scholarly journals Consumer Preferences for Skin Cancer Screening Using Mobile Teledermoscopy: A Qualitative Study

Dermatology ◽  
2020 ◽  
Vol 236 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Fleur Kong ◽  
Caitlin Horsham ◽  
Jenna Rayner ◽  
Marko Simunovic ◽  
Montana O’Hara ◽  
...  
Keyword(s):  
Consumer Preferences ◽  
Controlled Trial ◽  
Structured Interview ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Skin Cancer Screening ◽  
Skin Examination ◽  
Direct To Consumer ◽  
Skin Cancers ◽  
Randomised Controlled

Background: Mobile teledermoscopy is a rapidly advancing technology that promotes early detection and management of skin cancers. Whilst the use of teledermoscopy has proven to be effective and has a role in the detection of skin cancers, patients’ attitudes towards the multiple ways in which this technology can be utilised has not been explored. Methods: Data were obtained from a large randomised controlled trial comparing mobile teledermoscopy-enhanced skin self-examinations (SSEs) with naked-eye SSE. A semi-structured interview guide was developed by the investigators with questions focusing on people’s previous skin screening behaviours and 2 of the major pathways which can be utilised in mobile teledermoscopy: (i) direct-to-consumer and (ii) doctor-to-doctor. All interviews were tape-recorded and transcribed verbatim. Thematic analysis was undertaken by 2 independent researchers. Results: Twenty-eight participants were interviewed. Eighty-six percent of participants (n = 24/28) had previously had a clinical skin examination. Only 18% of participants (n = 5/28) visited the same doctor for each clinical skin examination. Five main themes were identified in the interviews that affected how people felt about the integration of mobile teledermoscopy into skin screening pathways: history of clinical skin examinations, continuity of the doctor-patient relationship, convenience of the direct-to-consumer teledermoscopy, expedited review enhancing the doctor-to-doctor setting and mobile teledermoscopy as a partner-assisted task. Conclusions: Overall mobile teledermoscopy was viewed positively for both direct-to-consumer and doctor-to-doctor interaction. Continuity of care in the doctor-patient relationship was not found to be a priority for clinical skin examination with most participants visiting several doctors throughout their clinical skin examination history.

scholarly journals Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Bernadette Bartlam ◽  
Trishna Rathod ◽  
Gillian Rowlands ◽  
Joanne Protheroe
Keyword(s):  
Mixed Methods ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Health Behaviours ◽  
Structured Interview ◽  
Health Care Practitioner ◽  
Self Management ◽  
Baseline Survey ◽  
Ageing Population ◽  
Randomised Controlled

This article reports a mixed methods process evaluation of a pilot feasibility randomised controlled trial comparing a Lay Health Trainer (LHT) intervention and usual care for those with poorly controlled Type 2 Diabetes Melitus (T2DM). Set in a deprived area in the UK, this research explores patient and health care practitioner (HCP) views on whether a structured interview between a patient and a Lay Health Trainer (LHT), for the purpose of developing a tailored self-management plan for patients, is acceptable and likely to change health behaviours. In doing so, it considers the implications for a future, randomised controlled trial (RCT). Participants were patients, LHTs delivering the intervention, service managers, and practice nurses recruiting patients to the study. Patients were purposively sampled on their responses to a baseline survey, and semistructured interviews were conducted within an exploratory thematic analysis framework. Findings indicate that the intervention is acceptable to patients and HCPs. However, LHTs found it challenging to work with older patients with long-term and/or complex conditions. In order to address this, given an ageing population and concomitant increases in those with such health needs, LHT training should develop skills working with these populations. The design of any future RCT intervention should take account of this.

scholarly journals Psychodynamic approaches to teaching medical students about the doctor–patient relationship: randomised controlled trial

2011 ◽  
Vol 35 (8) ◽  
pp. 308-313 ◽  
Author(s):  
Jessica Yakeley ◽  
Peter Shoenberg ◽  
Richard Morris ◽  
David Sturgeon ◽  
Sarah Majid
Keyword(s):  
Medical Students ◽  
Teaching Methods ◽  
Psychodynamic Psychotherapy ◽  
Teaching Method ◽  
Controlled Trial ◽  
Control Group ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Partial Control ◽  
Balint Group

