Use of key performance indicators in histological dissection.

AIMS: Reports into standards in the National Health Service and quality in pathology have focused on the way we work in pathology and how to provide assurance that this is of a high standard. There are a number of external quality assurance schemes covering pathology and histopathology specifically; however, there is no scheme covering the process of histological surgical dissection. This is an area undergoing development, emerging from the sole preserve of medically qualified pathologists to a field populated by a number of highly trained biomedical scientists, but remains without any formal quality assurance. METHODS: This work builds on Barnes, taking the guidance of the Royal College of Pathologists (RCPath)and Institute of Biomedical Science (IBMS)to form a series of key performance indicators relating to dissection. These were developed for use as an indicator of individual practice, highlighting areas of variation, weakness or strength. Once identified, a feedback event provided opportunities to address these errors and omissions, or to enable areas of strength to be shared. RESULTS: The data obtained from the checklists demonstrate a large variation in practice at the outset of this study. The use of the checklists alone served to reduce this variation in practice, the addition of the training event showed further reduction in variation. The combination of these two tools was an effective method for enhancing standardisation of practice. CONCLUSIONS: The results of this work show that training events serve to reduce variation in practice by, and between, dissectors, driving up standards in dissection-directly addressing the needs of the modern pathology service.

The role of partner relationships in the young person's adherence to the diabetes self-care regime.

BACKGROUND: This study investigated the role of partner relationships in the young person's experience of diabetes. It was predicted that those people reporting a better quality relationship would report greater social support and better diabetes management. METHOD: Fifty young adults with diabetes and their spouse/partner completed web-based questionnaires. RESULTS: A better quality relationship did not correlate with high reported levels of social support or with better diabetes management. Path analysis demonstrated, however, that for males with diabetes high reported quality of relationship predicted better diabetes management. CONCLUSIONS: Relationship quality does not generally predict better diabetes management; however, there may be a unique feature to good relationships that support men's diabetes self-care.

The extended health belief model applied to the experience of diabetes in young people.

OBJECTIVES: The experience of diabetes in young people was investigated within the theoretical framework of the extended health belief model (EHBM). It was anticipated that participant reports of high internal locus of control, high diabetes related empowerment, coping with hypoglycaemia, and diabetes related social support would be associated with good patient adherence to the self-care regime. METHOD: 118 participants aged 16-25 years with Type 1 diabetes mellitus were sent a set of questionnaires incorporating previously published scales measuring all variables of the EHBM. RESULTS: High levels of family support and low locus of control beliefs in powerful others to control their diabetes reduce the young person's perception of severity and vulnerability to diabetes related complications. High internal locus of control beliefs and high levels of self-efficacy predicted the benefits of adhering to the self-care regime as outweighing the costs of doing so. Adherence to self-care regime was predicted by high levels of family support. CONCLUSION: The final model explained 12% of the variance in the young person's adherence to diabetes self-care regime. It is proposed that the EHBM is an adequate model for understanding the socio-psychological factors present in the young person's appraisal of their diabetes, which, in turn, influences adherence to the diabetes self-care regime.