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Wärjerstam S, Dew-Hattens C, Rasmussen M, Heitmann BL, Raffing R, Tønnesen H. Preferences for Follow-Up Procedures among Patients Lost to Follow-Up after Smoking Cessation Intervention among Therapists-An Interview Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:726. [PMID: 38928972 PMCID: PMC11203566 DOI: 10.3390/ijerph21060726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/28/2024]
Abstract
Achieving high follow-up rates after smoking cessation interventions (SCIs) is a general challenge. The aim of this study was to identify preferences among patients and therapists for improving follow-up rates and to assess smoking status at 6 months among patients lost to follow-up. From the Danish STOPbase for Tobacco and Nicotine, which collects data on SCI across health care, 20 representative patients lost to follow-up by routine procedures were identified together with 11 therapists. All participated in individual semi-structured phone interviews, which for patients also included 6-month smoking status. Deductive and inductive analyses were performed. Four themes emerged from the analyses with several subthemes, all regarding contacts. Both patients and therapists preferred to intensify the follow-up process by boosting it with additional attempts and using voice messages, e-mail and/or SMS, calling at specified times of the day and avoiding calls from unknown numbers. In addition, some patients mentioned that they were busy or were not carrying their mobile devices at the time of a call as a barrier. Some therapists mentioned that barriers could include an expectation of relapse, but also a poor mental state, the time of day and patient fear of public systems. Among the patients originally lost to follow-up, 35% (95% CI 16%-59%) experienced continuous smoking cessation for 6 months, and the overall national rate was 22% (21.6-23.3%). In conclusion, both patients and therapists preferred intensified follow-up. The 6-month smoking status for patients lost to follow-up seemed to be similar to that of the routinely followed-up patients. These findings will be examined experimentally in a larger study.
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Affiliation(s)
- Sanne Wärjerstam
- WHO Collaborating Centre, Clinical Health Promotion Centre, Research Unit for Dietary Studies, The Parker Institute, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, DK-2400 Copenhagen, Denmark
| | - Camilla Dew-Hattens
- WHO Collaborating Centre, Clinical Health Promotion Centre, Research Unit for Dietary Studies, The Parker Institute, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, DK-2400 Copenhagen, Denmark
| | - Mette Rasmussen
- WHO Collaborating Centre, Clinical Health Promotion Centre, Research Unit for Dietary Studies, The Parker Institute, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, DK-2400 Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, DK-1455 Copenhagen, Denmark
| | - Berit Lilienthal Heitmann
- WHO Collaborating Centre, Clinical Health Promotion Centre, Research Unit for Dietary Studies, The Parker Institute, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, DK-2400 Copenhagen, Denmark
- Section for General Practice, Department of Public Health, University of Copenhagen, DK-1172 Copenhagen, Denmark
| | - Rie Raffing
- WHO Collaborating Centre, Clinical Health Promotion Centre, Research Unit for Dietary Studies, The Parker Institute, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, DK-2400 Copenhagen, Denmark
| | - Hanne Tønnesen
- WHO Collaborating Centre, Clinical Health Promotion Centre, Research Unit for Dietary Studies, The Parker Institute, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, DK-2400 Copenhagen, Denmark
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Hijdra RW, Robroek SJW, Sadigh Y, Burdorf A, Schuring M. The effects of an interdisciplinary employment program on paid employment and mental health among persons with severe mental disorders. Int Arch Occup Environ Health 2024; 97:253-262. [PMID: 38200231 PMCID: PMC10944804 DOI: 10.1007/s00420-023-02039-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE This study evaluates the effects of the interdisciplinary employment program 'Work As Best Care (WABC)' on employment participation and mental health of persons with severe mental disorders. METHODS WABC is a 'work first' employment program for unemployed persons with severe mental disorders in which employment professionals work closely together with mental health professionals. In a longitudinal non-randomized controlled study, participants of WABC (n = 35) are compared with participants of the control group (n = 37), who received regular employment support. Participants were followed for 1 year and filled out questionnaires on individual characteristics and health at baseline, after 6 and 12 months. This information was enriched with monthly register data on employment status from 2015 until 2020. Difference-in-differences analyses were performed to investigate changes in employment participation among participants of WABC and the control group. A generalized linear mixed-effects model was used to compare changes in mental health (measured on 0-100 scale) between the two groups. RESULTS Before WABC, employment participation was 22.0%points lower among participants of WABC compared to the control group. After starting WABC, employment participation increased with 15.3%points per year among participants of WABC, compared to 5.6%points in the control group. Among all participants of WABC, no change in mental health was found (β 1.0, 95% CI - 3.4; 5.5). Only female participants of WABC showed a significant change in mental health (β 8.0, 95% CI 2.6; 13.4). CONCLUSION To enhance employment participation of persons with severe mental disorders, an interdisciplinary 'work-first' approach in which professionals of employment services and mental health services work in close collaboration, is of paramount importance.
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Affiliation(s)
- R W Hijdra
- Department of Public Health, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000, Rotterdam, CA, The Netherlands
| | - S J W Robroek
- Department of Public Health, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000, Rotterdam, CA, The Netherlands
| | - Y Sadigh
- Department of Public Health, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000, Rotterdam, CA, The Netherlands
| | - A Burdorf
- Department of Public Health, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000, Rotterdam, CA, The Netherlands
| | - M Schuring
- Department of Public Health, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000, Rotterdam, CA, The Netherlands.
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Hussaini SMQ, Ren Y, Racioppi A, Lew MV, Bohannon L, Johnson E, Li Y, Thompson JC, Henshall B, Darby M, Choi T, Lopez RD, Sarantopoulos S, Gasparetto C, Long GD, Horwitz ME, Chao NJ, Zafar SY, Sung AD. Financial Toxicity and Quality of Life in Patients Undergoing Stem-Cell Transplant Evaluation: A Single-Center Analysis. JCO Oncol Pract 2024; 20:351-360. [PMID: 38127876 DOI: 10.1200/op.23.00243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/27/2023] [Accepted: 10/23/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE We investigated the prevalence of financial toxicity in a population undergoing hematopoietic cell transplantation (HCT) evaluation and measured its impact on post-transplant clinical and health-related quality-of-life outcomes. MATERIALS AND METHODS This was a prospective study in patients undergoing evaluation for allogeneic HCT between January 1, 2018, and September 23, 2020, at a large academic medical center. Financial health was measured via a baseline survey and the comprehensive score for financial toxicity-functional assessment of chronic illness therapy (COST-FACIT) survey. The cohort was divided into three groups: none (grade 0), mild (grade 1), and moderate-high financial toxicity (grades 2-3). Health-related quality of life outcomes were measured at multiple time points. Multivariate logistic regression analysis evaluated factors associated with financial toxicity. Kaplan-Meier curves and log-rank tests was used to evaluate overall survival (OS) and nonrelapse survival. RESULTS Of 245 patients evaluated for transplant, 176 (71.8%) completed both questionnaires (median age was 57 years, 63.1% were male, 72.2% were White, and 39.2% had myelodysplastic syndrome, 38.1% leukemia, and 13.6% lymphoma). At initial evaluation, 83 (47.2%) patients reported no financial toxicity, 51 (29.0%) with mild, and 42 (23.9%) with moderate-high financial toxicity. Patients with financial toxicity reported significant cost-cutting behaviors, including reduced spending on food or clothing, using their savings, or not filling a prescription because of costs (P < .0001). Quality of life was lower in patients with moderate-high financial toxicity at 6 months (P = .0007) and 1 year (P = .0075) after transplant. Older age (>62; odds ratio [OR], 0.33 [95% CI, 0.13 to 0.79]; P = .04) and income ≥$60,000 in US dollars (USD) (OR, 0.17 [95% CI, 0.08 to 0.38]; P < .0001) were associated with lower odds of financial toxicity. No association was noted between financial toxicity and selection for transplant, OS, or nonrelapse mortality. CONCLUSION Financial toxicity was highly correlated with patient-reported changes in compensatory behavior, with notable impact on patient quality of life after transplant.
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Affiliation(s)
- S M Qasim Hussaini
- O'Neal Comprehensive Cancer, University of Alabama at Birmingham, Birmingham, AL
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Yi Ren
- Duke Cancer Institute Biostatistics Shared Resource, Durham, NC
| | | | - Meagan V Lew
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Lauren Bohannon
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Ernaya Johnson
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Yan Li
- Duke Cancer Institute Biostatistics Shared Resource, Durham, NC
| | - Jillian C Thompson
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Bethany Henshall
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Maurisa Darby
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Taewoong Choi
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Richard D Lopez
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | | | - Cristina Gasparetto
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Gwynn D Long
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Mitchell E Horwitz
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Nelson J Chao
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - S Yousuf Zafar
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Anthony D Sung
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
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Dragano N, Burr H, Formazin M, Schulz A, Rose U. [Long Working and Commuting Times as Risk Factors for Depressive Symptoms: Cross-Sectional and Longitudinal Analyses]. DAS GESUNDHEITSWESEN 2023; 85:1016-1026. [PMID: 37972582 PMCID: PMC11135465 DOI: 10.1055/a-2090-1553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Hintergrund Regelmäßige lange Arbeitszeiten und Arbeitswege könnten negative Folgen für die psychische Gesundheit haben. Die Studienergebnisse hierzu sind jedoch nicht eindeutig und variieren nach Ländern. Die vorliegende Analyse prüft für Deutschland Zusammenhänge zwischen langen Pendel- bzw. Arbeitszeiten und depressiver Symptomatik. Methode Die „Studie Mentale Gesundheit bei der Arbeit“ (S-MGA) ist eine Längsschnittuntersuchung einer Zufallsstichprobe sozialversicherungspflichtig Beschäftigter. An der Basiserhebung nahmen 3 413 Personen teil, von denen 2 019 nach 5 Jahren erneut befragt wurden. Wöchentliche Arbeits- und Pendelzeiten sowie Covariaten (Alter, Geschlecht, berufliche Position, psychosoziale Arbeitsbedingungen) wurden zur Basisuntersuchung erhoben. Depressive Symptome wurden zu beiden Messzeitpunkten mit dem Patient Health Questionnaire (PHQ-9) erfasst. Um Zusammenhänge zu untersuchen, wurden mittels logistischer Regression Odds Ratios mit 95%-Konfidenzintervallen unter Kontrolle von Covariaten kalkuliert. Es wurden sowohl Querschnitts- (nur Basiserhebung) als auch Längsschnittsanalysen (Basis- und Nacherhebung) durchgeführt. Ergebnisse Zur Basiserhebung hatten 7% der Beschäftigten lange wöchentliche Arbeitszeiten von≥55 Stunden, weitere 8% arbeiteten 49 bis 54 Stunden. Im Querschnitt waren lange Arbeitszeiten mit einer moderaten Erhöhung der depressiven Symptomatik gegenüber der Normalarbeitszeit (35 bis<40 h/Wo) assoziiert. Wenn die nach fünf Jahren neu auftretende depressive Symptomatik betrachtet wurde, war der Zusammenhang für Arbeitszeiten von 55 und mehr Stunden deutlich ausgeprägt (Odds ratio (OR) 2,14; 95% Konfidenzintervall (KI) 1,11;4,12), nicht jedoch für Arbeitszeiten von 49 bis 54 Stunden (OR 1,26, KI 0,65;2,43). Beschäftigte, die wöchentlich zehn Stunden und mehr pendelten, hatten im Querschnitt häufiger eine depressive Symptomatik (OR 1,83; KI 1,13;2,94) im Vergleich zur Referenzgruppe, die<2,5 Stunden pendelte. Dieser Zusammenhang war im Längsschnitt nicht zu beobachten. Schlussfolgerungen Die Ergebnisse legen nahe, dass überlange Arbeits- und Pendelzeiten mit einer depressiven Symptomatik bei Beschäftigten assoziiert sind, wobei die Effekte bzgl. Pendelzeit nur im Querschnitt zu finden waren. Die Ergebnisse unterstreichen die Bedeutung der Einhaltung von Arbeitszeitregelungen und der Vermeidung überlanger Arbeitszeiten für die Mitarbeitergesundheit. Zur Rolle des Pendelns sind weiterführende Untersuchungen nötig.
