Patients Instructed on Home Injections Not More Confident with Simulation

Adding simulation did not improve satisfaction or self-confidence, but did assuage worry, when compared with verbal and written teaching alone.
Adding simulation did not improve satisfaction or self-confidence, but did assuage worry, when compared with verbal and written teaching alone.

ORLANDO, FL—Results of a study to identify the effect of two teaching methods on patient and caregiver satisfaction and confidence in administering home injections found that adding simulation did not improve learner satisfaction or self-confidence, but did assuage worry, when compared with verbal and written teaching alone, according to a presentation at the ONS 40th Annual Congress.

The data suggest both education methodologies are equivalent in preparing patients to administer prefilled self-injections such as pegfilgrastim, said Erica Fischer-Cartlidge, MSN, RN, CNS, CBCN®, AOCNS®, Memorial Sloan Kettering Cancer Center, New York, New York.

“Teaching patients/caregivers self-injection results in increased self-efficacy, feelings of independence, adherence, and empowerment,” said Fischer-Cartlidge. “Self-injection is shown to be more convenient, with time and cost-saving depending on distance, time, and cost involved with traveling to the health care setting.”

Although nurses use a variety of modalities to teach self-injection, evidence is lacking to suggest which method results in preparing patients to be confident with the technique.

The nurse-led clinical trial compared whether patient/caregiver satisfaction and self-confidence improved with verbal and written teaching (control group) or with verbal and written teaching plus simulation using an injection model (intervention). Patients/caregivers were assessed before and after teaching regarding their satisfaction as well as changes in worry about injection. Nurse satisfaction was also determined.

The study sampled patients; the first 25 were enrolled to the control group and the second 25 to the intervention. Of those, 38 were patients and 13 were caregivers. Structured questionnaires were administered to participants before the teaching, immediately after the teaching, and after the injection was performed at home.

The study showed  no statistically significant difference between control and intervention groups in worry or confidence after teaching; however, participant satisfaction with the teaching experience appears significantly higher in the intervention arm,” she reported.

“Worry was also significantly lower after teaching was provided compared to baseline for the overall sample but was not impacted by the addition of simulation.”

However, after administering the injection, participant satisfaction with how the teaching prepared them decreased compared with postteaching levels, implying neither methodology was viewed as substantive preparation for administration, she said of the incidental findings.

“Nursing support at the actual time of injection may provide the greatest satisfaction and benefit to the person administering the injection whenever possible,” Fischer-Cartlidge concluded.

Underwriting or Funding was provided by Research grant received from The Geri & Me Fund.

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