Raising concerns about family history of breast cancer in primary care consultations: prospective, population based study. Women's Concerns Study Group.
Ontology highlight
ABSTRACT:
SUBMITTER: Hyland F
PROVIDER: S-EPMC26605 | biostudies-literature | 2001 Jan
REPOSITORIES: biostudies-literature
Publications
Raising concerns about family history of breast cancer in primary care consultations: prospective, population based study. Women's Concerns Study Group.
Hyland F F Kinmonth A L AL Marteau T M TM Griffin S S Murrell P P Spiegelhalter D D Todd C C Walter F F Berrington B B Bobrow M M Mackay J J
BMJ (Clinical research ed.) 20010101 7277
Similar Datasets
Project description:ObjectivesFamily health history underpins genetic medicine. Our study aimed to explore language and patterns of communication relating to family health history observed in interactions between general practitioners (GPs) and their patients within routine primary care consultations.DesignSecondary analysis of patient and GP routine consultation data (n=252).ParticipantsConsultations that included 'family health history' were eligible for inclusion (n=58).Primary outcomesA qualitative inductive analysis of the interactions from consultation transcripts.Results46/58 conversations about family health history were initiated by the GP. Most discussions around family history lasted for between approximately 1 to 2 min. Patients were invited to share family health history through one of two ways: non-specific enquiry (eg, by asking the patient about 'anything that runs in the family'); or specific enquiry where they were asked if they had a 'strong family history' in relation to a particular condition, for example, breast cancer. Patients often responded to either approach with a simple no, but fuller negative responses also occurred regularly and typically included an account of some kind (eg, explaining family relationships/dynamics which impeded or prevented the accessibility of information).ConclusionsFamily health history is regarded as a genetic test and is embedded in the sociocultural norms of the patient from whom information is being sought. Our findings highlight that it is more complex than asking simply if 'anything' runs in the family. As the collection of family health history is expected to be more routine, it will be important to also consider it from sociocultural perspectives in order to help mitigate any inequities in how family history is collected, and therefore used (or not) in a person's healthcare. Orientating an enquiry away from 'anything' and asking more specific details about particular conditions may help facilitate the dialogue.
| S-EPMC8493894 | biostudies-literature
Project description: Not available
| S-EPMC9903148 | biostudies-literature
Project description: Not available
| S-EPMC9125389 | biostudies-literature
Project description:ObjectivesTo examine patients' accounts of their use of the internet before seeing a general practitioner (GP) using thematic analysis of semistructured interviews.DesignQualitative semistructured interview study with transcripts analysed thematically.SettingPrimary care patients consulting with 10 GPs working at 7 GP practices of varying sizes and at a range of locations around London and the Southeast of England.Participants28 adult patients: 16 women and 12 men ranging in age from 18 to 75 from a range of self-defined ethnic backgrounds. Participants were selected based on instances when the patients reported having used the internet before the consultation, when patients referred to the internet in the consultation or when the physician used the internet or made reference to it during the consultation.ResultsPatients report that they can find health information online that they believe is reliable and helpful for both themselves and their GP. However, they report uncertainty about how to share internet-based findings and reluctance to disclose their efforts at researching health issues online for fear of appearing disrespectful or interfering with the flow of the consultation.ConclusionsDespite the democratisation of access to information about health due via the internet, patients continue to experience their use of the internet for health information as a sensitive and potentially problematic topic. The onus may well be on GPs to raise the likelihood (without judgement) that patients will have looked things up before consulting and invite them to talk about what they found.
