Background: Multiple factors influence warfarin metabolism and can significantly affect the risk of adverse events. The extent to which patients understand the modifiable factors that impact on warfarin safety and efficacy is unclear. Methods: A 52-item questionnaire related to knowledge of warfarin was administered to patients with atrial fibrillation in a face-to-face interview with a dietitian. Results were compiled based on five categories: general warfarin knowledge, compliance, drug interactions, herbal or vitamin interactions, and diet. Results: 100 patients were surveyed. Stroke risk factors included hypertension (57%), heart failure (36%), age >75 years (33%), diabetes (22%), and prior stroke/transient ischemic attack (29%). The majority were either high-school (49%) or college graduates (27%). Ten (10%) had a stroke while on warfarin, 11 (11%) had a blood transfusion, and 26 (26%) had at least one fall. The percentages correct for questionnaire items in the five categories were as follows: general knowledge (62%), compliance (71%), drug interactions (17%), herbal or vitamin interactions (7%), and diet (23%). Neither education level nor duration of therapy correlated with warfarin knowledge. Patients at highest risk of stroke had very low knowledge scores in general. Discussion: Patients on warfarin have a poor general understanding of the medication, particularly those at highest risk of stroke.
Optimal growth and nutrition status predict better lung function and longevity for children with cystic fibrosis (CF). Daily nutrition therapy for children with CF requires adequate food resources, parental knowledge of nutrition and behavior management, and confidence in one’s ability to apply the skills. The Mountain West Cystic Fibrosis Consortium Questionnaire (MWCFC-Q) was designed to identify educational intervention targets to improve the growth and nutrition of children with CF. Parents of children with CF returned 305 anonymous MWCFC-Qs. Data analyzed included household food security, knowledge of nutrition and general CF therapies, and self-confidence in one’s ability to manage components of CF care. Factors associated with food insecurity were reported by 26.3% of respondents. The median accuracy for questions regarding nutrient content of commonly used foods was 71.4% and 57.9% for CF nutrition therapy. Parents’ self-confidence in overall CF management was relatively high at a mean value 8.28 ± 1.22 of 10 possible. However, mean self-confidence in the CF nutrition domain was significantly less than mean self-confidence for the CF-related tasks domain, which included chest physiotherapy and medication administration (7.75 ± 1.56, 8.62 ± 1.24, P < .001, respectively). Parental knowledge of nutrition for CF and confidence in the application of this knowledge can improve the growth and nutrition status of children with CF. Identification of food security issues may enable health care professionals to adjust nutrition interventions and direct families to appropriate food resources. The MWCFC-Q could be useful for designing and testing educational interventions for nutrition management of CF.
Objective. To evaluate the cost savings and clinical effectiveness of a Cooperative Extension Service diabetes education program for improving nutrition knowledge, food portioning skills, hemoglobin A 1c (A1C), and anthropometric indices.Design. Clients with type 1 or type 2 diabetes enrolled in a 3-month diabetes education course focused on food portioning skills. Pre-and postcourse anthropometric measurements, a written food portion test, an observational food portioning skill test, and an A1C test were administered and scored. Paired t tests were calculated between pre-and postcourse scores to measure statistical significance.Results. Data analysis showed improvement in food portion knowledge written test scores (49.67% preand 59.56% post-course, P = 0.004), food portioning skills (out of a possible score of 5, 2.43 pre-, 4.29 post-course, P = 0.023), A1C results (7.16% pre-, 6.43% post-course, P = 0.000), body mass index (BMI) (32.60 kg/m 2 pre-, 31.78 kg/m 2 post-course, P = 0.000), weight (202.58 lb pre-, 199.74 lb postcourse, P = 0.000), waist circumference (42.43 inches pre-, 41.16 inches post-course, P = 0.000), hip circumference (45.96 inches pre-, 45.36 inches post-course, P = 0.000), and waist-tohip ratio (0.92 pre-, 0.91 post-course, P = 0.000). Conclusions/Applications. Evaluation of the Utah State University ExtensionService diabetes education program showed improved nutrition knowledge, anthropometric measures, and glucose control. These improvements have been estimated to reduce medical costs by $94,010.
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