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Snippen NC, de Vries HJ, Hagedoorn M, Brouwer S. Training for occupational health physicians to involve significant others in the return-to-work process of workers with chronic diseases: a randomized controlled trial. Disabil Rehabil 2022:1-11. [PMID: 35940304 DOI: 10.1080/09638288.2022.2107091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine the efficacy of the "Training for Occupational health physicians To Involve Significant others" (TOTIS) e-learning module for improving occupational health physicians' (OHPs) knowledge, attitudes, and self-efficacy regarding involving significant others in the return-to-work process. MATERIALS AND METHODS A randomized controlled trial with 87 OHPs, involving an intervention group and a wait-listed control group. Between-group differences in knowledge, attitude, and self-efficacy outcomes, and retention of effects were assessed using ANOVA and paired t-tests. Reactions to the e-learning module were analyzed with descriptive statistics and thematic analysis. RESULTS We found moderate to large effects on OHPs' knowledge (p < 0.001, ηp2 = 0.202), attitudes (p = 0.003, ηp2 = 0.098), and self-efficacy (p < 0.001, ηp2 = 0.237), with retention of all changes at 10-week follow-up. OHPs graded the e-learning module with a mean score of 7.9 out of 10 (SD = 1.11) and indicated that the module increased their awareness of the role of significant others and encouraged them to address this more often. CONCLUSIONS The TOTIS e-learning module and accompanying materials are valuable resources for OHPs to learn how significant others influence work outcomes of workers with chronic diseases and to manage their involvement in the re-integration process. TRIAL REGISTRATION This study is registered in the Netherlands Trial Register under trial number NL8744; https://www.trialregister.nl/trial/8744.Implications for rehabilitationThe TOTIS e-learning module is the first evidence-based training to improve the knowledge, attitudes, and self-efficacy of occupational health physicians with regard to involving significant others in the re-integration process of workers with chronic diseases.The e-learning module and accompanying tools can increase the awareness of occupational health physicians about the role of significant others and encourage them to address the role of significant others in the re-integration process of sick-listed workers.It could be beneficial to expand on the e-learning module with a face-to-face training program involving group interaction, peer discussion, and skills development.
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Affiliation(s)
- Nicole C Snippen
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Haitze J de Vries
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mariët Hagedoorn
- Department of Health Sciences, Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Cabañero-Martínez MJ, Ramos-Pichardo JD, Velasco-Álvarez ML, García-Sanjuán S, Lillo-Crespo M, Cabrero-García J. Availability and perceived usefulness of guidelines and protocols for subcutaneous hydration in palliative care settings. J Clin Nurs 2019; 28:4012-4020. [PMID: 31410903 DOI: 10.1111/jocn.15036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/25/2019] [Accepted: 08/04/2019] [Indexed: 01/21/2023]
Abstract
AIMS AND OBJECTIVES To evaluate the availability of, adherence to, and perceived usefulness of guidelines and protocols for managing hydration and subcutaneous hydration in palliative care settings. BACKGROUND Hydration at the end of life and the use of a subcutaneous route to hydrate generate some controversy among health professionals for different reasons. Having guidelines and protocols to assist in decision-making and to follow a standard procedure may be relevant in clinical practice. DESIGN Cross-sectional telephone survey, with closed-ended and open-ended questions designed specifically for this study. METHODS Data were obtained from 327 professionals, each from a different palliative care service. Mean, standard deviation, minimum and maximum were calculated for continuous variables; frequency distributions were obtained for categorical variables. A qualitative content analysis was performed on the open-ended questions. The article adheres to the STROBE guidelines for reporting observational studies. RESULTS Only 24.8% of the participants had guidelines available to assist in making decisions regarding hydration, and 55.6% claimed to follow them 'always or almost always'. Of the participants, 38.8% had subcutaneous hydration protocols available, while 78.7% stated that they 'always or almost always' followed these protocols. The remaining participants considered the protocols as useful tools despite not having them available. CONCLUSIONS Only 25% of the participants' services had guidelines for hydration, and less than 40% had protocols for subcutaneous hydration. However, adherence was high, especially in cases where protocols existed. Among the participants who did not have guidelines and protocols, attitudes were mostly favourable, but mainly as a reference and support for an individualised clinical practice. RELEVANCE TO CLINICAL PRACTICE Guidelines and protocols on hydration in palliative care may be more useful as a solid reference and support for individualised practice than as instruments for standardising care. From this perspective, their development and availability in palliative care services are recommended.
