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Kindblom K, Edvardsson D, Boström AM, Vikström S. A learning process towards person-centred care: A second-year follow-up of guideline implementation. Int J Older People Nurs 2021; 16:e12373. [PMID: 33739623 DOI: 10.1111/opn.12373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 11/24/2020] [Accepted: 02/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Research claims that 'learning by doing' creates new thinking, often leading to new practice. OBJECTIVES The aim was to explore and describe the staff learning process from the first to the second year when adopting person-centred care into clinical practice in a nursing home for persons with dementia. METHOD The data consisted of poster texts from staff and written notes by researchers obtained from the group discussions. The study involved 24 care units (200 staff). Content analysis was chosen as method to explore the learning process. RESULT The staff described the actions that they took during year 1 and year 2, in which five categories emerged, activities, environment, information, priorities and staff routines. With researchers' analysis the categories together created the learning process and formed a sub-theme. They further formed an overarching theme from simplicity to complexity and consensus. Staff changes year 1 pertained more to planning and doing, while year 2 changes constituted a larger complexity of person-centred care with reflection, collaborative learning and a mind-set change. CONCLUSION Staff chose the development area, and the learning process was illuminated by the researchers. This underscores the value to visualise and verbalise the steps of change as well as include these steps in the design of an implementation process. The concept of person-centred care could be viewed on different levels. The findings may contribute to a more comprehensive understanding of staff learning process when implementation of person-centred care. IMPLICATIONS FOR PRACTICE Making staff's learning process visible can be a guide for improvement and change from a generic care towards person-centred care. The Regional Board of Research Ethics approved the study (Reg no. 2010/1234-31/5).
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Tseng LM, Lien PJ, Huang CY, Tsai YF, Chao TC, Huang SM. Developing a Web-Based Shared Decision-Making Tool for Fertility Preservation Among Reproductive-Age Women With Breast Cancer: An Action Research Approach. J Med Internet Res 2021; 23:e24926. [PMID: 33729164 PMCID: PMC8074988 DOI: 10.2196/24926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 01/08/2021] [Accepted: 02/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background The pregnancy rate after cancer treatment for female survivors is lower than that of the general population. Future infertility is a significant concern for patients with breast cancer and is associated with a poor quality of life. Reproductive-age patients with breast cancer have safe options when choosing a type of fertility preservation method to be applied. Better information and support resources aimed at women to support their decision making are needed. Objective The objective of this study was to develop a web-based shared decision-making tool for helping patients with breast cancer make decisions on fertility preservation. Methods We used the action research cycle of observing, reflecting, planning, and acting to develop a web-based shared decision-making tool. The following four phrases were applied: (1) observe and reflect—collect and analyze the decision-making experiences of patients and health care providers; (2) reflect and plan—apply the initial results to create a paper design and modify the content; (3) plan and act—brainstorm about the web pages and modify the content; (4) act and observe—evaluate the effectiveness and refine the website’s shared decision-making tool. Interviews, group meetings, and constant dialogue were conducted between the various participants at each step. Effectiveness was evaluated using the Preparation for Decision-Making scale. Results Five major parts were developed with the use of the action research approach. The Introduction (part 1) describes the severity of cancer treatment and infertility. Options (part 2) provides the knowledge of fertility preservation. The shared decision-making tool was designed as a step-by-step process (part 3) that involves the comparison of options, patient values, and preferences; their knowledge regarding infertility and options; and reaching a collective decision. Resources (part 4) provides information on the hospitals that provide such services, and References (part 5) lists all the literature cited in the website. The results show the web-based shared decision-making meets both patients’ and health providers’ needs and helps reproductive-age patients with breast cancer make decisions about fertility preservation. Conclusions We have created the first web-based shared decision-making tool for making fertility preservation decisions in Taiwan. We believe female patients of reproductive age will find the tool useful and its use will become widespread, which should increase patient autonomy and improve communication about fertility preservation with clinicians. Trial Registration Clinicaltrials.gov NCT04602910; https://clinicaltrials.gov/ct2/show/NCT04602910
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Cabilan CJ, Eley R, Snoswell CL, Johnston ANB. What can we do about occupational violence in emergency departments? A survey of emergency staff. J Nurs Manag 2021; 30:1386-1395. [PMID: 33723863 DOI: 10.1111/jonm.13294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
AIMS To explore and collate solutions for occupational violence from emergency department (ED) staff. BACKGROUND Despite publications highlighting the progressively worsening issue of occupational violence in EDs and its detrimental impacts, few strategies aimed to reduce or manage it have been discussed in the literature. METHODS This was a cross-sectional study involving ED staff. Participants completed an electronic survey that prompted interventions for occupational violence. Free-text data were analysed and logically categorized using validated techniques. RESULTS Participants (N = 81) suggested 24 interventions: 12 were classified as prevention strategies, 10 as response strategies and two as recovery strategies. Prevention and response strategies for occupational violence targeted key participants: patients, staff and ED environment. Recovery strategies centred around staff management of the personal impacts of incidences of occupational violence and on systems in place to support them after occupational violence incidents. CONCLUSION Solutions to occupational violence should be multifaceted encompassing prevention, response and recovery for patients, staff and the ED environment. IMPLICATIONS FOR NURSING MANAGEMENT No single, universal intervention can be endorsed to reduce or mitigate the impacts of occupational violence in EDs. However, a combination of the interventions (strategies) discussed in this paper can be recommended.
