scholarly journals Personalising screening of sight-threatening diabetic retinopathy - qualitative evidence to inform effective implementation

2020 ◽  
Author(s):  
Paula Byrne ◽  
Clare Thetford ◽  
Mark Gabbay ◽  
Pam Clarke ◽  
Emily Doncaster ◽  
...  
Keyword(s):  
Health Care ◽  
Diabetic Retinopathy ◽  
Health Care Professionals ◽  
Controlled Trial ◽  
Comparative Method ◽  
Variable Interval ◽  
Incidence Rates ◽  
Successful Implementation ◽  
Eye Screening ◽  
Screening Intervals

Abstract Background Internationally, systematic screening for sight-threatening diabetic retinopathy (STDR) usually includes annual recall. Researchers and policy-makers support extending screening intervals, citing evidence from observational studies with low incidence rates. However, there is little research around the acceptability to people with diabetes (PWD) and health care professionals (HCP) about changing eye screening intervals. Methods We conducted a qualitative study to explore issues surrounding acceptability and the barriers and enablers for changing from annual screening, using in-depth, semi-structured interviews analysed using the constant comparative method. PWD were recruited from general practices and HCPs from eye screening networks and related specialties in North West England using purposive sampling. Interviews were conducted prior to the commencement of and during a randomised controlled trial (RCT) comparing fixed annual with variable (6, 12 or 24 month) interval risk-based screening. Results Thirty PWD and 21 HCP participants were interviewed prior to and 30 PWD during the parallel RCT. The data suggests that a move to variable screening intervals was generally acceptable in principle, though highlighted significant concerns and challenges to successful implementation. The current annual interval was recognised as unsustainable against a backdrop of increasing diabetes prevalence. There were important caveats attached to acceptability and a need for clear safeguards around: the safety and reliability of calculating screening intervals, capturing all PWDs, referral into screening of PWDs with diabetic changes regardless of planned interval. For PWDs the 6-month interval was perceived positively as medical reassurance, and the 12-month seen as usual treatment. Concerns were expressed by many HCPs and PWDs that a 2-year interval was too lengthy and was risky for detecting STDR. There were also concerns about a negative effect upon PWD care and increasing non-attendance rates. Amongst PWDs, there was considerable conflation and misunderstanding about different eye-related appointments within the health care system. Conclusions Implementing variable-interval screening into clinical practice is generally acceptable to PWD and HCP with important caveats, and misconceptions must be addressed. Clear safeguards against increasing non-attendance, loss of diabetes control and alternative referral pathways are required. For risk calculation systems to be safe, reliable monitoring and clear communication is required.

scholarly journals Personalising screening of sight-threatening diabetic retinopathy - qualitative evidence to inform effective implementation

2020 ◽  
Author(s):  
Paula Byrne ◽  
Clare Thetford ◽  
Mark Gabbay ◽  
Pam Clarke ◽  
Emily Doncaster ◽  
...  
Keyword(s):  
Health Care ◽  
Diabetic Retinopathy ◽  
Health Care Professionals ◽  
Controlled Trial ◽  
Comparative Method ◽  
Variable Interval ◽  
Incidence Rates ◽  
Successful Implementation ◽  
Eye Screening ◽  
Screening Intervals

