scholarly journals Patient perspectives on the pathway to psoriatic arthritis diagnosis: results from a web-based survey of patients in the United States

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Alexis Ogdie ◽  
W. Benjamin Nowell ◽  
Eddie Applegate ◽  
Kelly Gavigan ◽  
Shilpa Venkatachalam ◽  
...  

Abstract Background There are limited real-world data on the diagnostic experiences of patients with psoriatic arthritis (PsA), including medical care sought and potential barriers to diagnosis. We aim to describe patient experiences related to receiving a PsA diagnosis. Methods Ours was a mixed-method, 2-phase study. Phase 1 comprised concept elicitation and cognitive interviews with clinical experts and adults diagnosed with PsA to develop a cross sectional, web-based survey. US adults with a self-reported PsA diagnosis were recruited through a patient support community (CreakyJoints), an online patient research registry (ArthritisPower), and social media outreach. In Phase 2, the online survey collected data on sociodemographics, clinical symptoms, disease burden, and diagnosis history of survey respondents with PsA. Results Of the 203 respondents included, 172 (84.7%) were female, and the mean (SD) age was 51.6 (10.8) years. The time between seeking medical attention and receiving a diagnosis was < 6 months for 69 respondents, 6 months to 4 years for 68 respondents, and ≥ 5 years for 66 respondents. Most respondents sought care from general practitioners (79.8%) and rheumatologists (66.5%). Common initial symptoms that led respondents to seek medical attention were joint pain (70.0%) and stiffness (53.7%). Among the initial symptoms that led respondents to seek care, joint pain, swollen joints, and sausage-like fingers or toes (indicating dactylitis) were more common among respondents with shorter time to diagnosis, whereas stiffness, fatigue, enthesitis (indicated by foot problems, tendon and ligament pain), and back pain were more common among respondents with longer time to diagnosis. Common misdiagnoses were psychosomatic issues (26.6%) and osteoarthritis (21.7%). Respondents with shorter times to diagnosis had lower frequencies of misdiagnosis. Conclusions Respondents with PsA reported delays in diagnosis and misdiagnoses on their journey to a PsA diagnosis. Symptom differences, such as enthesitis and stiffness, were noted among respondents with shorter vs longer time to diagnosis. Increased understanding of diagnostic barriers may lead to earlier diagnosis and appropriate management to improve outcomes.

2021 ◽  
pp. 004723952110160
Author(s):  
Kristen L. Granger ◽  
Maureen A. Conroy ◽  
Kevin S. Sutherland ◽  
Edward G. Feil ◽  
Jessica Wright ◽  
...  

The purpose of this article is to describe the adaptation process of an evidence-based early childhood Tier-2 intervention program, BEST in CLASS-Prekindergarten, from a face-to-face format to a web-based delivery format called BEST in CLASS-Web. We describe the three-phase iterative development process used to adapt the parent program for delivery via the web. Activities in these phases included focus groups, interviews, an expert panel review, alpha and beta testing (Phase 1), feasibility testing (Phase 2), and a pilot promise study (Phase 3). Each phase included a series of refinements and improvements to materials based on data and stakeholder feedback. Lessons learned and implications for developing and implementing professional development services via online platforms are discussed.


RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001546
Author(s):  
Marco Garrido-Cumbrera ◽  
Helena Marzo-Ortega ◽  
Laura Christen ◽  
Pedro Plazuelo-Ramos ◽  
Dale Webb ◽  
...  

