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Hanff AM, Pauly C, Pauly L, Schröder VE, Hansen M, Meyers GR, Kaysen A, Hansen L, Wauters F, Krüger R. Unmet Needs of People With Parkinson's Disease and Their Caregivers During COVID-19-Related Confinement: An Explorative Secondary Data Analysis. Front Neurol 2021; 11:615172. [PMID: 33536999 PMCID: PMC7848016 DOI: 10.3389/fneur.2020.615172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/21/2020] [Indexed: 11/21/2022] Open
Abstract
Self-perceived unmet needs in people with typical and atypical parkinsonism (PwP) and their caregivers, support network, personalized ways to address self-perceived unmet needs during confinement, as well as the prevalence of self-reported COVID-19 related symptoms, confirmed SARS-CoV-2 infection, and self-reported COVID-19 related hospitalization in Luxembourg and the Greater Region were assessed. From 18th March to 10th April 2020, 679 PwP were contacted by phone. Data was collected in the form of a semi-structured interview. The thematic synthesis identified 25 themes where PwP need to be supported in order to cope with consequences of the pandemic, and to adapt their daily and health-related activities. The present work highlights that in the context of personalized medicine, depending on the individual needs of support of the patient the identified self-perceived unmet needs were addressed in various ways ranging from one-directed information over interaction up to proactive counseling and monitoring. Family and health professionals, but also other support systems were taking care of the unmet needs of PwP (e.g., shopping, picking-up medication, etc.) during the pandemic. 7/606 PwP (1.15%) reported COVID-19 related symptoms, 4/606 (0.66%) underwent a rRT-PCR-based diagnostic test and 2/606 (0.33%) were confirmed as SARS-CoV-2 positive. None of these PwP reported being hospitalized due to COVID-19. Our results will allow health professionals to expand their services in a meaningful way i.e., personalize their support in the identified themes and thus improve the healthcare of PwP in times of crisis.
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Schouten MJE, Nieuwenhuijsen K, Wind H, Andriessen S, Frings-Dresen MHW. Usability and consistency in findings of the work support needs assessment tool. Work 2021; 68:243-253. [PMID: 33427723 PMCID: PMC7902961 DOI: 10.3233/wor-203371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Structured work support needs assessment could facilitate professionals and increase assessment consistency. OBJECTIVES Evaluating usability of the Work Support Needs Assessment Tool and test if professionals' (labour experts, coaches) findings become more consistent after a tool training. The tool includes a 21 item checklist for assessing work support needs of people with disabilities. METHODS Usability was explored through 28 interviews with professionals. Consistency was evaluated in an experimental pre-post study design, in which thirty-nine other professionals assessed work support needs of standardized clients before and after a protocolized training. Quantitative content analysis was conducted. Consistency of findings between professionals covered three categories: type (client-focused coaching), focus (topics to be addressed) and duration of support. An increase in consistency was defined as a decrease in the total number of different sub-categories of findings in each category. RESULTS Nineteen professionals indicated that the tool was useful, as they gained relevant information and insights. Regarding consistency, the number of findings differed pre- and post-training for type of support (8 vs 9) and focus of support (18 vs 15 and 18 vs 17). CONCLUSIONS Participants had positive experiences with the tool. Increased consistency in findings of professionals after the training was not demonstrated with the current study design.
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Chang YH, Lai YH, Lee PH, Tsai MK, Shun SC. Unmet Care Needs and Related Factors of Spouses of Liver or Kidney Transplant Recipients. Clin Nurs Res 2021; 30:1038-1046. [PMID: 33403861 DOI: 10.1177/1054773820985289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to (1) explore the unmet care needs of spouses of liver or kidney transplant recipients, (2) compare the unmet care needs, depression, and anxiety levels of transplant recipients and their spouses, and (3) identify factors related to spouses' unmet care needs. A cross-sectional study was conducted using purposive sampling from transplant outpatient departments at a medical center. Ninety-one liver or kidney transplant recipient-spouse dyads were recruited. Most unmet needs for dyads were involved in the psychological needs and health system and service needs domains. Spouses had significantly higher unmet needs, anxiety, and depression than recipients did. The significant factors related to the spouses' unmet needs included being male, having higher anxiety, and whose partners had higher unmet needs. Health care professionals must attend to the needs of both recipients and spouses. Providing disease-specific information and resources to spouses who potentially had higher unmet needs is strongly suggested.
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Gomez-Sanchez-Lafuente C, Guzman-Parra J, Lopez-Zambrano MA, Moreno-Kustner B, Mayoral-Cleries F. Met and Unmet Needs in an Inpatient Psychiatry Setting in Spain. Neuropsychiatr Dis Treat 2021; 17:1859-1868. [PMID: 34135587 PMCID: PMC8197593 DOI: 10.2147/ndt.s307394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Patients with severe mental disorder have health and social needs that require care. The aim of the study was to determine the main areas of perceived needs among inpatients with severe mental disorders and to identify risk factors of the group of patients with the greatest unmet needs. PATIENTS AND METHODS A total of 150 patients with severe mental illness were assessed during admission prior to discharge from the hospital. Camberwell Assessment of Needs was used as evaluation measure, in addition to clinical status (The Brief Psychiatric Rating Scale), social functioning (Personal and Social Performance) and sociodemographic variables. A descriptive and a multivariate logistic regression analysis were used to analyse variables related to the group of patients with the highest number of unmet needs (≥3). RESULTS Mean number of needs was 7.93, being 4.61 the mean number of needs met and 3.32 the needs unmet. The highest proportion of unmet needs were intimate relationships (44.0%), company (40.7%) and daytime activities (38.7%). A relationship was also found between the presence of three or more unmet needs and the following variables: Brief Psychiatric Rating Scale score (p=0.004), Personal and Social Performance score (p = 0.013), marital status (p=0.018), employment status (p=0.009) and voluntary admission (p=0.032). The multivariate model explained 29.5% of the variance (Nagelkerke's R2: 0.295). CONCLUSION Treatments aimed at improving social relationships and daytime activities could be a good option for inpatients with many unmet needs.
