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Biomedical subjects

Carole Pinnock

Publications and source records attributed to Carole Pinnock.

6 recordsLinked to original sources

Clinicians' attitudes to prostate cancer peer-support groups.

OBJECTIVE: To assess clinicians' knowledge and attitudes to prostate cancer peer-support groups, essential in improving support services for men with prostate cancer, as patients' perceptions of their clinicians' attitudes to such groups predict patients' positive and negative perceptions of their experiences at such groups. SUBJECTS AND METHODS: In all, 36 clinicians (75% response) across Australia, of whom 27 were urologists and nine were radiation oncologists, were interviewed in-depth using a key-informant approach. Nine clinicians were from regional Australia, with the remaining 27 from major metropolitan settings. Subsequently, 30 clinicians (69% response) completed surveys to confirm identified themes. RESULTS: Peer support was rated positively by most clinicians and most report a fair to good knowledge of such groups. However, less than a quarter regularly refer their patients to these groups. While clinicians can describe positive aspects of peer support, many are concerned that biased viewpoints and misinformation within these groups might potentially contribute to patients' decisional uncertainty and regret. CONCLUSIONS: Further research is needed to establish for whom these support groups are most helpful. Concerns about misleading information that might be proffered in support groups is a barrier to clinician referral to these groups. Dialogue between prostate cancer interest groups and clinicians to resolve concerns presents as a key strategy to improve support for men with prostate cancer.

Attitude of Health Personnel↗

Evaluating peer support for prostate cancer: the Prostate Cancer Peer Support Inventory.

OBJECTIVE: To develop and test a measure for assessing peer support for men attending prostate cancer support groups, and to describe socio-demographic, medical and adjustment characteristics of Australian men who attend these support groups. PATIENTS AND METHODS: In all, 1224 men (51% response) from 44 prostate-cancer support groups across Australia were recruited by mail. Men completed self-report measures that included the Prostate Cancer Peer Support Inventory (PCSI), the UCLA Prostate Cancer Index bother scales, psychological distress, quality of life (QoL), bother from pain and tiredness, perception of the clinician's support for group participation. Group-level variables were also included in the analyses. RESULTS: Peer support was rated positively by most men; a high satisfaction with support groups was related to better QoL, lower pain, younger age, higher perceived clinician support for group participation, use of alternative therapies, lower education, and regular attendance; dissatisfaction with support groups was related to higher psychological distress, lower QoL, and lower perceived clinician support for group participation. Group variables did not predict positive or negative support. Overall QoL was similar to community norms and psychological distress was low, with only 8% of men reporting high distress. The most common physical symptom was sexual bother, with 74% of men reporting moderate or high bother. CONCLUSIONS: The PCSI was a useful measure of peer support. Perception of the benefits of peer support was related to individual but not group differences. The clinicians' attitudes to participation in support groups influenced the men's experience of these groups, and this finding has implications for developing support services for these men.

Adaptation, Psychological↗

The informationist: a prospective uncontrolled study.

OBJECTIVE: To determine whether doctors in an Australian tertiary hospital would use an informationist service, and to identify how the service would influence care. DESIGN: A prospective uncontrolled pilot study July 2002-January 2003. SETTING: A teaching hospital in South Australia. STUDY PARTICIPANTS: Fourteen doctors working in the selected units. INTERVENTION: An informationist attended specified medical in-patient ward rounds and clinical meetings in the Respiratory Medicine, Sleep Disorders, and Rheumatology units. Main outcomes measures. Clinician self-assessed impact of information on a range of outcomes relating to clinical decision-making, clinician education, and avoidance of adverse events. RESULTS: In 23 weeks, 52 questions were generated by nine of 14 eligible doctors. Forty-eight of 52 (92%) feedback forms were completed, indicating an average of 5.7 impacted outcomes per response. Twenty-five of 48 (52%) provided new information to doctors, and 24/48 (50%) provided at least some information that could be used immediately. Most common contributions of the service to patient care were revision of treatment plan (21/48, 44%) and confirmation of proposed therapy (18/48, 38%). Thirteen of 48 (27%) contributed to avoiding adverse events, and 10/48 (21%) contributed to avoiding additional tests and procedures. Eleven of 11 (100%) doctors who used the service assessed that it contributed or probably contributed to their professional development, with 8/10 (80%) indicating a similar impact on improving clinical outcomes. CONCLUSION: Medical staff will use an informationist service, which contributes substantially to a multiplicity of outcomes relating to medical decision-making, clinician education, and clinical outcomes.

Delivery of Health Care↗

The informationist in Australia: a feasibility study.

OBJECTIVES: A clinical informationist could provide the best available published evidence in response to clinicians' questions identified during the process of care. This study sought to assess the feasibility of an informationist service and to propose a model for its delivery in an Australian teaching hospital. Whilst similar services are increasing in the UK, with a long history in the USA, this is the first Australian study in an acute public hospital. METHODS: The views of 40/49 (82%) medical staff at the Daw Park Repatriation General Hospital, South Australia were canvassed using a questionnaire designed to address key issues relating to a proposed service. RESULTS: Doctors were receptive to its potential benefits, perceived it as relevant and likely to be used, and were interested in a pilot. They typically indicated a required response time of 24 h. They expressed limited concerns other than a likely high workload for such a service, and reported currently searching infrequently for evidence in response to clinical questions, citing time issues and unavailability of computers as current key barriers to pursuing clinical questions. CONCLUSIONS: An informationist service is feasible. Results suggest that a pilot could be run in an area of acute medicine where questions about therapy and diagnosis are likely to proliferate, and the informationist should attend consultant ward rounds and clinical meetings, aiming to provide a response within 24 h.

Attitude of Health Personnel↗