Aims and methodTo evaluate the effectiveness of two psychodynamic psychotherapy teaching methods, a student psychotherapy scheme (SPS) and participation in a Balint group, in teaching first-year clinical medical students about doctor–patient communication and the doctor–patient relationship. The 28 students, who were randomly allocated to three groups (SPS group, Balint group starting at baseline and Balint group starting at 3 months and acting as partial controls), were rated on a questionnaire testing their knowledge of emotional and psychodynamic aspects of the doctor–patient relationship administered at baseline, at 3 months and at 1 year.ResultsAt 3 months, students in the SPS and Balint groups scored higher than the partial control group, the difference approaching significance at the 5% level. At 1 year, participation in either teaching method led to significantly higher scores compared with baseline.Clinical implicationsPsychodynamic psychotherapy teaching methods are effective in increasing students' knowledge of the doctor-patient relationship and potentially also improving their communication skills.

Differentiating perinatal Insomnia Disorder and sleep disruption: A longitudinal study from pregnancy to 2 years postpartum

SLEEP ◽  
2022 ◽  
Author(s):  
Nina Quin ◽  
Jin Joo Lee ◽  
Donna M Pinnington ◽  
Louise Newman ◽  
Rachel Manber ◽  
...  
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Controlled Trial ◽  
Structured Interview ◽  
Sleep Disruption ◽  
Depression And Anxiety ◽  
P Values ◽  
Sleep Complaints ◽  
Insomnia Disorder ◽  
Randomised Controlled

Abstract Study Objectives Insomnia Disorder diagnoses require persistent sleep complaints despite “adequate sleep opportunity”. Significant perinatal sleep disruption makes this diagnosis challenging. This longitudinal study distinguished between Insomnia Disorder and Perinatal Sleep Disruption and their sleep and mental health correlates. Methods 163 nulliparous females (age M±SD=33.35±3.42) participating in a randomised-controlled trial repeated the Insomnia Disorder module of the Duke Structured Interview for Sleep Disorders and PROMIS measures for sleep and mental health at 30 and 35 weeks’ gestation, and 1.5, 3, 6, 12, and 24 months postpartum (944 interviews, 1009 questionnaires completed). We compared clinical features when DSM-5 Insomnia Disorder criteria were: (1) met (Insomnia Disorder), (2) not met only because of the sleep opportunity criteria (Perinatal Sleep Disruption), and (3.) not met due to other criteria (Low Complaint). Results Proportions of Insomnia Disorder were 16.0% and 19.8% during early and late third trimester, and ranged 5.3-11.7% postpartum. If the sleep opportunity criteria were not considered, rates of Insomnia would be 2-4 times higher (21.4-40.4%) across time-points. Mixed effects models adjusting for covariates showed that compared to Low Complaint, both Insomnia Disorder and Perinatal Sleep Disruption scored significantly higher on insomnia and sleep disturbance scales, sleep effort, and sleep-related impairments (p-values<.01), but depression and anxiety were comparable (p-values>.12). Conclusion Assessing sleep complaints without considering sleep opportunity can result in over-diagnosis of Insomnia Disorder in the perinatal periods. Insomnia Disorder and perinatal sleep disruption were associated with adverse sleep and mood outcomes, and need to be carefully differentiated and appropriately addressed.

scholarly journals Mindfulness for musicians: A mixed methods study investigating the effects of 8-week mindfulness courses on music students at a leading conservatoire

2020 ◽  
pp. 102986492094157
Author(s):  
Anne-Marie Louise Czajkowski ◽  
Alinka Elizabeth Greasley ◽  
Michael Allis
Keyword(s):  
Controlled Trial ◽  
Music Performance ◽  
Body Awareness ◽  
Structured Interview ◽  
Music Students ◽  
Five Facet Mindfulness Questionnaire ◽  
Post Intervention ◽  
Design Elements ◽  
Positive Effects ◽  
Randomised Controlled

Mindfulness courses are beneficial in clinical domains for anxiety and depression and are becoming more prevalent as interventions in education. However, little is known about what effects mindfulness might have on musicians. In an exploratory study, 25 music students, who completed one of four 8-week MBSR/MBCT mindfulness courses adapted for musicians at the Guildhall School of Music and Drama, completed the validated Five Facet Mindfulness Questionnaire and a bespoke Mindfulness for Musicians questionnaire pre- and post-intervention. Twenty-one music students also took part in a post-intervention one-to-one semi-structured interview. Post-intervention mindfulness scores for both questionnaires increased significantly in comparison to pre-intervention scores. In interviews, participants were reportedly more aware and focused in instrumental lessons, were less self-critical, and developed increased body awareness, which improved their learning of instrumental technique. Participants also described enhanced teacher/pupil communication. In instrumental practice sessions, participants reported more efficient, effective and creative practice, and said that mindfulness exercises helped them deal with problems experienced while practising. Participants also described enhanced listening skills and improved socio-collaboration in ensemble rehearsals. They reported that mindfulness strategies had positive effects on music performance anxiety and described changes in time perception, enhanced expressivity, and positive post-performance effects. Future researchers could adopt a more robust methodology, such as a randomised controlled trial, and incorporate further design elements, such as longitudinal follow-up. Providing more systematic evidence of the beneficial role of mindfulness for conservatoire music students as learners and performers may encourage greater provision of such opportunities in musical settings in the future.

