18 results on '"Dean, Sarah"'
Search Results
2. Randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support for inactive adults with chronic health conditions: the e-coachER trial
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Taylor, Adrian, Taylor, Rod S, Ingram, Wendy, Dean, Sarah Gerard, Jolly, Kate, Mutrie, Nanette, Lambert, Jeff, Yardley, Lucy, Streeter, Adam, Greaves, Colin, McAdam, Chloe, Price, Lisa, Anokye, Nana Kwame, and Campbell, John
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Adult ,Male ,diabetes mellitus type 2 ,obesity ,hypertension ,Adolescent ,Health Behavior ,physical activity ,primary care ,Young Adult ,Behavior Therapy ,Humans ,Referral and Consultation ,Original Research ,Aged ,Internet ,Social Support ,Middle Aged ,behaviour ,Exercise Therapy ,chronic ,accelerometer ,osteoarthritis ,Chronic Disease ,depression ,Female ,Physical and Mental Health ,internet ,Sedentary Behavior ,human activities - Abstract
Trial registration number ISRCTN15644451. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. Objective: To determine whether adding web-based support (e-coachER) to an exercise referral scheme (ERS) increases objectively assessed physical activity (PA). Design: Multicentre trial with participants randomised to usual ERS alone (control) or usual ERS plus e-coachER (intervention). Setting: Primary care and ERS in three UK sites from 2015 to 2018. Participants: 450 inactive ERS referees with chronic health conditions. Interventions: Participants received a pedometer, PA recording sheets and a user guide for the web-based support. e-coachER interactively encouraged the use of the ERS and other PA options. Main outcome measures: Primary and key secondary outcomes were: objective moderate-to-vigorous PA (MVPA) minutes (in ≥10 min bouts and without bouts), respectively, after 12 months. Secondary outcomes were: other accelerometer-derived and self-reported PA measures, ERS attendance, EQ-5D-5L, Hospital Anxiety and Depression Scale and beliefs about PA. All outcomes were collected at baseline, 4 and 12 months. Primary analysis was an intention to treat comparison between intervention and control arms at 12-month follow-up. Results: There was no significant effect of the intervention on weekly MVPA at 12 months between the groups recorded in ≥10 min bouts (mean difference 11.8 min of MVPA, 95% CI: -2.1 to 26.0; p=0.10) or without bouts (mean difference 13.7 min of MVPA, 95% CI: -26.8 to 54.2; p=0.51) for 232 participants with usable data. There was no difference in the primary or secondary PA outcomes at 4 or 12 months. Conclusion: Augmenting ERS referrals with web-based behavioural support had only a weak, non-significant effect on MVPA. Trial registration number: ISRCTN15644451. National Institute for Health Research (NIHR), Health Technology Assessment Programme (grant reference: 13/25/20).
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- 2021
3. Effectiveness and cost-effectiveness of basic versus biofeedback-mediated intensive pelvic floor muscle training for female stress or mixed urinary incontinence: Protocol for the OPAL randomised trial
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Hagen, Suzanne, McClurg, Doreen, Bugge, Carol, Hay-Smith, Jean, Dean, Sarah Gerard, Elders, Andrew, Glazener, Cathryn, Abdel-Fattah, Mohamed, Agur, Wael Ibrahim, Booth, Jo, Guerrero, Karen, Norrie, John, Kilonzo, Mary, McPherson, Gladys, and McDonald, Alison
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education - Abstract
Introduction Accidental urine leakage is a distressing problem that affects around one in three women. The main types of urinary incontinence (UI) are stress, urgency and mixed, with stress being most common. Current UK guidelines recommend that women with UI are offered at least 3 months of pelvic floor muscle training (PFMT). There is evidence that PFMT is effective in treating UI, however it is not clear how intensively women have to exercise to give the maximum sustained improvement in symptoms, and how we enable women to achieve this. Biofeedback is an adjunct to PFMT that may help women exercise more intensively for longer, and thus may improve continence outcomes when compared with PFMT alone. A Cochrane review was inconclusive about the benefit of biofeedback, indicating the need for further evidence. Methods and analysis This multicentre randomised controlled trial will compare the effectiveness and cost-effectiveness of PFMT versus biofeedback-mediated PFMT for women with stress UI or mixed UI. The primary outcome is UI severity at 24 months after randomisation. The primary economic outcome measure is incremental cost per quality-adjusted life-year at 24 months. Six hundred women from UK community, outpatient and primary care settings will be randomised and followed up via questionnaires, diaries and pelvic floor assessment. All participants are offered six PFMT appointments over 16 weeks. The use of clinic and home biofeedback is added to PFMT for participants in the biofeedback group. Group allocation could not be masked from participants and healthcare staff. An intention-to-treat analysis of the primary outcome will estimate the mean difference between the trial groups at 24 months using a general linear mixed model adjusting for minimisation covariates and other important prognostic covariates, including the baseline score. Ethics and dissemination Approval granted by the West of Scotland Research Ethics Committee 4 (16/LO/0990). Written informed consent will be obtained from participants by the local research team. Serious adverse events will be reported to the data monitoring and ethics committee, the ethics committee and trial centres as required. A Standard Protocol Items: Recommendations for Interventional Trials checklist and figure are available for this protocol. The results will be published in international journals and included in the relevant Cochrane review. Trial registration number ISRCTN57746448; Pre-results.
