Understanding User Reactions and Interactions with an Internet-Based Intervention for Tinnitus Self-Management: Mixed-Methods Process Evaluation (Preprint)

2017 ◽  
Author(s):  
Kate Greenwell ◽  
Magdalena Sereda ◽  
Neil Coulson ◽  
Derek J Hoare
Keyword(s):  
Process Evaluation ◽  
Online Survey ◽  
Negative Impact ◽  
Skills Training ◽  
Psychological Support ◽  
Self Management ◽  
Common Symptom ◽  
User Engagement ◽  
Programme Content ◽  
The Uk

BACKGROUND Tinnitus is a common symptom that can affect an individual’s quality of life, requiring psychological support that is not readily accessible. Internet-based interventions have the potential to reduce the disparity in access to psychological support that people with tinnitus currently experience. One example is the Tinnitus E-Programme, which was developed in the UK to support self-management in people with tinnitus. Although freely available online, it had not been formally evaluated. OBJECTIVE To carry out a process evaluation to explore past, current, and new users’ reactions and interactions with the Tinnitus E-Programme. METHODS Study 1 used an online survey to gather past and current users’ reactions to and interactions with the intervention (n=27). Study 2 used interviews and a relaxation log to explore this aim with new users and assess how well they were able to implement the skills they learned during the intervention in their everyday lives (n=13). Findings were triangulated to develop an in-depth understanding of the intervention’s mechanisms of impact and identify any implementation or contextual factors that strengthen or impede its delivery and functioning. RESULTS Generally, users expressed positive views of the Tinnitus E-Programme content and design features. Users particularly valued the education about tinnitus and its management, and relaxation skills training, whereas reactions and usage of the self-monitoring tools, online support forum, and therapist support were mixed. Implementation was limited by instances of poor usability and accessibility, user engagement, and adherence to relaxation goals. Users’ perceptions of the intervention’s credibility and relevance, and beliefs regarding the intervention’s negative impact on their tinnitus influenced their engagement with the intervention. Users in both studies identified several benefits gained from the intervention, including functional and emotional management; self-efficacy for managing and coping with tinnitus; understanding tinnitus and its management; social support; and acceptance of tinnitus. CONCLUSIONS Findings suggest that acceptability was high among the target group but also highlighted some areas for improvement. These findings will be used to inform further development work.

scholarly journals P106 Psychological and self-management support for people with systemic vasculitis or CTDs: a mixed methods study of health professionals’ perception of provision in Rheumatology and Nephrology departments in the UK

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Joanna C Robson ◽  
Michael Shepherd ◽  
Mwidimi Ndosi ◽  
Lorraine Harper ◽  
Caroline Flurey ◽  
...  
Keyword(s):  
Health Professional ◽  
Health Professionals ◽  
Online Survey ◽  
Psychological Support ◽  
Self Management ◽  
Free Text ◽  
Management Support ◽  
The Uk