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Affiliation(s)
- Nico Dragano
- Institut für Medizinische Soziologie,
Universitätsklinikum Düsseldorf, Düsseldorf,
Germany
| | - Hermann Burr
- Fachbereich 3 Arbeit und Gesundheit, Bundesanstalt für
Arbeitsschutz und Arbeitsmedizin Standort Berlin, Berlin, Germany
| | - Maren Formazin
- Fachbereich 3 Arbeit und Gesundheit, Bundesanstalt für
Arbeitsschutz und Arbeitsmedizin Standort Berlin, Berlin, Germany
| | - Anika Schulz
- Fachbereich 3 Arbeit und Gesundheit, Bundesanstalt für
Arbeitsschutz und Arbeitsmedizin Standort Berlin, Berlin, Germany
| | - Uwe Rose
- Fachbereich 3 Arbeit und Gesundheit, Bundesanstalt für
Arbeitsschutz und Arbeitsmedizin Standort Berlin, Berlin, Germany
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Hare MM, Walker CS, Sarver DE, Lim CS, Brown DC, Annett RD. Assessing attitudes towards pediatric research participation across diverse populations: Psychometric properties of a novel tool. Contemp Clin Trials 2023; 133:107321. [PMID: 37652358 PMCID: PMC10591922 DOI: 10.1016/j.cct.2023.107321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/09/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Clinical trials play a crucial role in advancing medical knowledge and improving health outcomes. However, there is a recognized need for greater representation of marginalized groups to ensure that research findings can be generalized and effectively applied to all individuals. While the Pediatric Research Participation Questionnaire (PRPQ) was developed to assist pediatric clinical trials research by identifying benefits and barriers to research participation among children with chronic medical conditions, there is still limited insight into the structure of the PRPQ when administered in diverse samples, including the general pediatric population. Therefore, the current study examined the factor structure of the PRPQ in a general pediatric population to investigate whether rural-urban differences exist in the PRPQ factor structure. METHODS Caregivers (N = 600) of children under age 18 completed the PRPQ in a population-based survey in Mississippi. Sampling was stratified to ensure equal representation in rural (n = 300) and urban areas (n = 300). Exploratory and confirmatory factor analyses were conducted to determine the factor structure of the PRPQ. RESULTS A five-factor structure was identified, compromising: social pressure, direct benefit, reasons for participation, mistrust in research/researchers, reasons against participation. While results were similar among urban participants, a three-factor structure emerged for rural participants. CONCLUSIONS This study contributes to the broader understanding of research participation among underrepresented groups. The findings suggest that clinical researchers should consider tailoring recruitment strategies to increase clinical trial participation among children in rural areas. Understanding factors that influence pediatric research participation, particularly among marginalized communities, is crucial for developing effective recruitment and retention strategies.
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Affiliation(s)
- Megan M Hare
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL 33199, USA
| | - Courtney S Walker
- Center for Advancement of Youth, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39110, USA; Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS 39110, USA
| | - Dustin E Sarver
- Center for Advancement of Youth, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39110, USA; Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS 39110, USA.
| | - Crystal S Lim
- Department of Health Psychology, University of Missouri, Columbia, MO 65211, USA
| | - Dustin C Brown
- Department of Sociology and Social Science Research Center, Mississippi State University, Mississippi State, MS 39762, USA
| | - Robert D Annett
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
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Sommacal A, Bingisser R, Filippi A, Bethke M, Thieringer FM, Jaquiéry C, Berg BI. Dental and Maxillofacial Emergency Algorithms in Swiss Emergency Departments. J Clin Med 2023; 12:jcm12082952. [PMID: 37109288 PMCID: PMC10144593 DOI: 10.3390/jcm12082952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/28/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to evaluate the availability and use of dental and maxillofacial emergency algorithms in Swiss hospitals. A survey was performed among physicians at Swiss emergency departments (ED) and participants of the "36th Annual Meeting of the Society for Oral and Cranio-Maxillofacial Surgery". Eighty-nine EDs in Switzerland were questioned about the availability and use of electronic algorithms in their hospitals. Eighty-one (91%) participated in the study. In 75 (93%) of the EDs, electronic algorithms are used, mainly "medStandards". Six have no available algorithms. Fifty-two (64%) use algorithms daily. Eight (10%) Swiss EDs have maxillofacial and dental algorithms, and 73 (90%) have no access to or do not know about them. For dental algorithms, 28 (38%) of the respondents would like to have access, and 16 (22%) do not desire access. For maxillofacial algorithms, 23 (32%) want to have access and 21 (29%) do not want it. Most (74%) of the participating maxillofacial surgeons did not know about the existence of ED algorithms regarding their specialty. Our study shows that the existence of specific algorithms is often not known. Furthermore, there is a demand for dental and maxillofacial algorithms in Swiss EDs.
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Affiliation(s)
- Adelita Sommacal
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
| | - Roland Bingisser
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Emergency Department, University Hospital Basel, 4031 Basel, Switzerland
| | - Andreas Filippi
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Clinic of Oral Surgery and Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland
| | - Mascha Bethke
- Emergency Department, University Hospital Basel, 4031 Basel, Switzerland
| | - Florian M Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Swiss MAM Research Group, Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Claude Jaquiéry
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
| | - Britt-Isabelle Berg
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
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Cagliero D, Deuitch N, Shah N, Feudtner C, Char D. A framework to identify ethical concerns with ML-guided care workflows: a case study of mortality prediction to guide advance care planning. J Am Med Inform Assoc 2023; 30:819-827. [PMID: 36826400 PMCID: PMC10114055 DOI: 10.1093/jamia/ocad022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE Identifying ethical concerns with ML applications to healthcare (ML-HCA) before problems arise is now a stated goal of ML design oversight groups and regulatory agencies. Lack of accepted standard methodology for ethical analysis, however, presents challenges. In this case study, we evaluate use of a stakeholder "values-collision" approach to identify consequential ethical challenges associated with an ML-HCA for advanced care planning (ACP). Identification of ethical challenges could guide revision and improvement of the ML-HCA. MATERIALS AND METHODS We conducted semistructured interviews of the designers, clinician-users, affiliated administrators, and patients, and inductive qualitative analysis of transcribed interviews using modified grounded theory. RESULTS Seventeen stakeholders were interviewed. Five "values-collisions"-where stakeholders disagreed about decisions with ethical implications-were identified: (1) end-of-life workflow and how model output is introduced; (2) which stakeholders receive predictions; (3) benefit-harm trade-offs; (4) whether the ML design team has a fiduciary relationship to patients and clinicians; and, (5) how and if to protect early deployment research from external pressures, like news scrutiny, before research is completed. DISCUSSION From these findings, the ML design team prioritized: (1) alternative workflow implementation strategies; (2) clarification that prediction was only evaluated for ACP need, not other mortality-related ends; and (3) shielding research from scrutiny until endpoint driven studies were completed. CONCLUSION In this case study, our ethical analysis of this ML-HCA for ACP was able to identify multiple sites of intrastakeholder disagreement that mark areas of ethical and value tension. These findings provided a useful initial ethical screening.
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Affiliation(s)
- Diana Cagliero
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Natalie Deuitch
- Department of Genetics, Stanford University School of Medicine, Stanford, California, USA
- National Institutes of Health, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Nigam Shah
- Center for Biomedical Informatics Research, Stanford University School of Medicine, Palo Alto, California, USA
| | - Chris Feudtner
- The Department of Medical Ethics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Departments of Pediatrics, Medical Ethics and Healthcare Policy, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Danton Char
- Division of Pediatric Cardiac Anesthesia, Department of Anesthesiology, Stanford University School of Medicine, Stanford, California, USA
- Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California, USA
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Goetti P, Achkar J, Sandman E, Balg F, Rouleau DM. Phone Administration of the Western Ontario Shoulder Instability Index Is More Reliable Than Administration via Email. Clin Orthop Relat Res 2023; 481:84-93. [PMID: 35943525 PMCID: PMC9750603 DOI: 10.1097/corr.0000000000002320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 06/21/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND The Western Ontario Shoulder Instability (WOSI) questionnaire is a 21-item questionnaire to evaluate quality of life in patients with shoulder instability. Completing the questionnaire is time-consuming because each item is evaluated on a visual analog scale. Telephone or email versions of the score are appealing alternatives to administering it during the standard in-person patient visit; however, their validity and reliability remain unknown. QUESTIONS/PURPOSES (1) Does the numerical scale (NS) version of the WOSI correlate with the original WOSI and Quick-DASH? (2) Do telephone and email administration of the NS-WOSI have good reliability and consistency? (3) Compared with the original WOSI form, does the NS form lead to faster completion for patients and quicker data extraction for researchers? METHODS Between 2014 and 2019, 50 patients with a documented history of shoulder dislocation with persistent symptomatic shoulder instability, whether anterior, posterior, or multidirectional; patients scheduled for surgery; and patients with traumatic or nontraumatic injuries were prospectively recruited from the outpatient clinic of two university hospitals acting as Level 1 trauma centers and sports traumatology tertiary referral centers. The median (IQR) age was 28 years (24 to 36), and 80% (40 of 50) were men. Most (52% [26 of 50]) patients had two to five lifetime shoulder dislocations. Validity of the NS-WOSI was assessed using the Pearson correlation coefficient during an in-person visit; the original WOSI questionnaire (or its previously validated French-language version), NS-WOSI, and Quick-DASH questionnaires were administered in a random order. After a minimum 7-day interval, 78% (39 of 50) of patients completed the phone interview, and 74% (37 of 50) of patients completed the email version of the NS-WOSI score to evaluate NS-WOSI's reliability using the intraclass correlation coefficient (ICC), which was interpreted as poor (< 0.5), moderate (0.50-0.75), strong (0.75-0.90), and very strong (> 0.90). The standard error of measurement (SEM) was used to evaluate variability around the true score, with a low value indicating a high reliability. The 95% minimal detectable change (MDC 95% ) was calculated to evaluate the minimal change in score that was not related to measurement errors. Lastly, the Cronbach alpha was used to assess internal consistency (intercorrelation strength), where a value > 0.70 was considered good. The time needed for the patient to complete the various versions and for researchers to extract data was recorded. RESULTS The NS-WOSI score was very strongly correlated with the original WOSI score (r = 0.96 [95% confidence interval (CI) 0.93 to 0.98]; p < 0.001). Although telephone-acquired and email-acquired data for the NS-WOSI questionnaires were correlated with the NS-WOSI (telephone r = 0.91 [95% CI 0.83 to 0.95]; p < 0.001; email r = 0.84 [95% CI 0.71 to 0.91]; p < 0.001), the ICC was higher for telephone interviews (0.92 [95% CI 0.86 to 0.96] versus email 0.80 [95% CI 0.64 to 0.89]), indicating that although both had good reliability, the phone interview was more suitable. The phone interview was also preferable to email regarding SEM (3% [52 of 2100 points] versus 6% [132 of 2100 points]) and the MDC 95% (7% [144 of 2100 points] versus 17% [366 of 2100 points]). The 95% CI of the MDC acquired by email was superior to the reported minimum clinically important difference for the original WOSI (7% [152 of 2100 points]), meaning that an error of measurement could wrongly be interpreted as a clinically significant change in score. Internal consistency was deemed good, with a Cronbach alpha of 0.96 (95% CI 0.92 to 98) and 0.89 (95% CI 0.79 to 0.94) for NS-WOSI telephone and email, respectively. The time to complete the NS-WOSI was reduced compared with the original WOSI (221 ± 153 seconds versus 266 ± 146 seconds, mean difference -45 seconds [95% CI -72 to -12]; p = 0.009). Lastly, data extraction was faster (62 ± 15 seconds versus 209 ± 52 seconds, mean difference -147 seconds [95% CI -164 to -130]; p < 0.001) with the NS-WOSI than with the original WOSI. CONCLUSION The NS-WOSI in person, by telephone, or by email is a valid, reliable, and timesaving alternative to the original WOSI questionnaire. However, the reliability of data acquisition by telephone interviews was superior to that of email. CLINICAL RELEVANCE Given that there were no important differences in performance for the NS-WOSI, regardless of whether it was administered in person or by phone, we suggest that physicians use both interchangeably based on patient convenience. However, we do not recommend using the email version, especially for research purposes, since it was not as reliable when compared with in-person administration. The responsiveness of the modified NS-WOSI, as well as factors influencing response rates to phone interview, are questions that remain to be explored.
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Affiliation(s)
- Patrick Goetti
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Department of Orthopaedics and Traumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jacquelina Achkar
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Emilie Sandman
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- CIUSSS (Centre Intégré Universitaire de Santé et des Servives Sociaux) du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Frédéric Balg
- Centre Intégré Universitaire de Santé et des Servives Sociaux CIUSSS-de-l’Estrie-Centre Hospitalier Universitaire Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Dominique M. Rouleau
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- CIUSSS (Centre Intégré Universitaire de Santé et des Servives Sociaux) du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
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Fries J, Kovacs K, Zeilinger EL, Pietschnig J. Is There a "Gifted Personality"? Initial Evidence for Differences between MENSA and General Population Members in the HEXACO Personality Inventory. J Intell 2022; 10:jintelligence10040092. [PMID: 36412773 PMCID: PMC9680308 DOI: 10.3390/jintelligence10040092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022] Open
Abstract
Contrary to the common notion that personality and intelligence are unrelated constructs, numerous correlational studies have demonstrated substantial associations between the two domains. Moreover, samples of intellectually gifted individuals have been found to differ from the general population in specific aspects of their personalities. However, most studies so far have relied on the Five-Factor Model of Personality (FFM), while none have investigated this phenomenon using the HEXACO personality framework. We recruited 617 adult members of the international high-IQ society MENSA and compared them to 3 reference samples (combined N = 112,637) regarding their personalities as measured by the HEXACO-60 personality inventory. We found that gifted persons scored higher in Honesty-Humility and Conscientiousness but lower in Emotionality compared to reference samples. Interestingly, gifted individuals scored only slightly higher in Openness to Experience, and no consistent differences emerged for Agreeableness. We demonstrate that some known personality differences between gifted and non-gifted persons translate from the FFM to the HEXACO model, while others do not. Our results indicate that within the HEXACO factor structure differences in sociability are more pronounced, while intellect-related differences are comparatively weak.
