Evaluation of a Webinar to Increase Health Professionals’ Knowledge about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
Abstract
:1. Introduction
1.1. The Present Research
1.2. Hypotheses
2. Materials and Methods
2.1. Procedure
2.2. Measures
2.2.1. Prior Teaching, Experience with ME/CFS, Confidence
2.2.2. Knowledge about ME/CFS
2.2.3. Demographics
2.3. Participants
2.4. Data-Analytical Strategy and Transformations
2.5. Dropout Analyses
3. Results
3.1. Hypothesis 1: Baseline Formal Teaching and Confidence
3.2. Hypothesis 2: Knowledge Increase in Intervention Condition
3.3. Hypotheses 3 and 4: Comparison to Control Condition
3.4. Exploratory Analyses: Investigation of Single Items of the Knowledge Test
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Carruthers, B.M.; van de Sande, M.I.; de Meirleir, K.L.; Klimas, N.G.; Broderick, G.; Mitchell, T.; Staines, D.; Powles, A.C.P.; Speight, N.; Vallings, R.; et al. Myalgic encephalomyelitis: International Consensus Criteria. J. Intern. Med. 2011, 270, 327–338. [Google Scholar] [CrossRef] [Green Version]
- National Institute for Health Care Excellence. Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome: Diagnosis and Management: NICE Guideline [NG206]. Available online: https://www.nice.org.uk/guidance/ng206 (accessed on 25 July 2023).
- Institute of Medicine. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness; National Academies Press: Washington, DC, USA, 2015; ISBN 9780309316897. [Google Scholar]
- Stussman, B.; Williams, A.; Snow, J.; Gavin, A.; Scott, R.; Nath, A.; Walitt, B. Characterization of post-exertional malaise in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Front. Neurol. 2020, 11, 1025. [Google Scholar] [CrossRef]
- Fujii, H.; Sato, W.; Kimura, Y.; Matsuda, H.; Ota, M.; Maikusa, N.; Suzuki, F.; Amano, K.; Shin, I.; Yamamura, T.; et al. Altered structural brain networks related to adrenergic/muscarinic receptor autoantibodies in Chronic Fatigue Syndrome. J. Neuroimaging 2020, 30, 822–827. [Google Scholar] [CrossRef] [PubMed]
- Wirth, K.; Scheibenbogen, C. A unifying hypothesis of the pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Recognitions from the finding of autoantibodies against ß2-adrenergic receptors. Autoimmun. Rev. 2020, 19, 102527. [Google Scholar] [CrossRef]
- Fluge, Ø.; Mella, O.; Bruland, O.; Risa, K.; Dyrstad, S.E.; Alme, K.; Rekeland, I.G.; Sapkota, D.; Røsland, G.V.; Fosså, A.; et al. Metabolic profiling indicates impaired pyruvate dehydrogenase function in myalgic encephalopathy/chronic fatigue syndrome. JCI Insight 2016, 1, e89376. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Naviaux, R.K.; Naviaux, J.C.; Li, K.; Bright, A.T.; Alaynick, W.A.; Wang, L.; Baxter, A.; Nathan, N.; Anderson, W.; Gordon, E. Metabolic features of chronic fatigue syndrome. Proc. Natl. Acad. Sci. USA 2016, 113, E5472–E5480. [Google Scholar] [CrossRef]
- Davenport, T.E.; Lehnen, M.; Stevens, S.R.; VanNess, J.M.; Stevens, J.; Snell, C.R. Chronotropic intolerance: An overlooked determinant of symptoms and activity limitation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome? Front. Pediatr. 2019, 7, 82. [Google Scholar] [CrossRef]
- Nunes, J.M.; Kell, D.B.; Pretorius, E. Cardiovascular and haematological pathology in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A role for viruses. Blood Rev. 2023, 60, 101075. [Google Scholar] [CrossRef]
