Biomedical subjects

Deborah Sharp

Publications and source records attributed to Deborah Sharp.

24 records · Page 2Linked to original sources

PubMed2002

Improving teenagers' knowledge of emergency contraception: cluster randomised controlled trial of a teacher led intervention.

OBJECTIVE: To assess the effectiveness of a teacher led intervention to improve teenagers' knowledge about emergency contraception. DESIGN: Cluster randomised controlled trial. SETTING: 24 mixed sex, state secondary schools in Avon, south west England. PARTICIPANTS: 1974 boys and 1820 girls in year 10 (14-15 year olds). INTERVENTION: Teachers gave a single lesson on emergency contraception to year 10 pupils. The teachers had previously received in-service training on giving the lesson. The pupils were actively involved during the lesson. MAIN OUTCOME MEASURES: Questionnaires distributed to pupils at baseline and six months after the intervention assessed their knowledge of the correct time limits for hormonal emergency contraception and for use of the intrauterine device as emergency contraception, the proportion of pupils who were not virgins, the proportion who had used emergency contraception, and the pupils' intention to use emergency contraception in the future. RESULTS: The proportion of pupils knowing the correct time limits for both types of emergency contraception was significantly higher in the intervention group than in the control group at six months' follow up (hormonal contraception: proportion of boys 15.9% higher (95% confidence interval 6.5% to 25.3%), girls 20.4% (10.4% to 30.4%); intrauterine device used as emergency contraception: boys 4.2% (0.7% to 7.7%), girls 10.7% (0.4% to 21.0%). The number of pupils needed to be taught for one more pupil to know the correct time limits was six for boys and five for girls. The intervention and control groups did not differ in the proportion of pupils who were not virgins, in the proportion who had used emergency contraception, and in the proportion intending to use emergency contraception in the future. CONCLUSIONS: The intervention significantly improved the proportion of boys and girls knowing the correct time limits for both types of emergency contraception. The intervention did not change the pupils' sexual activity or use of emergency contraception.

Adolescent↗

PubMed2002

Effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy to treat patients with depression: randomised controlled trial.

OBJECTIVE: To assess the effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy. DESIGN: Parallel group, cluster randomised, controlled trial of an educational package on cognitive behaviour therapy. SETTING: General practices in north London. PARTICIPANTS: 84 general practitioner principals and 272 patients attending their practices who scored above the threshold for psychological distress on the hospital anxiety and depression scale. INTERVENTION: A training package of four half days on brief cognitive behaviour therapy. MAIN OUTCOME MEASURES: Scores on the depression attitude questionnaire (general practitioners) and the Beck depression inventory (patients). RESULTS: Doctors' knowledge of depression and attitudes towards its treatment showed no major difference between intervention and control groups after 6 months. The training had no discernible impact on patients' outcomes. CONCLUSION: General practitioners may require more training and support than a basic educational package on brief cognitive behaviour therapy to acquire skills to help patients with depression.

Adolescent↗

PubMed2002

Multiple sclerosis and quality of life: a qualitative investigation.

OBJECTIVES: Many people who live with long-term illness experience a decline in their quality of life. The primary aim of this qualitative study was to identify aspects of life that contributed to the quality of the lives of people who had one particular chronic illness, namely multiple sclerosis (MS). A secondary aim was to use this information to highlight areas where there was potential for effective intervention by health or social services. METHODS: Sixteen people with MS who lived in a variety of circumstances and had a range of disabilities were interviewed in depth. Views relating to personal experience of chronic illness, diagnosis, living with disability, and conventional and alternative treatments were explored. Transcripts were analysed using a grounded theory approach. RESULTS: Analysis of the interviews revealed that being subjectively reasonably happy and as socially active as desired was central to an acceptable quality of life. The extent of the personal control that participants were able to exert and their individual illness trajectory were found to be central to whether or not this aim was achieved. In addition, the importance of social comparison was revealed, although its influence upon quality of life was somewhat inconsistent. A number of other factors were found to play an influential role in the quality of people's lives. These are described and plausible links between factors are proposed. CONCLUSIONS: Many aspects of living with chronic illness are unavoidable, but health or social intervention can affect others. Inappropriate personal assistance may result in dependency, which detracts from personal control and worsens quality of life. When appropriate, however, support may have beneficial consequences. By recognising the specific factors that link personal control and the illness trajectory, appropriate and timely support can be negotiated.