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- 2019
4. Acceptability and experience of a functional training programme (ReTrain) in community-dwelling stroke survivors in South West England: a qualitative study
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Norris, Meriel, Poltawski, Leon, Calitri, Raff, Shepherd, Anthony I, Dean, Sarah Gerard, and ReTrain Team
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Rehabilitation Training (ReTrain) is a group-based approach to functional training post stroke. ReTrain has recently been evaluated through a pilot randomised controlled trial.\ud \ud Objective: This article reports on the acceptability of the intervention as described by trial participants.\ud \ud Design: A qualitative approach was undertaken. Of the 45 participants recruited into the trial, 23 were randomised to receive ReTrain. Following a sampling strategy, 10 participants undertook 1:1 semistructured audio-recorded interviews. Transcripts were analysed following a modified Framework Approach.\ud \ud Results: Six themes were developed including exploration of: the physical and psychological impacts of training,the perceived mechanisms of change, the interaction of the group and approach of the trainer. A further theme considered the reported longer term impact of participation. Overall, the results indicated the acceptability of the intervention, but also key areas for potential modification in the definitive trial. These include a need to consider potential impact on both physical and psychological function, careful consideration of dosing and fatigue and the interpersonal factors that facilitate appropriate level of delivery, the trainer to participant ratio, and enhancing features that support continuation of activity postintervention.\ud \ud Conclusion: Overall, this study supports the acceptability of ReTrain and the development of a definitive trial evaluation of this intervention to full.
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- 2018
5. Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial.
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Hagen, Suzanne, Elders, Andrew, Stratton, Susan, Sergenson, Nicole, Bugge, Carol, Dean, Sarah, Hay-Smith, Jean, Kilonzo, Mary, Dimitrova, Maria, Abdel-Fattah, Mohamed, Agur, Wael, Booth, Jo, Glazener, Cathryn, Guerrero, Karen, McDonald, Alison, Norrie, John, Williams, Louise R., and McClurg, Doreen
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PHYSIOLOGICAL control systems ,CONFIDENCE intervals ,ELECTROMYOGRAPHY ,MEDICAL cooperation ,RESEARCH ,STATISTICAL sampling ,URINARY stress incontinence ,WOMEN'S health ,RANDOMIZED controlled trials ,QUALITY-adjusted life years ,URINARY urge incontinence ,KEGEL exercises - Published
- 2020
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6. Understanding why primary care doctors leave direct patient care: a systematic review of qualitative research.
