Health Professionals For People Research Articles

Foot orthoses for first metatarsophalangeal joint osteoarthritis: study protocol for the FORT randomised controlled trial

BackgroundFirst metatarsophalangeal (MTP) joint osteoarthritis (OA) is a painful and debilitating condition affecting nearly one in 10 people aged over 50 years. Non-drug, non-surgical treatments are recommended by OA clinical guidelines, yet there have only ever been two randomised controlled trials (RCTs) evaluating such strategies in people with first MTP joint OA. Foot orthoses are a common non-drug, non-surgical strategy used by allied health professionals for people with first MTP joint OA, however, it is unknown whether these devices are effective in improving the symptoms associated with the condition. This clinical trial aimed to determine whether contoured foot orthoses lead to greater reductions in first MTP joint pain on walking compared to sham flat insoles in people with first MTP joint OA.MethodsThe FORT trial (Foot ORthoses for big Toe joint osteoarthritis) is a two-arm participant- and assessor-blinded, multi-site RCT conducted in Melbourne, Sydney, Brisbane and the Gold Coast, Australia. We are recruiting 88 community-dwelling people with symptomatic radiographic first MTP joint OA. Following baseline assessment, participants are randomized to receive either: i) contoured foot orthoses; or ii) sham flat insoles following baseline assessment. Participants have two visits with a study podiatrist where they are provided with their allocated insoles, to be worn daily for 12 weeks at all times when wearing shoes. The primary outcome is self-reported first MTP joint pain on walking (numerical rating scale), assessed at baseline and 12 weeks. Secondary outcomes include additional measures of first MTP joint and foot pain, physical function, quality of life, participant-perceived global ratings of change (pain and function), and level of physical activity.DiscussionThis study will provide novel evidence about whether contoured foot orthoses improve pain and other symptoms compared to sham insoles in people with first MTP joint OA. Outcomes will help to inform clinical guidelines and practice about the use of foot orthoses for managing symptoms in this under-researched group of people with OA.Trial registrationProspectively registered with the Australian New Zealand Clinical Trials Registry (reference: ACTRN12619000926134) on 3/07/2019.

Instruments to assess mental health-related stigma among health professionals and students in health sciences: A systematic psychometric review.

To evaluate the psychometric properties of the instruments to assess the mental health-related stigma among health professionals and students in health sciences. Evidence on the stigmatization by health professionals of people with mental health illness is increasingly compelling. Valid and reliable instruments are needed for the assessment of mental health-related stigma and effectiveness of anti-stigma interventions. Systematic psychometric review. MEDLINE (via PubMed), CINAHL (via EBSCO), PsycINFO, Scopus, and Open Grey from their inception to August 2017. No limits were applied. We included studies on the development of a measurement instrument or on the evaluation of one or more of its measurement properties. The methodological quality of the included studies and quality of the measurement instruments identified were assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. We included 25 studies involving 15 measurement instruments. The "Atributtion Questionnaire" (five studies) and the "Opening Minds Scale for Health Care providers (OMS-HC)" (four studies) were the most investigated instruments. Internal consistency, content validity, structural validity, and hypothesis testing were the measurement properties most commonly evaluated. Measurement error and responsiveness were investigated in only two studies. Eight psychometric properties of OMS-HC were evaluated, three of which have a positive strong level of evidence. A substantial number of instruments have been developed to assess mental health-related stigma among health professionals. There is a lack of any assessment of certain measurement properties. The OMS-HC is the instrument that had the strongest evidence.

