Health professionals’ inclusion of green space in the management of long term conditions: a scoping review

2020 ◽  
pp. 1-12
Author(s):  
Amy Buckley ◽  
Karl Brownlie ◽  
Karl Hill ◽  
Ruby-Rose Hallamore ◽  
Nikita Vijan ◽  
...  
2019 ◽  
pp. 174239531983646
Author(s):  
Jessica Young ◽  
Ursula Poole ◽  
Fardowsa Mohamed ◽  
Shona Jian ◽  
Martyn Williamson ◽  
...  

Objectives There is renewed attention to the role of social networks as part of person-centred long-term conditions care. We sought to explore the benefits of ‘care maps’ – a patient-identified social network map of their care community – for health professionals in providing person-centred care. Methods We piloted care maps with 39 patients with long-term conditions in three urban and one rural general practice and two hospital wards. We interviewed the health professionals (n = 39) of these patients about what value, if any, care maps added to patient care. We analysed health professional interview data using thematic analysis to identify common themes. Results Health professionals all said they learned about their patients as a person-in-context. There was an increased understanding of patients’ support networks, synthesising what is known and unknown. Health professionals understood patients’ perceptions of health professionals and what really mattered to patients. There was discussion about the therapeutic value of care maps. The maps prompted reflection on practice. Discussion Care maps facilitated a broader focus than the clinical presentation. Using care maps may enable health professionals to support self-management rather than feeling responsible for many aspects of care. Care maps had ‘social function’ for health professionals. They may be a valuable tool for patients and clinicians to bridge the gap between medical treatment and patients’ lifeworlds.


2018 ◽  
Author(s):  
Sung Wook Kim ◽  
Jason Madan ◽  
Melina Dritsaki ◽  
Carol Bryce ◽  
Vera Forjaz ◽  
...  

BACKGROUND Since the introduction of digital health technologies in National Health Service (NHS), health professionals are starting to use email, text, and other digital methods to consult with their patients in a timely manner. There is lack of evidence regarding the economic impact of digital consulting in the United Kingdom (UK) NHS. OBJECTIVE This study aimed to estimate the direct costs associated with digital consulting as an adjunct to routine care at 18 clinics serving young people aged 16-24 years with long-term conditions. METHODS This study uses both quantitative and qualitative approaches. Semistructured interviews were conducted with 173 clinical team members on the impacts of digital consulting. A structured questionnaire was developed and used for 115 health professionals across 12 health conditions at 18 sites in the United Kingdom to collect data on time and other resources used for digital consulting. A follow-up semistructured interview was conducted with a single senior clinician at each site to clarify the mechanisms through which digital consulting use might lead to outcomes relevant to economic evaluation. We used the two-part model to see the association between the time spent on digital consulting and the job role of staff, type of clinic, and the average length of the working hours using digital consulting. RESULTS When estimated using the two-part model, consultants spent less time on digital consulting compared with nurses (95.48 minutes; P<.001), physiotherapists (55.3 minutes; P<.001), and psychologists (31.67 minutes; P<.001). Part-time staff spent less time using digital consulting than full-time staff despite insignificant result (P=.15). Time spent on digital consulting differed across sites, and no clear pattern in using digital consulting was found. Health professionals qualitatively identified the following 4 potential economic impacts for the NHS: decreasing adverse events, improving patient well-being, decreasing wait lists, and staff workload. We did not find evidence to suggest that the clinical condition was associated with digital consulting use. CONCLUSIONS Nurses and physiotherapists were the greatest users of digital consulting. Teams appear to use an efficient triage system with the most expensive members digitally consulting less than lower-paid team members. Staff report showed concerns regarding time spent digitally consulting, which implies that direct costs increase. There remain considerable gaps in evidence related to cost-effectiveness of digital consulting, but this study has highlighted important cost-related outcomes for assessment in future cost-effectiveness trials of digital consulting.


2020 ◽  
Vol 6 ◽  
pp. 205520762094235
Author(s):  
Jackie Sturt ◽  
Caroline Huxley ◽  
Btihaj Ajana ◽  
Caitjan Gainty ◽  
Chris Gibbons ◽  
...  