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Ren J, Han D, Zhang J, Wang Y, Huang Q, Tian T, Li X. Development and Psychometric Testing of the Supportive Care Needs Scale for Patients with Tuberculosis (SCN-TB). Patient Prefer Adherence 2021; 15:2267-2278. [PMID: 34675491 PMCID: PMC8502070 DOI: 10.2147/ppa.s330225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Patients affected by tuberculosis have diverse unmet supportive care needs (SCN) that may seriously affect their treatment adherence. Accurately assessing patients' SCN is important for providing efficient patient-centred care, but few instruments are suitable for use in clinical practice. Therefore, the purpose of this study was to develop an SCN scale for patients with tuberculosis (SCN-TB) and to evaluate its psychometrical properties. PATIENTS AND METHODS Based on the SCN framework, the SCN-TB was designed via a literature review, Delphi consultation and pilot study. Then, 550 patients from four tuberculosis specialist hospitals in Shaanxi Province were enrolled by convenience sampling to further test the validity and reliability of the SCN-TB. RESULTS A total of 518 patients completed the survey. The final scale encompasses 25 items in five domains: physical, practical, psycho-emotional, social, and informational. The content validity for the scale was 0.93, with that for each item ranging from 0.80 to 1.00. Five factors that explained 80.38% of the variance were identified in exploratory factor analysis. A five-factor model was then confirmed with confirmatory factor analysis using maximum likelihood estimation with bootstrapping. The model fit indices were χ 2/df=1.062 (Bollen-Stine χ 2=281.382, df=265, p<0.001), CFI=0.997, RMSEA=0.016, SRMR=0.053, NFI=0.951, and GFI=0.929. All factors had acceptable convergent and discriminant validity. The Cronbach's α, split-half, and test-retest reliability coefficients of the scale were 0.884, 0.883, and 0.854, respectively. CONCLUSION The SCN-TB is a valid and reliable theory based tool for assessing the needs of patients with tuberculosis and can be applied in both clinical practice and research.
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Diasso D, Doudou MH, Levrak MC, Sedutto HD, Savadogo A. Municipalities' organisational capacity to support the implementation of the Multi-Sector Nutrition Plan in Burkina Faso. Glob Health Action 2021; 14:1979279. [PMID: 34586046 PMCID: PMC8491720 DOI: 10.1080/16549716.2021.1979279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Government of Burkina Faso committed to the multi-sector approach on nutrition in 2014 and has conducted the development of a Multi-Sector Nutrition Plan 2020–2024. This study aims to understand and analyse the Nutrition organizational capacities at the municipal level to support the scaling up of interventions within the National Multi-Sector Nutrition Plan. A qualitative study was conducted at the end of 2017, based on the framework for nutrition capacity developed by the United Nations Network Secretariat in collaboration with five funding agencies, to assess the organizational capacity dimension. Data collection consisted of focus groups and information collection through workshops with key informants. In total, 22 rural municipalities were targeted and 152 key informants were involved, including mayors, municipal councillors, members of the village development committee, and local technical agents in charge of agriculture, livestock and health. The gaps identified were poor integration of nutrition into local development strategic plans, less evolved coordination on nutrition, weak development of nutrition community approaches and dependence on the state budget matched to a non-existent budget monitoring system. The findings showed an unequal distribution and limited number of technical agents to cover villages within a given municipality, inadequate skills to support services expansions such as water and sanitation, health, agriculture and livestock. In addition, no reference was made to monitoring and evaluation, accountability or sharing information. The main capacity needs on nutrition are the transfer of technical competencies from the regional to the municipal level, the strengthening of technical skills on nutrition, and the setting up of an integrated data collection system involving key players. The identification of needs and opportunities and the newly finalized guide on nutrition integration into local development plans and strategies are useful to drive change for multisectoral implementation.