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Bekkema N, Niemeijer A, Frederiks B, de Schipper C. Exploring restrictive measures using action research: A participative observational study by nursing staff in nursing homes. J Adv Nurs 2021; 77:2785-2795. [PMID: 33719113 DOI: 10.1111/jan.14825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 01/18/2021] [Accepted: 02/23/2021] [Indexed: 12/01/2022]
Abstract
AIM In nursing homes, nursing staff have a key role in the use of restrictive measures. However, their active role in reducing restrictive measures has so far been limited. The aim of this study is to explore how and when the application of restrictive measures in nursing homes occurs including underlying factors, together with nursing staff. DESIGN Participatory action research was chosen for a bottom-up understanding of the use of restrictive measures. METHOD Two Dutch nursing homes participated in 2016/2017 with 18 nursing staff members in the action research team. Nursing staff carried out 33 observations followed by a reflective interview. RESULTS Nursing staff observed a wide range of restrictions, including restrictions in freedom of choice, not being able to go outside, not being in charge of medication, and a directive/unresponsive care attitude. Factors influencing restrictions included habits and institutionalization, cognitive ability of the resident, availability of personnel, and responsibility for safety. A responsive care attitude and raising awareness were seen as good practices to enhance freedom. CONCLUSIONS By taking a distant view on their work, nursing staff discovered a broad range of restrictions, including 'less obvious' restrictions. Active forms of learning may position nursing staff to discuss and reduce restrictive measures. IMPACT What problem did the study address?: Restrictive measures are still common in nursing homes. Despite their key role in using restrictive measures, nursing staff's active role in research has been limited. What were the main findings?: By participating as researchers, nursing staff gained a broader perspective on restrictive measures. Many 'less obvious' restrictions were related to routines and institutionalization and were considered as eye opening by nursing staff. Where and on whom will the research have impact?: Active forms of learning such as observing and reflecting has the potential to position nursing staff as 'agents of change'.
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Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study. Int J Integr Care 2021; 21:11. [PMID: 33716594 PMCID: PMC7934796 DOI: 10.5334/ijic.5575] [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] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to co-create a definition and generic descriptors for person-centred coordinated care for Ireland generated from service users’ narratives. An overarching action research approach was used to engage and empower people to tangibly impact health policy and practice. Through focus groups and a qualitative survey, primary data were collected from a national sample of health services users, caregivers and health care service users’ representative groups. Thematic analysis was used to analyse the data. Three major themes were co-produced as essential care elements. These were: ‘My experience of healthcare’, ‘Care that I am confident in’ and ‘My journey through healthcare’. Through an IPPOSI partner project steering group and their membership groups’ contribution, these themes were further refined into a definition of person-centred coordinated care and nineteen related generic descriptors. Key findings demonstrate that within complex, fragmented healthcare systems, the subjective expectations of service users should be integrated into care delivery, with a scaffolding of services to meet service users’ needs between care settings and disciplines and over time.
