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Parkinson A, Jorm L, Douglas KA, Gee A, Sargent GM, Lujic S, McRae IS. Recruiting general practitioners for surveys: reflections on the difficulties and some lessons learned. Aust J Prim Health 2015; 21:254-8. [PMID: 24581281 DOI: 10.1071/py13129] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 01/21/2014] [Indexed: 11/23/2022]
Abstract
Surveys of GPs are essential to facilitate future planning and delivery of health services. However, recruitment of GPs into research has been disappointing with response rates declining over recent years. This study identified factors that facilitated or hampered GP recruitment in a recent survey of Australian GPs where a range of strategies were used to improve recruitment following poor initial responses. GP response rates for different stages of the survey were examined and compared with reasons GPs and leaders of university research networks cited for non-participation. Poor initial response rates were improved by including a questionnaire in the mail-out, changing the mail-out source from an unknown research team to locally known network leaders, approaching a group of GPs known to have research and training interests, and offering financial compensation. Response rates increased from below 1% for the first wave to 14.5% in the final wave. Using a known and trusted network of professionals to endorse the survey combined with an explicit compensation payment significantly enhanced GP response rates. To obtain response rates for surveys of GPs that are high enough to sustain external validity requires an approach that persuades GPs and their gatekeepers that it is worth their time to participate.
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Stanton R, Franck C, Reaburn P, Happell B. A Pilot Study of the Views of General Practitioners Regarding Exercise for the Treatment of Depression. Perspect Psychiatr Care 2015; 51:253-9. [PMID: 25307254 DOI: 10.1111/ppc.12088] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 08/04/2014] [Accepted: 09/05/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To investigate the views of general practitioners (GPs) regarding exercise and the treatment of depression. DESIGN AND METHODS Twenty GPs completed a 25-item survey investigating their knowledge, beliefs, perceived benefits and barriers, and recommendations to patients regarding exercise for the treatment of depression. The exercise habits of the GPs were also recorded. FINDINGS GPs are positive toward exercise in the treatment of depression despite low levels of confidence in prescribing exercise or limited measurable benefits. Exercise patterns of GPs were not associated with GP exercise prescription habits. PRACTICE IMPLICATIONS Education, use of support materials and referral schemes, and increasing exercise behavior among GPs may increase the use of exercise as treatment for people with depression.
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Affiliation(s)
- Robert Stanton
- Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Central Queensland University, Rockhampton, Queensland, Australia
| | - Chris Franck
- Central Queensland Medicare Local, Rockhampton, Queensland, Australia
| | - Peter Reaburn
- Institute for Health and Social Science Research, School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Brenda Happell
- Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Central Queensland University, Rockhampton, Queensland, Australia
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Validation of a New Instrument for Self-care in Spanish Palliative Care Professionals Nationwide. SPANISH JOURNAL OF PSYCHOLOGY 2015; 18:E67. [PMID: 26364786 DOI: 10.1017/sjp.2015.71] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Self-care is a cornerstone issue for those who deal with stressful events, as it is the case of palliative care professionals. It has been related to awareness, coping with death and quality of life, among others, but no measurement instruments have been used in palliative care professionals. This research presents and validates a brief new measure with clinical and psychometric good properties, called Professional Self-Care Scale (PSCS). The PSCS assesses professionals' self-care in three areas: physical self-care, inner self-care, and social self-care. Data come from a cross-sectional survey in a sample of 385 professionals of palliative care. The Mindful Attention Awareness Scale, the Coping with Death Scale, and the Professional's Quality of Life measure were also used. Results of the CFA showed adequate fit (χ2(24, N = 385) = 140.66, p < .01; CFI = .91; GFI = .93; SRMR = .09; and RMSEA = .10). Evidence pointed better reliability indices for the 3-item physical and inner factors of self-care than for the social dimension (Rho and GLB of .64, .90, and .57, respectively). Evidence regarding validity was consistent with previous literature. When levels of self-care were examined, women showed higher levels of inner and social self-care (F(3, 371) = 3.19, p = .02, η2 = .03, as also did psychologists when compared to doctors and nurses (F(9, 1074) = 2.00, p = .04, η2 = .02. The PSCS has shown adequate psychometric properties, and thus it could be used as diagnostic instrument when studying professionals' health.
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Sansó N, Galiana L, Oliver A, Pascual A, Sinclair S, Benito E. Palliative Care Professionals' Inner Life: Exploring the Relationships Among Awareness, Self-Care, and Compassion Satisfaction and Fatigue, Burnout, and Coping With Death. J Pain Symptom Manage 2015; 50:200-7. [PMID: 25701688 DOI: 10.1016/j.jpainsymman.2015.02.013] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 01/30/2015] [Accepted: 02/14/2015] [Indexed: 11/29/2022]
Abstract
CONTEXT Professionals working in the landscape of death and dying frequently are exposed to existential issues, psychological challenges, and emotional distress associated with care at the end of life. Identifying factors that help professionals cope with frequent exposure to issues related to mortality could enhance palliative care providers' and patients' quality of life. OBJECTIVES To improve our understanding of the factors associated with professionals' inner life, through the assessment of an adapted version of Kearney and Kearney's awareness model of self-care. The main assumptions of the study were that competence in coping with death and awareness would be positively related to compassion satisfaction and negatively to compassion fatigue and burnout; moreover, participating in a specific training program aimed at facing suffering and death, and self-care would positively predict coping with death. METHODS A cross-sectional online survey of Spanish palliative care professionals was conducted through the member e-mail list of the Spanish Society of Palliative Care. A total of 387 professionals completed the survey, which included demographic data, and personal and professional scales on the mentioned constructs. RESULTS Data fit reasonably well with the estimated model. Whereas the hypothesis relating spiritual training to coping with death was not supported by the data, all other aspects of the hypotheses were supported, namely self-care and awareness positively predicted professionals' competence in coping with death, and this, together with awareness, positively predicted compassion satisfaction and negatively predict compassion fatigue and burnout. CONCLUSION The awareness-based model of self-care was successfully tested in a multidisciplinary sample of Spanish palliative care professionals. This research applies a quantitative evaluation of the model, providing evidence of a constellation of key variables for health professionals' quality of life, such as specific training, self-care, awareness and coping with death competency.
