Objectives: The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-cal... more Objectives: The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-call (AHHC) is one key protective option available to doctors in the service and has been linked to low burnout and increased satisfaction in AHHC. This study aims to explore the patterns of engagement of escorts in Australian AHHC. Method: A questionnaire-based, electronic survey of all 300 doctors involved in AHHC through the National Home Doctor Service (NHDS), Australia’s largest providers of the service. Results: A total of 168 valid responses (56.0%) were received. 60.8% of the doctors engaged escorts. Of the doctors that engage chauffeurs, three-quarters do so “all or most times”, while only one-quarter engage chaperones to the same degree of frequency. Hiring escorts is very popular among Brisbane (91.7%) and Sydney-based (88.2%) practitioners, but is unpopular in the City of Gold Coast (26.1%). There were moderate patronages in Adelaide (52.9%) and Melbourne (46.4%). Compared to fe...
Journal of Medical Education and Curricular Development
Background: Online education options increasingly complement traditional face-to-face (F2F) appro... more Background: Online education options increasingly complement traditional face-to-face (F2F) approaches. Few studies have compared both formats on doctors, and little evidence exists to prove that the online approach is universally effective. This gap needs to be addressed to ensure that the quality of education and health care delivery is not compromised. Methods: A quantitative survey targeting 881 doctors that required online and F2F teaching sessions offers identical contents over a 12-month period. The surveyed doctors work in the Australian after-hours house-call (AHHC) industry, and the teachings were parts of their continuing professional development activities. Results: In all, 89 responses were received; 10 (11.2%) participated exclusively online, while 23 (25.8%) did so by F2F; 52 (58.4%) engaged through both modalities. No statistical differences existed based on sex, specialty, and post-graduate fellowship status, as well as on the perceptions with teaching structure, co...
No previous study had ever looked at Burnout among medical practitioners involved in after-hours ... more No previous study had ever looked at Burnout among medical practitioners involved in after-hours house calls (AHHC) in Australia. The growing popularity of AHHC and the high number of overseas-trained doctors involved in it make this a subject of both local and international significance. This study aims to assess the levels of burnout among Australian-based doctors involved in the service. This is a quantitative, questionnaire-based survey of all the 300 doctors engaged in AHHC through the National Home Doctor Service (NHDS), Australia's largest home doctor-visit service providers. The study looked at experiences of the participants over the 12-months period from October 2013 to September 2014. The main outcome measure was the 22-item Maslach Burnout Inventory (MBI). Results were presented as Means and Frequency Percentages. A total of 168 valid questionnaires out of 300 were returned, giving a 56.0 % response rate. The Total Maslach Mean Scores (MMS) obtained were 15.97 for Em...
Journal of evaluation in clinical practice, Apr 1, 2018
Minimizing the risks and distress arising from aggression in after-hours house call (AHHC) servic... more Minimizing the risks and distress arising from aggression in after-hours house call (AHHC) services will help improve service quality in the industry. Unfortunately, no national study has ever evaluated this in Australian AHHCs. Apart from reducing this gap, findings from this work will have global relevance given the rising popularity of the AHHC industry worldwide. A survey of all 300 doctors employed by the National Home Doctor Service, Australia's largest AHHC service provider. A validated electronic questionnaire was used to examine the doctors' experiences over a 12-month period. There were 168 valid responses (56% response rate). Aggression prevalence was 47.1%, and just over half (51.8%) of the cases came from the patients. "Verbal aggression" was the commonest (48.3%). Others are "threats" (26.6%), "vexatious complaints" (13.3%), "property damage" (4.2%), "physical violence" (4.2%), "sexual harassment" (2.8...