AimTo assess the impact of the COVID-19 pandemic on patients with rheumatic and musculoskeletal diseases (RMDs).MethodsREUMAVID is a cross-sectional study using an online survey developed by an international multidisciplinary patient-led collaboration across seven European countries targeting unselected patients with RMDs. Healthcare access, daily activities, disease activity and function, well-being (WHO Five Well-Being Index (WHO-5)), health status, anxiety/depression (Hospital Anxiety and Depression Scale (HADS)) and access to information were evaluated. Data were collected in April–July 2020 (first phase).ResultsData from the first phase included 1800 patients with 15 different RMDs (37.2% axial spondyloarthritis, 29.2% rheumatoid arthritis, 17.2% osteoarthritis and others). Mean age was 53, 80% female and 49% had undertaken university studies. During the beginning of the pandemic, 58.4% had their rheumatology appointment cancelled and 45.6% reported not having received any information relating to the possible impact of SARS-CoV-2 infection in their RMDs, with the main source being patient organisations (27.6%).Regarding habits, 24.6% increased smoking, 18.2% raised their alcohol consumption, and 45.6% were unable to continue exercising. Self-reported disease activity was high (5.3±2.7) and 75.6% reported elevated pain. Half the patients (49.0%) reported poor well-being (WHO-5) and 46.6% that their health had changed for the worse during lockdown. According to HADS, 57.3% were at risk of anxiety and 45.9% of depression.ConclusionThroughout the first wave of the COVID-19 pandemic, patients with RMDs have experienced disruption in access to healthcare services, poor lifestyle habits and negative effects on their overall health, well-being and mental health. Furthermore, information on COVID-19 has not reached patients appropriately.


2008 ◽  
Vol 14 (8) ◽  
pp. 404-409 ◽  
Author(s):  
Lavanya Janardhanan ◽  
Yung H Leow ◽  
Martin TW Chio ◽  
Yongmin Kim ◽  
Cheong B Soh

We introduced a web-based teledermatology system, the distributed personal health information management system (DPHIMS), into a nursing home in Singapore. The introduction was conducted in two phases. Five staff nurses in Phase 1 and nine nurse aides in Phase 2 performed the data entry and uploaded digital images of the resident's skin condition. By the end of Phase 2, there were 50 residents registered with DPHIMS. The average age of the participants was 82 years and 84% were women. There were 31 first-time referral requests registered in the system during Phase 2. The average time taken to complete a referral request was 86 minutes. The average time taken by the dermatologist to prepare and submit a diagnosis/treatment report was 11 minutes. An online survey form was given to the nurses and the dermatologists to gauge their level of satisfaction and their experience of using DPHIMS. All the nurses said they would readily recommend DPHIMS to other nurses. Overall, the dermatologists felt that DPHIMS was helpful in obtaining specialist care for the residents. However, some skin conditions required a face-to-face consultation. Thus a mixture of face-to-face consultations and consultations via teledermatology may be necessary to provide complete diagnosis and treatment to patients. Our experience suggests that understanding and addressing the organizational concerns is as important as solving the technical problems.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Imelda K. Moise ◽  
Lola R. Ortiz-Whittingham ◽  
Vincent Omachonu ◽  
Marah Clark ◽  
Rui-De Xue

Abstract Background The stay-at-home orders imposed in early April 2020 due to the COVID-19 pandemic in various states complicated mosquito control activities across the United States (US), and Florida was no exception. Mosquito control programs are the first line of defense against mosquito-borne pathogens. The purpose of this study was to examine the capabilities of Florida mosquito programs to implement key mosquito measures during the COVID-19 pandemic lockdown. Methods Using a self-administered online survey, we examined the capabilities of all Florida mosquito control programs (both state-approved mosquito districts, N = 63; and open programs, N = 27) at a time when the state of Florida was still under heightened awareness of, stay-at-home orders and planning a phase 1 reopening over the COVID-19 pandemic (June to July 2020). The final sample included mosquito control programs structured as the Board of County Commissioners (BOCC) (n = 42), independent tax district (n = 16), municipal (n = 10), and health or emergency department (n = 5). We used descriptive statistics to summarize information about the characteristics of responding programs, their implemented mosquito control and surveillance activities.  wWe used bivariate analysis to compare the characteristics of responding programs and the self-reported mosquito measures. Results Of the recruited mosquito control programs, 73 completed the survey (81.1% response rate; 73/90). Of these, 57.5% (n = 42) were Board of County Commissioners (BOCC) mosquito control programs, 21.9% (n = 16) were independent tax district programs, 13.7% (n = 10) were municipal mosquito control programs, and only 6.8% (n = 5) were either health or emergency department mosquito control programs. Except for arbovirus surveillance, most programs either fully or partially performed larval (61.8%) and adult (78.9%) surveillance; most programs conducted species-specific control for Aedes aegypti (85.2%, n = 54), Aedes albopictus (87.3%, n = 55), Culex quinquefasciatus (92.1%, n = 58), and Culex nigripalpus (91.9%, n = 57). Conclusions Findings underscore the importance of ongoing mosquito control activities, and suggest that Florida mosquito control programs are vigilant and have significant capability to handle potential mosquito-borne disease threats, but arbovirus surveillance systems (laboratory testing of mosquito pools and testing of human and nonhuman specimens for arboviruses) are needed during pandemics as well.


