Smith Caroline A, Chang Esther, Gallego Gisselle, Khan Afshan, Armour Mike, Balneaves Lynda G
NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2571, Australia.
School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.
BMC Geriatr. 2019 May 7;19(1):129. doi: 10.1186/s12877-019-1143-x.
National policies seek to involve older Australian's in decisions regarding their care; however, research has found varying levels of decision self-efficacy and health literacy skills. An increasing number of older Australians use complementary medicine (CM). We examined the effectiveness of a CM educational intervention delivered using a web or DVD plus booklet format to increase older adults' decision self-efficacy and health literacy.
A randomised controlled trial was conducted. We recruited individuals aged over 65 years living in retirement villages or participating in community groups, in Sydney Australia. Participants were randomly allocated to receive a CM education intervention delivered using a website or DVD plus booklet versus booklet only. The primary outcome was decision self-efficacy. A secondary outcome included the Preparation for Decision-Making scale and health literacy. Outcomes were collected at 3 weeks, and 2 months from baseline, and analysed using an adjusted ANOVA, or repeated measures ANOVA.
We randomised 153 participants. Follow up at 3 weeks and 2 months was completed by 131 participants. There was a 14% (n = 22) attrition rate. At the end of the intervention, we found no significant differences between groups for decision self-efficacy (mean difference (MD) 3.8, 95% confidence interval (CI) -2.0 to 9.6 p = 0.20), there were no differences between groups on nine health literacy domains, and the Preparation for Decision-Making scale. Over 80% of participants in both groups rated the content as excellent or good.
Decision self-efficacy improved for participants, but did not differ between groups. Decision self-efficacy and health literacy outcomes were not influenced by the delivery of education using a website, DVD or booklet. Participants found the resources useful, and rated the content as good or excellent. CM Web or DVD and booklet resources have the potential for wider application.
The trial was registered with the Australian New Zealand Clinical Trials Registry: ACTRN ( ACTRN12616000135415 ). The trial was registered on 5 February 2016.
国家政策旨在让澳大利亚老年人参与有关其护理的决策；然而，研究发现他们的决策自我效能感和健康素养技能水平各不相同。越来越多的澳大利亚老年人使用补充医学（CM）。我们研究了以网络或DVD加手册形式提供的补充医学教育干预措施提高老年人决策自我效能感和健康素养的效果。
进行了一项随机对照试验。我们招募了居住在悉尼退休村或参加社区团体的65岁以上个体。参与者被随机分配接受通过网站或DVD加手册提供的补充医学教育干预，或仅接受手册。主要结局是决策自我效能感。次要结局包括决策准备量表和健康素养。在基线后的3周和2个月收集结局，并使用调整后的方差分析或重复测量方差分析进行分析。
我们随机分配了153名参与者。131名参与者完成了3周和2个月的随访。失访率为14%（n = 22）。在干预结束时，我们发现两组在决策自我效能感方面无显著差异（平均差（MD）3.8，95%置信区间（CI）-2.0至9.6，p = 0.20），在九个健康素养领域以及决策准备量表上两组之间也无差异。两组中超过80%的参与者将内容评为优秀或良好。
参与者的决策自我效能感有所提高，但两组之间无差异。决策自我效能感和健康素养结局不受通过网站、DVD或手册提供教育的影响。参与者认为这些资源有用，并将内容评为良好或优秀。补充医学网络或DVD及手册资源有更广泛应用的潜力。
该试验在澳大利亚新西兰临床试验注册中心注册：ACTRN（ACTRN12616000135415）。该试验于2016年2月5日注册。