Abstract Background Internationally, systematic screening for sight-threatening diabetic retinopathy (STDR) usually includes annual recall. Researchers and policy-makers support extending screening intervals, citing evidence from observational studies with low incidence rates. However, there is little research around the acceptability to people with diabetes (PWD) and health care professionals (HCP) about changing eye screening intervals. Methods We conducted a qualitative study to explore issues surrounding acceptability and the barriers and enablers for changing from annual screening, using in-depth, semi-structured interviews analysed using the constant comparative method. PWD were recruited from general practices and HCPs from eye screening networks and related specialties in North West England using purposive sampling. Interviews were conducted prior to the commencement of and during a randomised controlled trial (RCT) comparing fixed annual with variable (6, 12 or 24 month) interval risk-based screening. Results Thirty PWD and 21 HCP participants were interviewed prior to and 30 PWD during the parallel RCT. The data suggests that a move to variable screening intervals was generally acceptable in principle, though highlighted significant concerns and challenges to successful implementation. The current annual interval was recognised as unsustainable against a backdrop of increasing diabetes prevalence. There were important caveats attached to acceptability and a need for clear safeguards around: the safety and reliability of calculating screening intervals, capturing all PWDs, referral into screening of PWDs with diabetic changes regardless of planned interval. For PWDs the 6-month interval was perceived positively as medical reassurance, and the 12-month seen as usual treatment. Concerns were expressed by many HCPs and PWDs that a 2-year interval was too lengthy and was risky for detecting STDR. There were also concerns about a negative effect upon PWD care and increasing non-attendance rates. Amongst PWDs, there was considerable conflation and misunderstanding about different eye-related appointments within the health care system. Conclusions Implementing variable-interval screening into clinical practice is generally acceptable to PWD and HCP with important caveats, and misconceptions must be addressed. Clear safeguards against increasing non-attendance, loss of diabetes control and alternative referral pathways are required. For risk calculation systems to be safe, reliable monitoring and clear communication is required.

scholarly journals Personalising screening of sight-threatening diabetic retinopathy - qualitative evidence to inform effective implementation

2020 ◽  
Author(s):  
Paula Byrne ◽  
Clare Thetford ◽  
Mark Gabbay ◽  
Pam Clarke ◽  
Emily Doncaster ◽  
...  
Keyword(s):  
Health Care ◽  
Diabetic Retinopathy ◽  
Health Care Professionals ◽  
Controlled Trial ◽  
Comparative Method ◽  
Variable Interval ◽  
Incidence Rates ◽  
Successful Implementation ◽  
Eye Screening ◽  
Screening Intervals

Abstract Background: Internationally, systematic screening for sight-threatening diabetic retinopathy (STDR) usually includes annual recall. Researchers and policy-makers support extending screening intervals, citing evidence from observational studies with low incidence rates. However, there is little research around the acceptability to people with diabetes (PWD) and health care professionals (HCP) about changing eye screening intervals. Methods: We conducted a qualitative study to explore issues surrounding acceptability and the barriers and enablers for changing from annual screening, using in-depth, semi-structured interviews analysed using the constant comparative method. PWD were recruited from general practices and HCPs from eye screening networks and related specialties in North West England using purposive sampling. Interviews were conducted prior to the commencement of and during a randomised controlled trial (RCT) comparing fixed annual with variable (6, 12 or 24 month) interval risk-based screening. Results: Thirty PWD and 21 HCP participants were interviewed prior to and 30 PWD during the parallel RCT. The data suggests that a move to variable screening intervals was generally acceptable in principle, though highlighted significant concerns and challenges to successful implementation. The current annual interval was recognised as unsustainable against a backdrop of increasing diabetes prevalence. There were important caveats attached to acceptability and a need for clear safeguards around: the safety and reliability of calculating screening intervals, capturing all PWDs, referral into screening of PWDs with diabetic changes regardless of planned interval. For PWDs the 6-month interval was perceived positively as medical reassurance, and the 12-month seen as usual treatment. Concerns were expressed by many HCPs and PWDs that a 2-year interval was too lengthy and was risky for detecting STDR. There were also concerns about a negative effect upon PWD care and increasing non-attendance rates. Amongst PWDs, there was considerable conflation and misunderstanding about different eye-related appointments within the health care system. Conclusions: Implementing variable-interval screening into clinical practice is generally acceptable to PWD and HCP with important caveats, and misconceptions must be addressed. Clear safeguards against increasing non-attendance, loss of diabetes control and alternative referral pathways are required. For risk calculation systems to be safe, reliable monitoring and clear communication is required.

scholarly journals Personalising screening of sight-threatening diabetic retinopathy - qualitative evidence to inform effective implementation