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Affiliation(s)
- Jonathan Fries
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, 1010 Vienna, Austria
- Correspondence:
| | - Kristof Kovacs
- Institute of Psychology, ELTE Eotvos Lorand University Budapest, 1053 Budapest, Hungary
| | - Elisabeth L. Zeilinger
- Clinical Division of Palliative Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Jakob Pietschnig
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, 1010 Vienna, Austria
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Linde F, Rydberg M, Zimmerman M. Surgically Treated Carpal Tunnel Syndrome and Ulnar Nerve Entrapment at the Elbow in Different Occupations and their Effect on Surgical Outcome. J Occup Environ Med 2022; 64:e369-e373. [PMID: 35543630 PMCID: PMC9275840 DOI: 10.1097/jom.0000000000002539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVE We investigated whether certain occupations were over-represented among surgically treated carpal tunnel syndrome and ulnar entrapment at the elbow, and if manual occupation affected surgical outcome. METHODS We included 9030 patients operated for CTS and 1269 for UNE registered in the Swedish National Quality Register for Hand Surgery (HAKIR) 2010-2016. Occupational data was retrieved from Statistics Sweden. Outcome was assessed using the QuickDASH questionnaire. RESULTS In patients operated for CTS, there were more assistant nurses, attendants/care providers/personal assistants, nannies/student assistants, carpenters/bricklayers/construction workers, cleaners, nurses, and vehicle mechanics than in the general population. In the UNE population, assistant nurses and attendants/care providers/personal assistants were over-represented. Manual workers with CTS scored the preoperative QuickDASH higher than non-manual workers. CONCLUSIONS Manual workers are overrepresented among surgically treated CTS and UNE. Manual workers with CTS have more symptoms preoperatively than non-manual workers.
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Differential item functioning to validate setting of delivery compatibility in PROMIS-global health. Qual Life Res 2022; 31:2189-2200. [PMID: 35050447 DOI: 10.1007/s11136-022-03084-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Patient-reported outcomes measures (PROMs) such as PROMIS are increasingly utilized in healthcare to assess patient perception and functional status, but the effect of delivery setting remains to be fully investigated. To our knowledge, no current study establishes the absence of differential item functioning (DIF) across delivery setting for these PROMIS- Global Health (PROMIS-GH) measures among orthopedic patients. We sought to investigate the correlation of PROMIS-GH scores across in-clinic versus remote delivery by evaluating DIF within the Global Physical Health (GPH) and Global Mental Health (GMH) items. We hypothesize that the setting of delivery of the GPH and GMH domains of PROMIS-GH will not impact the results of the measure, allowing direct comparison between the two delivery settings. METHODS Five thousand and seven hundred and eighty-five complete PROMIS-Global Health measures were analyzed retrospectively using the 'Lordif' package on the R platform. DIF was measured for GPH and GMH domains across setting of response (in-clinic vs remote) during the pre-operative period, immediate post-operative period, and 1-year post-operative period using Monte Carlo estimation. McFadden pseudo-R2 thresholds (> 0.02) were used to assess the magnitude of DIF for individual PROMIS items. RESULTS No GPH or GMH items contained in the PROMIS-GH instrument yielded DIF across in-clinic vs remote delivery setting during the pre-operative, immediate post-operative, or 1-year post-operative window. CONCLUSION The GPH and GMH domains within the PROMIS-GH instrument may be delivered in the clinic or remotely with comparable accuracy. This cross-delivery setting validation analysis may aid to improve the quality of patient care by allowing mixed platform PROMIS-GH data tailored to individual patient circumstance.
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12
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Ghoshal A, O'Carroll RE, Ferguson E, Shepherd L, Doherty S, Mathew M, Morgan K, Doyle F. Assessing medical mistrust in organ donation across countries using item response theory. J Health Psychol 2021; 27:2806-2819. [PMID: 34963351 DOI: 10.1177/13591053211064985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although medical mistrust (MM) may be an impediment to public health interventions, no MM scale has been validated across countries and the assessment of MM has not been explored using item response theory, which allows generalisation beyond the sampled data. We aimed to determine the dimensionality of a brief MM measure across four countries through Mokken analysis and Graded Response Modelling. Analysis of 1468 participants from UK (n = 1179), Ireland (n = 191), India (n = 49) and Malaysia (n = 49) demonstrated that MM items formed a hierarchical, unidimensional measure, which is very informative about high levels of MM. Possible item reduction and scoring changes were also demonstrated. This study demonstrates that this brief MM measure is suitable for international studies as it is unidimensional across countries, cross cultural, and shows that minor adjustments will not impact on the assessment of MM when using these items.
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Affiliation(s)
- Arunangshu Ghoshal
- Tata Memorial Centre, India.,Homi Bhaba National Institute (HBNI), India
| | | | | | | | | | | | - Karen Morgan
- Perdana University-Royal College of Surgeons in Ireland School of Medicine, Malaysia
| | - Frank Doyle
- Royal College of Surgeons in Ireland, Ireland
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Schneider S, Junghaenel DU, Zelinski EM, Meijer E, Stone AA, Langa KM, Kapteyn A. Subtle mistakes in self-report surveys predict future transition to dementia. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12252. [PMID: 34934800 PMCID: PMC8652408 DOI: 10.1002/dad2.12252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/30/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION We investigate whether indices of subtle reporting mistakes derived from responses in self-report surveys are associated with dementia risk. METHODS We examined 13,831 participants without dementia from the prospective, population-based Health and Retirement Study (mean age 69 ± 10 years, 59% women). Participants' response patterns in 21 questionnaires were analyzed to identify implausible responses (multivariate outliers), incompatible responses (Guttman errors), acquiescent responses, random errors, and the proportion of skipped questions. Subsequent incident dementia was determined over up to 10 years of follow-up. RESULTS During follow-up, 2074 participants developed dementia and 3717 died. Each of the survey response indices was associated with future dementia risk controlling for confounders and accounting for death as a competing risk. Stronger associations were evident for participants who were younger and cognitively normal at baseline. DISCUSSION Mistakes in the completion of self-report surveys in longitudinal studies may be early indicators of dementia among middle-aged and older adults.
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Affiliation(s)
- Stefan Schneider
- Dornsife Center for Self‐Report Science & Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Leonard Davis School of GerontologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Doerte U. Junghaenel
- Dornsife Center for Self‐Report Science & Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Leonard Davis School of GerontologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Elizabeth M. Zelinski
- Leonard Davis School of GerontologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Erik Meijer
- Dornsife Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Arthur A. Stone
- Dornsife Center for Self‐Report Science & Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Kenneth M. Langa
- Department of Internal MedicineInstitute for Social Research and VA Center for Clinical Management ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Arie Kapteyn
- Dornsife Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
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Eliasen EH, Weihe P, Petersen MS. The Faroese Septuagenarians cohort: A comparison of well-being before and during the COVID-19 pandemic among older home-dwelling Faroese. Scand J Public Health 2021; 50:136-143. [PMID: 34727762 DOI: 10.1177/14034948211056209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Despite success in avoiding morbidity and mortality in the oldest members of the population during the COVID-19 pandemic, the crisis may have affected the well-being of older adults, for example due to social distancing measures. The aim of this study was to examine the well-being of older Faroese by conducting a direct comparison of well-being indicators on the same group of elderly people before and during the COVID-19 pandemic. METHODS Data were collected from 227 home-dwelling adults aged 82-86 years from the Faroese Septuagenarians cohort. The pre-COVID-19 period was from December 2017 to January 2019, and the COVID-19 period was from 8 June to 15 July 2020. Three aspects of well-being were assessed: loneliness, self-rated health and quality of life (WHOQOL-BREF). RESULTS During the COVID-19 pandemic, there were significant increases in loneliness (21.8% vs. 6.8%; p<0.001) and in worse self-rated health compared to the previous year (37.2% vs. 19.0%; p<0.001). In terms of quality of life, the domains of overall quality of life (74.33±14.96 vs. 71.88±15.21; p=0.04) and physical health (73.81±17.11 vs. 71.66±17.37; p=0.03) deteriorated. On the other hand, the domains of social relationships (78.87±16.52 vs. 85.81±13.35; p<0.001), environment (82.49±10.78 vs. 87.06±7.88; p<0.001) and psychological health (77.07±11.52 vs. 80.53±10.89; p<0.001) improved during the pandemic. CONCLUSIONS Our findings suggest that attention should be directed to loneliness and physical well-being amongst home-dwelling old adults, despite the elderly showed resilience and improved psychological health, social relations and environment domains in a quality of life assessment during the COVID-19 pandemic.
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Affiliation(s)
- Eina H Eliasen
- Department of Occupational Medicine and Public Health, the Faroese Hospital System, Faroe Islands
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, the Faroese Hospital System, Faroe Islands.,Center of Health Sciences, University of the Faroe Islands, Faroe Islands
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, the Faroese Hospital System, Faroe Islands.,Center of Health Sciences, University of the Faroe Islands, Faroe Islands
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Gal DB, Deuitch N, Lee SSJ, Simon RT, Char DS. Parental Attitudes Toward Clinical Genomic Sequencing in Children With Critical Cardiac Disease. Pediatr Crit Care Med 2021; 22:e419-e426. [PMID: 33591072 PMCID: PMC8357848 DOI: 10.1097/pcc.0000000000002669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Through improving diagnostics and prognostics genomic sequencing promises to significantly impact clinical decisions for children with critical cardiac disease. Little is known about how families of children with critical cardiac disease perceive the impact of genomic sequencing on clinical care choices. DESIGN Qualitative interview study. SETTING A high-volume, tertiary pediatric heart center. SUBJECTS Families of children with critical cardiac disease. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Thematic analysis of interview response content. Thirty-five families were interviewed. Three themes emerged: 1) benefits versus challenges of having genomic sequencing results, and 2) fears of clinical applications of genomic sequencing, and 3) nonclinical fears related to genomic sequencing. Participants struggled with perceived uses of genomic sequencing-derived knowledge. They described comfort in foreknowledge of their child's likely disease course but articulated significant apprehension around participating in care decisions with limited knowledge of genomic sequencing, genomic sequencing uses to inform clinical resource rationing decisions, and genomic sequencing uses by third parties impacting financial pressures families experience caring for a child with critical cardiac disease. CONCLUSIONS Families' perceptions of genomic sequencing uses in critical cardiac disease appear to strain their overall trust in the health system. Erosion of trust is concerning because the potential of genomic sequencing in critical cardiac disease will be unrealized if families are unwilling to undergo genomic sequencing, let alone to participate in the ongoing research needed to link genomic sequencing variants to clinical outcomes. Our findings may have implications for genomic sequencing use in children with other critical, high-acuity diseases.
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Affiliation(s)
- Dana B Gal
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
- Lucile Packard Children's Hospital Stanford, Palo Alto, CA
| | - Natalie Deuitch
- Center for Biomedical Ethics, Stanford University School of Medicine, Palo Alto, CA
| | - Sandra Soo Jin Lee
- Division of Ethics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | | | - Danton S Char
- Center for Biomedical Ethics, Stanford University School of Medicine, Palo Alto, CA
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA
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Raja A, Spertus J, Yeh RW, Secemsky EA. Assessing health-related quality of life among patients with peripheral artery disease: A review of the literature and focus on patient-reported outcome measures. Vasc Med 2021; 26:317-325. [PMID: 33295253 PMCID: PMC8169614 DOI: 10.1177/1358863x20977016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Peripheral artery disease (PAD) is a progressive atherosclerotic disease associated with high rates of morbidity and mortality. Symptomatic PAD typically presents with claudication, and symptom severity strongly associates with reduced health-related quality of life (HRQoL). Existing treatment strategies for PAD are aimed at reducing symptom severity and improving functional outcomes. However, there is a need to incorporate patient-reported outcome measures (PROMs) into PAD treatment and research in order to provide more patient-centered care. This review will discuss the impact of PAD on HRQoL, existing PROMs available to assess PAD-related HRQoL, utilization of PROMs in research studies and registries, and challenges and solutions related to the integration of PROMs into research and clinical settings.
