A consumer informed workshop can improve knowledge and attitude to patient-centered care among hospital clinicians-in-training.

PURPOSE: Patient and family involvement in the education and training of medical practitioners increases the likelihood that the care delivered will meet the needs of service users and carers. The purpose of this study was to determine the effect of a consumer informed educational program on knowledge and attitude to patient-centered care among hospital clinical trainees. METHODS: A total of 66 junior medical staff and 35 orthoptists in training were invited to participate in a controlled before-and-after trial at the Royal Victorian Eye and Ear Hospital from October to November, 2011. Thirty-eight participants were allocated to the intervention program (interactive workshop) and 63 to the control program (assigned reading). Questionnaires regarding knowledge, attitude, and practice, patient-practitioner orientation and communication were administered. Differences between groups and differences before and after the program were evaluated using the t-test or Chi-square test, as appropriate. Narrative data obtained from the questionnaires were analyzed using Grounded Theory qualitative analysis techniques. RESULTS: A total of 24 participants (63%) completed the intervention program and eight (13%) the control program. The intervention group felt more prepared to introduce themselves and their role (Chi-square = 11.19, P = 0.01) and to acknowledge patients' waiting time prior to consultation (Chi-square 8.52, P = 0.04) compared with the control group. For the intervention group, there was an improvement in mean score on the Communication Assessment Tool (mean change = 0.55, P = 0.01). CONCLUSION: There were minor improvements in self-perceived knowledge and attitude to patient-centered care and communication among hospital clinicians-in-training following a consumer informed education program. The majority of participants who received this program agreed it would influence how they conducted future consultations. Further work is required to determine if these improvements translate to sustainable changes in clinical practice and patient satisfaction.

Developing the impact of Vision Impairment-Very Low Vision (IVI-VLV) questionnaire as part of the LoVADA protocol.

PURPOSE: To design and evaluate an instrument appropriate for assessing vision-related quality of life (VRQoL) in persons with severe vision loss. METHODS: A total of 603 legally blind persons (better eye visual acuity of <20/200) were interviewed using an item pool based on the original Impact of Vision Impairment (IVI) questionnaire, augmented by items appropriate for persons with severe vision loss. Refinement and item reduction was done in three steps using factor and Rasch analysis to assess psychometric properties, exploring key indices, such as response category functioning (floor and ceiling effects), instrument unidimensionality, discriminant ability, and targeting of item difficulty to patient ability. RESULTS: A final pool of 28 items was selected that grouped into two subscales of the IVI-VLV: activities of daily living, mobility, and safety (ADLMS; 16 items) and emotional well-being (EWB; 12 items). Both subscales are unidimensional, able to differentiate reliably between at least three different levels of VRQoL, and item difficulty was adequate for the assessed sample. Using generalized linear models and controlling for age, we found that only poor general health (P = 0.005 and P = 0.007) and concurrent depression and anxiety (P = 0.019 and P < 0.001) were associated with a lower ADLMS and EWB subscale score, respectively. CONCLUSIONS: The IVI-VLV is a valid and reliable VRQoL measure in persons with severe vision loss, and its measurement is almost unaffected by participants' self-perceived general or mental health. The IVI-VLV can be used as an outcome measure in trials attempting sight restoration.

Trachoma surveillance annual report, 2008. A report by the National Trachoma Surveillance and Reporting Unit.