Headaches present commonly in general practice, and doctors face uncertainties and pressures in d... more Headaches present commonly in general practice, and doctors face uncertainties and pressures in dealing with them. This study identifies key characteristics of headaches investigated through head imaging, in the hope of strengthening existing guidelines. A 7-year retrospective analysis of head imaging scans ordered for investigating headaches among patients aged ≥18 in an Australian general practice setting. A total of 109 of the 517 (21.1%) patients required head imaging, although 14 (2.7%) of these had repeat scans. Three-quarters were females, and most of the headaches were recurrent (56.9%), severe (62.4%) or had associated red flags (78.0%). Computed tomography (CT) and magnetic resonance imaging (MRI) were the only scans adopted (4:1 and 1:1 for first and repeat scans, respectively). Twelve (11.0%) scans had findings likely to explain the headaches after the initial scans, with no difference in findings between diagnoses from CTs and MRIs (P = 0.41). Repeat scans offered no ad...
Background: Multiple factors potentially influence doctors’ decisions regarding neuroimaging for ... more Background: Multiple factors potentially influence doctors’ decisions regarding neuroimaging for headaches in general practice and psycho-morbidities are one of such. Unfortunately, other non-clinical factors at play among psychological patients with headaches are poorly known and the need to identify these factors has become important in view of recent findings on the impact of psychological issues in managing headaches in primary care. The findings from this study are expected to help improve efficiency and confidence in managing headaches in this subset of patients.Method: This is a 7-year retrospective study exploring headache presentations of patients aged ≥18 in an Australian general practice setting from 1 January 2010 to 1 April 2017.Results: A total of 517 patients were identified, with an average age of 45.5 +/- 16.2 years (range of 18 to 94 years). Psycho-morbidities were reported among 190 (36.8%) patients. The female to male ratio was 72% to 28%. Most cases of headache...
Journal of evaluation in clinical practice, Jun 2, 2018
This study explores the postconsultation follow-up behaviours of patients who used the Australian... more This study explores the postconsultation follow-up behaviours of patients who used the Australian after-hours house-call (AHHC) medical services. These behaviours provide insights into the nature of the continuity of care (CoC) in the industry and are a measure quality in AHHC service delivery. Understanding the patterns of these CoCs and their predictors will enable stakeholders in the industry, both locally and globally, plan and implement higher quality services. This is a cross-sectional survey of all 10,838 patients who used AHHC during the last week of January 2016. A validated questionnaire was used, distributed through a mix of online and postal questionnaires. One thousand two hundred twenty-eight questionnaires were returned (11.3%). Had the AHHC not been available, 38.6% of respondents would have gone to their own general practitioners (GPs), 40.1% to an emergency department (ED), 15.9% to an office-based after-hours service, and 5.5% would have done nothing. After the AH...
Objectives The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-call... more Objectives The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-call (AHHC) is one key protective option available to doctors in the service, and has been linked to low burnout and increased satisfaction in AHHC. This study aims to explore the patterns of engagement of escorts in Australian AHHC. Method This is a questionnaire-based, electronic survey of all 300 doctors involved in AHHC through the National Home Doctor Service (NHDS), Australia’s largest providers of the service. The survey explored the doctor’s experiences over the 12-month period from October 2013 to September 2014. Results This survey received a total of 168 valid responses, giving a response rate of 56%. Nearly 61% of the doctors involved in AHHC engaged escorts (chauffeurs and chaperones). Of those doctors that engage chauffeurs, three-quarters do so “all or most times”, while only one-quarter engaged chaperones to the same degree of frequency. Hiring escorts is very popular among B...
Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school heal... more Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school health education program. The questionnaire was designed to collect knowledge of, attitudes toward, and experiences with cancer and cancer prevention. Data were collected from randomly selected health classes preceding a presentation on breast and cervical cancer prevention. Results showed that the girls were pessimistic about chances of surviving cancer and did not differentiate survival by type or site of the cancer. Although there was considerable confusion about its purpose, 27.6% reported having had a Papanicolaou smear within the past year and 79.2% correctly identified the Pap smear as a test for cancer.
Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school heal... more Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school health education program. The questionnaire was designed to collect knowledge of, attitudes toward, and experiences with cancer and cancer prevention. Data were collected from randomly selected health classes preceding a presentation on breast and cervical cancer prevention. Results showed that the girls were pessimistic about chances of surviving cancer and did not differentiate survival by type or site of the cancer. Although there was considerable confusion about its purpose, 27.6% reported having had a Papanicolaou smear within the past year and 79.2% correctly identified the Pap smear as a test for cancer.
