Measuring the burden of treatment for chronic disease: implications of a scoping review of the literature

Background: Although there has been growing research on the burden of treatment, the current state of evidence on measuring this concept is unknown. This scoping review aimed to provide an overview of the current state of knowledge as well as clear recommendations for future research, within the context of chronic disease. Methods: Four health-based databases, Scopus, CINAHL, Medline, and PsychInfo, were comprehensively searched for peer-reviewed articles published between the periods of 2000–2016. Titles and abstracts were independently read by two authors. All discrepancies between the authors were resolved by a third author. Data was extracted using a standardized proforma and a comparison analysis was used in order to explore the key treatment burden measures and categorize them into three groups. Results: Database searching identified 1458 potential papers. After removal of duplications, and irrelevant articles by title, 1102 abstracts remained. An additional 22 papers were added via snowball searching. In the end, 101 full papers were included in the review. A large number of the studies involved quantitative measures and conceptualizations of treatment burden (n = 64; 63.4%), and were conducted in North America (n = 49; 48.5%). There was significant variation in how the treatment burden experienced by those with chronic disease was operationalized and measured. Conclusion: Despite significant work, there is still much ground to cover to comprehensively measure treatment burden for chronic disease. Greater qualitative focus, more research with cultural and minority populations, a larger emphasis on longitudinal studies and the consideration of the potential effects of “identity” on treatment burden, should be considered

Work-Life interference among working Australian Muslim men: Where religion and culture unite

This goal of this study was to expand our understanding of the interference between work and personal life (work-life interference) by collecting survey questionnaires from 301 Australian Muslim men, a significant ethno-religious cultural minority. Australian Muslims have distinct cultural and religious values, which provide ground to suspect that they may have different experiences from the mainstream Australian population. Results indicated that participants experience low levels of interference and the pattern is similar to that found among workers from societies known to uphold collectivistic cultural values. In accordance with workers in such societies, job demands were a stronger predictor of interference than work hours, which raise doubts about the effectiveness of work-life policies such as flexible work options around working hours

The ideal healthcare: priorities of people with chronic conditions and their carers

Background It is well established that health consumer opinions should be considered in the design, delivery, and evaluation of health services. However, the opinions of people with chronic conditions and their carers and what they actually consider as ideal healthcare is limited. The aim of this study is to investigate the healthcare priorities of consumers with chronic conditions and their carers, if there are differences between these two groups, and if priorities differ depending on geographical location. Methods The nominal group technique was used as a method to identify what is currently important to, or valued by, participants. This method was also particularly suited to learning about healthcare problems and generating important solutions, thereby helping to bridge the gap between research and policy. Recruitment was carried out via purposive sampling, with the assistance of community pharmacies, general practices, various health agencies, government and non-government organisations. A total of 11 nominal groups were conducted; five groups consisted predominantly of consumers (n = 33 participants), two groups consisted predominantly of carers (n = 12 participants) and four were mixed groups, i.e. consumers, carers, and both (n = 26 participants). Results The findings suggested that to create a model of ideal healthcare for people with chronic conditions and their carers, appropriate and timely healthcare access was of paramount importance. Continuity and coordinated care, patient-centred care and affordability were equally the second most important healthcare priorities for all groups. When compared with other groups, access was discussed more frequently among participants residing in the rural area of Mount Isa. Compared to consumers, carers also discussed priorities that were more reminiscent with their caring roles, such as increased access and continuity and coordinated care. Conclusions Access to healthcare is the most important priority for people with chronic conditions and their carers. In the event of inappropriate access for certain groups, all other efforts to increase the quality of healthcare delivery, e.g. patient-centred care, may be pointless. However, health professionals alone may be limited in their ability to address the concerns related to healthcare access; structural changes by health policy makers may be needed

Интеграция информационных технологий в учебный процесс общей и специальной (коррекционной) школы

В статье рассматриваются вопросы, связанные с возможностью и необходимостью интеграции информационных технологий в учебный процесс общей и специальной (коррекционной) школы, изменения содержания, методов и организационных форм обучения с применением информационных технологий, а также формирования навыков компьютерной грамотности в сфере специального образования. Формулируются функциональные задачи для использования компьютерных технологий в специальном обучении

Is the pharmacy profession innovative enough?: meeting the needs of Australian residents with chronic conditions and their carers using the nominal group technique

Background Community pharmacies are ideally located as a source of support for people with chronic conditions. Yet, we have limited insight into what innovative pharmacy services would support this consumer group to manage their condition/s. The aim of this study was to identify what innovations people with chronic conditions and their carers want from their ideal community pharmacy, and compare with what pharmacists and pharmacy support staff think consumers want. Methods We elicited ideas using the nominal group technique. Participants included people with chronic conditions, unpaid carers, pharmacists and pharmacy support staff, in four regions of Australia. Themes were identified via thematic analysis using the constant comparison method. Results Fifteen consumer/carer, four pharmacist and two pharmacy support staff groups were conducted. Two overarching themes were identified: extended scope of practice for the pharmacist and new or improved pharmacy services. The most innovative role for Australian pharmacists was medication continuance, within a limited time-frame. Consumers and carers wanted improved access to pharmacists, but this did not necessarily align with a faster or automated dispensing service. Other ideas included streamlined access to prescriptions via medication reminders, electronic prescriptions and a chronic illness card. Conclusions This study provides further support for extending the pharmacist’s role in medication continuance, particularly as it represents the consumer’s voice. How this is done, or the methods used, needs to optimise patient safety. A range of innovative strategies were proposed and Australian community pharmacies should advocate for and implement innovative approaches to improve access and ensure continuity of care

Treatment Burden and Chronic Illness: Who is at Most Risk?