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Affiliation(s)
- Aishwarya Raja
- Richard A and Susan F Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - John Spertus
- Department of Cardiovascular Medicine, Saint Luke’s Mid America Heart Institute, Kansas City, MO, USA
| | - Robert W Yeh
- Richard A and Susan F Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Eric A Secemsky
- Richard A and Susan F Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Kuprasertkul A, Christie AL, Zimmern P. A standardized telephone interview with validated questionnaires for very long‐term evaluation of women lost to follow‐up after a stress urinary incontinence procedure. Low Urin Tract Symptoms 2021; 13:366-371. [DOI: 10.1111/luts.12378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/24/2021] [Accepted: 03/15/2021] [Indexed: 11/29/2022]
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Intra-Articular Injections Prior to Total Knee Arthroplasty Do Not Increase the Risk of Periprosthetic Joint Infection: A Prospective Cohort Study. Antibiotics (Basel) 2021; 10:antibiotics10030330. [PMID: 33801092 PMCID: PMC8004162 DOI: 10.3390/antibiotics10030330] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 01/28/2023] Open
Abstract
Periprosthetic joint infections (PJI) occur in 0.5 to 2.8% of total knee arthroplasties (TKA) and expose them to an increase of morbidity and mortality. TKA are mainly performed after failure of non-surgical management of knee osteoarthritis, which frequently includes intra-articular injections of corticosteroids or hyaluronic acid. Concerning the potential impact of intra-articular injections on TKA infection, literature provides a low level of evidence because of the retrospective design of the studies and their contradictory results. In this prospective cohort study, we included patients after a total knee arthroplasty, at the time of their admission in a rehabilitation center, and we excluded patients with any prior knee surgery. 304 patients were included. Mean follow-up was 24.9 months, and incidence proportion of PJI was 2.6%. After multivariate logistic regression, male was the only significant risk factor of PJI (OR = 19.6; p = 0.006). The incidence of PJI did not differ between patients who received prior intra-articular injections and others, especially regarding injections in the last 6 months before surgery. The use of intra-articular injection remains a valid therapeutic option in the management of knee osteoarthritis, and a TKA could still be discussed.
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Investigating the Bias in Orthopaedic Patient-reported Outcome Measures by Mode of Administration: A Meta-analysis. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2020; 4:e20.00194. [PMID: 33986216 PMCID: PMC7721213 DOI: 10.5435/jaaosglobal-d-20-00194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 11/18/2022]
Abstract
Background: Patient-reported outcome measures (PROMs) are critical and frequently used to assess clinical outcomes to support medical decision-making. Questions/Purpose: The purpose of this meta-analysis was to compare differences in the modes of administration of PROMs within the field of orthopaedics to determine their impact on clinical outcome assessment. Patients and Methods: The PubMed database was used to conduct a review of literature from 1990 to 2018 with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. All articles comparing PROMs for orthopaedic procedures were included and classified by the mode of administration. Each specific survey was standardized to a scale of 0 to 100, and a repeated random effectsmodel meta-analysis was conducted to determine the mean effect of each mode of survey. Results: Eighteen studies were initially included in the study, with 10 ultimately used in the meta-analysis that encompassed 2384 separate patient survey encounters. Six of these studies demonstrated a statistically notable difference in PROM scores by mode of administration. The meta-analysis found that the standardized mean effect size for telephone-based surveys on a 100-point scale was 71.7 (SE 5.0) that was significantly higher (P , 0.0001) than survey scores obtained via online/tech based (65.3 [SE 0.70]) or self-administered/paper surveys (61.2 [SE 0.70]). Conclusions: Overall, this study demonstrated that a documented difference exists in PROM quality depending on the mode of administration. PROM scores obtained via telephone (71.7) are 8.9% higher than scores obtained online (65.3, P , 0.0001), and 13.8% higher than scores obtained via self-administered on paper (61.8, P , 0.0001). Few studies have quantified statistically notable differences between PROM scores based solely on the mode of acquisition in orthopaedic
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Sinow C, Burgart A, Char DS. How Anesthesiologists Experience and Negotiate Ethical Challenges from Drug Shortages. AJOB Empir Bioeth 2020; 12:84-91. [PMID: 33124970 DOI: 10.1080/23294515.2020.1839596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND In the face of ongoing drug shortages, anesthesiologists have been described as having to become "Iron Chefs, challenged to create safe patient outcomes with missing ingredients. Unfortunately, developing responsive ethical guidance for how anesthesiologists should best handle ethical concerns with ongoing and mutable drug shortages is limited by the dearth of studies examining how bedside clinicians actually experience drug shortages and what ethical challenges they encounter. In order to better understand what ethical concerns individual anesthesiologists experience around drug shortages and how they negotiate them, we undertook this qualitative interview study. Methods: We conducted semi-structured interviews with anesthesiologists at three field sites: an academic tertiary care adult hospital that performs approximately 46,000 anesthetics annually comprising cases ranging across all surgical disciplines; the affiliated veteran's affairs hospital that performs 12,000 anesthetics annually; and, the affiliated children's hospital that performs 20,500 anesthetics annually. Results: 29 anesthesiologists were interviewed (17 adult and 12 pediatric anesthesiologists), representing a spectrum of practice areas in clinical anesthesia: general, pediatric, regional, pain, critical care, obstetrics, liver transplant, and palliative medicine. Three themes emerged: (1) uncertainty about responsibility for clinical decisions made in consequence to a shortage; (2) creativity, and its limits, in choosing anesthetic plans; and, (3) disclosure of concerns about shortages (to patients and colleagues). Conclusions: Our data suggests anesthesiologists have unmet needs for ethical guidance on how to approach drug shortages. First is managing responsibility for decisions stemming from a drug shortage. Second, interviewees struggled with disclosure of their concerns, both to patients and to surgical colleagues. A formal shared decision making approach may present the best solution, since the act of structuring a shared decision making conversation or creating a decision making tool will have to incorporate the views of all stakeholders around shortages and their potential clinical consequences.
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Affiliation(s)
- Carolyn Sinow
- Division of Obstetrics and Gynecology, Kaiser Permanente Santa Clara, Santa Clara, California, USA
| | - Alyssa Burgart
- Department of Anesthesiology, School of Medicine Division of Pediatric Anesthesia, Stanford University, Stanford, California, USA.,Center for Biomedical Ethics, School of Medicine, Stanford University, Stanford, California, USA
| | - Danton S Char
- Department of Anesthesiology, School of Medicine Division of Pediatric Cardiac Anesthesia, Stanford University, Stanford, California, USA.,Center for Biomedical Ethics, School of Medicine, Stanford University, Stanford, California, USA
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21
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Braekman E, Charafeddine R, Demarest S, Drieskens S, Berete F, Gisle L, Van der Heyden J, Van Hal G. Comparing web-based versus face-to-face and paper-and-pencil questionnaire data collected through two Belgian health surveys. Int J Public Health 2020; 65:5-16. [PMID: 31993674 DOI: 10.1007/s00038-019-01327-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/10/2019] [Accepted: 12/30/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Using the European Health Interview Survey (EHIS) questionnaire, a web-based survey was organized alongside a face-to-face (F2F) survey including a paper-and-pencil (P&P) questionnaire for sensitive topics. Associated with these different modes, other design features varied too (e.g., recruitment, incentives, sampling). We assessed whether these whole data collection systems developed around the modes produced equivalent health estimates. METHODS Data were obtained from two population-based surveys: the EHISWEB (web-administered, n = 1010) and the Belgian Health Interview Survey 2018 (BHIS2018) (interviewer-administered, n = 2748). Logistic regression analyses were used to assess mode system differences while adjusting for socio-demographic differences in the net samples. RESULTS For the P&P mode of the BHIS, significant mode system differences were detected for 2 of the 9 health indicators. Among the indicators collected via the F2F mode, 9 of the 18 indicators showed significant differences. CONCLUSIONS Indicators collected via the web-based and P&P self-administered modes were generally more comparable than indicators collected via the web-based and F2F mode. Furthermore, fewer differences were detected for indicators based on simple and factual questions compared to indicators based on subjective or complex questions.
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Affiliation(s)
- Elise Braekman
- Department Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium.
- Unit of Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
| | - Rana Charafeddine
- Department Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Stefaan Demarest
- Department Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Sabine Drieskens
- Department Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Finaba Berete
- Department Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Lydia Gisle
- Department Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Johan Van der Heyden
- Department Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Guido Van Hal
- Unit of Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
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22
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Kamdar BB, Suri R, Suchyta MR, Digrande KF, Sherwood KD, Colantuoni E, Dinglas VD, Needham DM, Hopkins RO. Return to work after critical illness: a systematic review and meta-analysis. Thorax 2020; 75:17-27. [PMID: 31704795 PMCID: PMC7418481 DOI: 10.1136/thoraxjnl-2019-213803] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/11/2019] [Accepted: 09/01/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Survivors of critical illness often experience poor outcomes after hospitalisation, including delayed return to work, which carries substantial economic consequences. OBJECTIVE To conduct a systematic review and meta-analysis of return to work after critical illness. METHODS We searched PubMed, Embase, PsycINFO, CINAHL and Cochrane Library from 1970 to February 2018. Data were extracted, in duplicate, and random-effects meta-regression used to obtain pooled estimates. RESULTS Fifty-two studies evaluated return to work in 10 015 previously employed survivors of critical illness, over a median (IQR) follow-up of 12 (6.25-38.5) months. By 1-3, 12 and 42-60 months' follow-up, pooled return to work prevalence (95% CI) was 36% (23% to 49%), 60% (50% to 69%) and 68% (51% to 85%), respectively (τ2=0.55, I2=87%, p=0.03). No significant difference was observed based on diagnosis (acute respiratory distress syndrome (ARDS) vs non-ARDS) or region (Europe vs North America vs Australia/New Zealand), but was observed when comparing mode of employment evaluation (in-person vs telephone vs mail). Following return to work, 20%-36% of survivors experienced job loss, 17%-66% occupation change and 5%-84% worsening employment status (eg, fewer work hours). Potential risk factors for delayed return to work include pre-existing comorbidities and post-hospital impairments (eg, mental health). CONCLUSION Approximately two-thirds, two-fifths and one-third of previously employed intensive care unit survivors are jobless up to 3, 12 and 60 months following hospital discharge. Survivors returning to work often experience job loss, occupation change or worse employment status. Interventions should be designed and evaluated to reduce the burden of this common and important problem for survivors of critical illness. TRIAL REGISTRATION NUMBER PROSPERO CRD42018093135.
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Affiliation(s)
- Biren B Kamdar
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla, California, USA
| | - Rajat Suri
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Mary R Suchyta
- InstaCare, Intermountain Health Care, Salt Lake City, Utah, USA
| | - Kyle F Digrande
- Department of Medicine, University of California Irvine, Irvine, California, USA
| | - Kyla D Sherwood
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Elizabeth Colantuoni
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins University-Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Victor D Dinglas
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ramona O Hopkins
- Center for Humanizing Critical Care, Intermountain Health Care, Murray, Utah, USA
- Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah, USA
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23
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Deuitch N, Soo-Jin Lee S, Char D. Translating genomic testing results for pediatric critical care: Opportunities for genetic counselors. J Genet Couns 2019; 29:78-87. [PMID: 31701594 DOI: 10.1002/jgc4.1182] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022]
Abstract
Genomic sequencing (GS), such as whole genome and exome sequencing, is rapidly being integrated into pediatric critical care settings. Results are being used to make high impact decisions including declarations of futility, withdrawal of care, and rationing of scarce resources. In this qualitative study, we conducted interviews with clinicians involved in the care of critically ill children with congenital heart disease (CHD) to investigate their views on implementation of GS into clinical practice. Interviews were transcribed and inductively analyzed for major themes using grounded theory and thematic analysis. Three major themes emerged surrounding the use of genomic information in the high-stakes, time pressured decision making that characterizes clinical care of critically ill children with CHD: (a) that clinicians felt they did not have sufficient training to accurately assess genetic results despite pressure to incorporate results into clinical decisions; (b), that they desire knowledge support from genetic specialists, such as genetic counselors, who both understand the critical care context and are available within the time constraints of critical care clinical pressures; and (c), that clinicians feel a pressing need for increased genetics education to be able to safely and appropriately incorporate GS results into clinical decisions Our data suggest that genetics specialists may need a stronger presence in the pediatric critical care setting.
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Affiliation(s)
- Natalie Deuitch
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Sandra Soo-Jin Lee
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Danton Char
- Department of Anesthesiology, Perioperative and Pain Management, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, CA, USA
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24
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Te M, Blackstock F, Chipchase L. Fostering cultural responsiveness in physiotherapy: curricula survey of Australian and Aotearoa New Zealand physiotherapy programs. BMC MEDICAL EDUCATION 2019; 19:326. [PMID: 31470833 PMCID: PMC6717323 DOI: 10.1186/s12909-019-1766-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 08/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Developing cultural responsiveness among physiotherapists is considered essential to promote quality and equity in healthcare provision for our culturally diverse populations. The aim of this study was to evaluate how entry-level physiotherapy programs in Australia and Aotearoa New Zealand (NZ) design curricula to foster the development of cultural responsiveness in physiotherapy students. Further, the challenges of integrating educational content and approaches, and the perceptions of the effectiveness of these curricula were also explored. METHODS A cross-sectional telephone survey with closed and open-ended questions, was conducted with 18 participants representing 24 entry-level physiotherapy programs (82% of all programs) in Australia and NZ between May and September 2017. Data were analysed descriptively in the form of frequencies, percentages or ratios as appropriate. Open-ended responses were thematically analysed. RESULTS Results suggest variability in the structure, and teaching and assessment methods used across all programs. The majority of programs appeared to rely on didactic teaching methods, along with knowledge based and implicit assessment methods. The main challenges reported were that cultural responsiveness was thought to be perceived by academic staff as unimportant and that the curriculum was perceived to be 'overcrowded'. Participants also felt there was room for improvement despite perceiving the curriculum to be effective at fostering cultural responsiveness. CONCLUSION Results provide insight into the educational content and approaches integrated in entry-level physiotherapy curricula in Australia and NZ, and suggest opportunities for further research and development to foster cultural responsiveness among physiotherapy students.
