Does the professional and working context of United Kingdom clinicians predict if they use practices to support patients with long term conditions to self manage?

INTRODUCTION: Our study examines how the professional and employment context may influence clinicians' practice self management support for patients with long term conditions (LTC). MATERIAL AND METHODS: We surveyed clinicians working with patients with depression, chronic obstructive pulmonary disorder (COPD), chronic musculo skeletal pain and diabetes. RESULTS: Clinicians most frequently endorsed items on a scale concerned with patient centeredness, and less frequently endorsed items concerned with clinical and organizational self management support. The most important factors predicting these latter activities were the intensity of working experience with patients with LTC and attending professional training addressing the principles and practice of self management support. Practicing patient centeredness was endorsed by nearly all respondents, and so was not sensitive to variation on work variables. CONCLUSIONS: The interaction of training and intensity of work with patients with LTC seems to have the most powerful effect on undertaking clinical and organizational self management support practices. To facilitate clinicians' practice of self management support for patients with LTC it is very important to provide relevant professional training and to build specialized patient care teams with professionals having complimentary skills

A randomised controlled trial of the effectiveness of a breastfeeding training DVD on improving breastfeeding knowledge and confidence among healthcare professionals in China.

Background: Despite almost all babies being breastfed initially, the rates of exclusive breastfeeding rate at six months is only 30% in China. Improving professionals' knowledge and practical skill is a key government strategy to increase breastfeeding rates. This study aimed to test the effectiveness of a breastfeeding DVD training method for clinicians on improving their knowledge and confidence in breastfeeding support skills of teaching mothers Positioning and Attachment (P & A) and Hand Expression (HE). Methods: A randomised controlled trial was conducted in three hospitals in Zhejiang province, China in 2014. Participants were recruited before their routine breastfeeding training course and randomly allocated to intervention group (IG) and control group (CG). The 15 minute "Breastfeeding: Essential Support Skills DVD" was the intervention for IG and vaginal delivery DVD was used for CG. All participants completed questionnaires of job information, knowledge and confidence in the two skills before (baseline) and immediately after viewing the DVD (post DVD). Results: Out of 210 participants, 191 completed knowledge assessments before and after watching the DVD (IG n=96, CG n=95), with the response rate of 91.0%. At baseline, there are no significant differences in job variables, knowledge scores and confident scores. The total knowledge score significantly increased post-DVD for IG (pre-DVD: M=5.39, SD=2.03; post-DVD: M=7.74, SD=1.71; t (95) =-10.95, p<0.01), but no significant change in total knowledge score for CG between pre- and post-DVD (pre-DVD: M=5.67, SD=1.70; post-DVD: M=5.56, SD=1.63; t (94) =0.85). The total confidence scores were significantly higher post-DVD than pre-DVD in IG (pre-DVD: M=66.49, SD=11.27; post- DVD: M=71.81, SD=9.33; t (68) =-4.92, p<0.01), but no significant difference was seen in CG between pre- and post-DVD total confidence scores (pre-DVD: M=68.33, SD=11.08; post-DVD: M=68.35, SD=11.40; t (65) =-0.25). Personal and job variables did not mediate these effects. Conclusions: The breastfeeding training DVD improved professionals' knowledge and confidence of the two breastfeeding support skills. However, the effect on professionals' practice and on breastfeeding outcomes needs to be examined in the future

Web-based self-management for young cancer survivors: consideration of user requirements and barriers to implementation.

PURPOSE: As the population of young cancer survivors increases, there is a need to develop alternative ways of providing post-treatment support. Online systems potentially offer self-management and e-learning support following cancer treatment. This research aims to explore the self-management support needs of teenage and young adult cancer survivors and consider whether those needs can be met through a web-based self-management resource. METHODS: A mixed methods approach was adopted including an online survey (n = 24), focus groups and interviews with teenage and young adult cancer survivors (n = 7) and interviews with parents of survivors (n = 6), information technology specialists (n = 8) and clinical, nursing and social work professionals (n = 11). RESULTS: All stakeholders were supportive of web-based self-management to meet information and support needs that would supplement continued direct interaction with clinical staff. Barriers to implementation were identified in terms of risks to young people, governance issues and the challenges of providing a long-term service. CONCLUSION: Computer access and use amongst teenagers and young adults is commonplace, and there is an expectation that self-management needs will be met at least partially online in the future. There is a desire for online social support through peer interaction as well personal developmental and clinical management. These elements may need to be run through different systems to cater for governance requirements. IMPLICATIONS FOR CANCER SURVIVORS: An online self-management system could provide support at a number of different levels. The barriers to implementation should be addressed, to ensure that survivors can be supported in this way in the future

