1
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Silvestre Salvador JF, Heras Mendaza F, Hervella Garcés M, Palacios-Martínez D, Sánchez Camacho R, Senan Sanz R, Apellaniz González A, Giménez-Arnau AM. Guidelines for the Diagnosis, Treatment, and Prevention of Hand Eczema. ACTAS DERMO-SIFILIOGRAFICAS 2021; 111:26-40. [PMID: 32197684 DOI: 10.1016/j.ad.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/11/2019] [Accepted: 04/21/2019] [Indexed: 12/28/2022] Open
Abstract
Hand eczema is a common condition associated with significantly impaired quality of life and high social and occupational costs. Managing hand eczema is particularly challenging for primary care and occupational health physicians as the condition has varying causes and both disease progression and response to treatment are difficult to predict. Early diagnosis and appropriate protective measures are essential to prevent progression to chronic eczema, which is much more difficult to treat. Appropriate referral to a specialist and opportune evaluation of the need for sick leave are crucial to the good management of these patients. These guidelines cover the diagnosis, prevention, and treatment of chronic hand eczema and highlight the role that primary care and occupational health physicians can play in the early management of this disease.
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Affiliation(s)
| | - F Heras Mendaza
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - M Hervella Garcés
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España
| | - D Palacios-Martínez
- Medicina de Atención Primaria, Centro de Salud Isabel II, Parla, Madrid, España
| | | | - R Senan Sanz
- Equipo de Atención Primaria el Clot, Instituto Catalán de la Salud, Barcelona, España
| | - A Apellaniz González
- Departamento de Estomatología, Facultad de Medicina y Enfermería, Euskal Herriko Unibertsitatea-Universidad del País Vasco, Leioa, Bizkaia, España
| | - A M Giménez-Arnau
- Departamento de Dermatología, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, España
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2
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Rehabilitation and Prevention of Hand Eczema. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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3
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Munch PK, Jørgensen MB, Højberg H, Rasmussen CDN. Nation-Wide Dissemination of a Digital Checklist to Improve Work Environment in the Eldercare Sector in Denmark. Front Public Health 2020; 8:502106. [PMID: 33344392 PMCID: PMC7744467 DOI: 10.3389/fpubh.2020.502106] [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: 10/01/2019] [Accepted: 11/12/2020] [Indexed: 12/01/2022] Open
Abstract
In this study, we evaluated the dissemination of a digital checklist for improving implementation of work environment initiatives in the Danish eldercare sector. We evaluated the impact of the checklist using the RE-AIM framework. Initiated in 2016, researchers and relevant stakeholders were responsible for disseminating the checklist to all workplaces in the eldercare sector in Denmark through a national campaign. The checklist guided the user to define an action plan to implement, and the checklist covered 11 implementation concept points that should be addressed to reach full implementation of the action in focus. One year after the launch of the campaign almost all municipalities in Denmark had visited the website hosting the checklist (96%), 17% of individual workers within the eldercare responding to a union survey was reached, 4% (n = 199) of all eligible eldercare workplaces in Denmark and 8% of all nursing homes had adopted the checklist. Of the workplaces that used the checklist, 46% typed an action in the checklist. There were 13% of the first time users that used the checklist twice and 29% of the actions were revised (maintenance) after working with the implementation. Finally, the workplaces that had used the checklist showed a higher prioritization of work environment compared to workplaces not using the checklist both at baseline and at follow up. In conclusion, this study employing various strategies, including a 1-year national campaign to disseminate a checklist shows potential to impact implementation of work environment initiatives in the Danish eldercare sector. While dissemination is satisfactory and likely to increase further with time, more efforts is needed to ensure maintenance.
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Affiliation(s)
| | | | - Helene Højberg
- National Research Centre for the Working Environment, Copenhagen, Denmark
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4
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Sonne M, Agner T, Nørreslet LB, Lund TT. The Efficacy to Prevent Irritant Hand Eczema: an Overview of the Interventional Procedures. CURRENT TREATMENT OPTIONS IN ALLERGY 2020. [DOI: 10.1007/s40521-020-00270-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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5
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Keefe AR, Demers PA, Neis B, Arrandale VH, Davies HW, Gao Z, Hedges K, Holness DL, Koehoorn M, Stock SR, Bornstein S. A scoping review to identify strategies that work to prevent four important occupational diseases. Am J Ind Med 2020; 63:490-516. [PMID: 32227359 DOI: 10.1002/ajim.23107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts. METHODS To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants. RESULTS We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity. CONCLUSIONS This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.
