Ha Phil, Hean Rattanak, Tang Patrick, Choy Audrey, Thakur Udit, Dev Anouk
Department of Gastroenterology and Hepatology, Monash Health, Melbourne, VIC, Australia.
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Front Public Health. 2019 Dec 10;7:372. doi: 10.3389/fpubh.2019.00372. eCollection 2019.
Chronic Hepatitis B (CHB) contributes to a high public health burden in Australia from chronic liver disease and hepatocellular carcinoma. Health literacy impacts on multiple aspects of long term management, including surveillance and long term follow up. We designed and implemented a multilingual educational iPad application for outpatients to use while in the clinic waiting room. The application employed an interactive and multimodal approach to education. It utilized graphics, audio and text to convey practical information regarding transmission of disease, long term complications, treatment and surveillance. Participants were recruited from a tertiary liver clinic and assigned to either standard treatment (routine clinical consult only) or the iPad group (clinical consult and additional education with the iPad app). There were 54 participants (control = 29, iPad = 25). Knowledge was assessed at baseline, secondly after the clinician appointment and finally at 6 months. Median follow up time was 6.1 months (range 0-18 months) and 87% of participants completed the final survey. At baseline, there was no difference in age, gender, proportion of newly referred patients, or use of antivirals. Baseline knowledge was similar in the two groups (61.4 vs. 55.1%, = 0.33). The iPad group scored significantly higher after the first consult (79.5 vs. 61.5%, = 0.0005). This improvement remained significant by the end of follow up (72.6 vs. 61.0%, = 0.0472). To conclude, interactive education with iPads may be an effective way to improve patient knowledge.
慢性乙型肝炎（CHB）在澳大利亚因慢性肝病和肝细胞癌导致了沉重的公共卫生负担。健康素养对长期管理的多个方面都有影响，包括监测和长期随访。我们设计并为门诊患者在诊所候诊室使用时实施了一款多语言教育iPad应用程序。该应用程序采用了交互式和多模式的教育方法。它利用图形、音频和文本传达有关疾病传播、长期并发症、治疗和监测的实用信息。参与者从一家三级肝病诊所招募，并被分配到标准治疗组（仅进行常规临床咨询）或iPad组（临床咨询并使用iPad应用程序进行额外教育）。共有54名参与者（对照组 = 29人，iPad组 = 25人）。在基线、临床医生预约后以及最后在6个月时评估知识水平。中位随访时间为6.1个月（范围0 - 18个月），87%的参与者完成了最终调查。在基线时，年龄、性别、新转诊患者比例或抗病毒药物使用方面没有差异。两组的基线知识水平相似（61.4%对55.1%，P = 0.33）。在第一次咨询后，iPad组的得分显著更高（79.5%对61.5%，P = 0.0005）。到随访结束时，这种改善仍然显著（72.6%对61.0%，P = 0.0472）。总之，使用iPad进行交互式教育可能是提高患者知识水平的有效方法。