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Lynch KA, Omisore AD, Famurewa O, Olasehinde O, Odujoko O, Vera J, Kingham TP, Alatise OI, Egberongbe AA, Morris EA, Atkinson TM, Sutton EJ. Designing Participatory Needs Assessments to Support Global Health Interventions in Time-Limited Settings: A Case Study From Nigeria. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2021; 20:10.1177/16094069211002421. [PMID: 35185442 PMCID: PMC8855957 DOI: 10.1177/16094069211002421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Social scientists have advocated for the use of participatory research methods for Global Health project design and planning. However, community-engaged approaches can be time and resource-intensive. This article proposes a feasible framework for conducting a participatory needs assessment in time-limited settings using multiple, triangulated qualitative methods. This framework is outlined through a case study: a participatory needs assessment to inform the design of an ultrasound-guided biopsy training program in Nigeria. Breast cancer is the leading cause of death for Nigerian women and most cases in Nigeria are diagnosed at an advanced stage; timely diagnosis is impeded by fractious referral pathways, costly imaging equipment, and limited access outside urban centers. The project involved participant observation, surveys, and focus groups at the African Research Group for Oncology (ARGO) in Ile-Ife, Nigeria. Through this timely research and engagement, participants spoke about diagnostic challenges, institutional power dynamics, and infrastructure considerations for program implementation.
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Buchanan BM, Brindley PG, Bagshaw SM, Alherbish A, Daniels VJ. Development of a critical care ultrasound curriculum using a mixed-methods needs assessment and engagement of frontline healthcare professionals. Can J Anaesth 2021; 68:71-80. [PMID: 33089414 DOI: 10.1007/s12630-020-01829-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/27/2020] [Accepted: 08/05/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Experts recommend that critical care medicine (CCM) practitioners should be adept at critical care ultrasound (CCUS). Published surveys highlight that many institutions have no deliberate strategy, no formalized curriculum, and insufficient engagement of CCM faculty and trainees. Consequently, proficiency is non-uniform. Accordingly, we performed a needs assessment to develop an inter-professional standardized CCUS curriculum as a foundation towards universal basic fluency. METHODS Mixed-methods study of CCM trainees, attendings, and nurse practitioners working across five academic and community medical-surgical intensive care units in Edmonton, Alberta. We used qualitative focus groups followed by quantitative surveys to explore, refine, and integrate results into a curriculum framework. RESULTS Focus groups with 19 inter-professional practitioners identified major themes including perceived benefits, learning limitations, priorities, perceived risks, characteristics of effective instruction, ensuring long-term success, and achieving competency. Sub-themes highlighted rapid attrition of skill following one- to two-day workshops, lack of skilled faculty, lack of longitudinal training, and the need for site-based mentorship. Thirty-five practitioners (35/70: 50%) completed the survey. Prior training included workshops (16/35; 46%) and self-teaching (11/35; 31%). Eleven percent (4/35) described concerns about potential errors in CCUS performance. The survey helped to refine resources, content, delivery, and assessment. Integration of qualitative and quantitative findings produced a comprehensive curriculum framework. CONCLUSION Building on published recommendations, our needs assessment identified additional priorities for a CCUS curriculum framework. Specifically, there is a perceived loss of skills following short workshops and insufficient strategies to sustain learning. Addressing these deficits could narrow the gap between national recommendations and frontline needs.
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Lee J, Kim J. Can menstrual health apps selected based on users' needs change health-related factors? A double-blind randomized controlled trial. J Am Med Inform Assoc 2020; 26:655-666. [PMID: 30946478 DOI: 10.1093/jamia/ocz019] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/06/2019] [Accepted: 02/17/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Most healthcare providers are reluctant to use health apps for healthcare because there is no rigorous way of choosing the best app for their patient or consumer. Accordingly, we developed a new method of app selection that fully considers target users' needs. This study verified whether health apps selected based on target users' needs can influence health-related factors. MATERIALS AND METHODS We conducted a randomized control trial of women with dysmenorrhea and premenstrual syndrome using App A (the best app selected using the new method) and App B (the app with the highest number of users worldwide). The intervention was performed over 4 months to include at least 3 menstrual cycles. RESULTS Sixty-one app users completed the 16-week intervention. While users rated both apps as higher in quality than previously used menstrual apps, only App A users showed significant improvements in overall satisfaction, app outcome expectancy, the number of days with records, app social influence, intent to recommend, and the possibility of behavioral or cognitive changes in their symptom management. The number of menus used increased over time. While the app self-efficacy and the number of relief methods did not significantly differ between groups, they still showed an increase in App A users. CONCLUSIONS When a menstrual app reflected users' needs, they recorded their symptoms more often and reported higher app quality, satisfaction, and intention to recommend. This study can not only benefit the selection of menstrual apps, but also confirm that mobile health apps can improve health-related factors.
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Hendriks MJ, Harju E, Michel G. The unmet needs of childhood cancer survivors in long-term follow-up care: A qualitative study. Psychooncology 2020; 30:485-492. [PMID: 33217089 PMCID: PMC8048447 DOI: 10.1002/pon.5593] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Evidence suggests benefits of long-term follow-up care attendance for childhood cancer survivors, but studies show poor inclusion of survivorship issues and needs. While information needs of childhood cancer survivors have been addressed previously, few studies specifically investigated the supportive care needs of survivors beyond the domain of information and communication. Therefore, this qualitative study aimed to assess the unmet needs of childhood cancer survivors with regards to their long-term survivorship. METHODS Childhood Cancer Switzerland invited survivors of childhood cancer to participate in our study. We used semistructured interviews to assess survivors' experiences regarding the impact of their disease and the (un)met needs during their survivorship. Data analysis followed the principles of qualitative content analysis. RESULTS Interviews were conducted with 28 childhood cancer survivors (mean age 31 years, age at diagnosis 9 years, time since end of treatment 19 years). Key themes in relation to unmet needs of survivors were (1) lacking psychosocial support, (2) lacking collaboration and decentralization of care, (3) starting from zero, and (4) need for centralized, specialized, and individualized services. CONCLUSIONS Our findings revealed a demand for integrating psychosocial support in long-term follow-up care and a strong need for personalized, centralized, and interdisciplinary long-term follow-up care. Current established interdisciplinary clinics should be further extended to provide centralized, personalized, and evidence-based long-term follow-up care including adequate psychosocial support for all childhood cancer survivors.