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Higa C, Davidson EJ, Loos JR. Integrating family and friend support, information technology, and diabetes education in community-centric diabetes self-management. J Am Med Inform Assoc 2021; 28:261-275. [PMID: 33164074 DOI: 10.1093/jamia/ocaa223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 09/01/2020] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Diabetes self-management (DSM) education, social support, and information technology interventions can improve patient engagement and health. A major challenge is animating, integrating, and accessing resources in under-resourced, rural communities. Set in an island community in Hawai'i, this study piloted a program that integrated friend-and-family support, community health services, telehealth-enabled DSM education, and mobile technologies by activating the community's social capital to support the program. MATERIALS AND METHODS An action research approach informed the design and implementation of a community-based DSM program that included: friends and family support, telehealth classes, personalized consultations, Bluetooth-enabled blood glucose monitors, and text messaging support. Outcomes were evaluated using biometric data, surveys, interviews, and participant observations. RESULTS The study spanned 9 months with 7 dyads, each with 1 individual with type 2 diabetes and a friend or family member. Six of the 7 participants with diabetes experienced reduced hemoglobin A1c percentages, with 3 reducing by more than 1%. The seventh participant maintained a hemoglobin A1c level within American Diabetes Association recommended ranges. DSM knowledge and self-care behaviors improved overall. Interviews and participant observations highlighted program strengths and social challenges associated with the interpersonal relationships between the members of the dyads. CONCLUSIONS A community-centric diabetes program can enhance understanding of diabetes etiology, DSM activities, and communication skills for effective disease management support in under-resourced rural communities. Social capital among community members, leveraged with health information technology, can catalyze and integrate limited health system resources for DSM and social support as a cost-effective strategy to develop community-centric chronic healthcare management initiatives.
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Chen SH, Liu JE, Bai XY, Yue P, Luo SX. Providing targeted psychological support to frontline nurses involved in the management of COVID-19: An action research. J Nurs Manag 2021; 29:1169-1179. [PMID: 33480133 PMCID: PMC8013568 DOI: 10.1111/jonm.13255] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/06/2020] [Accepted: 01/15/2021] [Indexed: 12/29/2022]
Abstract
Aim To develop and implement a targeted psychological support scheme for frontline nurses involved in the management of coronavirus disease 2019 (COVID‐19). Background Nurses play a vital role in managing the ongoing COVID‐19 pandemic, while confronting enormous challenges and psychological problems. Methods Action research design was adopted to develop and provide a targeted psychological support scheme to 1,496 frontline nurses. Data regarding nurses’ feedback were collected from WeChat group chat, letters and comments on theme lectures. Subsequently, qualitative content analysis was conducted using MAXQDA. Results A targeted psychological support scheme was formed via three action cycles according to nurses’ needs. Frontline nurses received psychological assistance from a research team, which offered (1) a sense of belonging, (2) a sense of professional value and pride, and (3) a sense of being protected and confident. Conclusion The researchers successfully provided targeted psychological support to nurses, and nurses were motivated and became more confident when their needs were addressed. Implications for Nursing Management Nurses have various types of psychological needs, which could be addressed by targeted support. It is suggested that nurse managers should identify nurses’ needs in real time and provide appropriate support through multidisciplinary collaboration to improve their confidence and enhance their resilience.
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Heldal F, Dehlin E, Oddane TA. Unmute the Organization Through Serious Play. Front Psychol 2021; 11:607919. [PMID: 33519615 PMCID: PMC7838540 DOI: 10.3389/fpsyg.2020.607919] [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: 09/18/2020] [Accepted: 12/14/2020] [Indexed: 11/21/2022] Open
Abstract
In this article, we sketch up an action research process designed to give voice to those who traditionally have not had a voice in organizations. In particular, the research process was structured around "serious play" and designed as a talk show, where researchers played parts, including a talk show host, and where questions pertaining to organizational life were discussed in depth. The structure of the discussion was construed based on reflective teams, i.e., two actors performing a dialogue (talk show host and guest) and a silent group (audience) as listeners. The key research question concerns in what ways such an action research process is replicable? Applying a critical lens, we argue that even if strong claims of replicability are not met, as in being able to reproduce results and/or generalize them, this is outside the point. Rather, as we set out to apply a qualitative research design to achieve cogenerative learning effects, we advance an understanding of replicability-as-recoverability. This entails giving explicit grounds for our epistemic anchoring in critical realism and sketching out a research design which is sufficiently clear and transparent to undergo critical scrutiny.
