***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Disease management programs ( DMPs ) that use multidisciplinary teams and specialized clinics reduce hospital admissions and improve quality of life and functional status . Evaluations of cardiac DMPs delivered by home health nurses are required . METHODS Between August 1999 and August 2000 we identified consecutive patients admitted to hospital with elevated cardiac enzymes . Patients who agreed were r and omly assigned to participate in a DMP or to receive usual care .  The DMP included 6 home visits by a cardiac-trained nurse , a st and ardized nurses ' checklist , referral criteria for specialty care , communication with the family physician and patient education . We measured readmission days per 1000 follow-up days for angina , congestive heart failure ( CHF ) and chronic obstructive pulmonary disease ( COPD ) ; all-cause readmission days ; and provincial cl aims for emergency department visits , physician visits , diagnostic or therapeutic services and laboratory services . RESULTS We screened 715 consecutive patients admitted with elevated cardiac markers between August 1999 and August 2000 . Of those screened 71 DMP and 75 usual care patients met the diagnostic criteria for myocardial infa rct ion , were eligible for visits from a home health nurse and consented to participate in the study . Readmission days for angina , CHF and COPD per 1000 follow-up days were significantly higher for usual care patients than for DMP patients ( incidence density ratio [ IDR ] = 1.59 , 95 % confidence interval [ CI ] 1.27 - 2.00 , p < 0.001 ) . All-cause readmission days per 1000 follow-up days were significantly higher for usual care patients than for DMP patients ( IDR = 1.53 , 95 % CI 1.37 - 1.71 , p < 0.001 ) . The difference in emergency department encounters per 1000 follow-up days was significant ( IDR = 2.08 , 95 % CI 1.56 - 2.77 , p < 0.001 ) . During the first 25 days after discharge , there were significantly fewer provincial cl aims su bmi tted for DMP patients than for usual care patients for emergency department visits ( p = 0.007 ) , diagnostic or therapeutic services ( p = 0.012 ) and laboratory services ( p = 0.007 ) . INTERPRETATION The results provide evidence that an appropriately developed and implemented community-based inner-city DMP delivered by home health nurses has a positive impact on patient outcomes Prehospital delay is a major problem in the management of patients with acute cardiac ischemia . The authors created a patient teaching program consisting of an educational video and written instructions design ed to reduce prehospital delays in patients with chest pain . Patients who received st and ard discharge instructions served as the control group , whereas those who received the new patient teaching in addition to st and ard discharge instructions  served as the intervention group . Of the 500 enrolled , 19 % were rehospitalized within 1 year . Analysis of rehospitalizations showed no significant difference between the two groups on the three outcome variables : percentage who presented within the first hour of pain , use of ambulance , and time from anginal onset to emergency department arrival . In a comparison of the index hospitalization to the rehospitalization , there was a significant increase in the use of ambulances for the intervention group , p = .03 , but not for the control group For this study a r and omized clinical trial was design ed to test the effects of an early home recovery information intervention on physical functioning , psychological distress , and symptom frequency 1 month following coronary artery bypass graft surgery ( CABG ) . Recovery outcomes were compared between two groups : those receiving an audiotape of information on expected physical sensations and their management ( Cardiac Home Information Program [ CHIP ] ) in addition to the usual care , and those receiving the usual cardiac discharge information protocol .  A nonprobability sample of 180 patients ( 84 women and 96 men ; mean age = 62 years ) was equally distributed between the two study groups . When controlling for age , comorbidity , and cardiac functional status , the results showed positive effects on physical functioning in women and psychological distress , vigor and fatigue in men . Consistent with other studies , women had worse physical functioning and more symptom frequency than men . These findings indicate that the CHIP intervention is an effective method to prepare CABG patients for home recovery A study of a r and om sample of hospitals in Engl and that provide information leaflets for women undergoing hysterectomy indicates a large variation in quality . In general , the findings reveal that written information for patients is given a relatively low priority . Production and dissemination of information for hysterectomy patients is somewhat ad hoc . It is not clear that any evaluation of the leaflets has been conducted to prove the efficacy of the available literature . While the majority of leaflets include information deemed essential by past hysterectomy patients , the presentation of the recovery process often implies no control for the patient , and conceives normality with a narrow perspective about what healthy behaviour means for women . The provision of a specific timetable