Project education programme. The statistics analysis will be

Project Title

A pilot scheme for
patient-centre education for CVDs : education for cardiac patients to enhance a
better understanding

 

Summary

My project is a pilot scheme for patient-centre education programme for
patients with Cardiovascular diseases in Bangkok Hospital. The overall goal of
the project is to enhance a better understanding of cardiovascular-related
knowledge and to increase patients’ adherence to self-management strongly
influencing the reduced risk of cardiovascular events and the increased
effectiveness of medical treatment and the enhanced health-related quality of
life. It will do this by 20 patients with CVDs were enrolled into single-blind
randomized controlled trial. Patients randomly allocated to either the
intervention group receiving the patients-centre education programme or the
controlled group receiving the traditional patient education programme. The statistics
analysis will be conducted to evaluate the effectiveness of patient-centre
education 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% of
re-hospitalisations for CVDs were transferred to the emergency department and
25 % of readmitted patients needed a critical care bed. Lack of patient education programmes for CVDs was considered as a significant factor
accounting for  the high numbers of
readmission CVDs patients (Laothavorn et al, 2010, Srisuk et
al, 2014).

Patient education is an essential step to enhance a
patient understanding of diseases, treatment and health-related lifestyle
self-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 knowledge
and motivation correlate closely to the concept of self-management and
adherence to recommended health regimens and prescribed medications
(Bodenheimer, 2002; Campbell, 2016) potentially leading to a better health
maintenance and the
low risk of subsequent Cardiovascular events and mortality in the long term.
Additionally, the presence of carers and their support has been regarded as a
vital 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-compromising
behaviours and to ignore
health-promoting suggestion (Goossens et al, 2013) producing a
detrimental effect on patients’ health and well-being. However, patient
education programme has not been developed to be systematic procedures.
Informed in verbal and unstructured way, cardiac patients face a difficulty of
comprehending and retaining medical knowledge (Goossens et al, 2013)

Given that this research focuses on patients
experiencing difficulties in education for CVDs, developing patient education
is vitally important for cardiac patients in order to promote healthy behaviours,
nutritional eating plan, physical activities and cardiovascular-related
self-management and reduce the risk of cardiovascular events.

 

Statement of
problem

Lack of patient education for Cardiovascular Diseases
in Thailand result in the inadequacy of health-related knowledge and
self-management and the reduction of the effectiveness of health treatment.

 

Main objective

The primary objective of the project is to develop and
evaluate patient-centre education programme for CVDs implemented in heart centre
of Bangkok Hospital in order for cardiac patients to consult and collaborate
with health providers to tailor intervention to suit their requirement thereby
positively affecting adherence to self-tailored health-related intervention.

 

Objective

1.     
Establish
a cooperation for the patient-centre education programme with healthcare
providers and patients in heart centre of Bangkok Hospital.

2.     
Develop
appropriate health educational materials that satisfy patients’ expectation and
facilitate the comprehension and the retention of cardiovascular-related
information

3.     
Recruit
patients with CVDs and screen them and recruit healthcare providers to be
educators in a pilot scheme for patient-centre education programme for CVDs.

4.     
Conduct
a single-blind randomized controlled trial for patients with CVDs

5.     
Evaluate
the effectiveness of patient-centre education programme.

 

Participants
& roles

Participants &
Roles

1. Project
coordinator : communicating with Heart Centre staff and Healthcare providers;
with IT staff and healthcare providers; patients; allocating voluntary
participants randomly by using statistics tools; analyzing, evaluating and
interpreting data

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; 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 suitable
intervention programme; conducting a follow-up process

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

6. Patients in the
intervention group : filling out a questionnaire, making a decision after
listening all necessary information about the study and giving a sign consent,
enrolling in trial; 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; receiving a
follow-up process.

7.Patients in the
controlled group : filling out a questionnaire, making a decision after
listening all necessary information about the study and giving a sign consent,
enrolling in trial; receiving a follow-up process.

 

Project implementation
plan

 

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
& Risks

Constraints

1. The possibility
that health professionals and staff at Heart Centre in Bangkok Hospital do not
approve this project.

To combat this
constraint, after having a discussion and receiving feedback and recommendation
from them, the modified project proposal will be proposed to health
professionals and staff at Heart Center in Bangkok Hospital.

2.The possibility
that members of patients’ family are not available to have a consultation with
patients and healthcare providers

To combat this
constraint, members of patients’ family can select either receiving a
consultation through telephone and all necessary patient information being
mailed or making an appointment to have a face-to-face consultation in
hospital. 

 

Risks

1.Some patients
are affected by uncontrolled factors.

To mitigate
against the risk, healthcare providers will note a

 

Reference List

References

Bauman, A., Fardy,
H., & Harris, P. (2018). Getting it right: why bother with
patient-centred care?. Mja.com.au. Retrieved 1 February 2018,
from
https://www.mja.com.au/journal/2003/179/5/getting-it-right-why-bother-patient-centred-care

Campbell, D.,
Tonelli, M., Hemmelgarn, B., Mitchell, C., Tsuyuki, R., & Ivers, N. et al.
(2018). Assessing outcomes of enhanced chronic disease care through
patient education and a value-based formulary study (ACCESS)—study protocol for
a 2×2 factorial randomized trial. Retrieved 1 February 2018, from

Ghisi, G., Abdallah,
F., Grace, S., Thomas, S., & Oh, P. (2018). A systematic review of
patient education in cardiac patients: Do they increase knowledge and promote
health behavior change?. Retrieved 1 February 2018, from

Goossens, E., Van
Deyk, K., Zupancic, N., Budts, W., & Moons, P. (2013). Effectiveness of
structured patient education on the knowledge level of adolescents and adults
with congenital heart disease. European Journal Of Cardiovascular
Nursing, 13(1), 63-70. http://dx.doi.org/10.1177/1474515113479231

Herbert, C. (2005).
Changing the culture: Interprofessional education for collaborative
patient-centred practice in Canada. Journal Of Interprofessional Care, 19(sup1),
1-4. http://dx.doi.org/10.1080/13561820500081539

Lynggaard, V.,
Nielsen, C., Zwisler, A., Taylor, R., & May, O. (2018). The patient
education — Learning and Coping Strategies — improves adherence in cardiac
rehabilitation (LC-REHAB): A randomised controlled trial. Retrieved 1
February 2018, from

Srisuk, N., Cameron,
J., Ski, C., & Thompson, D. (2018). Trial of a family-based
education program for heart failure patients in rural Thailand. Retrieved 1
February 2018, from