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Goldman Schuyler K, Watson LW, King E. How Generative Mindfulness Can Contribute to Inclusive Workplaces. HUMANISTIC MANAGEMENT JOURNAL 2021; 6:451-478. [PMCID: PMC8669398 DOI: 10.1007/s41463-021-00120-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/20/2021] [Indexed: 02/07/2024]
Abstract
Humanistic management and mindfulness practices can potentiate one another to foster an inclusive society. By moving beyond a limited instrumental understanding of mindfulness practice to a generative mindfulness that incorporates a recognition of the rich nature of the human mind, awareness of cultural practices, and deeply rooted ethical foundations, managers can create organizational cultures that honor the sacred in every human being. A set of interviews with noted consultants and researchers on mindfulness and leadership suggests convergence on this perspective, as does the experience of a university administrator in developing an anti-racist agenda for a large U.S. university. This article is based on both the personal experience and scholarly research of its authors and suggests ways that humanistic management education can contribute to creating inclusive workplaces through incorporating generative mindfulness in executive development as well as undergraduate programs.
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Tsai MF, Jao JC. Evaluation of the effectiveness of student learning and teacher instruction on team-based learning during quality control of diagnostic imaging. MEDICAL EDUCATION ONLINE 2020; 25:1732159. [PMID: 32090711 PMCID: PMC7048181 DOI: 10.1080/10872981.2020.1732159] [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: 07/12/2019] [Revised: 12/20/2019] [Accepted: 02/04/2020] [Indexed: 06/02/2023]
Abstract
Background: Team-Based Learning (TBL), which is a student-centered instructional approach, has been applied in various health-related courses, but research on the effectiveness of TBL in radiologic technology is limited. More research is needed to examine the effectiveness of TBL within the field of radiologic technology as well as to study teachers' reflective practices for instructional development in TBL.Objectives: This study examines the effectiveness of TBL on students' learning and course instructors' instructional development during quality control activities in diagnostic imaging.Design: This study employed an action research approach with mixed-methods. The study was categorized using four TBL modules as the topics: film/screen receptors and processors, radiography, mammography, and computed tomography. Quantitative data included pre-test scores on individual readiness assurance tests (IRAT-pre), group readiness assurance tests (GRAT), and post-test scores on individual readiness assurance tests (IRAT-post). Qualitative data included students' responses to open-ended questions about their experience with TBL and transcripts of instructors' interviews.Results: Forty junior college students participated in the study. A non-parametric test was conducted to compare the scores. The results showed that the GRAT score was significantly higher than the IRAT-pre-score, and the IRAT-post score was significantly higher than the IRAT-pre-score. The IRAT-post score was significantly higher than the GRAT score for the first and fourth modules, but IRAT-post score was significantly lower than the GRAT score on the second and third modules. Using direct content analysis, five themes were coded around instructional development, while 15 themes were coded to understand students' experiences with TBL.Conclusions: TBL can be an effective instructional approach to improve students' understanding of radiologic technology content. The results of this research can help instructors decide what action plan to implement to increase the effectiveness of TBL when further employing it for radiologic technology courses.
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Beauregard M, Brousseau N, Ouakki M, Kiely M, Sauvageau C, Clément P, Guay M. Participation in an action research project on vaccine services for children: relationship with vaccine delays. Hum Vaccin Immunother 2020; 16:3170-3176. [PMID: 32429743 PMCID: PMC8641605 DOI: 10.1080/21645515.2020.1748980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/28/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022] Open
Abstract
Multicomponent interventions are effective in improving vaccine coverage. However, few studies have assessed their effect on timely vaccination. The aim of this study was to compare the proportion of children with vaccine delays at 2- and 12-month visits according to whether or not health centers have participated in an action research project on the organization of vaccination services for 0-5-year-olds. The action research project included a multicomponent intervention and was conducted between 2011 and 2015 in Quebec, Canada. An ecological before/after design was used for this analysis. A total of 264,579 DTaP-IPV-Hib (2-month visits) and 240,541 Men-C-C (12-month visits) vaccine doses were administered during 2011-2012 to 2014-2015 fiscal years, including 19% in 14 participating health centers and the remaining in 78 nonparticipating centers. Vaccine delays demonstrated a more pronounced decreasing trend in participating versus nonparticipating health centers (p < .0001 at 2 and 12 months). Between 2011-2012 and 2014-2015, participating centers managed to eliminate 35% of their vaccine delays at 2-month visits and 33% at 12-month visits, whereas nonparticipating centers eliminated 19% of delays at both visits. Our results are consistent with a positive impact of the multicomponent intervention, despite the fact that it had not specifically aimed at decreasing vaccine delays.
