scholarly journals Physiotherapists perceived role in managing anxiety in patients with relapsing-remitting multiple sclerosis: a mixed-methods study

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Lauren Lucas ◽  
Jack Parker
Keyword(s):  
Multiple Sclerosis ◽  
Mixed Methods ◽  
Training Needs ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rehabilitation Process ◽  
Relapsing Remitting ◽  
Outpatient Settings ◽  
The Impact

Abstract Background Anxiety is common for people with Multiple Sclerosis (PwMS) and is higher in those with relapsing-remitting MS (RRMS) and in community-based samples. Anxiety can impact self-efficacy, pain, fatigue, engagement in physical activity and treatment adherence, all of which influence the rehabilitation process. Little is known about how physiotherapists manage anxiety in PwMS and the challenges associated with anxiety throughout the rehabilitation process, in community and outpatient settings. Methods A mixed-methods design, combining a cross-sectional survey and semi-structured interviews with UK-physiotherapists, was used to answer the research question. To inform the qualitative study, a cross-sectional survey collected data from physiotherapists working in neurology to understand the impact and management of anxiety in people with MS (PwMS) during rehabilitation. Analysis used descriptive statistics and the findings formed the interview guide. Semi-structured interviews with specialist physiotherapists explored barriers and facilitators to managing anxiety in PwMS in community and outpatient settings, identified perceived physiotherapy training needs and offered suggestions to develop physiotherapy research and practice. Themes were derived inductively. Results The survey suggested how PwMS present with anxiety, its impact during rehabilitation, physiotherapy management practices, and physiotherapist skills and training needs. Five semi-structured interviews with specialist physiotherapists expanded on the survey findings and identified five main themes: Understanding the MS journey, modifying assessment and treatment, anxiety management toolbox, lagging behind Musculoskeletal Physiotherapy, and gaining knowledge and skills. Conclusion Physiotherapists encounter anxiety in PwMS in community and outpatient rehabilitation and perceive they have a role in managing it as it presents. Facilitators included communication, listening skills and opportunities to develop strong therapeutic relationships. Poor training and support, lack of clinical guidelines and limited research evidence were considered barriers. Clinically relevant learning opportunities, interprofessional working, and greater support through clinical supervision is recommended to better develop physiotherapy practice.

scholarly journals Physiotherapists perceived role in managing anxiety in patients with Relapsing-Remitting Multiple Sclerosis: a mixed-methods study.

2021 ◽  
Author(s):  
Lauren Lucas ◽  
Jack Parker
Keyword(s):  
Mixed Methods ◽  
Clinical Supervision ◽  
Management Practices ◽  
Training Needs ◽  
Outpatient Rehabilitation ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physiotherapy Practice ◽  
The Impact

ABSTRACT Objectives: To explore how physiotherapists manage anxiety in patients with RRMS in community and outpatient settings. To identify further training and research to better develop physiotherapy practice. Design: A mixed-methods design, combining a cross-sectional survey and semi-structured interviews with UK-physiotherapists. Participants: Sixteen UK-registered physiotherapists: 11 in the survey, 5 in the interviews. Methods: To inform the qualitative study, a cross-sectional survey collected data from physiotherapists working in neurology to understand the impact and management of anxiety in people with MS (PwMS) during rehabilitation. Analysis used descriptive statistics and the findings formed the interview guide. Semi-structured interviews with specialist physiotherapists explored barriers and facilitators to managing anxiety, physiotherapy training needs and offered suggestions to develop physiotherapy research and practice. Themes were derived inductively. Results: The survey suggested how PwMS present with anxiety, its impact during rehabilitation, physiotherapy management practices, and physiotherapist skills and training needs. Five semi-structured interviews with specialist physiotherapists expanded on the survey findings and identified five main themes: Understanding the MS journey, modifying assessment and treatment, anxiety management toolbox, lagging behind Musculoskeletal Physiotherapy, and gaining knowledge and skills. Conclusion: Physiotherapists encounter anxiety in PwMS in community and outpatient rehabilitation and perceive they have a role in managing it as it presents. Facilitators included communication, listening skills and opportunities to develop strong therapeutic relationships. Poor training and support, lack of clinical guidelines and limited research evidence were considered barriers. Clinically relevant learning opportunities, interprofessional working, and greater support through clinical supervision is recommended to better develop physiotherapy practice.

