To develop and evaluate the PEM designed to enhance splenectomy patients' understanding, self-efficacy, and adherence to infection prevention behaviors, addressing the limitations of existing resources. We developed the PEM with reference to the successive approximation model and evaluated the PEM after 2 joint reviews by infectious disease specialists. The evaluation method was conducted using an online survey. Native Japanese-speaking adults aged ≥18 years were recruited. We measured Knowledge tests for post-splenectomy recommendations (12 points) and Infection-Prevention Practices score (18 points, Cronbach's α =. 849). In addition, Self-efficacy , Understandability , and Actionability were measured using single items. Correlation coefficients were calculated for each variable, and multivariate analysis with Knowledge and IPPS as the objective variables was conducted to verify the relationship between the factors. This study was approved by the Institutional Review Board of Graduate School of Human Sciences, Osaka University (Approval No: 24043). The final study participants were 300. There were 140 female (46.7%), with more than 75% aged 50 or younger. Although Knowledge for post-splenectomy recommendations were not correlated with any variables, subjective ratings of PEM Understandability and Actionability , along with Self-efficacy , showed a significant positive correlation with IPPS ( r = 0.23, 95% CI 0.11, 0.33, p < .001; r = 0 .25, 95% CI 0.14, 0.36 , p < .001 ; r = 0. 26, 95% CI 0.15, 0.36 , p < .001). However, the results of multivariate analysis with IPPS as the objective variable ( F 11, 288 = 4.76, p < .001, R 2 = 0.154) suggested that participants' health literacy and financial status might have a stronger influence on behavior than subjective ratings of PEM. Furthermore, 34% of participants showed a change in hesitancy toward vaccination after learning about the associated vaccine costs ( X 2 = 97.01, p < .001). We evaluated educational materials for patients undergoing splenectomy using an online survey. When developing PEMs, the ability to provide behavioral support should be considered, and a psychological approach that improves patients' subjective evaluation and fosters their sense of self-efficacy is essential.
Kita et al. (Sun,) studied this question.