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Santric-Milicevic M, Vasic M, Vasic V, Zivkovic-Sulovic M, Cirovic D, Lackovic M, Boskovic N. Uptake of Health Care Services by Refugees: Modelling a Country Response to a Western Balkan Refugee Crisis. Healthcare (Basel) 2020; 8:healthcare8040560. [PMID: 33327581 PMCID: PMC7765010 DOI: 10.3390/healthcare8040560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 11/16/2022] Open
Abstract
Planning and adjusting health capacities to meet the needs of refugees is a constant issue for transit and destination countries following the 2015/2016 Western Balkans refugee crisis. Understanding this crisis is important for taking the right steps in the future. The study informs about the prediction of the refugees’ health needs and demands for services in correspondence to political decision-making during 2015/2016 Western Balkan Refugee Crisis. Time series analysis, linear regression, and correlation analyses modelled the weekly flux of arrivals of more than half a million refugees to Serbia and the European Union, changes in the utilization of health care services, and disease diagnoses. With strategic planning, in the event of a recurrence of the refugee crises, the demand for health care services in the transit country could increase by 63 (95% CI: 21–105) for every additional 1000 refugees.
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Levy K, Grant PC, Clem K, Eadie DS, Rossi JL. Holding onto Hurt: The Prevalence of Interpersonal Hurt and Need for Forgiveness-Focused Solutions for Hospice Family Caregivers. J Palliat Med 2020; 24:1139-1146. [PMID: 33305995 DOI: 10.1089/jpm.2020.0521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Interpersonal hurt or offenses are common human experiences. Bereavement may be impacted for caregivers of a terminally ill loved one when these experiences occur. Objective: To determine the prevalence and impact of interpersonal hurt-based experiences for hospice caregivers and interest in forgiveness-based support. Design: Cross-sectional, mixed methods needs assessment. Settings/Subjects: Bereaved hospice caregivers (n = 162) and direct care hospice clinicians (n = 133) were surveyed through mail-in and online surveys. Measurements: Participants completed ad hoc surveys to assess prevalence and impact of interpersonal hurt experiences and interest in forgiveness-based support. Bereaved caregivers also completed the Core Bereavement Items (CBI). Results: 41.98% of the bereaved experienced an interpersonal hurt or offense during the care or passing of their loved one. Those with hurt experiences felt highly impacted (63.2%), "sometimes" or "often" revisited the experience (91.2%), felt that their bereavement was affected (61.5%), and experienced physical symptoms (46.3%). CBI scores positively correlated with the impact of the experience. Hurt caregivers had higher CBI scores compared with those who did not. Of those who had not forgiven the offender, 46.3% felt that they could benefit from forgiveness-based support services. Qualitative analysis revealed themes of Disagreements with Decisions, Lack of Support, Relational Interactions, and Impact on Bereavement. Clinician responses supported these results. Conclusions: Interpersonal hurt experiences can greatly impact the offended caregiver during caregiving and in bereavement. However, it should be noted that the decision to forgive is ultimately a personal choice and therefore forgiveness-based for forgiveness-specific interventions may not be appropriate for all individuals. Future research should assess the feasibility and usefulness of this type of support for caregivers and the bereaved.
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Stochitoiu IA, Vadeboncoeur C. Adaptation and Feasibility of the interRAI Family Carer Needs Assessment in a Pediatric Setting. Health Serv Insights 2020; 13:1178632920972655. [PMID: 33281455 PMCID: PMC7686600 DOI: 10.1177/1178632920972655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/14/2020] [Indexed: 11/24/2022] Open
Abstract
Family carers of children with serious illness contribute many hours of medical
care in addition to usual daily care. Assessing the needs and supports of family
carers is not routine practice. This study is the first to utilize the interRAI
Family Carer Needs Assessment in carers of children, seeking to evaluate and
improve its ability to capture their needs. This is a prospective pilot study of
family carers of children with serious illness receiving care at a pediatric
hospice. Thirty carers completed the self-assessment form. Additional feedback
was sought inquiring about the appropriateness of questions and missing
information relevant to the pediatric setting. All participants reported the
assessment captured important information across multiple domains. Additional
questions surrounding extra costs, home and school supports, as well as direct
impacts of caregiving activities on pain and relationships were identified as
important adaptations. The most common unmet needs in carers and care recipients
were episodic relief from caregiving (n=17) and housing adaptation (n=17),
respectively. Overall, a comprehensive assessment form is feasible in
identifying the diverse needs of family carers of children. Future research
should focus on using pediatric specific interRAI tools to guide improvements in
policy and practice that can address unmet needs.