Do health consultations for people with learning disabilities meet expectations? A narrative literature review

Accessible Summary People with learning disabilities have unmet health needs. Annual health checks were brought in to improve health care, but do they work? The research shows checks lead to more tests for illness and illness being identified. A lot of people still do not see their doctor, and not all doctors do health checks. Future research needs to understand how people with disabilities feel about seeing their doctor or nurse, and how doctors and nurses feel towards them. AbstractAimTo explore the benefits and disadvantages of annual health checks for people with learning disabilities, including: What are the rationales and outcome measures for health checks? How well do health checks meet the needs of people with learning disabilities? What areas does research in this topic need to focus on in the future? BackgroundHealth consultations are an interpersonal activity that influence health outcomes and attitudes towards self and health professionals for people with learning disabilities. Annual health checks have been introduced to improve health inequalities for people with learning disabilities.MethodA narrative literature review of health care for people with learning disabilities was undertaken to evaluate health care for this population, and specifically the outcomes from annual health checks.FindingsWhile annual health checks have made some improvements in terms of health outcomes, attendance for appointments is still low, provision is variable and experiences of health checks for people with learning disabilities are under‐researched.ConclusionsService user‐led research into their health experiences is needed. Research into the attitudes and experiences of health professionals in relation to people with learning disabilities is needed. Healthcare inequalities are only being partially addressed—improvement is needed in terms of service user experience and engagement.

Erratum

Journal of Applied Social PsychologyVolume 46, Issue 5 p. 315-315 ErratumFree Access Erratum This article corrects the following: Human values and non-adherence to doctors' instructions across Europe Salla Ahola, Volume 45Issue 4Journal of Applied Social Psychology pages: 214-225 First Published online: October 7, 2014 First published: 13 May 2016 https://doi.org/10.1111/jasp.12385AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat In the Journal of Applied Social Psychology 45:4 (2015), there was an error in the discussion section of the article “Human values and non-adherence to doctors’ instructions across Europe”, on page 223. It was claimed that there is no question in the European Social Survey (ESS) requesting respondents’ occupations, and that therefore it was not possible to test whether the views of doctors or other health care professionals might differ from other people's views regarding patient adherence. However, there actually is a question in the ESS requesting respondents’ occupations, and thus it is possible to distinguish health professionals and health associate professionals from people with other occupations. Logistic regression analyses in the pooled data from 14 countries (adjusted for the effects of countries) indicated that as compared to other people health professionals were less likely to have non-adherent views (OR = 0.62, 95% CI [0.41, 0.96], p = .032) and health associate professionals were more likely to have non-adherent views (OR = 1.55, 95% CI [1.24, 1.93], p < .001). As regards non-adherent behaviour, neither health professionals (OR = 1.12, 95% CI [0.79, 1.59], p = .511) nor health associate professionals (OR = 0.93, 95% CI [0.72, 1.19], p = .558) differed from other people. Nevertheless, the results reported in the above-mentioned article concerning the relationship between values and non-adherence remain essentially unchanged also after excluding health professionals and health associate professionals from the analyses. More specifically, the majority of the associations reported as statistically significant in the original article remained so also after excluding the two aforementioned groups of health professionals. The few associations that lost their significance are listed below: Regarding Table 1, the correlation between self-transcendence and conservation lost its significance as did the correlation between self-transcendence and non-adherent behavior. Regarding Table 2, the correlation between openness to change and non-adherent behavior lost its significance in Iceland. In Table 3, the odds ratios of marital status and subjective general health became non-significant in the block 2 of model 1 predicting non-adherent views. In Table 4, all of the associations originally reported as statistically significant remained so. Reference Ahola, S. (2015). Human values and non-adherence to doctors' instructions across Europe. Journal of Applied Social Psychology, 45, 214– 225. Volume46, Issue5May 2016Pages 315-315 ReferencesRelatedInformation

Public opinion on community-based education and exercise programs for managing hip and knee osteoarthritis-like symptoms: results of a survey.

