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  • 1
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim.  This paper reports a study to determine whether a nurse-initiated telephone follow-up programme could increase patients’ self-efficacy in managing dyspnoea and decrease health care service use.Background.  Chronic obstructive pulmonary disease is a worldwide health problem and has been labelled a burdensome disease. Because of the fear of activity-induced dyspnoea, patients with chronic obstructive pulmonary disease lack the confidence to perform daily activities. Studies of cardiac and diabetic patients have shown that telephone follow-up care is an effective approach to increasing self-efficacy. However, little such research has been done with patients with chronic obstructive pulmonary disease.Methods.  This was a randomized controlled study. A total of 60 participants (30 telephone follow-up, 30 control) with chronic obstructive pulmonary disease were recruited from an acute care hospital in Hong Kong. The Chinese Self-Efficacy Scale was used to assess self-efficacy. Measures of health care use were numbers of visits to an accident and emergency department, hospitalizations, and unscheduled visits by physicians.Findings.  The self-efficacy scores (U = 272·5, P = 0·009) of patients who were followed up by telephone improved significantly compared with those of patients in the control group. Multiple regression analyses showed that telephone follow-up (Beta = 0·33, CI: 0·19–0·48, P = 0·001), the pulmonary rehabilitation programme (Beta = 0·44, CI: 0·16–0·72, P = 0·003), smoking (Beta = 0·34, CI: 0·09–0·57, P = 0·009), and health care use (Beta = −0·27, CI: −0·47–(−0·07), P = 0·008) were significant factors in predicting patient self-efficacy.Conclusions.  Nurse-initiated telephone follow-up care was effective in increasing self-efficacy in managing dyspnoea. The study needs to be replicated in other setting to strengthen its external validity.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background.  Developmental action inquiry (DAI) was chosen as the change strategy for introducing problem-based learning (PBL) in a pre-registration nursing programme. The central task was to transform the tutor and student participants to become collaborators in this curriculum reconstruction project. Aim.  This paper expounds the way in which the action inquiry was constructed and in light of students’ feedback analysis, the way in which PBL has made a difference in student learning was evaluated. Design.  Taking into consideration the change context and different group characteristics, the DAI was conducted in terms of two dynamically interlinked circles that formed partnerships between PBL core group members and tutors, and between tutors and students in coconstructing knowledge useful for PBL curriculum development. Findings.  The findings of the student evaluation questionnaire reveal that the majority of students felt PBL made a difference to their expectations of self, the student group and the teacher role in creating a facilitative environment to enhance learning. However, there was a significant difference among individual student group responses. The students’ positive and negative PBL experience in self-learning, tutor–student interaction, and group-learning were identified as crucial factors contributing to these group variations. Conclusion.  The evaluation findings show that a paradigm shift from teacher-centred to student-centred learning, from valuing self-learning to co-operative group-learning, and from theory-based to practice-based learning occurred among the students. DAI was found to be an effective change strategy for transforming participants to become collaborators in searching for useful knowledge and coconstructing the PBL learning context.
    Type of Medium: Electronic Resource
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