scholarly journals The PROMISES study: a mixed methods approach to explore the acceptability of salivary progesterone testing for preterm birth risk among pregnant women and trained frontline healthcare workers in rural India

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040268
Author(s):  
Danielle Ashworth ◽  
Pankhuri Sharma ◽  
Sergio A Silverio ◽  
Simi Khan ◽  
Nishtha Kathuria ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Barriers And Facilitators ◽  
Rural India ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Thematic Framework

IntroductionIndia has an overall neonatal mortality rate of 28/1000 live births, with higher rates in rural India. Approximately 3.5 million pregnancies in India are affected by preterm birth (PTB) annually and contribute to approximately a quarter of PTBs globally. Embedded within the PROMISES study (which aims to validate a low-cost salivary progesterone test for early detection of PTB risk), we present a mixed methods explanatory sequential feasibility substudy of the salivary progesterone test.MethodsA pretraining and post-training questionnaire to assess Accredited Social Health Activists (ASHAs) (n=201) knowledge and experience of PTB and salivary progesterone sampling was analysed using the McNemar test. Descriptive statistics for a cross-sectional survey of pregnant women (n=400) are presented in which the acceptability of this test for pregnant women is assessed. Structured interviews were undertaken with ASHAs (n=10) and pregnant women (n=9), and were analysed using thematic framework analysis to explore the barriers and facilitators influencing the use of this test in rural India.ResultsBefore training, ASHAs’ knowledge of PTB (including risk factors, causes, postnatal support and testing) was very limited. After the training programme, there was a significant improvement in the ASHAs’ knowledge of PTB. All 400 women reported the salivary test was acceptable with the majority finding it easy but not quick or better than drawing blood. For the qualitative aspects of the study, analysis of interview data with ASHAs and women, our thematic framework comprised of three main areas: implementation of intervention; networks of influence and access to healthcare. Qualitative data were stratified and presented as barriers and facilitators.ConclusionThis study suggests support for ongoing investigations validating PTB testing using salivary progesterone in rural settings.

scholarly journals Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Jiayao Xu ◽  
Xiaomin Wang ◽  
Kai Sing Sun ◽  
Leesa Lin ◽  
Xudong Zhou
Keyword(s):  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Clinical Settings ◽  
Cross Sectional Survey ◽  
Self Medication ◽  
Cross Sectional ◽  
Prescribing Behavior ◽  
The Past ◽  
Outpatient Settings ◽  
The Impact

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.

scholarly journals Language diversity and challenges to communication in Indian emergency departments

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Katherine Douglass ◽  
Lalit Narayan ◽  
Rebecca Allen ◽  
Jay Pandya ◽  
Zohray Talib
Keyword(s):  
Emergency Departments ◽  
Critical Incident ◽  
English Language ◽  
Rapid Assessment ◽  
Assessment Process ◽  
Language Diversity ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background Communication in emergency departments (ED) in India is complicated by the country’s immense language diversity. Prior research has revealed challenges in language and communication as barriers to care. Our objective was to quantify language diversity among clinicians in Indian EDs and better understand issues related to clinician-clinician and clinician-patient communication. Methodology A cross-sectional survey of ED clinicians was conducted. Survey participants were recruited in-person and through email at six partner sites in India. ANOVA and binary logistic regression were used for subgroup analysis. Semi-structured interviews were conducted with ED clinicians. Interview data was analyzed using the rapid assessment process to determine predominant themes. Results 106 clinicians completed the survey. On average, clinicians spoke 3.75 languages. Seventy-one percent used a non-English language to speak to fellow clinicians most of the time, and 53% reported at least one critical incident over the last year where poor communication played a part. Interviews revealed challenges including low health literacy, high patient volume, and workplace hierarchy. Conclusions This study is the first to document the impact of language diversity and communication barriers in Indian EDs. The results highlight the need for effective strategies to improve communication between the multiple languages spoken by clinicians and patients.