IntroductionIn North America, delivery of targeted exercise and education programs by health professionals for people with hip and knee osteoarthritis (OA) poses challenges related to cost and access. Linking the wellness and health sectors could increase program availability. We evaluated if people with OA were willing to participate in programs delivered by trainers in community centers/gyms.MethodsWe conducted an online survey of the general public in Canada over a period of 2 months. Participants included those aged ≥30 years with self-reported chronic OA-like knee or hip pain. We evaluated access to community/fitness centers, exercise frequency, interest in attending an evidence-based program twice a week for 6 weeks, and willingness to pay. Analyses included descriptive statistics with 95% confidence intervals and chi-square tests to evaluate factors associated with willingness to attend the program.ResultsAfter removing duplicate records, 751 respondents completed the survey with 408 likely having hip and/or knee OA and never having received a joint replacement. These 408 respondents had an age range of 30 to ≥75 years and 86% were female. Of the 408, (63.7%) were between 45 and 64 years of age. Only two respondents reported that a community center was >1 hour away. One hundred and fifty-six (38%) reported a current membership, and 203 (50.4%) reported exercise 3 days/wk, 120 (29.8%) <3 days, and 80 (19.9%) reported no exercise. Two hundred and ninety-seven respondents (73.7%) were willing to attend a program, and, of these, 26% were willing to pay $100 Cdn or more. Age, sex, access to a community center/gym, current gym membership, and current frequency of exercise were not significantly associated with willingness to attend a program.ConclusionAlmost 75% of respondents with OA, despite one in three having a community center membership, were interested in attending a targeted program delivered in community/fitness centers. A program in the wellness sector may be a viable option to support people in managing their hip and or knee OA.

Effectiveness of Musculoskeletal Education Interventions in People With Low Literacy Levels: A Systematic Review

ObjectiveTo conduct a systematic review to assess the effectiveness of patient education interventions delivered or directed by health professionals for people with musculoskeletal conditions who also have lower levels of literacy.MethodsElectronic databases were searched from 1946 to May 2012. Randomized controlled trials with primary interventions designed specifically for individuals with musculoskeletal conditions and lower levels of literacy were eligible for inclusion. The quality of the study was determined by assessing method of randomization, allocation concealment, creation and maintenance of comparable groups, blinding of patients and providers, control of confounding, and the validity and reliability of outcome measures.ResultsOf the 2,440 studies located using the search strategy, 6 studies met the inclusion criteria. Three public health community studies and 3 rheumatology clinic-based studies delivered educational programs to people with musculoskeletal conditions who also had lower levels of literacy. Three moderate quality studies suggest that musculoskeletal educational interventions had a small short-term effect on knowledge and 2 moderate quality studies suggest musculoskeletal interventions had a small effect on self-efficacy (although results on self-efficacy were conflicting in 1 of these studies). Only 1 moderate quality study showed a small effect on anxiety and 1 on self-perceived health and well-being in people with lower literacy.ConclusionHigh quality evidence is lacking on the effectiveness of musculoskeletal education interventions for people with lower literacy levels. Research programs that test the effectiveness of patient education interventions for arthritis must recruit and engage people with lower levels of literacy.

Development of a theory-based intervention to increase prescription of inspiratory muscle training by health professionals in the management of people with chronic obstructive pulmonary disease.

The purpose of this paper is twofold: (1) to provide an overview of the literature on barriers to evidence-based practice (EBP) and the effectiveness of implementation interventions in health care; and (2) to outline the development of an implementation intervention for improving the prescription of inspiratory muscle training (IMT) by physical therapists and other health professionals for people with chronic obstructive pulmonary disease (COPD). Individuals, organizations, and the research itself present barriers to EBP in physical therapy. Despite the evidence supporting the use of IMT, this treatment continues to be under-used in managing COPD. Current health services research shows that traditional information-based approaches to implementation, such as didactic lectures, do not adequately address the challenges health professionals face when trying to make changes in practice. We propose the development of a theory-based intervention to improve health professionals' use of IMT in the management of COPD. It is postulated that a behavioural intervention, based on the theory of planned behaviour (TPB), may be more effective than an information-based strategy in increasing the prescription of IMT by health professionals. TPB may be used to understand the antecedents of health professionals' behaviour and to guide the development of implementation interventions. Further research is needed to evaluate the effectiveness of this proposed intervention in the management of people with COPD.

