scholarly journals Patient use of blood pressure self-screening facilities in general practice waiting rooms: a qualitative study in the UK

2017 ◽  
Vol 67 (660) ◽  
pp. e467-e473 ◽  
Author(s):  
Alice C Tompson ◽  
Sabrina Grant ◽  
Sheila M Greenfield ◽  
Richard J McManus ◽  
Susannah Fleming ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Qualitative Study ◽  
Ease Of Use ◽  
Structured Interviews ◽  
Waiting Room ◽  
Cross Sectional ◽  
History Of ◽  
The Uk ◽  
Patient Use ◽  
At Home

BackgroundBlood pressure (BP) self-screening, whereby members of the public have access to BP monitoring equipment outside of healthcare consultations, may increase the detection and treatment of hypertension. Currently in the UK such opportunities are largely confined to GP waiting rooms.AimTo investigate the reasons why people do or do not use BP self-screening facilities.Design and settingA cross-sectional, qualitative study in Oxfordshire, UK.MethodSemi-structured interviews with members of the general public recruited using posters in GP surgeries and community locations were recorded, transcribed, and coded thematically.ResultsOf the 30 interviewees, 20% were hypertensive and almost half had self-screened. Those with no history of elevated readings had limited concern over their BP: self-screening filled the time waiting for their appointment or was done to help their doctor. Patients with hypertension self-screened to avoid the feelings they associated with ‘white coat syndrome’ and to introduce more control into the measurement process. Barriers to self-screening included a lack of awareness, uncertainty about technique, and worries over measuring BP in a public place. An unanticipated finding was that several interviewees preferred monitoring their BP in the waiting room than at home.ConclusionBP self-screening appeared acceptable to service users. Further promotion and education could increase awareness among non-users of the need for BP screening, the existence of self-screening facilities, and its ease of use. Waiting room monitors could provide an alternative for patients with hypertension who are unwilling or unable to monitor at home.

scholarly journals Patient experience of home and waiting room blood pressure measurement: a qualitative study of patients with recently diagnosed hypertension

2018 ◽  
Vol 68 (677) ◽  
pp. e835-e843 ◽  
Author(s):  
Alice C Tompson ◽  
Claire L Schwartz ◽  
Susannah Fleming ◽  
Alison M Ward ◽  
Sheila M Greenfield ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Qualitative Study ◽  
Patient Experience ◽  
Blood Pressure Measurement ◽  
Lifestyle Changes ◽  
Waiting Room ◽  
Cross Sectional ◽  
Self Monitoring ◽  
The Impact ◽  
At Home

BackgroundOut-of-office blood pressure (BP) measurement is advocated to confirm hypertension diagnosis. However, little is known about how primary care patients view and use such measurement.AimTo investigate patient experience of out-of-office BP monitoring, particularly home and practice waiting room BP measurement, before, during, and after diagnosis.Design and settingA cross-sectional, qualitative study with patients from two UK GP surgeries participating in a feasibility study of waiting room BP measurement.MethodInterviewees were identified from recent additions to the practice hypertension register. Interviews were recorded, transcribed, and coded thematically.ResultsOf 29 interviewees, 9 (31%) and 22 (76%) had used the waiting room monitor and/or monitored at home respectively. Out-of-office monitoring was used by patients as evidence of control or the lack of need for medication, with the printed results slips from the waiting room monitor perceived to improve ‘trustworthiness’. The waiting room monitor enabled those experiencing uncertainty about their equipment or technique to double-check readings. Monitoring at home allowed a more intensive and/or flexible schedule to investigate BP fluctuations and the impact of medication and lifestyle changes. A minority used self-monitoring to inform drug holidays. Reduced intensity of monitoring was reported with both modalities following diagnosis as initial anxiety or patient and GP interest decreased.ConclusionHome and practice waiting room measurements have overlapping but differing roles for patients. Waiting room BP monitors may be a useful out-of-office measurement modality for patients unwilling and/or unable to measure and record their BP at home.

