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Biomedical subjects

Fiona Stevenson

Publications and source records attributed to Fiona Stevenson.

6 recordsLinked to original sources
PubMed2006

Internet interventions for long-term conditions: patient and caregiver quality criteria.

BACKGROUND: Interactive health communication applications (IHCAs) that combine high-quality health information with interactive components, such as self-assessment tools, behavior change support, peer support, or decision support, are likely to benefit people with long-term conditions. IHCAs are now largely Web-based and are becoming known as "Internet interventions." Although there are numerous professionally generated criteria to assess health-related websites, to date there has been scant exploration of patient-generated assessment criteria even though patients and professionals use different criteria for assessing the quality of traditional sources of health information. OBJECTIVE: We aimed to determine patients' and caregivers' requirements of IHCAs for long-term conditions as well as their criteria for assessing the quality of different programs. METHODS: This was a qualitative study with focus groups. Patients and caregivers managing long-term conditions used three (predominantly Web-based) IHCAs relevant to their condition and subsequently discussed the strengths and weaknesses of the different IHCAs in focus groups. Participants in any one focus group all shared the same long-term condition and viewed the same three IHCAs. Patient and caregiver criteria for IHCAs emerged from the data. RESULTS: There were 40 patients and caregivers who participated in 10 focus groups. Participants welcomed the potential of Internet interventions but felt that many were not achieving their full potential. Participants generated detailed and specific quality criteria relating to information content, presentation, interactivity, and trustworthiness, which can be used by developers and purchasers of Internet interventions. CONCLUSIONS: The user-generated quality criteria reported in this paper should help developers and purchasers provide Internet interventions that better meet user needs.

Adult↗
PubMed2005

The relationship between medicine and the public: the challenge of concordance.

Concordance is based on the idea that patients and practitioners should work together towards an agreement on treatment choice. This requires a redefinition of the relations and encounters between doctors and their patients. This redefinition emphasizes the need for patient involvement and participation. In this article we examine concordance against the background of wider social change, structural as well as interpersonal. We focus in particular on challenges to trust, noting that the almost instinctive trust that people formerly had for professional experts has for many reasons diminished. One consequence of this, we suggest, is that concordance is being espoused at a time when its accomplishment may be particularly threatened. In fact there are strong grounds for claiming that support for the notion of concordance could possibly result in a growth of 'hidden' communication pathologies by means of what the social theorist Habermas (1984) has termed 'systematically distorted communication'.

Communication↗
PubMed2004

The expression of aversion to medicines in general practice consultations.

Although the relevance of patients' views about medicines for their medicine taking behaviour is now well established, little is known about the ways in which these views are discussed in primary care consultations. In particular, many studies have demonstrated patients' aversion to medicines. This paper examines the form that aversion talk takes in the consultation and how doctors respond to patients' expression of aversion to medicines. It is based on a dataset of 35 case studies of general practice consultations in England. In interviews with researchers, aversion to medicines was expressed in 34 of the 35 cases. In consultations with doctors, aversion was expressed in 10 cases. The interactional dimension of aversion talk in consultations was analysed using Conversation Analysis, and two general patterns were identified. Aversion could be used as an interactional resource, or it could be a topic in its own right. If used as an interactional resource, no real discussion of patients' views of medicines took place. When aversion was a conversational topic in its own right, two situations were observed. Firstly, the doctor elicited patients' views directly. Secondly, patients initiated aversive talk using a range of indirect strategies to do so. Even when patients managed to express their aversion to medicines, doctors did not engage them in any real discussion of their views. A scheme of interpretation is suggested to explain these findings. In this scheme patients perceive medicines to be an extension of the doctor and to be beneficial. In this view it is right for doctors to prescribe medicines and for patients to take medicines. The results of this paper suggest that using aversion as an interactional resource might be the only safe way for patients to express their aversion without seeming to breach the social contract.

Adult↗
PubMed2004

Images of nature in relation to mood modifying medicines: a user perspective.

Appeals to nature are common, however the term is associated with multiple or even oppositional meanings. This article explores the way nature is evoked and references are made to chemicals in relation to both prescribed and herbal mood modifying medicines. Data are drawn from 23 interviews with people who were taking, had been offered or had taken, either or both prescribed and herbal mood modifying medicines. Fifteen of the 23 respondents used the ideas of natural and chemical when discussing their medicine taking decisions. Rather than a dichotomy between prescribed and herbal remedies in relation to the ideas of natural and chemical, the notion of translations, and ideas concerning risk, are suggested as more appropriate for understanding how different treatments are assessed.

Adolescent↗
PubMed2003

Developing and using quantitative instruments for measuring doctor-patient communication about drugs.

Previous qualitative work has identified communication problems between doctors and patients in general practice consultations, particularly in relation to prescribing. This study aimed to develop quantitative measures to extend the research and provide instruments for both researchers and practitioners to use in monitoring communication and prescribing. Questionnaires were developed from existing instruments. When used with patients and doctors in a variety of general practices, the instruments appeared to be acceptable and had high response rates. While many consultations were satisfactory in terms of patients' expectations and their experiences with medicines, only 38% did not have any poor outcome. The results using quantitative instruments were similar to but less striking compared to our previous qualitative work. The research was developmental and findings suggest that unnecessary prescribing and problems in communication are more likely to lead to poor outcomes in terms of non-adherence and patients having barriers to using their medication.

Communication↗