scholarly journals Adolescent and caregivers’ experiences of electronic adherence assessment in paediatric problematic severe asthma

2018 ◽  
Vol 22 (2) ◽  
pp. 238-250 ◽  
Author(s):  
Amy C Stewart ◽  
Kenneth N Gannon ◽  
Fran Beresford ◽  
Louise Fleming
Keyword(s):  
Severe Asthma ◽  
Healthcare Professionals ◽  
Electronic Monitoring ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Structured Interviews ◽  
Adherence Assessment ◽  
Patient’S Experience ◽  
Electronic Monitoring Device ◽  
The Impact

This study explored the experiences of adolescents and their caregivers regarding adherence to inhaled corticosteroids which are assessed through an electronic monitoring device (EMD). These devices are increasingly being used for assessing medication adherence, yet there is little information about patient’s experience of these tools. Semi-structured interviews were conducted with eight adolescents with severe asthma, aged 11–15 years, who were electronically monitored as part of their care, along with their caregivers. Interviews were analysed using thematic analysis. Three themes were identified: ‘they were trying to help me get better’, ‘checking up and catching out’ and ‘who is responsible?’ The themes highlighted differences in priorities between participant groups, the impact of monitoring on the healthcare relationship and the dilemma of transferring responsibility for asthma management to adolescents. The findings suggest it is important for healthcare professionals to engage with patient’s preferences and priorities when introducing EMDs.

scholarly journals The study of severe asthma in Latin America and Spain (1994-2004): characteristics of patients hospitalized with acute severe asthma

2009 ◽  
Vol 35 (7) ◽  
pp. 635-644 ◽  
Author(s):  
Gustavo Javier Rodrigo ◽  
Vicente Plaza ◽  
Jesús Bellido-Casado ◽  
Hugo Neffen ◽  
María Teresa Bazús ◽  
...  
Keyword(s):  
Latin America ◽  
Severe Asthma ◽  
Latin American ◽  
Inhaled Corticosteroids ◽  
Pulmonary Function Tests ◽  
Tertiary Care ◽  
Asthma Management ◽  
Case Series ◽  
Acute Severe Asthma ◽  
The Mean

OBJECTIVE: Studies assessing the characteristics and management of patients hospitalized with asthma have been limited to a small number of facilities and have evaluated short time periods. The present study evaluated long-term changes among hospitalized asthma patients at a large number of facilities. METHODS: This was a retrospective, hospital-based observational case series, designated the Study of Severe Asthma in Latin America and Spain, which was conducted in Spain and in eight Latin-American countries. We reviewed the hospital records of 3,038 patients (age range, 15-69 years) hospitalized with acute severe asthma at one of nineteen tertiary-care hospitals in 1994, 1999 and 2004. RESULTS: Over time, the use of inhaled corticosteroids and long-acting β2 agonists increased significantly, whereas the use of theophylline as a controller medication decreased. The utilization of pulmonary function tests also increased. There was a significant reduction in the mean hospital stay (8.5 days, 7.4 days and 7.1 days in 1994, 1999 and 2004, respectively, p = 0.0001) and a significant increase in the mean of the lowest arterial pH at hospital admission. In contrast, there was a significant decrease in the proportion of cases in which PEF was determined in the emergency room (48.6% in 1994 vs. 43.5% in 2004, p = 0.0001). We found the quality of asthma management and care to be generally better in Spain than in Latin America. CONCLUSIONS: Although there have been certain improvements in the management of asthma between severe exacerbations and during hospitalization, asthma management remains suboptimal in Spain and, especially, in Latin America.

scholarly journals ‘It’s a real fine balancing act’: directly employed care workers’ experiences of engaging with health services

2021 ◽  
Author(s):  
Jane Wilcock ◽  
Jill Manthorpe ◽  
Jo Moriarty ◽  
Steve Iliffe
Keyword(s):  
Health Services ◽  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Well Being ◽  
Care Work ◽  
Structured Interviews ◽  
Care Workers ◽  
The Impact ◽  
Health And Well Being