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Affiliation(s)
- Noemí Sansó
- Balearic Islands Palliative Care Regional Program, Palma de Mallorca, Spain; University of Balearic Islands, Palma de Mallorca, Spain
| | - Laura Galiana
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - Amparo Oliver
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain.
| | - Antonio Pascual
- Sant Pau Hospital, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Shane Sinclair
- Faculty of Nursing, University of Calgary, Calgary, Alberta Canada
| | - Enric Benito
- Balearic Islands Palliative Care Regional Program, Palma de Mallorca, Spain
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Pereko DD, Lubbe MS, Essack SY. Antibiotic use in Namibia: prescriber practices for common community infections. S Afr Fam Pract (2004) 2015. [DOI: 10.1080/20786190.2015.1024021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Stigma and treatment of eating disorders in Ireland: healthcare professionals’ knowledge and attitudes. Ir J Psychol Med 2015; 33:21-31. [DOI: 10.1017/ipm.2015.24] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ObjectivesThis study examines aspects of healthcare professionals’ knowledge and attitudes about eating disorders (EDs), which might impede the effective detection or treatment of EDs in Ireland.MethodsA total of 1,916 healthcare professionals were invited to participate in a web-based survey. Participants were randomly allocated to view one of five vignettes depicting a young person with symptoms consistent with anorexia nervosa, bulimia nervosa, binge-eating disorder, depression or type 1 diabetes. Study-specific questions examined participants’ responses to the vignettes and ED knowledge and experience.ResultsIn total, 171 clinicians responded (9% response rate). Participants had an average of 15.8 years of clinical experience (s.d.=9.2) and included psychiatrists, GPs, psychologists and counsellors. Although participants’ knowledge of EDs was moderately good overall, responses showed poor recognition of the symptoms of EDs compared with depression [χ2 (4, n=127)=20.17, p<0.001]. Participants viewed EDs as chronic disorders that primarily affected females. Participants believed that clinicians like working with patients with depression and diabetes more than with AN patients [F (4,101)=5.11, p=0.001]. Among the professionals surveyed, psychiatrists were the most knowledgeable about EDs [F (4,82)=9.18, p<0.001], and were more confident in their ability to diagnose and treat EDs than professionals of all other disciplines, except psychologists [F (4,85)=8.99, p<0.001]. Psychiatrists were also the most pessimistic about ED patients’ long-term life prospects [χ2 (4, n=65)=15.84, p=0.003].ConclusionsThis study recommends that specific attention should be given to EDs in professional educational programmes across healthcare disciplines. This training should not be restricted to improving healthcare professionals’ knowledge of EDs, but should also strive to increase service-providers’ awareness of how their own potentially stigmatising attitudes can undermine engagement with treatment.
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Blumenthal J, Jain S, Krakower D, Sun X, Young J, Mayer K, Haubrich R. Knowledge is Power! Increased Provider Knowledge Scores Regarding Pre-exposure Prophylaxis (PrEP) are Associated with Higher Rates of PrEP Prescription and Future Intent to Prescribe PrEP. AIDS Behav 2015; 19:802-10. [PMID: 25616837 DOI: 10.1007/s10461-015-0996-z] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The FDA approval of emtricitabine/tenofovir disoproxil fumarate for pre-exposure prophylaxis (PrEP) in 2012 has raised questions about the delivery of PrEP in a real-world setting. iPad-based questionnaires were given to providers at conferences in California and New York to assess knowledge, experience and attitudes regarding PrEP in HIV and non-HIV providers. HIV provider status was defined either by self-identification or by having greater than 5 years of HIV care experience. Knowledge scores were the sum of correct answers from five PrEP knowledge questions. Univariate analyses used t-test to compare knowledge scores and Fisher's exact test for past or future PrEP prescription between HIV and non-HIV providers. Multivariable linear or logistic regression models were used to assess factors associated with the outcomes. Of 233 respondents, the mean age was 40 years, 59 % were White, 59 % were physicians and 52 % were HIV providers. In univariate analysis, mean PrEP knowledge scores (max 5) were significantly higher for HIV providers (2.8 versus 2.2; p < 0.001), age > 41 (mean 2.8 versus 2.3; p = 0.004), White race (2.7 versus 2.2; p = 0.026) and participants in the New York region (3.0 versus 2.3; p < 0.001). In a multivariable model of knowledge scores, all but age remained significant. Among 201 potential prescribers, the rate of prior PrEP prescription was higher among HIV providers than non-HIV providers (34 versus 9 %; p < 0.001) and by knowledge score, but the association with provider status was no longer significant in multivariable analysis that controlled for knowledge. Intent to prescribe PrEP in the future was high for all provider types (64 %) and was associated with knowledge scores in multivariable analysis. The most common concerns about PrEP (>40 % of providers) were drug toxicities, development of resistance and patient adherence to follow-up; 32 % identified risk compensation as a concern. HIV providers had significantly greater PrEP knowledge than non-HIV providers, but differences by provider type in past PrEP prescription were largely dependent on knowledge. Future PrEP prescription was also associated with knowledge, though all providers expressed greater future use. Education of potential PrEP providers will be a key component of successful PrEP implementation.
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Freeman C, Cottrell WN, Kyle G, Williams ID, Nissen L. Pharmacists', General Practitioners' and Consumers' Views on Integrating Pharmacists into General Practice. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2015. [DOI: 10.1002/j.2055-2335.2012.tb00166.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - Greg Kyle
- Discipline of Pharmacy, University of Canberra
| | | | - Lisa Nissen
- School of Pharmacy; The University of Queensland; Brisbane Queensland
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Cottingham P, Adams J, Vempati R, Dunn J, Sibbritt D. The characteristics, experiences and perceptions of naturopathic and herbal medicine practitioners: results from a national survey in New Zealand. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:114. [PMID: 25888473 PMCID: PMC4405865 DOI: 10.1186/s12906-015-0616-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 03/16/2015] [Indexed: 12/02/2022]
Abstract
Background Despite the popularity of naturopathic and herbal medicine in New Zealand there remains limited data on New Zealand-based naturopathic and herbal medicine practice. In response, this paper reports findings from the first national survey examining the characteristics, perceptions and experiences of New Zealand-based naturopaths and herbal medicine practitioners across multiple domains relating to their role and practice. Methods An online survey (covering 6 domains: demographics; practice characteristics; research; integrative practice; regulation and funding; contribution to national health objectives) was administered to naturopaths and herbal medicine practitioners. From a total of 338 naturopaths and herbal medicine practitioners, 107 responded providing a response rate of 32%. Data were statistically analysed using STATA. Results A majority of the naturopaths and herbal medicine practitioners surveyed were female (91%), and aged between 45 and 54 years. Most practiced part-time (64%), with practitioner caseloads averaging 8 new clients and over 20 follow-up clients per month. Our analysis shows that researched information impacts upon and is useful for naturopaths and herbal medicine practitioners to validate their practices. However, the sources of researched information utilised by New Zealand naturopaths and herbal medicine practitioners remain variable, with many sources beyond publications in peer-reviewed journals being utilised. Most naturopathic and herbal medicine practitioners (82%) supported registration, with statutory registration being favoured (75%). Integration with conventional care was considered desirable by the majority of naturopaths and herbal medicine practitioners surveyed (83%). Naturopaths and herbal medicine practitioners feel that they contribute to several key national health objectives, including: improved nutrition (93%); increased physical activity (85%); reducing incidence and impact of CVD (79%); reducing incidence and impact of cancer (68%). Conclusions There is a need for greater understanding and communication between practitioners of conventional care and naturopathic and herbal medicine which could support informed, coordinated and effective health provision within the New Zealand health care system. There is a need for further in-depth research examining naturopaths and herbal medicine practitioners’ perceptions and practices, to provide insights of benefit to all those practising and managing health services as well as those directing health policy in New Zealand.
