Nurse-based education: an office-based comparative model for education of migraine patients

A person with migraine needs to be prepared to make therapeutic decisions on her own. For this reason, patients often need education to understand the nuisances of managing theirmigraines. In this study an educationalCD-ROM/DVD that described the pathophysiology was utilized by nurses in an office-based primary care setting for patient education. Outcomes from this encounter were measured.

(1) Identify educational information that assisted migraine patients feel empowered to more effectively manage migraine; (2) encourage patients to intervene during the mild headache phase of the migraine; (3) measure education related changes in patient satisfaction and confidence regarding management of migraine; (4) measure changes in nurse satisfaction and confidence in educating migraine patients; (5) compare the effectiveness of 3 methods of delivery of nurse-based migraine education.

One hundred and eighty migraineurs at 21 primary care practices were divided into 4 groups: group A watched the CD-ROM/DVD in the office with a nurse available to answer questions; group B was given the CD-ROM/DVD by a nurse knowledgeable of the content; group C received the educational CD-ROM/DVD from a nurse without comment; group D received no educational material. The 10 nurses in groups A and B participated in a 45-minute teleconference that reviewed the information on the CD-ROM/DVD. Patients and nurses answered a pre- and post-study migraine questionnaire. Patients filled in a treatment diary online within 24 hours of treating a migraine. Nurses completed a satisfaction questionnaire.

Of the 17 educational points tested on the pre-test, 75% of patients and nurses already knew about 1/3 of the information. There was significant improvement noted for both patients and nurses on the post-test in groups A, B, and C but not in group D. The percentage of correct responses by patients and nurses was directly and statistically significantly correlated with the involvement of the nurse in the educational effort. As a result of the education, patients felt more confident in their ability to manage and treat migraine. Likewise, nurses gained increased confidence in teaching patients about migraine. Patients did not intervene with acute therapy during the mild headache phase. Overall, 94% of the nurses were very satisfied or satisfied with the format and information provided.

All but objective 2 were met for groups A, B, and C compared to control group D. Patients readily accepted nurse-directed education and assimilated information that increased their confidence to manage migraine. This emphasizes the importance of training nurses about materials used to educate patients.