for resumption of housework duties in 65 % of the leaflets is a case in point . On the basis of the results of the survey , recommendations are made concerning the improvement of the st and ard of patient information leaflets The purpose of this study was to investigate the impact of a supportive-educative telephone program on the levels of knowledge and anxiety of patients undergoing coronary artery bypass graft surgery during the first 6 weeks after hospital discharge . With a posttest-only control group design , the first 74 patients scheduled , between September 1986 and February 1987 , for coronary artery bypass graft surgery in a large , western Canadian teaching hospital were r and omly assigned to either an experimental or a control group . The effect of the intervention , which was implemented by a cardiac rehabilitation nurse specialist , was assessed by a knowledge test and a state anxiety inventory . Data were collected without knowledge of the participants ' group assignment . As hypothesized , data analysis with independent t tests revealed a statistically significant ( p less than 0.05 ) difference between the knowledge level of the experimental and the control group in the areas of coronary artery disease , diet , medications , physical activity restrictions , exercise , and rest . A statistically significant difference between the state anxiety level of the experimental and the control group was also evident , as was a statistically significant inverse relationship between participants ' knowledge and anxiety levels . From these findings , several implication s and recommendations for nursing practice and research have been generated BACKGROUND This study evaluated the relative effects on compliance with recommended lifestyle changes of two experimental videotapes that involved different approaches for preparing coronary artery bypass graft ( CABG ) patients for the posthospital recovery period . The tapes differed in the extent to which they portrayed the recovery period as a steady , forward progression versus a series of " ups and downs . " METHODS Two hundred sixteen male and female CABG patients were assigned r and omly either to view one of the two videotapes before discharge from the hospital or to receive only the st and ard discharge preparation provided by the hospital . All patients completed measures of anxiety and self-efficacy at discharge , 1 month and 3 months after discharge from the hospital . Patients also completed measures of dietary fat consumption and activity level 1 and 3 months after discharge . RESULTS Relative to controls , patients who viewed either of the videotapes before hospital release reported higher self-efficacy for adhering to the recommended low-fat diet both at discharge and 1 month after surgery . Viewing either of the videotapes also result ed in significantly less dietary fat intake 1 month after hospital release compared with controls . Patients who viewed the tape that portrayed the recovery period as consisting of ups and downs also reported significantly more frequent moderate exercise at 1 month and more frequent strenuous exercise 3 months after discharge . CONCLUSIONS The experimental videotapes proved to be an effective method for increasing dietary and exercise compliance during the first 3 months after CABG Shortened hospitalizations following cardiac surgery necessitate re-evaluation of how pertinent information for self-care management and reduction of coronary artery disease risk factors can be incorporated into an effective inpatient cardiac patient teaching program . This study investigated the effect of three different teaching approaches ( i.e. , an inpatient teaching program , a postdischarge telephone follow-up program , and a postdischarge group teaching program ) among 90 patients who had undergone coronary artery bypass graft surgery . Teaching outcomes were evaluated in this study by use of the Heart Disease Management Question naire and Cardiac Surgical Patient Teaching Satisfaction Inventory . Analyses of the data revealed similar patient teaching outcomes regardless of the type of teaching intervention the participant received . Findings supported the effectiveness of the inpatient teaching protocol which focused on " survival skills " for self-care management postdischarge . The findings are important in the re design of teaching programs which are efficient yet meaningful to the patient within today 's health care environment . Additional findings indicated that patients who had longer  lengths of stay and those with more vessels bypassed were the least satisfied with their teaching . Further implication s for nurses involved in patient teaching are discussed The impact of patient education follow-up by telephone on the knowledge of the postmyocardial infa rct ion ( MI ) patient was investigated in this study . On the basis of Orem 's self-care framework , subjects ' levels of knowledge in six criterion areas were assessed according to measurement criteria developed by Horn and Swain . Fifty-one subjects from the total population of MI patients admitted to the coronary care unit of the study hospital during the period of research who met study criteria were r and omly assigned to experimental and control groups . Statistically significant differences ( p less than 0.05 ) were found