scholarly journals Addressing sickness absence among adolescents and young adults: an evaluation of the Medical Advice for Sick-reported Students intervention

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Suzanne J. van den Toren ◽  
Carmen B. Franse ◽  
Yvonne T. M. Vanneste ◽  
Rienke Bannink ◽  
Marjolein Lugtenberg ◽  
...  

Abstract Background Sickness absence is associated with lower school achievements and early school leaving. The Medical Advice for Sick-reported Students (MASS) intervention is a proactive school-based intervention focused primarily on early identification and reduction of sickness absence. This study used a program evaluation framework to evaluate the MASS intervention among intermediate vocational education students and Youth Health Care professionals. Outcome indicators were primarily number of sick days, education fit, and school performance, and secondarily, seven health indicators. Process indicators were dose delivered and received, satisfaction, and experience. Methods The MASS intervention evaluation was conducted in ten intermediate vocational education schools. Students with extensive sickness absence from school in the past three months were included in either the intervention or control condition. Students completed a baseline and a six-month follow-up self-report questionnaire. Linear and logistic regression analyses were applied. Students and Youth Health Care professionals completed an evaluation form regarding their satisfaction and experience with the intervention. Results Participants (n = 200) had a mean age of 18.6 years (SD = 2.02) and 78.5% were female. The MASS intervention showed positive results on decreasing sickness absence in days (β = -1.13, 95% CI = -2.22;-0.05, p < 0.05) and on decreasing depressive symptoms (β = -4.11, 95% CI = -7.06;-1.17, p < 0.05). No effects were found for other health indicators (p > 0.05). A significant interaction revealed a decline in sickness absence in males (p < 0.05) but not in females (p > 0.05). Youth Health Care professionals found the application of the MASS intervention useful (n = 35 forms). The mean rating of students for the consultation within the MASS intervention was an 8.3 (SD = 1.3) out of 10 (n = 14 forms). Conclusions Our study provides some indication that the MASS intervention has positive effects on decreasing both sickness absence and depressive symptoms among intermediate vocational education students. The Youth Health Care professionals who provided the consultation as part of the MASS intervention considered the intervention to be useful and stated that the consultation was delivered as intended in almost all cases. Students were generally satisfied with the intervention. We recommend that future research evaluates the MASS intervention in a large randomized controlled trial with a longer follow-up. Trial registration This study was prospectively registered in the Netherlands Trial Register under number NTR5556, in October 2015.

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Yvonne T. M. Vanneste ◽  
Frans J. M. Feron ◽  
Marlieke A. W. van Mook ◽  
Angelique de Rijk

An adequate approach to sickness absence can reduce school dropout which is a major problem in Intermediate Vocational Education (IVE). This practice-based study explores the sickness absence reasons and factors influencing reporting the sickness, from a student’s perspective. Semistructured interviews were held until saturation. Data were collected and analysed by a multidisciplinary research team including youth health care physicians working with IVE students. The results show that, according to the students, reasons for sickness reporting were health-related or related to problems at home or in school. Students view their sickness absence as necessity, as asking for understanding, or as pardonable. Their views depended on (1) the perception of medical legitimacy, (2) feeling able to take their own responsibility, (3) feeling being taken seriously at school, and (4) the perception that the sickness reporting procedure at school is anonymous and easy. In conclusion, reporting sickness seems more a reaction to a necessity or opportunity than the result of a conscious decision-making process. Personalizing the sickness reporting procedures and demonstrating interest rather than control while discussing the sickness absence with the individual IVE student might very well affect their sickness absence levels.


2012 ◽  
Vol 51 (8) ◽  
pp. 584-590 ◽  
Author(s):  
C. P. B. van der Ploeg ◽  
N. N. Uilenburg ◽  
M. A. Kauffman-de Boer ◽  
A. M. Oudesluys-Murphy ◽  
P. H. Verkerk

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C S Cardoso ◽  
N R Baldoni ◽  
C F Melo ◽  
L O Rezende ◽  
K Noronha ◽  
...  

Abstract Background Health assessments are necessary for the (re) formulation of effective public policies and to guarantee the quality of care offered. This study aim to evaluate the perception of health professionals concerning the institutional capacity of the health system to care for Chronic Conditions (CC) after intervention in a medium-sized municipality in Minas Gerais, Brazil. Methods It is a panel study with evaluation before, during and after an intervention in the health system with a focus on three CC, i.e., i) diabetes; ii) hypertension; and iii) pregnant women. Health care professionals from primary and specialized care units were interviewed using the Assessment of Chronic Illness Care (ACIC) scale, which was applied in nine focal groups organized by health care unit. Results A total of 240 professionals participated of this evaluation, being 94, 63 and 82 participants in 2013, 2015 and 2018 respectively. The ACIC scores showed an positive evolution in the capacity of the health system to care for CC over the years. In the first wave the global score was 5.40 (basic capacity), while in the third wave the score was 9.38 (optimal capacity), with a significant increase in the scores (p &lt; 0.01). Conclusions An important gain in the institutional capacity of the municipality was evidenced for the care of chronic conditions after intervention in the health system. Such an enhancement of the health system to operate in the CC might be sustainable over the time. Furthermore, its impact may directly reflect on the health indicators of the population. Key messages The results showed a strengthening of the local health system. These findings can subsidize other municipalities with a similar reality in the organization of the health care network and, consequently improve the care provided to chronic conditions.