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Hill TF, Stark CM, Sellers DE, Dollahite JS. Training Needs of Nutrition Educators Engaged in Policy, Systems, and Environmental Approaches. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:1131-1138. [PMID: 32896472 DOI: 10.1016/j.jneb.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/09/2020] [Accepted: 07/19/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Assess training needs of nutrition educators incorporating policy, systems, and environmental (PSE) approaches into their obesity prevention efforts, to identify content for online training. METHODS Conducted a national, online survey of state and local Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program Education professionals engaged in PSE efforts. RESULTS Respondents (n = 601) rated the importance of 24 training topics related to planning, implementing, and evaluating PSE approaches. Most (21) topics were rated very important or essential, confirming the need for a comprehensive approach. Paired-sample t tests found significant differences (P <0.001) in some training needs between local and state staff (eg, training in evaluation rated higher for state staff). Training needs did not differ by program, region, or length of employment. The top 5 settings for PSE efforts were schools, farmers' markets, food banks/pantries, community gardens, and after-school programs. CONCLUSIONS AND IMPLICATIONS Results informed the development of an online training for program implementers. Future research will be needed to assess and refine training needs further, which will evolve as nutrition educators gain more experience in PSE approaches.
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Abell K, Hopkin RJ, Bender PL, Jackson F, Smallwood K, Sullivan B, Stottmann RW, Saal HM, Weaver KN. Mandibulofacial dysostosis with microcephaly: An expansion of the phenotype via parental survey. Am J Med Genet A 2020; 185:413-423. [PMID: 33247512 DOI: 10.1002/ajmg.a.61977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/09/2020] [Accepted: 10/30/2020] [Indexed: 11/11/2022]
Abstract
Mandibulofacial dysostosis with microcephaly (MFDM) is due to haploinsufficiency of spliceosomal GTPase EFTUD2. Features include microcephaly, craniofacial dysmorphology, developmental disability, and other anomalies. We surveyed parents of individuals with MFDM to expand knowledge about health, development, and parental concerns. Participants included attendees of the inaugural MFDM family conference in June 2019 and members of the MFDM online group. To explore MFDM variable expressivity, we offered targeted Sanger sequencing for untested parents. Forty-seven parents participated in the survey. 59% of individuals with MFDM were male, with mean age 6.4 years (range 8 months to 49 years). Similar to the literature (n = 123), common features include microcephaly, cleft palate, choanal stenosis, tracheoesophageal fistula, heart problems, and seizures. New information includes airway intervention details, age-based developmental outcomes, rate of vision refractive errors, and lower incidences of prematurity and IUGR. Family concerns focused on development, communication, and increased support. Targeted Sanger sequencing for families of seven individuals demonstrated de novo variants, for a total of 91.9% de novo EFTUD2 variants (n = 34/37). This study reports the largest single cohort of individuals with MFDM, expands phenotypic spectrum and inheritance patterns, improves understanding of developmental outcomes and care needs, and identifies development as the biggest concern for parents.
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Kornegay EC, Jackson TH, LaGarry-Cahoon A, Reside JM, Wolcott MD, Quinonez RB. "I don't think the problem's the student…I think it's us": Engaging faculty in curriculum innovation. J Dent Educ 2020; 85:582-588. [PMID: 33289087 DOI: 10.1002/jdd.12495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/27/2020] [Accepted: 11/14/2020] [Indexed: 11/08/2022]
Abstract
PURPOSE The need to innovate predoctoral dental education is well established; however, there are few recent reports to guide substantial curriculum transformation. The purpose of this study was to describe faculty perspectives on their vision of future graduates, curriculum needs, and potential barriers to a successful redesign. This information would be used to inform strategic planning for the predoctoral curriculum transformation. METHODS Eighty full-time faculty from the University of North Carolina Adams School of Dentistry participated in 60-minute focus groups in March 2018. Focus group questions were developed to elicit perceptions about the current curriculum, what the dental graduate should know in 2040, and what is needed to engage faculty in curriculum change. Transcripts of the focus group sessions were analyzed by a third-party research group using qualitative thematic analysis to identify pertinent themes shared by participants. RESULTS Faculty identified that developing clinical skill that engages multiple specialties, student time to engage in advocacy activities, and opportunities to integrate biomedical, clinical, and behavioral sciences as critical features of the curriculum. They believed the 2040 graduate should be able to critically evaluate literature, exhibit strong leadership skills, and adapt to the changing healthcare environment. To better engage faculty in curriculum change, there needs to be dedicated time, sufficient resources, a clear plan, and greater collaboration across the school. CONCLUSION When embarking on curriculum transformation, engagement with faculty is a critical component of the change process. Focus groups can be used as a technique to better understand faculty perspectives about curricular needs and the overall vision.
