Retrieved 1 February 2018,fromhttps://www.mja.com.au/journal/2003/179/5/getting-it-right-why-bother-patient-centred-careCampbell, D.,Tonelli, M.
, Hemmelgarn, B., Mitchell, C., Tsuyuki, R., & Ivers, N. et al.(2018). Assessing outcomes of enhanced chronic disease care throughpatient education and a value-based formulary study (ACCESS)—study protocol fora 2×2 factorial randomized trial. Retrieved 1 February 2018, fromGhisi, G.
, Abdallah,F., Grace, S., Thomas, S., & Oh, P. (2018). A systematic review ofpatient education in cardiac patients: Do they increase knowledge and promotehealth behavior change?. Retrieved 1 February 2018, fromGoossens, E.
, VanDeyk, K., Zupancic, N., Budts, W., & Moons, P.
(2013). Effectiveness ofstructured patient education on the knowledge level of adolescents and adultswith congenital heart disease. European Journal Of CardiovascularNursing, 13(1), 63-70. http://dx.doi.org/10.
1177/1474515113479231Herbert, C. (2005).Changing the culture: Interprofessional education for collaborativepatient-centred practice in Canada. Journal Of Interprofessional Care, 19(sup1),1-4. http://dx.
doi.org/10.1080/13561820500081539Lynggaard, V.,Nielsen, C., Zwisler, A., Taylor, R.
, & May, O. (2018). The patienteducation — Learning and Coping Strategies — improves adherence in cardiacrehabilitation (LC-REHAB): A randomised controlled trial. Retrieved 1February 2018, fromSrisuk, N., Cameron,J., Ski, C.
, & Thompson, D. (2018). Trial of a family-basededucation program for heart failure patients in rural Thailand. Retrieved 1February 2018, from