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Viktorsson L, Törnvall E, Falk M, Yngman-Uhlin P. Using online health information for unknown symptoms common among young adults: a qualitative analysis of health-related web pages illustrating the need for numeracy skills, the ability to deal with uncertainty, and the risk of ruling out self-care. Scand J Prim Health Care 2024:1-9. [PMID: 39331046 DOI: 10.1080/02813432.2024.2408610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 09/20/2024] [Indexed: 09/28/2024] Open
Abstract
Young adults experiencing unfamiliar symptoms commonly seek health information online. This study's aim was to explore how health information websites express and communicate health information about symptoms common among young adults and guide readers in regard to health, illness, and care. Symptoms commonly searched for by young adults were used as search terms. The resulting data comprised material from 24 web pages and was analyzed using content analysis. The foremost purpose of online health information is to try to narrow down the user's symptoms and then advise the user on what actions to take. This is done by first forming a foundation of knowledge through descriptions and explanations, then specifying the symptom's time, duration, and location, and finally giving advice on whether to self-manage symptoms or seek additional information about them. However, the uncertainty of the diagnosis may rule out self-care. For readers inexperienced with health care, forming a decisive conclusion about diffuse symptoms on the sole basis of online health information could be challenging. The necessity of numeracy skills and the ability to deal with uncertainty are highlighted. There is a discrepancy between health advice given online and readers' accessibility to health care that needs to be addressed in future policy and research.
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Affiliation(s)
- Lisa Viktorsson
- Research and Development Unit in Region Östergötland, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Eva Törnvall
- Management Department in Region Östergötland, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Magnus Falk
- Primary Health Care Centre Kärna, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Pia Yngman-Uhlin
- Research and Development Unit in Region Östergötland, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Dineen-Griffin S, Benrimoj SI. The landscape of self-care in Australia: A pharmacy perspective. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 13:100396. [PMID: 38174289 PMCID: PMC10762451 DOI: 10.1016/j.rcsop.2023.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
The evolving landscape of self-care in Australia underscores the imperative of recognizing and integrating the crucial role of pharmacists in promoting greater levels of self-care. Although the social and economic justifications for self-care are acknowledged internationally and in the literature, there is very little policy recognition in relation to self-care specifically in Australian health policy. Additionally, the distinct contributions of pharmacies to self-care, i.e., their experiences and accessibility in primary health care, are not consistently highlighted. Community pharmacies in Australia are currently navigating a transformative shift, expanding their scope of practice to deliver highly individualized care, with a special emphasis on the implementation of professional services crucial for the sector's enduring viability. Although pharmacists already play a substantial role in supporting self-care, there exists a compelling demand for a systematic and structured approach. Despite the limited availability of theoretical frameworks or models for pharmacists in self-care support within the existing literature, tangible practical evidence attests to the success of interventions. In an era where patients increasingly assume responsibility for self-managing conditions, the pharmacist's role in facilitating self-care and judicious self-medication is pivotal, promising not only tangible benefits for individuals but also contributing significantly to the long-term sustainability of the healthcare system in Australia. This necessitates a strategic and comprehensive framework that positions pharmacists as essential catalysts in the broader landscape of healthcare, ensuring their contributions are optimally leveraged to enhance patient outcomes and system efficiency.
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Affiliation(s)
- Sarah Dineen-Griffin
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, New South Wales, Australia
| | - Shalom I. Benrimoj
- Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Spain
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Westin E, Gustafsson IL, Svensson A, Sund-Levander M, Elmqvist C. Advising parents when their child has a fever: a phenomenographic analysis of nurses' perceptions when working at a telephone helpline, at primary care or at a paediatric emergency department in Sweden. BMJ Open 2024; 14:e074823. [PMID: 38286694 PMCID: PMC10826557 DOI: 10.1136/bmjopen-2023-074823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVES To describe nurses' perceptions of advising parents when their child has a fever. DESIGN/METHOD Inductive, descriptive study with a qualitative, phenomenographic approach. PARTICIPANTS AND SETTING A purposive sampling was used. To be included, the 24 online interviewed nurses had to have experience advising parents of febrile children between birth and 5 years of age. They were recruited from three different parts of the healthcare system from four regions in the south of Sweden. RESULTS The nurses described advising parents when their child has a fever as four different kinds of balancing acts: balancing between the parents' story and objective assessment, balancing between listening and teaching, balancing between self-confidence and trust in the expert, and balancing between independence and having someone by one's side. CONCLUSIONS Giving advice to parents when their child has a fever is a process where the nurse needs to listen, assess and give advice based on the situation. This requires a correct assessment that depends on the parents' story. Creating a trusting relationship is perceived as necessary for parents to assimilate the advice that is provided. What dominates are the nurses' perceptions of the inner qualities required to achieve a balance in the process, for example, the importance of experience and security in their professional role, while it is also necessary to get support from colleagues.