- Cullinan, J.; Pheby, D.F.H.; Araja, D.; Berkis, U.; Brenna, E.; de Korwin, J.-D.; Gitto, L.; Hughes, D.A.; Hunter, R.M.; Trepel, D.; et al. Perceptions of European ME/CFS experts concerning knowledge and understanding of ME/CFS among primary care physicians in Europe: A report from the European ME/CFS Research Network (EUROMENE). Medicina 2021, 57, 208. [Google Scholar] [CrossRef] [PubMed]
- Lim, E.-J.; Ahn, Y.-C.; Jang, E.-S.; Lee, S.-W.; Lee, S.-H.; Son, C.-G. Systematic review and meta-analysis of the prevalence of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). J. Transl. Med. 2020, 18, 100. [Google Scholar] [CrossRef]
- Wong, T.L.; Weitzer, D.J. Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)-A systemic review and comparison of clinical presentation and symptomatology. Medicina 2021, 57, 418. [Google Scholar] [CrossRef] [PubMed]
- Kedor, C.; Freitag, H.; Meyer-Arndt, L.; Wittke, K.; Hanitsch, L.G.; Zoller, T.; Steinbeis, F.; Haffke, M.; Rudolf, G.; Heidecker, B.; et al. A prospective observational study of post-COVID-19 chronic fatigue syndrome following the first pandemic wave in Germany and biomarkers associated with symptom severity. Nat. Commun. 2022, 13, 5104. [Google Scholar] [CrossRef] [PubMed]
- Komaroff, A.L.; Bateman, L. Will COVID-19 lead to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome? Front. Med. 2021, 7, 606824. [Google Scholar] [CrossRef] [PubMed]
- Mirin, A.A.; Dimmock, M.E.; Jason, L.A. Updated ME/CFS prevalence estimates reflecting post-COVID increases and associated economic costs and funding implications. Fatigue Biomed. Health Behav. 2022, 10, 83–93. [Google Scholar] [CrossRef]
- Roessler, M.; Tesch, F.; Batram, M.; Jacob, J.; Loser, F.; Weidinger, O.; Wende, D.; Vivirito, A.; Toepfner, N.; Ehm, F.; et al. Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germany. PLoS Med. 2022, 19, e1004122. [Google Scholar] [CrossRef]
- Kassenärztliche Bundesvereinigung. Stellungnahme des KBV Zum Antrag der CDU/CSU-Bundestagsfraktion “ME/CFS-Betroffenen Sowie Deren Angehörigen Helfen-Für Eine Bessere Gesundheits-Sowie Therapieversorgung, Aufklärung Und Anerkennung: [Statement of the KBV on the Motion of the CDU/CSU Parliamentary Group “Help People with ME/CFS and Their Relatives-for Better Health and Therapy Care, Education and Recognition]. Available online: https://www.bundestag.de/resource/blob/943000/60468062de2e557ef6436afb4e5c9173/20_14_0095-5-_Kassenaerztliche-Bundesvereinigung_ME-CFS_nicht-barrierefrei-data.pdf (accessed on 25 July 2023).
- Froehlich, L.; Hattesohl, D.B.R.; Jason, L.A.; Scheibenbogen, C.; Behrends, U.; Thoma, M. Medical care situation of people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Germany. Medicina 2021, 57, 646. [Google Scholar] [CrossRef]
- Sunnquist, M.; Nicholson, L.; Jason, L.A.; Friedman, K.J. Access to medical care for individuals with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: A call for centers of excellence. Mod. Clin. Med. Res. 2017, 1, 28–35. [Google Scholar] [CrossRef]
- Tidmore, T.M.; Jason, L.A.; Chapo-Kroger, L.; So, S.; Brown, A.; Silverman, M.C. Lack of knowledgeable healthcare access for patients with neuro-endocrine-immune diseases. Front. Clin. Med. 2015, 2, 46–54. [Google Scholar]
- Tschopp, R.; König, R.S.; Rejmer, P.; Paris, D.H. Health system support among patients with ME/CFS in Switzerland. J. Taibah Univ. Med. Sci. 2023, 18, 876–885. [Google Scholar] [CrossRef]
- Baken, D.M.; Harvey, S.T.; Bimler, D.L.; Ross, K.J. Stigma in Myalgic Encephalomyelitis and its association with functioning. Fatigue: Biomed. Health Behav. 2018, 6, 30–40. [Google Scholar] [CrossRef]