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Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC)-Phase 2. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238863. [PMID: 33260563 PMCID: PMC7731235 DOI: 10.3390/ijerph17238863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 01/07/2023]
Abstract
Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC) is part of California Breast Cancer Research Program’s (CBCRP) Initiative strategic priority to disseminate and implement high-impact, population-based primary prevention interventions. CLASP-BC is informed by six years of funded program dissemination and implementation (D&I) research and evaluation conducted by the Canadian Partnership Against Cancer (CPAC) through its Coalitions Linking Action and Science for Prevention (CLASP). In its second phase, CLASP-BC will fund multi-sector, multi-jurisdictional initiatives that integrate the lessons learned from science with the lessons learned from practice and policy to reduce the risk of developing breast cancer and develop viable and sustainable infrastructure models for primary prevention breast cancer programs and research evidence implementation. Applications will be solicited from research, practice, policy, and community teams to address one or more of the intervention goals for the 23 risk factors identified in Paths to Prevention: The California Breast Cancer Primary Prevention Plan (P2P), expanding upon existing primary prevention efforts into two or more California jurisdictions, focused on disadvantaged, high risk communities with unmet social needs. The lessons learned from CLASP-BC will be widely disseminated within the participating jurisdictions, across California and, where applicable, to jurisdictions outside the state.
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Intergroup 'Skype' Quiz Sessions in Care Homes to Reduce Loneliness and Social Isolation in Older People. Geriatrics (Basel) 2020; 5:geriatrics5040090. [PMID: 33187242 PMCID: PMC7709588 DOI: 10.3390/geriatrics5040090] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/19/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022] Open
Abstract
Video calls using software such as Skype, Zoom and FaceTime can improve socialisation among older people and family, however it is unknown if video calls are able to improve socialisation among older people and their peers. Twenty-two residents across three British care homes engaged with each other using ‘Skype quiz’ sessions with the support of staff once a month over an eight-month trial. Video calls were accessed via a ‘Skype on Wheels’ intervention that comprised a wheeled device that could hold an iPad, or through Skype TV. Residents met other residents from the three care homes to build new friendships and participate in a thirty-minute quiz session facilitated by eight staff. Staff were collaborators who recruited older people, implemented the intervention and provided feedback that was analysed using thematic analysis. Residents enjoyed being able to see other residents’ faces and surroundings. Analysis of the field notes revealed five themes of: residents with dementia remember faces not technology, inter and intra connectedness, re-gaining sense of self and purpose, situational loneliness overcome and organisational issues create barriers to long-term implementation. Inter-care home connection through video calls to reduce feelings of loneliness in residents seems acceptable and a feasible, low cost model, especially during times of public crisis such as COVID-19.
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Ramos S, Costa P, Passos AM, Silva SA, Sacadura-Leite E. Intervening on Burnout in Complex Organizations - The Incomplete Process of an Action Research in the Hospital. Front Psychol 2020; 11:2203. [PMID: 33071844 PMCID: PMC7538901 DOI: 10.3389/fpsyg.2020.02203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/05/2020] [Indexed: 11/19/2022] Open
Abstract
Health professionals are at high risk for developing burnout symptoms. Directed at reducing the organizational variables affecting professionals’ burnout, an action research was developed in a specific sector of a large hospital, with 59 doctors, 66 nurses, and 42 ancilliary professionals. Researchers conducted 11 interviews, one focus group, and 20 h of in loco observation. Professionals report demotivation and the need to address the emotional part of their job. Nonetheless, the hierarchy blocked the proposed intervention possibilities. Organizational factors are unequivocally relevant, particularly in complex settings with emotionally charged interactions, and the direct hierarchy is pivotal for facilitating organizational change.