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Do pediatricians recognize fetal alcohol spectrum disorders in children with developmental and behavioral problems? J Dev Behav Pediatr 2015; 36:197-202. [PMID: 25767932 DOI: 10.1097/dbp.0000000000000146] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Limited studies have examined pediatricians' knowledge, attitudes, and practice about fetal alcohol spectrum disorders (FASDs), and none have examined alcohol-related neurodevelopmental disabilities (ARND). This study examined whether pediatricians consider FASDs in children with developmental and behavioral problems. METHODS All 149 pediatricians, 55 males and 94 females, in New Haven County, CT, were contacted to complete a web-based survey. They were given cases of preschool boys with (1) fetal alcohol syndrome (FAS), (2) ARND, and (3) Williams Syndrome (WS) and asked to provide a diagnosis and rate their confidence in this. They could access up to 7 additional pieces of information. RESULTS Sixty-six pediatricians responded (44.3%), and 46 had complete data (30.9%). Eight (17.4%) correctly identified FAS and 29 (63.1%) ARND. Significantly fewer pediatricians diagnosed FAS versus ARND and WS (p < .001), and they were less confident in identifying FAS and ARND than WS (10.9 % and 45.7% vs. 73.9%, p < .01). After viewing the photographs with sentinel dysmorphology and case description, respondents were more likely to diagnose WS (37%) versus FAS (19.6%) (p = .064), less confident in their diagnosis (p = .009), and required more information to make an FAS diagnosis (p = .002). CONCLUSIONS Pediatricians underrecognize FASDs, lack confidence in making this diagnosis, and are unfamiliar with the diagnostic criteria. They need more training to consider the possibility of an FASD when seeing children with developmental and behavioral problems.
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Happell B, Stanton R, Hoey W, Scott D. Reduced ambivalence to the role of the cardiometabolic health nurse following a 6-month trial. Perspect Psychiatr Care 2015; 51:80-5. [PMID: 24602142 DOI: 10.1111/ppc.12066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/24/2014] [Accepted: 02/06/2014] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To determine the changes in attitudes toward the inclusion of a cardiometabolic health nurse for the physical healthcare management of people with serious mental illness following a 6-month trial. DESIGN AND METHODS Repeated survey of nurses working in a regional mental health facility. FINDINGS Nurses working in mental health were initially supportive of the role. A 6-month trial of a cardiometabolic health nurse in the workplace reduced ambivalence and increased positivity toward the role. PRACTICE IMPLICATIONS Reduced ambivalence and improved positivity toward the role may facilitate less organization resistance to the implementation of a cardiometabolic health nurse in the mental healthcare setting. Specialized training and role recognition may be needed to further support this role.
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Affiliation(s)
- Brenda Happell
- Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Central Queensland University, Rockhampton, Queensland, Australia
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Villanueva-Felez A, Woolley R, Cañibano C. Nanotechnology researchers' collaboration relationships: a gender analysis of access to scientific information. SOCIAL STUDIES OF SCIENCE 2015; 45:100-129. [PMID: 25803919 DOI: 10.1177/0306312714552347] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Women are underrepresented in science, technology, engineering, and mathematics fields, particularly at higher levels of organizations. This article investigates the impact of this underrepresentation on the processes of interpersonal collaboration in nanotechnology. Analyses are conducted to assess: (I) the comparative tie strength of women's and men's collaborations, (2) whether women and men gain equal access to scientific information through collaborators, (3) which tie characteristics are associated with access to information for women and men, and (4) whether women and men acquire equivalent amounts of information by strengthening ties. Our results show that the overall tie strength is less for women's collaborations and that women acquire less strategic information through collaborators. Women and men rely on different tie characteristics in accessing information, but are equally effective in acquiring additional information resources by strengthening ties. This article demonstrates that the underrepresentation of women in science, technology, engineering, and mathematics has an impact on the interpersonal processes of scientific collaboration, to the disadvantage of women scientists.
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Happell B, Platania-Phung C, Stanton R, Millar F. Exploring the views of nurses on the cardiometabolic health nurse in mental health services in australia. Issues Ment Health Nurs 2015; 36:135-44. [PMID: 25397354 DOI: 10.3109/01612840.2014.901449] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
People with serious mental illness experience premature death due to higher rates of cardiometabolic conditions (e.g. cardiovascular disease, diabetes) than the general population. Mental health services often do not provide sufficient cardiometabolic clinical care to address these risks. The cardiometabolic health nurse (CHN) role has been suggested as a strategy for ensuring integrated care is provided and sustained. The views of nurses in mental health would be essential in informing the viability and development for this initiative. This paper presents the findings of open-ended comments from a cross-sectional online survey of nurses working in mental health in Australia (n = 643) eliciting views about the possible introduction of the cardiometabolic nurse. Thematic analysis was undertaken, of 133 open comments on this topic. The findings suggest that nurses see the specialist role as suitable and valuable for mental health services. Some nurses voiced concern about specialisation leading to fragmentation (e.g. in responsibilities for physical health, division of mental and physical health care, and less emphasis on equipping all nurses with comprehensive care skills), especially for settings where generalist nursing was seen as already available. The findings suggest this role is viewed favourably by nurses, provided that it is consistent with holistic and comprehensive care. Empirical research is needed to see whether this role increases holism (as valued by consumers and nurses) and cardiometabolic outcomes.