in the knowledge level of the experimental group in the areas of the disease , its effects , related self-care measures , recommended exercises , and all teaching areas together . Although significant differences were not found in the teaching areas of therapeutic diet , medications , physical activity restrictions , and recommended rest , a higher mean was produced for the experimental group in all but one area . These findings demonstrate that a telephone teaching program for MI patients 6 to 8 weeks after hospital discharge can be effective in increasing knowledge relative to the disease , self-care , and therapeutic regimen PURPOSE Patients who have undergone coronary artery bypass graft surgery ( CABG ) are obvious c and i date s for rehabilitation programs because of the potential for progression of disease . Such programs have been shown to foster risk-factor modification , improve quality of life , and prolong survival among post-myocardial infa rct ion ( MI ) patients . However , the efficacy of these programs has not been established among patients who have undergone CABG . METHODS A r and omized controlled trial was employed to evaluate whether a behavioral and educational cardiac rehabilitation program was effective in modifying cardiovascular disease risk factors and improving quality of life in a cohort of 86 patients after CABG . Patients were recruited from the cardiac ward of a large teaching hospital and were block-r and omized to either an intervention group or routine care . Subjects in the intervention group attended 6 weekly group sessions following hospital discharge , and booster sessions at 8 months and 1 year . They also received a personalized behavior modification program based on their baseline risk factors . Risk factor and quality of life measures were recorded at baseline ( 6 weeks after surgery ) , 4 months , 8 months , and 1 year . RESULTS The results indicated few differences between the study groups . However , the intervention group 's aerobic capacity ( VO2max ) improved over that of the routine care group . With regard to the quality of life variables , all patients tended to improve steadily over time . CONCLUSIONS The relatively moderate success of this intervention program compared with various post-MI studies may be indicative of differences between the treatment needs of patients after acute myocardial infa rct ion or CABG . Future post-CABG rehabilitation research should explore these patients ' unique treatment needs , and investigate a variety of program strategies The purpose of this study was to investigate primary nursing , discharge teaching and patient satisfaction in a group of ambulatory cataract patients . A sample ( n = 72 ) of subjects was divided r and omly into a primary group ( n = 36 ) and a control group ( n = 36 ) . Data on patient knowledge and satisfaction was collected by telephone 24 - 48 hours after surgery . Knowledge levels were high , and there was no significant difference between the primary and control groups in total score or in sub-scores on self-care , normal side effects , or complications . Women had significantly higher total scores than men ( p > .05 ) . There was a very high level of satisfaction with care , and almost all patients felt ready to go home when discharged OBJECTIVE To establish whether the provision of commercially produced written information in addition to routine hospital information can improve patients ' knowledge and satisfaction and affect their health-related quality of life . METHODS Elective surgical patients were r and omised into an experimental group ( N = 54 ) who received three commercially produced information booklets  at pre- assessment , before surgery and at discharge , and a  control group ( N = 55 ) who received st and ard hospital information only .  RESULTS The experimental group were significantly less anxious immediately before their operation , and reported greater perceived control compared to controls post-operatively . Two weeks after discharge , health status for the two groups was similar except the experimental group reported significantly less pain . Overall satisfaction was fairly high and similar in both groups . The experimental group demonstrated greater knowledge at pre-admission , but not at discharge or follow-up . DISCUSSION Patients increasingly expect written information ; however amount , quality and timeliness vary considerably . Combining commercially produced information with st and ard hospital information may be to the patient 's benefit . PRACTICE IMPLICATION S Providing patients with commercially produced st and ardised information in addition to internally produced hospital information could have an additional , though limited , benefit to patients ' health outcomes . This could be a way of incorporating the expertise of both providers to the patient 's benefit OBJECTIVE To examine functional status outcomes among patients with a coronary artery bypass graft ( CABG ) over time ( ie , at baseline ; 3 months , 6 
    Output:
    
Major results : Findings indicate that delivery of postoperative patient education through the individualization of content , use of combined media for delivery , provision of education on a one-on-one basis , and in multiple sessions is associated with improvement in educational/health outcomes .