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Urruticoechea-Arana A, Sanz J, Ginard D, González-Lama Y, Juanola X, Almirall M, Borruel N, Gratacós J, Loza E. Implementation of the recommendations for the psychological management of patients with spondyloarthritis and inflammatory bowel disease. REUMATOLOGIA CLINICA 2023; 19:423-429. [PMID: 37805255 DOI: 10.1016/j.reumae.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/07/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To assess and improve the level of implementation of the recommendations for the psychological management of patients with spondyloarthritis (SpA) and associated inflammatory bowel disease (IBD). METHODS Qualitative study. We performed a narrative literature review to identify the recommendations for the psychological management of SpA and associated IBD and to explore their level of implementation. Based on the findings, we developed a national survey to assess: (1) current level of knowledge and implementation of the recommendations; (2) attitudes towards the recommendations; and (3) barriers and facilitators to their implementation. The results of the review and survey were discussed by a multidisciplinary group of 9 expert rheumatologists and gastroenterologists, who defined implementation strategies to increase the uptake of the recommendations. RESULTS The review included 4 articles, 2 of them included direct recommendations on the identification and management of psychological problems in patients with SpA and IBD. None assessed the level of implementation of the recommendations in routine clinical practice. Our survey showed a great lack of awareness and implementation of the recommendations, even though psychological issues are very relevant for health professionals. Lack of time, resources, and knowledge are considered the main barriers to adherence to the recommendations. We propose several implementation strategies related to educational activities, clinical practice, and others to increase the uptake of reported recommendations. CONCLUSIONS Further research and efforts are required to achieve behaviour changes in clinical practice to improve the identification and management of psychological problems and needs in patients with SpA and IBD.
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Affiliation(s)
| | - Jesús Sanz
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Daniel Ginard
- Servicio de Gastroenterología, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Yago González-Lama
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología y Hepatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Xavier Juanola
- Servicio de Reumatología, Hospital Universitario Bellvitge, IDIBELL, Barcelona, Spain
| | - Miriam Almirall
- Servicio de Reumatología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Natalia Borruel
- Unidad de atención Crohn-Colitis (UACC), Servicio del Aparato Digestivo, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jordi Gratacós
- Servicio de Reumatología, Hospital Universitario Parc Taulí Sabadell, I3PT, Departamento de Medicina UAB, Barcelona, Spain
| | - Estíbaliz Loza
- Instituto de Salud Musculoesquelética (InMusc), Madrid, Spain.
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Lee SI, Hanley S, Vowles Z, Plachcinski R, Azcoaga-Lorenzo A, Taylor B, Nelson-Piercy C, McCowan C, O'Reilly D, Hope H, Abel KM, Eastwood KA, Locock L, Singh M, Moss N, Brophy S, Nirantharakumar K, Thangaratinam S, Black M. Key outcomes for reporting in studies of pregnant women with multiple long-term conditions: a qualitative study. BMC Pregnancy Childbirth 2023; 23:551. [PMID: 37528358 PMCID: PMC10391909 DOI: 10.1186/s12884-023-05773-5] [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: 09/20/2022] [Accepted: 06/10/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Maternal multiple long-term conditions are associated with adverse outcomes for mother and child. We conducted a qualitative study to inform a core outcome set for studies of pregnant women with multiple long-term conditions. METHODS Women with two or more pre-existing long-term physical or mental health conditions, who had been pregnant in the last five years or planning a pregnancy, their partners and health care professionals were eligible. Recruitment was through social media, patients and health care professionals' organisations and personal contacts. Participants who contacted the study team were purposively sampled for maximum variation. Three virtual focus groups were conducted from December 2021 to March 2022 in the United Kingdom: (i) health care professionals (n = 8), (ii) women with multiple long-term conditions (n = 6), and (iii) women with multiple long-term conditions (n = 6) and partners (n = 2). There was representation from women with 20 different physical health conditions and four mental health conditions; health care professionals from obstetrics, obstetric/maternal medicine, midwifery, neonatology, perinatal psychiatry, and general practice. Participants were asked what outcomes should be reported in all studies of pregnant women with multiple long-term conditions. Inductive thematic analysis was conducted. Outcomes identified in the focus groups were mapped to those identified in a systematic literature search in the core outcome set development. RESULTS The focus groups identified 63 outcomes, including maternal (n = 43), children's (n = 16) and health care utilisation (n = 4) outcomes. Twenty-eight outcomes were new when mapped to the systematic literature search. Outcomes considered important were generally similar across stakeholder groups. Women emphasised outcomes related to care processes, such as information sharing when transitioning between health care teams and stages of pregnancy (continuity of care). Both women and partners wanted to be involved in care decisions and to feel informed of the risks to the pregnancy and baby. Health care professionals additionally prioritised non-clinical outcomes, including quality of life and financial implications for the women; and longer-term outcomes, such as children's developmental outcomes. CONCLUSIONS The findings will inform the design of a core outcome set. Participants' experiences provided useful insights of how maternity care for pregnant women with multiple long-term conditions can be improved.
