Objective This study examines the potential benefit of an interactive counselling program via a mobile application (app), which can instantly provide patients with the necessary information and correct response regarding their condition. Methods We designed a free ‘Ureteric Stent Interactive Program’ for patients receiving ureterorenoscopic lithotripsy and provided the program to interested patients. Patient data were collected from medical records and depending on whether patients used our program, they were divided into two groups: ‘program-user’ and ‘non-user’. The differences between the groups were analysed using Fisher’s exact tests. Results Of the 70 patients, 50 elected to use the program. The program-user group was significantly younger (<60 years: 74% vs 15%, P<0.001) and had higher education levels (40% vs 5%, P = 0.004). All 50 patients in the program-user group reported being satisfied (32%) or very satisfied (68%) with the program. Patients over 60 years were significantly more satisfied with program (35.5% vs 6.3%, P = 0.04). Conclusions Younger patients with high education levels were more likely to use the app and improve their health knowledge. Using the program resulted in high satisfaction, especially among older patients. This study demonstrates the benefits of interactive application for educating patients regarding their health.
Rationale: Chondromas are benign tumors comprising cartilaginous tissue that commonly occur in the small bones of the hands and feet. Chondromas are extremely rare in extraskeletal soft tissues, and only six cases of bladder chondromas have been reported thus far. Patient concerns: A 75-year-old woman presented with abdominal pain and urinary symptoms, including increased frequency and a weak stream. Diagnosis: Cystoscopy revealed a well-defined bladder mass over the anterior bladder wall. The pathology report showed neoplastic chondrocytes within the hyalinized and focal myxoid matrix, and immunopositivity for S-100, leading to the seventh known diagnosis of bladder chondroma. Interventions: The tumor was endoscopically resected. The postoperative stay was uneventful, and 5 days later, the patient was discharged after the removal of the urinary catheter. Outcomes: One month after surgery, repeated cystoscopy showed no recurrence of the bladder tumor, and the patient reported improvement in urinary symptoms and relief of lower abdominal pain. Lessons: Chondromas of the urinary bladder can present as urinary symptoms and abdominal pain in older patients. Transurethral resection is the treatment of choice.
BACKGROUND Health education is important for improving patients’ adherence to treatment, thereby reducing morbidity. Face-to-face communication is not sufficient nowadays, and online interaction can improve patient–physician communication and education. OBJECTIVE We designed a chatbot for patients who received indwelling double-J ureteric stents (DJs) after ureterorenoscopic lithotripsy (URSL) and evaluated the efficacy of this chatbot in improving patient satisfaction in clinical practice. METHODS We designed a chatbot, based on the free module provided by the communication application Line©, which described the associated symptoms with DJs and the self-care of DJs after discharge and emphasized the importance of timely DJ removal. Patients could interact with the chatbot for any concerns regarding their DJs after discharge. We prospectively included patients who received indwelling DJs after URSL at our hospital from August 1st, 2019 to November 30th, 2019. Patient education on DJ-related information was conducted either by medical staff before discharge or by using the chatbot, based on patients’ preference. Patients were asked to rate the severity of their DJ-related symptoms and their satisfaction with using the free chatbot on a five-point scale before DJ removal. Fisher’s exact test was used to evaluate the effect of the chatbot on the severity of DJ-related symptoms and the possible factors associated with the satisfaction with this chatbot. RESULTS A total of 70 patients were included. Twenty patients received routine education by medical staff while 50 patients elected to have additional interaction through the chatbot. The patients in the chatbot group were significantly younger (age <60 years: 74% versus 15%, P < .001), had a higher education level (40% versus 5%, P = .004), and reported more severe gross hematuria (66% versus 15%, P < .001) than those in the medical-staff group. No differences were observed for other DJ-associated symptoms. On multivariate analysis, severe gross hematuria was significantly associated with age younger than 60 years (odds ratio 6.704, P = .003, 95% CI 1.898–23.673) and the use of the chatbot (odds ratio 6.63, P = .02, 95% 1.374–31.989). All 50 patients in the chatbot group reported being satisfied (32%) or very satisfied (68%) with the chatbot tool. Patients older than 60 years were significantly more satisfied with the chatbot (35.5% versus 6.3%, P = .04). Education level, the severity of DJ-associated symptoms, and the recognition of the necessity of DJ removal were not significantly associated with the degree of satisfaction. CONCLUSIONS The use of a chatbot resulted in high satisfaction of the patients, especially elderly patients. Younger patients with higher education levels were more likely to adopt this new form of communication, which helped improve their knowledge of DJ-associated symptoms.
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