Patient voice and health education for familial hypercholesterolaemia

2021 ◽  
pp. 001789692110559
Author(s):  
Scott McIntosh ◽  
Cameron Coykendall ◽  
Yifei Sylvia Lin ◽  
Matthew Caufield ◽  
Joe Muller ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Health Education ◽  
Health Knowledge ◽  
Familial Hypercholesterolaemia ◽  
Family Members ◽  
Primary Care Providers ◽  
Diagnosis And Treatment ◽  
Health Priorities ◽  
Care Providers ◽  
Premature Cardiovascular Disease

Objective: Familial hypercholesterolaemia (FH), an autosomal dominant disorder causing elevated low-density lipoprotein (LDL) cholesterol from birth resulting in premature cardiovascular disease, is only diagnosed in 10% of affected patients. This study involved partnering with patients with FH and with primary care providers (PCPs) to understand health priorities and translate them into hypotheses for future research and enhancement of health practices via electronic health records (EHRs). The goal was to strengthen genetic health education for clinicians and for patients and their families, including improved diagnosis, knowledge and treatment. Perceptions regarding genetic health education and healthcare related to FH facilitated by the use of an EHR for diagnosis and treatment have not been studied. Design: Mixed-methods exploratory qualitative research and surveys. Setting: Qualitative research included five focus groups, 34 semi-structured key informant interviews and open-ended survey items with patients and PCPs at a large medical centre in Western New York. Method: Data were thematically coded to identify themes as formative work for the improvement of relevant EHR features, diagnosis, treatment and genetic health education via information sharing between clinicians and patients. Results: Themes included genetic health knowledge; the importance of being diagnosed; communication between patients, family members and medical professionals; outreach via patients’ own advocacy; and treatment, technology, motivation, trust, outside resources (for further genetic health education and support) and awareness of effective treatments. Conclusion: Patients and clinicians can contribute to the development of EHR support for the genetic health education of patients and their families, and for improved diagnosis and treatment of FH. Using their ideas in the development of effective strategies could improve the currently low rate of FH diagnosis and cascade screening (for family members), as well as enhance physician and patient genetic health knowledge and self-empowerment.

scholarly journals Complementary and Integrative Health Knowledge and Practice in Primary Care Settings: A Survey of Primary Care Providers in the Northwestern United States

2021 ◽  
Vol 10 ◽  
pp. 216495612110233
Author(s):  
Malaika R Schwartz ◽  
Allison M Cole ◽  
Gina A Keppel ◽  
Ryan Gilles ◽  
John Holmes ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Knowledge ◽  
Care Delivery ◽  
Primary Care Providers ◽  
The United States ◽  
Research Network ◽  
Care Providers ◽  
Integrative Health ◽  
And Training

Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.

How do Iranian female adolescents express their health education needs? A needs assessment with qualitative thematic analysis

2014 ◽  
Vol 26 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Zohreh Shahhosseini ◽  
Zeinab Hamzehgardeshi
Keyword(s):  
Health Education ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Health Knowledge ◽  
Health Needs ◽  
Female Adolescents ◽  
Care Providers ◽  
Northern Iran ◽  
Qualitative Thematic Analysis ◽  
Education Needs

Abstract Background: Adolescent girls have little knowledge about health information, especially about more sensitive issues. We know little about the perspectives of adolescents about their educational health needs. Objective: The aim of this study is to explore the perceptions of Iranian female adolescents about their educational health needs. Subjects: The study participants were 67 female adolescents aged 12–19 years currently in junior high and high schools in the city of Sari, located in northern Iran. Methods: The present study is a qualitative study of thematic analysis. The 67 female adolescents participated in eight focus group discussions (FGDs). The participants were selected from schools in Mazandaran, Iran. The sampling methods were purposeful sampling and a maximum variance sampling method. All tape-recorded data was fully transcribed, and thematic analysis was performed to identify key themes. Results: The findings of this research around adolescent health education needs emphasized four overarching themes, including appropriate content, suitable method, well-informed sources and an appropriate age for education. Conclusion: Our results show that the promotion of reproductive health knowledge and life skills are the most important health education needs. Education about these issues via parents, schools and health care providers could promote the health status of adolescents.