scholarly journals Changes in the pattern of suicide attempters visiting the emergency room after COVID-19 pandemic: an observational cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ji-Hun Kang ◽  
Si-Won Lee ◽  
Jae-Gu Ji ◽  
Jae-Kwang Yu ◽  
Yun-Deok Jang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Suicide Attempt ◽  
Systolic Blood Pressure ◽  
Emergency Room ◽  
Suicide Attempts ◽  
Educational Background ◽  
Management Program ◽  
Cross Sectional ◽  
History Of ◽  
At Home

Abstract Background This study aimed to find out the change in the rate and pattern of suicide attempts during severe acute respiratory syndrome COVID-19 pandemic period. Methods This study was a retrospective analysis of data collected as a part of an emergency room-based post-suicide management program. The data were collected through interviews and from medical records of suicide attempts, maintained in the emergency room, from January 19 to October 31, 2020, during the “COVID-19 period,” and those who attempted suicide from January 19 to October 31, 2019 “pre-COVID-19 period.” We extracted educational background, marital status, occupation, presence of domestic partner, history of mental illness, alcohol consumption, history of previous suicide attempts; suicide attempt method and location (i.e., at home or a place other than home) at the time of attempt, and whether the attempt was a mass suicide. In addition, we compared patient severity between “COVID-19 period” and “pre-COVID-19 period” using the initial KTAS (South Korean triage and acuity scale) level, consciousness level, and systolic blood pressure. In 2012, KTAS was developed through the Ministry of Health and Welfare’s research project to establish triage system in South Korea. Results The analysis of the number of suicide attempts during “pre-COVID-19 period” and “ COVID-19 period” showed that the number of suicide attempts during “COVID-19 period” (n = 440) increased compared to the “pre-COVID-19 period” (n = 400). Moreover, the method of suicide attempts during “COVID-19 period” included overdose of drugs such as hypnotics, antipsychotics, and pesticides that were already possessed by the patient increased compared to the “pre-COVID-19 period” (P < 0.05). At the time of the visit to the emergency room, high KTAS level, low level of consciousness, and low systolic blood pressure, were observed, which were significantly different between “COVID-19 period” and “pre-COVID-19 period” (P < 0.05). Conclusion With the worldwide COVID-19 virus spread, suicide rate and suicide attempts at home have significantly increased. In addition, patient severity was higher in the “COVID-19 period” than that in the “pre-COVID-19 period.” The increasing suicide attempt rate should be controlled by cooperation between the emergency room and regional organizations.

scholarly journals Cross Sectional E-Health Evaluation Study for Telemedicine and M-Health Approaches in Monitoring COVID-19 Patients with Chronic Obstructive Pulmonary Disease (COPD)

2021 ◽  
Vol 18 (16) ◽  
pp. 8513
Author(s):  
Abdullah H. Alsharif
Keyword(s):  
Healthcare Services ◽  
Evaluation Study ◽  
Ease Of Use ◽  
Chronic Obstructive ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Remote Healthcare ◽  
Remote Care ◽  
At Home

Monitoring COVID-19 patients with COPD has become one of the major tasks in preventing transmission and delivering emergency healthcare services after vaccination in case of any issues. Most COVID-19-affected patients are suggested to self-quarantine at home or in institutionalized quarantine centers. In such cases, it is essential to provide remote healthcare services. For remote healthcare monitoring, two approaches are being considered in this study, which include mHealth and Telehealth. A mixed-methods approach is adopted, where survey questionnaires are used for collecting information from 108 patients and semi-structured interviews are used with seven physicians regarding mHealth and Telehealth approaches. Survey results indicated that mHealth is rated to be slightly more effective than Telehealth, and interview results indicated that Telehealth is identified to be slightly more effective than mHealth in relation to parameters including usefulness, ease of use and learnability, interface and interaction quality, reliability, and satisfaction. However, both physicians and patients opined that both mHealth and Telehealth have a promising future with increasing adoption. Based on the findings, it can be concluded that both mHealth and Telehealth are considered to be effective in delivering remote care for COPD patients infected with COVID-19 at home. Implications of the study findings are discussed.

scholarly journals Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amir Motamedi ◽  
Maryam Ekramzadeh ◽  
Ehsan Bahramali ◽  
Mojtaba Farjam ◽  
Reza Homayounfar
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Diet Quality ◽  
Dietary Diversity ◽  
Antihypertensive Drugs ◽  
Healthy Eating Index ◽  
Cross Sectional ◽  
Common Chronic Disease ◽  
History Of ◽  
Prevention Of Hypertension

