Background and objectives Fresh blood product transfusion requires patient education for fully informed consent, and written consumer information is frequently used. Few studies have examined consumer preferences regarding written and verbal transfusion information provided. As a qualitative study, this research was designed to explore participant understanding and by analysing and integrating themes, generate a model to understand how transfusion information should be developed and used in practice. Materials and methods Semi‐structured interviews were conducted with healthcare consumers of transfusion information from various hospital clinical departments. Transcripts were coded to qualitatively compare nature/extent of content and opinions regarding transfusion information through thematic analysis. Results Analysis identified themes relating to healthcare engagement, purpose of information, mode of delivery and content delivered. Differences were identified between perceived purpose of information provided to consumers between 13 transfusion prescribers and consumers. Prescribers viewed information as a tool for obtaining informed consent, whereas consumers desired reassurance and knowledge. Consumers described both the specialized nature and volume of information as limiting their ability to question professionals on whom they were dependent. Information provided should be tailored to consumers and utilize simple, succinct explanations. Conclusion Both groups were satisfied with written information adjunctive to verbal information. These findings will be used to redesign transfusion information and may be employed at the bedside when discussing transfusion. They may have implications for consumer information in other settings.
Introduction Genioglossus neural drive and the ensuing tongue dilatory movement may be dissociated in obstructive sleep apnoea (OSA), but this has not been studied. This study aimed to investigate this relationship and its potential role in OSA pathophysiology. Methods During awake nasal breathing in the supine position, inspiratory tongue dilatory movement, quantified with tagged magnetic resonance imaging, and inspiratory peak genioglossus electromyography (EMG) normalised to the maximum voluntary contraction (tongue protrusion), were measured in 4 tongue neuromuscular compartments from 8 controls [apnea-hypopnea index (AHI)<5 events/h] and 34 patients with untreated OSA [AHI>10 events/h]. Results Although larger inspiratory dilatory movement was associated with increased drive to genioglossus (partial Spearman, r=0.23, p=0.016, n=115/68% of compartments), in 14% of the compartments (n=16), there was a large dilatory (>1mm) movement but minimal EMG (<4th percentile). This occurred only in the horizontal compartment. In another group of 18 compartments (16%), there was a large peak EMG (>4th percentile) but minimal dilatory movement (<1mm). This occurred more commonly in the oblique compartments. Dissociation between the amplitude of the peak EMG and inspiratory tongue dilatory movement was most commonly seen in severe OSA patients (AHI>30 events/h, Fisher's exact test, p=0.047). Conclusions Inspiratory tongue dilatory function generally remains closely linked to muscle drive during wakefulness, with larger movement associated with higher peak EMG. However, for approximately one-third of the neuromuscular tongue compartments, neural drive was dissociated from the dilatory motion in severe OSA patients. This may contribute to OSA pathogenesis and have implications for neural stimulation therapy targets.
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