Transition clinic attendance is associated with improved beliefs and attitudes toward medicine in patients with inflammatory bowel disease.
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ABSTRACT:
SUBMITTER: Fu N
PROVIDER: S-EPMC5550790 | biostudies-other | 2017 Aug
REPOSITORIES: biostudies-other
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Project description:ObjectiveTo find out what sociodemographic and academic variables are associated with better knowledge and attitudes towards family medicine, before and after carrying out an assignment in primary care.Design"Before-after" study.SettingFaculty of Medicine.ParticipantsStudents enrolled in a primary health care assignment.Main measurementsKnowledge and attitudes on family medicine have been evalaluated as dependent variables, using an ad hoc designed questionnaire, consisting of 34 questions with 5 response options on a Likert type scale. The questionnaire, which also included questions on the sociodemographic and academic characteristics of the students was administered the day before classes started and at the end of the course. The scores on knlwledge and attitudes have been evaluated according to the different values of the sociodemographic and academic variable using multiple linear regression analysis.ResultsA total of 44 students filled in both questionnaires (54.3% of those enrolled). Sex was the only variable that was associated with the questionnaire total score before starting the classess (P=0.004). However, when age was was included in the model as a dichotomic variable (19 years vs. 20 years or more) and the sex-age interaction, these were also significant (P=0.011 and P=0.031, respectively). At the end of the course, only sex showed a significant association (P=0.013).ConclusionsFemales and younger student are the ones who demonstrate more favourable attitudes towards family medicine and primary health care.
| S-EPMC7021959 | biostudies-literature
Project description:PurposeThis paper reports on a novel measure, attitudes toward genomics and precision medicine (AGPM), which evaluates attitudes toward activities such as genetic testing, collecting information on lifestyle, and genome editing - activities necessary to achieve the goals of precision medicine.DiscussionThe AGPM will be useful for researchers who want to explore attitudes toward genomics and precision medicine. The association of concerns about precision medicine activities with demographic variables such as religion and politics, as well as higher levels of education, suggests that further education on genomic and precision activities alone is unlikely to shift AGPM scores significantly.MethodsWe wrote items to represent psychological and health benefits of precision medicine activities, and concerns about privacy, social justice, harm to embryos, and interfering with nature. We validated the measure through factor analysis of its structure, and testing associations with trust in the health information system and demographic variables such as age, sex, education, and religion.ResultsThe AGPM had excellent alpha reliability (.92) and demonstrated good convergent validity with existing measures. Variables most strongly associated with higher levels of concern with precision medicine activities included: regular religious practice, republican political leanings, and higher levels of education.
| S-EPMC8278159 | biostudies-literature
Project description:BackgroundPatients' beliefs about medicine may either reflect the necessity for treatment or concerns regarding the treatment. We explored the extent to which these beliefs have an effect on thiopurine metabolite levels and premature discontinuation in patients with inflammatory bowel disease (IBD).Patients and methodsPatients enrolled in the 'Thiopurine response Optimization by Pharmacogenetic testing in Inflammatory Bowel Disease Clinics' (TOPIC) trial were asked to complete the Beliefs about Medicine Questionnaire (BMQ) 4 weeks after thiopurine initiation. The BMQ measures perceptions about treatment necessity and concerns. On the basis of the necessity and concern scores, patients can be categorized as accepting, ambivalent, indifferent, or skeptical. The thiopurine discontinuation rates for these belief subgroups were compared by Kaplan-Meier curves. Furthermore, clinical response and metabolite levels were compared between the belief subgroups.ResultsA total of 767 patients with IBD started thiopurine treatment, of whom 576 (75%) completed the BMQ. Patients could be classified as accepting (34%), indifferent (17%), ambivalent (34%), or skeptical (15%). Compared with patients in the accepting group (discontinuation rate 22%), patients with an indifferent (35%; P=0.02), ambivalent (37%; P<0.01), or skeptical belief (54%; P<0.01) had higher thiopurine discontinuation rates. No differences were observed in the steady-state thiopurine metabolite levels between the different belief subgroups.ConclusionPatients with a low perceived treatment necessity or high concerns toward IBD treatment were more likely to discontinue thiopurine treatment prematurely. Extra attention toward these patients might prevent premature discontinuation.