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Affiliation(s)
- Maxine Te
- School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Felicity Blackstock
- School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lucy Chipchase
- School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
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25
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Differences in Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey Scores by Recency of the Last Visit: Implications for Comparability of Periodic and Continuous Sampling. Med Care 2019; 57:e80-e86. [PMID: 31107400 DOI: 10.1097/mlr.0000000000001134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient experience data can be collected by sampling patients periodically (eg, patients with any visits over a 1-year period) or sampling visits continuously (eg, sampling any visit in a monthly interval). Continuous sampling likely yields a sample with more frequent and more recent visits, possibly affecting the comparability of data collected under the 2 approaches. OBJECTIVE To explore differences in Consumer Assessment of Healthcare Providers and Systems Clinician and Group survey (CG-CAHPS) scores using periodic and continuous sampling. RESEARCH DESIGN We use observational data to estimate case-mix-adjusted differences in patient experience scores under 12-month periodic sampling and simulated continuous sampling. SUBJECTS A total of 29,254 adult patients responding to the CG-CAHPS survey regarding visits in the past 12 months to any of 480 physicians, 2007-2009. MEASURES Overall doctor rating and 4 CG-CAHPS composite measures of patient experience: doctor communication, access to care, care coordination, and office staff. RESULTS Compared with 12-month periodic sampling, simulated continuous sampling yielded patients with more recent visits (by definition), more frequent visits (92% of patients with 2+ visits, compared with 76%), and more positive case-mix-adjusted CAHPS scores (2-3 percentage points higher). CONCLUSIONS Patients with more frequent visits reported markedly higher CG-CAHPS scores, but this causes only small to moderate changes in adjusted physician-level scores between 12-month periodic and continuous sampling schemes. Caution should be exercised in trending or comparing scores collected through different schemes.
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26
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Clausen T, Conway PM, Burr H, Kristensen TS, Hansen ÅM, Garde AH, Hogh A. Does leadership support buffer the effect of workplace bullying on the risk of disability pensioning? An analysis of register-based outcomes using pooled survey data from 24,538 employees. Int Arch Occup Environ Health 2019; 92:941-948. [PMID: 30982156 DOI: 10.1007/s00420-019-01428-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate whether self-reported exposure to workplace bullying predicts the risk of disability pensioning among employees in two occupational groups-(1) employees working with clients or customers and (2) office workers and manual workers-and whether leadership support and occupational group moderates that association. METHODS Survey data from 24,538 employees (112,889 person years) were fitted to a national register containing information on disability-pension payments. Using multi-adjusted Cox-regression analysis, observations were followed in the register to assess the risk of disability pensioning. The average follow-up time was 4.6 years (standard deviation [SD] = 1.5). RESULTS Self-reported exposure to workplace bullying predicted an increased risk of disability pensioning (hazard ratio [HR] = 1.46; 95% confidence interval [CI]: 1.15-1.86). This association was moderated by leadership support: the association between workplace bullying and disability pensioning was significantly different for respondents who reported low leadership support (HR = 1.97; 95% CI: 1.38-2.80) compared to respondents who reported medium (HR = 1.03; 95% CI: 0.60-1.76) or high leadership support (HR = 1.08; 95% CI: 0.60-1.95). Further analyses showed similar associations between workplace bullying and the risk of disability pensioning among the two occupational groups. CONCLUSIONS Self-reported workplace bullying increases the risk of disability pensioning, and this association is buffered by leadership support. Workplace bullying should be considered an important workplace stressor. This study indicates that workplaces may enhance worker retention by actively promoting measures to eliminate the occurrence of workplace bullying and to enhance leadership support.
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Affiliation(s)
- Thomas Clausen
- National Research Centre for the Working Environment, Lersoe Parkalle 105, 2100, Copenhagen, Denmark.
| | | | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | | | - Åse Marie Hansen
- National Research Centre for the Working Environment, Lersoe Parkalle 105, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Helene Garde
- National Research Centre for the Working Environment, Lersoe Parkalle 105, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Annie Hogh
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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27
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Lange S, Burr H, Conway PM, Rose U. Workplace bullying among employees in Germany: prevalence estimates and the role of the perpetrator. Int Arch Occup Environ Health 2018; 92:237-247. [PMID: 30390155 PMCID: PMC6341046 DOI: 10.1007/s00420-018-1366-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/21/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of this study was to examine the prevalence of workplace bullying in Germany while also taking the perpetrator and severity level (measured by frequency) into account and considering the role of gender, age and socio-economic status. METHODS We used data from a large representative sample (N = 4143) of employees in Germany subject to social security contributions. Self-reported bullying was assessed for different combinations of perpetrators (co-workers, superiors) and according to severity, i.e., being exposed at all and to severe bullying (at least weekly). RESULTS Prevalence estimates varied from 2.9% for severe bullying by co-workers to 17.1% for overall bullying (i.e., without distinguishing by perpetrator, less severe bullying also included). Unskilled workers reported more bullying by both perpetrators than academics/managers. We also observed an age trend for severe bullying by superiors (i.e., bossing), with younger employees being more affected from bossing than elder. No gender differences were detected. CONCLUSIONS The findings indicate that it is crucial to consider type of perpetrator and severity of the behaviors when examining the prevalence of workplace bullying. The way bullying is defined and operationalized strongly contributes to the prevalence estimates. Differences between subgroups and associations or cause-effect relationships should be analyzed with these variations in mind.
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Affiliation(s)
- Stefanie Lange
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstraße 40-42, 10317 Berlin, Germany
| | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstraße 40-42, 10317 Berlin, Germany
| | | | - Uwe Rose
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstraße 40-42, 10317 Berlin, Germany
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28
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Panza GA, Armstrong LE, Taylor BA, Puhl RM, Livingston J, Pescatello LS. Weight bias among exercise and nutrition professionals: a systematic review. Obes Rev 2018; 19:1492-1503. [PMID: 30176183 DOI: 10.1111/obr.12743] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/20/2018] [Accepted: 06/28/2018] [Indexed: 12/16/2022]
Abstract
Obesity affects approximately one-third of American adults. Recent evidence suggests that weight bias may be pervasive among both exercise and nutrition professionals working with adults who have obesity. However, the published literature on this topic is limited. This review aimed to (i) systematically review existing literature examining weight bias among exercise and nutrition professionals; (ii) discuss the implications of this evidence for exercise and nutrition professionals and their clients; (iii) address gaps and limitations of this literature; and (iv) identify future research directions. Of the 31 studies that met the criteria for this review, 20 examined weight bias among exercise professionals, of which 17 (85%) found evidence of weight bias among professionals practicing physical therapy (n = 4), physical education (n = 8) and personal/group fitness training (n = 5). Of 11 studies examining weight bias among nutrition professionals, eight (73%) found evidence of weight bias. These findings demonstrate fairly consistent evidence of weight bias among exercise and nutrition professionals. However, the majority of studies were cross-sectional (90%). Given that weight bias may compromise quality of care and potentially reinforce weight gain and associated negative health consequences in patients with obesity, it is imperative for future work to examine the causes and consequences of weight bias within exercise and nutrition professions using more rigorous study designs.
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Affiliation(s)
- G A Panza
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA.,Department of Cardiology, Hartford Hospital, Hartford, CT, USA
| | - L E Armstrong
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - B A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA.,Department of Cardiology, Hartford Hospital, Hartford, CT, USA
| | - R M Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA.,Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA
| | - J Livingston
- Department of Research Services, University of Connecticut, Storrs, CT, USA
| | - L S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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Neijenhuis M, Gevers TJG, Atwell TD, Gunneson TJ, Schimek AC, Kievit W, Drenth JPH, Kamath PS. Development and Validation of a Patient-Reported Outcome Measurement for Symptom Assessment in Cirrhotic Ascites. Am J Gastroenterol 2018; 113:567-575. [PMID: 29557942 DOI: 10.1038/ajg.2018.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/28/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES As current treatments of cirrhotic ascites are not associated with survival benefit, symptom relief is the major therapeutic end point. We developed a questionnaire (Ascites-Q; modified polycystic liver disease questionnaire) and assessed validity and responsiveness for symptom assessment in cirrhotic ascites. METHODS Ascites-Q was compared with Functional Assessment of Chronic Illness Therapy-Ascites Index (FACIT-AI; developed for malignant ascites) and Japanese Ascites Symptom Inventory-7 (ASI-7) in cirrhotics undergoing large-volume paracentesis. Convergent validity was defined as correlation >0.4 between ascites questionnaires and quality of life (QoL) visual analog scale. Responsiveness was assessed by comparing scores at baseline and 7 days after large-volume paracentesis. To test discriminative ability, we compared scores of patients with cirrhotic controls without ascites (n=24) and diuretic-sensitive ascites (n=46). RESULTS We included 90 patients with refractory cirrhotic ascites (61% male, mean age 59 years, Model of End-Stage Liver Disease (MELD) score 16, median paracentesis volume 4,100 ml). Higher symptoms scores were correlated with lower QoL (Ascites-Q: r=0.479, P<0.001, FACIT-AI: r=0.313, P=0.007; ASI-7: r=0.340, P=0.004), but only Ascites-Q showed convergent validity (r>0.4). Symptoms decreased after paracentesis (Ascites-Q: 57 to 34, FACIT-AI: 44 to 33, and ASI-7: 57 to 25, all P<0.001). Ascites-Q and ASI-7 discriminated between controls without ascites, diuretic-sensitive, and refractory ascites (Ascites-Q: 16 vs. 35 vs. 56 points, ASI-7: 2 vs. 25 vs. 61 points, all P<0.05), whereas FACIT-AI (39 vs. 40 vs. 52 points) could not (P=0.314). Ascites-Q was validated at 3 months in an independent cohort with ascites controlled with a pump. CONCLUSIONS The Ascites-Q is the best ascites-specific outcome to evaluate symptom relief in cirrhotic ascites.
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Affiliation(s)
- Myrte Neijenhuis
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tom J G Gevers
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Thomas D Atwell
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Tim J Gunneson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Amanda C Schimek
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Wietske Kievit
- Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Patrick S Kamath
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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Anticipating uncertainty and irrevocable decisions: provider perspectives on implementing whole-genome sequencing in critically ill children with heart disease. Genet Med 2018; 20:1455-1461. [PMID: 29493583 DOI: 10.1038/gim.2018.25] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/30/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To investigate the potential impacts of whole-genome sequencing (WGS) in the pediatric critical-care context, we examined how clinicians caring for critically ill children with congenital heart disease (CHD) anticipate and perceive the impact of WGS on their decision-making process and treatment recommendations. METHODS We conducted semistructured in-person and telephone interviews of clinicians involved in the care of critically ill children with CHD at a high-volume pediatric heart center. We qualitatively analyzed the transcribed interviews. RESULTS In total, 34 clinicians were interviewed. Three themes emerged: (i) uncertainty about the accuracy of WGS testing and adequacy of testing validation; (ii) the use of WGS to facilitate life-limiting decisions such as futility, rationing, and selective prenatal termination; and (iii) moral distress over using WGS with a lack of decision support. CONCLUSION Despite uncertainty about WGS testing, the interviewed clinicians were using, and anticipated expanding the use of, WGS results to justify declarations of futility, withdrawal of care, and rationing in critically ill children with CHD. This situation is causing moral distress in providers who have to make high-stakes decisions involving WGS results, with only partial understanding of them. Decision support for clinicians, and discussion with families of the risks of using WGS for rationing or withdrawal, is needed.
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31
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Tan MP, Nalathamby N, Mat S, Tan PJ, Kamaruzzaman SB, Morgan K. Reliability and Validity of the Short Falls Efficacy Scale International in English, Mandarin, and Bahasa Malaysia in Malaysia. Int J Aging Hum Dev 2018; 87:415-428. [DOI: 10.1177/0091415017752942] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While the prevalence of falls among Malaysian older adults is comparable to other older populations around the world, little is currently known about fear of falling in Malaysia. The Falls Efficacy Scale International (FES-I) and short FES-I scales to measure fear of falling have not yet been validated for use within the Malaysian population, and are currently not available in Bahasa Malaysia (BM). A total of 402 participants aged ≥63 years were recruited. The questionnaire was readministered to 149 participants, 4 to 8 weeks after the first administration to determine test–retest reliability. The original version of the 7-item short FES-I is available in English, while the Mandarin was adapted from the 16-item Mandarin FES-I. The BM version was translated according to protocol by four experts. The internal structure of the FES-I was examined by factor analysis. The 7-item short FES-I showed good internal reliability and test–retest reliability for English, Mandarin, and BM versions for Malaysia.
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Affiliation(s)
- Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nemala Nalathamby
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pey June Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Health Services and Policy Research Division, Geriatric Education and Research Institute, Singapore
| | - Shahrul Bahyah Kamaruzzaman
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karen Morgan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Perdana University – Royal College of Surgeons in Ireland, Serdang, Selangor, Malaysia
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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Abstract
The CASP-19 is an age-specific measure of quality of life. It comprises four domains: control, autonomy, self-realisation and pleasure, and is widely used in large cohort studies in temperate climates. Our objective was to translate the CASP-19 into Bahasa Malaysia and validate it for use in older Malaysians in their three commonly used languages of English, Bahasa Malaysia and Traditional Chinese. CASP-19 showed good internal consistency and test-retest reliability with acceptable construct validity compared with the 12-item short-form health survey. Factor analysis found the best fit for the Taiwanese five-domain model. The validity of CASP-19 may be limited by cultural differences.