From tagging to theorizing: deepening engagement with cultural heritage through crowdsourcing

Crowdsourcing, or “obtaining information or services by soliciting input from a large number of people,” is becoming known for the impressive productivity of projects that ask the public to help transcribe, describe, locate, or categorize cultural heritage resources. This essay argues that crowdsourcing projects can also be a powerful platform for audience engagement with museums, offering truly deep and valuable connection with cultural heritage through online collaboration around shared goals or resources. It includes examples of well-designed crowdsourcing projects that provide platforms for deepening involvement with citizen history and citizen science; useful definitions of “engagement”; and evidence for why some activities help audiences interact with heritage and scientific material. It discusses projects with committed participants and considers the role of communities of participants in engaging participants more deeply

Methods of Promoting Learning and Data Quality in Citizen and Community Science

Citizen science or community science (CS) programmes are engaging volunteers in specific stages of the scientific research, mostly data collection and processing. They are less likely to have an explicit objective to support and promote volunteers' learning. In response to that, “citizen inquiry” emphases citizens' learning and community education, by viewing CS as an opportunity to educate the general public in thinking and acting scientifically. In citizen inquiry, citizens can take part in all the stages of the scientific research, from setting up an inquiry of personal interest, to deciding on the methods of data collection, analysis, and reporting. To ensure data quality when non-professionals design their own or take part in existing investigations, we have designed a bespoke online technological solution, the nQuire platform (nquire.org.uk), with support from the Open University/BBC partnership. nQuire scaffolds the design of high quality scientific inquiries through an authoring functionality and a process of data quality review by experts. In this paper, we detail how nQuire can support data quality assurance and control. We present case studies of how data quality was managed in two projects: “Heatwaves: Are you coping?” and “Pollinator Watch.

We need to talk about purpose : a critical interpretive synthesis of health and social care professionals’ approaches to self-management support for people with long-term conditions

Acknowledgements Many thanks to Cynthia Fraser, Information Specialist (Health Services Research Unit, University of Aberdeen), for leading the design and conduct of the literature searches, document retrieval and reference management. The Health Services Research Unit, University of Aberdeen is core funded by the Chief Scientist Office of the Scottish Government’s Health and Social Care Directorates. The authors accept full responsibility for this paper. Funding This research was funded by The Health Foundation (Project reference 7209).Peer reviewedPublisher PD

The Relational Impact of Multiple Sclerosis: An Integrative Review of the Literature Using a Cognitive Analytic Framework

This integrative literature review uses cognitive analytic therapy (CAT) theory to examine the impact of a chronic illness, multiple sclerosis (MS), on relationships and mental health. Electronic searches were conducted in six medical and social science databases. Thirty-eight articles met inclusion criteria, and also satisfied quality criteria. Articles revealed that MS-related demands change care needs and alter relationships. Using a CAT framework, the MS literature was analysed, and five key patterns of relating to oneself and to others were identified. A diagrammatic formulation is proposed that interconnects these patterns with wellbeing and suggests potential “exits” to improve mental health, for example, assisting families to minimise overprotection. Application of CAT analysis to the literature clarifies relational processes that may affect mental health among individuals with MS, which hopefully will inform how services assist in reducing unhelpful patterns and improve coping. Further investigation of the identified patterns is needed

Breastfeeding works: the role of employers in supporting women who wish to breastfeed and work in four organizations in England

An important factor influencing duration of breastfeeding is mother's employment status. The main aim of this study was to determine the experience and views of employees (n = 46) in four large public sector organizations concerning breastfeeding support at work. Participants were recruited if they were employed by one of four public service employers and if they were planning to go on maternity leave in the next 6 months, on maternity leave or within 6 months of return from maternity leave. They completed a questionnaire anonymously. Almost 80 of women wanted to continue breastfeeding after returning to work. However, 90 of all respondents were not aware of any employer policy nor offered any information concerning support to enable breastfeeding after returning to work, despite two organizations having a range of maternity- and breastfeeding-related policies in development and some facilities in place. Almost 90 of respondents stated the employers should do more to support breastfeeding. This should include providing pregnant staff with information about breastfeeding support that they should expect and could therefore plan to use, including access to facilities to express and to store breast milk, to enable them to work flexible hours and to take rest breaks during working hours. Recommendations are made for employers. © The Author 2006, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved