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Raghavan A, Vishnubala D, Iqbal A, Hunter R, Marino K, Eastwood D, Nykjaer C, Pringle A. UK Nurses Delivering Physical Activity Advice: What Are the Challenges and Possible Solutions? A Qualitative Study. Int J Environ Res Public Health 2023; 20:7113. [PMID: 38063543 PMCID: PMC10706598 DOI: 10.3390/ijerph20237113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023]
Abstract
There are a multitude of health benefits gained from regular physical activity (PA). Currently, PA advice implementation from NHS nurses is inadequate despite their ever-increasing role in lifestyle and preventive medicine. By assessing their knowledge of current PA guidance, this study proposed to investigate the issues with regular PA advice being given and expand upon nurses' proposed barriers and solutions. A qualitative approach using semi structured interviews was undertaken between March and August 2023 involving 13 NHS nurses. Thematic analysis was undertaken using Braun and Clarke's six step approach. Four themes and fifteen subthemes emerged as barriers and solutions in delivering PA advice. Intrinsic barriers included a lack of nurse knowledge on the topic and PA being seen as an afterthought. Extrinsic barriers included time pressures and a lack of staff engagement. Solutions involved increasing staff awareness of guidelines through teaching, policy, encouraging staff to be active and optimising PA advice delivery through a piecemeal approach and utilising online and visual resources. This study displayed an insight into nurses' thoughts on their consultations with patients regarding PA, and proposed several barriers and solutions. Further work is needed to improve nurses' PA knowledge and to assess the proposed strategies to improve its delivery.
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Affiliation(s)
| | - Dane Vishnubala
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK; (D.V.); (D.E.); (C.N.)
- School of Public Health, Imperial College London, London SW7 2BX, UK
| | - Adil Iqbal
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield HD3 3EA, UK;
| | - Ruth Hunter
- York and Scarborough Teaching Hospitals NHS Foundation Trust, York YO31 8HE, UK;
| | | | - David Eastwood
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK; (D.V.); (D.E.); (C.N.)
- Musculoskeletal Department, Locala Health and Wellbeing, Huddersfield HD1 4EW, UK
| | - Camilla Nykjaer
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK; (D.V.); (D.E.); (C.N.)
| | - Andy Pringle
- Clinical Exercise and Rehabilitation Research Centre, School of Sport and Exercise Science, University of Derby, Derby DE22 1GB, UK;
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Marino KR, Donnelly G, Moore IS, De Vivo M, Vishnubala D. Pregnancy and physical activity: facilitating change. Br J Sports Med 2023; 57:1285-1286. [PMID: 37507198 DOI: 10.1136/bjsports-2023-107265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Affiliation(s)
| | | | - Isabel S Moore
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - Marlize De Vivo
- Canterbury Christ Church University, Canterbury, UK
- Active Pregnancy Foundation, London, UK
| | - Dane Vishnubala
- Hull York Medical School, Hull, UK
- University of Leeds, Leeds, UK
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3
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Salman D, Marino K, Griffin S, Shafik A, Fitzpatrick D, Majeed A, Vishnubala D. Concussion in sport: are new guidelines a game changer for primary care? Br J Gen Pract 2023; 73:440-442. [PMID: 37770212 PMCID: PMC10544523 DOI: 10.3399/bjgp23x735009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Affiliation(s)
- David Salman
- MSk Lab, Faculty of Medicine and Department of Primary Care and Public Health, Imperial College London; Specialty Registrar, Sport and Exercise Medicine, Whittington Health NHS Trust, London
| | - Katie Marino
- University Hospitals of North Midlands NHS Trust; Academic GP Registrar, School of Medicine, Keele University, Keele
| | - Steffan Griffin
- Medical Services Department, Rugby Football Union, Twickenham Stadium, London; GP Registrar, Chelsea and Westminster Hospital NHS Foundation Trust
| | - Andrew Shafik
- Medical Department, Crystal Palace Football Club, London; GP Registrar, Epsom and St Helier University Hospitals NHS Trust
| | - Dan Fitzpatrick
- Sport and Exercise Medicine, Barts Health NHS Trust, London; Honorary Research Fellow, School of Sport and Health Sciences, University of Brighton, Brighton
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London; Public Health Directorate, Imperial College Healthcare NHS Trust, London
| | - Dane Vishnubala