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Laursen DH, Christensen KB, Christensen U, Frølich A. Assessment of short and long-term outcomes of diabetes patient education using the health education impact questionnaire (HeiQ). BMC Res Notes 2017; 10:213. [PMID: 28619041 PMCID: PMC5471707 DOI: 10.1186/s13104-017-2536-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Type 2 diabetes is a progressive chronic illness that will affect more than 500 million people worldwide by 2030. It is a significant cause of morbidity and mortality. Finding the right care management for diabetes patients is necessary to effectively address the growing population of affected individuals and escalating costs. Patient education is one option for improving patient self-management. However, there are large discrepancies in the outcomes of such programs and long-term data are lacking. We assessed the short and long-term outcomes of diabetes patient education using the health education impact questionnaire (HeiQ). METHODS We conducted a observational cohort study of 83 type 2 diabetes patients participating in patient education programs in Denmark. The seven-scale HeiQ was completed by telephone interview at baseline and 2 weeks (76 participants, 93%) and 12 months (66, 80%) after the patient education ended. Changes over time were assessed using mean values and standard deviation at each time point and Cohen effect sizes. RESULTS Patients reported improvements 2 weeks after the program ended in 4 of 7 constructs: skills and technique acquisition (ES = 0.59), self-monitoring and insight (ES = 0.52), constructive attitudes and approaches (ES = 0.43) and social integration and support (ES = 0.27). After 12 months, patients reported improvements in 3 of 7 constructs: skills and technique acquisition (ES = 0.66), constructive attitudes and approaches (ES = 0.43), and emotional wellbeing (ES = 0.44). Skills and technique showed the largest short- and long-term effect size. No significant changes were found in health-related activity or positive and active engagement in life over time. CONCLUSION After 12 months, diabetes patients who participated in patient education demonstrated increased self-management skills, improved acceptance of their chronic illness and decreased negative emotional response to their disease. Applying HeiQ as an outcome measure yielded new knowledge as to what patients with diabetes can obtain by participating in a patient education.
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Affiliation(s)
- Ditte Hjorth Laursen
- Research Unit of Chronic Conditions, Bispebjerg and Frederiksberg Hospital, Bispebjerg Bakke 23, 20D, 2400, Copenhagen NV, Denmark.
| | - Karl Bang Christensen
- Department of Biostatistics, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postboks 2099, 1014, Copenhagen K, Denmark
| | - Ulla Christensen
- Department of Social Medicine, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postboks 2099, 1014, Copenhagen K, Denmark
| | - Anne Frølich
- Research Unit of Chronic Conditions, Bispebjerg and Frederiksberg Hospital, Bispebjerg Bakke 23, 20D, 2400, Copenhagen NV, Denmark
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Algren MH, Ekholm O, van Lenthe F, Mackenbach J, Bak CK, Andersen PT. Health-risk behaviour among residents in deprived neighbourhoods compared with those of the general population in Denmark: A cross-sectional study. Health Place 2017; 45:189-198. [PMID: 28412595 DOI: 10.1016/j.healthplace.2017.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
This study compares health-risk behaviours (including the co-occurrence of health-risk behaviours) of residents in the deprived neighbourhoods with those of the general population of Denmark. It also examines associations between sociodemographic and socioeconomic characteristics and health-risk behaviours in deprived neighbourhoods in Denmark. Even after adjustment for socioeconomic characteristics there were large differences in health-risk behaviours between residents in deprived neighbourhoods and the general population. In the deprived neighbourhoods large sociodemographic and socioeconomic differences in health-risk behaviours were found among the residents. Our findings highlight the need for health promotion programmes targeting residents in deprived neighbourhoods.
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Affiliation(s)
- Maria Holst Algren
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Niels Bohrs Vej 9-10, 6700 Esbjerg, Denmark.
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Frank van Lenthe
- Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, Netherlands
| | - Johan Mackenbach
- Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, Netherlands
| | - Carsten Kronborg Bak
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220 Aalborg, Denmark
| | - Pernille Tanggaard Andersen
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Niels Bohrs Vej 9-10, 6700 Esbjerg, Denmark
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McGrath BM, Norris CM, Hardwicke-Brown E, Welsh RC, Bainey KR. Quality of life following coronary artery bypass graft surgery vs. percutaneous coronary intervention in diabetics with multivessel disease: a five-year registry study. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2017; 3:216-223. [DOI: 10.1093/ehjqcco/qcw055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/16/2017] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
The aim of this study is to investigate the long-term relationship between revascularization technique and health status in diabetics with multivessel disease.
Methods and results
Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry, we captured 1319 diabetics with multivessel disease requiring revascularization for an acute coronary syndrome (January 2009–December 2012) and reported health status using the Seattle Angina Questionnaire (SAQ) at baseline, 1, 3 and 5-years [599 underwent coronary artery bypass grafting (CABG); 720 underwent percutaneous coronary intervention (PCI)]. Adjusted analyses were performed using a propensity score-matching technique. After adjustment (including baseline SAQ domain scores), 1-year mean (95% CI) SAQ scores (range 0–100 with higher scores reflecting improved health status) were significantly greater in selected domains for CABG compared to PCI (exertional capacity: 81.7 [79.5–84.0] vs. 78.8 [76.5–81.0], P = 0.07; angina stability: 83.1 [80.4–85.9] vs. 75.0 [72.3–77.8], P < 0.001]; angina frequency 93.2 [91.6–95.0] vs. 90.0 [87.8–91.3], P = 0.003; treatment satisfaction: 93.6 [92.2–94.9] vs. 90.8 [89.2–92.0], P = 0.003; quality of life [QOL]: 83.8 [81.7–85.8] vs. 77.2 [75.2–79.2] P < 0.001). At 3-years, these benefits were attenuated (exertional capacity: 79.3 [76.9–81.7] vs. 78.7 [76.3–81.1], P = 0.734; angina stability 79.3 [76.3–82.3] vs. 75.5 [72.5–78.5], P = 0.080; angina frequency: 93.2 [91.3–95.1] vs. 90.9 [89.0–92.8], P = 0.095; treatment satisfaction: 92.5 [91.0–94.0] vs. 91.5 [90.0–93.0] P = 0.382; QOL: 83.2 [81.1–85.2] vs. 80.3 [78.2–82.4], P = 0.057). At 5-years, majority of domains were similar (exertional capacity: 77.8 [75.0–80.6] vs. 76.3 [73.2–79.3], P = 0.482; angina stability: 78.0 [74.8–81.2] vs. 74.8 [71.4–78.2], P = 0.175; angina frequency: 94.2 [92.3–96.0] vs. 90.9 [89.0–92.9], P = 0.018; treatment satisfaction: 93.7 [92.2–95.1] vs. 92.2 [90.6–93.7], P = 0.167; QOL: 84.1 [82.0–86.3] vs. 81.1 [78.8–83.4], P = 0.058). Majority in both groups remained angina-free at 5-years (75.0% vs. 70.3%, P = 0.15).
Conclusion
Improvements in health status with CABG compared with PCI were not sustained long-term. This temporal sequence should be considered when contemplating a revascularization strategy in diabetics with multivessel disease.
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Affiliation(s)
- Brent M. McGrath
- Division of Cardiology, 2C2 Walter Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
| | - Colleen M. Norris
- Division of Cardiology, 2C2 Walter Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
- Cardiovascular Health and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
- Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease, Edmonton, AB, Canada
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Emeleigh Hardwicke-Brown
- Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease, Edmonton, AB, Canada
| | - Robert C. Welsh
- Division of Cardiology, 2C2 Walter Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
- The Canadian VIGOUR Centre, University of Alberta, Edmonton, AB, Canada
| | - Kevin R. Bainey
- Division of Cardiology, 2C2 Walter Mackenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
- The Canadian VIGOUR Centre, University of Alberta, Edmonton, AB, Canada
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Hammarstedt JE, Redmond JM, Gupta A, Dunne KF, Vemula SP, Domb BG. Survey mode influence on patient-reported outcome scores in orthopaedic surgery: telephone results may be positively biased. Knee Surg Sports Traumatol Arthrosc 2017; 25:50-54. [PMID: 26499997 DOI: 10.1007/s00167-015-3802-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/16/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Patient-reported outcome (PRO) scores are used to evaluate treatment modalities in orthopaedic surgery. The method of PRO collection may introduce bias to reported surgical outcomes due to the presence of an interviewer. This study evaluates post-operative PROs for variation of outcomes between survey methods-in-person, online, or telephone. METHODS From 2008 to 2011, 456 patients underwent arthroscopic surgical treatment for acetabular labral tears. All pre-operative surveys were completed in the clinic during pre-operative visit. Two-year follow-up questionnaires were completed by 385 (84 %) patients. The PRO data were prospectively collected pre- and post-operatively using five tools: modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADLS), Hip Outcome Score Sports-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), and visual analog scale. Patients were grouped according to method of 2-year follow-up: in-person during follow-up visit (102 patients, 26 %), online by email prompt (138 patients, 36 %), or telephone with an interviewer (145 patients, 38 %). RESULTS Pre-operative baseline PRO scores demonstrated no statistically significant difference between groups for mHHS, HOS-ADLS, HOS-SSS, and NAHS. Two-year post-operative PRO scores obtained by telephone were statistically greater than scores obtained in-person or online for mHHS (p < 0.001), HOS-ADLS (p < 0.001), and HOS-SSS (p < 0.01). CONCLUSION This study demonstrates higher patient-reported outcome scores and greater improvement by telephone surveys compared to in-person or online. The variation of results between collection methods is indicative of a confounding variable. Clinically, it is important to understand these confounding variables in order to assess patient responses and guide treatment. LEVEL OF EVIDENCE IV.
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Affiliation(s)
| | | | | | | | | | - Benjamin G Domb
- American Hip Institute, Westmont, IL, USA.
- Hinsdale Orthopaedics, 1010 Executive Court, Suite 250, Westmont, IL, 60559, USA.
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
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Bokshan SL, Godzik J, Dalton J, Jaffe J, Lenke LG, Kelly MP. Reliability of the revised Scoliosis Research Society-22 and Oswestry Disability Index (ODI) questionnaires in adult spinal deformity when administered by telephone. Spine J 2016; 16:1042-6. [PMID: 26997110 PMCID: PMC5026890 DOI: 10.1016/j.spinee.2016.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/09/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The non-response rates are as high as 20% to 50% after 5 years of follow-up in adult spinal deformity (ASD) surgery. Minimizing loss to follow-up is essential to protect the quality of data in long-term studies. Phone and internet administration of outcomes instruments has grown in popularity and has been found to not only provide a convenient way of collecting data, but also show improved response rates. PURPOSE The study aimed to examine the reliability of the revised Scoliosis Research Society-22 (SRS-22r) and the Oswestry Disability Index (ODI) questionnaires in ASD patients when administered by telephone. STUDY DESIGN/SETTING This is a single-center, randomized crossover phone validation of ASD patients. PATIENT SAMPLE The study included ASD patients presenting to a tertiary spine care center. OUTCOME MEASURES The outcome measures were ODI and SRS-22r. METHODS Forty-nine patients (mean age: 55.7 years) with ASD were randomized in a 1:1 ratio to either phone completion of the SRS-22r and ODI followed by in-office completion, or to in-office completion followed by phone completion. An interval of 2 to 4 weeks was placed between administrations of each version. A paired t test was used to assess the difference between the written and phone versions, and intraclass correlation coefficients were used to assess homogeneity. Finally, goodness-of-fit testing was used to assess version preference. RESULTS There was no significant difference between the phone and in-office versions of the SRS-22r (p=.174) or the ODI (p=.320). The intraclass correlation coefficients of the SRS-22r and ODI were 0.91 and 0.86, respectively. Completion over the phone was the most popular option (57% preferred phone, 29% preferred in-office, and 14% had no preference). CONCLUSIONS Phone administration of the SRS-22r and ODI to ASD patients provides a convenient and reliable tool for reducing loss of follow-up data.