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Moradi P, Omid A, Yamani N. Needs assessment of the public health curriculum based on the first-level health services package in Isfahan University of Medical Sciences. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:314. [PMID: 33426118 PMCID: PMC7774605 DOI: 10.4103/jehp.jehp_82_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/14/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION After graduation, public health students should be able to work as health care givers providing first-level health care services. Therefore, the educational objectives of public health bachelor's programs should ensure that they acquire the capabilities necessary for this purpose. This study identified the educational objectives that are essential for these students and compared them with the current curriculum in Isfahan, Iran. METHODS This needs assessment study was conducted in two phases. In the first phase, the essential educational objectives were identified using a qualitative approach, which involved eight focus group discussions held by a group consisting of experts of the public health headquarters and public health network administration offices of Isfahan province and the public health graduates working in the province's comprehensive health service centers, who were chosen using the purposive sampling method (n = 59). In the second phase, a comparative study was performed by turning the list of essential educational objectives into a checklist and using it to compare these objectives with the objectives in the current course plan in the examined curriculum. In the end, a list of educational objectives not included in the current curriculum of the public health bachelor's program was created. RESULTS The focus group discussions produced 433 educational objectives in the cognitive domain, 79 objectives in the affective domain, and 179 objectives in the psychomotor domain, which were arranged in eight competency categories. Comparison of the essential educational objectives with the current curriculum showed that the current curriculum does not cover any of the essential objectives regarding care for the age groups of 18-29 and 30-59 and the first aid and only partially covers essential objectives in other competency categories. CONCLUSION This study found that considering the requirements of first-level health services and the tasks expected from public health graduates to be providing these services, the current curriculum does not cover all essential learning objectives and should be revised to meet additional essential educational objectives.
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Rogers SN, Semple CJ, Humphris GM, Lowe D, Kanatas A. Using the Patient Concerns Inventory in the identification of fatigue following treatment for head and neck cancer. Int J Oral Maxillofac Surg 2020; 50:865-872. [PMID: 33250271 DOI: 10.1016/j.ijom.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/10/2020] [Accepted: 11/02/2020] [Indexed: 11/27/2022]
Abstract
Fatigue has a profound impact on health-related quality of life (HRQOL). The aim of this study was to describe the clinical characteristics and HRQOL of head and neck cancer patients who raised the issue of fatigue on the Patient Concerns Inventory (PCI) at their review consultation. Eight consultants were randomized to use the PCI as part of a cluster-controlled trial. Patients also completed the University of Washington Quality of Life version 4 (UWQOL), EQ-5D-5L (EuroQol Group), and Distress Thermometer questionnaires. The study included 140 patients who attended clinics at a median of 108 (interquartile range 70-165) days after the end of treatment. The PCI item 'fatigue' was the sixth most commonly selected, by 29% (n=40). Those with advanced tumours were more likely to have selected the item (30/84, 36% vs 10/56, 18%; P=0.02), as were those treated with radiotherapy±chemotherapy (34/87, 39% vs 6/53, 11%; P<0.001). The PCI fatigue group reported significantly worse overall quality of life, social-emotional and physical function composite scores (UWQOL), Distress Thermometer, and EQ-5D-5L. PCI fatigue was common in those with sleeping, nausea, mood, depression, mobility, breathing, and energy level concerns. In conclusion, given the problems associated with fatigue, it is appropriate to screen and seek interventions that might help patients address this.
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Plant N, Šumilo D, Chapman R, Webber J, Saravanan P, Nirantharakumar K. Unmet needs of women with GDM: a health needs assessment in Sandwell, West Midlands. J Public Health (Oxf) 2020; 42:e516-e524. [PMID: 31822919 DOI: 10.1093/pubmed/fdz172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) affects over 4% of pregnancies in England. We investigated GDM epidemiology within ethnically diverse population and the current offer of services to women with previous GDM to reduce their type 2 diabetes mellitus (T2DM) risk. METHODS (i) Analysis of routinely collected maternity data examining GDM incidence and risk factors; (ii) local authority self-assessment questionnaire on public health interventions targeting women with previous GDM and (iii) service development discussions regarding the current pathway and areas for improvement. RESULTS Of 9390 births between 2014 and 2018, 6.8% had a record of GDM. High body mass index (BMI), maternal age, and ethnicity (South Asian and some mixed ethnic backgrounds) were independent predictors of GDM. There were no public health commissioned services specifically targeting women with previous GDM. Weaknesses in transition from secondary to primary care and areas for improvement when screening for GDM were identified. CONCLUSIONS GDM burden in this population was high. Awareness should be raised on the importance of regular glucose testing and lifestyle modification to delay or prevent progression to T2DM, particularly within high risk groups. The potential for health visitors to contribute to this should be explored. Commissioners should review evidence to develop a flexible lifestyle services model to meet the specific needs of these women.