Introduction - Previous research suggests that Canadian academic health sciences librarians value knowledge of the health sciences and spend a considerable amount of time gaining and maintaining it. The current study replicates the earlier Canadian survey but employs a larger American sample to address three questions: Do academic health sciences librarians working in the United States find knowledge of the health sciences to be important, and if so, how do they acquire it? Do the attitudes of Canadian and American academic health sciences librarians differ with respect to subject knowledge? Methods - An invitation to participate in a Web-based survey was sent to 711 academic health sciences librarians working in the US; 154 participated. Results - Academic health sciences librarians in the US felt that keeping up with the scientific and medical literature was important to doing their jobs, although only 50% of respondents felt that a degree in the health sciences was somewhat or very useful. Discussion - Participating in professional organizations, visiting Web sites, and reading or browsing journals or magazines were rated by respondents as the best ways to become informed about the health sciences. Findings were similar to those of an earlier survey of Canadian academic health sciences librarians.


Author(s):  
Joao Filipe Raposo ◽  
Marina V Shestakova ◽  
Juming Lu ◽  
Emilie Court ◽  
Alexander Y Mayorov

Aim: To identify and understand the main unmet needs of individuals with Type 2 diabetes (T2D). Materials & methods: An online survey was conducted in Brazil, China and Russia of individuals with recently diagnosed T2D. Results: The survey, involving 300 individuals with T2D, identified a need for more information regarding food/diet and for increased awareness of T2D symptoms. While most participants (94%) had experienced symptoms prior to their diagnosis, only 55% of symptomatic individuals sought medical attention. Conclusion: Novel strategies to increase awareness of diabetes should be developed and tested, and may enable earlier diagnosis and improve patients’ quality of life.


Author(s):  
Mélissa Généreux ◽  
Philip J. Schluter ◽  
Elsa Landaverde ◽  
Kevin KC Hung ◽  
Chi Shing Wong ◽  
...  

Nearly a year after the classification of the COVID-19 outbreak as a global pandemic, it is clear that different factors have contributed to an increase in psychological disorders, including public health measures that infringe on personal freedoms, growing financial losses, and conflicting messages. This study examined the evolution of psychosocial impacts with the progression of the pandemic in adult populations from different countries and continents, and identified, among a wide range of individual and country-level factors, which ones are contributing to this evolving psychological response. An online survey was conducted in May/June 2020 and in November 2020, among a sample of 17,833 adults (Phase 1: 8806; Phase 2: 9027) from eight countries/regions (Canada, the United States, England, Switzerland, Belgium, Hong Kong, the Philippines, New Zealand). Probable generalized anxiety disorder (GAD) and major depressive episode (MDE) were assessed. The independent role of potential factors was examined using multilevel logistic regression. Probable GAD or MDE was indicated by 30.1% and 32.5% of the respondents during phases 1 and 2, respectively (a 7.9% increase over time), with an important variation according to countries/regions (range from 22.3% in Switzerland to 38.8% in the Philippines). This proportion exceeded 50% among young adults (18–24 years old) in all countries except for Switzerland. Beyond young age, several factors negatively influenced mental health in times of pandemic; important factors were found, including weak sense of coherence (adjusted odds ratio aOR = 3.89), false beliefs (aOR = 2.33), and self-isolation/quarantine (aOR = 2.01). The world has entered a new era dominated by psychological suffering and rising demand for mental health interventions, along a continuum from health promotion to specialized healthcare. More than ever, we need to innovate and build interventions aimed at strengthening key protective factors, such as sense of coherence, in the fight against the adversity caused by the concurrent pandemic and infodemic.


