Biomedical subjects

Fiona Fylan

Publications and source records attributed to Fiona Fylan.

5 recordsLinked to original sources

PubMed2007

Health promotion at NHS breast cancer screening clinics in the UK.

Suboptimal diets, sedentary lifestyles, overweight and obesity expose two-thirds of women in England aged over 50 to a heightened risk of lifestyle-related morbidities. The UK's NHS Breast Cancer Screening Programme now reaches 75% of all women aged 53-64 but provides only mammography screening. This cross-sectional survey of 413 women attending two NHS breast screening clinics in North Yorkshire found that the majority of women were interested in having diet and exercise advice at screening clinics and anticipated a neutral or positive effect on their future screening appointments. Interest was highest among older, less educated and overweight women suggesting that this may be a particularly effective medium for reaching higher risk subgroups. Women showed most interest in problem-solving advice, which provided short-term, life-enhancing benefits such as looking and feeling better, having more energy, losing weight and reducing menopausal symptoms, as well as potentially reducing their disease risk. Most appeared to find doing sufficient exercise more problematic than eating healthily and this might be exacerbated by low awareness of exercise guidelines. Given a choice, preferences were to access advice in leaflets or one to one from an expert; however, many younger, professional women were also interested in computer access. Findings indicate the need first for flexible, multi-level access, combining some broad-based information dissemination with pathways to more personalized support and secondly for the relevant 'consumer benefits' associated with better diet and exercise to be promoted as well as longer-term disease prevention. Overall, this study indicates that the UK's NHS Breast Cancer Screening Programme may be uniquely placed to provide health-enhancing advice as well as mammography screening to the majority of women in England, throughout the course of their mid-life.

Aged↗

PubMed2006

The DAMASK trial protocol: a pragmatic randomised trial to evaluate whether GPs should have direct access to MRI for patients with suspected internal derangement of the knee.

BACKGROUND: Though new technologies like Magnetic Resonance Imaging (MRI) may be accurate, they often diffuse into practice before thorough assessment of their value in diagnosis and management, and of their effects on patient outcome and costs. MRI of the knee is a common investigation despite concern that it is not always appropriate. There is wide variation in general practitioners (GPs) access to, and use of MRI, and in the associated costs. The objective of this study was to resolve uncertainty whether GPs should refer patients with suspected internal derangement of the knee for MRI or to an orthopaedic specialist in secondary care. METHODS/DESIGN: The design consisted of a pragmatic multi-centre randomised trial with two parallel groups and concomitant economic evaluation. Patients presenting in general practice with suspected internal derangement of the knee and for whom their GP was considering referral to an orthopaedic specialist in secondary care were eligible for inclusion. Within practices, GPs or practice nurses randomised eligible and consenting participants to the local radiology department for an MRI examination, or for consultation with an orthopaedic specialist. To ensure that the waiting time from GP consultation to orthopaedic appointment was similar for both trial arms, GPs made a provisional referral to orthopaedics when requesting the MRI examination. Thus we evaluated the more appropriate sequence of events independent of variations in waiting times. Follow up of participants was by postal questionnaires at six, twelve and 24 months after randomisation. This was to ensure that the evaluation covered all events up to and including arthroscopy. DISCUSSION: The DAMASK trial should make a major contribution to the development of evidence-based partnerships between primary and secondary care professionals and inform the debate when MRI should enter the diagnostic pathway.

Adolescent↗

PubMed2005

Visual illusions? Beliefs and behaviours of presbyope clients in optometric practice.

Many clients in optometry practice have reported that they do not receive sufficient information from practitioners to make informed purchasing decisions for corrective spectacles. The aim of this study was to identify participants' attitudes and beliefs towards visiting an optician and purchasing spectacles, to compare clients' and practitioners' perceptions of purchasing decisions, and to examine clients' preferences for information and decision making. One hundred and fifty-eight presbyopes completed a questionnaire to examine attitudes and behaviours regarding visiting an optician. Thirty-four practitioners completed a questionnaire examining the purchasing recommendations they make to clients, and their perceptions of clients' purchasing decisions and information needs. Participants reported positive attitudes towards visiting an optician but required more information about their eyesight and about purchasing options. A discrepancy was found between client and practitioner perceptions of purchasing decisions and of involvement in the decision making process. Practitioners overestimated the importance of price to clients and underestimated the importance of their own recommendations on purchasing decisions. The findings of this study could be used to guide practitioners in their provision of information to clients.

Attitude of Health Personnel↗

PubMed2005

Four different types of client attitudes towards purchasing spectacles in optometric practice.

BACKGROUND: Unmet expectations are a major cause of client dissatisfaction, yet very little is known about the expectations and health values that clients in optometry practice hold about having an eye examination and purchasing spectacles. This study identified different attitudes and behaviours held by presbyope clients in optometric practices. METHOD: A total of 158 presbyope clients, recruited from 14 practices, completed a questionnaire which was developed from the theory of planned behaviour. The questionnaire examined attitudes towards spectacles and visiting the optician, motivation to visit the optician, perceptions of barriers to attending the opticians, information requirements, and preferences for shared decision-making. Responses were analysed using principal components analysis. RESULTS AND CONCLUSIONS: Four factors were identified, which were labelled style, vision, avoiding and seeking. Style is concerned with the importance of appearing fashionable or stylish, and desiring approval from others. Vision relates to clients' attitudes towards obtaining clear vision and to maintaining healthy eyesight. Avoiding describes the perceived difficulties associated with visiting the optician and purchasing new spectacles. Seeking corresponds to the desire for information on the technical details of lenses. Practitioners could use these characteristics to tailor information to meet the needs and address the expectations of individual clients. This may make the information provided more personally relevant, and could enhance client satisfaction.

Adult↗

PubMed2002

Information within optometric practice: comprehension, preferences and implications.

The partnership approach to health care, in which patients take an active role in decision making, can potentially improve patient satisfaction and adherence to clinician recommendations. However, the process can be impeded by insufficient or poor-quality information provision. This study explored participants' understanding of, and requirements for, optometric information. Information leaflets were obtained from 12 optometry practices and four internet-based resources. Sixty-four patients/ clients participated in focus groups that explored: (1) their understanding of diagrams of visual function, (2) perceptions of good information, (3) information requirements and (4) perceptions of the effects of improved information. A theory-led thematic analysis identified three major themes within each of the four categories. The use of jargon and the inappropriate layout of diagrams and text impeded comprehension of the leaflets. High-quality information was defined as being written concisely with simple explanations and clear diagrams. There was also a preference for information to be relevant and applicable to the patient's own eye care needs. In addition, participants expressed a desire for both written and verbal information regarding eye examination procedures and interpretation of prescriptions. Advice regarding eye care was also requested. To facilitate a partnership approach and improve patient satisfaction, patients should be provided with jargon-free concisely written and clearly presented information. In addition to general information, patients would also benefit from personalised information regarding test results and eyecare regimes.

Humans↗