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Affiliation(s)
- Brenda Happell
- Central Queensland University, Institute for Health and Social Science Research and Centre for Mental Health Nursing Innovation , Rockhampton , Australia
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Young JM, O'Halloran A, McAulay C, Pirotta M, Forsdike K, Stacey I, Currow D. Unconditional and conditional incentives differentially improved general practitioners' participation in an online survey: randomized controlled trial. J Clin Epidemiol 2014; 68:693-7. [PMID: 25450450 DOI: 10.1016/j.jclinepi.2014.09.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/08/2014] [Accepted: 09/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the impact of unconditional and conditional financial incentives on response rates among Australian general practitioners invited by mail to participate in an online survey about cancer care and to investigate possible differential response bias between incentive groups. STUDY DESIGN AND SETTING Australian general practitioners were randomly allocated to unconditional incentive (book voucher mailed with letter of invitation), conditional incentive (book voucher mailed on completion of the online survey), or control (no incentive). Nonresponders were asked to complete a small subset of questions from the online survey. RESULTS Among 3,334 eligible general practitioners, significantly higher response rates were achieved in the unconditional group (167 of 1,101, 15%) compared with the conditional group (118 of 1,111, 11%) (P = 0.0014), and both were significantly higher than the control group (74 of 1,122, 7%; both P < 0.001). Although more positive opinions about cancer care were expressed by online responders compared with nonresponders, there was no evidence that the magnitude of difference varied by the incentive group. The incremental cost for each additional 1% increase above the control group response rate was substantially higher for the unconditional incentive group compared with the conditional incentive group. CONCLUSION Both unconditional and conditional financial incentives significantly increased response with no evidence of differential response bias. Although unconditional incentives had the largest effect, the conditional approach was more cost-effective.
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Affiliation(s)
- Jane M Young
- Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, University of Sydney, Level 6 North, Lifehouse (C39Z), NSW 2006, Sydney, Australia.
| | - Anna O'Halloran
- Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, University of Sydney, Level 6 North, Lifehouse (C39Z), NSW 2006, Sydney, Australia
| | - Claire McAulay
- Cancer Epidemiology and Services Research (CESR), Sydney School of Public Health, University of Sydney, Level 6 North, Lifehouse (C39Z), NSW 2006, Sydney, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, 200 Berkeley St, Carlton, VIC 3053, Australia
| | - Kirsty Forsdike
- Department of General Practice, University of Melbourne, 200 Berkeley St, Carlton, VIC 3053, Australia
| | - Ingrid Stacey
- Cancer Institute NSW, Australian Technology Park, Level 9, 8 Central Avenue, Everleigh, NSW 2015, Australia
| | - David Currow
- Cancer Institute NSW, Australian Technology Park, Level 9, 8 Central Avenue, Everleigh, NSW 2015, Australia
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Stevens JP, Kachniarz B, Wright SB, Gillis J, Talmor D, Clardy P, Howell MD. When policy gets it right: variability in u.s. Hospitals' diagnosis of ventilator-associated pneumonia*. Crit Care Med 2014; 42:497-503. [PMID: 24145845 DOI: 10.1097/ccm.0b013e3182a66903] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The Centers for Disease Control has recently proposed a major change in how ventilator-associated pneumonia is defined. This has profound implications for public reporting, reimbursement, and accountability measures for ICUs. We sought to provide evidence for or against this change by quantifying limitations of the national definition of ventilator-associated pneumonia that was in place until January 2013, particularly with regard to comparisons between, and ranking of, hospitals and ICUs. DESIGN A prospective survey of a nationally representative group of 43 hospitals, randomly selected from the American Hospital Association Guide (2009). Subjects classified six standardized vignettes of possible cases of ventilator-associated pneumonia as pneumonia or no pneumonia. SUBJECTS Individuals responsible for ventilator-associated pneumonia surveillance at 43 U.S. hospitals. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We measured the proportion of standardized cases classified as ventilator-associated pneumonia. Of 138 hospitals consented, 61 partially completed the survey and 43 fully completed the survey (response rate 44% and 31%, respectively). Agreement among hospitals about classification of cases as ventilator-associated pneumonia/not ventilator-associated pneumonia was nearly random (Fleiss κ 0.13). Some hospitals rated 0% of cases as having pneumonia; others classified 100% as having pneumonia (median, 50%; interquartile range, 33-66%). Although region of the country did not predict case assignment, respondents who described their region as "rural" were more likely to judge a case to be pneumonia than respondents elsewhere (relative risk, 1.25, Kruskal-Wallis chi-square, p = 0.03). CONCLUSIONS In this nationally representative study of hospitals, assignment of ventilator-associated pneumonia is extremely variable, enough to render comparisons between hospitals worthless, even when standardized cases eliminate variability in clinical data abstraction. The magnitude of this variability highlights the limitations of using poorly performing surveillance definitions as methods of hospital evaluation and comparison, and our study provides very strong support for moving to a more objective definition of ventilator-associated complications.
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Affiliation(s)
- Jennifer P Stevens
- 1Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA. 2Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, MA. 3Harvard Medical School, Boston, MA. 4Department of Medicine, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA. 5Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA. 6Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, IL
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Kogelman L, Barnett ED, Chen LH, Quinn E, Yanni E, Wilson ME, Benoit C, Karchmer AW, Ooi WW, Jentes ES, Hamer DH. Knowledge, attitudes, and practices of US practitioners who provide pre-travel advice. J Travel Med 2014; 21:104-14. [PMID: 24593023 DOI: 10.1111/jtm.12097] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 10/05/2013] [Accepted: 11/04/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND As international travel increases, many health care professionals are being asked to provide pre-travel advice. We designed an anonymous web-based survey to assess the extent to which primary care providers (PCPs) provide travel medicine advice and how their understanding and delivery of itinerary-specific advice and management compare with that of travel medicine specialists. METHODS We surveyed randomly selected US PCPs registered in the Pri-Med Institute (now pmiCME) database and US travel medicine specialists from the International Society of Travel Medicine (ISTM), American Society of Tropical Medicine and Hygiene (ASTMH), and Centers for Disease Control and Prevention (CDC) yellow fever (YF) vaccine provider mailing lists. SAS software (SAS Institute, Cary, NC, USA) was used for all analyses. RESULTS Of 14,932 e-mails sent to valid e-mail addresses, 902 yielded complete or partially completed surveys (6.0% response rate). Eighty percent of respondents personally provided pre-travel advice (95% of travel medicine specialists versus 73% of PCPs). About two thirds of PCPs (68%) providing pre-travel consultations saw <50 travelers per year whereas 30% of travel medicine specialists saw <50 travelers per year. More travel medicine specialists (59%) than PCPs (18%) saw >500 travelers per year. Familiarity with travel-specific vaccines (YF, Japanese encephalitis) and provision of written educational materials increased as volume of travelers increased. Familiarity with antimalarial side effects and malaria resistance patterns, and knowledge scores based on brief pre-travel scenarios were higher in travel medicine specialists, ASTMH or ISTM certificate holders, and respondents who saw more pre-travel patients. CONCLUSIONS Many PCP survey participants provided pre-travel advice, but most saw few travelers. Volume of travelers and holding an ASTMH or ISTM certificate had the greatest influence on knowledge of travel medicine and provision of appropriate advice and recommendations. Creating easily accessible travel medicine education programs for US providers from a wide range of disciplines is needed to improve the management of travelers.