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Long, Linda, Moore, Darren, Robinson, Sophie, Sansom, Anna, Aylward, Alex, Fletcher, Emily, Welsman, Jo, Dean, Sarah Gerard, Campbell, John L., and Anderson, Rob
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Background UK general practitioners (GPs) are leaving direct patient care in significant numbers. We undertook a systematic review of qualitative research to identify factors affecting GPs’ leaving behaviour in the workforce as part of a wider mixed methods study (ReGROUP). Objective To identify factors that affect GPs’ decisions to leave direct patient care. Methods Qualitative interview-based studies were identified and their quality was assessed. A thematic analysis was performed and an explanatory model was constructed providing an overview of factors affecting UK GPs. Non-UK studies were considered separately. Results Six UK interview-based studies and one Australian interview-based study were identified. Three central dynamics that are key to understanding UK GP leaving behaviour were identified: factors associated with low job satisfaction, high job satisfaction and those linked to the doctor–patient relationship. The importance of contextual influence on job satisfaction emerged. GPs with high job satisfaction described feeling supported by good practice relationships, while GPs with poor job satisfaction described feeling overworked and unsupported with negatively impacted doctor–patient relationships. Conclusions Many GPs report that job satisfaction directly relates to the quality of the doctor–patient relationship. Combined with changing relationships with patients and interfaces with secondary care, and the gradual sense of loss of autonomy within the workplace, many GPs report a reduction in job satisfaction. Once job satisfaction has become negatively impacted, the combined pressure of increased patient demand and workload, together with other stress factors, has left many feeling unsupported and vulnerable to burn-out and ill health, and ultimately to the decision to leave general practice. [ABSTRACT FROM AUTHOR]
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- 2020
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7. Workforce predictive risk modelling: development of a model to identify general practices at risk of a supply−demand imbalance.
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Abel, Gary A., Gomez-Cano, Mayam, Mustafee, Navonil, Smart, Andi, Fletcher, Emily, Salisbury, Chris, Chilvers, Rupa, Dean, Sarah Gerard, Richards, Suzanne H., Warren, F., and Campbell, John L.
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Objective: This study aimed to develop a risk prediction model identifying general practices at risk of workforce supply–demand imbalance. Design: This is a secondary analysis of routine data on general practice workforce, patient experience and registered populations (2012 to 2016), combined with a census of general practitioners’ (GPs’) career intentions (2016). Setting/Participants: A hybrid approach was used to develop a model to predict workforce supply–demand imbalance based on practice factors using historical data (2012–2016) on all general practices in England (with over 1000 registered patients n=6398). The model was applied to current data (2016) to explore future risk for practices in South West England (n=368). Primary outcome measure: The primary outcome was a practice being in a state of workforce supply–demand imbalance operationally defined as being in the lowest third nationally of access scores according to the General Practice Patient Survey and the highest third nationally according to list size per full-time equivalent GP (weighted to the demographic distribution of registered patients and adjusted for deprivation). Results: Based on historical data, the predictive model had fair to good discriminatory ability to predict which practices faced supply–demand imbalance (area under receiver operating characteristic curve=0.755). Predictions using current data suggested that, on average, practices at highest risk of future supply–demand imbalance are currently characterised by having larger patient lists, employing more nurses, serving more deprived and younger populations, and having considerably worse patient experience ratings when compared with other practices. Incorporating findings from a survey of GP’s career intentions made little difference to predictions of future supply–demand risk status when compared with expected future workforce projections based only on routinely available data on GPs’ gender and age. Conclusions It is possible to make reasonable predictions of an individual general practice’s future risk of undersupply of GP workforce with respect to its patient population. However, the predictions are inherently limited by the data available. [ABSTRACT FROM AUTHOR]
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- 2020
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8. Effectiveness and cost-effectiveness randomised controlled trial of basic versus biofeedback-mediated intensive pelvic floor muscle training for female stress or mixed urinary incontinence: protocol for the OPAL (optimising pelvic floor exercises to achieve long-term benefits) trial mixed methods longitudinal qualitative case study and process evaluation