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Bakhshi F, Mitchell R, Nasrabadi AN, Varaei S, Hajimaghsoudi M. Behavioural changes in medication safety: Consequent to an action research intervention. J Nurs Manag 2020; 29:152-164. [PMID: 32955774 DOI: 10.1111/jonm.13128] [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: 05/22/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
AIM To explore the extent to which action research assists developing medication safety behaviours among emergency medicine staff. BACKGROUND Health care staff involved in medication therapy are frequently required to implement progressive changes. To permanently improve medication safety, we must consider staff behaviour. This study utilizes action research to engage health care workers and engender behavioural changes. METHOD Two cycles of action research were implemented. Data were collected through pre- and post-medication safety surveys, unstructured interviews and field notes. Staff in the emergency department worked together to progress the study cycles. RESULTS The pre-evaluation phase revealed deficiencies in staff medication safety behaviour. Subsequent to the implementation of safety initiatives, pre- to post-evaluation comparison indicated significant improvement in medication safety behaviours. In response to qualitative reflection phase data in reflection, ward pharmacists were placed in the emergency department and anew policy on responding to medication error was developed. Analysed field notes revealed improved safe patient care, enhanced pharmaceutical knowledge and changes in the emergency department climate. CONCLUSIONS Through action research, this study introduced actions to improve medication safety behaviours in the emergency department. Staff involvement led to changed safety behaviours. IMPLICATION FOR NURSING MANAGEMENT This study advises nurse managers of the benefit of pharmacist-led medication therapy, interprofessional medication safety courses and active communication between front-line staff and managers regarding medication safety.
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Foss M, le May WA, Gobbi M. The development and testing of a co-designed distance learning programme to improve the knowledge of trained auxiliary nurse midwives in normal midwifery practice in central India. J Res Nurs 2020; 25:541-558. [PMID: 34394672 PMCID: PMC7932305 DOI: 10.1177/1744987120952836] [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: 11/16/2022] Open
Abstract
BACKGROUND In the Indian State of Madhya Pradesh maternal health is poor, and women's social status is low. For some women, autonomy and decision-making within the family is limited as they seek medical treatment through their husband or father-in-law. The then state government identified a need to strengthen midwifery care given by auxiliary nurse midwives to improve maternal and neonatal health.>. METHODS This cross-cultural, two phase study was designed in partnership with an Indian non-governmental organisation, utilising Elliot's action research model within the paradigm of critical theory. Phase 1 investigated the then current situation and established a potential solution to strengthening midwifery practice within Madhya Pradesh. This comprised an educational approach using a specifically designed self-directed distance learning programme focussing on normal pregnancy and childbirth. The distance learning programme was a hard copy workbook supported by a multimedia resource informed by the Rowntree and Analysis Design Development Implementation Evaluation models of educational material development. Phase 2 involved the use and evaluation of the distance learning programme with an initial primary group sample of 28 comprising auxiliary nurse midwives (22), lady health visitors (4) and staff nurses (2) in Madhya Pradesh. Fourteen auxiliary nurse midwife participants completed knowledge tests using a pre- and post-programme multiple choice question paper. This primary group negotiated a 3-day workshop to cover identified gaps within their original 12-week study period. Nineteen additional auxiliary nurse midwife participants joined this workshop (group 2). RESULTS The multiple choice question test results indicated that the first group had poor knowledge of the normal process of pregnancy and childbirth. After the workshop, they marginally improved their personal performance scores. The second group demonstrated greater change, which suggests that coupling self-directed guided study material with an enabling, face-to-face environment can be successful. CONCLUSIONS Distance learning among auxiliary nurse midwives in central India may be enhanced when accompanied by face-to-face workshops. Partnership working - at organisational, team and individual levels, was a crucial, and empowering, component of this cross-cultural action research study. Both points have relevance for others undertaking similar studies.
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Duncan LG, Gollek C, Potter DD. eLIPS: Development and Validation of an Observational Tool for Examining Early Language in Play Settings. Front Psychol 2020; 11:1813. [PMID: 32849070 PMCID: PMC7412886 DOI: 10.3389/fpsyg.2020.01813] [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: 04/30/2020] [Accepted: 07/01/2020] [Indexed: 11/13/2022] Open
Abstract
Intervention in the early years can help to mitigate the risks that early language and communication difficulties pose for later learning and well-being. Critical to this is the capacity of early years educators to evaluate language development accurately in the classroom in order to target individual support effectively. This article reports on the development and testing of the Early Language in Play Settings (eLIPS) tool, an observational measure of child language. An action research model was used in the design of the tool with the result that the methodology adopted was compatible with an early years child-centered approach. Observations of children in play settings were used to gather information about early language through subscales measuring social communication, receptive and expressive language. A series of preliminary trials with 3- to 5-year-olds, established that the eLIPS measures have concurrent validity with scores from a standardized language assessment, the Clinical Evaluation of Language Fundamentals-Preschool 2 UK . Investigation of internal consistency showed reliability for use by researchers and early years educators together with inter-rater reliability across these groups. It was concluded that eLIPS has potential as a tool to assist early years educators in understanding individual patterns of language acquisition in a play-based environment and for framing team discussions about approaches to early language support.