| S-EPMC5757657 | biostudies-literature
Project description:BackgroundLung cancer (LC) is the leading cause of cancer-related death for veterans cared for by the US Veterans Health Administration. The LC burden among veterans is almost double that of the general population. Before implementation of an LC screening program, we set out to assess the role of beliefs and attitudes toward LC screening among veterans.MethodsVeterans presenting to the Ralph H. Johnson VA Medical Center were invited to complete a self-administered survey. The survey comprised questions about demographics, smoking status, health status, and knowledge about LC and willingness to be screened. Responses from veteran ever and never smokers were compared.ResultsA total of 209 veterans completed the survey. Smokers were significantly (P < .05) more likely than never smokers to be less educated, have a lower income, and report poorer health. Smokers were more likely than never smokers to have two or more comorbidities, which trended toward significance (P = .062). Smokers were more likely to have been told by a physician that they were at high risk for LC and to believe that they were at risk. Nearly all veterans surveyed (92.8%) would have a CT scan for LC screening, and 92.4% would have surgery for a screen-detected LC.ConclusionsVeterans are overwhelmingly willing to undergo screening for LC, and it seems that participation will not be a barrier to implementation of an LC screening program. The mortality benefit of LC screening, however, may not be generalizable to the veteran population because of a higher number of comorbid conditions.
| S-EPMC3848465 | biostudies-literature
Project description:Purpose To grasp public opinion accurately, we conducted an opinion poll on beliefs and attitudes toward physician-assisted suicide (PAS). Methods A randomized telephone survey ensuring a representative sample was conducted, 1,007 participants aged 18 years or older (response rate, 9.5%). Results The main results are as follows i) 61.1% of participants thought that the current social support system for terminally ill patients and their families is insufficient; ii) 60% of participants did not recognize the term “hospice and palliative care”; iii) 81.7% of participants would not like to receive life-sustaining treatment if there is no possibility of recovery; iv) 58.4% of participants would like to receive hospice and palliative care if they are diagnosed with a terminal illness; v) the priorities for dignified dying were preparing a support system to reduce the burden of care (28.6%), economic support including reduction of medical expenses (26.7%), expansion of hospice and palliative care services (25.4%), and legalization of PAS (13.6%); and vi) 58.3% of participants agreed that the expansion of hospice and palliative care should precede the legalization of PAS. Conclusion Koreans currently want other efforts, including expansion of hospice and palliative care services, instead of the legalization of PAS.
| S-EPMC10179991 | biostudies-literature
Project description:BackgroundInflammatory bowel disease (IBD) is a chronic gastrointestinal condition affecting over 5 million people globally and 1.6 million in the United States but currently lacks a precisely determined cause or cure. The range of symptoms IBD patients experience are often debilitating, and the societal stigmas associated with some such symptoms can further degrade their quality of life. Better understanding the nature of this public reproach then is a critical component for improving awareness campaigns and, ultimately, the experiences of IBD patients.ObjectiveThe objective of this study was to explore and assess the public's awareness and knowledge of IBD, as well as what relationship, if any, exists between the social stigma surrounding IBD, knowledge of the disease, and various media usage, including social media.MethodsUtilizing a Web-based opt-in platform, we surveyed a nationally representative sample (n=1200) with demographics mirroring those of the US Census figures across baseline parameters. Using constructed indices based on factor analysis, we were able to build reliable measures of personal characteristics, media behaviors, and perceptions and knowledge of IBD.ResultsAmong the American public, IBD is the most stigmatized of seven diseases, including genital herpes and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Additionally, IBD knowledge is generally low with 11.08% (133/1200) of the sample indicating no familiarity with the disease and 85.50% (1026/1200) of participants inaccurately answering two-thirds of the IBD index questions with which their knowledge was assessed. Increased knowledge of IBD is associated with lower levels of stigma. However, social media use is currently related to lower levels of IBD knowledge (P<.05). Furthermore, findings indicate that participants who most frequently engaged in producing social media content are less knowledgeable about IBD (P<.10), highlighting the potential for a dangerous cycle should they be contributing to a Web-based IBD dialogue.ConclusionsGreater efforts must be taken to stymie IBD misinformation across all media, but especially in social media channels, to increase IBD knowledge and reduce stigma surrounding IBD. These findings pave the way for further research qualitatively examining the pervasiveness of specific IBD messages found in today's social media landscape and their impact on enacted stigmas so as to better equip providers and patient advocacy organizations with impactful communication solutions.