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Grant, Aileen, Dean, Sarah, Hay-Smith, Jean, Hagen, Suzanne, McClurg, Doreen, Taylor, Anne, Kovandzic, Marija, and Bugge, Carol
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Introduction Female urinary incontinence (UI) is common affecting up to 45% of women. Pelvic floor muscle training (PFMT) is the first-line treatment but there is uncertainty whether intensive PFMT is better than basic PFMT for long-term symptomatic improvement. It is also unclear which factors influence women's ability to perform PFMT long term and whether this has impacts on long-term outcomes. OPAL (optimising PFMT to achieve long-term benefits) trial examines the effectiveness and cost-effectiveness of basic PFMT versus biofeedback-mediated PFMT and this evaluation explores women's experiences of treatment and the factors which influence effectiveness. This will provide data aiding interpretation of the trial findings; make recommendations for optimising the treatment protocol; support implementation in practice; and address gaps in the literature around long-term adherence to PFMT for women with stress or mixed UI. Methods and analysis This evaluation comprises a longitudinal qualitative case study and process evaluation (PE). The case study aims to explore women's experiences of treatment and adherence and the PE will explore factors influencing intervention effectiveness. The case study has a two-tailed design and will recruit 40 women, 20 from each trial group; they will be interviewed four times over 2 years. Process data will be collected from women through questionnaires at four time-points, from health professionals through checklists and interviews and by sampling 100 audio recordings of appointments. Qualitative analysis will use case study methodology (qualitative study) and the framework technique (PE) and will interrogate for similarities and differences between the trial groups regarding barriers and facilitators to adherence. Process data analyses will examine fidelity, engagement and mediating factors using descriptive and interpretative statistics. Ethics and dissemination Approval from West of Scotland Research Ethics Committee 4 (16/LO/0990). Findings will be published in journals, disseminated at conferences and through the final report. [ABSTRACT FROM AUTHOR]
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- 2019
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9. Singing for people with aphasia (SPA): a protocol for a pilot randomised controlled trial of a group singing intervention to improve well-being.
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Tarrant, Mark, Carter, Mary, Dean, Sarah Gerard, Taylor, Rod S., Warren, Fiona C., Spencer, Anne, Adamson, Jane, Landa, Paolo, Code, Chris, and Calitri, Raff
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Introduction The singing for people with aphasia (SPA) intervention aims to improve quality of life and well-being for people with poststroke aphasia. A definitive randomised controlled trial (RCT) is required to assess the clinical and cost effectiveness of SPA. The purpose of this pilot study is to assess the feasibility of such a definitive trial and inform its design. Methods and analysis A two-group, assessor-blinded, randomised controlled external pilot trial with parallel mixed methods process evaluation and economic evaluation. Forty-eight participants discharged from clinical speech and language therapy will be individually randomised 1:1 to SPA (10 group sessions plus a resource booklet) or control (resource booklet only). Outcome assessment at baseline, 3 and 6 months postrandomisation include: ICEpop CAPability measure for adults, Stroke and Aphasia Quality of Life, EQ-5D-5L, modified Reintegration into Normal Living Index, Communication Outcome After Stroke, Very Short Version of the Minnesota Aphasia Test, Service Receipt Inventory and Care Related Quality of Life. Feasibility, acceptability and process outcomes include recruitment and retention rates, with measurement burden and trial experiences being explored in qualitative interviews (15 participants, 2 music facilitators and 2 music champions). Analyses include: descriptive statistics, with 95% CIs where appropriate; qualitative themes; intervention fidelity from videos and session checklists; rehearsal of health economic analysis. Ethics and dissemination NHS National Research Ethics Service and the Health Research Authority confirmed approval in April 2017; recruitment commenced in June 2017. Outputs will include: pilot data to inform whether to proceed to a definitive RCT and support a funding application; finalised intervention manual for multicentre replication of SPA; presentations at conferences, public involvement events; internationally recognised peer reviewed journal publications, open access sources and media releases. trial registration number NCT03076736. [ABSTRACT FROM AUTHOR]
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- 2018
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10. Multicentred randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support in individuals with metabolic, musculoskeletal and mental health conditions: protocol for the e-coachER trial.