Abstract Background People with a connective tissue disease (CTD) or systemic vasculititis have diseases which can be life and organ threatening, require complicated medication regimens and impact on all aspects of health-related quality of life. People are routinely managed across multiple medical specialities and have to navigate their way through complex health care systems. The aim of this study was to investigate current psychological and self-management support available for people with CTDs and vasculitis in rheumatology and nephrology departments in the UK. Methods An online survey of health professionals in rheumatology and nephrology departments was conducted with follow-up interviews. The survey comprised 45 multiple-choice and free-text questions. Quantitative material was analysed descriptively. Follow-up interviews were recorded, transcribed and analysed thematically, together with free-text survey responses, to identify health professionals’ perceptions on unmet needs and key improvements required. Results The online survey included 120 health professional respondents (34 % specialist nurses, 51% doctors and 12 % allied health professionals and pharmacists). Respondents worked primarily in rheumatology (52.9%) and nephrology (21.5%). Access to self-management programmes or clinics for people with CTD and vasculitis was available in 23% of rheumatology and 8% of nephrology departments. In response to the question “How well is your team providing self-management support to people with CTD and vasculitis?”, 38% of respondents reported not very well, or not well at all. Direct access to psychological support (either within their department or within the hospital) was available for patients in 76.9% of nephrology and 32.8% of rheumatology departments. Where psychological referrals were direct, the assessment of the quality of the service by health professionals was higher than when the referrals were indirect (i.e when patients were either referred to primary care or asked to self-refer) (X2=13.83, p < 0.001). Over 80% of health-professional respondents reported they would like additional training in providing self-management support. Key themes from the qualitative data included the need for dedicated psychological support within departments, self-management programmes (specifically for people with CTD and vasculitis or opening up established programmes for people with other conditions), the benefits of a whole team approach (specialist teams not individual clinicians working to empower patients to take a lead in managing their own care), individual staff training needs ( training in brief psychological interventions and support for health professionals to set up self-management programmes) and signposting to additional resources for patients and their families ( disease-specific written and online information and support from patient charities). Conclusion People with CTD and vasculitis have complex needs and systemic improvements in support are required. Patients in nephrology departments are more likely to have access to psychological support than those in rheumatology. There is inadequate access to structured self-management programmes in both nephrology and rheumatology. Disclosures J.C. Robson None. M. Shepherd None. M. Ndosi None. L. Harper None. C. Flurey None. S. Logan None. K. Austin None. E. Dures None.

scholarly journals Mental Health, Information and Being Connected: Qualitative Experiences of Social Media Use during the COVID-19 Pandemic from a Trans-National Sample

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 735
Author(s):  
Schoultz Mariyana ◽  
Leung Janni ◽  
Bonsaksen Tore ◽  
Ruffolo Mary ◽  
Thygesen Hilde ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Media ◽  
Health Information ◽  
Online Survey ◽  
Negative Impact ◽  
National Study ◽  
Free Text ◽  
Cross Sectional ◽  
Mental Health Information ◽  
The Uk

Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.

scholarly journals The Society for Acute Medicine (UK) Acute Medicine Training Survey 2007

2008 ◽  
Vol 7 (1) ◽  
pp. 50-54
Author(s):  
Hannah Skene ◽  
◽  
David K Ward ◽  
Keyword(s):  
Online Survey ◽  
Workforce Planning ◽  
Skills Training ◽  
Training Programme ◽  
Current Situation ◽  
Acute Medicine ◽  
Part Time ◽  
The Uk

An online survey of training in Acute Medicine was conducted to assemble a true picture of the current situation in the UK. The specialty is flourishing, with over 60 trainees having predicted CCT dates in Acute Medicine in 2010 and 2011 alone. 128 respondents highlighted a multitude of issues, including the need for improvements in management and special skills training and part time opportunities. We have used the results of this survey to suggest action points for Deaneries, Training Programme Directors, the Society for Acute Medicine (UK) and those involved in workforce planning.

scholarly journals Access to and adequacy of psychological services for adult patients in UK hospices: a national, cross-sectional survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Daisy McInnerney ◽  
Bridget Candy ◽  
Patrick Stone ◽  
Nicola Atkin ◽  
Joana Johnson ◽  
...  
Keyword(s):  
Best Practice ◽  
Online Survey ◽  
National Level ◽  
Psychological Support ◽  
Psychological Services ◽  
Adult Patients ◽  
Future Research ◽  
Cross Sectional ◽  
Facilitators And Barriers ◽  
The Uk

Abstract Background Providing psychological support to people living with terminal illness is a fundamental part of hospice care. Recent research on delivery of psychological services in hospices in the United Kingdom (UK) on a national level, including inequalities or variation in practice, is limited. A nationwide survey will highlight any differences in provision and in doing so help focus future research and inform best practice both within the UK, and internationally. The specific objectives of this survey are to (1) chart the types of psychological support available to adult patients in hospices in the UK in line with the National Institute for Health and Care Excellence model; (2) explore how services are organised; and (3) gather service perspectives on adequacy of care, and facilitators and barriers to appropriate practice. Methods A cross-sectional online survey emailed to adult hospices in the UK in November–December 2019. One staff member involved in the delivery and/or organisation of psychological support was invited to participate per hospice. Of 193 invited hospices, 116 took part. Results Sixteen percent rated their hospice psychological service as wholly adequate. The majority reported that services can access specialist professionals, but many relied on external referrals. Barriers to best practice included funding and staff capacity; facilitators included clear referral structures, audit and appropriate needs and outcome assessments. Conclusions Access to psychological professionals has improved since the last survey 15 years ago, but the majority of responders felt their overall service was not wholly adequate. Basic emotional support is largely felt to be sufficient, but our results indicate a need for improvements in access to more specialist care. Partnerships with external mental health services may be key. Our findings highlight core facilitators and barriers to providing good psychological care at the end of life that should be considered by services both within the UK and on an international level.