- Froehlich, L.; Hattesohl, D.B.R.; Cotler, J.; Jason, L.A.; Scheibenbogen, C.; Behrends, U. Causal attributions and perceived stigma for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. J. Health Psychol. 2022, 27, 2291–2304. [Google Scholar] [CrossRef] [PubMed]
- Hng, K.N.; Geraghty, K.; Pheby, D.F.H. An audit of UK hospital doctors’ knowledge and experience of Myalgic Encephalomyelitis. Medicina 2021, 57, 885. [Google Scholar] [CrossRef] [PubMed]
- Pheby, D.F.H.; Araja, D.; Berkis, U.; Brenna, E.; Cullinan, J.; de Korwin, J.-D.; Gitto, L.; Hughes, D.A.; Hunter, R.M.; Trepel, D.; et al. A literature review of GP knowledge and understanding of ME/CFS: A report from the socioeconomic working group of the European Network on ME/CFS (EUROMENE). Medicina 2021, 57, 7. [Google Scholar] [CrossRef] [PubMed]
- Wilshire, C.E.; Kindlon, T.; Courtney, R.; Matthees, A.; Tuller, D.; Geraghty, K.; Levin, B. Rethinking the treatment of Chronic Fatigue Syndrome—A reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT. BMC Psychol. 2018, 6, 6. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Jason, L.A.; Paavola, E.; Porter, N.; Morello, M.L. Frequency and content analysis of chronic fatigue syndrome in medical text books. Aust. J. Prim. Health 2010, 16, 174–178. [Google Scholar] [CrossRef]
- DEGAM. Müdigkeit-S3-Leitlinie: [Fatigue-S3 Guideline]. Available online: https://awmf-register.dev.howto.health/de/leitlinien/detail/053-002 (accessed on 25 July 2023).
- Medizinischer Fakultätentag. Nationaler Kompetenzbasierter Lernzielkatalog Medizin Version 2.0: [National Competence-Based Learning Goals Catalogue Medicine Version 2.0]. Available online: https://nklm.de/ (accessed on 25 July 2023).
- Topor, D.R.; Budson, A.E. Twelve tips to present an effective webinar. Med. Teach. 2020, 42, 1216–1220. [Google Scholar] [CrossRef]
- Cheng, C.; Papadakos, J.; Umakanthan, B.; Fazelzad, R.; Martimianakis, M.A.; Ugas, M.; Giuliani, M.E. On the advantages and disadvantages of virtual continuing medical education: A scoping review. Can. Med. Educ. J. 2022, 14, 41. [Google Scholar] [CrossRef]
- Richmond, H.; Copsey, B.; Hall, A.M.; Davies, D.; Lamb, S.E. A systematic review and meta-analysis of online versus alternative methods for training licensed health care professionals to deliver clinical interventions. BMC Med. Educ. 2017, 17, 227. [Google Scholar] [CrossRef] [Green Version]
- Verma, A.; Verma, S.; Garg, P.; Yadav, S.; Banoth, B. Webinar as future of continued medical education: A survey. Indian J. Surg. 2022, 84, 336–337. [Google Scholar] [CrossRef]
- Elfers, S. LA-MED: Online-Fortbildungen Werden Bei Fachärzten Und Fachärztinnen Immer Beliebter: [LA-MED: Online Continuing Medical Education Increasingly Popular among Specialized Physicians]. Available online: https://www.healthrelations.de/fortbildungsverhalten-aerzte/ (accessed on 25 July 2023).
- Haldar, S.K.; Lloyd, G.; Ng, G.A.; Ray, S.G.; Dobson, R.; Cartwright, C.; Hargreaves, C.; O’Flynn, R.; Greenwood, J.P. The changing face of medical education in the aftermath of COVID-19: The true digital era begins. J. Eur. CME 2022, 11, 2035949. [Google Scholar] [CrossRef]
- Elfers, S. Ärztebefragung: Wie Attraktiv Ist Die Digitale Fortbildung?: [Survey Among Physicians: How Attractive Is Digital Continuing Medical Education?]. Available online: https://www.healthrelations.de/digitale-fortbildung-fuer-aerzte/ (accessed on 25 July 2023).