Given the dearth of government-sponsored programmes, preventive lifestyles and practices are the ... more Given the dearth of government-sponsored programmes, preventive lifestyles and practices are the realistic hopes for millions of women in developing countries against cervical cancer. Early interventions for teenage high school girls have been advocated recently, but evidence-base for sustainable activities at this demographic is lacking. This article reduces this gap by determining the impact of two cervical cancer education techniques. Method. This is a 6-month interventional cohort study of 432 female high school students in South-eastern Nigeria. Results. A total of 317 (73.4%) and 301 (69.7%) valid responses were received from the preintervention (16.8 ± 1.5 years) and post-intervention (17.2 ± 1.6 years) surveys, respectively. About 213 (70.8%) were fully engaged with the interventions. Logistic regression revealed that participants who were ‘engaged’ with the interventions, either through symposium attendance or by reading of the printed handouts, showed significant improvements across multiple cervical cancer parameters regarding knowledge on ‘pap smears’ (analysed with four items), ‘HPV vaccine’ (two items) and ‘risk factors’ (two items). Improvements in Knowledge of ‘early symptoms’ were not improved, with ‘post-coital bleeding’ [odds ratio (OR) = 0.95; P = 0.87] and ‘being asymptomatic’ (OR = 0.69; P = 0.32) remaining statistically similar between the engaged and the unengaged. If ‘engagement’ with either intervention was disregarded, a chi-square analysis identified no significant improvement in knowledge on any parameter. Conclusion. Ensuring ‘engagement’ with intervention campaigns is vital to achieving effective and sustainable cervical cancer knowledge. Engagement may be achieved by repeating the education activities across all the years/classes that make up high school in each developing country, along with formal examinations at each level. Key words: Cervical cancer, high school, intervention, knowledge, secondary school, teenage women.
Objectives: The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-cal... more Objectives: The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-call (AHHC) is one key protective option available to doctors in the service and has been linked to low burnout and increased satisfaction in AHHC. This study aims to explore the patterns of engagement of escorts in Australian AHHC. Method: A questionnaire-based, electronic survey of all 300 doctors involved in AHHC through the National Home Doctor Service (NHDS), Australia’s largest providers of the service. Results: A total of 168 valid responses (56.0%) were received. 60.8% of the doctors engaged escorts. Of the doctors that engage chauffeurs, three-quarters do so “all or most times”, while only one-quarter engage chaperones to the same degree of frequency. Hiring escorts is very popular among Brisbane (91.7%) and Sydney-based (88.2%) practitioners, but is unpopular in the City of Gold Coast (26.1%). There were moderate patronages in Adelaide (52.9%) and Melbourne (46.4%). Compared to fe...
Journal of Medical Education and Curricular Development
Background: Online education options increasingly complement traditional face-to-face (F2F) appro... more Background: Online education options increasingly complement traditional face-to-face (F2F) approaches. Few studies have compared both formats on doctors, and little evidence exists to prove that the online approach is universally effective. This gap needs to be addressed to ensure that the quality of education and health care delivery is not compromised. Methods: A quantitative survey targeting 881 doctors that required online and F2F teaching sessions offers identical contents over a 12-month period. The surveyed doctors work in the Australian after-hours house-call (AHHC) industry, and the teachings were parts of their continuing professional development activities. Results: In all, 89 responses were received; 10 (11.2%) participated exclusively online, while 23 (25.8%) did so by F2F; 52 (58.4%) engaged through both modalities. No statistical differences existed based on sex, specialty, and post-graduate fellowship status, as well as on the perceptions with teaching structure, co...