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Affiliation(s)
- Siang Ing Lee
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Stephanie Hanley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Zoe Vowles
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - Amaya Azcoaga-Lorenzo
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Beck Taylor
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Colin McCowan
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | - Holly Hope
- Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK
| | - Kathryn M Abel
- Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Kelly-Ann Eastwood
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
- St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Louise Locock
- Health Services Research Unit, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Megha Singh
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ngawai Moss
- Patient and public representative, London, UK
| | - Sinead Brophy
- Data Science, Medical School, Swansea University, Swansea, UK
| | | | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Mairead Black
- Aberdeen Centre for Women's Health Research, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
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Hristova-Atanasova E, Iskrov G, Raycheva R, Mandova V, Stefanov R. Preconception-Health-Related Attitudes of Bulgarian Women of Reproductive Age. Healthcare (Basel) 2023; 11:healthcare11070989. [PMID: 37046916 PMCID: PMC10094175 DOI: 10.3390/healthcare11070989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Preconception care (PC) is relatively new area of practice. While the volume and quality of PC activities depend on local settings, the awareness of women is critical for the successful promotion of PC services. The aim of this study was to examine the preconception-health-related attitudes and experiences of Bulgarian women of reproductive age. A qualitative study conducted among 20 women aged 18 to 49 years was performed between May and July 2022. Two focus groups were used with mixed samples of nulligravida, pregnant, and postpartum women. The participants thought that the Internet and their obstetrician-gynecologist were the only places where they could learn about getting pregnant. Only two of them discussed their PC plans with their physicians. Women pointed out that general practitioners (GPs) need to be more proactive in promoting PC. All respondents outlined the need for a web-based educational platform that could serve as a primary source of health information for future families. The role and functions of GPs in the continuum of PC should be reconsidered. We recommend targeted educational measures for all stakeholders, including women and GPs. In this regard, an easily accessible, knowledge-based web platform could enhance Bulgarian women’s awareness and perceptions of PC.
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Xiao H, Ye J. Application of Health Education Based on Phased Transition Theory Model in Continuous Nursing for Patients with Inflammatory Bowel Disease. Emerg Med Int 2022; 2022:4194178. [PMID: 35855891 PMCID: PMC9288322 DOI: 10.1155/2022/4194178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/09/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To explore the application effect of health education based on phased transition theory model in the continuous nursing for patients with inflammatory bowel disease (IBD). Method A total of 106 patients with IBD admitted to the hospital were enrolled as the research objects between October 2020 and September 2021. According to random number table method, they were divided into observation group and control group, 53 cases in each group. The control group was given routine nursing, while observation group was additionally given health education based on phased transition theory model. The nutritional status (serum prealbumin (PA), albumin (ALB), body mass index (BMI)), scores of Disease Knowledge Mastery Scale, exercise of self-care agency scale (ESCA), and Inflammatory Bowel Disease Questionnaire (IBDQ) were compared between the two groups before and after intervention. Results After intervention, PA, ALB, and BMI in observation group were higher than those in control group (P < 0.05), scores of Disease Knowledge Mastery Scale, total mastery rate, scores and total score of ESCA, and scores and total score of IBDQ were significantly higher than those in control group (P < 0.05). Conclusion The application of health education based on phased transformation theory model in the continuous nursing improves disease knowledge mastery, self-care ability, nutritional status, and quality of life in IBD patients.
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Affiliation(s)
- Hongmei Xiao
- Department of Gastroenterology, Taizhou People's Hospital, Taizhou 225300, Jiangsu, China
| | - Jun Ye
- Department of Nosocomial Infection Management, Jinhua People's Hospital, Jinhua 321015, Zhejiang, China
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