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Affiliation(s)
- Anya R. Keefe
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
| | - Paul A. Demers
- Occupational Cancer Research Centre, Cancer Care Ontario Toronto Ontario Canada
| | - Barbara Neis
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
| | | | - Hugh W. Davies
- Occupational and Environmental Health, School of Population and Public HealthUniversity of British Columbia Vancouver British Columbia Canada
| | - Zhiwei Gao
- Department of Clinical Epidemiology, Faculty of MedicineMemorial University St. John's Newfoundland Canada
| | - Kevin Hedges
- Occupational Health Clinics for Ontario Workers Ottawa Ontario Canada
| | - D. Linn Holness
- Department of Medicine and Public Health SciencesSt. Michael's Hospital/University of Toronto, Toronto, Ontario, Canada
| | - Mieke Koehoorn
- Occupational and Environmental Health, School of Population and Public HealthUniversity of British Columbia Vancouver British Columbia Canada
| | - Susan R. Stock
- Division of Biological Risks and Occupational HealthInstitut national de santé publique du Québec (Quebec Institute of Public Health) Montreal Quebec Canada
- Department of Social and Preventive MedicineSchool of Public Health, Université de Montreal Montreal Quebec Canada
| | - Stephen Bornstein
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
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6
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Madan I, Parsons V, Ntani G, Coggon D, Wright A, English J, McCrone P, Smedley J, Rushton L, Murphy C, Cookson B, Williams HC. A behaviour change package to prevent hand dermatitis in nurses working in the National Health Service: results of a cluster randomized controlled trial. Br J Dermatol 2020; 183:462-470. [PMID: 31989580 PMCID: PMC7497001 DOI: 10.1111/bjd.18862] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Occupational hand dermatitis poses a serious risk for nurses. OBJECTIVES To evaluate the clinical and cost-effectiveness of a complex intervention in reducing the prevalence of hand dermatitis in nurses METHODS: This was a cluster randomized controlled trial conducted at 35 hospital trusts, health boards or universities in the UK. Participants were (i) first-year student nurses with a history of atopic conditions or (ii) intensive care unit (ICU) nurses. Participants at intervention sites received access to a behavioural change programme plus moisturizing creams. Participants at control sites received usual care. The primary outcome was the change of prevalent dermatitis at follow-up (adjusted for baseline dermatitis) in the intervention vs. the control group. Randomization was blinded to everyone bar the trials unit to ensure allocation concealment. The trial was registered on the ISRCTN registry: ISRCTN53303171. RESULTS Fourteen sites were allocated to the intervention arm and 21 to the control arm. In total 2040 (69·5%) nurses consented to participate and were included in the intention-to-treat analysis. The baseline questionnaire was completed by 1727 (84·7%) participants. Overall, 789 (91·6%) ICU nurses and 938 (84·0%) student nurses returned completed questionnaires. Of these, 994 (57·6%) had photographs taken at baseline and follow-up (12-15 months). When adjusted for baseline prevalence of dermatitis and follow-up interval, the odds ratios (95% confidence intervals) for hand dermatitis at follow-up in the intervention group relative to the controls were 0·72 (0·33-1·55) and 0·62 (0·35-1·10) for student and ICU nurses, respectively. No harms were reported. CONCLUSIONS There was insufficient evidence to conclude whether our intervention was effective in reducing hand dermatitis in our populations. Linked Comment: Brans. Br J Dermatol 2020; 183:411-412.