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Affiliation(s)
- Emma Westin
- Department of Health and Caring Sciences, Linnaeus University Faculty of Health and Life Sciences, Vaxjo, Sweden
- Department of Pediatrics, Region Kronoberg, Vaxjo, Sweden
| | - Ingrid L Gustafsson
- Department of Health and Caring Sciences, Linnaeus University Faculty of Health and Life Sciences, Vaxjo, Sweden
- Department of Caring Sciences, University College of Boras Faculty of Caring Science Work Life and Social Welfare, Boras, Sweden
| | - Anders Svensson
- Department of Health and Caring Sciences, Linnaeus University Faculty of Health and Life Sciences, Vaxjo, Sweden
- Department of Ambulance Service, Region Kronoberg, Vaxjo, Sweden
| | | | - Carina Elmqvist
- Department of Health and Caring Sciences, Linnaeus University Faculty of Health and Life Sciences, Vaxjo, Sweden
- Head of Research, Region Kronoberg, Vaxjo, Sweden
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Dineen-Griffin S, Benrimoj SI, Rogers K, Williams KA, Garcia-Cardenas V. Cluster randomised controlled trial evaluating the clinical and humanistic impact of a pharmacist-led minor ailment service. BMJ Qual Saf 2020; 29:921-931. [PMID: 32139400 DOI: 10.1136/bmjqs-2019-010608] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/03/2020] [Accepted: 02/17/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Community pharmacists are well positioned to support patients' minor ailments. The objective was to evaluate the clinical and humanistic impact of a minor ailment service (MAS) in community pharmacy compared with usual pharmacist care (UC). METHODS A cluster randomised controlled trial was conducted. Intervention patients received MAS, which included a consultation with the pharmacist. MAS pharmacists were trained in clinical pathways and communication systems mutually agreed with general practitioners and received monthly support. Control patients received UC. All patients were followed up by telephone at 14 days. Clinical and humanistic impact were defined by primary (appropriate referral rate and appropriate non-prescription medicine rate) and secondary outcomes (clinical product-based intervention rate, referral adherence, symptom resolution, reconsultation and EuroQol EQ-5D visual analogue scale (VAS)). RESULTS Patients (n=894) were recruited from 30 pharmacies and 82% (n=732) responded to follow-up. Patients receiving MAS were 1.5 times more likely to receive an appropriate referral (relative rate (RR)=1.51; 95% CI 1.07 to 2.11; p=0.018) and were five times more likely to adhere to referral, compared with UC (RR=5.08; 95%CI 2.02 to 12.79; p=0.001). MAS patients (94%) achieved symptom resolution or relief at follow-up, while this was 88% with UC (RR=1.06; 95% CI 1 to 1.13; p=0.035). MAS pharmacists were 1.2 times more likely to recommend an appropriate medicine (RR 1.20, 95% CI 1.1 to 1.3; p=0.000) and were 2.6 times more likely to perform a clinical product-based intervention (RR=2.62, 95% CI 1.28 to 5.38; p=0.009), compared with UC. MAS patients had a greater mean difference in VAS at follow-up (4.08; 95% CI 1.23 to 6.87; p=0.004). No difference in reconsultation was observed (RR=0.98; 95% CI 0.75 to 1.28; p=0.89). CONCLUSION The study demonstrates improved clinical and humanistic outcomes with MAS. National implementation is a means to manage minor ailments more effectively in the Australian health system. TRIAL REGISTRATION NUMBER ACTRN12618000286246.