2009 ◽  
Vol 16 (3) ◽  
pp. 148-154 ◽  
Author(s):  
CA Graham ◽  
WO Kwok ◽  
YL Tsang ◽  
TH Rainer

Objective To explore why patients in Hong Kong seek medical advice from the emergency department (ED) and to identify the methods by which patients would prefer to be updated on the likely waiting time for medical consultation in the ED. Methods The study recruited 249 semi-urgent and non-urgent patients in the ED of Prince of Wales Hospital from 26th September 2005 to 30th September 2005 inclusive. A convenience sample of subjects aged ≥15 years old in triage categories 4 or 5 were verbally consented and interviewed by research nurses using a standardized questionnaire. Results From 1715 potential patients, 249 were recruited ad hoc (mean age 44 years [SD18]; 123 females). About 63% indicated that an acceptable ED waiting time was less than or equal to two hours, and 88% felt that having individual number cards and using a number allocation screen in the ED waiting area would be useful. Perceived reasons for attending the ED rather than other health care providers such as primary health care or the general outpatient clinic (GOPC) included: a desire for more detailed investigations (56%); a perception that more professional medical advice was given in the ED (35%); patients were under the continuing care of the hospital (19%); and patients were referred to the ED by other health care professionals (11%). Notably, 26% of participants had considered attending the GOPC prior to attending the ED. Patients educated to tertiary level expected a shorter waiting time than those educated to lesser degrees (p=0.026, Kruskal-Wallis test). Suggestions were made on how to provide a more pleasant ED environment for the wait for consultations, which included the provision of a television screen with sound in the waiting area (43%), more comfortable chairs (37%) and health care promotion programs (32%). Conclusion Patients chose ED services because they believed they would receive more detailed investigations and more professional medical advice than available alternatives. Clear notification of the likely waiting times and enhancement of comfort before consultation are considered desirable by patients. Enhanced public education about the role of the ED and making alternatives to ED care more accessible may be useful in reducing inappropriate ED attendances in Hong Kong.


2020 ◽  
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  

BACKGROUND Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. OBJECTIVE This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. METHODS Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. RESULTS Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (<i>χ</i><sup>2</sup><sub>4</sub>=12.3; <i>P</i>=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). CONCLUSIONS The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.


2021 ◽  
Vol 26 (01) ◽  
pp. 84-91
Author(s):  
Shivangi Saha ◽  
Suvashis Dash ◽  
Mohammed Tahir Ansari ◽  
Ashish Dhanraj Bichupuriya ◽  
Amit Kumar Gupta ◽  
...  

Background: With the emergence of the COVID-19 pandemic, most health-care personnel and resources are redirected to prioritize care for seriously-ill COVID patients. This situation may poorly impact our capacity to care for critically injured patients. We need to devise a strategy to provide rational and essential care to hand trauma victims whilst the access to theatres and anaesthetic support is limited. Our center is a level 1 trauma center, where the pandemic preparedness required reorganization of the trauma services. We aim to summarise the clinical profile and management of these patients and highlight, how we modified our practice to optimize their care. Methods: This is a single-centre retrospective observational study of all patients with hand injuries visiting the Department of Plastic Surgery from 22nd March to 31st May 2020. Patient characteristics, management details, and outcomes were analysed. Results: A total of 102 hand injuries were encountered. Five patients were COVID-19 positive. The mean age was 28.9 ± 14.8 years and eighty-two (80.4%) were males. Thirty-one injuries involved fractures/dislocations, of which 23 (74.2%) were managed non-operatively. Seventy-five (73.5%) patients underwent wound wash or procedure under local anaesthetic and were discharged as soon as they were comfortable. Seventeen cases performed under brachial-plexus block, were discharged within 24 hours except four cases of finger replantation/ revascularisation and one flap cover which were discharged after monitoring for four days. At mean follow-up of 54.4 ± 21.8 days, the rates of early complication and loss to follow-up were 6.9% and 12.7% respectively. Conclusions: Essential trauma care needs to continue keeping in mind, rational use of resources while ensuring safety of the patients and health-care professionals. We need to be flexible and dynamic in our approach, by utilising teleconsultation, non-operative management, and regional anaesthesia wherever feasible.


2019 ◽  
pp. 1-6
Author(s):  
Magnus Petersson-Ahrholt ◽  
Thomas Wiebe ◽  
Lars Hjorth ◽  
Thomas Relander ◽  
Helena M. Linge

PURPOSE Survival rates after childhood cancer have increased from 20% to 80% since the 1970s. The increased number of survivors emphasizes the importance of late effects and their monitoring. Late effects may have a strong impact on quality of life in survivors. The purpose of this study was to make key data in a quality registry available for direct clinical use, enabling health care professionals to perform efficient and appropriate long-term medical follow-up after childhood cancer treatment. METHODS The population-based quality registry upon which this study is centered contains data on all individuals diagnosed with childhood cancer (diagnosed at 18 years of age or younger) in southern Sweden since January 1, 1970, and treatment data on 5-year survivors. Web tools, which were developed and implemented in a health care setting, generate a personalized treatment summary for each patient and enable risk group stratification of survivors. RESULTS Generation of a personalized treatment summary and risk group stratification of survivors led to identification of women at risk for developing breast cancer as a consequence of childhood cancer treatment. Three novel cases of previously undiagnosed breast cancer were identified. CONCLUSION The registry, together with the developed tools, enabled health care professionals to perform medical follow-up in this at-risk patient population.


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