| S-EPMC8094327 | biostudies-literature
Project description:BackgroundDoctors and medical students have a professional responsibility to raise concerns. Failure to raise concerns may compromise patient safety. It is widely known that medical students frequently encounter unprofessional behaviours in the workplace, but little is known about the barriers to raising concerns amongst medical students. This paper explores these issues and discusses some innovations in the medical undergraduate curriculum, offering a good practice model for other medical and healthcare curricula. We set out to ascertain the attitudes and experiences of medical students in relation to raising concerns. This data was then used to innovate the raising concerns curriculum, and access to the raising concerns system, in order to fundamentally improve patient safety and experience, as well as the student experience.MethodsThe authors conducted a mixed methods quantitative and qualitative research study. Research was based at a UK medical school and involved data collection using an anonymous, voluntary survey emailed to all medical students (n = 363) as well as voluntary attendance focus groups (n = 24) recruited by email. Both tools investigated student attitudes towards raising concerns and explored student ideas for solutions to improving the process. The focus group data was thematically analysed by three researchers.ResultsThe authors identified five key themes which described medical student attitudes towards raising concerns. This article discusses these themes and the resulting work to enhance medical education within the medical school curriculum.ConclusionsMore research is needed to further address the barriers that medical students find in raising concerns. However, despite being a single study in one UK medical school, the authors propose some changes which they hope may inspire other educators to build upon their raising concerns curricula to foster more transparent undergraduate cultures and ultimately improve patient experience and safety.
| S-EPMC6064143 | biostudies-literature
Project description:IntroductionAccess to contraceptive consultations and the content of these consultations are important to achieve a safe and satisfying sexual life and successful reproduction when desired. The aim of this study was to investigate Norwegian women's experiences of and opinions on contraceptive consultations.MethodsWe conducted a cross-sectional study with a questionnaire distributed via Facebook with 1917 respondents of age ≥15 years. Descriptive analyses were used.ResultsFew women found it hard to access consultations (5%). Across all age groups, side effects were the most common topic that women (69%) wanted more information about. Concern about side effects was also the most frequent reason given (27%) for not using hormonal contraceptives. Among women aged 25-34 years, 54% wanted to know more about different available contraceptives. The majority of women deemed issues of sexual wellbeing important to address during a contraceptive consultation. Few women reported that these topics had been raised. Just under half of the women found it appropriate to see a midwife for contraceptive/sexual health consultations. Only one-third knew that midwives can prescribe and administer long-acting reversible contraceptives (LARCs).ConclusionsWomen want contraceptive consultations to include more information on side effects and available hormonal contraceptives. Women want to be asked about their sexual health and wellbeing during contraceptive consultations. Women should be made aware that midwives can provide contraceptive services including LARCs.
| S-EPMC7839094 | biostudies-literature
Project description:BACKGROUND:Despite availability of modern contraceptive methods and documented unmet need for family planning in Ghana, many women still report forgoing modern contraceptive use due to anticipated side effects. The goal of this study was to examine the use of modern family planning, in particular hormonal methods, in one district in rural Ghana, and to understand the role that side effects play in women's decisions to start or continue use. METHODS:This exploratory mixed-methods study included 281 surveys and 33 in-depth interviews of women 18-49?years old in the Amansie West District of Ghana between May and July 2018. The survey assessed contraceptive use and potential predictors of use. In-depth interviews examined the context around uptake and continuation of contraceptive use, with a particular focus on the role of perceived and experienced side effects. RESULTS:The prevalence of unmet need for modern family planning among sexually active women who wanted to avoid pregnancy (n?=?135) was 68.9%. No factors were found to be significantly different in comparing those with a met need and unmet for modern family planning. Qualitative interviews revealed significant concerns about side effects stemming from previous method experiences and/or rumors regarding short-term impacts and perceived long-term consequences of family planning use. Side effects mentioned include menstrual changes (heavier bleeding, amenorrhea or oligomenorrhea), infertility and childbirth complications. CONCLUSION:As programs have improved women's ability to access modern family planning, it is paramount to address patient-level barriers to uptake, in particular information about side effects and misconceptions about long-term use. Unintended pregnancies can be reduced through comprehensive counseling about contraceptive options including accurate information about side effects, and the development of new contraceptive technologies that meet women's needs in low-income countries.