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Ingram, Wendy, Webb, Douglas, Taylor, Rod S., Anokye, Nana, Yardley, Lucy, Jolly, Kate, Mutrie, Nanette, Campbell, John L., Dean, Sarah Gerard, Greaves, Colin, Steele, Mary, Lambert, Jeffrey D., McAdam, Chloe, Jane, Ben, King, Jennie, Jones, Ray B., Little, Paul, Woolf, Anthony, Erwin, Jo, and Charles, Nigel
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Introduction Physical activity is recommended for improving health among people with common chronic conditions such as obesity, diabetes, hypertension, osteoarthritis and low mood. One approach to promote physical activity is via primary care exercise referral schemes (ERS). However, there is limited support for the effectiveness of ERS for increasing long-term physical activity and additional interventions are needed to help patients overcome barriers to ERS uptake and adherence. This study aims to determine whether augmenting usual ERS with web-based behavioural support, based on the LifeGuide platform, will increase long-term physical activity for patients with chronic physical and mental health conditions, and is cost-effective. Methods and analysis A multicentre parallel two-group randomised controlled trial with 1:1 individual allocation to usual ERS alone (control) or usual ERS plus web-based behavioural support (intervention) with parallel economic and mixed methods process evaluations. Participants are low active adults with obesity, diabetes, hypertension, osteoarthritis or a history of depression, referred to an ERS from primary care in the UK. The primary outcome measure is the number of minutes of moderate-to-vigorous physical activity (MVPA) in ≥10 min bouts measured by accelerometer over 1 week at 12 months. We plan to recruit 413 participants, with 88% power at a two-sided alpha of 5%, assuming 20% attrition, to demonstrate a between-group difference of 36-39 min of MVPA per week at 12 months. An improvement of this magnitude represents an important change in physical activity, particularly for inactive participants with chronic conditions. Ethics and dissemination Approved by North West Preston NHS Research Ethics Committee (15/NW/0347). Dissemination will include publication of findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals. Results will be disseminated to ERS services, primary healthcare providers and trial participants. trial registration number ISRCTN15644451; Pre-results. [ABSTRACT FROM AUTHOR]
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- 2018
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11. Community-based rehabilitation training after stroke: results of a pilot randomised controlled trial (ReTrain) investigating acceptability and feasibility.
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Dean, Sarah G., Poltawski, Leon, Forster, Anne, Taylor, Rod S., Spencer, Anne, James, Martin, Allison, Rhoda, Stevens, Shirley, Norris, Meriel, Shepherd, Anthony I., Landa, Paolo, Pulsford, Richard M., Hollands, Laura, and Calitri, Raff
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Objectives To assess acceptability and feasibility of trial processes and the Rehabilitation Training (ReTrain) intervention including an assessment of intervention fidelity. Design A two-group, assessor-blinded, randomised controlled trial with parallel mixed methods process and economic evaluations. Setting Community settings across two sites in Devon. Participants Eligible participants were: 18 years old or over, with a diagnosis of stroke and with self-reported mobility issues, no contraindications to physical activity, discharged from National Health Service or any other formal rehabilitation programme at least 1 month before, willing to be randomised to either control or ReTrain and attend the training venue, possessing cognitive capacity and communication ability sufficient to participate. Participants were individually randomised (1:1) via a computer-generated randomisation sequence minimised for time since stroke and level of functional disability. Only outcome assessors independent of the research team were blinded to group allocation. Interventions ReTrain comprised (1) an introductory one-to-one session; (2) ten, twice-weekly group classes with up to two trainers and eight clients; (3) a closing one-to-one session, followed by three drop-in sessions over the subsequent 3 months. Participants received a bespoke home-based training programme. All participants received treatment as usual. The control group received an exercise after stroke advice booklet. Outcome measures Candidate primary outcomes included functional mobility and physical activity. Results Forty-five participants were randomised (ReTrain=23; Control=22); data were available from 40 participants at 6 months of follow-up (ReTrain=21; Control=19) and 41 at 9 months of follow-up (ReTrain=21; Control=20). We demonstrated ability to recruit and retain participants. Participants were not burdened by the requirements of the study. We were able to calculate sample estimates for candidate primary outcomes and test procedures for process and health economic evaluations. Conclusions All objectives were fulfilled and indicated that a definitive trial of ReTrain is feasible and acceptable. Trial registration number NCT02429180; Results. [ABSTRACT FROM AUTHOR]
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- 2018
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12. Why do GPs leave direct patient care and what might help to retain them? A qualitative study of GPs in South West England.
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Sansom, Anna, Terry, Rohini, Fletcher, Emily, Salisbury, Chris, Long, Linda, Richards, Suzanne H., Aylward, Alex, Welsman, Jo, Sims, Laura, Campbell, John L., and Dean, Sarah G.
