Nurses/Doctors/Teachers: How to explain stats/research studies in 60 seconds or less?

OK, the time isn’t really important, but I need to know how to teach someone what some studies mean, while that someone is not highly educated in math and/or science, she’s in pain (and on painkillers which make her a little fuzzy minded) and highly emotional.

I’ve got a patient getting home health care who has a very severe (stage IV) pressure ulcer. We (her health care team) strongly believe that it’s time to start negative pressure therapy (“a wound vac”) but she doesn’t want it. I’ve found a couple of studies showing decreased hospitalization rates, decreased healing times, etc with the treatment we’re recommending vs. the treatment she’s getting now, but I’m not sure how to explain them to her and be both simple and accurate.
Schwien T, Gilbert J, Lang C. Pressure ulcer prevalence and the role of negative pressure wound therapy in home health quality outcomes.
Ostomy Wound Management. 2005 Sep;51(9):47-60.

Early versus late initiation of negative pressure wound therapy: examining the impact on home care length of stay.:

Any suggestions? I don’t want to bully her into saying yes, but I want to be certain she knows what she’s saying no to.

Why doesn’t she want it? Instead of bringing out studies, can you ask her what she knows/understands and why she is refusing, and then you can better clarify what negative pressure is, why you, as the health team, think it is time for negative pressure, etc. If someone is in pain and highly emotional, I would think that hearing the thoughts and opinions of the people on her personal health care team would be more swaying than some statistics done in some study by people she’s never heard of.


Based on what you provided:

"Using this technique earlier rather than later or not at all would make it more likely that you can stay out of the hospital, maybe as much as three times as likely, and heal faster. The biggest issue with it is the cost.

What concerns do you have about it?"

This does not sound like someone who needs or who wants the study details. Instead you need to find out what her concerns actually are (which may be more emotional ones and while not necessarily rational very real and cogent to her) and address those. What is she scared of? Does it represent a path to becoming machine dependent, a path to being on a vent? Some other reason?

On preview, yeah, what yams!! said.

Thank you. That helps me feel like I’m on the right track, since that’s how I’ve approached it thus far. My adding the study info in really to make sure I’ve covered therational benefits/risks, so I feel that her informed refusal is truly informed. I’m not legally responsible for getting the informed consent (her MD is), but I do feel ethically responsible for making sure she’s got the information, y’know?

Her main argument against it is “I don’t want that tube thing sticking out’ my back.” Which…I can’t really argue against. I get it. She’s already got a Foley tube sticking out her nethers, she’s already wheelchair and bedbound and has to have someone else help her for absolutely everything, including turning over. This whole thing absolutely totally sucks for her, a relatively young and, until a recent stroke, independent woman.

The other emotional aspect is that she was given the impression by the wound care consultant that if she got the wound vac, the consultant would become her nurse, and she doesn’t want to lose me as her nurse. Got that one tidied up and corrected before I left yesterday, reassuring her that I will receive training from the wound vac company and will continue to be her nurse if/when that’s what she chooses. Asked her to sleep on it before she let herself get attached to a decision. I’m on my way there now to see what’s up for her today. I won’t overwhelm her with numbers, but I will share with her that I looked up a few studies, and repeat what DSeid said.

The new Wound Vac tubing is quite flexible. Were she to have it on her back or butt, it’s not like the tubing is going to stick straight out like a tail–it can be adjusted for positioning and not be incredibly conspicuous while she’s, say, up and about in a wheelchair.

That’s what I pictured when you mentioned “that tube thing sticking out.” Maybe she is too? And if she’s laying in bed and not right on top of the Vac dressing, she wouldn’t even notice the tubing.

Better than studies, Whynot, whynot her some before & after photos of wounds that have improved from VAC therapy? I bet the VAC rep has some.