Background While studies have examined the impact of digital communication technology on healthcare, there is little exploration of how new models of digital care change the roles and identities of the health professional and patient. The purpose of the current study is to generate multidisciplinary reflections and questions around the use of digital consulting and the way it changes the meaning of being a patient and/or a health professional. Method We used a large pre-existing qualitative dataset from the Long-term Conditions Young People Networked Communication (LYNC) study which involved interviews with healthcare professionals and a group of 16–24 years patients with long-term physical and mental health conditions. We conducted a three-stage mixed methods analysis. First, using a small sample of interview data from the LYNC study, we identified three key themes to explore in the data and relevant academic literature. Second, in small groups we conducted secondary analysis of samples of patient and health professional LYNC interview data. Third, we ran a series of rapid evidence reviews. Findings We identified three key themes: workload/flow, impact of increased access to healthcare and vulnerabilities. Both health professionals and patients were 'on duty' in their role more often. Increased access to healthcare introduced more responsibilities to both patients and health professionals. Traditional concepts in medical ethics, confidentiality, empathy, empowerment/power, efficiency and mutual responsibilities are reframed in the context of digital consulting. Conclusions Our collaboration identified conflicts and constraints in the construction of digital patients and digital clinicians. There is evidence that digital technologies change the nature of a medical consultation and with it the identities and the roles of clinicians and patients which, in turn, calls for a redefinition of traditional concepts of medical ethics. Overall, digital consulting has the potential to significantly reduce costs while maintaining or improving patient care and clinical outcomes. Timely study of digital engagement in the National Health Service is a matter of critical importance.


2020 ◽  
Vol 37 (6) ◽  
pp. 845-853
Author(s):  
Martha M C Elwenspoek ◽  
Lauren J Scott ◽  
Katharine Alsop ◽  
Rita Patel ◽  
Jessica C Watson ◽  
...  

Abstract Background Studies have shown unwarranted variation in test ordering among GP practices and regions, which may lead to patient harm and increased health care costs. There is currently no robust evidence base to inform guidelines on monitoring long-term conditions. Objectives To map the extent and nature of research that provides evidence on the use of laboratory tests to monitor long-term conditions in primary care, and to identify gaps in existing research. Methods We performed a scoping review—a relatively new approach for mapping research evidence across broad topics—using data abstraction forms and charting data according to a scoping framework. We searched CINAHL, EMBASE and MEDLINE to April 2019. We included studies that aimed to optimize the use of laboratory tests and determine costs, patient harm or variation related to testing in a primary care population with long-term conditions. Results Ninety-four studies were included. Forty percent aimed to describe variation in test ordering and 36% to investigate test performance. Renal function tests (35%), HbA1c (23%) and lipids (17%) were the most studied laboratory tests. Most studies applied a cohort design using routinely collected health care data (49%). We found gaps in research on strategies to optimize test use to improve patient outcomes, optimal testing intervals and patient harms caused by over-testing. Conclusions Future research needs to address these gaps in evidence. High-level evidence is missing, i.e. randomized controlled trials comparing one monitoring strategy to another or quasi-experimental designs such as interrupted time series analysis if trials are not feasible.


2017 ◽  
Vol 18 (1) ◽  
Author(s):  
John Owens ◽  
Vikki A. Entwistle ◽  
Alan Cribb ◽  
Zoë C. Skea ◽  
Simon Christmas ◽  
...  

2020 ◽  
Vol 105 (11) ◽  
pp. 1093-1104
Author(s):  
Sarah Blower ◽  
Veronica Swallow ◽  
Camila Maturana ◽  
Simon Stones ◽  
Robert Phillips ◽  
...  

