scholarly journals Taking charge of eczema self-management: a qualitative interview study with young people with eczema

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e044005
Author(s):  
Kate Greenwell ◽  
Daniela Ghio ◽  
Ingrid Muller ◽  
Amanda Roberts ◽  
Abigail McNiven ◽  
...  
Keyword(s):  
Young People ◽  
Health Professionals ◽  
Perceived Control ◽  
Behavioural Change ◽  
Active Role ◽  
Self Management ◽  
Semistructured Interview ◽  
Negative Consequences ◽  
Qualitative Interview Study ◽  
The Uk

ObjectivesTo explore young people’s experiences of eczema self-management and interacting with health professionals.DesignSecondary qualitative data analysis of data sets from two semistructured interview studies. Data were analysed using inductive thematic analysis.SettingParticipants were recruited from the UK primary care, dermatology departments and a community-based sample (eg, patient representative groups, social media).ParticipantsData included 28 interviews with young people with eczema aged 13–25 years (mean age=19.5 years; 20 female).ResultsAlthough topical treatments were generally perceived as effective, young people expressed doubts about their long-term effectiveness, and concerns around the safety and an over-reliance on topical corticosteroids. Participants welcomed the opportunity to take an active role in their eczema management, but new roles and responsibilities also came with initial apprehension and challenges, including communicating their treatment concerns and preferences with health professionals, feeling unprepared for transition to an adult clinic and obtaining treatments. Decisions regarding whether to engage in behaviours that would exacerbate their eczema (eg, irritants/triggers, scratching) were influenced by young people’s beliefs regarding negative consequences of these behaviours, and perceived control over the behaviour and its negative consequences.ConclusionsBehavioural change interventions must address the treatment concerns of young people and equip them with the knowledge, skills and confidence to take an active role in their own eczema management.

scholarly journals ‘Just because I’m old it doesn’t mean I have to be fat’: a qualitative study exploring older adults’ views and experiences of weight management

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025680 ◽  
Author(s):  
Sarah E Jackson ◽  
Linn Holter ◽  
Rebecca J Beeken
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Weight Management ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Well Being ◽  
Semistructured Interview ◽  
Negative Consequences ◽  
The Uk ◽  
Health And Well Being

ObjectivesThe aim of this study was to explore older adults’ beliefs about the appropriateness of weight management, and how their experiences and expectations of weight management have changed as they have got older.DesignQualitative semistructured interview study.SettingUK.ParticipantsOlder adults (≥65 years) in the UK who had recent (<5 years) experience of trying to manage their weight (n=15; 12 women; 73% white British).ResultsData were analysed using thematic analysis. Emergent themes highlighted that weight remained a concern for many older adults, although having a high body weight was seen to be more acceptable at older than younger ages. Excess weight was reported to have negative consequences for health and well-being which participants felt could be alleviated by losing weight. Participants were motivated to lose weight for appearance and health reasons, but mentioned finding it harder to lose weight as they had got older and generally felt they had received limited guidance on weight management from health professionals.ConclusionsThe views of our participants highlight the need for further research into safe and effective methods of weight loss for older people and indicate that advice and support from health professionals would be welcomed.

scholarly journals GP views on strategies to cope with increasing workload: a qualitative interview study

2017 ◽  
Vol 67 (655) ◽  
pp. e148-e156 ◽  
Author(s):  
Rebecca FR Fisher ◽  
Caroline HD Croxson ◽  
Helen F Ashdown ◽  
FD Richard Hobbs
Keyword(s):  
Primary Care ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Self Management ◽  
Telephone Triage ◽  
Workload Management ◽  
Qualitative Interview Study ◽  
Data Saturation ◽  
The Uk ◽  
Maximum Variation Sample

BackgroundThe existence of a crisis in primary care in the UK is in little doubt. GP morale and job satisfaction are low, and workload is increasing. In this challenging context, finding ways for GPs to manage that workload is imperative.AimTo explore what existing or potential strategies are described by GPs for dealing with their workload, and their views on the relative merits of each.Design and settingSemi-structured, qualitative interviews with GPs working within NHS England.MethodAll GPs working within NHS England were eligible. Of those who responded to advertisements, a maximum-variation sample was selected and interviewed until data saturation was reached. Data were analysed thematically.ResultsResponses were received from 171 GPs, and, from these, 34 were included in the study. Four main themes emerged for workload management: patient-level, GP-level, practice-level, and systems-level strategies. A need for patients to take greater responsibility for self-management was clear, but many felt that GPs should not be responsible for this education. Increased delegation of tasks was felt to be key to managing workload, with innovative use of allied healthcare professionals and extended roles for non-clinical staff suggested. Telephone triage was a commonly used tool for managing workload, although not all participants found this helpful.ConclusionThis in-depth qualitative study demonstrates an encouraging resilience among GPs. They are proactively trying to manage workload, often using innovative local strategies. GPs do not feel that they can do this alone, however, and called repeatedly for increased recruitment and more investment in primary care.