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Affiliation(s)
- I Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - V Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - G Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - D Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - A Wright
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, U.K
| | - J English
- Dermatology, Circle Nottingham NHS Treatment Centre, Nottingham, U.K
| | - P McCrone
- Centre for the Economics of Mental and Physical Health, King's College London, London, U.K
| | - J Smedley
- Occupational Health Service, University Hospital Southampton NHS Foundation Trust, Southampton, U.K
| | - L Rushton
- Epidemiology and Biostatistics, Imperial College London, London, U.K
| | - C Murphy
- King's Clinical Trial Unit, King's College London, London, U.K
| | - B Cookson
- Medical Microbiology, University College London, London, U.K
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
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7
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Erdil D, Koku Aksu AE, Falay Gür T, Gürel MS. Hand eczema treatment: Change behaviour with text messaging, a randomized trial. Contact Dermatitis 2020; 82:153-160. [DOI: 10.1111/cod.13448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/29/2019] [Accepted: 12/02/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Duygu Erdil
- Istanbul Training and Research Hospital, Department of Dermatology Istanbul Turkey
| | - Ayşe E. Koku Aksu
- Istanbul Training and Research Hospital, Department of Dermatology Istanbul Turkey
| | - Tuğba Falay Gür
- Sultan Abdulhamid Han Training and Research Hospital, Department of Dermatology Istanbul Turkey
| | - Mehmet S. Gürel
- Medeniyet University Goztepe Training and Research Hospital, Department of Dermatology Istanbul Turkey
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8
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Rehabilitation and Prevention of Hand Eczema. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_71-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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9
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10
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Shepherd HL, Geerligs L, Butow P, Masya L, Shaw J, Price M, Dhillon HM, Hack TF, Girgis A, Luckett T, Lovell M, Kelly B, Beale P, Grimison P, Shaw T, Viney R, Rankin NM. The Elusive Search for Success: Defining and Measuring Implementation Outcomes in a Real-World Hospital Trial. Front Public Health 2019; 7:293. [PMID: 31681724 PMCID: PMC6813570 DOI: 10.3389/fpubh.2019.00293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/27/2019] [Indexed: 11/13/2022] Open
Abstract
Objective and Study Setting: Research efforts to identify factors that influence successful implementation are growing. This paper describes methods of defining and measuring outcomes of implementation success, using a cluster randomized controlled trial with 12 cancer services in Australia comparing the effectiveness of implementation strategies to support adherence to the Australian Clinical Pathway for the Screening, Assessment and Management of Anxiety and Depression in Adult Cancer Patients (ADAPT CP). Study Design and Methods: Using the StaRI guidelines, a process evaluation was planned to explore participant experience of the ADAPT CP, resources and implementation strategies according to the Implementation Outcomes Framework. This study focused on identifying measurable outcome criteria, prior to data collection for the trial, which is currently in progress. Principal Findings: We translated each implementation outcome into clearly defined and measurable criteria, noting whether each addressed the ADAPT CP, resources or implementation strategies, or a combination of the three. A consensus process defined measures for the primary outcome (adherence) and secondary (implementation) outcomes; this process included literature review, discussion and clear measurement parameters. Based on our experience, we present an approach that could be used as a guide for other researchers and clinicians seeking to define success in their work. Conclusions: Defining and operationalizing success in real-world implementation yields a range of methodological challenges and complexities that may be overcome by iterative review and engagement with end users. A clear understanding of how outcomes are defined and measured, based on a strong theoretical framework, is crucial to meaningful measurement and outcomes. The conceptual approach described in this article could be generalized for use in other studies. Trial Registration: The ADAPT Program to support the management of anxiety and depression in adult cancer patients: a cluster randomized trial to evaluate different implementation strategies of the Clinical Pathway for Screening, Assessment and Management of Anxiety and Depression in Adult Cancer Patients was prospectively registered with the Australian New Zealand Clinical Trials Registry Registration Number: ACTRN12617000411347.
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Affiliation(s)
- Heather L Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Sydney, NSW, Australia
| | - Liesbeth Geerligs
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Sydney, NSW, Australia
| | - Lindy Masya
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Melanie Price
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Sydney, NSW, Australia
| | - Thomas F Hack
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada.,Psychosocial Oncology & Cancer Nursing Research, St. Boniface Hospital Research Centre, Winnipeg, MB, Canada
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Tim Luckett
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Melanie Lovell
- HammondCare Northern Sydney, Greenwich, NSW, Australia.,Northern Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Philip Beale
- Cancer Services for the Sydney Local Health District (Incorporating Royal Prince Alfred, Concord and Canterbury Hospitals), Sydney, NSW, Australia
| | - Peter Grimison
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Tim Shaw
- Charles Perkins Centre, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, UTS Business School, University of Technology Sydney, Sydney, NSW, Australia
| | - Nicole M Rankin
- Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
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11
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Butow P, Shaw J, Shepherd HL, Price M, Masya L, Kelly B, Rankin NM, Girgis A, Hack TF, Beale P, Viney R, Dhillon HM, Coll J, Kelly P, Lovell M, Grimison P, Shaw T, Luckett T, Cuddy J, White F. Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial. BMC Cancer 2018. [PMID: 30404619 DOI: 10.1186/s12885‐018‐4962‐9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Health service change is difficult to achieve. One strategy to facilitate such change is the clinical pathway, a guide for clinicians containing a defined set of evidence-based interventions for a specific condition. However, optimal strategies for implementing clinical pathways are not well understood. Building on a strong evidence-base, the Psycho-Oncology Co-operative Research Group (PoCoG) in Australia developed an evidence and consensus-based clinical pathway for screening, assessing and managing cancer-related anxiety and depression (ADAPT CP) and web-based resources to support it - staff training, patient education, cognitive-behavioural therapy and a management system (ADAPT Portal). The ADAPT Portal manages patient screening and prompts staff to follow the recommendations of the ADAPT CP. This study compares the clinical and cost effectiveness of two implementation strategies (varying in resource intensiveness), designed to encourage adherence to the ADAPT CP over a 12-month period. METHODS This cluster randomised controlled trial will recruit 12 cancer service sites, stratified by size (large versus small), and randomised at site level to a standard (Core) versus supported (Enhanced) implementation strategy. After a 3-month period of site engagement, staff training and site tailoring of the ADAPT CP and Portal, each site will "Go-live", implementing the ADAPT CP for 12 months. During the implementation phase, all eligible patients will be introduced to the ADAPT CP as routine care. Patient participants will be registered on the ADAPT Portal to complete screening for anxiety and depression. Staff will be responsible for responding to prompts to follow the ADAPT CP. The primary outcome will be adherence to the ADAPT CP. Secondary outcomes include staff attitudes to and experiences of following the ADAPT CP, using the ADAPT Portal and being exposed to ADAPT implementation strategies, collected using quantitative and qualitative methods. Data will be collected at T0 (baseline, after site engagement), T1 (6 months post Go-live) and T2 (12 months post Go-live). DISCUSSION This will be the first cluster randomised trial to establish optimal levels of implementation effort and associated costs to achieve successful uptake of a clinical pathway within cancer care. TRIAL REGISTRATION The study was registered prospectively with the ANZCTR on 22/3/2017. Trial ID ACTRN12617000411347.