| S-EPMC5741823 | biostudies-literature
Project description:ObjectiveDeveloping and evaluating effective transition interventions for young people (16-25 years) with inflammatory bowel disease (IBD) is a high priority. While transition clinics (TCs) have been recommended, little is known about their operating structures and outcomes. This study aimed to gain insight into the value of a TC compared with direct handover care.DesignControlled mixed-methods evaluation of process outcomes, clinical outcomes and patient-reported outcomes.SettingTwo outpatient IBD clinics in the Netherlands.ParticipantsData collection included: semistructured interviews with professionals (n=8), observations during consultations with young people (5×4 hours), medical chart reviews of patients transferred 2 to 4 years prior to data collection (n=56 in TC group; n=54 in control group) and patient questionnaires (n=14 in TC group; n=19 in control group).OutcomesData were collected on service structures and daily routines of the TC, experienced barriers, facilitators and benefits, healthcare use, clinical outcomes, self-management outcomes and experiences and satisfaction of young people with IBD.ResultsAt the TC, multidisciplinary team meetings and alignment of care between paediatric and adult care providers were standard practice. Non-medical topics received more attention during consultations with young people at the TC. Barriers experienced by professionals were time restrictions, planning difficulties, limited involvement of adult care providers and insufficient financial coverage. Facilitators experienced were high professional motivation and a high case load. Over the year before transfer, young people at the TC had more planned consultations (p=0.015, Cohen's d=0.47). They showed a positive trend in better transfer experiences and more satisfaction. Those in direct handover care more often experienced a relapse before transfer (p=0.003) and had more missed consultations (p=0.034, Cohen's d=-0.43) after transfer.ConclusionA TC offer opportunities to improve transitional care, but organisational and financial barriers need to be addressed before guidelines and consensus statements in healthcare policy and daily practice can be effectively implemented.
| S-EPMC6955474 | biostudies-literature
Project description:IntroductionIn recent years, computerized cognitive training (CCT) programs have been developed commercially for widespread public consumption. Despite early enthusiasm, whether these programs enhance cognitive abilities in healthy adults is a contentious area of investigation. Given the mixed findings in the literature, researchers are beginning to investigate how beliefs and attitudes toward CCT impact motivation, expectations, and gains after cognitive training.MethodWe collected survey data from 497 North American participants from Amazon's Mechanical Turk (MTurk). This survey asked novel questions regarding respondents' beliefs about the effectiveness of CCT for improving different domains of cognition, mood, and daily life; beliefs about whether CCT programs are supported by research; and whether impressions of CCT have improved or worsened over time. Exploratory analyses are reported descriptively, while parametric tests were used to analyze a priori hypotheses.ResultsAlmost half of the surveyed participants had used CCT, and respondents with a self-reported psychological or neurological disorder were more likely to have used CCT platforms than participants without such conditions. Motivations for using CCT included curiosity; to improve or maintain cognition; to prevent cognitive decline; and/or for enjoyment or fun. Participants believed that CCT is somewhat effective for improving mood and cognition across a variety of domains. Greater age and fewer years of education predicted perceived effectiveness of CCT. Finally, participants largely reported unchanged opinions of CCT platforms over time.ConclusionOur study suggests the need for future research regarding the general population's beliefs and attitudes toward CCT, along with knowledge translation for relevant stakeholders.
| S-EPMC7147517 | biostudies-literature
Project description:Ulcerative colitis and Crohn's disease are traditionally defined as the two main subtypes of inflammatory bowel disease. However, a more recent view considers IBD as a spectrum of heterogeneous phenotypes with consistent differences in clinical presentation and behaviors, likely explained by differences in underlying pathogenetic mechanisms. The etiology is still elusive, and the suggested pathogenesis is a complex interplay among genetic predisposition and abnormal immune response at the mucosal intestinal level, activated by only partially identified environmental triggers leading to altered intestinal permeability and impaired handling of gut microbiota. The undeniable continuous progress of medical therapy with more frequent shifts from traditional to more advanced modalities also underlines the actual unmet needs. We are using medications with completely different mechanisms of action, with a lack of predictive factors of outcomes and response and still an unsatisfactory rate of success. In addition, we are missing still valuable and accurate markers to predict disease progression and severity in order to avoid under- or over-treatment. In such a complex scenario, it is undoubtful that the application of artificial intelligence and machine learning algorithms may improve the management and pave the way for precision and eventually personalized medicine in these patients; however, there are still several challenges that will be the focus of this review.
| S-EPMC10487169 | biostudies-literature
Project description:IntroductionThe demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis.MethodsSix EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA.Results173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score). Attitudes trended to more negative in successive post-graduate year (PGY) levels.ConclusionEM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels.
| S-EPMC4100860 | biostudies-literature