- Department of Primary Care and Public Health, Imperial College London, London; Academic Clinical Lead MSc SEM, Faculty of Biological Sciences, University of Leeds, Leeds; Consultant Physician in Sport and Exercise Medicine, Yorkshire Sports Medicine Clinic, York
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Eastwood D, Varney J, Pringle A, Vishnubala D. Physical Activity Clinical Champions: a peer-to-peer physical activity education programme in England. Br J Sports Med 2023; 57:897-898. [PMID: 37385717 DOI: 10.1136/bjsports-2023-107269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/01/2023]
Affiliation(s)
- David Eastwood
- Moving Healthcare Professionals Programme, Office for Health Improvement and Disparities, London, UK
| | - Justin Varney
- Director of Public Health, Birmingham City Council, Birmingham, Birmingham, UK
| | - Andy Pringle
- Clinical Exercise and Rehabilitation Research Centre, School of Human Sciences, University of Derby, Derby, UK
| | - Dane Vishnubala
- Moving Healthcare Professionals Programme, Office for Health Improvement and Disparities, London, UK
- School of Biomedical Sciences, University of Leeds, Leeds, UK
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Marino KR, Jones N, Small C, Shur N, Chatterjee R, Power J, Wright L, Tillett E, Vishnubala D. Sport and exercise medicine in the UK: what lies beyond the crossroads? Br J Sports Med 2023; 57:891-892. [PMID: 37369555 DOI: 10.1136/bjsports-2023-107278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Affiliation(s)
- Katherine Rose Marino
- British Association of Sport and Exercise Medicine, Doncaster, UK
- Keele University, Keele, UK
| | - Natasha Jones
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Faculty Of Sport and Exercise Medicine, Edinburgh, UK
| | - Claire Small
- Pure Sports Medicine, London, UK
- Queen Mary University of London, London, UK
| | - Natalie Shur
- University Hospitals of Leicester NHS Trust, Leicester, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Robin Chatterjee
- British Association of Sport and Exercise Medicine, Doncaster, UK
- Institute of Sport, Exercise and Health (ISEH), London, UK
| | | | - Lucy Wright
- British Association of Sport and Exercise Medicine, Doncaster, UK
- University of Exeter, Exeter, UK
| | - Eleanor Tillett
- British Association of Sport and Exercise Medicine, Doncaster, UK
- University College London, London, UK
| | - Dane Vishnubala
- British Association of Sport and Exercise Medicine, Doncaster, UK
- University of Leeds, Leeds, UK
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Stead A, Vishnubala D, Marino KR, Iqbal A, Pringle A, Nykjaer C. UK physiotherapists delivering physical activity advice: what are the challenges and possible solutions? A qualitative study. BMJ Open 2023; 13:e069372. [PMID: 37116991 PMCID: PMC10151243 DOI: 10.1136/bmjopen-2022-069372] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
OBJECTIVES Despite the known health benefits of physical activity (PA), PA levels are in decline. Healthcare professionals, including physiotherapists, have been identified as ideal conduits to promote PA, yet their knowledge and awareness of PA guidelines are poor. The aims of this study were to explore current knowledge of PA guidelines among UK physiotherapists and identify barriers and possible solutions to delivering PA advice. DESIGN A qualitative approach using semistructured interviews that took place between March and May 2021. Data were analysed with a thematic approach using Braun and Clarke's six steps. SETTING Various inpatient and outpatient clinical settings across six UK regions. PARTICIPANTS Eighteen UK-based physiotherapists managing National Health Service patients were recruited through volunteer sampling in March 2021. RESULTS Five themes and 16 subthemes (shown in parenthesis) were identified as barriers and solutions to delivering PA advice: physiotherapist intrinsic barriers (knowledge, fear/confidence); a lack of emphasis and priority given to PA (time constraints, minimal educational and staff training); patient barriers (compliance, expectations and fear of doing PA); increasing awareness of the PA guidelines (staff training, signposting awareness, use of social media and television campaigns); and optimising delivery (use of visual resources, good communication and approaches involving being individualised and gradual for patients with chronic conditions). CONCLUSIONS In this study, physiotherapist participants seemed to have limited awareness of the PA guidelines despite recent updates and were faced with similar barriers to those previously reported in the literature. The solutions suggested could guide strategies to support physiotherapists being able to deliver PA advice. Further research is needed to evaluate the efficiency of any implemented solutions supporting the delivery of PA advice.