2020 ◽  
Vol 5 (6) ◽  
pp. 1666-1682
Author(s):  
Lena G. Caesar ◽  
Merertu Kitila

Purpose The purpose of this study was to investigate the perceptions of speech-language pathologists (SLPs) regarding their academic preparation and current confidence levels for providing dysphagia services, and the relationship between their perceptions of graduate school preparation and their current levels of confidence. Method This study utilized an online survey to gather information from 374 American Speech-Language-Hearing Association–certified SLPs who currently provide dysphagia services in the United States. Surveys were primarily distributed through American Speech-Language-Hearing Association Special Interest Group forums and Facebook groups. The anonymous survey gathered information regarding SLPs' perceptions of academic preparation and current confidence levels for providing dysphagia services in 11 knowledge and skill areas. Results Findings indicated that more than half of respondents did not feel prepared following their graduate academic training in five of the 11 knowledge and skill areas related to dysphagia service delivery. However, about half of respondents indicated they were currently confident about their ability to provide services in eight of the 11 knowledge and skill areas. Findings also indicated that their current confidence levels to provide dysphagia services were significantly higher than their perceptions of preparation immediately following graduate school. However, no significant relationships were found between respondents' self-reported current confidence levels and their perceptions of the adequacy of their academic preparation. Conclusions Despite SLPs' low perceptions of the adequacy of their graduate preparation for providing dysphagia services in specific knowledge and skill areas immediately following graduation, they reported high confidence levels with respect to their actual service delivery. Implications of these findings are discussed.


2020 ◽  
Vol 51 (4) ◽  
pp. 1172-1186
Author(s):  
Carolina Beita-Ell ◽  
Michael P. Boyle

Purpose The purposes of this study were to examine the self-efficacy of school-based speech-language pathologists (SLPs) in conducting multidimensional treatment with children who stutter (CWS) and to identify correlates of self-efficacy in treating speech-related, social, emotional, and cognitive domains of stuttering. Method Three hundred twenty randomly selected school-based SLPs across the United States responded to an online survey that contained self-efficacy scales related to speech, social, emotional, and cognitive components of stuttering. These ratings were analyzed in relation to participants' beliefs about stuttering treatment and their comfort level in treating CWS, perceived success in therapy, and empathy levels, in addition to their academic and clinical training in fluency disorders as well as demographic information. Results Overall, SLPs reported moderate levels of self-efficacy on each self-efficacy scale and on a measure of total self-efficacy. Significant positive associations were observed between SLPs' self-efficacy perceptions and their comfort level in treating CWS, self-reported success in treatment, beliefs about the importance of multidimensional treatment, and self-reported empathy. There were some discrepancies between what SLPs believed was important to address in stuttering therapy and how they measured success in therapy. Conclusions Among school-based SLPs, self-efficacy for treating school-age CWS with a multidimensional approach appears stronger than previously reported; however, more progress in training and experience is needed for SLPs to feel highly self-efficacious in these areas. Continuing to improve clinician self-efficacy for stuttering treatment through improved academic training and increased clinical experiences should remain a high priority in order to enhance outcomes for CWS. Supplemental Material https://doi.org/10.23641/asha.12978194


Crisis ◽  
2015 ◽  
Vol 36 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Erin F. Ward-Ciesielski ◽  
Madeline D. Wielgus ◽  
Connor B. Jones

Background: Suicide-bereaved individuals represent an important group impacted by suicide. Understanding their experiences following the suicide of a loved one is an important research domain, despite receiving limited attention. Although suicide-bereaved individuals may benefit from mental health treatment, their attitudes toward therapy and therapists are poorly understood. Aims: The present study aimed to understand the extent to which bereaved individuals’ attitudes toward therapy and therapists are impacted by whether their loved one was in therapy at the time of death. Method: Suicide-bereaved individuals (N = 243) from the United States were recruited to complete an online survey about their experience with and attitudes toward therapy and therapists following the suicide of a loved one. Results: Bereaved individuals whose loved one was in therapy at the time of death (N = 48, 19.8%) reported more negative and less positive attitudes toward the treating therapist than those whose loved one was not in therapy at the time of death (N = 81, 33.3%) or whose loved one was never in therapy/the deceased’s therapy status was unknown (N = 114, 46.9%). Conclusion: The deceased’s involvement with a therapist appears to be an important factor impacting the experience of bereaved individuals and should be considered when attempting to engage these individuals in postvention.


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