Attitude to Health↗

PubMed2002

Patient, hospital, and general practitioner characteristics associated with non-attendance: a cohort study.

Studies examining characteristics of non-attendance at hospital outpatients have given inconsistent results. We examined a cohort of 1972 referrals from 26 general practitioners, with complete follow-up. Five factors were found to be significantly associated with non-attendance: male sex, younger age, longer interval between referral and appointment, higher Jarman score and patients of a high-referring general practitioner. Targeting of strategies to reduce non-attendance is possible using these results.

Adolescent↗

PubMed2002

Questionnaire survey of users of NHS walk-in centres: observational study.

BACKGROUND: NHS walk-in centres have recently been established throughout England to improve access to primary health care. AIM: To determine the characteristics and experiences of people consulting NHS walk-in centres compared with general practice. DESIGN OF STUDY: Observational study using questionnaires. SETTING: Thirty-eight walk-in centres and 34 neighbouring general practices. METHOD: People attending randomly selected survey sessions at walk-in centres or neighbouring general practices on a 'same-day' basis were given a self-administered questionnaire. This collected data about socio-demographic characteristics, reasons for consulting, attitudes to continuity, satisfaction, enablement, referrals, and intentions. RESULTS: Walk-in centre visitors were more likely to be owner-occupiers (55% versus 49%; P<0.001), to have further education (25% versus 19%; P = 0.006), and to be white (88% versus 84%; P< 0.001) than general practice visitors. Main reasons for attending a walk-in centre were speed of access and convenience. Walk-in centre visitors were more likely to attend on the first day of illness (28% versus 10%; P<0.001), less likely to expect a prescription (38% versus 70%, P<0.001), and placed less importance on continuity of care (adjusted odds ratio = 0.58; 95% CI = 0.50 to 0.68) than general practice visitors. People were more satisfied with walk-in centres (adjusted mean difference = 6.6%; 95% CI = 5.0% to 8.2%). Enablement scores were slightly higher in general practice (adjusted mean difference = 0.40; 95 % CI = 0.11 to 0. 6). Following the consultation 13% of walk-in centre visitors were referred to general practice, but 32% intended to make an appointment. CONCLUSION: NHS walk-in centres improve access to care, but not necessarily for those people with greatest health needs. People predominantly attend with problems of recent onset as an alternative to existing health providers, and are very satisfied with the care received. These benefits need to be considered in relation to the cost, and in comparison with other ways of improving access to health care.

Adolescent↗

PubMed2000

Dementia and the Over-75 Check: the role of the primary care nurse.

Primary care nurses are very likely to provide a substantial part of the routine care for patients with dementia. In order to examine the knowledge and attitudes of the primary care nurses who undertake the Over-75 Check, towards assessing and managing patients with symptoms of dementia, and to assess their level of support for a clinical practice guideline, a postal questionnaire survey was undertaken of primary care nurses responsible for the Over-75 Check in 209 general practices in Gloucester, Avon and Somerset. The questionnaire ascertained some demographic information about the nurses, their training and the practice routine for the Over-75 Check. It also included a case vignette describing a typical presentation of dementia at an Over-75 Check. A 65% response rate was achieved. Only one-fifth of respondents ever used formal validated cognitive tests as part of the Over-75 Check. In response to the vignette, nearly 10% took no action at all and a further 25% simply referred the patient on. Amongst the remainder there was considerable variation regarding the tasks considered to be within their remit. The respondents strongly supported the introduction of guidelines. Given the variation in professional responsibilities between practices, it is proposed that a clinical practice guideline covering diagnosis, assessment and management of dementia should address the practice as a whole rather than be targeted to specific professionals. The guideline should prompt professionals carrying out an Over-75 Check to recognize symptoms of dementia and raise awareness of the range of tasks which need to be undertaken in confirming diagnosis, assessing needs and managing patients. Results from this study suggest that improved training and increased autonomy for primary care nurses would improve access to services for these patients and their carers.

Journal Article↗