- McMahon, G.T. Effect of the COVID-19 pandemic on accredited continuing medical education in the United States. J. Contin. Educ. Health Prof. 2022, 42, e125–e127. [Google Scholar] [CrossRef] [PubMed]
- Yo, E.C.; Witjaksono, A.N.; Fitriani, D.Y.; Werdhani, R.A.; Parikesit, D. Assessing webinar outcomes for health professionals: A perspective from Indonesia during coronavirus disease 2019 pandemic. Korean J. Med. Educ. 2021, 33, 87–96. [Google Scholar] [CrossRef] [PubMed]
- Ismail, I.I.; Abdelkarim, A.; Al-Hashel, J.Y. Physicians’ attitude towards webinars and online education amid COVID-19 pandemic: When less is more. PLoS ONE 2021, 16, e0250241. [Google Scholar] [CrossRef] [PubMed]
- Dev, P.; Thyavihally, B.Y.; Waigankar, S.S.; Agarwal, V.; Pednekar, A.P.; Shah, A. The value of webinars during COVID-19 pandemic: A questionnaire-based survey. Indian J. Urol. 2022, 38, 204–209. [Google Scholar] [CrossRef]
- Odayappan, A.; Venkatesh, R.; Tammineni, R.; Nachiappan, S.; Iswarya, M. Perspectives of physicians regarding the role of webinars on medical education during the COVID-19 pandemic. Indian J. Ophthalmol. 2021, 69, 1251–1256. [Google Scholar] [CrossRef]
- Kennedy, C.E.; Fonner, V.A.; Armstrong, K.A.; Denison, J.A.; Yeh, P.T.; O’Reilly, K.R.; Sweat, M.D. The Evidence Project risk of bias tool: Assessing study rigor for both randomized and non-randomized intervention studies. Syst. Rev. 2019, 8, 3. [Google Scholar] [CrossRef] [Green Version]
Fall 2021 (Study 1) | Fall 2022 (Study 2) |
---|---|
|
|
Study 1 Intervention Condition (N = 140) | Study 2 Control Condition (N = 50) | Study 2 Intervention Condition (N = 76) | |||||||
---|---|---|---|---|---|---|---|---|---|
T1 | T2 | T1 | T2 | T1 | T2 | ||||
Item | M (SD) | M (SD) | t (p) | M (SD) | M (SD) | t (p) | M (SD) | M (SD) | t (p) |
General Epidemiological Knowledge | |||||||||
| 0.54 (0.50) | 0.80 (0.40) | 5.74 *** (<0.001) | 0.50 (0.51) | 0.56 (0.50) | 1.00 (0.322) | 0.53 (0.50) | 0.72 (0.45) | 3.33 ** (0.001) |
| 0.96 (0.19) | 0.99 (0.08) | 2.02 * (0.045) | 0.98 (0.14) | 0.98 (0.14) | 0.00 (1.00) | 0.99 (0.11) | 0.99 (0.11) | 0.00 (1.00) |
| 0.96 (0.20) | 1.00 (0.00) | 2.49 * (0.014) | 0.98 (0.14) | 1.00 (0.00) | 1.00 (0.322) | 0.99 (0.11) | 1.00 (0.00) | 1.00 (0.321) |
| 0.93 (0.26) | 0.91 (0.28) | 0.53 (0.595) | 0.82 (0.39) | 0.86 (0.35) | 0.81 (0.420) | 0.93 (0.25) | 0.91 (0.29) | 0.70 (0.483) |
| 0.82 (0.38) | 0.97 (0.17) | 4.70 *** (<0.001) | 0.80 (0.40) | 0.86 (0.35) | 1.14 (0.261) | 0.86 (0.35) | 0.97 (0.16) | 3.17 ** (0.002) |
| 0.93 (0.26) | 0.95 (0.22) | 0.77 (0.441) | 0.96 (0.20) | 0.96 (0.20) | 0.00 (1.00) | 0.93 (0.25) | 0.93 (0.25) | 0.00 (1.00) |
| 0.94 (0.25) | 0.99 (0.08) | 2.90 ** (0.004) | 1.00 (0.00) | 1.00 (0.00) | 0.00 (1.00) | 1.00 (0.00) | 1.00 (0.00) | 0.00 (1.00) |
Definitions and Clinical Understanding | |||||||||