Improving diagnosis and treatment of benign paroxysmal positional vertigo

2021 ◽  
pp. 42-46
Author(s):  
Larry D. McIntire ◽  
Kindall Martin ◽  
Kunal Shah ◽  
Lauren Malinowski ◽  
John Paulson
Keyword(s):  
Primary Care ◽  
Population Health ◽  
Healthcare Costs ◽  
Benign Paroxysmal Positional Vertigo ◽  
Primary Care Providers ◽  
Diagnosis And Treatment ◽  
Care Providers ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: Vertigo is defined as an illusion of motion caused by a mismatch of information between the visual, vestibular and somatosensory systems. The most common diagnosis associated with whirling vertigo is benign paroxysmal positional vertigo (BPPV), which affects approximately 3.4% of patients older than 60 years of age. Objective: This paper aims to educate primary care providers on how to diagnose BPPV by performing canalith repositioning maneuvers at the initial point of care. Timely treatment of BPPV in the primary care office is believed to reduce healthcare costs by way of limiting unnecessary diagnostic testing and lowering referrals for specialty care. Immediate treatment is also believed to improve the quality of healthcare delivery for the vertigo patient by reducing morbidity and resolving the condition without the need for referrals or imaging. Population Health: A review of the literature finds that delayed diagnosis and treatment of BPPV is associated with a host of deleterious effects on patients. Population health impacts include increased rates of anxiety and depression; loss of work and/or change of career paths; inappropriate use of medications or emergency care resources; decreased access to healthcare services; increased healthcare costs; and reduced quality of care. Diagnosis: A history of positional vertigo and evidence of nystagmus with Dix-Hallpike positioning confirms the diagnosis. A detailed description of the performance of this test is elucidated. Treatment: The observed nystagmus is analyzed and classified based on directionality. Treatment can be initiated immediately with canalith repositioning maneuvers.

scholarly journals What Is the Experience of Practitioners in Health, Education or Social Care Roles Following a Death by Suicide? A Qualitative Research Synthesis

2019 ◽  
Vol 16 (18) ◽  
pp. 3293
Author(s):  
Hilary Causer ◽  
Kate Muse ◽  
Jo Smith ◽  
Eleanor Bradley
Keyword(s):  
Systematic Review ◽  
Qualitative Research ◽  
Health Education ◽  
Service User ◽  
Social Care ◽  
Family Members ◽  
Research Synthesis ◽  
Safe Practice ◽  
Cultural Contexts ◽  
Close Family

Recent research has highlighted that the number of people impacted by a death by suicide is far greater than previously estimated and includes wider networks beyond close family members. It is important to understand the ways in which suicide impacts different groups within these wider networks so that safe and appropriate postvention support can be developed and delivered. A systematic review in the form of a qualitative research synthesis was undertaken with the aim of addressing the question ‘what are the features of the experiences of workers in health, education or social care roles following the death by suicide of a client, patient, student or service user?’ The analysis developed three categories of themes, ‘Horror, shock and trauma’, ‘Scrutiny, judgement and blame’, and ‘Support, learning and living with’. The mechanisms of absolution and incrimination were perceived to impact upon practitioners’ experiences within social and cultural contexts. Practitioners need to feel prepared for the potential impacts of a suicide and should be offered targeted postvention support to help them in processing their responses and in developing narratives that enable continued safe practice. Postvention responses need to be contextualised socially, culturally and organisationally so that they are sensitive to individual need.

scholarly journals Hemophagocytic Lymphohistiocytosis for the Internist and Other Primary Care Providers