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Affiliation(s)
- Sarah Dineen-Griffin
- Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Shalom I Benrimoj
- Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Kris Rogers
- Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Kylie A Williams
- Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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Perera N, Agboola S. Are formal self-care interventions for healthy people effective? A systematic review of the evidence. BMJ Glob Health 2019; 4:e001415. [PMID: 31799010 PMCID: PMC6861059 DOI: 10.1136/bmjgh-2019-001415] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/08/2019] [Accepted: 04/13/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Preventative interventions are shown to be effective in reducing 40% of the mortality due to unhealthy behaviours and lifestyles. Health-promoting self-care has been recognised as a promising strategy in preventative health. However, self-care research is being done around the self-management of chronic illnesses and the promotion of self-care practices among healthy populations has been overlooked by many healthcare systems. Method The study methodology was a systematic review with a narrative synthesis. The search was done through seven academic databases, reference tracking of selected articles and grey literature. The scoping, selection, screening and quality assessments of the articles were reviewed independently by two reviewers. Results Sixteen studies met the inclusion criteria. Self-care behaviour, health-promotive lifestyle changes and medical care utilisation were some of the main outcomes evaluated in the studies. Positive effects were seen in increasing self-care and health-promotive behaviours in most interventions although limited or mixed impact was seen in health attitudes, beliefs and utilisation of medical services. Most studies were from high income settings with low-quality study designs. The complexity of the word ‘self-care’ and inconsistencies in the terminology used in health-promotive self-care were significant highlights of the study. Conclusion Health-promoting preventative self-care interventions show promise in increasing the well-being of healthy people. However, the methodological drawbacks limit the generalisability of the findings. As the demand for self-care interventions increases, the lack of a formal globally accepted definition and framework and complexity of behaviour change are key limitations to consider moving forward.
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Affiliation(s)
- Nilushka Perera
- Evaluation, Impact and Policy, Best Beginnings, Battaramulla, Sri Lanka
| | - Shade Agboola
- Public Health, Nottingham City Council, Nottingham, UK
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Gustafsson S, Sävenstedt S, Martinsson J, Wälivaara BM. Need for reassurance in self-care of minor illnesses. J Clin Nurs 2018; 27:1183-1191. [PMID: 29119676 DOI: 10.1111/jocn.14157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2017] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This study describes people's need for reassurance in self-care of minor illnesses. BACKGROUND Self-care and active surveillance are advocated as important strategies to manage minor illnesses. Reassurance influences patient satisfaction and confidence in the practicing of self-care. DESIGN This study is a descriptive and interpretive qualitative study. METHODS Twelve persons with experience in self-care and receiving self-care advice were recruited, and data were collected using semi-structured interviews between September-December 2014. Data were analysed using qualitative content analyses. RESULTS Having previous experience and the ability to actively manage symptoms using self-care interventions was described as reassuring. Participants became stressed and concerned when the symptoms persisted and interventions lacked the desired effect, which often resulted in a decision to consult. Participants wanted to feel that the nurse was an actual person, who was sympathetic, present and understanding, when they received self-care advice. The nurse's assessment and reasoning of the symptoms facilitated care-seekers' assessments of risk, and clear and concrete advice on how to manage the symptoms exerted a calming effect. Patients needed to trust that the nurse understood their situation to embrace the advice, and being invited to return created a feeling that the nurse had listened and taken them seriously. CONCLUSIONS Reassurance has the potential to allay doubts and fears to build confidence, which influences self-care and consultation behaviour. Personal presence in the encounter, receiving an assessment and an explanation of the symptoms and precise advice are reassuring. RELEVANCE TO CLINICAL PRACTICE The needs of nursing care may persist despite the absence of medical needs. The encounter between the nurse and care-seeker is a unique possibility for reassurance and confidence that a minor illness is self-limiting in its nature, and self-care interventions provide relief and comfort.