No previous study had ever looked at Burnout among medical practitioners involved in after-hours ... more No previous study had ever looked at Burnout among medical practitioners involved in after-hours house calls (AHHC) in Australia. The growing popularity of AHHC and the high number of overseas-trained doctors involved in it make this a subject of both local and international significance. This study aims to assess the levels of burnout among Australian-based doctors involved in the service. This is a quantitative, questionnaire-based survey of all the 300 doctors engaged in AHHC through the National Home Doctor Service (NHDS), Australia's largest home doctor-visit service providers. The study looked at experiences of the participants over the 12-months period from October 2013 to September 2014. The main outcome measure was the 22-item Maslach Burnout Inventory (MBI). Results were presented as Means and Frequency Percentages. A total of 168 valid questionnaires out of 300 were returned, giving a 56.0 % response rate. The Total Maslach Mean Scores (MMS) obtained were 15.97 for Em...
Journal of evaluation in clinical practice, Apr 1, 2018
Minimizing the risks and distress arising from aggression in after-hours house call (AHHC) servic... more Minimizing the risks and distress arising from aggression in after-hours house call (AHHC) services will help improve service quality in the industry. Unfortunately, no national study has ever evaluated this in Australian AHHCs. Apart from reducing this gap, findings from this work will have global relevance given the rising popularity of the AHHC industry worldwide. A survey of all 300 doctors employed by the National Home Doctor Service, Australia's largest AHHC service provider. A validated electronic questionnaire was used to examine the doctors' experiences over a 12-month period. There were 168 valid responses (56% response rate). Aggression prevalence was 47.1%, and just over half (51.8%) of the cases came from the patients. "Verbal aggression" was the commonest (48.3%). Others are "threats" (26.6%), "vexatious complaints" (13.3%), "property damage" (4.2%), "physical violence" (4.2%), "sexual harassment" (2.8...
Headaches present commonly in general practice, and doctors face uncertainties and pressures in d... more Headaches present commonly in general practice, and doctors face uncertainties and pressures in dealing with them. This study identifies key characteristics of headaches investigated through head imaging, in the hope of strengthening existing guidelines. A 7-year retrospective analysis of head imaging scans ordered for investigating headaches among patients aged ≥18 in an Australian general practice setting. A total of 109 of the 517 (21.1%) patients required head imaging, although 14 (2.7%) of these had repeat scans. Three-quarters were females, and most of the headaches were recurrent (56.9%), severe (62.4%) or had associated red flags (78.0%). Computed tomography (CT) and magnetic resonance imaging (MRI) were the only scans adopted (4:1 and 1:1 for first and repeat scans, respectively). Twelve (11.0%) scans had findings likely to explain the headaches after the initial scans, with no difference in findings between diagnoses from CTs and MRIs (P = 0.41). Repeat scans offered no ad...
Background: Multiple factors potentially influence doctors’ decisions regarding neuroimaging for ... more Background: Multiple factors potentially influence doctors’ decisions regarding neuroimaging for headaches in general practice and psycho-morbidities are one of such. Unfortunately, other non-clinical factors at play among psychological patients with headaches are poorly known and the need to identify these factors has become important in view of recent findings on the impact of psychological issues in managing headaches in primary care. The findings from this study are expected to help improve efficiency and confidence in managing headaches in this subset of patients.Method: This is a 7-year retrospective study exploring headache presentations of patients aged ≥18 in an Australian general practice setting from 1 January 2010 to 1 April 2017.Results: A total of 517 patients were identified, with an average age of 45.5 +/- 16.2 years (range of 18 to 94 years). Psycho-morbidities were reported among 190 (36.8%) patients. The female to male ratio was 72% to 28%. Most cases of headache...
Journal of evaluation in clinical practice, Jun 2, 2018
This study explores the postconsultation follow-up behaviours of patients who used the Australian... more This study explores the postconsultation follow-up behaviours of patients who used the Australian after-hours house-call (AHHC) medical services. These behaviours provide insights into the nature of the continuity of care (CoC) in the industry and are a measure quality in AHHC service delivery. Understanding the patterns of these CoCs and their predictors will enable stakeholders in the industry, both locally and globally, plan and implement higher quality services. This is a cross-sectional survey of all 10,838 patients who used AHHC during the last week of January 2016. A validated questionnaire was used, distributed through a mix of online and postal questionnaires. One thousand two hundred twenty-eight questionnaires were returned (11.3%). Had the AHHC not been available, 38.6% of respondents would have gone to their own general practitioners (GPs), 40.1% to an emergency department (ED), 15.9% to an office-based after-hours service, and 5.5% would have done nothing. After the AH...