Little is known of the experiences of directly employed care workers communicating with healthcare providers about the situations of their employers. We report findings from 30 in-depth semi-structured interviews with directly employed care workers in England undertaken in 2018–19. Findings relate to role content, communication with healthcare professionals and their own well-being. Directly employed care workers need to be flexible about the tasks they perform and the changing needs of those whom they support. Having to take on health liaison roles can be problematic, and the impact of care work on directly employed workers’ own health and well-being needs further investigation.

scholarly journals Severe Asthma Toolkit: an online resource for multidisciplinary health professionals—needs assessment, development process and user analytics with survey feedback

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e032877
Author(s):  
Steven Maltby ◽  
Peter G Gibson ◽  
Helen K Reddel ◽  
Lorraine Smith ◽  
Peter A B Wark ◽  
...  
Keyword(s):  
Needs Assessment ◽  
Severe Asthma ◽  
Health Professionals ◽  
Healthcare Professionals ◽  
Reference Group ◽  
Asthma Management ◽  
Web Design ◽  
Skills Training ◽  
Evidence Based ◽  
Internet Resource

ObjectivesSevere asthma imposes a significant burden on individuals, families and the healthcare system. New treatment and management approaches are emerging as effective options for severe asthma. Translating new knowledge to multidisciplinary healthcare professionals is a priority. We developed ‘The Severe Asthma Toolkit’(https://toolkit.severeasthma.org.au) to increase awareness of severe asthma, provide evidence-based resources and support decisionmaking by healthcare providers.SettingRoundtable discussions and a survey of Australians clinicians were conducted to determine clinician preferences, format and content for a severe asthma resource.ParticipantsA reference group from stakeholder and consumer bodies and severe asthma experts provided advice and feedback. A multidisciplinary team of international experts was engaged to develop content. Written content was based on up-to-date literature. Peer and editorial review were performed to finalise content and inform web design. Website design focused on user experience, navigation, engagement, interactivity and tailoring of content for a clinical audience.ResultsA web-based resource was developed. Roundtable discussions and a needs assessment survey identified the need for dedicated severe asthma management resources to support skills training. The end-product, which launched 26 March 2018, includes an overview of severe asthma, diagnosis and assessment, management, medications, comorbidities, living with severe asthma, establishing a clinic, paediatrics/adolescents and clinical resources. Analytics indicate access by users worldwide (32 169 users from 169 countries). User survey results (n=394) confirm access by the target audience (72% health professionals), who agreed the toolkit increased their knowledge (73%) and confidence in managing severe asthma (66%), and 75% are likely to use the resource in clinic.ConclusionsThe Severe Asthma Toolkit is a unique, evidence-based internet resource to support healthcare professionals providing optimal care for people with severe asthma. It is a comprehensive, accessible and independent resource developed by leading severe asthma experts to improve clinician knowledge and skills in severe asthma management.

scholarly journals Electronic monitoring of adherence to inhaled corticosteroids: an essential tool in identifying severe asthma in children

2017 ◽  
Vol 50 (6) ◽  
pp. 1700910 ◽  
Author(s):  
Anja Jochmann ◽  
Luca Artusio ◽  
Angela Jamalzadeh ◽  
Prasad Nagakumar ◽  
Edgar Delgado-Eckert ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Electronic Monitoring ◽  
Inhaled Corticosteroids ◽  
Good Control ◽  
Clinical Parameter ◽  
Poor Adherence ◽  
Poor Control ◽  
Good Adherence ◽  
Asthmatic Children ◽  
Monitoring Devices

