scholarly journals Patient involvement in assessing consultation quality: validation of patient enablement instrument (PEI) in Lithuanian general practice

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Aelita Skarbalienė ◽  
Arnoldas Jurgutis ◽  
Eva Lena Strandberg ◽  
Teresa Pawlikowska
Keyword(s):  
General Practice ◽  
Rural Areas ◽  
Patient Involvement ◽  
Internal Reliability ◽  
Factors Associated ◽  
Geographical Regions ◽  
Consultation Outcome ◽  
Patient Enablement ◽  
Patient Enablement Instrument ◽  
And Coping

Abstract Background The Patient Enablement Instrument (PEI) was designed to encapsulate consultation outcome from the perspective that increasing their understanding and coping ability would underpin a positive consultation outcome for patients. The objective of the study was the validation of the PEI in Lithuanian general practice and comparison of Lithuanian patients’ enablement with previous studies in Europe to see if factors associated with patient enablement in Lithuania were reflective of those in the previous studies. Methods The Patient Enablement Instrument was translated into Lithuanian and included in the questionnaire along with the questions about a person’s health, reasons for visiting the doctor and feeling about the consultation. Practices from 4 different municipalities that are situated in different geographical regions which have both town and rural areas were sampled randomly. Patients scheduled consecutively aged 18 years or more were the subjects of the study. The data analyses focused on internal reliability and concept validity. Results The overall mean patient enablement score was 6.43. Enablement scores declined with increasing patient age, and female patients were more enabled. Patients with biomedical problems had the highest enablement results, while patients with complex problems had the lower results. Enablement was positively related to receiving a prescription and knowing a doctor, and negatively related to wish having consultation with another doctor. Conclusions This study substantiates the rationality of using PEI in assessing primary care consultations in Lithuania. The correlations of enablement largely reflect the situation in Western and Central Europe: longer consultation and access to the same physician increases patient enablement.

Psycho-social factors associated with maternal neonaticide

2017 ◽  
Vol 41 (S1) ◽  
pp. S583-S583
Author(s):  
T. Amirejibi
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Extended Family ◽  
The Body ◽  
Criminal Offense ◽  
Factors Associated ◽  
Competing Interest ◽  
Legal Frameworks ◽  
Premarital Sexual ◽  
And Coping

Current research presents five case studies of maternal neonaticide in Georgia. Participants were under the age of thirty, with incomplete secondary education, unemployed, dependent on their families’ low income, living in the rural areas of Georgia. In three cases, participants resided with their family of origin. They were not married or in a relationship with the father of the child. They described their families and communities as conservative, holding strong cultural/religious beliefs against premarital sexual relations/childbirth out of wedlock. They lacked problem solving and coping skills, avoided making decisions concerning the pregnancy by concealing it. This being their first pregnancy, they gave birth alone followed by panic and fear of detection, committed neonaticide and hid the body of the infant. None of them had a prior criminal record. In the remaining cases, participants were married, lived with their spouses and children, had financial hardships. Both reported psychological and physical abuse from their spouses. One of them had a prior criminal offense for possessing controlled substances. The motive for neonaticide was an unwanted child due to an extramarital affair and threat of financial abandonment from extended family. In both cases, infants suffered fatal injuries. All participants reported lack of social support and emotional neglect from family members. These results are in line with international research, suggesting that certain patterns among these mothers are shared. Psychosocial factors associated with neonaticide should be utilized in the process of planning and implementing preventive strategies in health, social and legal frameworks.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals The validity, reliability, sensitivity and responsiveness of a modified Patient Enablement Instrument (PEI-2) as a tool for serial measurements of health enablement

2020 ◽  
Author(s):  
Laura Elizabeth Bedford ◽  
Maegan Hon Yan Yeung ◽  
Chi Ho Au ◽  
Emily Tsui Yee Tse ◽  
Wing Yee Yim ◽  
...  
Keyword(s):  
Construct Validity ◽  
Convergent Validity ◽  
Cronbach’S Alpha ◽  
Internal Reliability ◽  
Retest Reliability ◽  
Cronbach's Alpha ◽  
Reliability Sensitivity ◽  
Patient Enablement ◽  
Patient Enablement Instrument ◽  
Test Retest Reliability

Abstract Background Patient enablement is a core tenet of patient-centred and holistic primary care. The Patient Enablement Instrument (PEI) is a transitional measure limited in its ability to measure changes over time. A modified version, PEI-2, has been developed to measure enablement at a given time-point without comparison to a recalled baseline. Objective To assess the validity, reliability, sensitivity and responsiveness of PEI-2. Methods PEI-2 was modified from the Chinese PEI to assess enablement over 4 weeks in a prospective cohort study nested within a community support programme [Trekkers Family Enhancement Scheme (TFES)] in Hong Kong. Construct validity was assessed by factor analysis and convergent validity by Spearman’s correlations with health-related quality of life and depressive symptoms. Internal reliability was assessed using Cronbach’s alpha. Test–retest reliability was assessed by intraclass correlation (ICC), responsiveness by 12–24-month change in PEI-2 score and sensitivity by differences in change of PEI-2 score between TFES participants and a control group. Results PEI-2 demonstrated construct validity with all items loading on one factor (factor loadings >0.7). Convergent validity was confirmed by significant correlations with 12-item Short Form Questionnaire, version 2 (r = 0.1089–0.1919) and Patient Health Questionnaire-9 (r = −0.2030). Internal reliability was high (Cronbach’s alpha = 0.9095) and test–retest reliability moderate (ICC = 0.520, P = 0.506). Significant improvements in PEI-2 scores among the TFES group suggested good responsiveness (P < 0.001). The difference in change of PEI-2 scores between TFES and control was significant (P = 0.008), indicating good sensitivity. Conclusions This study supports the validity, reliability, sensitivity and responsiveness of PEI-2 in measuring changes in enablement, making it a promising tool for evaluating enablement in cohort and intervention studies.