Objectives The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-call... more Objectives The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-call (AHHC) is one key protective option available to doctors in the service, and has been linked to low burnout and increased satisfaction in AHHC. This study aims to explore the patterns of engagement of escorts in Australian AHHC. Method This is a questionnaire-based, electronic survey of all 300 doctors involved in AHHC through the National Home Doctor Service (NHDS), Australia’s largest providers of the service. The survey explored the doctor’s experiences over the 12-month period from October 2013 to September 2014. Results This survey received a total of 168 valid responses, giving a response rate of 56%. Nearly 61% of the doctors involved in AHHC engaged escorts (chauffeurs and chaperones). Of those doctors that engage chauffeurs, three-quarters do so “all or most times”, while only one-quarter engaged chaperones to the same degree of frequency. Hiring escorts is very popular among B...
Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school heal... more Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school health education program. The questionnaire was designed to collect knowledge of, attitudes toward, and experiences with cancer and cancer prevention. Data were collected from randomly selected health classes preceding a presentation on breast and cervical cancer prevention. Results showed that the girls were pessimistic about chances of surviving cancer and did not differentiate survival by type or site of the cancer. Although there was considerable confusion about its purpose, 27.6% reported having had a Papanicolaou smear within the past year and 79.2% correctly identified the Pap smear as a test for cancer.
Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school heal... more Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school health education program. The questionnaire was designed to collect knowledge of, attitudes toward, and experiences with cancer and cancer prevention. Data were collected from randomly selected health classes preceding a presentation on breast and cervical cancer prevention. Results showed that the girls were pessimistic about chances of surviving cancer and did not differentiate survival by type or site of the cancer. Although there was considerable confusion about its purpose, 27.6% reported having had a Papanicolaou smear within the past year and 79.2% correctly identified the Pap smear as a test for cancer.
Given the dearth of government-sponsored programmes, preventive lifestyles and practices are the ... more Given the dearth of government-sponsored programmes, preventive lifestyles and practices are the realistic hopes for millions of women in developing countries against cervical cancer. Early interventions for teenage high school girls have been advocated recently, but evidence-base for sustainable activities at this demographic is lacking. This article reduces this gap by determining the impact of two cervical cancer education techniques. Method. This is a 6-month interventional cohort study of 432 female high school students in South-eastern Nigeria. Results. A total of 317 (73.4%) and 301 (69.7%) valid responses were received from the preintervention (16.8 ± 1.5 years) and post-intervention (17.2 ± 1.6 years) surveys, respectively. About 213 (70.8%) were fully engaged with the interventions. Logistic regression revealed that participants who were ‘engaged’ with the interventions, either through symposium attendance or by reading of the printed handouts, showed significant improvements across multiple cervical cancer parameters regarding knowledge on ‘pap smears’ (analysed with four items), ‘HPV vaccine’ (two items) and ‘risk factors’ (two items). Improvements in Knowledge of ‘early symptoms’ were not improved, with ‘post-coital bleeding’ [odds ratio (OR) = 0.95; P = 0.87] and ‘being asymptomatic’ (OR = 0.69; P = 0.32) remaining statistically similar between the engaged and the unengaged. If ‘engagement’ with either intervention was disregarded, a chi-square analysis identified no significant improvement in knowledge on any parameter. Conclusion. Ensuring ‘engagement’ with intervention campaigns is vital to achieving effective and sustainable cervical cancer knowledge. Engagement may be achieved by repeating the education activities across all the years/classes that make up high school in each developing country, along with formal examinations at each level. Key words: Cervical cancer, high school, intervention, knowledge, secondary school, teenage women.
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Papers by Chris O Ifediora
Key words: Cervical cancer, high school, intervention, knowledge, secondary school, teenage women.
Key words: Cervical cancer, high school, intervention, knowledge, secondary school, teenage women.