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Affiliation(s)
- Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Heather L Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Melanie Price
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Lindy Masya
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Brian Kelly
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Nicole M Rankin
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.,Cancer Council NSW, Woolloomooloo, NSW, Australia
| | - Afaf Girgis
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.,Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Kensington, Australia
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,CancerCare Manitoba Research Institute, Winnipeg, Canada
| | - Philip Beale
- Cancer Services for the Sydney Local Health District (Incorporating Royal Prince Alfred, Concord and Canterbury Hospitals, Campsie, NSW, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, Sydney, NSW, Australia
| | - Joseph Coll
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Patrick Kelly
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Melanie Lovell
- HammondCare Northern Sydney, Sydney, NSW, Australia.,Northern Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Peter Grimison
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Tim Shaw
- Charles Perkins Centre Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Tim Luckett
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), University of Technology Sydney, Ultimo, NSW, Australia
| | - Jessica Cuddy
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Fiona White
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
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12
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Butow P, Shaw J, Shepherd HL, Price M, Masya L, Kelly B, Rankin NM, Girgis A, Hack TF, Beale P, Viney R, Dhillon HM, Coll J, Kelly P, Lovell M, Grimison P, Shaw T, Luckett T, Cuddy J, White F. Comparison of implementation strategies to influence adherence to the clinical pathway for screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP): study protocol of a cluster randomised controlled trial. BMC Cancer 2018; 18:1077. [PMID: 30404619 PMCID: PMC6223096 DOI: 10.1186/s12885-018-4962-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/16/2018] [Indexed: 12/02/2022] Open
Abstract
Background Health service change is difficult to achieve. One strategy to facilitate such change is the clinical pathway, a guide for clinicians containing a defined set of evidence-based interventions for a specific condition. However, optimal strategies for implementing clinical pathways are not well understood. Building on a strong evidence-base, the Psycho-Oncology Co-operative Research Group (PoCoG) in Australia developed an evidence and consensus-based clinical pathway for screening, assessing and managing cancer-related anxiety and depression (ADAPT CP) and web-based resources to support it - staff training, patient education, cognitive-behavioural therapy and a management system (ADAPT Portal). The ADAPT Portal manages patient screening and prompts staff to follow the recommendations of the ADAPT CP. This study compares the clinical and cost effectiveness of two implementation strategies (varying in resource intensiveness), designed to encourage adherence to the ADAPT CP over a 12-month period. Methods This cluster randomised controlled trial will recruit 12 cancer service sites, stratified by size (large versus small), and randomised at site level to a standard (Core) versus supported (Enhanced) implementation strategy. After a 3-month period of site engagement, staff training and site tailoring of the ADAPT CP and Portal, each site will “Go-live”, implementing the ADAPT CP for 12 months. During the implementation phase, all eligible patients will be introduced to the ADAPT CP as routine care. Patient participants will be registered on the ADAPT Portal to complete screening for anxiety and depression. Staff will be responsible for responding to prompts to follow the ADAPT CP. The primary outcome will be adherence to the ADAPT CP. Secondary outcomes include staff attitudes to and experiences of following the ADAPT CP, using the ADAPT Portal and being exposed to ADAPT implementation strategies, collected using quantitative and qualitative methods. Data will be collected at T0 (baseline, after site engagement), T1 (6 months post Go-live) and T2 (12 months post Go-live). Discussion This will be the first cluster randomised trial to establish optimal levels of implementation effort and associated costs to achieve successful uptake of a clinical pathway within cancer care. Trial registration The study was registered prospectively with the ANZCTR on 22/3/2017. Trial ID ACTRN12617000411347
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Affiliation(s)
- Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Heather L Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Melanie Price
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Lindy Masya
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Brian Kelly
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Nicole M Rankin
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.,Cancer Council NSW, Woolloomooloo, NSW, Australia
| | - Afaf Girgis
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.,Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Kensington, Australia
