title: [Exploring the effectiveness of a health education program on the stimuli frame and on uncertainty in patients with sudden hearing loss].
abstract: BACKGROUND
  Uncertainty may limit communication and affect the ability of patients to adapt to their illness. A high level of uncertainty in patients concurrent with sudden hearing loss has been related to poor comprehension of communications and poor illness understanding. Currently, there is no any certain standard information sheet in the clinical setting.
  
  
  OBJECTIVE
  This study evaluates the effect of a one-to-one oral instruction strategy combined with an information sheet firstly on the stimuli frame and then on uncertainty in patients suffering from idiopathic sudden sensorineural hearing loss.
  
  
  METHODS
  An experimental design was employed and 60 patients were randomly assigned to either the experimental group (n=28) or the control group (n=32). A structured questionnaire that included the stimuli frame of uncertainty and the Mishel uncertainty illness scale was used to collect data. All samples received regular care following admission to the hospital and received the pretest within 24 hours after admission. The experimental group received the one-to-one oral instruction strategy combined with an information sheet immediately after the pretest. All participants completed the posttest three days later.
  
  
  RESULTS
  The health education program increased perceived understanding of illness in patients with the sudden hearing loss, and reduced their illness uncertainty. Perceived understanding of illness was negatively related to the level of illness uncertainty. The stimuli frame of uncertainty acted as a mediator between the intervention and the uncertainty. The intervention increased the level of cognition of the stimuli frame of uncertainty and then indirectly lowered the uncertainty level.
  
  
  CONCLUSIONS
  These findings support the effectiveness of the individual health education strategy with the information sheet in delivering to patients critical information about their condition and treatment. Moreover, this intervention may effectively increase illness cognition and reduce uncertainty in patients with sudden hearing loss. Clinical nurse staffs may use the findings of this study to improve their health education efficacy.
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Nursing, Fu-Jen Catholic University;, Taiwan, ROC. 033550@mail.fju.edu.tw.
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Wang
authors.affiliation: College of Medical, National Cheng Kung University, Taiwan, ROC.
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taiwan, ROC.
authors.forename: An-Suey
authors.initials: AS
authors.lastname: Shiao
authors.affiliation: Department of Otology, Taipei Veterans General Hospital, Taiwan, ROC.
authors.forename: Tzong-Yang
authors.initials: TY
authors.lastname: Tu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D003639:Hearing Loss, Sudden / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D035501:Uncertainty
keywords: health education program; stimuli frame of uncertainty; sudden sensorineural hearing loss; uncertainty in illness