A cost–effectiveness analysis of a multimedia learning education program for stoma patients
Shu-Fen Lo
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorYun-Tung Wang
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorLi-Yue Wu
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorMei-Yu Hsu
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorShu-Chuan Chang
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorMark Hayter
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorShu-Fen Lo
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorYun-Tung Wang
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorLi-Yue Wu
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorMei-Yu Hsu
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorShu-Chuan Chang
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorMark Hayter
Authors: Shu-Fen Lo , MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Yun-Tung Wang , PhD, MSW, Assistant Professor, Department of Social Work, National Taiwan University, Taipei, Taiwan; Li-Yue Wu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Mei-Yu Hsu , BSc, RN, Wound Ostomy and Incontinence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, and Graduate Student, Graduate Institute of Nursing, Tzu Chi University, Hualien, Taiwan; Shu-Chuan Chang , PhD, RN, Director, Department of Nursing, Buddhist Tzu Chi General Hospital, and Associate Professor, Department of Nursing, Tzu Chi University, Hualien, Taiwan; Mark Hayter , BA (Hons), MSc, PhD, RN, Cert Ed, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
Search for more papers by this authorAbstract
Study aims. The purpose of this study was to compare the costs and effectiveness of enterostomal education using a multimedia learning education program (MLEP) and a conventional education service program (CESP).
Background. Multimedia health education programs not only provide patients with useful information in the absence of health professionals, but can also augment information provided in traditional clinical practice. However, the literature on the cost–effectiveness of different approaches to stoma education is limited.
Design. This study used a randomised experimental design.
Methods. A total of 54 stoma patients were randomly assigned to MLEP or CESP nursing care with a follow-up of one week. Effectiveness measures were knowledge of self-care (KSC), attitude of self-care (ASC) and behavior of self-care (BSC). The costs measures for each patient were: health care costs, MLEP cost and family costs.
Results. Subjects in the MLEP group demonstrated significantly better outcomes in the effectiveness measures of KSC, ASC and BSC. Additionally, the total social costs for each MLEP patient and CESP patient were US$7396·90 and US$8570·54, respectively. The cost–effectiveness ratios in these two groups showed that the MLEP model was better than the CESP model after one intervention cycle. In addition, the Incremental Cost Effectiveness Ratio was −20·99.
Conclusion. This research provides useful information for those who would like to improve the self-care capacity of stoma patients. Due to the better cost–effectiveness ratio of MLEP, hospital policy-makers may consider these results when choosing to allocate resources and develop care and educational interventions.
Relevance to clinical practice. This study provides a cost effective way of addressing stoma care in the post-operative period that could be usefully transferred to stoma care settings internationally.
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