Life stories of people with rheumatoid arthritis who retired early: how gender and other contextual factors shaped their everyday activities, including paid work

The aim of the present study was to explore how contextual factors affect the everyday activities of women and men with rheumatoid arthritis (RA), as evident in their life stories. Fifteen people with RA, who had retired early due to the disease, were interviewed up to three times, according to a narrative biographic interview style. The life stories of the participants, which were reconstructed from the biographical data and from the transcribed 'told story' were analysed from the perspective of contextual factors, including personal and environmental factors. The rigour and accuracy of the analysis were enhanced by reflexivity and peer-review of the results. The life stories of the participants in this study reflected how contextual factors (such as gender, the healthcare system, the support of families and social and cultural values) shaped their everyday activities. In a society such as in Austria, which is based on traditional patriarchal values, men were presented with difficulties in developing a non-paid-work-related role. For women, if paid work had to be given up, they were more likely to engage in alternative challenging activities which enabled them to develop reflective skills, which in turn contributed to a positive and enriching perspective on their life stories. Health professionals may thus use some of the women's strategies to help men. Interventions by health professionals in people with RA may benefit from an approach sensitive to personal and environmental factors.

Exploring men's and women's experiences of depression and engagement with health professionals: more similarities than differences? A qualitative interview study

BackgroundIt is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis was to explore how men and women with depression articulate their emotional distress, and examine whether there are gender differences or similarities in the strategies that respondents found useful when engaging with health professionals.MethodsIn-depth qualitative interviews with 22 women and 16 men in the UK who identified themselves as having had depression, recruited through general practitioners, psychiatrists and support groups.ResultsWe found gender similarities and gender differences in our sample. Both men and women found it difficult to recognise and articulate mental health problems and this had consequences for their ability to communicate with health professionals. Key gender differences noted were that men tended to value skills which helped them to talk while women valued listening skills in health professionals, and that men emphasised the importance of getting practical results from talking therapies in their narratives, as opposed to other forms of therapy which they conceptualised as 'just talking'. We also found diversity among women and among men; some respondents valued a close personal relationship with health professionals, while others felt that this personal relationship was a barrier to communication and preferred 'talking to a stranger'.ConclusionOur findings suggest that there is not a straightforward relationship between gender and engagement with health professionals for people with depression. Health professionals need to be sensitive to patients who have difficulties in expressing emotional distress and critical of gender stereotypes which suggest that women invariably find it easy to express emotional distress and men invariably find it difficult. In addition it is important to recognise that, for a minority of patients, a personal relationship with health professionals can act as a barrier to the disclosure of emotional distress.

Quality of care for people with osteoarthritis: a qualitative study

The overall aim of this qualitative study was to explore within primary care the experiences of management and care of individuals with end-stage lower limb osteoarthritis who are on the waiting list for joint replacement. Osteoarthritis, one of the most common chronic diseases, causes loss of physical function and severe pain among sufferers. Improving quality of care and service provision for individuals with chronic diseases is high on the UK's NHS agenda. Data were collected by semi-structured qualitative interviews with 21 individuals with osteoarthritis who were waiting for a hip or knee replacement operation. Interviews were analysed using framework analysis. Participants had been suffering with osteoarthritis for between seven months and 38 years. The management by health professionals for people on the waiting list for joint replacement was minimal. However, participants spoke of 'hiding' their symptoms from health professionals and were trying to 'self-manage' their symptoms. Families became more involved in helping individuals with osteoarthritis to manage with everyday life. Management of individuals' osteoarthritis while on the waiting list needs to be given consideration by health professionals in primary and secondary care. Health professionals need to be working with each other to provide more comprehensive care across the primary and secondary care interface. Case managers or community matrons could be identified as the co-ordinator and assessor of the needs of patients with osteoarthritis so as to try and improve pain management and service provision for these individuals especially while on the waiting list.