Sleep: Multi-Professional Perspectives

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At the completion of Round 2 and 3, items were categorised using a priori criteria based on the group median Likert score and interquartile range IQR where:. For the Round 3 questionnaire only, each participant was sent an individualised report of Round 2 results appropriate to their group via email or post SA-COPD only. Controlled feedback was provided on: This provided an opportunity for participants to reconsider their rating of items with low group agreement from Round 2, in order to encourage more decisive ratings toward unimportance or importance in Round 3.

For the Round 4 questionnaire, all participants were provided with, and invited to rate, the same list of items collated into common themes.

Participant groups were characterised using descriptive statistics with findings tabulated for comparison across groups. To identify items and themes considered as important across all participant groups primary aim , the median Likert score and IQR of all items at the end of Round 4 was calculated for each group.

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Sequential Bonferroni corrections were applied to reduce risk of type one error with multiple comparisons. Seventy-three participants were included in this study.

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Figure 3 outlines the participant flow from Rounds 1 to 4. Participant groups are described in Table 1. These nine themes were: For average rating of items within themes, significant differences existed predominantly between the NL-COPD group and remaining groups.

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The three key findings of this study were: A clear focus of important items and themes was disease management important items: This included management of symptoms breathlessness, fatigue —the single theme important to all four participant groups to improve PA, SB and sleep—and management of co-existing conditions cardiac conditions, pain, and anxiety. There is however limited evidence that optimising function with for example bronchodilator therapy Gimeno-Santos et al. Important items and themes also commonly concerned the need to target behavioural factors important items: To improve PA and SB, this included provision of physician advice or encouragement and intervention strategies relating to health counselling or self-management.

However, there is currently no universally accepted approach for health counselling with interventions commonly comprised of various combinations of different behaviour change techniques Wilson et al.

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As such, it is not clear which exact intervention components have led to the often small, positive effects on PA. The most common behaviour change techniques explored to date have included a combination of: This overlaps with strategies important to our Delphi participants, which were self-monitoring, goal-setting, positive feedback and education on how and why to change behaviour. Typically, such factors would be addressed with self-management interventions Zwerink et al. To improve sleep, education on sleep hygiene principles was the single important behavioural strategy.

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The effects of sleep hygiene education on sleep quality has not been well explored in people without a clinical sleep disorder Irish et al. Few items and themes considered as important concerned the need to adapt the social or physical environments important items: Where specific items were considered important to our Delphi participants, these concerned adapting the social environment e.

These findings overlap with two recent studies in the COPD population, where having an active resident loved one Mesquita et al. There were significant differences in importance rating of specific items within themes predominantly between the NL-COPD group and remaining groups. This may reflect some cultural differences.

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For example, while maintaining some level of employment was important to both COPD patient groups to improve PA and SB; volunteer work was rated significantly higher by Dutch participants. Differences at the theme, rather than item level, were mostly seen with sleep. Compared to the remaining groups, few themes were important to the COPD expert group to improve sleep. It is possible that how we asked our Delphi participants about what is important for people with COPD to improve sleep may have resulted in some level of confusion around whether to treat sleep in this population as a medical problem or as a behaviour subject to change through general, non-clinical behaviour change strategies.

Participating in moderate-to-vigorous activities such as gym exercise, walking or cycling was frequently suggested by our Delphi participants as a way to improve all behaviours. This suggests that there exist implicit assumptions that:. Perceptions around movement-related behaviours are likely to have been influenced by several decades of public health messaging promoting PA. This approach takes into consideration the effect that all behaviours have on health: For the greatest health benefits, it may be advantageous to spend more time throughout the waking day in light activities than in SB or to substitute prolonged sleep for SB Chastin et al.

For sleep, optimal durations for adults have been shown to be between seven and nine hours Cappuccio et al. To achieve meaningful reductions in SB it would be more feasible to modify or replace SB with light activities. This research study was strengthened by the systematic Delphi approach used to obtain participant perspectives. Following recommendations by Diamond et al. Furthermore, the Delphi process maintains participant anonymity avoiding common problems such as influence of a dominant group member or pressures to conform to group opinions.

Science Library Li and Ma. Find it at other libraries via WorldCat Limited preview. Bibliography Includes bibliographical references and indexes. The Science of Sleep: Biological Rhythms that Influence Sleep. Medical Anthropology and Children's Sleep: The Sociological Aspects of Sleep. A Question of Balance: In this unit, students' transition into the tertiary setting will be supported and the roles, responsibilities and expectations of students as healthcare profession students will be outlined.

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They will be engaged via adult learning teaching and learning principles in this unit as they begin to develop their professional identity. This unit will commence students on the pathway to becoming experts in food knowledge and application and culturally competent, self aware healthcare professionals. Interprofessional learning opportunities with other healthcare profession students will help strengthen the learning in this unit. Students will be introduced to reflective practice and commence a professional portfolio.

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