ORCID Profile
0000-0002-8866-1078
Current Organisations
University of Adelaide
,
South Western Sydney Local Health District
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 21-07-2020
DOI: 10.1111/JGH.15159
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-039503
Abstract: Evidence regarding effective communication between clinicians and patients with inflammatory bowel disease (IBD) is limited. Studies that investigate clinical communication in IBD are much fewer in number than studies that investigate the perceptions of patients and clinicians about communication in clinical encounters. The current review aims to identify, organise and summarise systematically what is currently known about (1) the characteristics of interactions between clinicians who manage IBD and patients with IBD, and (2) how clinical discussion affects health outcomes in IBD. Scopus, PubMed, Embase, Communication Abstracts, Health & Society, Linguistics and Language Behavior Abstracts and PsycINFO will be systematically searched for studies that investigate the characteristics of IBD clinical interactions during recorded consultations, from earliest available dates within each database to May 2020. A specifically developed quality assessment tool, grounded in linguistic theory, will be used to critically assess the evidence. In addition, a data extraction template will be developed and utilised to provide a description of the characteristics of IBD clinical communication as well as an estimation of its effect on health outcomes in a narrative synthesis. Ethical review and approval is not required for this systematic review as no primary data will be collected. The results will be published in peer-reviewed journals and presented at academic conferences. International Prospective Register of Systematic Reviews (PROSPERO) on 28 April 2020 (registration number: CRD42020169657).
Publisher: Walter de Gruyter GmbH
Date: 08-2023
Abstract: This study explored the variation in emerging adults’ communication with gastroenterologists around the management of inflammatory bowel disease (IBD). Nineteen emerging adults with IBD aged 18–25 and seven gastroenterologists participated in the study. Outpatient specialist consultations of consenting participants were audio-recorded and transcribed. Transcribed consultations were analysed in terms of the linguistic structure of the consultations and the gastroenterologist-patient role relationship. Variations in the emerging adults’ communication with their gastroenterologists stem partly from variation in their ability, opportunity, or need to contribute to the different phases of the consultation and partly from variations in the gastroenterologists’ style of communication. Gastroenterologists differed in the construction of their role relationship with the patient, resulting in variations in employing empowering strategies including eliciting, exploring, and clarifying the patient’s concerns, sharing clinical reasoning, and validating the patient experience. Variations were also observed in the length of appointments and the gastroenterologists’ assessment and addressing of adherence issues. Techniques used by the gastroenterologist varied (1) from simply confirming adherence, to a comprehensive assessment of the patient’s understanding of their management plan and their feedback, and (2) from use of persuasion to values calibration. Evidence-based consumer interventions and communication guidelines for clinicians are needed to address the identified variations in providing care to emerging adults living with chronic conditions.
Publisher: Wiley
Date: 31-05-2022
DOI: 10.1111/IMJ.15299
Abstract: Despite the availability of evidence‐based inflammatory bowel disease (IBD) guidelines, suboptimal care persists. There is little published research assessing barriers to IBD guideline adherence. To identify barriers to IBD guideline adherence including gastroenterologists' knowledge and attitudes towards guidelines. An online cross‐sectional survey of 824 Australian gastroenterologists was conducted from April to August 2018, with 198 (24%) responses. A novel survey was developed that was informed by the theoretical domain's framework. Confidence in guideline recommendations was high however, referral to them was low. The European Crohn's and Colitis Organisation guidelines were referred to most commonly (43.6%). In multivariate analysis, significant predictors of frequent versus infrequent guideline referral were: high confidence in the guideline (odds ratio (OR) 7.70 95% confidence interval (CI): 2.43–24.39 P = 0.001), and low (≤10 years) clinical experience (OR 3.62 95% CI: 1.11–11.79 P = 0.03). The most common barriers to guideline adherence were not having time (62%), followed by guideline specifics being difficult to remember (61%). Low confidence was reported in managing pregnancy and IBD (34%) and loss of response to therapy (29%). High confidence was reported in managing immunomodulators however, only 43% answered the associated knowledge question correctly. Although gastroenterologists have high confidence in guidelines, they use them infrequently, primarily due to specifics being difficult to remember and lack of time. Self‐reported confidence in an area of IBD management does not always reflect knowledge. An intervention targeting these barriers, for ex le, computer‐based clinical decision support tools, might improve adherence and standardise care.
Publisher: Oxford University Press (OUP)
Date: 07-06-2022
Abstract: With the evolving inflammatory bowel disease (IBD) management landscape, it is critical that gastroenterologists keep up to date with the clinical practice guidelines (CPGs). Several studies in IBD have documented suboptimal adherence to CPGs. We aimed to gain an in-depth understanding of guideline adherence barriers reported by gastroenterologists and determine how evidence-based education can best be delivered. Interviews were conducted with a purposive s le of gastroenterologists’ representative of the current workforce. Questions focused on previously identified problematic areas and shaped by the theoretical domains framework, a theory-informed approach to understanding clinician behavior, to assess all determinants of behavior. Questions explored perceived barriers to adherence and clinicians’ preferred content and modes of delivery for an educational intervention. Interviews were conducted by a single interviewer and qualitative analysis performed. A total of 20 interviews were conducted before data saturation was achieved (male = 12, work in a metropolitan area = 17). Five dominant subthemes for barriers to adherence emerged: negative experiences impacting future decisions, time constraints, long guidelines are impractical, unfamiliar with guideline specifics and prescribing restrictions. Adherence enablers were identified including features that improved the usability of CPGs. Computer- or smart phone-based educational interventions were preferred. This study identified several barriers and enablers for IBD guideline adherence and gained insight into how gastroenterologists prefer to receive evidence-based education. These results will inform the development of a targeted intervention to improve IBD guideline adherence. Improving guideline adherence is expected to facilitate standardized IBD care, ultimately leading to improved patient outcomes.
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJOPEN-2021-051053
Abstract: This systematic review aims to investigate what is currently known about the characteristics of interactions between patients with inflammatory bowel disease (IBD) and their clinicians and its effect on patient outcomes. Scopus, PubMed, Embase, Communication Abstracts, Health & Society, Linguistics and Language Behaviour Abstracts and PsycINFO were systematically searched from inception to June 2021. Peer-reviewed journal articles and book chapters in English investigating the characteristics of naturally occurring interactions between clinicians that manage IBD and patients with IBD during recorded consultations were included. Risk of bias was assessed using a specifically developed quality assessment tool, grounded in linguistic theory and the Mixed Methods Appraisal Tool. A narrative synthesis guided by the linguistic concept of metafunction was performed to synthesise the findings. Of the 2883 abstracts reviewed five formed the basis of the review. Interactions between IBD nurses and patients have been mostly characterised in terms of information provision regarding prescribed medications without consideration of the interpersonal aspect. Discussing online medical information with nurses has been shown to improve patient satisfaction. Analyses of gastroenterologist–patient interactions have concentrated on the clinical relationship which has been shown to be disease-centred. Shared decision making in ulcerative colitis has been shown to be compromised due to lack of transparency regarding treatment goals. This review did not include articles in languages other than English. Cumulative evidence could not be produced due to the small number of included studies and the ersity of contexts, theories and data types. There is a paucity of systematic research on naturally occurring clinical communication in IBD and its effect on outcomes. Further research needs to be done to address this knowledge gap. CRD42020169657.
No related grants have been discovered for Ria Kanazaki.