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Affiliation(s)
- Steven L. Bokshan
- Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO
| | - Jakub Godzik
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ
| | - Jonathan Dalton
- Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO
| | - Jennifer Jaffe
- Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO
| | - Lawrence G. Lenke
- Department of Orthopedic Surgery, Columbia College of Physicians and Surgeons, New York, NY
| | - Michael P. Kelly
- Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO,Corresponding Author and Address: Michael P. Kelly, MD, MS, Washington University School of Medicine, Department of Orthopaedic Surgery, 660 South Euclid Avenue, Box 8233, St. Louis, MO 63110, Phone: (314) 747-2535, Fax: (314) 747-2599,
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Laursen DH, Christensen KB, Christensen U, Frølich A. Self-rated health as a predictor of outcomes of type 2 diabetes patient education programmes in Denmark. Public Health 2016; 139:170-177. [PMID: 27475450 DOI: 10.1016/j.puhe.2016.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/24/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To explore if self-rated health (SRH) can predict differences in outcomes of patient education programmes among patients with type 2 diabetes over time. STUDY DESIGN This is an observational cohort study conducted among 83 patients with type 2 diabetes participating in patient education programmes in the Capital Region of Denmark. METHODS Questionnaire data were collected by telephone interview at baseline and 2 weeks (77 participants, 93%) and 12 months (66, 80%) after the patient education ended. The seven-scale Health Education Impact Questionnaire (HeiQ) was the primary outcome. The independent variable was SRH, which was dichotomized into optimal or poor SRH. Changes over time were assessed using mean values and standard deviation (SD) at each time point and Cohen effect sizes. Odds ratios and 95% confidence intervals were calculated for the likelihood of having poor SRH for each baseline sociodemographic and health-related variable. RESULTS Twelve months after patient education programmes, 60 (72%) patients with optimal SRH at baseline demonstrated increased self-management skills, overall acceptance of chronic illness, positive social interaction with others, and improved emotional well-being. Participants with poor SRH (23, 28%) reported no improvements over time. Not being married (odds ratio [OR] 7.79, P < 0.001), living alone (OR 4.93, P = 0.003), having hypertension (OR 8.00, P = 0.031), and being severely obese (OR 4.07, P = 0.009) were significantly associated with having poor SRH. After adjusting for sex, age and vocational training, marital status (OR 9.35, P < 0.001), cohabitation status (OR = 4.96, P = 0.005) and hypertension (OR 10.9, P = 0.03) remained associated with poor SRH. CONCLUSIONS We found a strong association between SRH and outcomes of patient education, as measured by the HeiQ, at 12 months. Only participants with optimal SRH appeared to benefit from patient education. Other patient characteristics may be responsible to explain the observed difference between patients with optimal and poor SRH.
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Affiliation(s)
- D H Laursen
- Bispebjerg Hospital, Research Unit of Chronic Conditions, Bispebjerg Bakke 23, 20D, 2400 Copenhagen NV, Denmark.
| | - K B Christensen
- University of Copenhagen, Department of Biostatistics, Institute of Public Health, Øster Farimagsgade 5, Postboks 2099, 1014 Copenhagen K, Denmark.
| | - U Christensen
- University of Copenhagen, Department of Social Medicine, Institute of Public Health, Øster Farimagsgade 5, Postboks 2099, 1014 Copenhagen K, Denmark.
| | - A Frølich
- Bispebjerg Hospital, Research Unit of Chronic Conditions, Bispebjerg Bakke 23, 20D, 2400 Copenhagen NV, Denmark.
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Hogh A, Conway PM, Clausen T, Madsen IEH, Burr H. Unwanted sexual attention at work and long-term sickness absence: a follow-up register-based study. BMC Public Health 2016; 16:678. [PMID: 27475538 PMCID: PMC4967501 DOI: 10.1186/s12889-016-3336-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/21/2016] [Indexed: 12/15/2022] Open
Abstract
Background The current understanding of the relationship between unwanted sexual attention at work and long-term sickness absence (LTSA) is limited for three reasons: 1) the under-researched role of unwanted sexual attention perpetrated by individuals outside the work organization; 2) a widespread use of self-reported measures of sickness absence, with an unclear identification of sickness absence episodes of long duration; 3) the cross-sectional design of most existing studies. The aim of this study was therefore to investigate the relationship between self-reported unwanted sexual attention at work and subsequent LTSA (≥3 weeks), stratifying by gender and source of exposure (i.e., colleagues, managers and/or subordinates vs. clients/customers/patients). Methods This prospective study is based on a pooled sample of 14,605 employees from three Danish surveys conducted in 2000, 2004 and 2005, providing a total of 19,366 observations. A single questionnaire-based item was used to assess exposure to unwanted sexual attention. The pooled dataset was merged with Danish register data on LTSA. The risk of first-onset episode of LTSA (up to 18 months after baseline) in connection with unwanted sexual attention was examined using Cox proportional hazards models. We estimated Hazard ratios (HR) and 95 % confidence intervals (95 % CI) adjusted for age, influence at work, work pace, occupational group and mode of data collection. We also adjusted for repeated measures from individual respondents by stratifying the Cox models by wave of survey. Results Unwanted sexual attention from colleagues, managers and/or subordinates predicted LTSA among men (HR 2.66; 95 % CI 1.42-5.00). Among women, an elevated but non-statistically significant risk of LTSA (HR 1.18; 95 % CI 0.65-2.14) was found. Unwanted sexual attention from clients/customers/patients did not predict LTSA, neither among men nor among women. Conclusions The findings indicate a significantly elevated risk of LTSA, among men only, in relation to exposure to unwanted sexual attention from colleagues, managers and/or subordinates. This study therefore suggests both individual and organizational costs associated with unwanted sexual attention at work. Due to the low prevalence of unwanted sexual attention, larger studies with more statistical power are needed to confirm (or disconfirm) the present findings.
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Affiliation(s)
- Annie Hogh
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen, Denmark.
| | - Paul Maurice Conway
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen, Denmark
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersoe Parkalle 105, 2100, Copenhagen, Denmark
| | | | - Hermann Burr
- Federal Institute of Occupational Safety and Health, Nöldnerstraße 40-42, 10317, Berlin, Germany
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Kolla NJ, van der Maas M, Toplak ME, Erickson PG, Mann RE, Seeley J, Vingilis E. Adult attention deficit hyperactivity disorder symptom profiles and concurrent problems with alcohol and cannabis: sex differences in a representative, population survey. BMC Psychiatry 2016; 16:50. [PMID: 26920911 PMCID: PMC4769555 DOI: 10.1186/s12888-016-0746-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 02/12/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Adult attention deficit hyperactivity disorder (ADHD) shows a robust association with alcohol and cannabis misuse, and these relationships are expressed differently in males and females. Manifestation of specific ADHD symptom profiles, even in the absence of the full disorder, may also be related to problems with alcohol and cannabis, although these relationships have not been investigated in epidemiological studies. To address this question, we studied the sex-specific associations of ADHD symptomatology with problematic alcohol and cannabis use in a representative sample of adults aged 18 years and older residing in Ontario, Canada. METHODS Data were obtained from the Centre for Addiction and Mental Health Monitor, an ongoing cross-sectional telephone survey, between January 2011 and December 2013. Respondents (n = 5080) reported on current ADHD symptomatology, measured using the Adult ADHD Self-Report Version 1.1 Screener (ASRS-V1.1) and four additional items, and alcohol and cannabis use, which were measured using the Alcohol Use Disorders Identification Test (AUDIT) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), respectively. Logistic regression analyses were conducted in men and women to test the association of each ADHD symptom cluster (hyperactivity, inattentiveness, impulsivity) with problematic alcohol and cannabis use. RESULTS After controlling for age, education, and comorbid internalizing and externalizing psychopathology, hyperactive symptoms were associated with problematic alcohol use in both men and women and with problematic cannabis use in men. Impulsive symptoms were independently associated with problematic cannabis use in men. By contrast, inattentive symptomatology predicted problems with alcohol and cannabis only in women. In all models, age was negatively associated with substance misuse and externalizing behavior was positively correlated and the strongest predictor of hazardous alcohol and cannabis use. CONCLUSIONS ADHD symptom expression in adulthood is related to concurrent hazardous use of alcohol and cannabis. Distinctive ADHD symptom profiles may confer increased risk for substance misuse in a sex-specific manner.
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Affiliation(s)
- Nathan J. Kolla
- Centre for Addiction and Mental Health, Toronto, ON Canada ,Department of Psychiatry, University of Toronto, Toronto, ON Canada ,CAMH, 250 College Street, Toronto, ON Canada
| | - Mark van der Maas
- Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Sociology, University of Toronto, Toronto, ON, Canada.
| | | | | | - Robert E. Mann
- Centre for Addiction and Mental Health, Toronto, ON Canada ,Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Jane Seeley
- Department of Family Medicine, University of Western Ontario, London, ON, Canada.
| | - Evelyn Vingilis
- Department of Family Medicine, University of Western Ontario, London, ON, Canada.
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Gill TK, Tucker GR, Avery JC, Shanahan EM, Menz HB, Taylor AW, Adams RJ, Hill CL. The use of self-report questions to examine the prevalence of musculoskeletal problems: a test-retest study. BMC Musculoskelet Disord 2016; 17:100. [PMID: 26911879 PMCID: PMC4766689 DOI: 10.1186/s12891-016-0946-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/13/2016] [Indexed: 12/22/2022] Open
Abstract
Background Case definition has long been an issue for comparability of results obtained for musculoskeletal pain prevalence, however the test-retest reliability of questions used to determine joint pain prevalence has not been examined. The objective of this study was to determine question reliability and the impact of question wording, ordering and the time between questions on responses. Methods A Computer Assisted Telephone Interviewing (CATI) survey was used to re-administer questions collected as part of a population-based longitudinal cohort study. On two different occasions questions were asked of the same sample of 203 community dwelling respondents (which were initially randomly selected) aged 18 years and over at two time points 14 to 27 days apart (average 15 days). Reliability of the questions was assessed using Cohen’s kappa (κ) and intraclass correlation coefficient (ICC) and whether question wording and period effects existed was assessed using a crossover design. Results The self-reported prevalence of doctor diagnosed arthritis demonstrated excellent reliability (κ = 0.84 and κ = 0.79 for questionnaires 1 and 2 respectively). The reliability of questions relating to musculoskeletal pain and/or stiffness ranged from moderate to excellent for both types of questions, that is, those related to ever having joint pain on most days for at least a month (κ = 0.52 to κ = 0.95) and having pain and/or stiffness on most days for the last month (κ = 0.52 to κ = 0.90). However there was an effect of question wording on the results obtained for hand, foot and back pain and/or stiffness indicating that the area of pain may influence prevalence estimates. Conclusions Joint pain and stiffness questions are reliable and can be used to determine prevalence. However, question wording and pain area may impact on estimates with issues such as pain perception and effect on activities playing a possible role in the recall of musculoskeletal pain.
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Affiliation(s)
- Tiffany K Gill
- NHMRC Early Career Fellow, School of Medicine, Faculty of Health Sciences, The University of Adelaide, Level 7, SAHMRI, North Tce, Adelaide, SA, 5000, Australia.
| | - Graeme R Tucker
- School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Jodie C Avery
- Population Research and Outcome Studies, Discipline of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - E Michael Shanahan
- Rheumatology Department, Southern Adelaide Health Service, Repatriation General Hospital, Daws Rd, Daw Park, SA, 5042, Australia. .,School of Medicine, Flinders University, Bedford Park, SA, 5041, Australia.
| | - Hylton B Menz
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Vic, 3083, Australia.
| | - Anne W Taylor
- Population Research and Outcome Studies, Discipline of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Robert J Adams
- School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia. .,The Health Observatory, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Catherine L Hill
- The Health Observatory, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, SA, 5005, Australia. .,Rheumatology Department, The Queen Elizabeth Hospital, Woodville Rd, Woodville, SA, 5011, Australia.
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Fink DS, Cohen GH, Sampson LA, Gifford RK, Fullerton CS, Ursano RJ, Galea S. Incidence of and risk for post-traumatic stress disorder and depression in a representative sample of US Reserve and National Guard. Ann Epidemiol 2016; 26:189-97. [PMID: 26907538 DOI: 10.1016/j.annepidem.2016.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/04/2016] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE We aim to determine the incidence rates (IR) of first-ever post-traumatic stress disorder (PTSD) and depression in a population-based cohort of US Reserve and National Guard service members. METHODS We used data from the US Reserve and National Guard Study (n = 2003) to annually investigate incident and recurrent PTSD and depression symptoms from 2010 to 2013. We estimated the IR and recurrence rate over 4 years and according to several sociodemographic and military characteristics. RESULTS From 2010 to 2013, IRs were 4.7 per 100 person-years for both PTSD and depression symptoms using the sensitive criteria, 2.9 per 100 person-years using the more specific criteria, recurrence rates for both PTSD and depression were more than 4 times as high as IRs, and IRs were higher among those with past-year civilian trauma, but not past-year deployment. CONCLUSIONS The finding that civilian trauma, but not past-year military deployment, is associated with an increased risk of PTSD and depression incidence suggest that Reserve National Guard psychopathology could be driven by other, nonmilitary, traumatic experiences.