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Affiliation(s)
- Laura Kogelman
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA
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Bradley V, Burney C, Hughes G. Do patients die well in your emergency department? Emerg Med Australas 2013; 25:334-9. [PMID: 23911024 DOI: 10.1111/1742-6723.12099] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Although the role of the ED in the management of patients needing palliative care is recognised internationally, there are little Australasian data on this issue. This study aimed to determine the current knowledge and attitude to the provision of palliative care in Australasian EDs. METHODS All ED directors in Australasia were invited to complete an online survey about the provision of palliative care in their department. Quantitative data were described using counts and proportions, and qualitative data were summarised thematically. RESULTS Of 165 eligible ED directors, 35 completed the survey (22%; 95% CI, 15-28%). Only 17/35 (49%; 95% CI, 32-65%) believed that ED provided good palliative care, and 28/35 (80%; 95% CI, 67-93%) were unaware of international gold standard palliative care protocols. Most had access to hospital-based palliative care specialists 27/35 (77%; 95% CI, 63-91%); however, only 5/27 (19%; 95% CI, 4-33%) used them. Few EDs undertake formal training in palliative care 10/35 (29%; 95% CI, 16-45%). Respondents showed concern about the quality of palliative care they provide and advocated for more palliative care training. CONCLUSION Although limited by the low response rate, this survey indicates that there is a need and a desire for greater integration of the values and standards of high-quality palliative care in Australasian EDs.
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Affiliation(s)
- Victoria Bradley
- Emergency Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
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Cameron AC, Lees KR, Booth MG, Bailey A, Hunter W. A survey of principal researchers who lead research into Adults with Incapacity in Scotland. Scott Med J 2013; 58:30-3. [PMID: 23596026 DOI: 10.1177/0036933012474592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Scotland's 'A' Research Ethics Committee (SAREC, previously MREC A) has exclusive authority to consider research involving Adults with Incapacity in Scotland. No appeal facility exists although resubmissions are accepted. Legislation covering research in England and Wales has created anomalies. RECs 'recognised' by the UK Ethics Committee (3 in Scotland, several in England) can approve drug studies involving Adults with Incapacity in Scotland. Several English RECs can approve studies led from outside Scotland. METHODS We conducted an anonymous online survey of researchers experienced in studies involving Adults with Incapacity to establish their opinions on the role of SAREC. The survey had 5 multiple-choice questions. Two questions invited a free-text comment. RESULTS Seventy-seven researchers (45% response) completed the survey. The majority (61/76, 80%) received a favourable opinion from SAREC immediately/after minor revision. The consensus was a single, experienced committee is advantageous to researchers (69/77 (90%)) and research participants (65/75 (87%)). There was no association between application outcome and opinion on whether a single committee is advantageous for researchers (p = 0.39 (Fisher's exact test)) or research participants (p = 0.49). Most (42/76, 55%) favoured the current system for reviewing decisions. CONCLUSIONS The research establishment favours retaining expertise in one committee. Most are content not having an external appeal facility.
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Watson BM, Heatley ML, Kruske SG, Gallois C. An empirical investigation into beliefs about collaborative practice among maternity care providers. AUST HEALTH REV 2013; 36:466-70. [PMID: 22958328 DOI: 10.1071/ah11104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 03/15/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate agreement with the National Health and Medical Research Council (NHMRC) definition of collaboration in maternity care by care providers, and to examine their preferences for models of care in order to shed light on the lack of success in implementing collaborative practice. METHODS Maternity care providers completed a survey in Queensland. The final sample consisted of 337 participants, including 281 midwives (83.38%), 35 obstetricians (10.39%), and 21 general practitioners (6.23%). RESULTS Ninety-one percent of the participants agreed with the NHMRC definition of collaboration: Midwives (M=5.97, s.d.=1.2) and doctors (obstetricians and general practitioners: M=5.7, s.d.=1.35) did not differ significantly in their level of agreement with definition (t (332)=-1.8, P=.068). However, 72% of doctors endorsed a doctor-led model of care, whereas only 6.8% of midwives indicated agreement with it. Fewer (56%) doctors agreed with the midwife-led model of care, whereas 99.3% of midwives endorsed it. CONCLUSION The concept of collaboration does not recognise the different interpretations by midwives and doctors of its impact on their roles and behaviours. Successful collaborative practice requires the development of guidelines that recognise these differences and specify the communication behaviour that would assist midwives and doctors to practice collaboratively.
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Affiliation(s)
- Bernadette M Watson
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia.
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Sochos A, Bowers A, Kinman G. Work Stressors, Social Support, and Burnout in Junior Doctors: Exploring Direct and Indirect Pathways. JOURNAL OF EMPLOYMENT COUNSELING 2012. [DOI: 10.1002/j.2161-1920.2012.00007.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Newton PJ, Davidson PM, Sanderson C. An online survey of Australian physicians reported practice with the off-label use of nebulised frusemide. BMC Palliat Care 2012; 11:6. [PMID: 22546176 PMCID: PMC3422185 DOI: 10.1186/1472-684x-11-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 04/30/2012] [Indexed: 11/10/2022] Open
Abstract
Background Off-label prescribing is common in palliative care. Despite inconsistent reports of the benefit of nebulised frusemide for breathlessness, its use continues to be reported. Methods An online survey was emailed to 249 members of the Australian and New Zealand Society of Palliative Medicine to estimate the use of nebulised frusemide for breathlessness by Australian physicians involved in palliative care in the previous 12 months. Results There were 52/249 (21%) respondents to the survey. The majority (44/52; 85%) had not prescribed nebulised frusemide in the previous 12 months. The most common (18/44; 43%) reason for not prescribing nebulised frusemide was a belief that there was not enough evidence to support its use. Whilst only a few respondents (8/52; 15%) reported having used nebulised frusemide, all that had used it thought there was at least some benefit in relieving breathlessness. Conclusion This report adds to the series of case studies reporting some benefit from nebulised frusemide in relieving breathlessnes.
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Affiliation(s)
- Phillip J Newton
- Centre for Cardiovascular & Chronic Care, Faculty of Nursing, Midwifery & Health, University of Technology Sydney, PO Box 123 Broadway, Sydney, NSW, 2007, Australia.
