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Exposure and attitudes to adolescent health amongst Paediatric trainees in Northern Ireland: a mixed-methods study.

ABSTRACT: Aims:To determine the exposure and attitudes of paediatric trainees towards adolescent medicine. Methods:All paediatric trainees in the Northern Ireland deanery (n=107) were invited to participate in an online survey in March 2016. The questionnaire was based on the 'Modified Perceptions of Adolescent Issues and Resources: Care of Adolescents' questionnaire. The questions included a 5-point Likert scale (1-strongly disagree, 5-strongly agree) as well as open questions. All paediatric trainees were invited to attend focus groups to expand on themes generated from the questionnaire. Results:The response rate for the paediatric survey was 62% (n=66). Trainees identified adolescence as an area of importance similar to paediatrics and neonates; however, knowledge, confidence, skills and previous teaching in adolescent medicine were lower than for neonatal medicine and general paediatrics. Trainees who saw ?6 adolescent patients per week were more likely to rate the importance of adolescent medicine higher. Trainees' perceived confidence, knowledge, self-rated skills and prior teaching in adolescent medicine were strongly correlated. Most (70%) respondents stated that they had not attended an adolescent transition clinic during their postgraduate training. Undergraduate and postgraduate teaching for adolescent health was rated poorly. Conclusions:This project identified a paediatric trainee population that are aware of the importance of adolescent health but with low perceived knowledge, skills and confidence to manage them. Education is required to enhance learning and improve outcomes for adolescent patients.

SUBMITTER: Mullen S

PROVIDER: S-EPMC7061885 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Exposure and attitudes to adolescent health amongst Paediatric trainees in Northern Ireland: a mixed-methods study.

Mullen Stephen S Shields Michael D MD O'Donoghue Dara D

BMJ paediatrics open 20200308 1

<h4>Aims</h4>To determine the exposure and attitudes of paediatric trainees towards adolescent medicine.<h4>Methods</h4>All paediatric trainees in the Northern Ireland deanery (n=107) were invited to participate in an online survey in March 2016. The questionnaire was based on the 'Modified Perceptions of Adolescent Issues and Resources: Care of Adolescents' questionnaire. The questions included a 5-point Likert scale (1-strongly disagree, 5-strongly agree) as well as open questions. All paediat ...[more]

PMID: 32201742

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Project description:IntroductionBurnout is becoming an increasingly recognised phenomenon within the medical profession. This study aims to investigate the presence of burnout amongst neurosurgical trainees in the UK and Ireland as well as investigating potential exacerbating and protective factors.MethodAn online survey was sent to all neurosurgical trainees in the UK and Ireland via the British Neurosurgical Trainees' Association (BNTA) mailing list. Responding participants anonymously completed the Copenhagen Burnout Inventory (CBI) and answered questions about known risk factors for burnout including workplace environment, workplace bullying, time spent on leisure activities and sleep and reported likelihood of leaving neurosurgery. We also collated data on responders' demographics. We compared CBI scores for participants with and without risk factors to determine correlation with CBI.ResultsThere were 75 respondents (response rate 42%) from a range of ages and all training grades, 72% of whom were male. The median CBI score was 38.85 (IQR 17.76). Participants showed a higher degree of personal and workplace burnout (median CBIs of 47.02, IQR 25.00; and 49.14, IQR 19.64, respectively) compared with patient-related burnout (median CBI 18.67, IQR 25.00). Participants with the following self-reported risk factors were significantly more likely to have higher CBIs: workplace bullying (p = 0.01), getting on less well with colleagues (p < 0.05), working longer hours (p < 0.05) and insufficient sleep, exercise and leisure time (all p < 0.01). Those with higher CBI scores were more likely to consider leaving neurosurgical training (p = 0.01).ConclusionWe identified a high burnout incidence in a cohort representative of UK neurosurgical trainees, although our results may have been skewed somewhat by selection bias. We determined potential risk factors for burnout related to specific workplace stressors and time for non-work activities. In the future, changes to training curricula should address these issues, aiming to improve training, enhance patient care and reduce attrition rates.