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,CancerCare Manitoba Research Institute, Winnipeg, Canada
| | - Philip Beale
- Cancer Services for the Sydney Local Health District (Incorporating Royal Prince Alfred, Concord and Canterbury Hospitals, Campsie, NSW, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, Sydney, NSW, Australia
| | - Joseph Coll
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Patrick Kelly
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Melanie Lovell
- HammondCare Northern Sydney, Sydney, NSW, Australia.,Northern Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Peter Grimison
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Tim Shaw
- Charles Perkins Centre Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Tim Luckett
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), University of Technology Sydney, Ultimo, NSW, Australia
| | - Jessica Cuddy
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
| | - Fiona White
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, 2006, Australia
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Bauer A, Rönsch H, Elsner P, Dittmar D, Bennett C, Schuttelaar MA, Lukács J, John SM, Williams HC. Interventions for preventing occupational irritant hand dermatitis. Cochrane Database Syst Rev 2018; 4:CD004414. [PMID: 29708265 PMCID: PMC6494486 DOI: 10.1002/14651858.cd004414.pub3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Occupational irritant hand dermatitis (OIHD) causes significant functional impairment, disruption of work, and discomfort in the working population. Different preventive measures such as protective gloves, barrier creams and moisturisers can be used, but it is not clear how effective these are. This is an update of a Cochrane review which was previously published in 2010. OBJECTIVES To assess the effects of primary preventive interventions and strategies (physical and behavioural) for preventing OIHD in healthy people (who have no hand dermatitis) who work in occupations where the skin is at risk of damage due to contact with water, detergents, chemicals or other irritants, or from wearing gloves. SEARCH METHODS We updated our searches of the following databases to January 2018: the Cochrane Skin Specialised Register, CENTRAL, MEDLlNE, and Embase. We also searched five trials registers and checked the bibliographies of included studies for further references to relevant trials. We handsearched two sets of conference proceedings. SELECTION CRITERIA We included parallel and cross-over randomised controlled trials (RCTs) which examined the effectiveness of barrier creams, moisturisers, gloves, or educational interventions compared to no intervention for the primary prevention of OIHD under field conditions. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. The primary outcomes were signs and symptoms of OIHD developed during the trials, and the frequency of treatment discontinuation due to adverse effects. MAIN RESULTS We included nine RCTs involving 2888 participants without occupational irritant hand dermatitis (OIHD) at baseline. Six studies, including 1533 participants, investigated the effects of barrier creams, moisturisers, or both. Three studies, including 1355 participants, assessed the effectiveness of skin protection education on the prevention of OIHD. No studies were eligible that investigated the effects of protective gloves. Among each type of intervention, there was heterogeneity concerning the criteria for assessing signs and symptoms of OIHD, the products, and the occupations. Selection bias, performance bias, and reporting bias were generally unclear across all studies. The risk of detection bias was low in five studies and high in one study. The risk of other biases was low in four studies and high in two studies.The eligible trials involved a variety of participants, including: metal workers exposed to cutting fluids, dye and print factory workers, gut cleaners in swine slaughterhouses, cleaners and kitchen workers, nurse apprentices, hospital employees handling irritants, and hairdressing apprentices. All studies were undertaken at the respective work places. Study duration ranged from four weeks to three years. The participants' ages ranged from 16 to 67 years.Meta-analyses for barrier creams, moisturisers, a combination of both barrier creams and moisturisers, or skin protection education showed imprecise effects favouring the intervention. Twenty-nine per cent of participants who applied barrier creams developed signs of OIHD, compared to 33% of the controls, so the risk may be slightly reduced with this measure (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.72 to 1.06; 999 participants; 4 studies; low-quality evidence). However, this risk reduction may not be clinically important. There may be a clinically important protective effect with the use of moisturisers: in the intervention groups, 13% of participants developed symptoms of OIHD compared to 19% of the controls (RR 0.71, 95% CI 0.46 to 1.09; 507 participants; 3 studies; low-quality evidence). Likewise, there may be a clinically important protective effect from using a combination of barrier creams and moisturisers: 8% of participants in the intervention group developed signs of OIHD, compared to 13% of the controls (RR 0.68, 95% CI 0.33 to 1.42; 474 participants; 2 studies; low-quality evidence). We are uncertain whether skin protection education reduces the risk of developing signs of OIHD (RR 0.76, 95% CI 0.54 to 1.08; 1355 participants; 3 studies; very low-quality evidence). Twenty-one per cent of participants who received skin protection education developed signs of OIHD, compared to 28% of the controls.None of the studies addressed the frequency of treatment discontinuation due to adverse effects of the products directly. However, in three studies of barrier creams, the reasons for withdrawal from the studies were unrelated to adverse effects. Likewise, in one study of moisturisers plus barrier creams, and in one study of skin protection education, reasons for dropout were unrelated to adverse effects. The remaining studies (one to two in each comparison) reported dropouts without stating how many of them may have been due to adverse reactions to the interventions. We judged the quality of this evidence as moderate, due to the indirectness of the results. The investigated interventions to prevent OIHD probably cause few or no serious adverse effects. AUTHORS' CONCLUSIONS Moisturisers used alone or in combination with barrier creams may result in a clinically important protective effect, either in the long- or short-term, for the primary prevention of OIHD. Barrier creams alone may have slight protective effect, but this does not appear to be clinically important. The results for all of these comparisons were imprecise, and the low quality of the evidence means that our confidence in the effect estimates is limited. For skin protection education, the results varied substantially across the trials, the effect was imprecise, and the pooled risk reduction was not large enough to be clinically important. The very low quality of the evidence means that we are unsure as to whether skin protection education reduces the risk of developing OIHD. The interventions probably cause few or no serious adverse effects.We conclude that at present there is insufficient evidence to confidently assess the effectiveness of interventions used in the primary prevention of OIHD. This does not necessarily mean that current measures are ineffective. Even though the update of this review included larger studies of reasonable quality, there is still a need for trials which apply standardised measures for the detection of OIHD in order to determine the effectiveness of the different prevention strategies.
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Affiliation(s)
- Andrea Bauer
- University Hospital Carl Gustav Carus, Technical University DresdenDepartment of DermatologyFetscherstr. 74DresdenGermany01307
| | - Henriette Rönsch
- University Hospital Carl Gustav Carus, Technical University DresdenDepartment of DermatologyFetscherstr. 74DresdenGermany01307
| | - Peter Elsner
- Friedrich Schiller UniversityDepartment of Dermatology and AllergologyErfurter Strasse 35JenaGermanyD 07743
| | - Daan Dittmar
- University Medical Center GroningenDepartment of DermatologyHanzeplein 1GroningenNetherlands9713 GZ
| | - Cathy Bennett
- Coventry UniversityCentre for Innovative Research Across the Life Course (CIRAL)Richard Crossman BuildingGosford StreetCoventryUKCV1 5FB
| | | | - Judit Lukács
- University Hospital JenaDepartment of DermatologyErfurter Str. 35JenaGermany07743
| | - Swen Malte John
- University of OsnabrueckDepartment of Dermatology, Environmental Medicine, Health TheorySedanstr 115OsnabrueckGermanyDE 49069
| | - Hywel C Williams
- University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
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Japundžić I, Novak D, Kuna M, Novak-Bilić G, Lugović-Mihić L. Analysis of Dental Professionals' and Dental Students' Care for their Skin. Acta Stomatol Croat 2018; 52:46-52. [PMID: 30034004 PMCID: PMC6050747 DOI: 10.15644/asc52/1/7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives To determine prevalence of undesirable, work-related skin lesions and their
localizations in dental professionals and students, and to collect data
about diagnostic procedures they undergo and skin care they take when these
lesions occur. Subjects and methods Our research included 444 respondents (dentists, dental assistants, dental
technicians, dental students) who filled out a questionnaire. They were
asked to specify if they had observed any lesions on their skin and where;
if they had undergone any treatments and in what way; if they had undergone
any allergy tests; and if they had taken any protective measures. Results Of all the respondents that took part in the survey, 249 (56.1%) reported
undesirable skin reactions commonly on their hands and fingers (96%). Before
our survey, only 15% of them had seen a dermatologist, while 33% had
undergone allergy tests (without a dermatologists’ clinical
examination). Also, 45% of them sometimes used soaps for sensitive skin and
the majority (61%) of them used protective hand creams 1-2 times per
day. Conclusion Although a large number of dental professionals and students have noticed
work-related skin lesions, only some of them sought dermatologists’
professional help and most of them did not take care of their skin
adequately when those lesions occurred. According to the results of this
study, it is necessary to take additional preventive measures to increase
dental professionals’ and students’ awareness of occupational
dermatoses and adequate skin care.
