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Providing critical appraisal training to a haemodialysis patient - Toft

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Presented at LILAC 2019

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Providing critical appraisal training to a haemodialysis patient - Toft

  1. 1. Providing critical appraisal training to a haemodialysis patient involved in a systematic review Suzanne Toft BA (Hons) PGDip MScEcon MCLIP Training Librarian (Chartered)
  2. 2. Overview  Origins  Background to research patient is involved in  How health librarians can interact and engage with patients involved in research  Benefits to patient
  3. 3. Origins  Library received request from Senior Clinical Educator (Haemodialysis)  Renal unit very research active  Long standing relationship with Library https://units.renal.org/index.pl?c=derby [Accessed 2 April 2019]
  4. 4. Haemodialysis  Most common method used to treat end-stage renal disease  Available since 1960s  Still a complicated and inconvenient therapy  Three times a week for 3-5 hours (Kidney Care UK, undated)7
  5. 5. Systematic Review Comparison of outcomes of buttonhole and rope ladder cannulation of arteriovenous fistulae used for haemodialysis for patients with end-stage kidney disease: a systematic review of randomised control trials https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94656 [Accessed 2 April 2019]
  6. 6.  Aim to capture patient’s opinion in context of his personal experience of needling  alongside systematic data extraction and critical appraisal performed by 2 other authors  Does patient believe the findings are relevant to them?  Does the patient feel that the patient experience is adequately reflected in the studies?  Is the patient interpreting the results in a way that is correct?  Has the author’s interpretation missed the point, from a patient's perspective? Patient’s Contribution to SR https://www.uhdb.nhs.uk/service-renal-services [Accessed 2 April 2019]
  7. 7.  Patient experience to be captured in a systematic manner, rather than just chatting to him.  Created a form for patient to complete.  Authors doing data extraction can then analyse patient’s thoughts and use it to assist in interpretation of the formal data extraction and critical appraisal.  Librarian was asked her opinion/ thoughts regarding the form  made suggestions regarding numerical scale and words used Data Collection
  8. 8. Expert Patient  The Expert Patient Programme is a free self management course for people with a long-term condition. (Multiple Sclerosis Trust 2018)9.  6-week course  Delivered by accredited tutors; most have a long-term health condition  Course aims to give people:  Confidence to self-manage their health  To be active participants in the care of their condition.  Covers general topics e.g. healthy eating, dealing with pain & fatigue, relaxation techniques, coping with negative feelings, etc.
  9. 9.  Meet patient  Find out prior knowledge  Carryout training session at bedside  Introduction to Critical Appraisal  Looking at RCTs  Useful Sources  Fake News Role of Librarian
  10. 10. Hierarchy of Evidence "Research design and evidence" by CFCF - Own work. Licensed under CC BY-SA 4.0 via Wikimedia Commons. http://alertandoriented.com/the-devolution-of- evidence-based-medicine/. [Accessed 2 April 2019]
  11. 11.  Hierarchy of Evidence  Critical appraisal using CASP tools  Behind the Headlines & Fake News Sources Discussed https://casp-uk.net/ https://www.nhs.uk/news/
  12. 12. https://www.ifla.org/publications/node/11174
  13. 13.  How did it help you?  Background was very helpful  Helped with judging papers  Helped with assessing research motivations  No longer take research papers at face value  Do you feel you now have a greater understanding of research pitfalls?  Able to spot bias by purposeful omissions by the authors – now reading what is not being said  Greater confidence to read between the lines of research and spot buried information  Other benefits being involved in research?  Motivation to learn more about treatment  Gave added dimension to his hospital visits  Interesting to see what other research projects are out there concerning patient’s condition  Other, unforeseen benefits?  Realised how good at research we are at the Royal Derby Hospital  How good we are at infection control Follow-up with patient
