Patient interviews were planned to investigate the effectiveness of proposed PILs.
Main themes such as: patient understanding of information in the PIL,
readability and recall of information,
compliance/adherance to instructions and patient satisfaction were focussed upon. These were explored to gain more insight about the value of providing a PIL with every patient appointment (fig.
What are the key points which need to be included in a PIL for patients attending interventional radiology procedures – varicoceole embolisation and FLGJI?
Do patients understand the information in the leaflet?
3.Do the PILs support the outpatients prepare appropriately for the procedure and manage self-care as directed through the PIL?
Designing Evidence-based PILs
The leaflets produced were designed with the insight and supervision of a resident consultant radiologist who was responsible for performing the procedures,
through review of PILs and literature by the researcher,
as well as some input from the angiography team; and thus,
evidence-based PILs were developed to provide radiological procedural information - preparation,
explanation of interventional procedures and aftercare.
Readability was tested via validated readability programs and the author also compared the PILs with various texts (fig.
2,3). The interpretation can be retreived with the use of Table 1.
Radiology approved content was confirmed and this constituted the expert knowledge for the leaflet production. However,
this might not satisfy the information needs of the patient11 and so the researcher included feedback from the patient experience to improve the leaflets to support a more patient oriented outcome.
The process for leaflet from production to distribution is outlined in figure 4. Target Population Inclusion Criteria:
- Outpatients only
- Patients who were able to understand the written Maltese or English language
Target Population Exclusion Criteria:
- Patient who were unable to communication
- Patients who could not or did not read the leaflet.
Patient feedback sessions
Consent was sought before patients were interviewed. The interview was conducted either in Maltese or English according to the patients’ choice,
to facilitate their understanding and answering of questions but since this was an interview,
at times the researcher could also switch languages in order to allow the best chance for the patient to fully understand what was being asked. Questions were created,
aligned to sections from the leaflet to test for understanding,
memory and compliance.
The first few patients (n=6 overall; 4 for FLGJI and 2 for varicoceole embolisation) who accepted to participate in the survey were allocated for pilot involvement,
to test the research instrument’s reliability and the changes suggested,
at validity stage.
The information gathered by the questions in the interview schedule underpinned:
For both leaflets
- Demographics: to obtain a picture of the participant’s sex,
- Confirmation that the leaflet was read.
- Preferance between language chosen was identified.
Additional questions were asked to test the readability and understanding of the leaflet and also to identify satisfaction of information provided.
Varicoceole embolisation leaflet specific questions:
- Understanding of varicoceole embolisation and from where was
- Questions about: local anaesthesia,
remaining hydrated by drinking
if they knew who would perform the procedure,
knew what medicine would be injected in the joint,
where all asked to
test the level of understanding as well as attention after having read the
- Participants were asked for their opinion on the leaflet and whether they
felt reassured by it.
Recommendations that could enhance the leaflet
- The length of the leaflet was queried and participants rated the
importance of the sections.
Fluoroscopy guided joint injection leaflet specific questions:
- Some patients were returning patients so participants were asked
whether they were first time patients.
- To check understanding of the leaflet; participants were asked if they
knew: who would perform the procedure, what is local anaesthetic,
what medicine would be injected in the joint and prompted to mention
some of the instructions listed as important to tell the staff before
- The leaflet was rated by the participant for relevance of the various
sections and their opinion sought for recommendations that could
enhance the leaflet.
- The participants were also asked whether they felt reassured by the
leaflet and the length of the leaflet was queried.
Post-procedure Telephone Interviews
Participants were contacted 7 days post-procedure to check if the leaflet matched the reality of their experience,
whether they adhered to the instructions of aftercare and if they needed to call their doctor due to pain in the following days after the procedure. They were finally asked if they had suggestions for the leaflet to add value to the information in the leaflet.