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Affiliation(s)
- Iva Japundžić
- Clinical Department of Dermatovenereology, University Hospital Centre "Sestre milosrdnice", Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Dario Novak
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Matea Kuna
- Clinical Department of Dermatovenereology, University Hospital Centre "Sestre milosrdnice", Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Gaby Novak-Bilić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Liborija Lugović-Mihić
- Clinical Department of Dermatovenereology, University Hospital Centre "Sestre milosrdnice", Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Rasmussen CDN, Højberg H, Bengtsen E, Jørgensen MB. Identifying knowledge gaps between practice and research for implementation components of sustainable interventions to improve the working environment - A rapid review. APPLIED ERGONOMICS 2018; 67:178-192. [PMID: 29122189 DOI: 10.1016/j.apergo.2017.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 06/09/2017] [Accepted: 09/24/2017] [Indexed: 06/07/2023]
Abstract
In a recent study, we involved all relevant stakeholders to identify practice-based implementation components for successful implementation and sustainability in work environment interventions. To understand possible knowledge gaps between evidence and practice, the aim of this paper is to investigate if effectiveness studies of the 11 practice-based implementation components can be identified in existing scientific literature. PubMed/MEDLINE, PsycINFO, and Web of Science were searched for relevant studies. After screening, 38 articles met the inclusion criteria. Since some of the studies describe more than one practice-based implementation concept a total of 125 quality criteria assessments were made. The overall result is that 10 of the 11 practice-based implementation components can be found in the scientific literature, but the evaluation of them is poor. From this review it is clear that there are knowledge gaps between evidence and practice with respect to the effectiveness of implementation concepts.
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Affiliation(s)
| | - Helene Højberg
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Elizabeth Bengtsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Marie Birk Jørgensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
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Alfonso J, Bauer A, Bensefa-Colas L, Boman A, Bubas M, Constandt L, Crepy M, Goncalo M, Macan J, Mahler V, Mijakoski D, Ramada Rodilla J, Rustemeyer T, Spring P, John S, Uter W, Wilkinson M, Giménez-Arnau A. Minimum standards on prevention, diagnosis and treatment of occupational and work-related skin diseases in Europe - position paper of the COST Action StanDerm (TD 1206). J Eur Acad Dermatol Venereol 2017; 31 Suppl 4:31-43. [DOI: 10.1111/jdv.14319] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 12/23/2022]
Affiliation(s)
- J.H. Alfonso
- Department of Occupational Medicine and Epidemiology; National Institute of Occupational Health; Oslo Norway
| | - A. Bauer
- Department of Dermatology; University Allergy Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - L. Bensefa-Colas
- Department of Occupational and Environmental Diseases; AP-HP; Paris Descartes University; Sorbonne Paris Cité; Paris France
- Laboratoire Santé Publique et Environnement; Paris France
| | - A. Boman
- Institute of Environmental Medicine; Occupational and Environmental Dermatology; Stockholm Sweden
| | - M. Bubas
- Department for Education and Information; Croatian Institute for Health Protection and Safety at Work; Zagreb Croatia
| | - L. Constandt
- Fedris, Agence Fédérale des risques professionnels; Brussels Belgium
| | - M.N. Crepy
- Department of Occupational and Environmental Diseases; AP-HP; Paris Descartes University; Sorbonne Paris Cité; Paris France
| | - M. Goncalo
- Clinic of Dermatology; University Hospital and Faculty of Medicine; University of Coimbra; Coimbra Portugal
| | - J. Macan
- Unit for Occupational and Environmental Health; Institute for Medical Research and Occupational Health; Zagreb Croatia
| | - V. Mahler
- Department of Dermatology; University Hospital of Erlangen; Erlangen Germany
| | - D. Mijakoski
- Institute for Occupational Health of Republic of Macedonia; Skopje Macedonia
| | - J.M. Ramada Rodilla
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM); CIBER de Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
| | - T. Rustemeyer
- Department of Dermatology and Allergology; VU University Medical Centre; Amsterdam The Netherlands
| | - P. Spring
- Department of Dermatology; University of Lausanne; Lausanne Switzerland
| | - S.M. John
- Department of Dermatology, Environmental Medicine; University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Lower-Saxony Institute of Occupational Dermatology (NIB); Osnabrück Germany
| | - W. Uter
- Department of Medical Informatics, Biometry and Epidemiology; Friedrich-Alexander Universität Erlangen/Nürnberg; Erlangen Germany
| | | | - A.M. Giménez-Arnau
- Department of Dermatology; Hospital del Mar; Institut Mar d´Investigacions Mèdiques (IMIM); Universitat Autònoma de Barcelona; Barcelona Spain
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Mollerup A, Harboe G, Johansen JD. User evaluation of patient counselling, combining nurse consultation and eHealth in hand eczema. Contact Dermatitis 2016; 74:205-16. [PMID: 26822623 DOI: 10.1111/cod.12534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 12/08/2015] [Accepted: 12/08/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE This study reports the findings from a user evaluation of a counselling programme for hand eczema patients in which face-to-face encounters were supplemented with user access to a new website. PATIENTS AND METHODS Patients treated for hand eczema in two different settings were included consecutively. Website utilization was examined by use of the transaction log. Comparisons were made between participants who used the website and those who did not. The patients' perspectives were explored by the use of interviews. RESULTS Among potential website users (n = 140), 88 patients (63%) had an average of 5.1 site visits. At follow-up, the website users had improved more in quality of life (p = 0.014), current burden of disease (p = 0.053), and itching (p = 0.042). The website users reported more changes in habits than did the non-website users (p = 0.024). No differences in clinical severity of hand eczema were found. The interviewees were generally satisfied with the counselling and the website. The strict log-on procedures were considered to be an obstacle to using the site. The consecutive inclusion of participants was considered to be a barrier to engagement in the dialogue forum. CONCLUSIONS The website users benefited from the website, although this was not substantiated by clinical measurements. The trial design partly hampered website utilization. An initial feasibility study could have been warranted.