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Affiliation(s)
- David S Fink
- Department of Epidemiology, Columbia University, New York, NY.
| | - Gregory H Cohen
- Department of Epidemiology, Columbia University, New York, NY
| | | | - Robert K Gifford
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Carol S Fullerton
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Robert J Ursano
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Sandro Galea
- Dean of School of Public Health, Boston University, Boston, MA
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Ørstavik RE, Jacobsen GW. Er det slutt på dugnadsånden? TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2016; 136:1059. [DOI: 10.4045/tidsskr.16.0539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Lozano F, Lobos JM, March JR, Carrasco E, Barros MB, González-Porras JR. Self-administered versus interview-based questionnaires among patients with intermittent claudication: Do they give different results? A cross-sectional study. SAO PAULO MED J 2016; 134:63-9. [PMID: 26786606 PMCID: PMC10496590 DOI: 10.1590/1516-3180.2015.01733009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 05/29/2015] [Accepted: 09/30/2015] [Indexed: 01/22/2023] Open
Abstract
CONTEXT AND OBJECTIVE Many clinical investigations use generic and/or specific questionnaires to obtain information about participants and patients. There is disagreement about whether the administration method can affect the results. The aim here was to determine whether, among patients with intermittent claudication (IC), there are differences in the Walking Impairment Questionnaire (WIQ) and European Quality of Life-5 Dimension (EQ-5D) scores with regard to: 1) the questionnaire administration method (self-administration versus face-to-face interview); and 2) the type of interviewer (vascular surgeon, VS, versus general practitioner, GP). DESIGN AND SETTING Cross-sectional observational multicenter epidemiological study carried out within the Spanish National Health Service. METHODS 1,641 evaluable patients with IC firstly completed the WIQ and EQ-5D questionnaires and then were interviewed by their doctor on the same day. Pearson correlations and Chi-square tests were used. RESULTS There was a strong correlation (r > 0.800; P < 0.001) between the two methods of administering the WIQ and EQ-5D questionnaires, and between the VS and GP groups. Likewise, there was a high level of concordance (P > 0.05) between the different dimensions of the WIQ-distance and EQ-5D (self-administration versus face-to-face) in the VS and GP groups. CONCLUSION There was no difference between the different methods of administering the WIQ and EQ-5D questionnaires, among the patients with IC. Similarly, the two types of interviewers (VS or GP) were equally valid. Therefore, it seems unnecessary to expend effort to administer these questionnaires by interview, in studies on IC.
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Affiliation(s)
- Francisco Lozano
- Angiology and Vascular Surgery Department, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, Spain
| | | | - José Ramón March
- Angiology and Vascular Surgery Department, Hospital Universitario de Getafe, Madrid, Spain
| | | | - Marcello Barbosa Barros
- Angiology and Vascular Surgery Department, Hospital Universitario de Valladolid, Valladolid, Spain
| | - José Ramón González-Porras
- Hematology Department, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, Spain
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Survey mode influence on patient-reported outcome scores in orthopaedic surgery: telephone results may be positively biased. KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY : OFFICIAL JOURNAL OF THE ESSKA 2015. [PMID: 26499997 DOI: 10.1007/s00167-015-3802-6.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
PURPOSE Patient-reported outcome (PRO) scores are used to evaluate treatment modalities in orthopaedic surgery. The method of PRO collection may introduce bias to reported surgical outcomes due to the presence of an interviewer. This study evaluates post-operative PROs for variation of outcomes between survey methods-in-person, online, or telephone. METHODS From 2008 to 2011, 456 patients underwent arthroscopic surgical treatment for acetabular labral tears. All pre-operative surveys were completed in the clinic during pre-operative visit. Two-year follow-up questionnaires were completed by 385 (84 %) patients. The PRO data were prospectively collected pre- and post-operatively using five tools: modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADLS), Hip Outcome Score Sports-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), and visual analog scale. Patients were grouped according to method of 2-year follow-up: in-person during follow-up visit (102 patients, 26 %), online by email prompt (138 patients, 36 %), or telephone with an interviewer (145 patients, 38 %). RESULTS Pre-operative baseline PRO scores demonstrated no statistically significant difference between groups for mHHS, HOS-ADLS, HOS-SSS, and NAHS. Two-year post-operative PRO scores obtained by telephone were statistically greater than scores obtained in-person or online for mHHS (p < 0.001), HOS-ADLS (p < 0.001), and HOS-SSS (p < 0.01). CONCLUSION This study demonstrates higher patient-reported outcome scores and greater improvement by telephone surveys compared to in-person or online. The variation of results between collection methods is indicative of a confounding variable. Clinically, it is important to understand these confounding variables in order to assess patient responses and guide treatment. LEVEL OF EVIDENCE IV.
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Casu G, Gremigni P. Screening for infertility-related stress at the time of initial infertility consultation: psychometric properties of a brief measure. J Adv Nurs 2015; 72:693-706. [DOI: 10.1111/jan.12830] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Giulia Casu
- Department of Psychology; University of Bologna; Italy
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Loengaard K, Bjorner JB, Fink PK, Burr H, Rugulies R. Medically unexplained symptoms and the risk of loss of labor market participation--a prospective study in the Danish population. BMC Public Health 2015; 15:844. [PMID: 26329362 PMCID: PMC4556215 DOI: 10.1186/s12889-015-2177-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/21/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medically Unexplained Symptoms (MUS) are frequently encountered in general practice. However, little is known whether MUS affects labor market participation. We investigated the prospective association between MUS at baseline and risk of long-term sickness absence (LTSA), unemployment, and disability pensioning in a 5-year-follow-up study. METHODS In the Danish Work Environment Cohort Study 2005, 8187 randomly selected employees from the Danish general population answered a questionnaire on work and health. Responses were linked with national registers on prescribed medication and hospital treatment. Participants were classified with MUS if they: a) had reported three or more symptoms during the last month, and b) did not have a chronic condition, neither in the self-reported nor the register data. We assessed LTSA, unemployment, and disability pensioning by linking our data with National registers of social transfer payments. RESULTS Of the 8187 participants, 272 (3.3%) were categorized with MUS. Compared to healthy participants, participants with MUS had an increased risk of LTSA (Rate ratio (RR) = 1.76, 95% CI = 1.28-2.42), and of unemployment (RR = 1.48, 95% CI = 1.02-2.15) during follow-up. MUS participants also showed an elevated RR with regard to risk of disability pensioning, however this association was not statistically significant (RR = 2.06, 95% CI = 0.77-5.52). CONCLUSION MUS seem to have a negative effect on labor market participation defined by LTSA and unemployment, whereas it is more uncertain whether MUS affects risk of disability pensioning.
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Affiliation(s)
- Katja Loengaard
- National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark.
| | - Jakob Bue Bjorner
- National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark. .,Department of Public Health, University of Copenhagen, Copenhagen, Denmark. .,QualityMetric, Lincoln, RI, USA.
| | - Per Klausen Fink
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.
| | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark. .,Department of Public Health, University of Copenhagen, Copenhagen, Denmark. .,Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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Zhong L, Xi G, Zhang L, Liu S, Wan L, Yu L, Zhou M, Zhang J, He Y. The estimation of prevalence and risk factors of hepatitis B virus infection among blood donors in Chengdu, China. J Med Virol 2015; 88:260-7. [PMID: 26241150 DOI: 10.1002/jmv.24339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2015] [Indexed: 12/29/2022]
Abstract
The reported positive rates of hepatitis B virus surface antigen (HBsAg) among Chinese blood donors generally do not include data from pre-donation rapid tests. The aim of this study was to estimate the prevalence of serologic markers for HBsAg and risk factors among blood donors from Chengdu, China. From April 2010 to March 2011, a total of 16,875 blood donors were enrolled. Data from HBsAg tests before and after donations were collected to estimate the prevalence of HBsAg. A case-control study was conducted in 265 unique HBsAg-positive blood donors and 530 seronegative donors between January 2011 and October 2012. The odds ratio (OR) and 95% confidence interval (CI) were calculated using conditional logistic regression. The population attributable risk (PAR) was estimated. The prevalence of HBsAg was 3.17% (95%CI, 2.91-3.43%). The following risk factors were associated with HBV infection: non-vaccination for HBV (OR = 4.236; 95%CI, 2.72-6.60%), razor sharing (OR = 2.370; 95%CI, 1.46-3.84%), dental treatment (OR = 1.714; 95%CI, 1.21-2.43%), acupuncture (OR = 1.983; 95%CI, 1.20-3.28%), a family history of HBV infection (OR = 2.257; 95%CI, 1.32-3.86%), and endoscopy (OR = 2.17; 95%CI, 1.04-4.51%). The PAR values of the risk factors were 42.77%, 31.78%, 13.68%, 6.18%, 6.09%, and 2.85%, respectively, and the total PAR was 68.78%. The prevalence of HBsAg among Chinese blood donors is still high. HBV vaccinations can provide protection. Blood contact from sharing instruments is still a high risk route of transmission for HBV. Immunization programs and behavioral interventions should be used to prevent blood donation infections and improve blood safety.
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Affiliation(s)
- Li Zhong
- Department of Quality Control, Chengdu Blood Center, Chengdu, China
| | - Guangxiang Xi
- Department of Blood Supply, Chengdu Blood Center, Chengdu, China
| | - Lanjiang Zhang
- Department of Blood Screening, Chengdu Blood Center, Chengdu, China
| | - Shuangli Liu
- Department of Blood Collection, Chengdu Blood Center, Chengdu, China
| | - Like Wan
- Department of Blood Preparation, Chengdu Blood Center, Chengdu, China
| | - Lian Yu
- Department of Donor Service, Chengdu Blood Center, Chengdu, China
| | - Min Zhou
- Department of Donor Service, Chengdu Blood Center, Chengdu, China
| | - Jie Zhang
- Department of Administration Office, Chengdu Blood Center, Chengdu, China
| | - Yi He
- Department of Quality Control, Chengdu Blood Center, Chengdu, China
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Hajdarevic S, Hvidberg L, Lin Y, Donnelly C, Gavin A, Lagerlund M, Pedersen AF, Rasmussen BH, Runesdotter S, Vedsted P, Tishelman C. Awareness of sunburn in childhood, use of sunbeds and change of moles in Denmark, Northern Ireland, Norway and Sweden. Eur J Public Health 2015; 26:29-35. [DOI: 10.1093/eurpub/ckv112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Swallow V, Smith T, Webb NJA, Wirz L, Qizalbash L, Brennan E, Birch A, Sinha MD, Krischock L, van der Voort J, King D, Lambert H, Milford DV, Crowther L, Saleem M, Lunn A, Williams J. Distributed expertise: qualitative study of a British network of multidisciplinary teams supporting parents of children with chronic kidney disease. Child Care Health Dev 2015; 41:67-75. [PMID: 24827413 PMCID: PMC4368419 DOI: 10.1111/cch.12141] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Long-term childhood conditions are often managed by hospital-based multidisciplinary teams (MDTs) of professionals with discipline specific expertise of a condition, in partnership with parents. However, little evidence exists on professional-parent interactions in this context. An exploration of professionals' accounts of the way they individually and collectively teach parents to manage their child's clinical care at home is, therefore, important for meeting parents' needs, informing policy and educating novice professionals. Using chronic kidney disease as an exemplar this paper reports on one aspect of a study of interactions between professionals and parents in a network of 12 children's kidney units in Britain. METHODS We conducted semi-structured, qualitative interviews with a convenience sample of 112 professionals (clinical-psychologists, dietitians, doctors, nurses, pharmacists, play-workers, therapists and social workers), exploring accounts of their parent-educative activity. We analysed data using framework and the concept of distributed expertise. RESULTS Four themes emerged that related to the way expertise was distributed within and across teams: (i) recognizing each other's' expertise, (ii) sharing expertise within the MDT, (iii) language interpretation, and (iv) acting as brokers. Two different professional identifications were also seen to co-exist within MDTs, with participants using the term 'we' both as the intra-professional 'we' (relating to the professional identity) when describing expertise within a disciplinary group (for example: 'As dietitians we aim to give tailored advice to optimize children's growth'), and the inter-professional 'we' (a 'team-identification'), when discussing expertise within the team (for example: 'We work as a team and make sure we're all happy with every aspect of their training before they go home'). CONCLUSIONS This study highlights the dual identifications implicit in 'being professional' in this context (to the team and to one's profession) as well as the unique role that each member of a team contributes to children's care. Our methodology and results have the potential to be transferred to teams managing other conditions.
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Affiliation(s)
- V Swallow
- School of Nursing, Midwifery and Social Work, Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of ManchesterManchester, UK,
Correspondence:, Veronica Swallow, School of Nursing, Midwifery and Social Work, Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Oxford Road, Manchester M13 9PT, UK, E-mail:
| | - T Smith
- Royal Manchester Children's HospitalManchester, UK
| | - N J A Webb
- Royal Manchester Children's HospitalManchester, UK
| | - L Wirz
- Health Psychology (Old Ward 1 Offices), Royal Victoria InfirmaryNewcastle, UK
| | - L Qizalbash
- The Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle, UK
| | - E Brennan
- Great Ormond Street Children's HospitalLondon, UK
| | - A Birch
- Nephrology, Alder Hey Children's NHS Foundation TrustLiverpool, UK
| | - M D Sinha
- Department of Pediatric Nephrology, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation TrustLondon, UK
| | - L Krischock
- Sydney Children's HospitalRandwick, NSW, Australia
| | | | - D King
- Yorkhill Children's HospitalGlasgow, UK
| | - H Lambert
- The Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle, UK
| | - D V Milford
- Birmingham Children's HospitalBirmingham, UK
| | - L Crowther
- Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation TrustManchester, UK
| | - M Saleem
- University of Bristol Children's Renal Unit, Bristol Royal Hospital for ChildrenBristol, UK
| | - A Lunn
- Children's Renal and Urology Unit, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, QMC CampusNottingham, UK
| | - J Williams
- School of Environment, Education and Development, University of ManchesterUK
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