scholarly journals Parents and GPs’ understandings and beliefs about food allergy testing in children with eczema: qualitative interview study within the Trial of Eczema allergy Screening Tests (TEST) feasibility trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041229
Author(s):  
Clare Clement ◽  
Matthew J Ridd ◽  
Kirsty Roberts ◽  
Miriam Santer ◽  
Robert Boyle ◽  
...  

AimTo explore parent and general practitioner (GP) understanding and beliefs about food allergy testing for children with eczema.Design and settingQualitative interview study in UK primary care within the Trial of Eczema allergy Screening Tests feasibility trial.ParticipantsSemi-structured interviews with parents of children with eczema taking part in the feasibility study and GPs at practices hosting the study.Results21 parents and 11 GPs were interviewed. Parents discussed a range of potential causes for eczema, including a role for food allergy. They believed allergy testing to be beneficial as it could potentially identify a cure or help reduce symptoms and they found negative tests reassuring, suggesting to them that no dietary changes were needed. GPs reported limited experience and uncertainty regarding food allergy in children with eczema. While some GPs believed referral for allergy testing could be appropriate, most were unclear about its utility. They thought it should be reserved for children with severe eczema or complex problems but wanted more information to advise parents and help guide decision making.ConclusionsParents’ motivations for allergy testing are driven by the desire to improve their child’s condition and exclude food allergy as a possible cause of symptoms. GPs are uncertain about the role of allergy testing and want more information about its usefulness to support parents and help inform decision making.Trial registration numberISRCTN15397185.

2020 ◽  
Vol 77 (1) ◽  
pp. 296-307
Author(s):  
Danique W. Bos‐van den Hoek ◽  
Maureen Thodé ◽  
Irene P. Jongerden ◽  
Hanneke W. M. Van Laarhoven ◽  
Ellen M. A. Smets ◽  
...  

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101092
Author(s):  
Vincent A van Vugt ◽  
Anja JThCM de Kruif ◽  
Johannes C van der Wouden ◽  
Henriëtte E van der Horst ◽  
Otto R Maarsingh

BackgroundInternet-based vestibular rehabilitation (VR) with physiotherapy support, known as blended VR, was effective in reducing vestibular symptoms in a recent randomised controlled trial. Blended VR is a complex intervention comprised of physiotherapeutic visits, the vertigo training website, and VR exercises. Because of these interacting components, it is important to understand how blended VR works, for whom it works best, and how it should ideally be delivered.AimTo investigate the experiences of both patients and physiotherapists with blended internet-based VR.Design & settingA qualitative interview study was performed with patients who received blended internet-based VR with physiotherapy support, and physiotherapists who provided this support.MethodSemi-structured interviews were conducted with 14 patients and eight physiotherapists after the 6-month follow-up of the randomised trial. All interviews were audio-recorded, transcribed, and thematically analysed.ResultsAccording to both patients and physiotherapists, the physiotherapist visits were useful in providing personal attention, helping patients safely execute exercises, and improving patients’ adherence to therapy. Some patients said they did not need physiotherapist support and, according to physiotherapists, both the necessity and the optimal way to deliver guidance differed greatly between patients. The Vertigo Training website and exercises provided patients with a sense of control over their symptoms. Patients reported that the VR exercises were easy to perform and most patients continued to use them long after the trial ended.ConclusionIn blended VR, physiotherapeutic visits appear to offer benefits above the vertigo training website and VR exercises alone. Physiotherapy support may best be used when individually tailored.


2018 ◽  
Vol 69 (678) ◽  
pp. e8-e14 ◽  
Author(s):  
Melissa Stepney ◽  
Paul Aveyard ◽  
Rachna Begh

BackgroundReports from royal colleges and organisations such as Public Health England suggest that GPs and nurses should advise patients to switch to electronic cigarettes (e-cigarettes) if they do not want to stop smoking using licensed medication. However, there are no data on what practitioners think, feel, or do about e-cigarettes.AimTo explore practitioners’ perceptions and attitudes towards e-cigarettes, and their experiences of discussing e-cigarettes with patients.Design and settingA qualitative interview study was carried out with semi-structured interviews conducted with nurses and GPs across England in 2017.MethodParticipants were interviewed once either via telephone or face to face. Data were analysed using thematic analysis.ResultsInterviews were conducted with 23 practitioners (eight nurses and 15 GPs). There were three key themes: ambivalence and uncertainty; pragmatism; and responsibility. Many practitioners had uncertainties about the safety and long-term risks of e-cigarettes. Some had ambivalence about their own knowledge and ability to advise on their use, as well as uncertainty about whether to and what to advise patients. Despite this, many sought to provide honesty in consultations by acknowledging these uncertainties about e-cigarettes with patients and taking a pragmatic approach, believing that e-cigarettes were a ‘step in the right direction’. Practitioners wanted advice from healthcare regulators such as the National Institute for Health and Care Excellence to reassure them about the safety of e-cigarettes, practical tools to support the consultation, and to control their use by providing behavioural support programmes for reduction or cessation.ConclusionCurrent dissemination strategies for guidelines are not effective in reaching practitioners, who are offering more cautious advice about e-cigarettes than guidelines suggest is reasonable.


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