scholarly journals INNV-24. THE EXPERIENCE OF FATIGUED BRAIN TUMOUR PATIENTS RECEIVING INNOVATIVE LIFESTYLE INTERVENTIONS: QUALITATIVE RESULTS FROM THE BT-LIFE RANDOMISED CONTROLLED TRIAL

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii121-ii122
Author(s):  
Claire Torrens ◽  
Julie Emerson ◽  
William Hewins ◽  
Amie Walker ◽  
Lisa Withington ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Controlled Trial ◽  
Health Behaviours ◽  
Structured Interview ◽  
Lifestyle Interventions ◽  
Motivation To Change ◽  
Primary Brain Tumour ◽  
Family Social Support ◽  
Clinically Significant ◽  
Randomised Controlled

Abstract BACKGROUND Most brain tumour patients report clinically significant fatigue. Here, we aimed to explore patients’ views of the experience, acceptability and usefulness of participating in a trial of novel lifestyle interventions for fatigue. METHODS Qualitative sub-study within the ‘BT-LIFE’ multi-centre phase II RCT (submitted separately). Fatigued adult primary brain tumour patients in receipt of one of the trial interventions (‘Health Coaching’: eight coaching sessions targeting lifestyle behaviours; plus or minus ‘Activation Coaching’: two additional interviews targeting motivation to change) took part in a semi-structured interview following completion of the interventions. A realist approach to the ‘framework’ method was used to analyse verbatim transcripts, with inductive and deductive codes assigned to the realist domains of Context-Mechanism-Outcome. RESULTS Twenty themes and 53 sub-themes were derived from the data. Patients’ (n= 21) understanding of and engagement with the interventions were influenced by their expectations, attitudes to life, and experience of living with a brain tumour. Behaviour change was supported by goal-setting, monitoring using a weekly diary, the motivational ‘push’ by coaches, and family/ social support where available. Barriers to engagement included technical diary difficulties, time limitations including work and holiday schedules, and interference from life events. Most patients described beneficial changes in health behaviours, self-efficacy, and general health and wellbeing. About half indicated actual improvement in fatigue levels; others reported no direct change but they could now cope better with fatigue. A minority experienced no change or worsening fatigue. CONCLUSION Most fatigued brain tumour patients were able to make positive changes after lifestyle coaching, despite physical and cognitive impairments. However, their experiences were varied. Those for whom the interventions were a good ‘fit’ with their pre-existing outlook, lifestyle, and physical and emotional capabilities, appeared to achieve most benefit. These qualitative findings will inform further work addressing the disabling symptom of brain tumour-related fatigue.

scholarly journals How Doctors Care for Others: Caring, Being with and Making the Difference

2020 ◽  
pp. 15-23
Author(s):  
Mariana Barstad Castro Neves ◽  
Rafaela Oliveira Grillo ◽  
Flavia Sollero-De-Campos
Keyword(s):  
Attachment Style ◽  
Patient Adherence ◽  
Structured Interview ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Internal Working Model ◽  
Attachment Figure ◽  
The Difference ◽  
Compliance To Treatment ◽  
The Individual

Although more frequent and intense on infancy, the attachment system can be triggered across the lifespan, from "the cradle to the grave." In adulthood, whenever the individual's internal working model does not have enough resources to sustain his/her insecurity, one seeks support from an attachment figure. Illness may trigger the attachment system, obliging the individual to pursue the proximity of an attachment figure. In our research on how the doctor's attachment style affects the doctor-patient relationship (Barstad-Castro Neves, 2018), we assessed the doctor's attachment style and correlated with a semi-structured interview script. One of the categories highlighted in our research was how physicians cared for their patients. The present article aims to explore, expand, and clarify the category mentioned. It is essential to discuss how the car ing and concerning doctor acts towards his/her patient, and how the caregiving system, from the lens of attachment theory, has a function in that matter. Our research may contribute to the discussion of strategies to improve the doctor-patient relationship, therefore refining patient adherence and compliance to treatment. Besides, it can also shed light on how to give support to medical professionals, starting from medical school.

