Search

To assess patterns of diagnosis, including concordance, and treatment within a clinical trial of traditional, acupuncture for low back pain. Setting: In a pragmatic randomised controlled clinical trial, 148 patients with low back pain, of between 4 weeks and 12 months duration, were randomised to the offer of individualised acupuncture and received up to 10 treatments. Methods: Standardised diagnosis and treatment records were completed by practitioners for 148 patients. The diagnosis was based on three pre-defined low back pain syndromes. For a subgroup of patients, one of the six practitioners then independently re-examined the patients, blind to the original diagnosis. The diagnostic inter-rater reliability was assessed in terms of percentage congruent classifications and Cohen's Kappa. Structured interviews of practitioners established further details about practice styles. Results: The most commonly diagnosed syndrome associated with low back pain was Qi and Blood Stagnation (88% of patients), followed by Kidney Deficiency (53%) and Bi Syndrome (28%), with more than one syndrome being identified for 65% of patients. For the subgroup examined twice, practitioner concordance was reasonable: between 47 and 80% of classifications were congruent, while Kappa values lay between 0 ('the same as chance') and 0.67 ('good'). Practitioners provided 1269 treatments in total, using 177 different acupuncture points. Most commonly used channels were Bladder and Gall Bladder, and the commonest points were BL-23 and the two lowest Huatuoji-aji points. Auxiliary treatments were utilised by all practitioners to varying degrees. Conclusions: Diagnostic concordance among practitioners was reasonable, and clear themes emerged for treatment. Further research is required to develop a flexible trial, protocol with scope for individualised treatment.

The involvement of patients and carers is central to the values of interprofessional education (IPE) which aims to improve the experience of care and care delivery. Partnership arrangements with service users and carers within Higher Education Institutions face the same barriers relating to status, power, and resources, as the implementation of IPE. The complexity of these alignments can be explained by Activity Theory (AT). Using a qualitative research methodology we set out to consider the stakeholder perspectives on whether patients should progress from telling their stories to taking on a leading teaching role, within a well-established IPE workshop. Following the principles of Participatory Action Research, data were collected cyclically, using consultation meetings, interviews (with tutors and patients) and focus groups (with students). The work was overseen by a steering group who reviewed and clarified the analysis, informed by AT. All stakeholders endorsed the validity of patients as teachers. Two new leadership roles were proposed; patients as Co-Tutors and as Mentors supporting the workshop. Service users and carers were realistic about the support required for progression. Students were more ambivalent, recognizing the right of patients to tell their stories but having concerns about their competence and potential bias when in leading roles. There is overall support for the development of a progressive route for patients to move beyond telling stories into leading teaching roles in IPE, but this brings added complexity and requires a supportive infrastructure, careful preparation of students and further research. [ABSTRACT FROM AUTHOR]

As more educators are involved in interprofessional education (IPE) it is important to consider how participation affects those who are sceptical about IPE. We report a prospective study in which the attitudes of 13 educators, unfamiliar with IPE, were compared before and after facilitating their first IPE. Their views, obtained as personal stories, were analysed through cognitive dissonance theory. Prior to teaching, all novice educators had concerns about IPE. Post-facilitation all were more positive about the value and meaning of IPE. [ABSTRACT FROM AUTHOR]

Background: This report outlines the action research used to develop a workshop for interprofessional student groups to enhance listening skills. Aim: The project aimed to enable students to reflect interprofessionally on the human factors central to effective communication using the power of storytelling by disabled people and their carers. Methods: Qualitative data from students and participating service users were collected using focus groups and one-to-one interviews over three pilot cycles. Results: The results from each pilot informed the cyclical development of the project so that each stage of data collection informed the next stage. During the pilots, 20 interviews with service users were completed and a total of 109 students participated. Transcribed data were analysed using principles from grounded theory. Quantitative scored questions on students' learning were analysed using statistical package for the social sciences. Conclusions: Both students (health and social care) and users benefitted from the education process which delivered highly relevant explicit learning opportunities, with analysis of how to improve communication for safe practice. Students benefitted from meaningful interactions with service users who shared their experiences and gave feedback on students' communication skills. The final workshop design resulted in a learning model which reflects the human side of healthcare delivery. [ABSTRACT FROM AUTHOR]

Background: Worldwide, the Coronavirus pandemic has had a major impact on people's health, lives, and livelihoods. However, this impact has not been felt equally across various population groups. People from ethnic minority backgrounds in the UK have been more adversely affected by the pandemic, especially in terms of their physical health. Their mental health, on the other hand, has received less attention. This study aimed to explore the mental health experiences of UK adults from ethnic minorities during the Coronavirus pandemic. This work forms part of our wider long-term UK population study "Mental Health in the Pandemic.", Methods: We conducted an exploratory qualitative study with people from ethnic minority communities across the UK. A series of in-depth interviews were conducted with 15 women, 14 men and 1 non-binary person from ethnic minority backgrounds, aged between 18 and 65 years old (mean age = 40). We utilized purposefully selected maximum variation sampling in order to capture as wide a variety of views, perceptions and experiences as possible. Inclusion criteria: adults (18+) from ethnic minorities across the UK; able to provide full consent to participate; able to participate in a video- or phone-call interview. All interviews took place via MS Teams or Zoom. The gathered data were transcribed verbatim and underwent thematic analysis following Braun and Clarke carried out using NVivo 12 software., Results: The qualitative data analysis yielded seven overarching themes: (1) pandemic-specific mental health and wellbeing experiences; (2) issues relating to the media; (3) coping mechanisms; (4) worries around and attitudes toward vaccination; (5) suggestions for support in moving forward; (6) best and worst experiences during pandemic and lockdowns; (7) biggest areas of change in personal life. Generally, participants' mental health experiences varied with some not being affected by the pandemic in a way related to their ethnicity, some sharing positive experiences and coping strategies (exercising more, spending more time with family, community cohesion), and some expressing negative experiences (eating or drinking more, feeling more isolated, or even racism and abuse, especially toward Asian communities). Concerns were raised around trust issues in relation to the media, the inadequate representation of ethnic minorities, and the spread of fake news especially on social media. Attitudes toward vaccinations varied too, with some people more willing to have the vaccine than others., Conclusion: This study's findings highlight the diversity in the pandemic mental health experiences of ethnic minorities in the UK and has implications for policy, practice and further research. To enable moving forward beyond the pandemic, our study surfaced the need for culturally appropriate mental health support, financial support (as a key mental health determinant), accurate media representation, and clear communication messaging from the Governments of the UK., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Van Bortel, Lombardo, Guo, Solomon, Martin, Hughes, Weeks, Crepaz-Keay, McDaid, Chantler, Thorpe, Morton, Davidson, John and Kousoulis.)