scholarly journals Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life course research

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Ashley Akbari ◽  
Ronan Lyons ◽  
Amrita Bandyopadhyay ◽  
Helen Bedford ◽  
Sinead Brophy ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Life Course ◽  
Rural Areas ◽  
Proportional Hazards ◽  
Survey Design ◽  
Mode Of Delivery ◽  
Cox Proportional Hazards ◽  
Housing Tenure ◽  
Factors Associated

IntroductionPrimary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing practices has received little attention. We investigated factors associated with changes in registration and record continuity in the Secure Anonymised Information Linkage (SAIL) databank, with ~80% practice coverage. Objectives and ApproachWe analysed linked pcEHRs for 1834 (882 girls) Millennium Cohort Study (MCS) participants, resident in Wales and with parental consent to health record linkage at the age seven MCS interview. We studied time from first to next general practice (GP) registration in Wales by fitting Cox proportional hazards models, and estimated mutually-adjusted hazard ratios (aHRs) for the following factors: child (sex, ethnicity, mode of delivery, gestation, birthweight, neonatal illness, wheeze, longstanding illness); maternal (age, education, lone parent status); household (income, housing tenure, residential mobility, urban/rural residence); GP type (SAIL-contributing/-non-contributing). Analyses were weighted for survey design (Stata: Release 15; StataCorp LP). ResultsThere were 3065 Welsh GP registrations for 1834 children. By age 5 years, 25% of children changed GP at least once, with 1070 (58.3%), 477 (26.0%) and 287 (15.7%) registered with 1, 2, 3+ GPs respectively up to 14 years of age. Children with older mothers (aHRs; 95% CI: 0.96; 0.95, 0.98; per year) or those residing in rural areas (0.75;0.56,0.99) were less likely, and those whose first registration was not with a SAIL contributing GP (2.16;1.60,2.93), whose mothers had no educational qualifications (1.40;1.15,1.71), or had recently changed address (1.62;1.21,2.16) more likely, to change GP. 305 (16.6%) children had never registered with a SAIL-contributing GP. Of 403 children initially registered with a SAIL contributing GP who then changed GP, 66.7% re-registered with a SAIL contributing GP. Conclusion/ImplicationsGeographically contiguous primary care databanks, such as the SAIL databank, enable a high proportion of children to be reliably followed over time despite changing GP. Similar analyses of databases based on geographically disparate volunteer GPs are needed to quality assure their suitability for life course epidemiology research.

scholarly journals Patient involvement in assessing consultation quality: a quantitative study of the Patient Enablement Instrument in Poland

2010 ◽  
Vol 13 (1) ◽  
pp. 13-23 ◽  
Author(s):  
Teresa R.B. Pawlikowska ◽  
Jeremy J. Walker ◽  
Pawel R. Nowak ◽  
Wieslawa Szumilo-Grzesik
Keyword(s):  
Quantitative Study ◽  
Patient Involvement ◽  
Patient Enablement ◽  
Patient Enablement Instrument

scholarly journals Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Carol Dezateux ◽  
Lucy J Griffiths ◽  
Bianca L De Stavola ◽  
Ashley Akbari ◽  
Amrita Bandyopadhyay ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Life Course ◽  
Rural Areas ◽  
Early Life ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Factors Associated ◽  
Changing Practice ◽  
Cox Proportional Hazards Models

Background Databanks of primary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing general practice has received little attention. ObjectiveWe investigated factors associated with changing general practice (GP) in early life and continuity of participation in the Secure Anonymised Information Linkage (SAIL) databank, to which approximately 80% of Welsh practices contribute. MethodsWe analysed linked pcEHRs for 1834 (882 girls) Millennium Cohort Study participants, resident in Wales, with consent to health record linkage. We studied time from first to next practice registration using Cox proportional hazards models, and estimated mutually-adjusted hazard ratios (aHRs) for child, household and practice factors. FindingsThere were 3065 Welsh GP registrations for 1834 children. By age 5 years, 25% changed practice at least once, with 1070 (58.3%), 477 (26.0%), 287 (15.7%) registered with 1, 2, or 3+ GPs respectively by age 14 years. Changing practice was related to maternal age (aHRs; 95% CI: 0.96; 0.95,0.98), living in rural areas (0.75;0.56,0.99), initial registration with a non-SAIL-practice (2.16;1.60,2.93), recent address change (1.62;1.21,2.16), and no maternal educational qualifications (1.40;1.15,1.71). Overall, 305 (16.6%) children had never registered with a SAIL practice. Of 403 children initially registered with a SAIL practice who then changed practice, 66.7% re-registered with a SAIL practice. ConclusionsIn a nationally representative sample of Welsh children, the majority remained registered with the same practice up to age 14 years, with change in practice varying by maternal and household factors. Continuity of participation in the Welsh SAIL databank over early life is high, reflecting the high proportion of practices contributing, and the high proportion of children registered with them. Geographically contiguous primary care databanks, such as SAIL, enable a high proportion of children to be followed over time despite changing general practice.

scholarly journals Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Adolescent Mothers ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Wealth Quintile ◽  
Adjusted Risk ◽  
Factors Associated

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.

Sign in / Sign up

Export Citation Format

Share Document