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      Improvements needed to support people living and working with a rare disease in Northern Ireland: current rare disease support perceived as inadequate

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          Abstract

          Background

          Many people living and working with rare diseases describe consistent difficulties accessing appropriate information and support. In this study an evaluation of the awareness of rare diseases, alongside related information and educational resources available for patients, their families and healthcare professionals, was conducted in 2018–2019 using an online survey and semi-structured interviews with rare disease collaborative groups (charities, voluntary and community groups) active across Northern Ireland (NI).

          Methods

          This study had 2 stages. Stage 1 was an online survey and stage 2 involved semi-structured interviews both with rare disease collaborative groups in Northern Ireland. The surveys and interviews were used to locate existing resources as well as identify gaps where the development of further resources would be appropriate.

          Results

          Ninety-nine rare disease collaborative groups engaged with the survey with 31 providing detailed answers. Resources such as information, communication, ‘registries’, online services, training and improvements to support services were queried. Excellent communication is an important factor in delivering good rare disease support. Training for health professionals was also highlighted as an essential element of improving support for those with a rare disease to ensure they approach people with these unique and challenging diseases in an appropriate way. Carers were mentioned several times throughout the study; it is often felt they are overlooked in rare disease research and more support should be in place for them. Current care/support for those with a rare disease was highlighted as inadequate. Nine semi-structured interviews were conducted with rare disease collaborative groups. Reoccurring themes included a need for more effective information and communication, training for health professionals, online presence, support for carers, and involvement in research.

          Conclusions

          All rare disease collaborative groups agreed that current services for people living and working with a rare disease are not adequate. An important finding to consider in future research within the rare disease field is the inclusion of carers perceptions and experiences in studies. This research provides insight into the support available for rare diseases across Northern Ireland, highlights unmet needs, and suggests approaches to improve rare disease support.

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          Most cited references41

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          Using thematic analysis in psychology

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            Interpreting Qualitative Data : Methods for Analyzing Talk, Text and Interaction

            In this exciting and major updating of one the most important textbooks for beginning qualitative researchers, David Silverman seeks to match the typical chronology of experience faced by the student-reader. Earlier editions of Interpreting Qualitative Data largely sought to provide material for students to answer exam questions, yet the undergraduate encounter with methods training is increasingly assessed by students doing their own research project. In this context, the objective of the Third Edition is to offer undergraduates the kind of hands-on training in qualitative research required to guide them through the process. New to the Third Edition: Substantially rewritten to better match the realities of undergraduate qualitative methods courses More worked examples throughout the book to help students work with their data Chapter 1 now provides an extensive discussion of the practical and design issues of how to get started, establish a limited research problem, select a method, address ethical issues, get the information required, and plan time effectively A completely new chapter on ‘writing up’ which includes a section on theorizing from data. Also, a completely new ethics chapter. Updating of all methods chapters In line with current undergraduate benchmarking practice, each section now begins with opening chapter objectives Interpreting Qualitative Data, Third Edition is a companion volume to David Silverman’s Doing Qualitative Research: A Practical Handbook (Sage, Second Edition 2005), a guide to the business of conducting a research project, together with its accompanying volume of key readings, Qualitative Research: Theory, Method & Practice (Sage, Second Edition 2004), which provides further, more focused, material that students require before contemplating their own qualitative research study. is a companion volume to David Silverman’s (Sage, Second Edition 2005), a guide to the business of conducting a research project, together with its accompanying volume of key readings, (Sage, Second Edition 2004), which provides further, more focused, material that students require before contemplating their own qualitative research study.
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              Australian families living with rare disease: experiences of diagnosis, health services use and needs for psychosocial support

              Background Families of children living with a rare disease report significant health and social burden, however, few studies have systematically examined family needs by using validated tools to assess the scope and extent of this burden. Our aim was to develop a comprehensive survey to assess health, psychosocial and financial impacts on Australian families caring for a child with a rare disease. Methods We developed a self-administered survey for parents/carers incorporating pre-validated tools. The survey included questions about experiences of diagnosis, health services use and needs, needs for peer and financial supports. Forty-seven families attending the state-wide Genetic Metabolic Disorders Service at the Children’s Hospital at Westmead, Sydney were invited to participate. Results Of 46 families who received the survey, 30 (65%) completed it. Most (93%) found the survey acceptable and relevant (91%). Patients were 1–17 years old, 14 (47%) male, and 12 (40%) non-Caucasian. Eighteen (60%) had a lysosomal storage disease and 12(40%) had a mitochondrial disorder. Eleven (38%) saw 3–5 doctors and four (14%) saw 6–10 doctors before receiving the correct diagnosis; 43% felt diagnosis was delayed. Four (13%) were dissatisfied with the way diagnosis was given, due to insensitive style of communication, inadequate information and psychological support. Psychosocial impact was moderate to high for 90% of families and the level of impact was not dependent on the level of health functioning of the child. Twenty-six (87%) wanted, but only 13(43%) received, information about peer-support groups. The 30 children accounted for 168 visits to general practitioners and 260 visits to specialist doctors; 21 (70%) children had at least one admission to hospital, including one who had 16 admissions in the previous 12 months. Most families (77%) received financial assistance but 52% believed this was insufficient. Families benefited from a specialised multi-disciplinary clinic but called for patient-held electronic medical records. Conclusions Australian families caring for children with genetic metabolic disorders are adversely impacted by delays in diagnosis, lack of easy access to peer support groups and lack of psychological support. Further research is needed to estimate economic impact and to analyse health service delivery models for children with rare diseases in Australia.
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                Author and article information

                Contributors
                raredisease@qub.ac.uk
                Journal
                Orphanet J Rare Dis
                Orphanet J Rare Dis
                Orphanet Journal of Rare Diseases
                BioMed Central (London )
                1750-1172
                9 November 2020
                9 November 2020
                2020
                : 15
                : 315
                Affiliations
                [1 ]GRID grid.4777.3, ISNI 0000 0004 0374 7521, Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, , Institute of Clinical Science, ; Block A, Grosvenor Road, Belfast, BT12 6BA UK
                [2 ]Northern Ireland Rare Disease Partnership, 2 William Street, Newtownards, BT23 4AH UK
                Author information
                http://orcid.org/0000-0001-8566-4807
                Article
                1559
                10.1186/s13023-020-01559-6
                7649905
                33168042
                b4f2b100-3e3e-4d41-98c4-0b1e348b81d1
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 30 May 2020
                : 24 September 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Award ID: MC_PC_16018
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Infectious disease & Microbiology
                collaborative groups,communication,northern ireland,online,rare disease,semi-structured interview,social media,support,survey

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