scholarly journals Language Diversity and Challenges to Communication in Indian Emergency Departments

2021 ◽  
Author(s):  
Katherine Douglass ◽  
Lalit Narayan ◽  
Rebecca Allen ◽  
Jay Pandya ◽  
Zohray Talib
Keyword(s):  
Emergency Departments ◽  
Critical Incident ◽  
English Language ◽  
Rapid Assessment ◽  
Assessment Process ◽  
Language Diversity ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract BackgroundCommunication in emergency departments (ED) in India is complicated by the country’s immense language diversity. Prior research has revealed challenges in language and communication as barriers to care. Our objective was to quantify language diversity among clinicians in Indian EDs and better understand issues related to clinician-clinician and clinician-patient communicationMethodologyA cross-sectional survey of ED clinicians was conducted. Survey participants were recruited in-person and through email at six partner sites in India. ANOVA and binary logistic regression were used for subgroup analysis. Semi-structured interviews were conducted with ED clinicians. Interview data was analyzed using the rapid assessment process to determine predominant themes.Results 106 clinicians completed the survey. On average, clinicians spoke 3.75 languages. 71% used a non-English language to speak to fellow clinicians most of the time. 53% reported at least one critical incident over the last year where poor communication played a part. Interviews revealed challenges including low health literacy, high patient volume,and workplace hierarchy.Conclusions This study is the first to document the impact of language diversity and communication barriers in Indian EDs. The results highlight the need for effective strategies to improve communication that account for the multiple languages spoken by clinicians and patients.

scholarly journals Symptom Co-occurrences Associated with Smoking in Individuals with Relapsing-Remitting Multiple Sclerosis

2016 ◽  
Vol 18 (4) ◽  
pp. 163-168 ◽  
Author(s):  
Pamela Newland ◽  
Louise Flick ◽  
Hong Xian ◽  
Florian P. Thomas
Keyword(s):  
Multiple Sclerosis ◽  
Factor Analysis ◽  
Linear Regression ◽  
Tobacco Use ◽  
Linear Regression Analysis ◽  
Disease Process ◽  
Behavioral Risk ◽  
Cross Sectional ◽  
Relapsing Remitting ◽  
The Impact

Background: The impact of tobacco on the multiple sclerosis (MS) disease process and symptoms is complex and not clearly understood. Tobacco may be used to self-treat some symptoms but also seems to intensify others. Studies to date have not characterized co-occurring symptoms (symptom patterns) and their association with tobacco use. Methods: This study describes tobacco use in patients with relapsing-remitting MS and associated symptoms and symptom co-occurrences. In this cross-sectional study, 101 participants with an average age of 43 years completed a survey adapted from the Behavioral Risk Factor Surveillance System and the revised MS-Related Symptom Checklist. Data reduction was performed using factor analysis on the 43 items of the checklist, and linear regression was used to detect associations between symptom clusters (factors) and smoking. Results: Using the factor analysis result, the linear regression analysis found that tobacco use is positively associated with co-occurring symptoms and symptoms of factor 1: Mental/Emotional (anxiety, loneliness, depression, and difficulty sleeping) and factor 4: Neuro/Autonomic (urinary). Conclusions: Smoking is associated with patterns of symptoms. The study of MS and tobacco use over time will allow determination of the temporal pattern of tobacco use and MS symptoms.

scholarly journals Do mentoring programmes influence women’s careers in the health and medical research sector? A mixed-methods evaluation of Australia’s Franklin Women Mentoring Programme

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052560
Author(s):  
Amy Vassallo ◽  
Karen Walker ◽  
Melina Georgousakis ◽  
Rohina Joshi
Keyword(s):  
Mixed Methods ◽  
Career Development ◽  
Medical Research ◽  
Secondary Outcome ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Career Women ◽  
Cross Sectional ◽  
Research Sector ◽  
Research Metrics