The National Trachoma Surveillance and Reporting Unit has reported data for trachoma endemic regions and communities in the Northern Territory, South Australia and Western Australia for 2006 to 2008. Aboriginal children aged 1-9 years were examined using the World Health Organization grading criteria. Screening in the Northern Territory was conducted by the primary health care staff from the Healthy School Age Kids program, the Australian Government Emergency Intervention and Aboriginal Community Controlled Health Services. Forty-three of 92 communities in 6 regions were screened and reported data (2,462 children). In South Australia, the Eye Health and Chronic Disease Specialist Support Program and a team of eye specialists visited 11 of 72 communities in regions serviced by 6 Aboriginal Community Controlled Health Services (365 children). In Western Australia, population health unit and primary health care staff screened and reported data for 67 of 123 communities in 4 regions (1,823 children). Prevalence rates of active trachoma varied between the regions with reported prevalence ranging from 4%-67% in the Northern Territory, 0%-13% in South Australia and 8%-25% in Western Australia. Statistical comparisons must be viewed with caution due to the year-to-year variation in the coverage of children examined and the small numbers. Comparisons of 2006, 2007 and 2008 regional prevalence of active trachoma showed that many communities had no change in prevalence, though there were a few statistically significant increases and decreases (P<0.05). The number of communities screened and the number of children examined has improved but still remains low for some regions. The implementation of the World Health Organization Surgery (for trichiasis), Antibiotics (with azithromycin), Facial cleanliness and Environmental improvement (SAFE) strategy has been variable. Few data continue to be reported for the surgery and environmental improvement components. In general, the availability of the community programs for surgery, antibiotic treatment, and facial cleanliness has improved. Reporting of antibiotic treatment has improved from 2006 to 2008. No significant changes were noted in bacterial resistance reported by pathology services from 2007 to 2008; these rates are comparable to national data collected by the Advisory Group on Antibiotic Resistance in 2005.

Trachoma surveillance annual report, 2007. A report by the National Trachoma Surveillance and Reporting Unit.

Trachoma screening was conducted in 2007 in trachoma-endemic regions and communities in the Northern Territory, South Australia and Western Australia. Aboriginal children aged 1 to 9 years were examined using the World Health Organization grading criteria. Screening in the Northern Territory was conducted by the primary health staff from the Healthy School Age Kids program, the Australian Government Emergency Intervention and Aboriginal Community Controlled Health Services with 60 of the 117 communities screened in 5 regions (1,703 children). In South Australia, the Eye Health and Chronic Disease Specialist Support Program and a team of eye specialists screened eight out of 91 communities in areas serviced by 5 Aboriginal Controlled Health Services (128 children). In Western Australia, population health unit and primary health care staff screened 62 out of 167 communities in 4 regions (1,666 children). Active trachoma prevalence rates varied between the regions with reported prevalence ranging from 5%-26% in the Northern Territory, 0%-21% in South Australia and 4%-22% in Western Australia. Comparisons of 2006 and 2007 regional active trachoma prevalence showed no consistent pattern in changes. Only a small amount of data were reported for the surgery and environmental improvement components of the World Health Organization recommended trachoma control activities of surgery (for trichiasis), antibiotic treatment (with azithromycin), facial cleanliness and environmental improvement. Reporting forthe antibiotic treatment and facial cleanliness components has improved since 2006; however, many gaps still exist. A method to monitor bacterial resistance to azithromycin has been implemented. Baseline data collected by pathology services found similar results to national data collected by the Advisory Group on Antibiotic Resistance.

Surveillance report for active trachoma, 2006: National Trachoma Surveillance and Reporting Unit.

The National Trachoma Surveillance and Reporting Unit (NTSRU) was established in November 2006 to improve the quality and consistency of data collection and reporting of active trachoma in Australia. Active trachoma data collected in 2006, prior to the commencement of the NTSRU, were reported by the Northern Territory, South Australia and Western Australia. In most regions, Aboriginal children aged 5-9 years were screened for signs of active trachoma, following the World Health Organization simplified trachoma grading system. In the Northern Territory the Healthy School Aged Kids program conducted school-based screening for active trachoma in 74 schools in five regions (n = 2,253). In South Australia Aboriginal school children presented for active trachoma screening when an eye team visited five Aboriginal Community Controlled Health Services (n = 275). In Western Australia population health units in collaboration with staff from population health care services, conducted school based screening for active trachoma in 53 schools in four regions (n = 1,719). Regional active trachoma prevalence for 2006 varied between the states and the Northern Territory with reported prevalences ranging from: Northern Territory = 2.5%-30%, South Australia = 0%-25%, and Western Australia = 18%-53%. Few data were reported on facial cleanliness or other aspects of the SAFE strategy, and no data were reported for trichiasis.