| 0.84 (0.37) | 0.96 (0.19) | 4.38 *** (<0.001) | 0.88 (0.33) | 0.88 (0.33) | 0.00 (1.00) | 0.87 (0.34) | 0.96 (0.20) | 2.41 * (0.019) |
| 0.66 (0.47) | 0.66 (0.47) | 0.00 (1.00) | 0.72 (0.45) | 0.64 (0.48) | 1.27 (0.209) | 0.70 (0.46) | 0.71 (0.46) | 0.21 (0.836) |
| 5.84 (1.60) | 6.49 (1.02) | 5.20 *** (<0.001) | 6.04 (1.38) | 6.12 (1.32) | 0.45 (0.655) | 6.20 (1.24) | 6.46 (1.03) | 2.16 * (0.034) |
| 0.31 (0.47) | 0.40 (0.49) | 2.39 * (0.018) | 0.28 (0.45) | 0.44 (0.50) | 2.68 * (0.010) | 0.49 (0.50) | 0.59 (0.49) | 2.04 * (0.045) |
Diagnostic Process and Diagnostic Criteria | |||||||||
| 1.66 (0.80) | 2.16 (0.50) | 7.46 *** (<0.001) | 1.62 (0.78) | 1.86 (0.67) | 2.37 * (0.022) | 1.83 (0.76) | 2.09 (0.61) | 2.85 ** (0.006) |
| 4.99 (1.00) | 5.26 (0.84) | 3.25 ** (0.001) | 5.00 (0.88) | 5.10 (0.97) | 0.93 (0.358) | 4.93 (1.00) | 5.37 (0.85) | 3.79 *** (<0.001) |
| 2.24 (0.43) | 2.39 (0.49) | 3.71 *** (<0.001) | 2.12 (0.44) | 2.28 (0.45) | 1.74 (0.088) | 2.28 (0.45) | 2.39 (0.49) | 2.00 * (0.049) |
| 1.66 (0.51) | 1.56 (0.50) | 1.89 (0.061) | 1.72 (0.45) | 1.66 (0.48) | 1.00 (0.322) | 1.62 (0.54) | 1.74 (0.44) | 1.91 (0.060) |
Treatment | |||||||||
| 1.48 (1.27) | 2.49 (1.17) | 9.13 *** (<0.001) | 1.72 (1.21) | 1.72 (1.16) | 0.00 (1.00) | 1.75 (1.23) | 2.58 (0.93) | 6.64 *** (<0.001) |
| 0.98 (0.15) | 1.00 (0.00) | 1.75 (0.083) | 0.98 (0.14) | 1.00 (0.00) | 1.00 (0.322) | 0.97 (0.16) | 1.00 (0.00) | 1.42 (0.159) |
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Froehlich, L.; Niedrich, J.; Hattesohl, D.B.R.; Behrends, U.; Kedor, C.; Haas, J.-P.; Stingl, M.; Scheibenbogen, C. Evaluation of a Webinar to Increase Health Professionals’ Knowledge about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Healthcare 2023, 11, 2186. https://doi.org/10.3390/healthcare11152186
Froehlich L, Niedrich J, Hattesohl DBR, Behrends U, Kedor C, Haas J-P, Stingl M, Scheibenbogen C. Evaluation of a Webinar to Increase Health Professionals’ Knowledge about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Healthcare. 2023; 11(15):2186. https://doi.org/10.3390/healthcare11152186
Chicago/Turabian StyleFroehlich, Laura, Jasmin Niedrich, Daniel B. R. Hattesohl, Uta Behrends, Claudia Kedor, Johannes-Peter Haas, Michael Stingl, and Carmen Scheibenbogen. 2023. "Evaluation of a Webinar to Increase Health Professionals’ Knowledge about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)" Healthcare 11, no. 15: 2186. https://doi.org/10.3390/healthcare11152186
APA StyleFroehlich, L., Niedrich, J., Hattesohl, D. B. R., Behrends, U., Kedor, C., Haas, J. -P., Stingl, M., & Scheibenbogen, C. (2023). Evaluation of a Webinar to Increase Health Professionals’ Knowledge about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Healthcare, 11(15), 2186. https://doi.org/10.3390/healthcare11152186