scholarly journals Epidemiology of visual impairment, sight-threatening or treatment-requiring diabetic eye disease in children and young people in the UK: findings from DECS

2020 ◽  
pp. bjophthalmol-2020-315886
Author(s):  
Maria Carolina Ibanez-Bruron ◽  
Ameenat Lola Solebo ◽  
Phillippa Cumberland ◽  
Jugnoo S Rahi
Keyword(s):  
Young People ◽  
Self Management ◽  
Eye Disease ◽  
Visual Disability ◽  
Children And Young People ◽  
Eye Screening ◽  
Diabetic Eye Disease ◽  
The Uk ◽  
Prevention Of Diabetes

BackgroundWe investigated the incidence and causes of sight-threatening diabetes-related eye disease in children living with diabetes in the UK, to inform the national eye screening programme and enable monitoring of trends.MethodsWe undertook a prospective active national surveillance via the British Ophthalmic Surveillance Unit. Eligible cases were children aged 18 years or younger, with type 1 or 2 diabetes, newly diagnosed between January 2015 and February 2017 with sight-threatening diabetic eye disease.ResultsEight children were reported. The annual incidence of all sight-threatening diabetes-related eye disease requiring referral to an ophthalmologist among children living with diabetes (n=8) in the UK was 1.21 per 10 000 person-years (95% CI 0.52 to 2.39) and was largely attributable to cataract (n=5) 0.76 per 10 000 person-years (95% CI 0.25 to 1.77). The incidence of sight-threatening diabetic retinopathy (n=3) among those eligible for screening (12 to 18 year-olds living with diabetes) was 1.18 per 10 000 person-years (95% CI 0.24 to 3.46). No subjects eligible for certification as visually impaired or blind were reported.ConclusionsSecondary prevention of visual disability due to retinopathy is currently the sole purpose of national eye screening programmes globally. However, the rarity of treatment-requiring retinopathy in children/young people living with diabetes, alongside growing concerns about suboptimal screening uptake, merit new consideration of the utility of screening for primary prevention of diabetes-related morbidity by using the screening event and findings as a catalyst for better diabetes self-management.

scholarly journals P106 Psychological and self-management support for people with systemic vasculitis or CTDs: a mixed methods study of health professionals’ perception of provision in Rheumatology and Nephrology departments in the UK

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Joanna C Robson ◽  
Michael Shepherd ◽  
Mwidimi Ndosi ◽  
Lorraine Harper ◽  
Caroline Flurey ◽  
...  
Keyword(s):  
Health Professional ◽  
Health Professionals ◽  
Online Survey ◽  
Psychological Support ◽  
Self Management ◽  
Free Text ◽  
Management Support ◽  
The Uk

Abstract Background People with a connective tissue disease (CTD) or systemic vasculititis have diseases which can be life and organ threatening, require complicated medication regimens and impact on all aspects of health-related quality of life. People are routinely managed across multiple medical specialities and have to navigate their way through complex health care systems. The aim of this study was to investigate current psychological and self-management support available for people with CTDs and vasculitis in rheumatology and nephrology departments in the UK. Methods An online survey of health professionals in rheumatology and nephrology departments was conducted with follow-up interviews. The survey comprised 45 multiple-choice and free-text questions. Quantitative material was analysed descriptively. Follow-up interviews were recorded, transcribed and analysed thematically, together with free-text survey responses, to identify health professionals’ perceptions on unmet needs and key improvements required. Results The online survey included 120 health professional respondents (34 % specialist nurses, 51% doctors and 12 % allied health professionals and pharmacists). Respondents worked primarily in rheumatology (52.9%) and nephrology (21.5%). Access to self-management programmes or clinics for people with CTD and vasculitis was available in 23% of rheumatology and 8% of nephrology departments. In response to the question “How well is your team providing self-management support to people with CTD and vasculitis?”, 38% of respondents reported not very well, or not well at all. Direct access to psychological support (either within their department or within the hospital) was available for patients in 76.9% of nephrology and 32.8% of rheumatology departments. Where psychological referrals were direct, the assessment of the quality of the service by health professionals was higher than when the referrals were indirect (i.e when patients were either referred to primary care or asked to self-refer) (X2=13.83, p &lt; 0.001). Over 80% of health-professional respondents reported they would like additional training in providing self-management support. Key themes from the qualitative data included the need for dedicated psychological support within departments, self-management programmes (specifically for people with CTD and vasculitis or opening up established programmes for people with other conditions), the benefits of a whole team approach (specialist teams not individual clinicians working to empower patients to take a lead in managing their own care), individual staff training needs ( training in brief psychological interventions and support for health professionals to set up self-management programmes) and signposting to additional resources for patients and their families ( disease-specific written and online information and support from patient charities). Conclusion People with CTD and vasculitis have complex needs and systemic improvements in support are required. Patients in nephrology departments are more likely to have access to psychological support than those in rheumatology. There is inadequate access to structured self-management programmes in both nephrology and rheumatology. Disclosures J.C. Robson None. M. Shepherd None. M. Ndosi None. L. Harper None. C. Flurey None. S. Logan None. K. Austin None. E. Dures None.