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Objective To identify factors influencing general practitioners' (GPs’) decisions about whether or not to remain in direct patient care in general practice and what might help to retain them in that role. Design Qualitative, in-depth, individual interviews exploring factors related to GPs leaving, remaining in and returning to direct patient care. Setting South West England, UK. Participants 41 GPs: 7 retired; 8 intending to take early retirement; 11 who were on or intending to take a career break; 9 aged under 50 years who had left or were intending to leave direct patient care and 6 who were not intending to leave or to take a career break. Plus 19 stakeholders from a range of primary care-related professional organisations and roles. Results Reasons for leaving direct patient care were complex and based on a range of job-related and individual factors. Three key themes underpinned the interviewed GPs’ thinking and rationale: issues relating to their personal and professional identity and the perceived value of general practice-based care within the healthcare system; concerns regarding fear and risk, for example, in respect of medical litigation and managing administrative challenges within the context of increasingly complex care pathways and environments; and issues around choice and volition in respect of personal social, financial, domestic and professional considerations. These themes provide increased understanding of the lived experiences of working in today’s National Health Service for this group of GPs. Conclusion Future policies and strategies aimed at retaining GPs in direct patient care should clarify the role and expectations of general practice and align with GPs’ perception of their own roles and identity; demonstrate to GPs that they are valued and listened to in planning delivery of the UK healthcare; target GPs’ concerns regarding fear and risk, seeking to reduce these to manageable levels and give GPs viable options to support them to remain in direct patient care. [ABSTRACT FROM AUTHOR]
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- 2018
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13. Community-based Rehabilitation Training after stroke: protocol of a pilot randomised controlled trial (ReTrain).
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Dean, Sarah G., Poltawski, Leon, Forster, Anne, Taylor, Rod S., Spencer, Anne, James, Martin, Allison, Rhoda, Stevens, Shirley, Norris, Meriel, Shepherd, Anthony I., and Calitri, Raff
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Introduction: The Rehabilitation Training (ReTrain) intervention aims to improve functional mobility, adherence to poststroke exercise guidelines and quality of life for people after stroke. A definitive randomised controlled trial (RCT) is required to assess the clinical and cost-effectiveness of ReTrain, which is based on Action for Rehabilitation from Neurological Injury (ARNI). The purpose of this pilot study is to assess the feasibility of such a definitive trial and inform its design. Methods and analysis: A 2-group, assessorblinded, randomised controlled external pilot trial with parallel mixed-methods process evaluation and economic evaluation. 48 participants discharged from clinical rehabilitation despite residual physical disability will be individually randomised 1:1 to ReTrain (25 sessions) or control (exercise advice booklet). Outcome assessment at baseline, 6 and 9 months include Rivermead Mobility Index; Timed Up and Go Test; modified Patient-Specific Functional Scale; 7-day accelerometry; Stroke Self-efficacy Questionnaire, exercise diary, Fatigue Assessment Scale, exercise beliefs and self-efficacy questionnaires, SF-12, EQ-5D- 5L, Stroke Quality of Life, Carer Burden Index and Service Receipt Inventory. Feasibility, acceptability and process outcomes include recruitment and retention rates; with measurement burden and trial experiences being explored in qualitative interviews (20 participants, 3 intervention providers). Analyses include descriptive statistics, with 95% CI where appropriate; qualitative themes; intervention fidelity from videos and session checklists; rehearsal of health economic analysis. Ethics and dissemination: National Health Service (NHS) National Research Ethics Service approval granted in April 2015; recruitment started in June. Preliminary studies suggested low risk of serious adverse events; however (minor) falls, transitory muscle soreness and high levels of postexercise fatigue are expected. Outputs include pilot data to inform whether to proceed to a definitive RCT and support a funding application; finalised Trainer and Intervention Delivery manuals for multicentre replication of ReTrain; presentations at conferences, public involvement events; internationally recognised peer-reviewed journal publications, open access sources and media releases. [ABSTRACT FROM AUTHOR]
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- 2016
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14. Creating psychological connections between intervention recipients: development and focus group evaluation of a group singing session for people with aphasia.