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Affiliation(s)
- Alexandra Stead
- School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Dane Vishnubala
- School of Biomedical Sciences, University of Leeds, Leeds, UK
- Hull York Medical School, Hull, UK
| | | | - Adil Iqbal
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, UK
| | - Andy Pringle
- Clinical Exercise and Rehabilitation Research Centre, School of Human Sciences, University of Derby, Derby, UK
| | - Camilla Nykjaer
- School of Biomedical Sciences, University of Leeds, Leeds, UK
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Vishnubala D, Iqbal A, Marino K, Pandya T, Salman D, Pringle A, Nykjaer C, Bazira P, Eastwood D, Finn G. Creating a sport and exercise medicine undergraduate syllabus: a delphi study. BMC Med Educ 2023; 23:179. [PMID: 36959591 PMCID: PMC10035170 DOI: 10.1186/s12909-023-04139-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Sport and Exercise Medicine (SEM) is a growing speciality in the United Kingdom (UK). This growth has not been replicated in SEM teaching at an undergraduate level and SEM-related topics in schools of medicine in the UK are under-represented. As SEM continues to develop as a specialty it is important to consider how it is embedded at all levels of training. The aim of this project was to establish a consensus on SEM-related skills and knowledge relevant for undergraduate medical students in the UK, ultimately creating a curriculum of learning objectives (LOs). METHODS A modified Delphi survey was utilised to seek consensus on LOs suitable for incorporation into UK medical school curricula. An expert panel with adequate knowledge in the field was recruited. The initial curriculum was created by the research team using already established postgraduate SEM curricula. All learning objectives were sent to the expert panel for opinions in phases. Levels of agreement and comments made by the expert panel were reviewed after each phase until a consensus on each learning objective was made. RESULTS The expert panel was made up of 45 individuals, with 35 also completing phase 2 (78% retention rate). The initial curriculum contained 58 learning objectives separated into 9 themes. In phase 1 31% (18/58) were accepted outright, 48% (28/58) were altered and 19% (11/58) were rejected. Two additional learning objectives were added. Of the 49 LOs included in phase 2, 98% (48/49) were accepted. The final curriculum was made up of 9 sub-themes and 48 LOs. CONCLUSION Sport and Exercise Medicine is a broad ranging and rapidly growing speciality. It is important to establish SEM education in all levels of medical education, including undergraduate level. This is the first published version of a Delphi SEM curriculum for undergraduate medical teaching.
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Affiliation(s)
- Dane Vishnubala
- Hull York Medical School, York, UK.
- University of Leeds, Leeds, UK.
- School of Public Health/MSK lab, Imperial College London, London, UK.
- University of York, Heslington, York, YO105DD, UK.