2020 ◽  
Author(s):  
Paula Byrne ◽  
Clare Thetford ◽  
Mark Gabbay ◽  
Pam Clarke ◽  
Emily Doncaster ◽  
...  
Keyword(s):  
Health Care ◽  
Diabetic Retinopathy ◽  
Health Care Professionals ◽  
Controlled Trial ◽  
Comparative Method ◽  
Variable Interval ◽  
Incidence Rates ◽  
Successful Implementation ◽  
Eye Screening ◽  
Screening Intervals

Abstract Background Internationally, systematic screening for sight-threatening diabetic retinopathy (STDR) usually includes annual recall. Researchers and policy-makers support extending screening intervals, citing evidence from observational studies with low incidence rates. However, there is little research around the acceptability to people with diabetes (PWD) and health care professionals (HCP) about changing eye screening intervals. Methods We conducted a qualitative study to explore issues surrounding acceptability and the barriers and enablers for changing from annual screening, using in-depth, semi-structured interviews analysed using the constant comparative method. PWD were recruited from general practices and HCPs from eye screening networks and related specialties in North West England using purposive sampling. Interviews were conducted prior to the commencement of and during a randomised controlled trial (RCT) comparing fixed annual with variable (6, 12 or 24 month) interval risk-based screening. Results Thirty PWD and 21 HCP participants were interviewed prior to and 30 PWD during the parallel RCT. The data suggests that a move to variable screening intervals was generally acceptable in principle, though highlighted significant concerns and challenges to successful implementation. The current annual interval was recognised as unsustainable against a backdrop of increasing diabetes prevalence. There were important caveats attached to acceptability and a need for clear safeguards around: the safety and reliability of calculating screening intervals, capturing all PWDs, referral into screening of PWDs with diabetic changes regardless of planned interval. For PWDs the 6-month interval was perceived positively as medical reassurance, and the 12-month seen as usual treatment. Concerns were expressed by many HCPs and PWDs that a 2-year interval was too lengthy and was risky for detecting STDR. There were also concerns about a negative effect upon PWD care and increasing non-attendance rates. Amongst PWDs, there was considerable conflation and misunderstanding about different eye-related appointments within the health care system. Conclusions Implementing variable-interval screening into clinical practice is generally acceptable to PWD and HCP with important caveats, and misconceptions must be addressed. Clear safeguards against increasing non-attendance, loss of diabetes control and alternative referral pathways are required. For risk calculation systems to be safe, reliable monitoring and clear communication is required.

Popular diets

2011 ◽  
pp. 213-216
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Health Care Professionals ◽  
Controlled Trial ◽  
Potential Harm ◽  
Randomized Controlled ◽  
Scientific Principles

This section is included to help orientate health-care professionals to diets that their patients may initiate or possibly seek advice about. It does not validate their efficacy. For many, evidence of benefit in the form of a randomized controlled trial is not available. However, the concerns, described below, about potential harm resulting from some diets are based on scientific principles....

Communication, Respect, and Leadership: Interprofessional Collaboration in Hospitals of Rural Ontario

2014 ◽  
Vol 75 (4) ◽  
pp. 173-179 ◽  
Author(s):  
Diane Morris ◽  
June Matthews
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Comparative Method ◽  
Rural Hospitals ◽  
Interprofessional Practice ◽  
Interprofessional Teams ◽  
Northern Areas ◽  
Constant Comparative Method

Purpose: Health care professionals are expected to work collaboratively across diverse settings. In rural hospitals, these professionals face different challenges from their urban colleagues; however, little is known about interprofessional practice in these settings. Methods: Eleven health care professionals from 2 rural interprofessional teams were interviewed about collaborative practice. The data were analyzed using a constant comparative method. Results: Common themes included communication, respect, leadership, benefits of interprofessional teams, and the assets and challenges of working in small or rural hospitals. Differences between the cases were apparent in how the members conceptualized their teams, models of which were then compared with an “Ideal Interprofessional Team”. Conclusions: These results suggest that many experienced health care professionals function well in interprofessional teams; yet, they did not likely receive much education about interprofessional practice in their training. Providing interprofessional education to new practitioners may help them to establish this approach early in their careers and build on it with additional experience. Finally, these findings can be applied to address concerns that have arisen from other reports by exploring innovative ways to attract health professionals to communities in rural, remote, and northern areas, as there is a constant need for dietitians and other health care professionals in these practice settings.