BackgroundThe use of patient-facing health technologies to manage long-term conditions is increasing; however, children and young people may have particular concerns or needs before deciding to use different health technologies.AimsTo identify children and young people’s reported concerns or needs in relation to using health technologies to self-manage long-term conditions.MethodsA scoping review was conducted. We searched MEDLINE, PsycINFO and CINAHL in February 2019. Searches were limited to papers published between January 2008 and February 2019. We included any health technology used to manage long-term conditions. A thematic synthesis of the data from the included studies was undertaken. We engaged children with long-term conditions (and parents) to support review design, interpretation of findings and development of recommendations.ResultsThirty-eight journal articles were included, describing concerns or needs expressed by n=970 children and/or young people aged 5–18 years. Most included studies were undertaken in high-income countries with children aged 11 years and older. Studies examined concerns with mobile applications (n=14), internet (n=9), social media (n=3), interactive online treatment programmes (n=3), telehealth (n=1), devices (n=3) or a combination (n=5). Children and young people’s main concerns were labelling and identity; accessibility; privacy and reliability; and trustworthiness of information.DiscussionThis review highlights important concerns that children and young people may have before using technology to self-manage their long-term condition. In future, research should involve children and young people throughout the development of technology, from identifying their unmet needs through to design and evaluation of interventions.


2020 ◽  
pp. 1-11
Author(s):  
Caitlin Glue ◽  
Rowan Haveron ◽  
Megan-Li Smith ◽  
Pranav Thiagarajan ◽  
Heather Edwards ◽  
...  

2020 ◽  
Vol 26 (4) ◽  
pp. 2811-2833
Author(s):  
Amalie Søgaard Nielsen ◽  
Kristian Kidholm ◽  
Lars Kayser

Data from digitally administered patient reported outcomes (PROs) is used more and more in routine healthcare for long-term conditions as a part of daily clinical practice. This literature study reviews empirical studies of digital PRO to examine patients’ reasons for non-use of digitally administered PRO data in routine care. This scoping review searched through PubMed, Embase, Web of Science and PsycINFO databases, reporting on study population, intervention, duration of intervention and motivational factors alongside stated reasons for nonparticipation or dropout for each study. The patients’ reasons for not participating, either from study start or by dropout, were analysed through a thematic approach. Fifty-one studies were included, published from 2010 to 2019, mostly from Europe and the Unites States covering different long-term conditions. The reasons for non-use are manifold and cover the themes of ability to use PRO, engagement, emotional distress and technical barriers. Several reasons are given explaining why patients with long-term conditions are not using digitally administered PRO as intended. This should be taken into account in the design phase of digital PRO interventions and considered in conversations with patients during the intervention.


2019 ◽  
Vol 12 (5) ◽  
pp. 339-351 ◽  
Author(s):  
David Lindsay ◽  
Daryl Brennan ◽  
Daniel Lindsay ◽  
Colin Holmes ◽  
Wendy Smyth

PurposeThe purpose of this paper is to describe the patterns of self-disclosure of long-term conditions at work by health professionals in a large regional health service. Recent research by the authors has reported on the self-reported long-term conditions of nursing, medical and allied health staff within a large regional hospital and health service in North Queensland, Australia. Data regarding self-disclosure of health information were gathered during those two previous studies, but has yet to be reported. This current study thus offers the opportunity to explore and describe patterns of self-disclosure by a multi-disciplinary cohort of health professionals within that regional health service.Design/methodology/approachThis current study was a component of two larger studies, reported elsewhere, which explored long-term conditions among health professional staff at a large regional health service in North Queensland, Australia. A cross-sectional survey design was used.FindingsDecision-making associated with self-disclosure of long-term conditions by health professional staff in the workplace is multifactorial, and affected by considerations of age, gender, workplace circumstances and nature of the health condition. It also differs according to professional grouping. The medical profession were less likely than nurses and allied health workers to disclose to their work colleagues. Respondents with a mental health condition were more cautious and selective in their disclosures, and alone in being more likely to disclose to their supervisor than to colleagues; they were also most likely to value the sympathy and understanding of their colleagues and managers.Research limitations/implicationsThis study was conducted across only one large regional health service; a fuller picture of patterns of self-disclosure of long-term conditions by health professional staff would be gained by expanding the number of sites to include metropolitan hospitals, smaller rural or remote health services and non-hospital settings.Practical implicationsHealthcare organizations need to develop support strategies and communication processes so that staff with one or more long-term condition, particularly those that have associated stigma, are empowered to disclose information to line managers and colleagues without fear of discrimination, ostracism, incivility or bullying.Originality/valueThere is a paucity of evidence about self-disclosure of long-term conditions by health professionals and this study therefore makes an important contribution to the extant literature. The findings raise important questions about the culture and dynamics of health care organizations in respect to the patterns of self-disclosure of health professional staff.


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