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Tarrant, Mark, Warmoth, Krystal, Code, Chris, Dean, Sarah, Goodwin, Victoria A., Stein, Ken, and Sugavanam, Thavapriya
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Objectives: The study sought to identify key design features that could be used to create a new framework for group-based health interventions. We designed and tested the first session of a group intervention for stroke survivors with aphasia which was aimed at nurturing new psychological connections between group members. Setting: The intervention session, a participant focus group and interviews with intervention facilitators were held in a local community music centre in the South West of England. Participants: A convenience sample of 10 community-dwelling people with poststroke aphasia participated in the session. Severity of aphasia was not considered for inclusion. Intervention: Participants took part in a 90-min group singing session which involved singing songs from a specially prepared song book. Musical accompaniment was provided by the facilitators. Primary and secondary outcome measures: Participants and group facilitators reported their experiences of participating in the session, with a focus on activities within the session related to the intervention aims. Researcher observations of the session were also made. Results: Two themes emerged from the analysis, concerning experiences of the session ('developing a sense of group belonging') and perceptions of its design and delivery ('creating the conditions for engagement'). Participants described an emerging sense of shared social identity as a member of the intervention group and identified fixed (eg, group size, session breaks) and flexible (eg, facilitator responsiveness) features of the session which contributed to this emergence. Facilitator interviews and researcher observations corroborated and expanded participant reports. Conclusions: Engagement with health intervention content may be enhanced in group settings when intervention participants begin to establish positive and meaningful psychological connections with other group members. Understanding and actively nurturing these connections should be a core feature of a general framework for the design and delivery of group interventions. [ABSTRACT FROM AUTHOR]
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- 2016
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15. Assessing interventions to increase compliance to patching treatment in children with amblyopia: a systematic review and meta-analysis.
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Dean, Sarah Elizabeth, Povey, Rachel Clare, and Reeves, Jessica
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VISUAL acuity , *AMBLYOPIA , *META-analysis , *DATA integrity , *DATA extraction , *THERAPEUTICS - Abstract
Background/Aims Amblyopia is the most common condition affecting visual acuity in childhood. Left untreated it will not resolve itself, leading to increased risk of blindness. Occluding the good eye with a patch is a highly effective treatment if carried out before age 7 years but compliance is a major problem. This systematic review addresses the question: How effective are existing interventions at increasing compliance to patching treatment in children with amblyopia? Methods Electronic searches were carried out in June 2014 and updated in April 2015 to identify studies reporting primary data on interventions to increase patching compliance. Data screening, extraction and quality ratings were performed independently by two researchers. Results Nine papers were included. Interventions including an educational element (5 studies) significantly increased patching compliance and had higher quality ratings than interventions that changed aspects of the patching regime (3 studies) or involved supervised occlusion (1 study). Meta-analysis was conducted on four studies and indicated that overall interventions involving an educational element have a significant small effect r=0.249, p<0.001. Conclusions Interventions to increase patching compliance should include educational elements. High quality research is needed to further assess the effectiveness of specific elements of educational interventions and additional behaviour change techniques. [ABSTRACT FROM AUTHOR]
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- 2016
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16. A systematic review of measures of self-reported adherence to unsupervised home-based rehabilitation exercise programmes, and their psychometric properties.
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Bollen, Jessica C., Dean, Sarah G., Siegert, Richard J., Howe, Tracey E., and Goodwin, Victoria A.
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Background: Adherence is an important factor contributing to the effectiveness of exercise-based rehabilitation. However, there appears to be a lack of reliable, validated measures to assess self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises. Objectives: A systematic review was conducted to establish what measures were available and to evaluate their psychometric properties. Data sources: MEDLINE, EMBASE, PsycINFO CINAHL ( June 2013) and the Cochrane library were searched (September 2013). Reference lists from articles meeting the inclusion criteria were checked to ensure all relevant papers were included. Study selection: To be included articles had to be available in English; use a self-report measure of adherence in relation to a prescribed but unsupervised home-based exercise or physical rehabilitation programme; involve participants over the age of 18. All health conditions and clinical populations were included. Data extraction: Descriptive data reported were collated on a data extraction sheet. The measures were evaluated in terms of eight psychometric quality criteria. Results: 58 studies were included, reporting 61 different measures including 29 questionnaires, 29 logs, two visual analogue scales and one tally counter. Only two measures scored positively for one psychometric property (content validity). The majority of measures had no reported validity or reliability testing. Conclusions: The results expose a gap in the literature for well-developed measures that capture self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises. [ABSTRACT FROM AUTHOR]
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- 2014
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17. Psychological consequences of false-positive screening mammograms in the UK.