scholarly journals Young people with attention deficit hyperactivity disorder in transition from child to adult services: a qualitative study of the experiences of general practitioners in the UK

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Tamsin Newlove-Delgado ◽  
Sharon Blake ◽  
Tamsin Ford ◽  
Astrid Janssens
Keyword(s):  
Primary Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
Young People ◽  
Attention Deficit ◽  
Adult Life ◽  
Hyperactivity Disorder ◽  
Adult Services ◽  
Specialist Services ◽  
Qualitative Interview Study ◽  
The Uk

Abstract Background Many young people with Attention Deficit Hyperactivity Disorder (ADHD) have impairing symptoms that persist into adulthood, yet only a minority experience continuity of care into adult life. Despite growing emphasis on the primary care role in ADHD management in NICE ADHD and transition guidance, little is known about GPs’ perspectives, which could hamper efforts to improve outcomes for young people leaving children’s services. This study aimed to understand GPs’ experiences of involvement with this group and explore their views on the roles and responsibilities of primary and secondary care in transition, to inform recommendations for policy and practice. Method Qualitative interview study with GPs across the UK. Semi-structured telephone interviews were carried out with 14 GPs recruited through a linked mapping study, social media, and snowballing; data were analysed using thematic analysis. Results In the absence of a smooth transition from child to adult services, many GPs became involved ‘by default’. GPs reacted by trying to identify suitable specialist services, and were faced with the decision of whether to continue ADHD prescribing. Such decisions were strongly influenced by perceptions that prescribing carried risks, and concerns over responsibility, particularly where specialist services were lacking. Participants described variation in service availability, and some highlighted tensions around how shared care works in practice. Conclusion Implementation of NICE guidance is highly variable, with implications for GPs and patients. Risk and responsibility for primary care ADHD prescribing are central concerns that need to be addressed, as is the inclusion of GPs in a planned transition process.

Faith-sensitive end of life care for children, young people and their families

2021 ◽  
Vol 30 (5) ◽  
pp. 276-279
Author(s):  
Claire Camara ◽  
Leah Rosengarten
Keyword(s):  
Young People ◽  
End Of Life ◽  
Health Professionals ◽  
End Of Life Care ◽  
Life Care ◽  
Personal Beliefs ◽  
Individual Level ◽  
Key Points ◽  
The Uk

This article is part of an at a glance series on palliation and end of life care in paediatrics and focuses on the provision of faith-sensitive end of life care. Particular religions are discussed, with some key points for care of patients from some of the most prevalent religions within the UK. This article is intended to give points for discussion and consideration, but health professionals are encouraged to speak to every patient and family on an individual level to ensure an understanding of their personal beliefs. Although there is a range of literature discussing faith during end-of-life care, there is litte that outlines the practical specifics and for this reason some of the supporting literature in this article is dated and, where possible, this has been supported with contemporary sources.

scholarly journals Improving mental health literacy among young people aged 11–15 years in Java, Indonesia: the co-development of a culturally-appropriate, user-centred resource (The IMPeTUs Intervention)

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Helen Brooks ◽  
Armaji Kamaludi Syarif ◽  
Rebecca Pedley ◽  
Irman Irmansyah ◽  
Benny Prawira ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Literacy ◽  
Young People ◽  
Health Professionals ◽  
Mental Health Literacy ◽  
Mental Health Problems ◽  
Health Problems ◽  
Adverse Outcomes ◽  
Self Management ◽  
Children And Young People