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Forner D, Hong P, Corsten M, Rac VE, Martino R, Shuman AG, Chepeha DB, Sawka AM, de Almeida JR, Irish JC, Brown DH, Taylor SM, Gullane PJ, Trites JR, Gilbert R, Rigby MH, Ringash J, Goldstein D. Needs assessment for a decision support tool in oral cancer requiring major resection and reconstruction: a mixed-methods study protocol. BMJ Open 2020; 10:e036969. [PMID: 33234615 PMCID: PMC7684801 DOI: 10.1136/bmjopen-2020-036969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Advanced oral cancer and its ensuing treatment engenders significant morbidity and mortality. Patients are often elderly with significant comorbidities. Toxicities associated with surgical resection can be devastating and they are often highlighted by patients as impactful. Given the potential for suboptimal oncological and functional outcomes in this vulnerable patient population, promotion and performance of shared decision making (SDM) is crucial.Decision aids (DAs) are useful instruments for facilitating the SDM process by presenting patients with up-to-date evidence regarding risks, benefits and the possible postoperative course. Importantly, DAs also help elicit and clarify patient values and preferences. The use of DAs in cancer treatment has been shown to reduce decisional conflict and increase SDM. No DAs for oral cavity cancer have yet been developed.This study endeavours to answer the question: Is there a patient or surgeon driven need for development and implementation of a DA for adult patients considering major surgery for oral cancer? METHODS AND ANALYSIS This study is the first step in a multiphase investigation of SDM during major head and neck surgery. It is a multi-institutional convergent parallel mixed-methods needs assessment study. Patients and surgeon dyads will be recruited to complete questionnaires related to their perception of the SDM process (nine-item Shared Decision-Making Questionnaire, SDM-Q-9 and SDM-Q-Doc) and to take part in semistructured interviews. Patients will also complete questionnaires examining decisional self-efficacy (Ottawa Decision Self-Efficacy Scale) and decisional conflict (Decisional Conflict Scale). Questionnaires will be completed at time of recruitment and will be used to assess the current level of SDM, self-efficacy and conflict in this setting. Thematic analysis will be used to analyse transcripts of interviews. Quantitative and qualitative components of the study will be integrated through triangulation, with matrix developed to promote visualisation of the data. ETHICS AND DISSEMINATION This study has been approved by the research ethics boards of the Nova Scotia Health Authority (Halifax, Nova Scotia) and the University Health Network (Toronto, Ontario). Dissemination to clinicians will be through traditional approaches and creation of a head and neck cancer SDM website. Dissemination to patients will include a section within the website, patient advocacy groups and postings within clinical environments.
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Alsoghier A, Riordain RN, Fedele S, Liew C, Porter S. Information needs and oral epithelial dysplasia: Development and psychometric evaluation of a novel instrument. Oral Dis 2020; 28:76-86. [PMID: 33200486 DOI: 10.1111/odi.13726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/17/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Oral epithelial dysplasia (OED) can lead to significant information needs (IN) related to the risk of cancer development, the need for long-term monitoring and potential intervention. The present study aimed to develop and perform preliminary psychometric testing for a novel IN instrument specific to OED. SUBJECTS AND METHODS Patients diagnosed with OED were invited to complete the Oral Epithelial Dysplasia Informational Needs Questionnaire (ODIN-Q), which was developed based on a known theoretical framework and with items generated via expert input and the literature. Face validity and content validity were initially assessed prior to finalisation of the tool. ODIN-Q was tested for internal consistency and test-retest reliability along with construct validity. RESULTS ODIN-Q consists of 35 items, categorised under six domains, and rated by dual 4-point Likert scales (amount of information received and degree of importance). Internal consistency (Cronbach's alpha) was rated "excellent" for the scale (0.93) and both subscales (0.92/0.94). For test-retest reliability, moderate agreement was found (κ = 0.49-0.53). Regarding construct validity, a significant but limited relationship was found between ODIN-Q and the Krantz Health Opinion Survey. CONCLUSION ODIN-Q showed adequate psychometric properties of reliability and validity. Further validation is, however, needed to assess its structural validity and responsiveness.
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Nicol GE, Ricchio AR, Metts CL, Yingling MD, Ramsey AT, Schweiger JA, Miller JP, Lenze EJ. A Smartphone-Based Technique to Detect Dynamic User Preferences for Tailoring Behavioral Interventions: Observational Utility Study of Ecological Daily Needs Assessment. JMIR Mhealth Uhealth 2020; 8:e18609. [PMID: 33055063 PMCID: PMC7695533 DOI: 10.2196/18609] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/14/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023] Open
Abstract
Background Mobile health apps are promising vehicles for delivering scalable health behavior change interventions to populations that are otherwise difficult to reach and engage, such as young adults with psychiatric conditions. To improve uptake and sustain consumer engagement, mobile health interventions need to be responsive to individuals’ needs and preferences, which may change over time. We previously created an ecological daily needs assessment to capture microprocesses influencing user needs and preferences for mobile health treatment adaptation. Objective The objective of our study was to test the utility of a needs assessment anchored within a mobile app to capture individualized, contextually relevant user needs and preferences within the framework of a weight management mobile health app. Methods Participants with an iOS device could download the study app via the study website or links from social media. In this fully remote study, we screened, obtained informed consent from, and enrolled participants through the mobile app. The mobile health framework included daily health goal setting and self-monitoring, with up to 6 daily prompts to determine in-the-moment needs and preferences for mobile health–assisted health behavior change. Results A total of 24 participants downloaded the app and provided e-consent (22 female; 2 male), with 23 participants responding to at least one prompt over 2 weeks. The mean length of engagement was 5.6 (SD 4.7) days, with a mean of 2.8 (1.1) responses per day. We observed individually dynamic needs and preferences, illustrating daily variability within and between individuals. Qualitative feedback indicated preferences for self-adapting features, simplified self-monitoring, and the ability to personalize app-generated message timing and content. Conclusions The technique provided an individually dynamic and contextually relevant alternative and complement to traditional needs assessment for assessing individually dynamic user needs and preferences during treatment development or adaptation. The results of this utility study suggest the importance of personalization and learning algorithms for sustaining app engagement in young adults with psychiatric conditions. Further study in broader user populations is needed.