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Bond, Mary, Pavey, Toby, Welch, Karen, Cooper, Chris, Garside, Ruth, Dean, Sarah, and Hyde, Christopher J.
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MAMMOGRAMS ,DIAGNOSTIC errors ,QUALITY assurance ,SYSTEMATIC reviews - Abstract
Objectives To identify the psychological effects of falsepositivescreening mammograms in the UK.Methods Systematic review of all controlled studies and qualitative studies of women with a false-positive screening mammogram. The control group participants had normal mammograms. All psychological outcomes including returning for routine screening were permitted.All studies had a narrative synthesis.Results The searches returned seven includable studies(7/4423). Heterogeneity was such that meta-analysis was not possible. Studies using disease-specific measures found that, compared to normal results, there could been during psychological distress that lasted up to 3 years;the level of distress was related to the degree of invasiveness of the assessment. At 3 years the relative risks were,further mammography, 1.28 (95% CI 0.82 to 2.00), fine needle aspiration 1.80 (95% CI 1.17 to 2.77), biopsy 2.07(95% CI 1.22 to 3.52) and early recall 1.82 (95% CI 1.22to 2.72). Studies that used generic measures of anxiety and depression found no such impact up to 3 months after screening. Evidence suggests that women with false-positive mammograms have an increased likelihood of failing to re-attend for routine screening, relative risk0.97 (95% CI 0.96 to 0.98) compared with women with normal mammograms.Conclusions Having a false-positive screening mammogram can cause breast cancer-specific distress for up to3 years. The degree of distress is related to the invasiveness of the assessment. Women with false-positive mammograms are less likely to return for routine assessment than those with normal ones. [ABSTRACT FROM AUTHOR]
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- 2013
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18. Psychological consequences of false-positive screening mammograms in the UK.
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Bond M, Pavey T, Welch K, Cooper C, Garside R, Dean S, and Hyde CJ
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- Adult, Aged, Biopsy adverse effects, Biopsy psychology, Breast Neoplasms psychology, False Positive Reactions, Female, Humans, Mammography adverse effects, Middle Aged, Stress, Psychological etiology, United Kingdom, Breast Neoplasms diagnosis, Mammography psychology
- Abstract
Objectives: To identify the psychological effects of false-positive screening mammograms in the UK., Methods: Systematic review of all controlled studies and qualitative studies of women with a false-positive screening mammogram. The control group participants had normal mammograms. All psychological outcomes including returning for routine screening were permitted. All studies had a narrative synthesis., Results: The searches returned seven includable studies (7/4423). Heterogeneity was such that meta-analysis was not possible. Studies using disease-specific measures found that, compared to normal results, there could be enduring psychological distress that lasted up to 3 years; the level of distress was related to the degree of invasiveness of the assessment. At 3 years the relative risks were, further mammography, 1.28 (95% CI 0.82 to 2.00), fine needle aspiration 1.80 (95% CI 1.17 to 2.77), biopsy 2.07 (95% CI 1.22 to 3.52) and early recall 1.82 (95% CI 1.22 to 2.72). Studies that used generic measures of anxiety and depression found no such impact up to 3 months after screening. Evidence suggests that women with false-positive mammograms have an increased likelihood of failing to reattend for routine screening, relative risk 0.97 (95% CI 0.96 to 0.98) compared with women with normal mammograms., Conclusions: Having a false-positive screening mammogram can cause breast cancer-specific distress for up to 3 years. The degree of distress is related to the invasiveness of the assessment. Women with false-positive mammograms are less likely to return for routine assessment than those with normal ones.
- Published
- 2013
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