| | | | | | - Tej Pandya
- Royal Bolton Hospital, Minerva Road, Farnworth, BL4OJR, UK
| | - David Salman
- School of Public Health/MSK lab, Imperial College London, London, UK
| | - Andy Pringle
- Sport Outdoor and Exercise Science, University of Derby, Derby, UK
| | - Camilla Nykjaer
- Faculty of Biological Sciences, University of Leeds, Leeds, UK
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8
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Vishnubala D, Iqbal A, Marino K, Whatmough S, Barker R, Salman D, Bazira P, Finn G, Pringle A, Nykjaer C. UK Doctors Delivering Physical Activity Advice: What Are the Challenges and Possible Solutions? A Qualitative Study. Int J Environ Res Public Health 2022; 19:ijerph191912030. [PMID: 36231332 PMCID: PMC9566007 DOI: 10.3390/ijerph191912030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 05/15/2023]
Abstract
Despite strategies to enable Health Care Professionals (HCPs) to give physical activity (PA) advice to patients, this appears to be rarely done in consultations. The aims of the present study were to gain an understanding of doctors' awareness of current PA guidelines and to explore their opinions on barriers and solutions. A qualitative approach using semi-structured interviews was adopted. This study included 15 doctors currently working in the UK's National Health Service (NHS). A thematic analysis approach was used to analyse the transcripts. Four themes and twelve sub-themes were deciphered. Intrinsic factors limiting the delivery of PA advice included a lack of knowledge of PA guidelines and PA being an afterthought. Barriers to delivering PA guidance included a lack of PA education, time pressures, and patient engagement. Solutions included staff training, incorporating PA into undergraduate training, and encouraging staff to be physically active. Methods to optimise PA guidance included individualised PA advice, local exercise services and schemes, utilising online and visual resources, and motivational interviewing. This study provides an updated insight into doctors' opinions on barriers and solutions to discussing PA with patients. It is clear that further work is needed to ensure greater awareness of PA guidelines amongst clinicians.
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Affiliation(s)
- Dane Vishnubala
- Health Professions Education Unit, Hull York Medical School, York YO10 5DD, UK
- Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
- School of Public Health, Imperial College London, London SW7 2BX, UK
- MSK Lab, Imperial College London, London SW7 2BX, UK
- Correspondence:
| | - Adil Iqbal
- Bradford Teaching Hospital Foundation Trust, Bradford BD9 6RJ, UK
| | | | | | - Ruth Barker
- Health Professions Education Unit, Hull York Medical School, York YO10 5DD, UK
| | - David Salman
- School of Public Health, Imperial College London, London SW7 2BX, UK
- MSK Lab, Imperial College London, London SW7 2BX, UK
| | - Peter Bazira
- Health Professions Education Unit, Hull York Medical School, York YO10 5DD, UK
| | - Gabrielle Finn
- Health Professions Education Unit, Hull York Medical School, York YO10 5DD, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Andy Pringle
- Sport Outdoor and Exercise Science, School of Human Sciences, Human Science Research Centre University of Derby, Derby DE22 1GB, UK
| | - Camilla Nykjaer
- Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
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Vishnubala D, Iqbal A, Marino KR, Salman D, Pringle A, Nykjaer C, Bazira P, Finn G. Creating a Sport and Exercise Medicine Masters syllabus for doctors: a Delphi study. BMJ Open Sport Exerc Med 2022; 8:e001252. [PMID: 35516072 PMCID: PMC8995950 DOI: 10.1136/bmjsem-2021-001252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Sport and Exercise Medicine (SEM) Masters curricula vary. This Delphi study is aimed to create a consensus curriculum for doctors undertaking SEM Masters courses. Methods A modified Delphi survey was used. An expert panel was established of individuals deemed to have adequate knowledge of the field. The research group developed the initial draft of the curriculum by collating and reviewing previously published UK-based postgraduate SEM-related curricula. There were two phases. In phase 1 the expert group either accepted, rejected or modified each learning objective (LO). During phase 2 the expert group were asked to accept or reject each LO that did not get accepted outright previously. The research group analysed the levels of agreements and the comments given by the expert panel after each phase. Results The expert panel consisted of 45 individuals, with 35 completing phase 2 (78% retention rate). Of the 136 LOs initially collated: 71 (52%) were accepted outright, 60 (44%) were altered in some way and reincluded in phase 2, and 5 (4%) were removed after phase 1. The research group added 2 (1%) new LOs on reflection over comments made by the expert panel. The final curriculum contained 133 LOs, divided into 11 subthemes. Conclusions The findings will better inform educators when developing SEM Masters curricula and inform students what they should look for when considering an SEM Masters. This consensus curriculum is an important step in standardising postgraduate SEM education.
