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基于网络的药物教育课程对孕妇药物信息素养和决策自我效能的有效性:随机对照试验

Effectiveness of a Web-Based Medication Education Course on Pregnant Women's Medication Information Literacy and Decision Self-Efficacy: Randomized Controlled Trial.

作者信息

Li Suya, Chen Hui-Jun, Zhou Jie, Zhouchen Yi-Bei, Wang Rong, Guo Jinyi, Redding Sharon R, Ouyang Yan-Qiong

机构信息

Wuhan University, Wuhan, China.

Department of Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

J Med Internet Res. 2025 Jan 22;27:e54148. doi: 10.2196/54148.

Abstract

BACKGROUND

Medication-related adverse events are common in pregnant women, and most are due to misunderstanding medication information. The identification of appropriate medication information sources requires adequate medical information literacy (MIL). It is important for pregnant women to comprehensively evaluate the risk of medication treatment, self-monitor their medication response, and actively participate in decision-making to reduce medication-related adverse events.

OBJECTIVE

This study aims to examine the effectiveness of a medication education course on a web-based platform in improving pregnant women's MIL and decision self-efficacy.

METHODS

A randomized controlled trial was conducted. Pregnant women were recruited from January to June 2021 in the Department of Obstetrics and Gynecology of a large hospital in a major city in central China. A total of 108 participants were randomly divided into a control group (CG), which received routine prenatal care from nurses and physicians, and an intervention group (IG), which received an additional 3-week web-based medication education course based on the theory of planned behavior as part of routine prenatal care. Participants completed a Medication Information Literacy Scale and a decision self-efficacy questionnaire at baseline, upon completion of the intervention, and at a 4-week follow-up. Generalized estimation equations (GEE) were used to analyze the main effect (time and grouping) and interaction effect (grouping×time) of the 2 outcomes. The CONSORT-EHEALTH (V 1.6.1) checklist was used to guide the reporting of this randomized controlled trial.

RESULTS

A total of 91 pregnant women (48 in the IG and 43 in the CG) completed the questionnaires at the 3 time points. The results of GEE indicated that there was no statistically significant difference in time×group interactions of MIL between the 2 groups (F=3.12; P=.21). The results of the main effect analysis showed that there were statistically significant differences in MIL between the 2 groups at T1 and T2 (F=17.79; P<.001). Moreover, the results of GEE indicated that there was a significant difference in decision self-efficacy regarding the time factor, grouping factor, and time×group interactions (F=21.98; P<.001). The results of the simple effect analysis indicated a statistically significant difference in decision self-efficacy between the 2 groups at T1 (F=36.29; P<.001) and T2 (F=36.27; P<.001) compared to T0. Results showed that MIL and decision self-efficacy in the IG were found to be significantly higher than those in the CG (d=0.81; P<.001 and d=1.26; P<.001, respectively), and they remained significantly improved at the 4-week follow-up (d=0.59; P<.001 and d=1.27; P<.001, respectively).

CONCLUSIONS

Web-based medication education courses based on the theory of planned behavior can effectively improve pregnant women's MIL and decision self-efficacy, and they can be used as supplementary education during routine prenatal care.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2100041817; https://www.chictr.org.cn/showproj.html?proj=66685.

摘要

背景

与药物相关的不良事件在孕妇中很常见,且大多数是由于对药物信息的误解。识别合适的药物信息来源需要足够的医学信息素养(MIL)。对孕妇而言,全面评估药物治疗风险、自我监测药物反应并积极参与决策以减少与药物相关的不良事件非常重要。

目的

本研究旨在探讨基于网络平台的药物教育课程在提高孕妇医学信息素养和决策自我效能方面的有效性。

方法

进行了一项随机对照试验。2021年1月至6月,在中国中部一个主要城市的一家大型医院的妇产科招募孕妇。共有108名参与者被随机分为对照组(CG)和干预组(IG),对照组接受护士和医生的常规产前护理,干预组在常规产前护理基础上,额外接受为期3周的基于计划行为理论的网络药物教育课程。参与者在基线、干预结束时和4周随访时完成药物信息素养量表和决策自我效能量表。采用广义估计方程(GEE)分析两个结局的主效应(时间和分组)和交互效应(分组×时间)。使用CONSORT-EHEALTH(V 1.6.1)清单指导本随机对照试验的报告。

结果

共有91名孕妇(IG组48名,CG组43名)在3个时间点完成了问卷。GEE结果表明,两组之间MIL的时间×组间交互作用无统计学显著差异(F = 3.12;P = 0.21)。主效应分析结果显示,两组在T1和T2时的MIL有统计学显著差异(F = 17.79;P < 0.001)。此外,GEE结果表明,决策自我效能在时间因素、分组因素和时间×组间交互作用方面存在显著差异(F = 21.98;P < 0.001)。简单效应分析结果表明,与T0相比,两组在T1(F = 36.29;P < 0.001)和T2(F = 36.27;P < 0.001)时的决策自我效能有统计学显著差异。结果显示,IG组的MIL和决策自我效能显著高于CG组(分别为d = 0.81;P < 0.001和d = 1.26;P < 0.001),且在4周随访时仍显著改善(分别为d = 0.59;P < 0.001和d = 1.27;P < 0.001)。

结论

基于计划行为理论的网络药物教育课程可有效提高孕妇的医学信息素养和决策自我效能,可作为常规产前护理期间的补充教育。

试验注册

中国临床试验注册中心ChiCTR2100041817;https://www.chictr.org.cn/showproj.html?proj=66685

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8cf/11799814/11ca11827013/jmir_v27i1e54148_fig1.jpg

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