2021 ◽  
Vol 12 ◽  
pp. 215013272110537
Author(s):  
Tanmayi Srinivas Pai ◽  
Fernando F. Stancampiano ◽  
Candido Rivera
Keyword(s):  
Primary Care ◽  
Immune System ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Immunosuppressive Treatment ◽  
Primary Care Providers ◽  
Outpatient Setting ◽  
Adult Patients ◽  
Diagnosis And Treatment ◽  
Care Providers ◽  
Life Threatening

Hemophagocytic lymphohistiocytosis (HLH) syndrome is a hyperinflammatory state that leads to life-threatening, disproportionate activation of the immune system and may be confused for and concomitantly exist with sepsis. However, its treatment differs from sepsis, requiring early initiation of immunosuppressive treatment. While HLH syndrome is more commonly diagnosed in children, internists and other primary care providers must be familiar with the diagnosis and treatment of adult patients with HLH in the hospital and outpatient setting. In this article, we review the essentials that an internist and other primary care providers managing adult HLH patients should know.

scholarly journals Instant Messaging: an Innovative Way to Recruit Primary Care Providers for Qualitative Research

2019 ◽  
Vol 35 (5) ◽  
pp. 1612-1614
Author(s):  
Justina Wu ◽  
Eleanor T. Lewis ◽  
Paul G. Barnett ◽  
Andrea L. Nevedal
Keyword(s):  
Primary Care ◽  
Qualitative Research ◽  
Instant Messaging ◽  
Primary Care Providers ◽  
Care Providers

scholarly journals The Mental Health Education Gap among Primary Care Providers in Rural Nepal

2016 ◽  
Vol 40 (4) ◽  
pp. 667-671 ◽  
Author(s):  
Bibhav Acharya ◽  
Soniya Hirachan ◽  
Jeffery S. Mandel ◽  
Craig van Dyke
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Education ◽  
Primary Care Providers ◽  
Care Providers ◽  
Mental Health Education ◽  
Education Gap ◽  
Rural Nepal

Are physicians social networks linked to breast cancer screening recommendations for older adults?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6550-6550 ◽  
Author(s):  
Craig Evan Pollack ◽  
Archana Radhakrishnan ◽  
Andrew M Parker ◽  
Kala Visvanathan ◽  
Sarah A Nowak
Keyword(s):  
Breast Cancer ◽  
Social Networks ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Poor Prognosis ◽  
Family Members ◽  
Primary Care Providers ◽  
Good Prognosis ◽  
Average Risk ◽  
Care Providers

6550 Background: Physicians’ prior experiences caring for patients with breast cancer along with experiences in their social networks including family members and friends may be a key and understudied driver of recommendations for cancer screening. Methods: The Breast Cancer Social Networks study (CanSNET) is a national, mailed survey of 2,000 primary care providers (PCPs) randomly selected from the American Medical Association Masterfile. PCPs were asked to provide detailed characteristics on up to 2 women they know who have been diagnosed with breast cancer and “whose cancer, broadly speaking, had the greatest impact” on them, including friends, family members and patients. Each woman was categorized as being diagnosed (a) through screening with a good prognosis, (b) not through screening with a good prognosis, (c) through screening with a poor prognosis or (d) not through screening with a poor prognosis. We used a logistic regression model to assess the association between the network member and recommendations for routine screening mammograms to average-risk women ages 75+, adjusting for provider and practice characteristics. Results: Overall 871 physicians responded to the survey yielding an adjusted response rate of 52.3% (out of 1665 eligible). We found that 67% of physicians recommended screening for women 75+. The sample reported on 762 patients, 378 family members and 476 other network members who had been diagnosed with breast cancer. Ten percent of patients and 25.1% of family members reported on died of their disease. In adjusted models, we found that physicians who reported on family members who did not receive a mammogram and had a poor prognosis were significantly more likely to recommend screening compared to those who did not (Odds Ratio 1.22, 95% Confidence Interval 1.03, 1.43). Conclusions: Physicians’ experiences with their social networks was linked to their breast cancer screening recommendations, underscoring the potential for information that is learned from social networks to differ from clinical guidelines and highlighting the need to address a broad array of influences in trying to reduce potential over-screening in cancer.

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