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Walls M, Broder-Fingert S, Feinberg E, Drainoni ML, Bair-Merritt M. Prevention and Management of Obesity in Children with Autism Spectrum Disorder Among Primary Care Pediatricians. J Autism Dev Disord 2019; 48:2408-2417. [PMID: 29450838 DOI: 10.1007/s10803-018-3494-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Children with autism spectrum disorder (ASD) are at high risk for being overweight and obese. Little is known about how obesity in children with ASD is being addressed in primary care. This article reports findings from a survey completed by 327 general pediatricians, which included a fictional clinical vignette and Likert-scales assessing attitudes, practices, self-efficacy, and barriers to obesity management. Although the majority of respondents agreed pediatricians should be the main providers to manage obesity in children with ASD, few reported receiving adequate training to do so. Pediatricians were more likely to refer to developmental-behavioral pediatricians and dietitians for a child with ASD compared to a child without ASD. Higher self-efficacy was associated with increased weight-related counseling frequency by pediatricians.
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Affiliation(s)
- Morgan Walls
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, 88 East Newton Street, Vose 3, Boston, MA, 02118, USA. .,Department of Pediatrics, Carolinas Healthcare System, 1350 S. Kings Drive, Charlotte, NC, 28207, USA.
| | - Sarabeth Broder-Fingert
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, 88 East Newton Street, Vose 3, Boston, MA, 02118, USA
| | - Emily Feinberg
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA.,Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA, 02118, USA
| | - Mari-Lynn Drainoni
- Department of Health Law, Policy and Management, 715 Albany Street, Talbot building, Boston, MA, 02118, USA.,Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Megan Bair-Merritt
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, 88 East Newton Street, Vose 3, Boston, MA, 02118, USA
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Willson ML, Vernooij RW, Gagliardi AR, Armstrong M, Bernhardsson S, Brouwers M, Bussières A, Fleuren M, Gali K, Huckson S, Jones S, Lewis SZ, James R, Marshall C, Mazza D. Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review. J Clin Epidemiol 2017; 86:25-38. [DOI: 10.1016/j.jclinepi.2016.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/27/2016] [Accepted: 12/23/2016] [Indexed: 01/26/2023]
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Use of theory to plan or evaluate guideline implementation among physicians: a scoping review. Implement Sci 2017; 12:26. [PMID: 28241771 PMCID: PMC5327520 DOI: 10.1186/s13012-017-0557-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 02/14/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Guidelines support health care decision-making and high quality care and outcomes. However, their implementation is sub-optimal. Theory-informed, tailored implementation is associated with guideline use. Few guideline implementation studies published up to 1998 employed theory. This study aimed to describe if and how theory is now used to plan or evaluate guideline implementation among physicians. METHODS A scoping review was conducted. MEDLINE, EMBASE, and The Cochrane Library were searched from 2006 to April 2016. English language studies that planned or evaluated guideline implementation targeted to physicians based on explicitly named theory were eligible. Screening and data extraction were done in duplicate. Study characteristics and details about theory use were analyzed. RESULTS A total of 1244 published reports were identified, 891 were unique, and 716 were excluded based on title and abstract. Among 175 full-text articles, 89 planned or evaluated guideline implementation targeted to physicians; 42 (47.2%) were based on theory and included. The number of studies using theory increased yearly and represented a wide array of countries, guideline topics and types of physicians. The Theory of Planned Behavior (38.1%) and the Theoretical Domains Framework (23.8%) were used most frequently. Many studies rationalized choice of theory (83.3%), most often by stating that the theory described implementation or its determinants, but most failed to explicitly link barriers with theoretical constructs. The majority of studies used theory to inform surveys or interviews that identified barriers of guideline use as a preliminary step in implementation planning (76.2%). All studies that evaluated interventions reported positive impact on reported physician or patient outcomes. CONCLUSIONS While the use of theory to design or evaluate interventions appears to be increasing over time, this review found that one half of guideline implementation studies were based on theory and many of those provided scant details about how theory was used. This limits interpretation and replication of those interventions, and seems to result in multifaceted interventions, which may not be feasible outside of scientific investigation. Further research is needed to better understand how to employ theory in guideline implementation planning or evaluation.