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Scott A, Jeon SH, Joyce CM, Humphreys JS, Kalb G, Witt J, Leahy A. A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors. BMC Med Res Methodol 2011. [PMID: 21888678 DOI: 10.1186/1471-2288-11-126.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Surveys of doctors are an important data collection method in health services research. Ways to improve response rates, minimise survey response bias and item non-response, within a given budget, have not previously been addressed in the same study. The aim of this paper is to compare the effects and costs of three different modes of survey administration in a national survey of doctors. METHODS A stratified random sample of 4.9% (2,702/54,160) of doctors undertaking clinical practice was drawn from a national directory of all doctors in Australia. Stratification was by four doctor types: general practitioners, specialists, specialists-in-training, and hospital non-specialists, and by six rural/remote categories. A three-arm parallel trial design with equal randomisation across arms was used. Doctors were randomly allocated to: online questionnaire (902); simultaneous mixed mode (a paper questionnaire and login details sent together) (900); or, sequential mixed mode (online followed by a paper questionnaire with the reminder) (900). Analysis was by intention to treat, as within each primary mode, doctors could choose either paper or online. Primary outcome measures were response rate, survey response bias, item non-response, and cost. RESULTS The online mode had a response rate 12.95%, followed by the simultaneous mixed mode with 19.7%, and the sequential mixed mode with 20.7%. After adjusting for observed differences between the groups, the online mode had a 7 percentage point lower response rate compared to the simultaneous mixed mode, and a 7.7 percentage point lower response rate compared to sequential mixed mode. The difference in response rate between the sequential and simultaneous modes was not statistically significant. Both mixed modes showed evidence of response bias, whilst the characteristics of online respondents were similar to the population. However, the online mode had a higher rate of item non-response compared to both mixed modes. The total cost of the online survey was 38% lower than simultaneous mixed mode and 22% lower than sequential mixed mode. The cost of the sequential mixed mode was 14% lower than simultaneous mixed mode. Compared to the online mode, the sequential mixed mode was the most cost-effective, although exhibiting some evidence of response bias. CONCLUSIONS Decisions on which survey mode to use depend on response rates, response bias, item non-response and costs. The sequential mixed mode appears to be the most cost-effective mode of survey administration for surveys of the population of doctors, if one is prepared to accept a degree of response bias. Online surveys are not yet suitable to be used exclusively for surveys of the doctor population.
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Affiliation(s)
- Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, Faculty of Business and Economics, The University of Melbourne, Carlton, VIC, Australia
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Scott A, Jeon SH, Joyce CM, Humphreys JS, Kalb G, Witt J, Leahy A. A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors. BMC Med Res Methodol 2011; 11:126. [PMID: 21888678 PMCID: PMC3231767 DOI: 10.1186/1471-2288-11-126] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 09/05/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Surveys of doctors are an important data collection method in health services research. Ways to improve response rates, minimise survey response bias and item non-response, within a given budget, have not previously been addressed in the same study. The aim of this paper is to compare the effects and costs of three different modes of survey administration in a national survey of doctors. METHODS A stratified random sample of 4.9% (2,702/54,160) of doctors undertaking clinical practice was drawn from a national directory of all doctors in Australia. Stratification was by four doctor types: general practitioners, specialists, specialists-in-training, and hospital non-specialists, and by six rural/remote categories. A three-arm parallel trial design with equal randomisation across arms was used. Doctors were randomly allocated to: online questionnaire (902); simultaneous mixed mode (a paper questionnaire and login details sent together) (900); or, sequential mixed mode (online followed by a paper questionnaire with the reminder) (900). Analysis was by intention to treat, as within each primary mode, doctors could choose either paper or online. Primary outcome measures were response rate, survey response bias, item non-response, and cost. RESULTS The online mode had a response rate 12.95%, followed by the simultaneous mixed mode with 19.7%, and the sequential mixed mode with 20.7%. After adjusting for observed differences between the groups, the online mode had a 7 percentage point lower response rate compared to the simultaneous mixed mode, and a 7.7 percentage point lower response rate compared to sequential mixed mode. The difference in response rate between the sequential and simultaneous modes was not statistically significant. Both mixed modes showed evidence of response bias, whilst the characteristics of online respondents were similar to the population. However, the online mode had a higher rate of item non-response compared to both mixed modes. The total cost of the online survey was 38% lower than simultaneous mixed mode and 22% lower than sequential mixed mode. The cost of the sequential mixed mode was 14% lower than simultaneous mixed mode. Compared to the online mode, the sequential mixed mode was the most cost-effective, although exhibiting some evidence of response bias. CONCLUSIONS Decisions on which survey mode to use depend on response rates, response bias, item non-response and costs. The sequential mixed mode appears to be the most cost-effective mode of survey administration for surveys of the population of doctors, if one is prepared to accept a degree of response bias. Online surveys are not yet suitable to be used exclusively for surveys of the doctor population.
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Affiliation(s)
- Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, Faculty of Business and Economics, The University of Melbourne, Carlton, VIC, Australia
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Scott A, Jeon SH, Joyce CM, Humphreys JS, Kalb G, Witt J, Leahy A. A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors. BMC Med Res Methodol 2011; 11:126. [PMID: 21888678 DOI: 10.1186/1471228811126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 09/05/2011] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Surveys of doctors are an important data collection method in health services research. Ways to improve response rates, minimise survey response bias and item non-response, within a given budget, have not previously been addressed in the same study. The aim of this paper is to compare the effects and costs of three different modes of survey administration in a national survey of doctors. METHODS A stratified random sample of 4.9% (2,702/54,160) of doctors undertaking clinical practice was drawn from a national directory of all doctors in Australia. Stratification was by four doctor types: general practitioners, specialists, specialists-in-training, and hospital non-specialists, and by six rural/remote categories. A three-arm parallel trial design with equal randomisation across arms was used. Doctors were randomly allocated to: online questionnaire (902); simultaneous mixed mode (a paper questionnaire and login details sent together) (900); or, sequential mixed mode (online followed by a paper questionnaire with the reminder) (900). Analysis was by intention to treat, as within each primary mode, doctors could choose either paper or online. Primary outcome measures were response rate, survey response bias, item non-response, and cost. RESULTS The online mode had a response rate 12.95%, followed by the simultaneous mixed mode with 19.7%, and the sequential mixed mode with 20.7%. After adjusting for observed differences between the groups, the online mode had a 7 percentage point lower response rate compared to the simultaneous mixed mode, and a 7.7 percentage point lower response rate compared to sequential mixed mode. The difference in response rate between the sequential and simultaneous modes was not statistically significant. Both mixed modes showed evidence of response bias, whilst the characteristics of online respondents were similar to the population. However, the online mode had a higher rate of item non-response compared to both mixed modes. The total cost of the online survey was 38% lower than simultaneous mixed mode and 22% lower than sequential mixed mode. The cost of the sequential mixed mode was 14% lower than simultaneous mixed mode. Compared to the online mode, the sequential mixed mode was the most cost-effective, although exhibiting some evidence of response bias. CONCLUSIONS Decisions on which survey mode to use depend on response rates, response bias, item non-response and costs. The sequential mixed mode appears to be the most cost-effective mode of survey administration for surveys of the population of doctors, if one is prepared to accept a degree of response bias. Online surveys are not yet suitable to be used exclusively for surveys of the doctor population.