  14. 14. Information Therapy  Benefits to patient include enhanced information literacy skills Bibliotherapy….  “……directed reading with a therapeutic dialogue or interaction between the patient and a facilitator, often librarian, who has received special training.” (Rani & Hemavathy 2016)11 Information Therapy  “…a new term for supplying patients with health information, enabling them to make informed decisions about their health and care, participate in their own well-being, and thus decrease the utilization of healthcare resources.” (Rani & Hemavathy 2016)11
  15. 15. Patient and Public Involvement  National Institute for Health Research (NIHR) - https://www.nihr.ac.uk/patients- and-public/  NIHR INVOLVE - https://www.invo.org.uk/find-out-more/what-is-public- involvement-in-research-2/  NICE - https://www.nice.org.uk/about/nice-communities/nice-and-the- public/public-involvement/public-involvement-programme/patient-public- involvement-policy  The King’s Fund - https://www.kingsfund.org.uk/topics/patient-involvement
  16. 16.  Senior Clinical Educator to sit with patient - what did he feel were the benefits of being involved in the systematic review?  Planning a publication about our patient involvement in the systematic review - a pre-cursor to supporting methodological development of Patient Public Involvement (PPI) for Systematic Reviews.  Authors to be the Senior Clinical Educator, one of her PhD supervisors, the patient and the librarian. Future Plans
  17. 17. Any Questions?
  18. 18. References 1. Ahmadizadeh, S., Bozorgi, A.S., & Kashani, L. (2017). The role of information therapy in reducing anxiety in patients undergoing in vitro fertilisation treatment. Health Information & Libraries Journal, 34(1), pp. 86–91. 2. Chartered Institute of Library and Information Professionals (2018). What is information literacy? [online] Available at: https://www.cilip.org.uk/news/news.asp?id=421972 [Accessed 30 Jan. 2019]. 3. Forster, M. (2013). Information literacy as a facilitator of ethical practice in the professions. Journal of Information Literacy, 7(1), pp.18-29. 4. Health Careers (2019). Library, knowledge and information services. [online]. Available at: https://www.healthcareers.nhs.uk/explore- roles/health-informatics/roles-health-informatics/libraries-and- knowledge-management [Accessed 30 Jan. 2019]. 5. Health Education England (2019). Health literacy. [online]. Available at: https://www.hee.nhs.uk/our-work/health-literacy [Accessed 30 Jan. 2019].
  19. 19. References 6. Kelham, C. (2014). Health care librarians and information literacy: an investigation. Health Information & Libraries Journal, 31(3), pp. 235– 238. 7. Kidney Care UK (undated). Haemodialysis [online]. Available at https://www.kidneycareuk.org/about-kidney- health/treatments/dialysis/Haemodialysis/ [Accessed 2 April 2019]. 8. Mettler, M. & Kemper, D. W. (2005). Information therapy: the strategic role of prescribed information in disease self-management. APLAR Journal of Rheumatology 8, 69–76. 9. Multiple Sclerosis Trust (2018). Expert Patient Programme [online]. Available at https://www.mstrust.org.uk/a-z/expert-patients- programme [Accessed 2 April 2019]. 10. Health Education England Library and Knowledge Services Leads (HEE LKSL) (2016). NHS Library Quality Assurance Framework (LQAF) England Version 2.3a April 2016 [online]. Available at http://www.libraryservices.nhs.uk/forlibrarystaff/lqaf/ [Accessed 2 April 2019].
  20. 20. References 11. Rani, A. N. & Hemavathy, V. (2016). Information Therapy. International Journal of Science and Research 5(1), 417-418. 12. Richards, T., Montori, V. M., Montori, V. M., Godlee, F., Lapsley, P. & Paul, D. Let the patient revolution begin. BMJ 2013, 346, f2614. 13. SCONUL Working Group on Information Literacy (2011). The SCONUL Seven Pillars of Information Literacy: A Research Lens for Higher Education [online]. Available at https://www.sconul.ac.uk/sites/default/files/documents/researchlens.pdf [Accessed 2 April 2019] 14. Truccolo, I. (2016). Providing patient information and education in practice: the role of the health librarian. Health Information & Libraries Journal, 33(2), pp. 161–166. 15. Whitney W, Keselman A, Humphreys B. (2017). Libraries and Librarians: Key Partners for Progress in Health Literacy Research and Practice. Studies in Health Technology and Informatics, 240, pp. 415-432. 16. World Health Organization (2019). WHO | Track 2: Health literacy and health behaviour. [online] Available at: https://www.who.int/healthpromotion/conferences/7gchp/track2/en/ [Accessed 30 Jan. 2019].
  21. 21. Suzanne Toft Training Librarian University Hospitals of Derby and Burton NHS Foundation Trust Email: suzanne.toft@nhs.net Telephone: 01332 788148 Twitter: @notsoloftytofty

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