Abstract Background Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. Methods This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs. Results Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension. Conclusions Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.

scholarly journals Home-Measured Blood Pressure Is Associated with Handgrip Strength in Patients with Type 2 Diabetes: The KAMOGAWA-HBP Study

2021 ◽  
Vol 10 (9) ◽  
pp. 1913
Author(s):  
Tomonori Kimura ◽  
Emi Ushigome ◽  
Yoshitaka Hashimoto ◽  
Naoko Nakanishi ◽  
Masahide Hamaguchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Pulse Pressure ◽  
Handgrip Strength ◽  
Cross Sectional Study ◽  
Home Blood Pressure ◽  
Cross Sectional ◽  
The Relationship ◽  
At Home

The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength.

scholarly journals Identifying Risk Factors Affecting the Usage of Digital and Social Media: A Preliminary Qualitative Study in the Dental Profession and Dental Education

2021 ◽  
Vol 9 (5) ◽  
pp. 53
Author(s):  
Rayan Sharka ◽  
Jonathan P. San Diego ◽  
Melanie Nasseripour ◽  
Avijit Banerjee
Keyword(s):  
Risk Factors ◽  
Qualitative Study ◽  
Perceived Risk ◽  
Dental Education ◽  
Dental Students ◽  
General Context ◽  
Structured Interviews ◽  
Factors Affecting ◽  
The Uk ◽  
Dental Professionals

Aims: This study aimed to identify the risk factors of using DSM to provide an insight into the inherent implications this has on dental professionals in practice and trainee professionals’ education. Materials and methods: Twenty-one participants (10 dental professionals and 11 undergraduate and postgraduate dental students) participated in this qualitative study using semi-structured interviews in a dental school in the UK. The interviews were analysed and categorised into themes, some of which were identified from previous literature (e.g., privacy and psychological risks) and others emerged from the data (e.g., deceptive and misleading information). Results: The thematic analysis of interview transcripts identified nine perceived risk themes. Three themes were associated with the use of DSM in the general context, and six themes were related to the use of DSM in professional and education context. Conclusions: This study provided evidence to understand the risk factors of using DSM in dental education and the profession, but the magnitude of these risks on the uptake and usefulness of DSM needs to be assessed.

scholarly journals University students’ understanding and perceptions of schizophrenia in the UK: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025813
Author(s):  
Charlotte Cadge ◽  
Charlotte Connor ◽  
Sheila Greenfield
Keyword(s):  
Qualitative Study ◽  
University Students ◽  
Help Seeking ◽  
Negative Symptoms ◽  
Health Campaigns ◽  
Structured Interviews ◽  
African Caribbean ◽  
Lay Understanding ◽  
The Uk ◽  
The University

ObjectiveTo explore lay understanding and perceptions of schizophrenia in university students.DesignQualitative study using semi-structured interviews and thematic analysis.SettingThe University of Birmingham, West Midlands.Participants20 UK home students of white British (n=5), Indian (n=5), Pakistani (n=5), African Caribbean (n=4) and dual white British and African Caribbean ethnicity (n=1).ResultsFindings revealed a lack of knowledge about schizophrenia, particularly the negative symptoms that were not mentioned. There were mixed ideas on the causes and sources of available help for schizophrenia; however, positively many said they would consult their general practitioner. While there was a general misconception among the students that schizophrenia caused multiple personalities and was a dangerous illness, there were some differences in perceptions and understanding between ethnic groups, with more Indian students perceiving upbringing as a causal factor in the development of the illness and more Pakistani students perceiving possession by a spirit as a cause.ConclusionsThe university students interviewed lacked knowledge about schizophrenia and stigma was widespread, both of which may delay help-seeking. Public health campaigns educating young people about schizophrenia are required to improve early identification and intervention and improve outcomes. Further research exploring ways to effectively tackle stigma is also required.

scholarly journals Blood pressure and cholesterol measurements in primary care: cross-sectional analyses in a dynamic cohort