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Affiliation(s)
- Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, Faculty of Business and Economics, The University of Melbourne, Carlton, VIC, Australia
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Brugha R, Balfe M, Jeffares I, Conroy RM, Clarke E, Fitzgerald M, O'Connell E, Vaughan D, Coleman C, McGee H, Gillespie P, O'Donovan D. Where do young adults want opportunistic chlamydia screening services to be located? J Public Health (Oxf) 2011; 33:571-8. [PMID: 21486871 DOI: 10.1093/pubmed/fdr028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study measured the acceptability of urine-based chlamydia screening to young adults, where young adults wanted opportunistic chlamydia screening services to be located, and by whom they wanted to be offered screening. METHODS A cross-sectional survey of 5685 university students and 400 young adult healthcares setting attendees (age: 18-29 years). RESULTS Ninety-six percent of males and 93% of females said that they would find it acceptable to be offered chlamydia screening. Seventy-six percent of males and 77% of females wanted to be offered screening by a doctor or nurse. Young women would prefer female staff. Most respondents preferred that screening be located in traditional healthcare settings such as General Practices, and offered by either doctors or nurses. More than 90% of respondents did not want screening services to be located in pharmacies and almost all rejected public non-health care screening settings. CONCLUSIONS Opportunistic chlamydia screening services should be located in traditional healthcare/medical settings, and screening should be offered by doctors and nurses.
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Affiliation(s)
- Ruairi Brugha
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin 2, Republic of Ireland
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Crouch S, Robinson P, Pitts M. A comparison of general practitioner response rates to electronic and postal surveys in the setting of the National STI Prevention Program. Aust N Z J Public Health 2011; 35:187-9. [PMID: 21463418 DOI: 10.1111/j.1753-6405.2011.00687.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To compare the response rates achieved for an online survey with a postal survey of general practitioners (GPs) as a method to evaluate the National STI Prevention Program. METHODS All GPs in Australia were asked to complete an online survey. A further sample of 509 GPs were asked to complete a postal survey. Response rates to both recruitment methods were compared. The demographic characteristics of responders were compared to the entire GP population of Australia. RESULTS Twenty GPs completed the online survey (response rate <0.1%). Sixty-three GPs completed the postal survey (response rate 12.4%). The demographic characteristics of those responding to the postal survey showed no statistically significant difference compared to the general GP population. CONCLUSION Our postal survey had a higher response rate than the online survey. Our response to the postal survey was lower than other similar studies and is likely to be due to a lack of incentives and follow-up. Even with the low response rate it appears that postal surveys can provide a good representation of the overall population. IMPLICATIONS Despite growing use of online surveys, postal surveys should still be the method of choice whenever possible. Postal surveys should include incentives and further follow-up of the initial recruitment should be conducted.
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Affiliation(s)
- Simon Crouch
- School of Public Health, Faculty of Health Sciences, La Trobe University, Victoria.
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Akl EA, Gaddam S, Mustafa R, Wilson MC, Symons A, Grifasi A, McGuigan D, Schünemann HJ. The effects of tracking responses and the day of mailing on physician survey response rate: three randomized trials. PLoS One 2011; 6:e16942. [PMID: 21373197 PMCID: PMC3044144 DOI: 10.1371/journal.pone.0016942] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 01/10/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The response rates to physician postal surveys remain modest. The primary objective of this study was to assess the effect of tracking responses on physician survey response rate (i.e., determining whether each potential participant has responded or not). A secondary objective was to assess the effects of day of mailing (Monday vs. Friday) on physician survey response rate. METHODS We conducted 3 randomized controlled trials. The first 2 trials had a 2 x 2 factorial design and tested the effect of day of mailing (Monday vs. Friday) and of tracking vs. no tracking responses. The third trial tested the effect of day of mailing (Monday vs. Friday). We meta-analyzed these 3 trials using a random effects model. RESULTS The total number of participants in the 3 trials was 1339. The response rate with tracked mailing was not statistically different from that with non-tracked mailing by the time of the first reminder (RR = 1.01 95% CI 0.84, 1.22; I² = 0%). There was a trend towards lower response rate with tracked mailing by the time of the second reminder (RR = 0.91; 95% CI 0.78, 1.06; I² = 0%). The response rate with mailing on Mondays was not statistically different from that with Friday mailing by the time of first reminder (RR = 1.01; 95% CI 0.87, 1.17; I² = 0%), and by the time of the 2(nd) reminder (RR = 1.08; 95% CI 0.84, 1.39; I² = 77%). CONCLUSIONS Tracking response may negatively affect physicians' response rate. The day of mailing does not appear to affect physicians' response rate.
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Affiliation(s)
- Elie A Akl
- Department of Medicine, State University of New York at Buffalo, Buffalo, New York, United States of America.