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Affiliation(s)
- Silje Gustafsson
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Stefan Sävenstedt
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Jesper Martinsson
- Department of Engineering Sciences and Mathematics, Luleå University of Technology, Luleå, Sweden
| | - Britt-Marie Wälivaara
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Rafferty E, Yaghoubi M, Taylor J, Farag M. Costs and savings associated with a pharmacists prescribing for minor ailments program in Saskatchewan. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2017; 15:3. [PMID: 28400708 PMCID: PMC5387257 DOI: 10.1186/s12962-017-0066-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 04/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health care systems around the world have started to develop pharmacists prescribing for minor ailments (PPMA) programs. These programs aim to improve the efficiency of care, reduce physician visits, and increase the accessibility to prescription medication (Rx). This study performed an economic impact analysis of the pharmacists prescribing for minor ailments program in Saskatchewan. METHODS We measured costs for the program and the alternative scenario (i.e. no PPMA program) from a public payer and societal perspective, using primary data on pharmacists prescribing consultations in Saskatchewan. Furthermore, we calculated public payer and societal savings, and return on investment ratios for the program, as well as projecting the costs and benefits over the next 5 years. RESULTS Overall, we found that from a societal perspective, the Saskatchewan PPMA program saved the province approximately $546,832 in 2014, while according to the public payer perspective, the program was only marginally cost-saving in 2014. After 5 years of implementation, from a societal perspective, cumulative cost savings were projected to be $3,482,660, and the return on investment ratio was estimated to be 2.53. CONCLUSIONS Our results demonstrate that this type of program may prove cost-saving and lead to improved access to the health care system in Canada, especially if savings to society are considered. This type of PPMA program may prove economically feasible and beneficial in many countries considering expanding pharmacists scope of practice.
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Affiliation(s)
- Ellen Rafferty
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Room 3334, Saskatoon, SK S7N 5E3 Canada
| | - Mohsen Yaghoubi
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Room 3334, Saskatoon, SK S7N 5E3 Canada
| | - Jeff Taylor
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Marwa Farag
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Room 3334, Saskatoon, SK S7N 5E3 Canada
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Abstract
Pharmacists have a long history of helping Canadians with minor ailments. This often has involved management with over-the-counter medications. If pharmacists felt that the best care required something more robust, they would refer the patient to a physician. In hopes of improving the care of such ailments, Canadian provinces have granted pharmacists the option of selecting medications traditionally under physician control. This review examines the Canadian perspective on pharmacists prescribing for minor ailments and the evidence of value for these programs. It might provide guidance for other jurisdictions contemplating such a move.
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Affiliation(s)
- Jeff Gordon Taylor
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon
| | - Ray Joubert
- Saskatchewan College of Pharmacy Professionals, Regina, SK, Canada
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Gustafsson S, Martinsson J, Wälivaara BM, Vikman I, Sävenstedt S. Influence of self-care advice on patient satisfaction and healthcare utilization. J Adv Nurs 2016; 72:1789-99. [DOI: 10.1111/jan.12950] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Silje Gustafsson
- Division of Nursing; Department of Health Science; Luleå University of Technology; Sweden
| | - Jesper Martinsson
- Department of Engineering Sciences and Mathematics; Luleå University of Technology; Sweden
| | - Britt-Marie Wälivaara
- Division of Nursing; Department of Health Science; Luleå University of Technology; Sweden
| | - Irene Vikman
- Division of Health and Rehab; Department of Health Science; Luleå University of Technology; Sweden
| | - Stefan Sävenstedt
- Division of Nursing; Department of Health Science; Luleå University of Technology; Sweden
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Snyder H, Engström J. The antecedents, forms and consequences of patient involvement: A narrative review of the literature. Int J Nurs Stud 2016; 53:351-78. [DOI: 10.1016/j.ijnurstu.2015.09.008] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/01/2015] [Accepted: 09/09/2015] [Indexed: 12/19/2022]
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Gustafsson S, Vikman I, Sävenstedt S, Martinsson J. Perceptions of needs related to the practice of self‐care for minor illness. J Clin Nurs 2015; 24:3255-65. [DOI: 10.1111/jocn.12888] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Silje Gustafsson
- Division of Nursing Department of Health Science Luleå University of Technology Luleå Sweden
| | - Irene Vikman
- Division of Health and Rehab Department of Health Science Luleå University of Technology Luleå Sweden
| | - Stefan Sävenstedt
- Division of Nursing Department of Health Science Luleå University of Technology Luleå Sweden
| | - Jesper Martinsson
- Mathematical Science Department of Engineering Sciences and Mathematics Luleå University of Technology Luleå Sweden
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