Talking About Weight With Families—Helping Health Care Professionals Start the Conversation: A Nonrandomized Controlled Trial

2020 ◽  
Vol 59 (9-10) ◽  
pp. 910-917
Author(s):  
Julie Bernard-Genest ◽  
Lisa Chu ◽  
Elizabeth Dettmer ◽  
Catharine M. Walsh ◽  
Amy C. McPherson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Repeated Measures ◽  
Pediatric Patients ◽  
Controlled Trial ◽  
Significant Decline ◽  
Healthy Weight ◽  
Baseline Assessment ◽  
Educational Videos ◽  
Underweight Patients

Health care professionals (HCPs) and trainees feel ill-equipped to discuss weight-related issues with children and their families. A whiteboard video for HCPs and trainees outlining strategies to communicate about weight was developed and evaluated. Seventy HCPs, including 15 trainees, participated in the baseline assessment and 39 repeated measures 4 to 6 months later. HCP self-efficacy for initiating conversations with overweight and underweight patients, measured immediately following the video, significantly improved from pre-video values ( Z = −5.6, P ≤ .001, and Z= −3.3, P = .001, respectively). Although improvements were not sustained 4 to 6 months later (overweight: P = .143, and underweight: P = .846), no significant decline was observed, suggesting retention of the skill. A majority of HCP respondents would recommend the video to a colleague and feel it will affect their practice. Thus, the present study suggests educational videos may be an effective tool for facilitating healthy weight-related conversations between HCPs and their pediatric patients.

scholarly journals Continuous Monitoring of Vital Signs in the General Ward Using Wearable Devices: Randomized Controlled Trial

10.2196/15471 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e15471
Author(s):  
Mariska Weenk ◽  
Sebastian J Bredie ◽  
Mats Koeneman ◽  
Gijs Hesselink ◽  
Harry van Goor ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Controlled Trial ◽  
Vital Signs ◽  
Physician Assistants ◽  
Wearable Devices ◽  
General Ward ◽  
Negative Effects ◽  
Randomized Controlled

Background Wearable devices can be used for continuous patient monitoring in the general ward, increasing patient safety. Little is known about the experiences and expectations of patients and health care professionals regarding continuous monitoring with these devices. Objective This study aimed to identify positive and negative effects as well as barriers and facilitators for the use of two wearable devices: ViSi Mobile (VM) and HealthPatch (HP). Methods In this randomized controlled trial, 90 patients admitted to the internal medicine and surgical wards of a university hospital in the Netherlands were randomly assigned to continuous vital sign monitoring using VM or HP and a control group. Users’ experiences and expectations were addressed using semistructured interviews. Nurses, physician assistants, and medical doctors were also interviewed. Interviews were analyzed using thematic content analysis. Psychological distress was assessed using the State Trait Anxiety Inventory and the Pain Catastrophizing Scale. The System Usability Scale was used to assess the usability of both devices. Results A total of 60 patients, 20 nurses, 3 physician assistants, and 6 medical doctors were interviewed. We identified 47 positive and 30 negative effects and 19 facilitators and 36 barriers for the use of VM and HP. Frequently mentioned topics included earlier identification of clinical deterioration, increased feelings of safety, and VM lines and electrodes. No differences related to psychological distress and usability were found between randomization groups or devices. Conclusions Both devices were well received by most patients and health care professionals, and the majority of them encouraged the idea of monitoring vital signs continuously in the general ward. This comprehensive overview of barriers and facilitators of using wireless devices may serve as a guide for future researchers, developers, and health care institutions that consider implementing continuous monitoring in the ward. Trial Registration Clinicaltrials.gov NCT02933307; http://clinicaltrials.gov/ct2/show/NCT02933307.