| S-EPMC7082910 | biostudies-literature
Project description:PurposeTo determine the relationship between positive family history (FH) and primary open-angle glaucoma (POAG) diagnosis and clinical presentation in the Primary Open-Angle African American Glaucoma Genetics (POAAGG) cohort.MethodsFH of POAG in first-degree relatives was assessed in 2365 subjects in the POAAGG cohort. A standardized interview was used to assess FH of glaucoma, demographic characteristics, lifestyle choices, and medical and ocular comorbidities.ResultsPositive FH was associated with increased risk of POAG (age-adjusted odds ratio and 95% confidence interval 3.4 [2.8, 4.1]). In age-adjusted analysis among POAG cases, positive FH was associated with younger age (P < .001), female sex (P < .001), hypertension (P = .006), use of hypertension medication (P = .03), and prior glaucoma surgery (P = .02). Cases with positive FH also had thicker retinal nerve fiber layers (P = .03).ConclusionsThe risk conferred by positive FH suggests strong genetic underpinnings for some patients with this disease, which will be investigated by genome-wide association studies and whole exome sequencing. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
| S-EPMC6064667 | biostudies-literature
Project description:BackgroundSafety-netting advice is information shared with a patient or their carer designed to help them identify the need to seek further medical help if their condition fails to improve, changes, or if they have concerns about their health.AimTo assess when and how safety-netting advice is delivered in routine GP consultations.Design and settingThis was an observational study using 318 recorded GP consultations with adult patients in the UK.MethodA safety-netting coding tool was applied to all consultations. Logistic regression for the presence or absence of safety-netting advice was compared between patient, clinician, and problem variables.ResultsA total of 390 episodes of safety-netting advice were observed in 205/318 (64.5%) consultations for 257/555 (46.3%) problems. Most advice was initiated by the GP (94.9%) and delivered in the treatment planning (52.1%) or closing (31.5%) consultation phases. Specific advice was delivered in almost half (47.2%) of episodes. Safety-netting advice was more likely to be present for problems that were acute (odds ratio [OR] 2.18, 95% confidence interval [CI] = 1.30 to 3.64), assessed first in the consultation (OR 2.94, 95% CI = 1.85 to 4.68) or assessed by GPs aged ≤49 years (OR 2.56, 95% CI = 1.45 to 4.51). Safety-netting advice was documented for only 109/242 (45.0%) problems.ConclusionGPs appear to commonly give safety-netting advice, but the contingencies or actions required on the patient's part may not always be specific or documented. The likelihood of safety-netting advice being delivered may vary according to characteristics of the problem or the GP. How to assess safety-netting outcomes in terms of patient benefits and harms does warrant further exploration.
| S-EPMC6863676 | biostudies-literature
Project description:OBJECTIVES:Identifying the issues and concerns that matter most to burns survivors can be challenging. For a number of reasons, but mainly relating to patient empowerment, some of the most pressing concerns patients may have during a clinical encounter may not naturally be the focal point of that encounter. The Patient Concerns Inventory (PCI) is a tried and tested concept initially developed in the field of head and neck cancer that empowers patients during a clinical encounter through provision of a list of prompts that allows patients to self-report concerns prior to consultation. The aim of this study was to develop a PCI for adult burns patients. DESIGN:Content for the PCI was generated from three sources: burns health-related quality of life tools, thematic analysis of one-to-one interviews with 12 adult burns patients and 17 multidisciplinary team (MDT) members. Content was refined using a Delphi consensus technique, with patients and staff members, using SurveyMonkey. SETTING:Within outpatient secondary care. PARTICIPANTS:Twelve adult burns patients and MDT members from two regional burns centres. RESULTS:A total of 111 individual items were generated from the three sources. The Delphi process refined the total number of items to 58. The main emergent domains were physical and functional well-being (18 items), psychological, emotional and spiritual well-being (22 items), social care and social well-being (7 items) and treatment-related concerns (11 items). CONCLUSIONS:The Adult Burns Patient Concerns Inventory is a 58-item, holistic prompt list, designed to be used in the outpatient clinic. It offers a new tool in burn care to improve communication between healthcare professionals and patients, empowering them to identify their most pressing concerns and hence deliver a more focused and targeted patient-centred clinical encounter.
| S-EPMC6955499 | biostudies-literature