International guidelines recommend that severe asthma can only be diagnosed after contributory factors, including adherence, have been addressed. Accurate assessment of adherence is difficult in clinical practice. We hypothesised that electronic monitoring in children would identify nonadherence, thus delineating the small number with true severe asthma.Asthmatic children already prescribed inhaled corticosteroids were prospectively recruited and persistence of adherence assessed using electronic monitoring devices. Spirometry, airway inflammation and asthma control were measured at the start and end of the monitoring period.93 children (62 male; median age 12.4 years) were monitored for a median of 92 days. Median (range) monitored adherence was 74% (21–99%). We identified four groups: 1) good adherence during monitoring with improved control, 24% (likely previous poor adherence); 2) good adherence with poor control, 18% (severe therapy-resistant asthma); 3) poor adherence with good control, 26% (likely overtreated); and 4) poor adherence with poor control, 32%. No clinical parameter prior to monitoring distinguished these groups.Electronic monitoring is a useful tool for identifying children in whom a step up in treatment is indicated. Different approaches are needed in those who are controlled when adherent or who are nonadherent. Electronic monitoring is essential in a paediatric severe asthma clinic.

scholarly journals Development and validation of the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ)

2019 ◽  
Vol 54 (1) ◽  
pp. 1801375 ◽  
Author(s):  
Simone Holley ◽  
Rebecca Knibb ◽  
Sue Latter ◽  
Christina Liossi ◽  
Frances Mitchell ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Symptom Management ◽  
Healthcare Professionals ◽  
Asthma Management ◽  
Reliability And Validity ◽  
Self Management ◽  
Future Research ◽  
The Impact ◽  
General Self Efficacy ◽  
Item Scale

Perceived self-efficacy is the belief that one can manage prospective situations. Good asthma self-management self-efficacy is associated with better asthma outcomes. However, a well-developed and validated tool to measure adolescent asthma self-management self-efficacy is lacking. Our objective was to develop and validate an Adolescent Asthma Self-Efficacy Questionnaire (AASEQ).The first stage of the study included a review of the literature, interviews with adolescents with asthma and consultations with parents and relevant healthcare professionals to develop a prototype scale. To assess reliability and validity, a further group of adolescents completed the prototype scale, the General Self-Efficacy Scale and KidCOPE (measures coping styles). Retesting was undertaken to assess longitudinal validity.Interviews with 28 adolescents and consultations with other stakeholders resulted in a 38-item prototype scale. Key themes were medication, symptom management, triggers, knowledge, attitude and beliefs around asthma, supportive relationships, schools and healthcare professionals. The prototype scale was completed by 243 adolescents. Factor and reliability analysis reduced it to a 27-item scale with four subsections: symptom management; medication; friends, family and school; and asthma beliefs. The 27-item scale had respectable to excellent internal consistency (α's 0.78–0.91) with results that were stable over time (intra-class correlation=0.82) in 63 subjects who completed it twice. Better adolescent asthma self-efficacy was associated with better general self-efficacy and indices of better asthma management.The AASEQ is a reliable and valid tool that is likely to aid future research and practice focused on adolescent asthma self-management and could be a useful intermediate outcome measure to assess the impact of behavioural interventions.

scholarly journals Journalists’ vision of the evolution of the (metaphorical) ecosystem of communication on health and biomedicine

2019 ◽  
Author(s):  
Gema Revuelta
Keyword(s):  
Social Media ◽  
Healthcare Professionals ◽  
Environmental Changes ◽  
Information Source ◽  
Working Environment ◽  
Online Information ◽  
Fake News ◽  
Structured Interviews ◽  
The Impact ◽  
Metaphorical Concept

This article analyses specialist journalists’ perception of transformations in public communication on health and biomedicine in Spain over the last two decades. A total of 20 semi-structured interviews were carried out. The analysis uses the metaphorical concept of “ecosystem”. According to the interviewees, the main “environmental” changes are technological (stressing the expansion and diversity of online information and the impact of social media). They perceive a multiplication and diversification among “information source-species”. Among these, the visibility of specialist sources (researchers and healthcare professionals) and civil associations (patients and consumers) has increased, but “opportunistic species”, such as promoters of fake news and pseudo-medicine, have also emerged. Health journalists rate their profession satisfactorily, while recognising that their working “environment” has deteriorated and perceiving a threat in the dependence on clickbait and social media positioning.

scholarly journals Design of Therapeutic Education Workshops for Home Heamodialysis in a Patient-Centered CKD Research: A Qualitative Study