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Alves S, Ribeiro O, Paúl C. Unmet needs of informal carers of the oldest old in Portugal. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2408-2417. [PMID: 32548965 DOI: 10.1111/hsc.13063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 05/13/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
Oldest-old individuals are a growing segment of the population that faces several challenges in terms of care demands. Informal caregivers experience more or less challenges, namely depending on the support they can access. The present study explores the unmet needs of a sample of informal caregivers of community-dwelling older adults aged 80+ and analyses the association of such needs with sociodemographic information, care-giving context (e.g., length of care),and health characteristics of the caregivers and care receivers (e.g., cognitive status and functionality). We recruited 175 care-giving dyads from the North of Portugal. Descriptive statistics summarised the sample's characteristics. Informal caregivers were mainly women with a mean age of 60.6 years (SD = 9.8). Care receivers' mean age was 88.7 years (SD = 5.6) and were functionally dependent (9.3 points [SD = 7.0] and 27.0 points [SD = 3.5] for Basic and Instrumental Activities of Daily Living, respectively). A thematic analysis of an open-ended question on unmet needs was performed, revealing the presence of unmet needs. The most relevant ones (financial support, caregiver support, primary care/medical specialities, and labour regulation) were further analysed, concerning the care-giving dyad's using Independent Student's t test or Mann-Whitney U Tests, and Chi-squared test or Fisher's Exact test depending on the variable. The most frequent unmet needs were associated with the caregiver's age, care receivers' kinship, number of care-giving hours, the caregiver's gender, professional status, the caregiver strain and medicines intake. Findings suggest the need for establishing policies that ensure adequate sustainability of the provision of informal care that takes into account the needs of care-giving dyads in the planning process.
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Bronson B, Perlman G. The Management Experiences, Priorities, and Challenges of Medical Directors in the Subspecialty of Consultation-Liaison Psychiatry: Results of a Needs Assessment. J Acad Consult Liaison Psychiatry 2020; 62:309-317. [PMID: 33092820 DOI: 10.1016/j.psym.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/17/2020] [Accepted: 09/17/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Medical directors need management skills, yet few studies describe the specific tasks that directors consider most important, their confidence for these tasks, and how their confidence develops. We studied these questions among directors in the subspecialty of Consultation-Liaison Psychiatry. METHODS A needs survey was sent to 48 registrants of a new forum for Consultation-Liaison Psychiatry directors. The survey asked about 6 professional experiences, the relative importance of 14 management tasks, and the directors' confidence in managing these tasks, using 7-point Likert scales. Correlations between experiences, task importance, and task confidence were performed. RESULTS Twenty-seven directors responded (56% response). The experiences that correlated most with management confidence were years in practice and health care leadership training, yet approximately half of responders were directors for ≤5 years and had received minimal training. Management tasks with the highest importance included demonstrating value of their service and roles for nonphysician clinical staff on their teams. Significant associations were identified between years in practice and confidence for leading faculty scholarship, trainee staffing ratios and roles, fee coding, measurement of faculty clinical productivity, and faculty recruitment. Leadership training correlated with confidence in demonstrating service value, measuring faculty clinical productivity, novel models of care, and growing a new service. CONCLUSION Consultation-Liaison directors with fewer years of experience and minimal health care management training need time and support to grow into their roles. They should be pointed toward training opportunities to improve their confidence to lead the wide range of management tasks that are important to their roles.
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Hall R, Rutledge J, Colón-Emeric C, Fish LJ. Unmet Needs of Older Adults Receiving In-Center Hemodialysis: A Qualitative Needs Assessment. Kidney Med 2020; 2:543-551.e1. [PMID: 33094273 PMCID: PMC7568084 DOI: 10.1016/j.xkme.2020.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Rationale & Objective Attention to geriatric impairments is not routinely provided to older adults receiving dialysis. Our objective was to identify patient and personnel perspectives on experiences with geriatric problems, unmet needs that may affect a patient’s ability to maintain his or her functional status, and preferences for design of a geriatric model of care tailored to address the unmet needs. Study Design Qualitative study using semi-structured interviews and focus groups. Setting & Participants 14 hemodialysis patients 55 years and older and 24 dialysis unit personnel (eg, nephrologists, nurses, patient care technicians, and social workers) representing 5 dialysis units. Analytical Approach Content analysis to identify themes reflecting unmet needs and design considerations for a geriatric model of care for older adults receiving dialysis. Results 4 themes (or unmet needs) identified from both patient and personnel transcripts were: (1) mobility, which referred to the insufficient mobility assessment and transportation services; (2) medications, which referred to insufficient attention to appropriate prescribing and medication self-management; (3) social support, which referred to insufficient support for activities of daily living and emotional problems; and (4) communication, which referred to insufficient patient-provider and interprofessional communication, including data transfer across separate health systems. Although participants generally acknowledged that an integrated model of care could result in benefits across all 4 areas of unmet need, they noted that the program design would need to minimize disruption of current workflow and practices in dialysis units. Limitations The findings may not be broadly representative of all older adults receiving dialysis and dialysis unit personnel. Conclusions There is insufficient attention to mobility, medication management, social support, and communication needs for older adults receiving in-center hemodialysis. Addressing these unmet needs in a geriatric model of care and measuring its effectiveness are areas of future research.
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