scholarly journals Hydroxychloroquine as prophylaxis when treating patients with coronavirus disease 2019 – Perception of frontline health care workers in South India

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Karthik Mani ◽  
Minu Velan
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
South India ◽  
Research Question ◽  
Physician Assistants ◽  
Successful Implementation ◽  
Snowball Sampling ◽  
Health Care Practitioners ◽  
Care Workers

Objectives: In March 2020, the Indian Council of Medical Research (ICMR) recommended the use of hydroxychloroquine (HCQ) for prophylaxis in asymptomatic health care workers who care for suspected or confirmed patients and household contacts of confirmed patients with coronavirus disease 2019 (COVID-19). This recommendation was received by health-care practitioners with mixed opinions. The objectives of the study were to explore the views of frontline health-care practitioners (physicians, nurses, and physician assistants) in South India related to the ICMR recommendation of HCQ prophylaxis. Material and Methods: The survey research design was used to conduct this study. A ten-item electronic survey was developed based on the research question. The survey link was shared with frontline health-care practitioners in South India through email and WhatsApp messages identified through convenience sampling. Furthermore, the recipients were requested to forward the link to other frontline health-care professionals in their network (snowball sampling). Data were collected from April 16, 2020, to May 7, 2020. Results: The number of responses received was 132. Of 80 respondents who treated or anticipate treating patients with COVID-19, only 29 respondents reported that they complied with the ICMR’s HCQ chemoprophylaxis recommendation. Participants expressed concerns about the side effects and lack of conclusive evidence. Conclusion: Frontline health care workers in South India have mixed opinions with regard to the safety of HCQ prophylaxis. To promote the acceptance of and successful implementation of prophylaxis recommendations, it is essential that health authorities consider research evidence and seek stakeholder input before finalizing recommendations.

scholarly journals Willingness to Use Digital Health Tools in Patient Care Among Health Care Professionals and Students at a University Hospital in Saudi Arabia: Quantitative Cross-sectional Survey

10.2196/18590 ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e18590
Author(s):  
Subash Thapa ◽  
Jesper Bo Nielsen ◽  
Abdullah M Aldahmash ◽  
Fatima R Qadri ◽  
Anja Leppin
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Patient Care ◽  
Health Care Professionals ◽  
Digital Health ◽  
University Hospital ◽  
Digital Tools ◽  
Successful Implementation ◽  
Cross Sectional Survey ◽  
Willingness To Use

Background The adoption rate of digital health in the health care sector is low in many countries. A facilitating factor for successful implementation and adoption of digital health is acceptance by current and future health care professionals. Objective This study was conducted to identify factors associated with willingness to use digital health tools in patient care among health care professionals and students. Methods This was a quantitative cross-sectional survey study conducted among health care professionals and students at a university hospital in Riyadh, Saudi Arabia. A nonprobability convenience sampling procedure was used to recruit participants. Data were collected using a self-completed e-questionnaire that was distributed by email. Chi-square tests, t tests, and logistic regression were used to analyze the data. Results We found that 181 out of 218 health care professionals (83.0%; 75.6% [59/78] physicians; 87.1% [122/140] nurses) and 115 out of 154 students (74.7%; 80.0% [76/95] medical students and 66.1% [39/59] nursing students) were willing to use digital tools in patient care. Willingness to use digital tools was significantly associated with attitude (Adjusted Odds Ratios [AOR] 1.96; 95% CI 1.14-3.36) and self-efficacy (AOR 1.64; 95% CI 1.17-2.30) among health care professionals, and with current year of study (AOR 2.08; 95% CI 1.18-3.68) and self-efficacy (AOR 1.77; 95% CI 1.17-2.69) among students. No significant difference in willingness to use digital tools was found between physicians and nurses (P=.113), and between medical and nursing students (P=.079). Conclusions The findings of this study should encourage policy makers and hospital managers to implement relevant eHealth interventions within routine health care systems in Saudi Arabia. For successful implementation, digital health education programs should be implemented simultaneously, so that current and future health care professionals are able to develop required positive attitudes as well as practical skills and competencies.

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