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Self-management recommendations for sickle cell disease: A Ghanaian health professionals' perspective.

ABSTRACT: Objective:To describe self-management recommendations for sickle cell disease (SCD) care among health professionals who manage SCD in Ghana. Method:Nine health care professionals (nurses, doctors, and physician assistants) who work in SCD were interviewed. The semistructured interviews were recorded, transcribed, and analysed using the qualitative content analysis method. Self-management recommendations were conceptualised as preventive health, self-monitoring, self-diagnosis, self-treatment, and self-evaluation. Results:Preventive health recommendations were the commonest, where the professionals described similar topics including avoidance of cold temperature, frequent oral hydration, and healthy nutrition. Self-monitoring recommendations included regular checks for pallor, urine colour, and splenic enlargement. Self-diagnosis recommendations were captured as warning signs and included pain, fever, unusual feelings, and enlarged spleen. Pain and fever management were the focus of most self-treatment advice, and there were some self-treatment recommendations for dactylitis, anaemia, and priapism. There was considerable variation in the strategies recommended for the management of individual SCD-related problems. Conclusion:Ghanaian health professionals involved in SCD care provide limited and inconsistent self-management recommendations. There is a need for the development of SCD standards and guidelines that support effective self-management. Health professionals working in SCD require continuing education in self-management.

SUBMITTER: Druye A

PROVIDER: S-EPMC6242362 | biostudies-other | 2018 Nov

REPOSITORIES: biostudies-other

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Self-management recommendations for sickle cell disease: A Ghanaian health professionals' perspective.

Druye Andrews A Robinson Brian B Nelson Katherine K

Health science reports 20180905 11

<h4>Objective</h4>To describe self-management recommendations for sickle cell disease (SCD) care among health professionals who manage SCD in Ghana.<h4>Method</h4>Nine health care professionals (nurses, doctors, and physician assistants) who work in SCD were interviewed. The semistructured interviews were recorded, transcribed, and analysed using the qualitative content analysis method. Self-management recommendations were conceptualised as preventive health, self-monitoring, self-diagnosis, sel ...[more]

PMID: 30623043

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Project description:ObjectivesSignificant problems with patients engaging with diabetes self-management education (DSME) exist. The role of healthcare professionals (HCPs) has been highlighted, with a lack of enthusiasm, inadequate information provision and poor promotion of available programmes all cited as affecting patients' decisions to attend. However, little is known about HCPs' views towards DSME. This study investigates the views of HCPs towards self-management generally and self-management in the context of DSME more specifically.DesignA qualitative study using semi-structured interviews to investigate HCPs views of type 2 diabetes self-management and DSME. Data were analysed thematically and emergent themes were mapped on to the constructs of Normalisation Process Theory (NPT).SettingTwo boroughs in London, UK.ParticipantsSampling was purposive to recruit a diverse range of professional roles including GPs, practice nurses, diabetes specialist nurses, healthcare assistants (HCAs), receptionists and commissioners of care.ResultsInterviews were conducted with 22 participants. The NPT analysis demonstrated that while a self-management approach to diabetes care was viewed by HCPs as necessary and, in principle, valuable, the reality is much more complex. HCPs expressed ambivalence about pushing certain patients into self-managing, preferring to retain responsibility. There was a lack of awareness among HCPs about the content of DSME and benefits to patients. Commitment to and engagement with DSME was tempered by concerns about suitability for some patients. There was little evidence of communication between providers of group-based DSME and HCPs or of HCPs engaging in work to follow-up non-attenders.ConclusionsHCPs have concerns about the appropriateness of DSME for all patients and discussed challenges to engaging with and performing the tasks required to embed the approach within practice. DSME, as a means of supporting self-management, was considered important in theory, but there was little evidence of HCPs seeing their role as extending beyond providing referrals.

Project description:BackgroundIn the last years, patients' empowerment has been increasingly recognized as a crucial dimension of patient-centered healthcare and patient safety. Nevertheless, little work has been done so far in the field of patient safety to investigate strategies for empowering psychiatric patients. Therefore, the aim of this study was to identify, by using focus groups, whether and how psychiatric patients' empowerment can improve risk management according to the perspective of healthcare providers (HPs).MethodsA mixed-method approach composed of a qualitative data collection method (i.e., focus groups) and a quantitative analysis technique (i.e., inductive content analysis) was applied. HPs working in mental health settings shared their perspectives on psychiatric patients' empowerment in risk management. After the transcription of the audio-taped discussions and the subsequent development of a hierarchical four-level coding system (strategy versus critical issue, thematic area, category, subcategory), two independent raters codified the transcripts and synthesized the content. Absolute frequencies are reported for quantitative data.ResultsTwelve focus groups consisting of six to ten participants, each with an overall sample size of 95 participants (65 women; average age ± SD 47 ± 9 yrs), were enrolled. A total of 1252 participants' verbal contributions (i.e., units of analysis) were assessed. Strategies and critical issues (Level 1) were mentioned almost equally (52 and 48%, respectively) by the HPs. Most of the contributions at Level 2 referred to the thematic areas Treatment and Cure (69%) and Emergency Management (21%). In the area Treatment and Cure, the category Therapeutic Compliance (Level 3) was discussed in one third of all contributions.ConclusionsOur results suggest that HPs consider patients as crucial partners in risk management and expect them to play a key role in actively enhancing safety. Policy makers should be aware that risk management in mental health settings particularly relies on the therapeutic relationship between HPs and patients. Therefore, allocating sufficient human and financial resources to mental health care aiming to further support the relationship between patients and HPs is of utmost importance.

Dataset Information

Self-management recommendations for sickle cell disease: A Ghanaian health professionals' perspective.

Publications

Self-management recommendations for sickle cell disease: A Ghanaian health professionals' perspective.

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