Search

Background: Few family interaction processes are more detrimental to children's health than family conflicts. Conflictual relationships in childhood predict a host of adverse health outcomes across the life course. The current study examines associations between household conflicts and the health of children aged 6–12 years and explores to which extent this may vary by socioeconomic status (SES) and multimorbidity (MM) in the household. Methods: Cross‐sectional study using questionnaire data gathered between 2016 and 2020 as part of the Lolland‐Falster Health Study (LOFUS) combined with routine register data on health care use and socio‐demography from the Danish nationwide administrative databases. The study sample consisted of 1065 children 6–12 years old, who answered LOFUS4 or LOFUS11, from 777 households for which at least one adult answered LOFUS18. Main outcome was children's health complaints, defined as headache, abdominal pain, back pain, and sleep difficulties. Covariates included MM, SES, and conflicts, all three measured at household level. Multivariable logistic regression models were used. Results: Conflicts were negatively associated with children's health. This was most pronounced for general conflicts in the household, with increased complaints of abdominal pain, back pain, and sleep difficulties. The associations varied when we stratified the households according to MM and SES. Significant associations were found within households without MM for abdominal pain, and within households with MM and low SES, and without MM and with high SES for sleep difficulties. While the higher level of abdominal pain for the above indicated households were found for both internal and external conflicts in the household, the higher level in sleep difficulties was mostly driven by internal conflicts. Conclusion: Children reporting frequent health complaints have a higher future health care use compared with children without such complaints. Our results indicate that growing up in a household with a high conflict level might be a predisposing factor. [ABSTRACT FROM AUTHOR]

Keywords: delabeling; drug allergy; drug provocation test; penicillin allergy; penicillin allergy labels EN delabeling drug allergy drug provocation test penicillin allergy penicillin allergy labels 969 973 5 09/05/23 20230901 NES 230901 Key messages Correct penicillin allergy labels are crucial for patient safety and correct patient management. Twenty-nine patients with a disproved allergy still had an incorrect penicillin allergy label in the hospital EMR, and of those, 16 (55.1%) also had an incorrect penicillin allergy label in primary care. The primary aim of this study was to investigate the degree of match/mismatch between penicillin allergy labels in hospital and primary care EMR systems in patients who had undergone penicillin allergy investigation in a hospital allergy clinic. Among patients with a disproved allergy, 93 patients (21.4%) still had an incorrect penicillin allergy label in primary care (79 GP clinics). [Extracted from the article]

Aim: To investigate approaches among healthcare providers (HCPs) that support or hinder person‐centredness in group‐based diabetes education programmes targeting persons with type 2 diabetes. Methods: Ethnographic fieldwork in a municipal and a hospital setting in Denmark. The two programmes included 21 participants and 10 HCPs and were observed over 5 weeks. Additionally, 10 in‐depth semi‐structured interviews were conducted with patients (n = 7) and HCPs (n = 3). Data were analysed using systematic text condensation. Results: Hindering approaches included a teacher‐centred focus on delivering disease‐specific information. Communication was dialog based, but HCPs primarily asked closed‐ended questions with one correct answer. Additional hindering approaches included ignoring participants with suboptimal health behaviours and a tendency to moralize that resulted in feelings of guilt among participants. Supporting approaches included letting participants set the agenda using broad, open‐ended questions. Discussion: Healthcare providers are often socialized into a biomedical approach and trained to be experts. However, person‐centredness involves redefined roles and responsibilities. Applying person‐centredness in practice requires continuous training and supervision, but HCPs often have minimum support for developing person‐centred communication skills. Techniques based on motivational communication, psychosocial methods and facilitating group processes are effective person‐centred approaches in a group context. Conclusion: Teacher‐centredness undermined person‐centredness because HCPs primarily delivered disease‐specific recommendations, leading to biomedical information overload for participants. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives This study aimed to evaluate the relative effectiveness of electronic and postal reminders for increasing adherence to the quality assurance programme for the international normalized ratio ( INR) point-of-care testing ( POCT) device in primary care. Methods All 213 family practices that use the Elective Laboratory of the Capital Region, Denmark, and regularly conduct INR POCT were randomly allocated into two similarly sized groups. During the 4-month intervention, these practices were sent either computer reminders ( Com Rem) or computer-generated postal reminders ( Postal) if they did not perform a split test to check the quality of their INR POCT for each calendar month. The adherence of the practices was tracked during the subsequent 8 months subdivided into two 4-month periods both without intervention. Outcomes were measures of split test procedure adherence. Results Both interventions were associated with an increase in adherence to the split test procedure - a factor 6.00 [95% confidence interval (CI) 4.46-7.72] and 8.22 [95% CI 5.87-11.52] for ComRem and Postal, respectively - but there is no evidence that one of the interventions was more effective than the other. In the Com Rem group, the expected number of split tests (out of four) was 2.54 (95% CI 2.33-2.76) versus 2.44 (95% CI 2.24-2.65) in the Postal group, P = 0.14. There was a slight decrease in adherence over the two follow-ups, but neither intervention was better than the other in achieving a lasting improvement in adherence. Conclusion Computer reminders are as efficient as postal reminders in increasing adherence to a quality assurance programme for the INR POCT device in primary care. [ABSTRACT FROM AUTHOR]