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Affiliation(s)
- Dane Vishnubala
- Hull York Medical School, Hull, UK.,University of Leeds, Leeds, UK.,School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | | | | | - David Salman
- School of Public Health/MSk lab, Imperial College Hospital, London, UK
| | - Andy Pringle
- Sport Outdoor and Exercise Science, University of Derby, Derby, UK
| | - Camilla Nykjaer
- Faculty of Biological Sciences, University of Leeds, Leeds, UK
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Marino KR, Vishnubala D, Oja P. Muscle-strengthening activities to improve health outcomes: what the evidence supports. Br J Sports Med 2022; 56:831-832. [PMID: 35361614 DOI: 10.1136/bjsports-2022-105481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 11/04/2022]
Affiliation(s)
| | - Dane Vishnubala
- Hull York Medical School, Hull, UK.,University of Leeds, Leeds, UK
| | - Pekka Oja
- UKK Institute for Health Promotion Research, Tampere, Finland
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11
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Zalecki CJ, Vishnubala D, Marino K, Nykjaer C, Sivan M. The use of single dose intra-articular local anaesthetics in the United Kingdom: A cross-sectional survey of sport and exercise medicine and musculoskeletal professionals. Musculoskeletal Care 2022; 20:681-685. [PMID: 35146889 PMCID: PMC9544231 DOI: 10.1002/msc.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Katie Marino
- Nottingham University Hospital NHS TrustNottinghamUK
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Abstract
The UK Chief Medical Officer guidelines provide convincing evidence of the role of physical activity (PA) in the prevention and management of a number of long-term conditions. Yet physical inactivity remains an important public health priority. Healthcare professionals (HCP) have been identified as being very important for the promotion of PA to their patients. Yet a number of barriers are faced by HCP in this respect including awareness, knowledge, self-efficacy, perceived competence, and time. This paper aims to share current projects and practices and reflect on the challenges of changing the behaviour of HCP to provide physical activity advice.
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Affiliation(s)
- D Vishnubala
- Hull York Medical School, John Hughlings Jackson Building, University Rd., Heslington, York YO10 5DD, UK
| | - A Pringle
- University of Derby School of Science, Derby, UK
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13
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Affiliation(s)
- David Salman
- MSk Lab, Imperial College London, London W12 0BZ, UK
- Department of Primary Care and Public Health, Imperial College London
| | - Dane Vishnubala
- Department of Primary Care and Public Health, Imperial College London
- Hull-York Medical School, York, UK
| | - Peter Le Feuvre
- MSk Lab, Imperial College London, London W12 0BZ, UK
- HQ Army Medical Services, Robertson House, Camberley, UK
| | - Thomas Beaney
- Department of Primary Care and Public Health, Imperial College London
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London
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14
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Vishnubala D, Marino KR, Pratten MK, Pringle A, Griffin SA, Finn G, Bazira P, Edwards K. Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study. BMJ Open Sport Exerc Med 2020; 6:e000888. [PMID: 33262891 PMCID: PMC7672496 DOI: 10.1136/bmjsem-2020-000888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS. METHODS Semi-structured interviews were undertaken to collect data from identified 'stakeholders'. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data. RESULTS N=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality. CONCLUSION The management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent 'unique selling points' of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.