scholarly journals Direct-to-consumer mobile teledermoscopy for skin cancer screening: Preliminary results demonstrating willingness-to-pay in Australia

2018 ◽  
Vol 24 (10) ◽  
pp. 683-689 ◽  
Author(s):  
Centaine L Snoswell ◽  
Jennifer A Whitty ◽  
Liam J Caffery ◽  
Lois J Loescher ◽  
Nicole Gillespie ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Skin Cancer ◽  
Willingness To Pay ◽  
Consumer Preferences ◽  
Screening Method ◽  
Randomised Control Trial ◽  
Skin Cancer Screening ◽  
Direct To Consumer ◽  
Screening Services ◽  
Self Examination

Introduction Internationally, teledermoscopy has been found to have clinical and economic efficacy. This study aims to identify the attributes of a mobile teledermoscopy service that consumers prefer. This preliminary study was set within a broader randomised control trial (RCT) investigating the effectiveness of direct to consumer mobile teledermoscopy. Methods We undertook a discrete choice experiment (DCE). The DCE comprised 24 choice sets, divided into in two blocks of 12. For each choice set, respondents were asked to make discrete choices between two opt-out choices and two skin cancer screening service options described by seven attributes. A mixed logit model was used to estimate preferences for skin cancer screening services. Consumer preferences weights were used to calculate marginal willingness-to-pay (WTP) for skin cancer screening services. Results The DCE was completed by 113 consumer respondents. Consumers’ preference for dermatologist involvement in their diagnosis, increased accuracy, and reduced excisions were all statistically significant in driving choice between service models. Consumers preferred having a professional involved in their skin cancer screening, rather than performing a self-examination. Consumers were only WTP $1.18 to change from a GP visit to mobile teledermoscopy (diagnosis using a phone camera). However, they were WTP $43 to have their results reviewed by a dermatologist rather than a GP, and $117 to increase the chance of detecting a melanoma if it was present from 65-75% to 95%. Conclusion Skin cancer screening services which are delivered by health professionals, rather than skin self-examination, are preferred by consumers. Consumers were willing to pay for their preferred skin cancer screening method, especially if a dermatologist was involved.

scholarly journals Consumer Preference and Willingness to Pay for Direct-to-Consumer Mobile Teledermoscopy Services in Australia

Dermatology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Centaine L. Snoswell ◽  
Jennifer A. Whitty ◽  
Liam J. Caffery ◽  
Joanna Kho ◽  
Caitlin Horsham ◽  
...  
Keyword(s):  
Willingness To Pay ◽  
Contingent Valuation ◽  
Controlled Trial ◽  
Waiting Times ◽  
Consumer Preference ◽  
Medical Professional ◽  
Skin Cancer Screening ◽  
Randomised Controlled ◽  
Self Examination ◽  
Improved Accuracy

<b><i>Objective:</i></b> To investigate consumer preference and willingness to pay for mobile teledermoscopy services in Australia. <b><i>Methods:</i></b> Consumers who were taking part in a randomised controlled trial comparing mobile teledermoscopy and skin self-examination were asked to complete a survey which incorporated a discrete choice experiment (DCE) and a contingent valuation question. Responses were used to determine their willingness to pay for mobile teledermoscopy services in Australia and their overall service preferences. <b><i>Results:</i></b> The 199 consumers who responded were 71% female and had a mean age of 42 years (range, 18–73). The DCE results showed that consumers prefer a trained medical professional to be involved in their skin cancer screening. Consumers were willing to pay AUD 41 to change from a general practitioner reviewing their lesions in-person to having a dermatologist reviewing the teledermoscopy images. Additionally, they were willing to pay for services that had shorter waiting times, that reduced the time away from their usual activities, and that have higher accuracy and lower likelihood of unnecessary excision of a skin lesion. When asked directly about their willingness to pay for a teledermoscopy service using a contingent valuation question, the majority (73%) of consumers selected the lowest two value brackets of AUD 1–20 or AUD 21–40. <b><i>Conclusion:</i></b> Consumers are willing to pay out of pocket to access services with attributes such as a dermatologist review, improved accuracy, and fewer excisions.

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