Improving adrenaline autoinjector adherence: A psychologically informed training for healthcare professionals.

BACKGROUND: Clinicians draw on instructional approaches when training patients with anaphylaxis to use adrenaline autoinjectors, but patient use is poor. Psychological barriers to these behaviours exist but are not considered routinely when training patients to use autoinjectors. Health Psychology principles suggest exploring these factors with patients could improve their autoinjector use. OBJECTIVE: To evaluate the impact of a 90-minute workshop training clinicians in strategies and techniques for exploring and responding to psychological barriers to autoinjector use with patients. Attendees' knowledge, confidence and likelihood of using the strategies were expected to improve. METHODS: Impact was evaluated using a longitudinal mixed-method design. Twenty-nine clinicians (general and specialist nurses, general practitioners, and pharmacists) supporting patients with anaphylaxis in UK hospitals and general practice attended. Self-rated knowledge, confidence, and likelihood of using the strategies taught were evaluated online 1 week before, 1 to 3, and 6 to 8 weeks after the workshop. Clinicians were invited for telephone interview after attending to explore qualitatively the workshop impact. RESULTS: χ2 analyses were significant in most cases (P < .05), with sustained (6-8 weeks) improvements in knowledge, confidence, and likelihood of using the strategies taught. Thematic analysis of interview data showed the workshop enhanced attendees' knowledge of the care pathway, understanding of patient's experience of anaphylaxis as psychological not purely physical, and altered their communication with this and other patient groups. However, interviewees perceived lack of time and organisational factors as barriers to using the strategies and techniques taught in clinical contexts. CONCLUSION: Training clinicians in psychologically informed strategies produce sustained improvements in their confidence and knowledge around patient autoinjector education, and their likelihood of using strategies in clinical practice. CLINICAL RELEVANCE: Exploring psychological barriers should be part of training patients with anaphylaxis in autoinjector use.

Application of Health Psychology: Development of a Practitioner Training Intervention in Anaphylaxis.

Adrenaline autoinjectors (AAIs) improve outcomes and reduce fatalities in patients with anaphylaxis, but many patients neither carry them nor know how to use them. Practitioner training in evidence-based strategies designed to increase patient adherence could improve the likelihood of AAI adherence and increase confidence among practitioners to initiate discussions about practical and perceptual barriers to AAI adherence. This article reports the development of a new practitioner training intervention, grounded in health psychology theory and evidence designed for practitioners in contact with patients with anaphylaxis to encourage adherence to AAIs. Potential implications for the design, implementation, and evaluation of future practitioner training in strategies they can use to encourage anaphylaxis patients' AAI adherence are discussed. Although designed for those working with anaphylaxis patients, this step-by-step process to encouraging adherence could be adapted for practitioners working with patients living with other long-term conditions.

Aging Anxieties and Disturbed Eating in Female Students: It's not all About Aging Appearance Concern.

Fear and anxiety about aging have increased amongst female university students and these personal aging concerns are associated with disturbed eating, also prevalent in this group. Evidence suggests concern about aging appearance could account for the link between aging anxiety and problem eating in young women due to their belief in the thin - youth ideal. However, whether appearance concern is the strongest aging anxiety predictor of global and specific disturbed eating behaviors is unclear. The study examines this in a sample of female students at a Midlands university in the United Kingdom (N = 200, 18 - 39 years) who completed the Anxiety about Aging Scale and the Eating Disorders Inventory-3. The findings show general and a model of four aging anxieties predicted significantly greater global disturbed eating with medium and large effects sizes respectively. However, greater anxiety about the psychological challenges and interpersonal losses associated with aging best predicted global and specific disturbed eating behaviors and aging appearance concern was a weaker predictor. Implications for interventions targeting female students eating behavior are considered.

Victimization among female and male sexual minority status groups: evidence from the British Crime Survey 2007-2010.

International surveys of victims show crime rates in England and Wales, including hate crimes, are among the highest in Europe. Nevertheless, sexual minority status is a less considered risk factor in general victimization research. This study used sexual minority status and sex to predict victimization across British Crime Surveys from 2007-2010. Logistic regression analyses showed sexual minority status groups were more likely than heterosexuals to be victimized from any and some specific crimes. However, bisexuals rather than lesbians or gay men were more consistently victimized, notably by sexual attacks and within the household. Implications for understanding victimization among these groups are discussed.