Keyes Daniel C, Arroyo Dylan L, Abdulshafi Ghadah W, Dabajeh Batoul, Polgar Joshua, Sakr Rima, Hasan Sakibur
Emergency Medicine, Trinity Health Livonia Hospital, Livonia, USA.
Medicine, University of Michigan Medical School, Ann Arbor, USA.
Cureus. 2024 Nov 30;16(11):e74825. doi: 10.7759/cureus.74825. eCollection 2024 Nov.
Background Preventive measures are critical in avoiding and limiting the severity of diseases. Key lifestyle behaviors include sleep hygiene, habitual exercise, a healthy diet, and avoidance of risky substances, particularly the use of tobacco. The transtheoretical model (TTM) of change suggests that patients can move towards healthful changes through education. This emergency department (ED) pilot study assessed patients' readiness and confidence to adopt healthy lifestyle behaviors after receiving a brief video educational intervention. The study also investigated the impact of this preventive education on patient satisfaction. Methods Adult patients with low-acuity chest pain were prospectively randomized to a 10-minute video-based educational intervention. The sample size of 105 patients was chosen to demonstrate feasibility and provide data that could be used to design a larger study with a more diverse population. The outcome of this study used validated Readiness-to-Change and Confidence-to-Change questionnaires, along with selected questions from the U.S. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Patient Satisfaction Survey. A Student t-test was used to measure the difference in means between comparison groups where normal distribution could be assumed. A logistic regression model assessed the relationship between various factors and participants' readiness in changing their lifestyle behaviors. Results Of the 105 subjects enrolled in the study, 63 were female, and 42 were male. This pilot study found a nonsignificant increase in Readiness-to-Change among those older (40-80 years) who watched the video, more than those younger (18-39 years). This study shows positive trends toward patients being receptive to change and increased patient satisfaction when an educational video is shown. Feasibility was demonstrated by using a video prevention tool in the ED. Conclusion The ED presents a unique "teachable moment" for preventive lifestyle health education. However, lifestyle behavioral health interventions have been largely absent from this setting. This pilot study demonstrates the feasibility of a video teaching model for use while patients wait for their episodic care. Studies with more robust and diverse populations are needed to confirm these findings and to implement more engaging models of behavior change.
背景 预防措施对于避免和减轻疾病的严重程度至关重要。关键的生活方式行为包括睡眠卫生、习惯性锻炼、健康饮食以及避免接触有害物质，尤其是吸烟。行为改变的跨理论模型（TTM）表明，患者可以通过教育朝着健康的改变迈进。这项急诊科（ED）试点研究评估了患者在接受简短的视频教育干预后，采取健康生活方式行为的意愿和信心。该研究还调查了这种预防教育对患者满意度的影响。
方法 将低危胸痛成年患者前瞻性随机分为接受10分钟基于视频的教育干预组。选择105名患者的样本量以证明可行性，并提供可用于设计针对更多样化人群的更大规模研究的数据。本研究的结果使用经过验证的改变意愿和改变信心问卷，以及美国医院患者医疗服务评估（HCAHPS）患者满意度调查中的部分问题。对于可假定为正态分布的比较组，使用学生t检验来测量均值差异。逻辑回归模型评估了各种因素与参与者改变生活方式行为意愿之间的关系。
结果 在该研究纳入的105名受试者中，63名女性，42名男性。这项试点研究发现，观看视频的年龄较大（40 - 80岁）的人群与年龄较小（18 - 39岁）的人群相比，改变意愿虽有增加但差异不显著。该研究表明，当播放教育视频时，患者对改变持接受态度且患者满意度呈上升趋势。在急诊科使用视频预防工具证明了其可行性。
结论 急诊科为预防性生活方式健康教育提供了独特的“教育时机”。然而，这种环境中很大程度上缺乏生活方式行为健康干预措施。这项试点研究证明了在患者等待急诊护理时使用视频教学模式的可行性。需要开展更强大、更多样化人群的研究来证实这些发现，并实施更具吸引力的行为改变模式。
