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Can Video Clips Improve Patient Comprehension at the Emergency Department?

2022年6月5日 更新者:Santi Di Pietro、IRCCS Policlinico S. Matteo

Can Video Clips Improve Patient Comprehension at the Emergency Department? A Multicentric Randomized Controlled Trial.

The aim of this study is to assess the utility of two interventional videos, showed to patients discharged from the ED with a diagnosis of atrial fibrillation or deep vein thrombosis. We have focused our attention on these two medical conditions because they share some important features: they are frequently seen in EDs; their main complication (stroke and pulmonary embolism) can cause significant morbidity and mortality; both conditions and their related complications are probably not very intuitive to comprehend for the general population. In fact, the understanding of these conditions implies the knowledge of a number of pathological processes, with which most people are unfamiliar.

The primary hypothesis is that patients enrolled in the study group will show a higher degree of comprehension of their medical condition and its related complications, as compared to the control group. Secondly, we will also analyze any possible effect of the videos on the knowledge of the therapy prescribed, return instructions and patients' satisfaction with the quality of communication in the ED.

Eventually, we will examine the association of some factors with the outcomes (age, sex, level of education, atrial fibrillation vs. deep vein thrombosis group).

調査の概要

研究の種類

介入

入学 (実際)

144

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • Lombardia
      • Pavia、Lombardia、イタリア、27100
        • Emergency Department, IRCCS San Matteo University Hospital

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

  • Age >18
  • Being diagnosed with one of the two medical condition under study: patients with first-time diagnosis of deep vein thrombosis; patients with first-time diagnosis of atrial fibrillation; patients with second episode in life of atrial fibrillation who have never been prescribed take-home medications for its cure or prevention of recurrence (anticoagulants, antiarrhythmic drugs including beta-blockers)
  • Being discharged home directly from the Emergency Department/Emergency Unit
  • Capacity of the patient to understand the explanations and instructions provided by the doctor (this includes excellent command of the Italian language)
  • Having provided a valid phone number
  • Having signed the informed consent

In case of patients lacking capacity, and in all cases of patients who will be judged by the recruiting doctor as incapable to safely receive the discharge instructions, the caregiver will be enrolled to the study with identical modalities.

In the context of a pragmatic trial, we did not set exclusion criteria in terms of education level and comorbidities of the enrolled patients.

Exclusion criteria:

  • Previous diagnosis of deep vein thrombosis
  • Two or more previous episodes of atrial fibrillation; or one previous episode of atrial fibrillation for which the patient has been prescribed one of the following take-home medications: anticoagulants, antiarrhythmic drugs including beta-blockers.
  • Being hospitalized

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:他の
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:ダブル

武器と介入

参加者グループ / アーム
介入・治療
実験的:Video group

All subjects enrolled in the study group will be showed during the discharge process the video related to patient's condition (DVT vs AF), using it as a graphic support to doctor's verbal explanation of the diagnosed pathology and its possible complications.

For the purposes of the study we have selected two 3D videoclips, available on various internet sites and not covered by any copyright restrictions; these have been modified and shortened to make them suitable to use in our study setting.

The images contained show the pathophysiological process underlying the two diseases under study, namely deep vein thrombosis and atrial fibrillation.

The SIs will show the videos to patients on the institutional computer or, alternatively, on their personal smartphone / tablet. The videos were purposely left without audio content.

The images contained in the videoclips show the pathophysiological process underlying the two diseases under study, namely deep vein thrombosis and atrial fibrillation.
介入なし:Control group

Patients of the control group will receive discharge explanations without the aid of any video.

The communication strategy in these cases won't be standardized, in order to leave the treating doctors free to express themselves in the way they are used to in their clinical practice, which is based solely on doctor's verbal and non-verbal communication skills.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Patient's comprehension of their medical condition and its potential complications
時間枠:Outcome assessed within 48 hours from ED discharge

The main outcome corresponds to interview's questions n°1-3-4. Patients' answers will receive a score on a 4-points Likert scale (from zero to three) from low to high knowledge.

Scores from the two independent reviewers will be averaged and then added to obtain an overall score. The score for the main outcomes will therefore range 0-18 for the main outcome.

To the best of our knowledge, no currently available validated questionnaires would serve for the purpose of our study, i.e. for the simultaneous measurement of different domains of comprehension across two different medical conditions.

Hence, we have developed the ad-hoc interview and its related interpretation scheme using face and content validity. Construct validation would require an amount of time and resources equivalent to that of the trial itself, pushing it beyond practical feasibility.

Outcome assessed within 48 hours from ED discharge

二次結果の測定

結果測定
メジャーの説明
時間枠
Patient's knowledge of the prescribed therapy
時間枠:Outcome assessed within 48 hours from ED discharge
This outcome is measured with interview's question n°2. Scores will range from 0-6 (low to high comprehension).
Outcome assessed within 48 hours from ED discharge
Patient's satisfaction
時間枠:Outcome assessed within 48 hours from ED discharge
This outcome is measured with interview's question n°5 and n°6. Scores will range from 0-12.
Outcome assessed within 48 hours from ED discharge

協力者と研究者

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研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2018年12月1日

一次修了 (実際)

2021年12月27日

研究の完了 (実際)

2022年6月5日

試験登録日

最初に提出

2018年11月6日

QC基準を満たした最初の提出物

2018年11月7日

最初の投稿 (実際)

2018年11月8日

学習記録の更新

投稿された最後の更新 (実際)

2022年6月8日

QC基準を満たした最後の更新が送信されました

2022年6月5日

最終確認日

2022年6月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 20180068344

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

未定

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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