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Read S, Aries AM, Ashby SM, Bambrick V, Blackburn SJ, Clifford H, Rhodes C, Thirlwall S, Watkins CA. Facilitating personal development for public involvement in health-care education and research: A co-produced pilot study in one UK higher education institute. Health Expect 2020; 23:1191-1201. [PMID: 32707602 PMCID: PMC7696120 DOI: 10.1111/hex.13097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/17/2020] [Accepted: 06/11/2020] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Public involvement in the education of students enrolled on higher education programmes has gained impetus. For students enrolled on professional health-care programmes and health-related modules in the UK, there is also a requirement by professional bodies to include "service user" involvement in preparation for entry to a professional health-care register and continuing professional development. Actively involving patients and members of the public in research is also a requirement by many research funders. In this article, the term Patient and Public Involvement (PPI) will be used throughout to include lay members, volunteers, user and carers. OBJECTIVES A unique pilot study was introduced across a health faculty to integrate PPI in a deliberate way. It aimed to provide an educational, focused programme of events that was meaningful to develop and inform peoples' knowledge, skills and confidence for their involvement in the health faculty. DESIGN PPI members volunteered to sit on a steering group to determine the educational journey; the outcomes of three focus groups with PPI members (N = 32) and academics informed the programme content which included a range of workshops covering the exploration of public roles and barriers to involvement, introduction to research and interviewing skills. RESULTS The workshops were well attended, and outcomes indicated the importance of co-production when designing, delivering and evaluating programmes. DISCUSSION Co-production underpinned this pilot study, resulting in a programme which was meaningfully received by public contributors. RECOMMENDATIONS Co-production was seen as integral to this research to ensure that outcomes were indeed "fit for purpose".
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Phetphum C, Noosorn N. Effects of a Youth-Engaging Intervention on Illegal Sales by Tobacco Retailers Near Schools in Thailand. Asia Pac J Public Health 2020; 32:340-345. [PMID: 32698607 DOI: 10.1177/1010539520942686] [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: 11/16/2022]
Abstract
This study assessed the effects of youth-engaging interventions on illegal sales by tobacco retailers near schools in Thailand. The youth were educated and engaged in the planning and implementation of a program to reduce tobacco retailers' illegal sales in the Uttaradit Municipality, Thailand. Intervention components included community education, retailer education, and direct approaches to tobacco retailers. A study included a pretest-posttest control group. The 6-month intervention focused on 114 tobacco retailers. The posttest showed that the percentage of tobacco retailers violating the retail law decreased: tobacco product displays at points of sales decreased from 67.5% to 23.7%, single cigarette sales declined from 71.1% to 36.0%, and tobacco sales to minors decreased from 74.6% to 5.3%. Asking for identification or the buyer's age before selling tobacco increased from 33.3% to 78.1%. The intervention led to a significant reduction in the violation of tobacco retail laws near schools.
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Williamson HJ, Chief C, Jiménez D, Begay A, Milner TF, Sullivan S, Torres E, Remiker M, Samarron Longorio AE, Sabo S, Teufel-Shone NI. Voices of Community Partners: Perspectives Gained from Conversations of Community-Based Participatory Research Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145245. [PMID: 32708111 PMCID: PMC7400085 DOI: 10.3390/ijerph17145245] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/08/2020] [Accepted: 07/18/2020] [Indexed: 11/16/2022]
Abstract
Community-based participatory research (CBPR) has been documented as an effective approach to research with underserved communities, particularly with racial and ethnic minority groups. However, much of the literature promoting the use of CBPR with underserved communities is written from the perspective of the researchers and not from the perspective of the community partner. The purpose of this article is to capture lessons learned from the community partners’ insight gained through their experiences with CBPR. A multi-investigator consensus method was used to qualitatively code the transcripts of a CBPR story-telling video series. Seven major themes were identified: (1) expectations for engaging in research, (2) cultural humility, (3) respecting the partnership, (4) open communication, (5) genuine commitment, (6) valuing strengths and recognizing capacities, and (7) collaborating to yield meaningful results. The themes drawn from the community partner’s voice align with the tenets of CBPR advanced in the academic literature. More opportunities to include the community voice when promoting CBPR should be undertaken to help introduce the concepts to potential community partners who may be research cautious.
