Enhanced fidelity of an educational intervention on skin self-examination through surveillance and standardization.
Enhanced fidelity of an educational intervention on skin self-examination through surveillance and standardization.
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DOI：
10.5430/jnep.v4n2p253
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Robinson JK
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文献类型：
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作者：
Gaber R;Mallett KA;Hultgren B;Turrisi R;Gilbertsen ML;Martini MC;Robinson JK
黑色素瘤可以转移，但在早期发现时通常可以成功治疗。黑色素瘤患者及其皮肤检查伙伴可以学习皮肤自我检查（SSE）技能，并且这些技能可以通过实践来提高。本研究的目的是确定受过培训的研究协调员可以向有发展另一种黑色素瘤风险的患者及其皮肤检查伙伴提供教育性亲自SSE干预的保真度。现场干预分两次进行。在第1阶段（2006-2008年），研究协调员接受了使用书面脚本进行干预的培训。在第二阶段（2011-2013年），研究协调员接受了培训，以使用PowerPoint辅助工具进行干预。每个研究协调员都由一位作者（KM）单独辅导，以确保标准化并提高干预措施的保真度。在16个保真度组件上比较了第1阶段和第2阶段。此外，通过比较提供干预的五名研究协调员的忠诚度平均得分来评估第二阶段的忠诚度。第2阶段使用PowerPoint辅助工具，与第1阶段相比具有更高的保真度，其中四个保真度组件的保真度明显高于第1阶段：1）黑色素瘤的详细解释，χ2（1，n = 199）= 96.31，p < .001，2）讨论何时请医生，χ2（1，n = 199）= 53.68，p < .001; 3）第1个月的解释性评估，χ2（1，n = 199）= 12.39，p < .01;以及4）第2个月的解释性评估，χ2（1，n = 199）= 117.75，p < .001。此外，在第2阶段的研究协调员中，未发现平均保真度存在显著差异。当使用PowerPoint助手时，研究协调员以高保真度（所有分数>14）提供干预措施，并且研究协调员之间的保真度没有平均差异，表明保真度的一致性。这可以归因于PowerPoint程序提供的标准化和提示。监督也是建立和保持患者教育过程的忠实性的关键组成部分。这种干预交付方法使训练有素的医疗保健专业人员能够以有效、一致的方式提供教育干预。
Melanoma can metastasize but is often successfully treated when discovered in an early stage. Melanoma patients and their skin check partners can learn skin self-examination (SSE) skills and these skills can be improved by practice. The purpose of this study is to determine the degree of fidelity with which educational in-person SSE intervention can be delivered by trained research coordinators to patients at risk of developing another melanoma and their skin check partners. The in-person intervention was performed in two iterations. In phase 1 (2006-2008), the research coordinators were trained to perform the intervention using a written script. In phase 2 (2011-2013), the research coordinators were trained to perform the intervention with a PowerPoint aid. Each research coordinator was individually counseled by one of the authors (KM) to insure standardization and enhance fidelity of intervention delivery. Phase 1 and Phase 2 were compared on 16 fidelity components. Further, Phase 2 fidelity was assessed by comparing mean scores of fidelity across the five research coordinators who delivered the intervention. Phase 2, which utilized a PowerPoint aid, was delivered with a higher degree of fidelity compared to phase 1with four fidelity components with significantly higher fidelity than Phase 1: 1) Explained details of melanoma, χ2 (1, n = 199)= 96.31, p < .001, 2) Discussed when to call doctor, χ2 (1, n = 199) = 53.68, p < .001 3) Explained assessment at month 1, χ2 (1, n = 199)= 12.39, p < .01, and 4) Explained assessment at month 2, χ2 (1, n = 199) = 117.75, p < .001. Further, no significant differences on mean fidelity were found across research coordinators in Phase 2. When using the PowerPoint aide, the research coordinators delivered the intervention with high fidelity (all scores >14) and there were no mean differences in fidelity across research coordinators, indicating consistency in fidelity. This can be attributed to the standardization and cueing that the PowerPoint program offered. Supervision was also a key component in establishing and maintaining fidelity of the patient educational process. This method of intervention delivery enables trained healthcare professionals to deliver an educational intervention in an effective, consistent manner.