Background: There is a need to ascertain the type and level of treatment burden experienced by people with co-morbidities. This is important to identify the characteristics of participants who are at most risk of treatment burden.  Objective: The aim of this study is to identify the characteristics of participants who are at most risk of treatment burden.  Methods: This cross-sectional study was part of a larger project and recruitment was conducted across four Australian regions: rural, semi-rural and metropolitan. Participants were asked about their treatment burden using an adapted version of a measure, which included the following five dimensions: medication, time and administrative, lifestyle change, social life and financial burden.  Results: In total, 581 participants with various chronic health conditions reported a mean global treatment burden of 56.5 out of 150 (standard deviation = 34.5). Number of chronic conditions (β = .34, p < 0.01), age, (β = −.27, p < 0.01), the presence of an unpaid carer (β = .22, p < 0.001) and the presence of diabetes mellitus and other endocrine conditions (β = .13, p < 0.01) were significant predictors of overall treatment burden. For the five dimensions of treatment burden, social, medicine and administrative burden were predicted by the same cluster of variables: number of conditions, age, presence of an unpaid carer and diabetes. However, in addition to these variables, financial dimensions were also predicted by education level, ethnicity and health insurance. Educational level also influenced lifestyle burden.  Conclusion: A substantial proportion of community-dwelling adults with chronic conditions have considerable levels of treatment burden. Specifically, health professionals should provide greater focus on managing overall treatment burden for persons who are of young age, have an endocrine condition or an unpaid carer, or a combination of these factors

The role of religion in work-life interface

Although religion is central to the lives of many people, little attempt has been made to understand its role within work–life conflict, work–life facilitation and more broadly, work–life balance. This study advances current knowledge by examining the role of religion within these concepts, and exploring its moderator influence. This is achieved through investigating the experiences of Australian Muslim men and the religion of Islam, which encourages multiple roles for its followers and involves well-defined physical acts of worship. To test various hypotheses, data were collected in the form of survey questionnaires, either face-to-face or online, from 301 Australian Muslim men. The findings support the proposition that religiosity can be beneficial for work–life balance, rather than competing with work and other non-work roles for time and energy. Furthermore, religiosity can moderate the relationships between job demands and work-to-life conflict, and work hours and work-to-life conflict, but not between work flexibility and work/life facilitation, and family demands and life-to-work conflict. The findings suggest that religiosity can be important for work–life balance and stress the need for a change in research direction in this area, one that is broadened to include other roles besides work and family, including religion

The role of religion in work-life interface

Although religion is central to the lives of many people, little attempt has been made to understand its role within work–life conflict, work–life facilitation and more broadly, work–life balance. This study advances current knowledge by examining the role of religion within these concepts, and exploring its moderator influence. This is achieved through investigating the experiences of Australian Muslim men and the religion of Islam, which encourages multiple roles for its followers and involves well-defined physical acts of worship. To test various hypotheses, data were collected in the form of survey questionnaires, either face-to-face or online, from 301 Australian Muslim men. The findings support the proposition that religiosity can be beneficial for work–life balance, rather than competing with work and other non-work roles for time and energy. Furthermore, religiosity can moderate the relationships between job demands and work-to-life conflict, and work hours and work-to-life conflict, but not between work flexibility and work/life facilitation, and family demands and life-to-work conflict. The findings suggest that religiosity can be important for work–life balance and stress the need for a change in research direction in this area, one that is broadened to include other roles besides work and family, including religion

The role of religion in work-life interface

Although religion is central to the lives of many people, little attempt has been made to understand its role within work–life conflict, work–life facilitation and more broadly, work–life balance. This study advances current knowledge by examining the role of religion within these concepts, and exploring its moderator influence. This is achieved through investigating the experiences of Australian Muslim men and the religion of Islam, which encourages multiple roles for its followers and involves well-defined physical acts of worship. To test various hypotheses, data were collected in the form of survey questionnaires, either face-to-face or online, from 301 Australian Muslim men. The findings support the proposition that religiosity can be beneficial for work–life balance, rather than competing with work and other non-work roles for time and energy. Furthermore, religiosity can moderate the relationships between job demands and work-to-life conflict, and work hours and work-to-life conflict, but not between work flexibility and work/life facilitation, and family demands and life-to-work conflict. The findings suggest that religiosity can be important for work–life balance and stress the need for a change in research direction in this area, one that is broadened to include other roles besides work and family, including religion

Work-life conflict in Australian Muslims: Is gender important?

Purpose This study aims to examine how working Australian Muslim men experience work-life conflict and how gender influences their experience. Design/methodology/approach Survey questionnaires were collected, either face-to-face or online, from 403 Australian Muslim men and women. Findings Work-to-life conflict is more prevalent than life-to-work conflict in both sexes, and there are no gender differences in the experiences of either direction of conflict. Job demands are a stronger predictor than work hours in both sexes and the findings corroborate existing Western research on the importance of work flexibility in helping both sexes cope with conflict. As expected, non-work related antecedents have more impacts on life-to-work conflict among women than in men, but the findings question the role of religion, indicating its beneficial rather than demanding nature. Finally, work-to-life conflict is a slightly stronger negative predictor of job satisfaction in women than men, whereas life-to-work conflict is a stronger negative predictor in men but not in women. Research limitations/implications A greater focus on the work-life experiences of nontraditional populations and a change in the direction of work-life research, one that is broadened to include other roles besides work and family, such as religion, are needed. Practical implications Workplace policies designed to mitigate the negative impact of work-life conflict need to be matched to the workforce for both the workers and workplace to gain full benefits. Originality/value This research broadens the scope of work-life knowledge, one that is predominantly based on Western societies on white, English-speaking backgrounds, to men and women of non-traditional minority populations