2021 ◽  
Author(s):  
Abdallah. Guerraoui ◽  
Roula. Galland ◽  
Flora Belkahla-Delabruyere ◽  
Odile Didier ◽  
Veronique. Berger ◽  
...  
Keyword(s):  
Family Environment ◽  
Therapeutic Education ◽  
Structured Interviews ◽  
Patient Centered ◽  
Home Dialysis ◽  
Patient’S Experience ◽  
Education Workshop ◽  
Choice Of Treatment ◽  
The Impact

Abstract Rationale & Objective: A quarter of the patients did not receive any information on any modality before the start of Renal Remplacement Therapy (RRT). We have therapeutic education workshops for all RRT except for home heamodialysis (HHD). We aimed to identify and describe the needs of patients and caregivers for RRT with HHD. Lastly, to conceive and carry out a Therapeutic Education Workshop. Setting & Participants: Two sequential methods of qualitative data collection were undertaken: (1) interviews with a patient who had been on HHD and a doctor specialized in HHD (2) semi-structured interviews with HHD patients in our center. Analytic Approach: Thematic analysis. Results: We identified six themes related to the barriers, facilitators, and potential solutions to home dialysis therapy: (1) HHD allows autonomy and freedom with constraints, (2) safety of the care environment, (3) the caregiver and family environment, (4) patient’s experience and experiential knowledge, (5) self-treatment experience - Impact on life, and (6) factors that impact the choice of treatment with HHD.We designed a model for a therapeutic education workshop in a group of patients and caregivers. . Conclusions: Our study confirmed previous results obtained about the major barriers, facilitators, and potential solutions to HHD. There are three important points regarding HHD: (1) the impact of the HHD on the caregiver, (2) the experience of patients already treated with HHD, and (3) the role of nurses and nephrologists in informing and educating. A program to develop patient-to-patient peer mentorship, allowing patients to discuss their dialysis experience, would be invaluable.

scholarly journals Living life in limbo: experiences of healthcare professionals during the HCPC fitness to practice investigation process in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill Maben ◽  
Linda Hoinville ◽  
Dawn Querstret ◽  
Cath Taylor ◽  
Magdalena Zasada ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Psychological Impact ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Individual Level ◽  
Healthcare Settings ◽  
Lack Of Information ◽  
The Uk ◽  
The Impact ◽  
Investigation Process

Abstract Background It is the responsibility of healthcare regulators to ensure healthcare professionals remain fit for practice in healthcare settings. If there are concerns about an individual healthcare professional they may undergo a fitness to practice investigation. This process is known to be hugely stressful for doctors and social workers, but little is known about the impact of this experience on other professions. This study explores the experiences of registrants going through the process of being reported to the UK’s Health and Care Professions Council (HCPC) and attending fitness to practice (FTP) hearings. We discuss the implications of this process on registrants’ wellbeing and, from our findings, present recommendations based on registrants experiences. In doing so we articulate the structural processes of the HCPC FTP process and the impact this has on individuals. Methods This study uses semi-structured interviews and framework analysis to explore the experiences of 15 registrants who had completed the FTP process. Participants were sampled for maximum variation and were selected to reflect the range of possible processes and outcomes through the FTP process. Results The psychological impact of undergoing a FTP process was significant for the majority of participants. Their stories described influences on their wellbeing at both a macro (institutional/organisational) and micro (individual) level. A lack of information, long length of time for the process and poor support avenues were macro factors impacting on the ability of registrants to cope with their experiences (theme 1). These macro factors led to feelings of powerlessness, vulnerability and threat of ruin for many registrants (theme 2). Suggested improvements (theme 3) included better psychological support (e.g. signposting or provision); proportional processes to the incident (e.g. mediation instead of hearings); and taking context into account. Conclusions Findings suggest that improvements to both the structure and conduct of the FTP process are warranted. Implementation of better signposting for support both during and after a FTP process may improve psychological wellbeing. There may also be value in considering alternative ways of organising the FTP process to enable greater consideration of and flexibility for registrants’ context and how they are investigated.

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