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He Y, Yang F, Mu D, Xing Y, Li X. Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study. BMJ Open 2016; 6:e012775. [PMID: 27707835 PMCID: PMC5073478 DOI: 10.1136/bmjopen-2016-012775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively. DESIGN Cross-sectional questionnaire study. SETTING The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China. PARTICIPANTS 416 hospital pharmacists (292 (70.2%) female) entered and completed the study. PRIMARY AND SECONDARY OUTCOME MEASURES Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs. RESULTS The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs. CONCLUSIONS The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour.
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Affiliation(s)
- Yuan He
- Department of Psychology, School of Health Policy and Management, Nanjing Medical University, Nanjing, People's Republic of China
| | - Fan Yang
- Department of Psychology, School of Education Science, Jiangsu Normal University, Xuzhou, People's Republic of China
| | - Dongqin Mu
- Department of English Languages, School of Foreign Languages, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuan Xing
- Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, People's Republic of China
| | - Xin Li
- Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, Nanjing, People's Republic of China
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Zwerver F, Schellart AJM, Anema JR, van der Beek AJ. Changes in insurance physicians' attitudes, self-efficacy, intention, and knowledge and skills regarding the guidelines for depression, following an implementation strategy. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:148-56. [PMID: 22763493 PMCID: PMC3563952 DOI: 10.1007/s10926-012-9378-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION To improve guideline adherence by insurance physicians (IPs), an implementation strategy was developed and investigated in a randomized controlled trial. This implementation strategy involved a multifaceted training programme for a group of IPs in applying the guidelines for depression. In this study we report the impact of the implementation strategy on the physicians' attitude, intention, self-efficacy, and knowledge and skills as behavioural determinants of guideline adherence. Any links between these self-reported behavioural determinants and levels of guideline adherence were also determined. METHODS Just before and 3 months after the implementation of the multifaceted training, a questionnaire designed to measure behavioural determinants on the basis of the ASE (attitude, social norm, self-efficacy) model was completed by the intervention (n = 21) and the control group (n = 19). Items of the questionnaire were grouped to form scales of ASE determinants. Internal consistency of the scales was calculated using Cronbach's alphas. Differences between groups concerning changes in ASE determinants, and the association of these changes with improvements in guideline adherence, were analyzed using analysis of covariance. RESULTS The internal consistency of the scales of ASE determinants proved to be sufficiently reliable, with Cronbach's alphas of at least 0.70. At follow-up after 3 months, the IPs given the implementation strategy showed significant improvement over the IPs in the control group for all ASE determinants investigated. Changes in knowledge and skills were only weakly associated with improvements in guideline adherence. CONCLUSIONS The implementation strategy developed for insurance physicians can increase their attitude, intention, self-efficacy, and knowledge and skills when applying the guidelines for depression. These changes in behavioural determinants might indicate positive changes in IPs' behaviour towards the use of the guidelines for depression. However, only changes in knowledge and skills related to the use of the guidelines were associated with improvements in IPs' actual performance when applying the guidelines.
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Affiliation(s)
- Feico Zwerver
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, Amsterdam, The Netherlands
- Dutch National Institute for Employee Benefits Schemes, Amsterdam, The Netherlands
| | - Antonius J. M. Schellart
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, Amsterdam, The Netherlands
- Dutch National Institute for Employee Benefits Schemes, Amsterdam, The Netherlands
| | - Johannes R. Anema
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, Amsterdam, The Netherlands
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