Abstract Background Many mental health problems emerge in late childhood and contribute significantly to the global burden of disease. Adverse outcomes can extend into adulthood if left untreated. This impact is exacerbated in low- and middle-income countries where significant treatment gaps persist. Improving mental health literacy may offer an effective strategy for early intervention but remains underexplored in these contexts. Methods An intervention was co-developed with children and young people (CYP) by undertaking a needs analysis combined with stakeholder consensus activities. A systematic review of mental health literacy interventions in South-East Asia was undertaken in addition to semi-structured interviews with 43 children and young people (19 with and 24 without experience of anxiety and depression), 19 parents of children with experience of mental health problems and 25 education and health professionals. A focus group was also held with 8 key stakeholders immersed nationally in policy and practice. Interview schedules explored participants’ experiences of mental health, unmet needs and priorities for intervention. Data were synthesised and presented at a 3-day co-production workshop. Attendees included 13 CYP, 6 parents/guardians, 2 teachers, 8 health professionals, 2 academics and 3 game designers. Consensus exercises were utilised to identify the preferred format, content and delivery of the intervention. A smaller group of patient and public involvement contributors worked with designers to further iterate the intervention. Results An immersive storyline digital application was co-developed for young people aged 11–15 with the primary aim of improving mental health literacy and self-management. The intervention comprises two chapters; one depression focussed, and the other anxiety focussed. The storyline format is interspersed with interactive games and exercises to promote engagement and encourage self-management. CYP also take part in group sessions delivered by trained facilitators before and after intervention use to discuss outcomes of and issues raised during the game. Conclusion The IMPeTUs intervention has been co-designed for CYP aged 11–15 to improve mental health literacy and enhance self-management abilities. To the best of our knowledge, this is the first Indonesian digital intervention to improve mental health literacy and self-management for this population. Implementation, acceptability, and impact are currently being explored in a multi-site case study evaluation.

Supporting people to self-manage their allergic rhinitis

2021 ◽  
Vol 32 (7) ◽  
pp. 264-268
Author(s):  
Viv Marsh
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Health Professionals ◽  
Hay Fever ◽  
Self Management ◽  
Nasal Allergy ◽  
The Uk ◽  
And Control ◽  
The Impact

Allergic rhinitis is common in the UK and can cause significant symptoms and reductions in quality of life. Viv Marsh considers how health professionals can support self-management of these patients Many of us look forward to the spring and summer months with warmer weather, longer days and more opportunity to spend time outdoors. But for hay fever sufferers these months can be truly miserable. For others, the winter months can be equally challenging as, with more time spent indoors, exposure to indoor allergens is greater. Hay fever is the term commonly used to describe seasonal nasal allergy triggered by pollen. It affects many children and adults in the UK, causing significant symptoms and reduction in quality of life. Often, people with allergic rhinitis try to manage the condition themselves using home or over-the-counter remedies to reduce and control symptoms. However, effective management may not be straightforward and guidance from knowledgeable and experienced health professionals can lead to improved outcomes. Taking an evidence-based approach, this article will explore the impact of allergic rhinitis on those who experience it, and will consider how health professionals can support self-management to enable people with the condition to manage their symptoms and minimise its impact on their lives.

Perspectives of Fear as a Barrier to Self-Management in Non-Hispanic Black Men With Type 2 Diabetes

2018 ◽  
Vol 45 (6) ◽  
pp. 987-996 ◽  
Author(s):  
Ledric D. Sherman ◽  
Joni S. Williams
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Perceived Control ◽  
Diabetes Management ◽  
Phenomenological Approach ◽  
Self Management ◽  
Semistructured Interview ◽  
Self Monitoring

Background. Self-managing type 2 diabetes (T2D) is critical but often challenging for non-Hispanic Black (NHB) men. Fears may contribute to poor self-management; however, the evidence is sparse. The purpose of this study is to examine the relationship between fear and diabetes self-management in NHB men from the southern United States. Methods. Nineteen NHB men with T2D were recruited from barbershops and churches. Interviews were conducted using a semistructured interview guide. Transcripts were analyzed using a phenomenological approach and focused on identifying common themes describing the perceptions of fear as a barrier to self-managing T2D in the study participants. Results. More than 68% of the sample was >55 years of age, where 42% reported an annual income of ≥$100,000, 74% were married, and 26% had a college degree. Fifty-three percent expressed fear with diabetes management, while 47% reported no fears with diabetes management. Direct fears associated with self-management included the use of needles and syringes for self-monitoring and medication adherence, respectively. Indirect fears were associated with the development of adverse complications resulting in poor mental and physical quality of life. No fears were reported secondary to diabetes knowledge, perceived control, and social support. Conclusions. In this sample of NHB men, fear was perceived by many as a direct barrier to self-management and an indirect barrier to optimal quality of life. These findings suggest the need to address the fears of NHB men when guiding treatment and developing research interventions to improve self-management skills.

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