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Affiliation(s)
- Dane Vishnubala
- Hull York Medical School, York, UK
- Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | | | | | - Andy Pringle
- School of Human Sciences, University of Derby, Derby, UK
| | | | | | | | - Kimberley Edwards
- Centre for Sports Medicine, Queens Medical Centre Nottingham, Nottingham, UK
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15
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Marino KR, Vishnubala D, Ahmed OH, Zondi PC, Whittaker JL, Shafik A, Le CY, Chatterjee D, Odulaja A, Jones NE, Thornton JS. Embrace your discomfort: leadership and unconscious bias in sport and exercise medicine. Br J Sports Med 2020; 55:303-304. [PMID: 33051213 DOI: 10.1136/bjsports-2020-103061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Katherine Rose Marino
- British Association of Sport and Exercise Medicine, Doncaster, South Yorkshire, UK .,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Osman Hassan Ahmed
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, Dorset, UK.,The FA Centre for Disability Football Research, The Football Association, Burton upon Trent, Staffordshire, UK
| | | | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Centre Of Canada, Richmond, British Columbia, Canada
| | - Andrew Shafik
- South Tyneside NHS Foundation Trust, South Shields, South Tyneside, UK.,Newcastle Thunder Academy, Newcastle, UK
| | - Christina Y Le
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Dean Chatterjee
- Nottingham University Hospitals NHS Trust, Nottingham, UK.,Nottingham Rugby, Nottingham, UK
| | | | - Nigel Edward Jones
- British Association of Sport and Exercise Medicine, Doncaster, South Yorkshire, UK.,University of Liverpool, Liverpool, Merseyside, UK
| | - Jane S Thornton
- Department of Family Medicine, Schulich School of Medicine & Dentistry, London, Ontario, Canada.,Fowler Kennedy Sport Medicine Clinic, London, Ontario, Canada
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16
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Kime N, Pringle A, Zwolinsky S, Vishnubala D. How prepared are healthcare professionals for delivering physical activity guidance to those with diabetes? A formative evaluation. BMC Health Serv Res 2020; 20:8. [PMID: 31900136 PMCID: PMC6942391 DOI: 10.1186/s12913-019-4852-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 12/19/2019] [Indexed: 12/25/2022] Open
Abstract
Background Physical activity is recognised as important for diabetes management and improved overall health of individuals with diabetes, yet many adults with diabetes are inactive. Healthcare professionals have been identified as key to promoting physical activity, including individuals with diabetes, but are ill-prepared to deliver this. Our paper evaluates the barriers/facilitators of healthcare professionals’ delivery of physical activity guidance to adults with diabetes and aims to inform efforts to investigate and enhance their preparedness to promote physical activity. Methods A sequential mixed method, two-phase design was adopted involving a purposeful sample of healthcare professionals. Phase one was an online pilot survey designed to test assumptions around healthcare professionals’ knowledge, training and preparedness to deliver physical activity guidance. Phase two comprised eighteen semi-structured interviews, thematically analysed to provide an in-depth exploration of healthcare professionals’ experiences of delivering physical activity guidance to adults with diabetes. Results Healthcare professionals are committed to promoting physical activity to adults with diabetes and are reasonably confident in giving basic, generic guidance. Yet, significant challenges prevent them from achieving this in their practice, including: lack of education and training around physical activity, diabetes and health; ignorance of recommended physical activity and diabetes guidelines; lack of awareness of referral options; limited time and accessibility to appropriate resources. Nevertheless, healthcare professionals believed discussions around physical activity needed to be an integral part of consultations, incorporating improved communication strategies for conveying key physical activity messages. Conclusions HCPs have a key role in the promotion of physical activity to people with long-term conditions such as diabetes and they are identified within both the strategic policy context and national interventions for physical activity. Yet, this study indicated that HCPs face multiple and at times complex barriers to physical activity promotion generally and with diabetes patients. Conversely HCPs also reported what works, why and how, when promoting physical activity. Rich information derived from the day-to-day, working healthcare professional is integral to shaping future practices going forward. The bottom up, iterative design adopted in this study provides an approach to tap into this information.
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Affiliation(s)
- N Kime
- Academic Unit for Elderly Care and Rehabilitation, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK.
| | - A Pringle
- College of Life and Natural Sciences, University of Derby, Derby, DE22 1GB, UK
| | - S Zwolinsky
- West Yorkshire and Harrogate Cancer Alliance, White Rose House, West Parade, Wakefield, WF1 1LT, UK
| | - D Vishnubala
- NHS Vale of York Clinical Commissioning Group, GP Haxby Group, York, YO24 3BU, UK
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