ObjectivesIt is known that women are under-represented in senior positions within the health and medical research sector. The Franklin Women Mentoring Programme (Programme) is a professionally facilitated, cross-organisational initiative designed to support career development for mid-career women. The objective of this study was to evaluate Programme outcomes reported by participants 12 months following its formal conclusion.DesignExplanatory sequential mixed-methods study design using a cross-sectional survey and semi-structured interviews.SettingHealth and medical research institutes in Sydney, Australia.ParticipantsHealth and medical researchers from the 2018 Programme.Primary and secondary outcome measuresChanges in knowledge, skills, behaviours and research metrics directly attributed to Programme participation.ResultsA total of 50 mentors and mentees participated in the cross-sectional survey (68% of the total cohort) and 14 mentors and mentees participated in the interviews. All reported changes to their knowledge, skills, behaviours and research metrics which were directly attributed to participation in the Programme. This included changes in knowledge and skills to be more inclusive (96% mentees, 83% mentors), resilience (88% mentees, 67% mentors), ability to have difficult workplace conversations (88% mentees, 71% mentors) and improvements in supervisory and team management (82% mentees, 75% mentors) skills. Positive impacts on promotions and grant opportunities were also reported. All evaluation participants believed this Programme was a worthwhile initiative for their workplaces to invest in.ConclusionParticipation in this cross-organisational, professionally facilitated, structured mentoring programme has led to positive outcomes for mentees, as well as mentors. Reported outcomes indicate the Programme is meeting its aims to support the career development of mid-career women in health and medical research, while facilitating a more inclusive workforce.

scholarly journals COVID-19 vaccination beliefs, attitudes, and behaviours among health and social care workers in the UK: a mixed-methods study

2021 ◽  
Author(s):  
Sadie Bell ◽  
Richard M Clarke ◽  
Sharif A Ismail ◽  
Oyinkansola Ojo-Aromokudu ◽  
Habib Naqvi ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Social Care ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Black African ◽  
Care Workers ◽  
Health And Social Care ◽  
The Uk

AbstractBackgroundThe UK began delivering its COVID-19 vaccination programme on 8 December 2020, with health and social care workers (H&SCWs) given high priority for vaccination. Despite well- documented occupational exposure risks, however, there is evidence of lower uptake among some H&SCW groups.MethodsWe used a mixed-methods approach - involving an online cross-sectional survey and semi- structured interviews – to gain insight into COVID-19 vaccination beliefs, attitudes, and behaviours amongst H&SCWs in the UK by socio-demographic and employment variables. 1917 people were surveyed – 1658 healthcare workers (HCWs) and 261 social care workers (SCWs). Twenty participants were interviewed.FindingsWorkplace factors contributed to vaccination access and uptake. SCWs were more likely to not be offered COVID-19 vaccination than HCWs (OR:1.453, 95%CI: 1.244 – 1.696). SCWs specifically reported uncertainties around how to access COVID-19 vaccination. Participants who indicated stronger agreement with the statement ‘I would recommend my organisation as a place to work’ were more likely to have been offered COVID-19 vaccination (OR:1.28, 95%CI: 1.06 – 1.56). Those who agreed more strongly with the statement ‘I feel/felt under pressure from my employer to get a COVID-19 vaccine’ were more likely to have declined vaccination (OR:1.75, 95%CI: 1.27– 2.41). Interviewees that experienced employer pressure to get vaccinated felt this exacerbated their vaccine concerns and increased distrust.In comparison to White British and White Irish participants, Black African and Mixed Black African participants were more likely to not be offered (OR:2.011, 95%CI: 1.026 – 3.943) and more likely to have declined COVID-19 vaccination (OR:5.55, 95%CI: 2.29 – 13.43). Reasons for declining vaccination among Black African participants included distrust in COVID-19 vaccination, healthcare providers, and policymakers.ConclusionH&SCW employers are in a pivotal position to facilitate COVID-19 vaccination access, by ensuring staff are aware of how to get vaccinated and promoting a workplace environment in which vaccination decisions are informed and voluntary.

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