Project description:ObjectivesMen who have sex with men (MSM) are at greater risk for human papillomavirus (HPV)-associated cancers. Since 2016, MSM have been offered the HPV vaccination, which is most effective when received prior to sexual debut, at genitourinary medicine clinics in the UK. In September 2019, the national HPV vaccination programme will be extended to boys. This study aimed to understand young MSM's (YMSM) knowledge and attitudes towards HPV vaccination.DesignQuestionnaires assessed YMSM demographics, sexual behaviour, culture, knowledge and attitudes towards HPV vaccination and stage of vaccine decision-making using the precaution adoption process model. Focus groups explored sexual health information sources, attitudes, barriers and facilitators to vaccination and strategies to support vaccination uptake. Questionnaire data were analysed using descriptive statistics and focus group data were analysed thematically.SettingQuestionnaires were completed online or on paper. Focus groups were conducted within Lesbian Gay Bisexual Transgender Queer organisational settings and a university student's union in England and Northern Ireland.ParticipantsSeventeen YMSM (M=20.5 years) participated in four focus groups and 51 (M=21.1 years) completed questionnaires.ResultsOver half of YMSM were aware of HPV (54.9%), yet few (21.6%) had previously discussed vaccination with a healthcare professional (HCP). Thematic analyses found YMSM were willing to receive the HPV vaccine. Vaccination programmes requiring YMSM to request the vaccine, particularly prior to sexual orientation disclosure to family and friends, were viewed as unfeasible. Educational campaigns explaining vaccine benefits were indicated as a way to encourage uptake.ConclusionsThis study suggests that to effectively implement HPV vaccination for YMSM, this population requires clearer information and greater discussion with their HCP. In support of the decision made by the Joint Committee on Vaccination and Immunisation, universal vaccination is the most feasible and equitable option. However, the absence of a catch-up programme will leave a significant number of YMSM at risk of HPV infection.

Project description:IntroductionThe singular relationship developed over the years between northern Indigenous peoples and dogs has been profoundly changed through historical trauma, settlements and increased use of snowmobiles. Issues related to dogs have become increasingly complex and worrisome with the endemic presence of the rabies virus among Arctic fox populations, and given the fact that northern Indigenous peoples may have a higher risk of dog bites than the general population. This study aimed to investigate factors related to the risk of dog bites in Naskapi and Innu communities located in northern Quebec (Canada) by (1) describing the knowledge, attitudes and practices (KAP) regarding dogs and dog bites in these communities, and (2) analyzing experiences of inhabitants and health professionals with regard to dog bites and their management.MethodsA mixed methods study design that combined an observational cross-sectional survey and individual interviews was used. The survey collected data on KAP regarding dogs and dog bites among 122 respondents. Individual interviews (n = 37) were then conducted with victims of dog bites, owners of dogs that have bitten a person before, and health professionals. Descriptive and inferential analysis (quantitative data) and thematic analysis (qualitative data) were performed.Results and discussionResults highlighted that 21% of respondents have had a dog bite in their lifetime. Most respondents were not aware of the risk of contracting rabies following a dog bite, although rabies risk perception was associated with risk perception of dogs (linear regression: coefficient = 0.69, 95% CI = 0.36-1.02). The odds of being more knowledgeable on rabies were higher (logistic regression: OR = 2.92, 95% CI = 1.07-7.98) among young adults. Dogs were perceived as both threats and protectors by community members. When the fear of dogs was present, it affected the quality of life of some inhabitants. There was confusion about responsibilities in the management of biting dogs, although protocols to follow after a bite were clear for health care professionals. This study revealed a lack of awareness and knowledge about dog bites and rabies risks in both communities. Results provide important knowledge for the development of interventions adapted to northern Indigenous communities.

Project description:BackgroundLittle is known about the participation of surgeons in preventative health activities in the non-admitted hospital care setting. The aim of this study was to identify which preventive health activities surgeons practice and to explore their attitudes towards preventive health.MethodsA mixed methods study was conducted using a sequential explanatory design. Quantitative results were obtained from a self-reported clinician survey (n = 16) and a Generalized Estimating Equation was used to assess the relationship between dependent (preventive health practice) and independent (confidence and knowledge in preventive health practice, years of practice, and attitudinal factors) variables. Using a building approach to integration, results from the quantitative analyses informed design of the interview guide. Surgeons' beliefs and attitudes were explored using in-depth, semi structured interviews with a purposeful sample of surgeons (n = 14). Responses were collected, independently coded and analysed using a qualitative descriptive approach.ResultsIn accordance with a contiguous narrative approach to integration, the quantitative and qualitative findings are reported separately. The clinician survey found that the surgeons carried out preventive health activities at low levels. Preventive health advice was predominantly verbal in nature, and few surgeons provided written material or referred patients to additional services. The GEE analyses indicated that the following factors best predicted the tendency to undertake preventive health activities: years of clinical practice (p = 0.041), and the perceived work priority placed on preventive health (p = 0.008). Interviews generated four themes that influenced the tendency of surgeons to undertake preventive health activities: perceptions of their role in preventive health, perceived motivation of patients, hospital structure, and facilitating factors. In regards to enabling factors that are likely to increase preventive health practice, surgeons unanimously advocated for referral pathways into specialist behaviour change programs that they could facilitate within their relatively brief consulting time.ConclusionsThe findings suggests that the majority of public hospital surgeons engage in routine preventive health advice at a low level. The high volume of non-admitted surgical consultations undertaken annually, coupled with medium to high self-reported knowledge and confidence in addressing behavioural risk factors, support an increased involvement of surgeons in preventive health practice.

Dataset Information

Exposure and attitudes to adolescent health amongst Paediatric trainees in Northern Ireland: a mixed-methods study.

Publications

Exposure and attitudes to adolescent health amongst Paediatric trainees in Northern Ireland: a mixed-methods study.

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