scholarly journals Acute impact of a national lockdown during the COVID-19 pandemic on wellbeing outcomes among individuals with chronic pain

2021 ◽  
pp. 135910532199596
Author(s):  
Zoë Zambelli ◽  
António R Fidalgo ◽  
Elizabeth J Halstead ◽  
Dagmara Dimitriou
Keyword(s):  
Chronic Pain ◽  
Multivariate Analysis ◽  
Online Survey ◽  
Access To Healthcare ◽  
Self Management ◽  
Anxiety And Depression ◽  
Community Based ◽  
Restricted Access ◽  
The Uk

Changes to wellbeing in a community-based sample of 638 adults with non-malignant chronic pain were assessed during a period of mandated lockdown measures in the UK to control the COVID-19 outbreak. Participants completed an online survey pre-lockdown and were followed up during lockdown. Multivariate analysis demonstrated that decreased ability to self-manage pain, restricted access to healthcare and increased dependence on others were associated with negative wellbeing outcomes related to sleep, anxiety and depression. Essential but non-urgent services are required during periods of lockdown to maintain independence and self-management in order to preserve wellbeing in this population.

scholarly journals Have We Lost Sight of the Women? An Observational Study About Normality-Centred Care in Australian Maternity Services.

2021 ◽  
Author(s):  
Harsha Ananthram ◽  
Venkat Vangaveti ◽  
Ajay Rane
Keyword(s):  
Health Care Providers ◽  
Online Survey ◽  
Negative Impact ◽  
Care Providers ◽  
Maternity Services ◽  
Normal Birth ◽  
Legal Obligations ◽  
Regulatory Standards ◽  
The Uk ◽  
Maternity Practice

Objective • Prioritising normal birth has led to harm in some instances in the UK • Australian organisations have also promoted normal birth in maternity practice • The negative impact of normal birth appears less well understood in Australia • The study explores this impact of normal birth promotion and the quality of clinical incident investigations Design • Survey-based research design Setting • Online survey Population or Sample • Australian maternity health care providers Methods • Open and close-ended questions on the survey • The survey received 1278 responses • Data analysed using SPSS software Main Outcome Measures • Perceptions on bias against or delay in interventions • Perceptions on systemic attempts to reduce caesarean rates • Perceptions on clinical incident investigations and the engagement of women in these processes Results • Promoting normal birth may by introduce bias against or delay interventions • Attempts to reduce caesarean section rates may reduce the agency of the woman to choose how she births • Incident investigations appear to be independent and improve outcomes for mothers and babies • Women with birth trauma appear to lack support and follow up postnatally Conclusions • Current regulatory standards for maternity services may need to be re-evaluated • Key performance indicators for maternity services need to change to reflect core ethical and legal obligations around informed consent

Perceived need of psychological support for taboo obsessions in new parents: A cross-sectional survey

2021 ◽  
Author(s):  
Klara Lauri ◽  
Kristina Aspvall ◽  
Eva Serlachius ◽  
David Mataix-Cols ◽  
Christian Ruck ◽  
...  
Keyword(s):  
Online Survey ◽  
Negative Impact ◽  
Intrusive Thoughts ◽  
Psychological Support ◽  
Obsessive Compulsive ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Compulsive Disorder ◽  
Perceived Need ◽  
Parental Function

Previous research has shown that many new parents experience intrusive thoughts about intentionally harming their child, also known as “taboo obsessions”. These thoughts can for some parents lead to increased anxiety, depression and have a negative impact on parental function and quality of life. Taboo obsessions can be stigmatizing and many parents who could benefit from psychological support do not seek help. One way to increase access to psychological interventions for new parents could be to deliver the treatment online. Our research group has developed and evaluated an internet-delivered intervention targeting taboo obsessions in individuals with a diagnosis obsessive-compulsive disorder (OCD), with promising results. It is conceivable that the intervention could be helpful to a large proportion of parents from the general population who struggle with taboo obsessions (i.e. not only individuals with OCD). In the current study, 594 new parents filled out an online survey about taboo obsessions and the perceived need for psychological support. Fifty six percent reported currently experiencing or had previously experienced taboo obsessions. About half (54%) responded that the taboo obsessions had a negative impact on their self-image. Additionally, 18-19% reported that the intrusive thoughts were difficult to control and/or had a negative impact on the relationship to the child. Importantly, 51% responded that they would absolutely or probably like to try online treatments for these intrusive thoughts. Keeping the limitations of an online survey in mind, the results suggest that an online intervention targeting taboo obsessions in new parents could be well received.

scholarly journals Testing the buffering hypothesis: breastfeeding problems, cessation and social support in the UK

2020 ◽  
Author(s):  
Abigail Emma Page ◽  
Emily H Emmott ◽  
Sarah Myers
Keyword(s):  
Social Support ◽  
Online Survey ◽  
Negative Impact ◽  
Interdisciplinary Approach ◽  
Postnatal Period ◽  
Cox Models ◽  
Wide Range ◽  
Buffering Hypothesis ◽  
The Uk ◽  
Breastfeeding Problems

Objectives: Physical breastfeeding problems can lead women to terminate breastfeeding earlier than planned. In high-income countries, breastfeeding problems have been attributed to the cultural and individual “inexperience” of breastfeeding, ultimately leading to lower breastfeeding rates. Yet, cross-cultural evidence suggests breastfeeding problems still occur in contexts where breastfeeding is common, prolonged and seen publicly. This suggests breastfeeding problems are not unusual and do not necessarily lead to breastfeeding cessation. Having evolved a cooperative childrearing system, what matters for breastfeeding continuation may be the availability of social support during the postnatal period. Here, we test the hypothesis that social support buffers mothers from the negative impact breastfeeding problems have on duration. Methods: We run cox models on a sample of 566 UK mothers who completed a retrospective online survey about infant feeding and social support in 2017-2018. Results: Breastfeeding problems were important predictors of cessation; however, the direction of the effect was dependent on the type of problem. These relationships were also moderated by informational, practical and emotional support from a range of supporters. Helpful support for discomfort issues (blocked ducts, too much milk) significantly reduced the hazard of cessation, as predicted. However, helpful support for reported milk insufficiency increased the hazard of cessation. Conclusions: Experiencing breastfeeding problems is the norm, but its impact may be mitigated via social support. Working from an interdisciplinary approach, our results highlight that a wide range of supporters who provide different types of support have potential to influence maternal breastfeeding experience.

scholarly journals P068 Exploring the impact of COVID-19 on self-management and healthcare provision in people with Inflammatory Arthritis: A qualitative study

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Emma Caton ◽  
Hema Chaplin ◽  
Lewis Carpenter ◽  
Melissa Sweeney ◽  
Hsiu Tung ◽  
...  
Keyword(s):  
Physical Activity ◽  
Inflammatory Arthritis ◽  
Negative Impact ◽  
Survey Study ◽  
Self Management ◽  
Baseline Survey ◽  
Severe Illness ◽  
Healthcare Provision ◽  
The Uk ◽  
The Impact

Abstract Background/Aims  Inflammatory arthritis (IA) patients have been identified as being at greater risk of severe illness from COVID-19. It is likely that lockdown restrictions enforced by the UK government in response to the COVID-19 pandemic, and subsequent changes made to healthcare provisions, could impact patients’ abilities to effectively manage their condition. The aim of this study was to qualitatively explore the impact of COVID-19 and lockdown on self-management behaviours and healthcare provision in people with IA. Methods  Semi-structured interviews were conducted with 21 patients with IA from across the UK (as part of a larger longitudinal survey study exploring the impact of COVID-19 on health-related quality of life for people with IA). Participants who gave consent for contact, following the completion of the baseline survey study, were approached to take part in the qualitative interviews. The interview schedule was developed with a Patient Research Partner and consisted of eight main questions to explore participants’ experiences of the COVID-19 pandemic, including the impact of COVID-19 on their self-management behaviours and access to healthcare services. The interviews were conducted via telephone and were recorded and transcribed before being analysed using inductive thematic analysis. Results  Participants were aged between 24-72 (mean age 50.0, SD 15.6) and were mostly female (71%) and White British (86%). Four main themes were identified: impact of COVID-19 on medication adherence, impact of COVID-19 on physical activity, impact of COVID-19 on diet, and impact of COVID-19 on healthcare access. Subthemes focused on positive and negative changes made to these areas, as well as behaviours which remained consistent. Some participants expressed that the lockdown period had enabled them to increase their physical activity, improve their diet and maintain their usual medication regimen, whilst others noted that lockdown had had a negative impact on their self-management behaviours. For example, some patients decided to discontinue their medication during the pandemic due to concerns that it would make them more susceptible to severe consequences from COVID-19. In relation to healthcare provision, the most commonly reported change was the introduction of telephone appointments to replace face-to-face consultations. Several patients found the telephone appointments ineffective, especially if their disease was relatively uncontrolled. Nevertheless, participants understood why a remote approach had been implemented during the pandemic. Conclusion  COVID-19 has had an impact on patients’ abilities to manage their IA. Healthcare professionals need to recognise the impact of COVID-19 on patient self-management and healthcare provision to ensure that adequate understanding and support is available to patients who may have inadequate disease control as a result. Disclosure  E. Caton: None. H. Chaplin: None. L. Carpenter: None. M. Sweeney: None. H. Tung: None. S. de Souza: None. S. Norton: None.

scholarly journals Psychological and self-management support for people with vasculitis or connective tissue diseases: UK health professionals’ perspectives

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Joanna C Robson ◽  
Michael Shepherd ◽  
Lorraine Harper ◽  
Mwidimi Ndosi ◽  
Keziah Austin ◽  
...  
Keyword(s):  
Health Professionals ◽  
Online Survey ◽  
Connective Tissue Diseases ◽  
Psychological Support ◽  
Care Staff ◽  
Self Management ◽  
Free Text ◽  
Team Approach ◽  
Management Support ◽  
Survey Responses

Abstract Objectives CTD and systemic vasculitis impact on health-related quality of life. Treatment can be complex, involving multiple medical specialities. The aim of this study was to investigate psychological and self-management support for patients in secondary care. Methods An online survey of health professionals in the UK, including 45 multiple-choice and free-text questions, was analysed descriptively. Free-text survey responses were analysed thematically to identify health professionals’ perceptions of best practice and unmet needs. Results The online survey included 120 health professionals (34% specialist nurses, 51% doctors and 12% allied health professionals), predominantly working in rheumatology (52.9%) and nephrology (21.5%) departments. Access to self-management programmes or clinics for people with CTD or vasculitis was available in 23% of rheumatology and 8% of nephrology departments. In response to ‘How well is your team providing self-management support to people with CTD or vasculitis?’, 38% of respondents reported ‘not very well’ or ‘not well at all’. Direct access to psychological support was available in 76.9% of nephrology and 32.8% of rheumatology departments. More than 80% of respondents would like additional training. Key themes from the qualitative data (free-text survey responses) included the importance of: dedicated psychological support and self-management programmes for people with CTD and vasculitis, a whole-team approach (specialist teams empowering people to manage their own care), staff training (e.g. brief psychological interventions) and signposting to resources, including patient charities. Conclusion People with CTD and vasculitis have complex needs, and improvements in self-management and psychological support are required in UK rheumatology and nephrology departments.

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