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LARANCE BRIONY, DEGENHARDT LOUISA, O'BRIEN SUSANNAH, LINTZERIS NICK, WINSTOCK ADAM, MATTICK RICHARDP, BELL JAMES, ALI ROBERT. Prescribers' perceptions of the diversion and injection of medication by opioid substitution treatment patients. Drug Alcohol Rev 2011; 30:613-20. [DOI: 10.1111/j.1465-3362.2010.00274.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Copertino N, Blackham R, Hamdorf JM. A short course for surgical supervisors and trainers: effecting behavioural change. ANZ J Surg 2010; 80:896-901. [DOI: 10.1111/j.1445-2197.2010.05523.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Joyce CM, Scott A, Jeon SH, Humphreys J, Kalb G, Witt J, Leahy A. The "medicine in Australia: balancing employment and life (MABEL)" longitudinal survey--protocol and baseline data for a prospective cohort study of Australian doctors' workforce participation. BMC Health Serv Res 2010; 10:50. [PMID: 20181288 PMCID: PMC2837653 DOI: 10.1186/1472-6963-10-50] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 02/25/2010] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND While there is considerable research on medical workforce supply trends, there is little research examining the determinants of labour supply decisions for the medical workforce. The "Medicine in Australia: Balancing Employment and Life (MABEL)" study investigates workforce participation patterns and their determinants using a longitudinal survey of Australian doctors. It aims to generate evidence to support developing effective policy responses to workforce issues such as shortages and maldistribution. This paper describes the study protocol and baseline cohort, including an analysis of response rates and response bias. METHODS/DESIGN MABEL is a prospective cohort study. All Australian doctors undertaking clinical work in 2008 (n = 54,750) were invited to participate, and annual waves of data collections will be undertaken until at least 2011. Data are collected by paper or optional online version of a questionnaire, with content tailored to four sub-groups of clinicians: general practitioners, specialists, specialists in training, and hospital non-specialists. In the baseline wave, data were collected on: job satisfaction, attitudes to work and intentions to quit or change hours worked; a discrete choice experiment examining preferences and trade-offs for different types of jobs; work setting; workload; finances; geographic location; demographics; and family circumstances. DISCUSSION The baseline cohort includes 10,498 Australian doctors, representing an overall response rate of 19.36%. This includes 3,906 general practitioners, 4,596 specialists, 1,072 specialists in training, and 924 hospital non-specialists. Respondents were more likely to be younger, female, and to come from non-metropolitan areas, the latter partly reflecting the effect of a financial incentive on response for doctors in remote and rural areas. Specialists and specialists in training were more likely to respond, whilst hospital non-specialists were less likely to respond. The distribution of hours worked was similar between respondents and data from national medical labour force statistics. The MABEL survey provides a large, representative cohort of Australian doctors. It enables investigation of the determinants of doctors' decisions about how much, where and in what circumstances they practice, and of changes in these over time. MABEL is intended to provide an important resource for policy makers and other stakeholders in the Australian medical workforce.
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Affiliation(s)
- Catherine M Joyce
- Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne Victoria 3004, Australia
| | - Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, Alan Gilbert Building, The University of Melbourne, Parkville Victoria 3010, Australia
| | - Sung-Hee Jeon
- Melbourne Institute of Applied Economic and Social Research, Alan Gilbert Building, The University of Melbourne, Parkville Victoria 3010, Australia
| | - John Humphreys
- School of Rural Health, Monash University, PO Box 666, Bendigo, Victoria 3552, Australia
| | - Guyonne Kalb
- Melbourne Institute of Applied Economic and Social Research, Alan Gilbert Building, The University of Melbourne, Parkville Victoria 3010, Australia
| | - Julia Witt
- Department of Economics, 501 Fletcher Argue Building, University of Manitoba, Winnipeg, MB R3T 5V5, Canada
| | - Anne Leahy
- Melbourne Institute of Applied Economic and Social Research, Alan Gilbert Building, The University of Melbourne, Parkville Victoria 3010, Australia
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Moalem J, Salzman P, Ruan DT, Cherr GS, Freiburg CB, Farkas RL, Brewster L, James TA. Should All Duty Hours Be the Same? Results of a National Survey of Surgical Trainees. J Am Coll Surg 2009; 209:47-54, 54.e1-2. [DOI: 10.1016/j.jamcollsurg.2009.02.053] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Revised: 02/09/2009] [Accepted: 02/12/2009] [Indexed: 11/16/2022]
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King R. Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers. Aust N Z J Psychiatry 2009; 43:453-9. [PMID: 19373707 DOI: 10.1080/00048670902817661] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. METHOD A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. RESULTS The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. CONCLUSION Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy.
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Affiliation(s)
- Robert King
- University of Queensland Psychiatry, St Lucia, Brisbane, Qld 4029, Australia.
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Poller D, Ljung BM, Gonda P. Use of streamed internet video for cytology training and education: www.PathLab.org. Diagn Cytopathol 2009; 37:340-6. [PMID: 19191291 DOI: 10.1002/dc.20996] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
An Internet-based method is described for submission of video clips to a website editor to be reviewed, edited, and then uploaded onto a video server, with a hypertext link to a website. The information on the webpages is searchable via the website sitemap on Internet search engines. A survey of video users who accessed a single 59-minute FNA cytology training cytology video via the website showed a mean score for usefulness for specialists/consultants of 3.75, range 1-5, n = 16, usefulness for trainees mean score was 4.4, range 3-5, n = 12, with a mean score for visual and sound quality of 3.9, range 2-5, n = 16. Fifteen out of 17 respondents thought that posting video training material on the Internet was a good idea, and 9 of 17 respondents would also consider submitting training videos to a similar website. This brief exercise has shown that there is value in posting educational or training video content on the Internet and that the use of streamed video accessed via the Internet will be of increasing importance.
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Affiliation(s)
- David Poller
- Department of Pathology, Queen Alexandra Hospital, Portsmouth, United Kingdom.
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Shirts BH, Perera S, Hanlon JT, Roumani YF, Studenski SA, Nace DA, Becich MJ, Handler SM. Provider management of and satisfaction with laboratory testing in the nursing home setting: results of a national internet-based survey. J Am Med Dir Assoc 2009; 10:161-166.e3. [PMID: 19233055 DOI: 10.1016/j.jamda.2008.08.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 08/25/2008] [Accepted: 08/27/2008] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To describe the management of and satisfaction with laboratory testing, and desirability of laboratory health information technology in the nursing home setting. DESIGN Cross-sectional study using an Internet-based survey. PARTICIPANTS AND SETTING National sample of 426 nurse practitioners and 308 physicians who practice in the nursing home setting. MEASUREMENTS Systems and processes available for ordering and reviewing laboratory tests, laboratory test result management satisfaction, self-reported delays in laboratory test result review, and desirability of computerized laboratory test result management features in the nursing home setting. RESULTS A total of 96 participants (48 physicians and 48 nurse practitioners) completed the survey, for an overall response rate of 13.1% (96/734). Of the survey participants, 77.1% had worked in the nursing home setting for more than 5 years. Over half of clinicians (52.1%) reported 3 or more recent delays in receiving laboratory test results. Only 43.8% were satisfied with their laboratory test results management. Satisfaction was associated with keeping a list of laboratory orders and availability of computerized laboratory test order entry. In the nursing home, 35.4% of participants reported the ability to electronically review laboratory test results, 12.5% and 10.4% respectively had computerized ordering of chemistry/hematology and microbiology/pathology tests. The following 3 features were rated most desirable in a computerized laboratory test result management system: showing abnormal results first, warning if a test result was missed, and allowing electronic acknowledgment of test results. CONCLUSION Delays in receiving laboratory test results and dissatisfaction with the management of laboratory test result information are commonly reported among physicians and nurse practitioners working in nursing homes. Test result management satisfaction was associated with computerized order entry and keeping track of ordered laboratory tests, suggesting that implementation of certain health information technology could potentially improve quality of care.
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Affiliation(s)
- Brian H Shirts
- School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
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