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0131
Author(s):  
Annemarijn de Boer ◽  
Monika Hollander ◽  
Ineke van Dis ◽  
Frank L.J. Visseren ◽  
Michiel L Bots ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Mixed Model ◽  
Time Window ◽  
Guideline Implementation ◽  
Cross Sectional ◽  
Menopausal Women ◽  
History Of ◽  
Post Menopausal

BackgroundGuidelines on cardiovascular risk management (CVRM) recommend blood pressure (BP) and cholesterol measurements every five years in men ≥40 and (post-menopausal) women ≥50 years.AimEvaluate CVRM guideline implementation.Design & settingCross-sectional analyses in a dynamic cohort using primary care electronic health record (EHR) data from the Julius General Practitioners’ Network (n=388,929).MethodWe assessed trends (2008–2018) in the proportion of patients with at least one measurement (BP and cholesterol) every one, two, and five years, in those with a history of (1) cardiovascular disease (CVD) and diabetes, (2) diabetes only, (3) CVD only, (4) cardiovascular risk assessment (CRA) indication based on other medical history, or (5) no CRA indication. We evaluated trends over time using logistic regression mixed model analyses.ResultsTrends in annual BP and cholesterol measurement increased for patients with a history of CVD from 37.0% to 48.4% (P<0.001) and 25.8% to 40.2% (P<0.001). In the five-year window 2014–2018, BP and cholesterol measurements were performed in respectively 78.5% and 74.1% of all men ≥40 years and 82.2% and 78.5% in all women ≥50 years. Least measured were patients without a CRA indication: men 60.2% and 62.4%; women 55.5% and 59.3%.ConclusionThe fairly high frequency of CVRM measurements available in the EHR of patients in primary care suggests an adequate implementation of the CVRM guideline. As nearly all individuals visit the general practitioner once within a five-year time window, improvement of CVRM remains very well possible, especially in those without a CRA indication.

scholarly journals The Severity of Dependence Scale (SDS) for Codeine: Preliminary Investigation of the Psychometric Properties of the SDS in an Online Sample of Codeine Users From the UK

2021 ◽  
Vol 12 ◽  
Author(s):  
Paolo Deluca ◽  
Michelle Foley ◽  
Jacklyn Dunne ◽  
Andreas Kimergård
Keyword(s):  
Psychometric Properties ◽  
Online Survey ◽  
Preliminary Investigation ◽  
Principal Component ◽  
Cross Sectional ◽  
Diagnostic And Statistical Manual ◽  
History Of ◽  
Dependence Scale ◽  
The Uk ◽  
Severity Of Dependence Scale

Objective: Investigate the psychometric properties of the Severity of Dependence Scale (SDS) for codeine and its association with aberrant codeine related behaviors.Design: A voluntary and uncompensated cross-sectional online survey.Setting: Online population (≥18 years).Respondents: Two hundred and eighty-six respondents (66% women) who had used codeine containing medicines in the last 3 months and were living in the UK.Results: Of the respondents (mean age = 35.4 years, SD = 12.5), more than half were employed. Only 3.5% respondents reported no income. The majority of respondents (45.1%) primarily obtained prescription-only codeine from a consultation with a health professional, whilst 40.9% mainly purchased “over-the-counter” codeine containing medicines in a pharmacy without a medical prescription. Principal component analysis indicated a single factor solution accounting for 75% of the variance. Factor loadings ranged from 0.83 to 0.89. Cronbach's Alpha was high (α = 0.92). Several behaviors relating to codeine use were found to significantly predict probable codeine dependence. These included: daily codeine use in the last 3 months (OR = 66.89, 95% CI = 15.8–283.18); tolerance to codeine (OR = 32.14, 95% CI = 13.82–74.75); problems with role responsibility due to intoxication (OR = 9.89, 95% CI = 4.95–19.78); having sought advice on the internet to manage codeine use (OR = 9.56, 95% CI = 4.5–20.31); history of alcohol or drug treatment (OR = 3.73, 95% CI = 1.88–7.43).Conclusions: The SDS was acceptable and feasible to use to assess probable psychological codeine dependence in an online sample of people using codeine containing medicines. SDS scores were associated with behaviors known to be indicators of codeine dependence. Studies are needed in well-defined populations of people who use codeine to test the different aspects of psychometry of the scale compared against “gold standard” criterion [a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)].

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