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Li CC. et al., 2022: Effect of Precision Health Education on Compliance Behavior after Extracorporeal Shock Wave Lithotripsy.

Li CC, Zhang ZW.
Department of Urology, Anhui No.2 Provincial People's Hospital, Hefei, Anhui 230041, China.

Abstract

Objective: The aim of this study was to investigate the effects of precision health education on patients' compliance behavior and lithotripsy efficacy after extracorporeal shock wave lithotripsy (ESWL).

Methods: From June 2018 to September 2018, 104 patients with upper urinary tract calculi who underwent ESWL at Anhui No.2 Provincial People's Hospital were randomly divided into two groups. The observation group (n = 53) was given precision health education guidance after ESWL treatment, while the control group (n = 51) was only informed of precautions after lithotripsy. Postoperative compliance behavior, stone expulsion time, and complications were recorded in both groups.

Results: The clinical baseline data of the two groups were similar in age, gender, number of stones, size of stones, location of stones, complications, number of lithotripsies, and voltage of lithotripsy between the two groups (P > 0.05). However, compared with the control group, the observation group had better compliance behavior of patients. Furthermore, we divided the patients into three groups based on whether they complied with medical advice. Compared with the noncompliance group (n = 17) and the partial compliance group (n = 23), the stone expulsion time in the complete compliance group (n = 64) was significantly shorter. Also, the number of patients with nausea and vomiting, lacrimation, and cold sweat in the complete compliance group was significantly lower than that in the other groups.

Conclusion: Precision health education for patients treated with ESWL can significantly enhance the compliance behavior of patients, thereby accelerating the expulsion of stones, improving the efficacy and relieving pain. Precision health education and good compliance behavior complement and reinforce each other.
Comput Math Methods Med. 2022 Sep 14;2022:3306036. doi: 10.1155/2022/3306036. eCollection 2022. PMID: 36158133. FREE ARTICLE

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Comments 1

Hans-Göran Tiselius on Tuesday, 27 December 2022 09:30

It is without any doubt the outcome of SWL roughly is determined by two factors: Stone disintegration and adequate follow-up regimens aiming at facilitated elimination of fragments.

In this regard the authors of this article have applied what they call “precision health education” based on the patient’s specific stones and results after one or several SWL sessions.

The two groups that were compared were given either very specific recommendation (G1) or only usual unspecific advice (G2).

The different parts of the health education comprised recommendations on water intake, medication, postoperative postural movement, recording of urine volume and collection of stone fragments.

Although very detailed instructions were given for stones in the upper and middle calyces, the renal pelvis, and the ureter, it is disappointing that only 4 stones in each group (G1 and G2) were in the kidney while all other stones were in the ureter. It appears as if the recommendation given for stones in the lower calyx is erroneously described.

Apparently stone expulsion was faster in the group with complete compliance. It is not understood why compliance also is mentioned for patients in G2.
No information is given on any pharmacological treatment even though most stones were in the ureter.
The idea presented in this article is interesting, but the information is hampered by the dominance of ureteral stones. I would personally like to see a similar study in which all treated stones were in the kidney.

One problem with studies of this kind is the lack of supporting objective variables such as information on the daily urine volumes for instance during the first 1-2 weeks. Moreover, there certainly is a difference between what patients say and what they do, factors that affect the “precision”.

Hans-Göran Tiselius

It is without any doubt the outcome of SWL roughly is determined by two factors: Stone disintegration and adequate follow-up regimens aiming at facilitated elimination of fragments. In this regard the authors of this article have applied what they call “precision health education” based on the patient’s specific stones and results after one or several SWL sessions. The two groups that were compared were given either very specific recommendation (G1) or only usual unspecific advice (G2). The different parts of the health education comprised recommendations on water intake, medication, postoperative postural movement, recording of urine volume and collection of stone fragments. Although very detailed instructions were given for stones in the upper and middle calyces, the renal pelvis, and the ureter, it is disappointing that only 4 stones in each group (G1 and G2) were in the kidney while all other stones were in the ureter. It appears as if the recommendation given for stones in the lower calyx is erroneously described. Apparently stone expulsion was faster in the group with complete compliance. It is not understood why compliance also is mentioned for patients in G2. No information is given on any pharmacological treatment even though most stones were in the ureter. The idea presented in this article is interesting, but the information is hampered by the dominance of ureteral stones. I would personally like to see a similar study in which all treated stones were in the kidney. One problem with studies of this kind is the lack of supporting objective variables such as information on the daily urine volumes for instance during the first 1-2 weeks. Moreover, there certainly is a difference between what patients say and what they do, factors that affect the “precision”. Hans-Göran Tiselius
Thursday, 13 June 2024