Patient journals/diaries/calendars: case(s)

I've just realized I haven't posted since October! I guess there has been a lot going on and not much time to write about it. Mostly I have been busy in the teaching rooms which continues to be productive and fascinating. The rest of the time is increasingly taken up with ordering pamphlets and tracking pamphlet orders. For some reason more and more of them are being requested by various nurses and doctors, even though fewer of them are available for order in print format as information goes digital. Finding a balance between print and e-resources is proving to be a challenge which is a topic for another day.

Keeping track

What I' m going to post today is a list of journals/diaries/calendars that can be given to patients and families when they are asked to keep track of behaviours, symptoms and/or side effects of medications. Doing so can help in the diagnostic and treatment process. Because it is often hard remember how often you can't sleep or feel anxious for example, keeping track while it happens helps the doctor/nurse get a better sense of what's really going on. There are a variety of instances in which such a thing can be useful.

Here are some of the most commonly requested:

Sleep:

Health Link BC: Sleep diary

Keeping track of symptoms:

Depression and Bipolar Support Alliance: Mood and anxiety calendar
Mood Disorders Association of Ontario: Mood diary (pdf)
International Foundation for Functional Gastrointestinal Disorders: Bowel disorder symptom diary (pdf)
Ovarian Cancer Action: Ovarian cancer symptom diary
About.com: Daily symptom diary for kids
About.com: Tracking fibromyalgia or chronic fatigue syndrome symptoms
The Lung Association: Asthma diary card (scroll down)
American Urogynecologic Society Foundation: Bladder diary
National Headache Foundation: Headache diary
World Headache Alliance: Headache diary

Medication side effects and pain:

American Cancer Society: Track cancer side effects and pain

Eating/exercise:

WebMD: Food diary and food allergy triggers
American Cancer Society's Great American health challenge: Food diary
US Gov. Weight-Control Information Network: Sample food diary (scroll down)

Low back pain week: 2 cases

I am glad to report that this week I was presented with not one, but two cases, both having to do with low back pain.

Case #1

Scenario

A French-speaking middle-aged man has been referred to me by his physician at the clinic. He suffers from chronic low back pain and would like to know which exercises might help.

Resolution

First I go to Passeportsanté, hoping to find something in French similar to the MedlinePlus interactive tutorials, or at least with illustrated exercises.

Passportsanté > A-Z > D > Dos (mal de). This takes you to the same page as Douleurs lombaires.

Unfortunately there are no illustrations and certainly nothing interactive. I print it out anyway and then try CiSMeF (sites médicaux francophones à destination des patients et de leurs familles) to see what they have there.

CiSMeF > keywords: "exercises dos." I get two results, neither of which include illustrations, or even examples of exercises. Somewhat interesting though, so I print them out too.

Mal de dos: guide pratique
Mal de dos: pour faire le point

At this point I decide it's time to go to MedlinePlus. Since the information is illustrated, and the patient does speak some English, he will still be able to benefit from it.

MedlinePlus > keywords: "back exercises." I print out the list of results so he can access it again at home, and also print out the text summary of the interactive tutorial (which includes illustrations), and the second hit on the list which is a Low back pain exercise guide from the American Academy of Orthopaedic Surgeons.


Case #2

Scenario

One of the health professionals (HP) at the clinic comes into my room and asks if there is a pamphlet on back exercises. I know which one he is thinking of but we have run out.

Resolution

Since the patient speaks English and I have already fielded a similar question earlier in the week, I go directly to MyHq where I have bookmarked some useful links under the Pain management section.

I show the HP the aforementioned MedlinePlus interactive tutorial which he thinks is great (it really is), and Low back pain exercise guide from the American Academy of orthopaedic Surgeons, and this time I also include Low back pain: tips on pain relief and prevention from familydoctor.org.

I ask the HP to fill out an Rx so I can document the consultation and he is happy to do so even though it means returning to the exam room to get the patient's information (name, chart no.). I run into him later in the hall and he tells me he was impressed by how quickly I was able to find the information and that he is going to go back and explore MedlinePlus for himself.

Discussion

I often find that the French language information I am able to find is rich in theory and somewhat lacking in terms of image/illustration and maintaining an appropriate reading level. Fortunately most of the patients I see at the clinic are able to read enough English to still benefit from those resources. It is interesting to note that CiSMeF links directly from each topic to the corresponding section in MedlinePlus. All roads lead...

It is also interesting to note that this resource that we (librarians/information professionals) take for granted, is still not well known to all health professionals. I think this is true of many of the resources we use on a regular basis. I have noticed that health professionals at the clinic often request information in pamphlet form, even though they are all too aware that their patients are going online for information. The clinic used to have a "pamphlet room" and a pamphlet database, so I suspect that this is partly due to habit rather than ignorance.