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Affiliation(s)
- Annette Mollerup
- The National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark
| | - Gitte Harboe
- Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark
| | - Jeanne D Johansen
- The National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark
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Meding B, Anveden Berglind I, Alderling M, Lindahl G, Wrangsjö K. Water exposure - challenging differences between occupations. Contact Dermatitis 2015; 74:22-8. [DOI: 10.1111/cod.12479] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/24/2015] [Accepted: 09/09/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Birgitta Meding
- Unit of Occupational and Environmental Dermatology; Institute of Environmental Medicine, Karolinska Institutet; SE-171 77 Stockholm Sweden
| | - Ingegärd Anveden Berglind
- Department of Medicine, Solna; Centre for Pharmaco-Epidemiology, Karolinska Institutet; SE-171 77 Stockholm Sweden
| | - Magnus Alderling
- Department of Public Health Sciences; Karolinska Institutet; SE-171 77 Stockholm Sweden
| | - Gunborg Lindahl
- Unit of Occupational and Environmental Dermatology; Institute of Environmental Medicine, Karolinska Institutet; SE-171 77 Stockholm Sweden
| | - Karin Wrangsjö
- Unit of Occupational and Environmental Dermatology; Institute of Environmental Medicine, Karolinska Institutet; SE-171 77 Stockholm Sweden
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Lhakhang P, Lippke S, Knoll N, Schwarzer R. Evaluating brief motivational and self-regulatory hand hygiene interventions: a cross-over longitudinal design. BMC Public Health 2015; 15:79. [PMID: 25649150 PMCID: PMC4323073 DOI: 10.1186/s12889-015-1453-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Frequent handwashing can prevent infections, but non-compliance to hand hygiene is pervasive. Few theory- and evidence-based interventions to improve regular handwashing are available. Therefore, two intervention modules, a motivational and a self-regulatory one, were designed and evaluated. METHODS In a longitudinal study, 205 young adults, aged 18 to 26 years, were randomized into two intervention groups. The Mot-SelfR group received first a motivational intervention (Mot; risk perception and outcome expectancies) followed by a self-regulatory intervention (SelfR; perceived self-efficacy and planning) 17 days later. The SelfR-Mot group received the same two intervention modules in the opposite order. Follow-up data were assessed 17 and 34 days after the baseline. RESULTS Both intervention sequences led to an increase in handwashing frequency, intention, self-efficacy, and planning. Also, overall gains were found for the self-regulatory module (increased planning and self-efficacy levels) and the motivational module (intention). Within groups, the self-regulatory module appeared to be more effective than the motivational module, independent of sequence. CONCLUSIONS Self-regulatory interventions can help individuals to exhibit more handwashing. Sequencing may be important as a motivation module (Mot) first helps to set the goal and a self-regulatory module (SelfR) then helps to translate this goal into actual behavior, but further research is needed to evaluate mechanisms.
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Affiliation(s)
- Pempa Lhakhang
- Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
| | - Sonia Lippke
- Jacobs University Bremen gGmbH, Campus Ring 1, 28759, Bremen, Germany.
| | - Nina Knoll
- Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
| | - Ralf Schwarzer
- Institute for Positive Psychology and Education, Australian Catholic University, 25A Barker Road, Strathfield, NSW, 2135, Australia. .,Department of Psychology, University of Social Sciences and Humanities, ul, Ostrowskiego 30b, 53-238, Wroclaw, Poland.
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