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Laird Y, Manner J, Baldwin L, Hunter R, McAteer J, Rodgers S, Williamson C, Jepson R. Stakeholders' experiences of the public health research process: time to change the system? Health Res Policy Syst 2020; 18:83. [PMID: 32682426 PMCID: PMC7368787 DOI: 10.1186/s12961-020-00599-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 07/03/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The importance of engaging stakeholders in the research process is well recognised. Whilst engagement is important, guidelines and practices vary for how stakeholders should be involved in research and how to facilitate effective collaborative relationships. METHODS This study aimed to explore the perspectives and experiences of stakeholders involved in the policy and practice area of outdoor space and non-communicable disease prevention. Stakeholders interviewed included academics, practitioners, policy-makers, knowledge brokers and a funder. RESULTS The findings suggest that stakeholders had positive experiences when engaged meaningfully in the research process, where research projects were carefully planned and managed with attention to context and culture, and where the research team was effective, respectful and communicative. These factors help to facilitate the translation of research into policy and practice. However, multiple challenges of collaborative research were identified which related to structural and systemic challenges, building and maintaining relationships, use and collection of data and information, cultural perceptions of research and research generation, and getting evidence into action. Participants felt that changing the funding system, exploring more collaborative research methodologies, improved research translation, and more effective collaborative relationships at all stages of the research process could address some of these challenges. CONCLUSIONS The findings highlight that, whilst stakeholder engagement in research was considered important, structural, cultural and individual practices impacted how this worked in practice. Identifying and testing solutions to address these challenges could improve synergies between research, policy, and practice and lead to the production of impactful research that reduces wastage of public funding, improves implementation of findings and ultimately improves public health outcomes.
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Steensgaard R, Kolbaek R, Jensen JB, Angel S. Action research as a catalyst for change: Empowered nurses facilitating patient participation in rehabilitation. Nurs Inq 2020; 28:e12370. [PMID: 32662213 DOI: 10.1111/nin.12370] [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: 02/07/2020] [Revised: 06/07/2020] [Accepted: 06/11/2020] [Indexed: 11/29/2022]
Abstract
Based on action research as a practitioner-involving approach, this article communicates the findings of a two-year study on implementing patient participation as an empowering learning process for both patients and rehabilitation nurses. At a rehabilitation facility for patients who have sustained spinal cord injuries, eight nurses were engaged throughout the process aiming at improving patient participation. The current practice was explored to understand possibilities and obstacles to patient participation. Observations, interviews and logbooks, creative workshops and reflective meetings led to the development and testing of four new rehabilitation initiatives aimed at enhancing patient participation. This study suggests that skills of critical reflection from action research toolbox shed light on both the notion of patient participation and caring in nursing rehabilitation. By actively involving nurses in research, the knowledge development stems from practice and the solutions therefore became practice-oriented. In addition, the personal and professional development experienced by the involved nurses points to a secondary gain in the form of an analytical and reflective approach to complex issues in relation to patient participation, rehabilitation in general and the individual nurses' sense of professional pride.
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Kerner JF, Kavanaugh-Lynch MHE, Baezconde-Garbanati L, Politis C, Prager A, Brownson RC. Doing What We Know, Knowing What to Do: Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5050. [PMID: 32674312 PMCID: PMC7399883 DOI: 10.3390/ijerph17145050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/24/2022]
Abstract
Given the lack of progress in breast cancer prevention, the California Breast Cancer Research Program (CBCRP) plans to apply current scientific knowledge about breast cancer to primary prevention at the population level. This paper describes the first phase of Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC). The foci of Phase 1 are building coalitions and coalition capacity building through community engagement in community-based participatory research (CBPR) and dissemination and implementation (D&I) research training. Based on the successful implementation and evaluation of Phase 1, the foci of Phase 2 (presented separately in this special issue) will be to translate the California Breast Cancer Prevention Plan overarching goal and specific intervention goals for 23 breast cancer risk and protective factors strategies into evidence-informed interventions (EIIs) that are disseminated and implemented across California. CLASP-BC is designed to identify, disseminate and implement high-impact, population-based prevention approaches by funding large scale EIIs, through multi-jurisdictional actions, with the intent to decrease the risk of breast cancer and other chronic diseases (sharing common risk factors), particularly among racial/ethnic minorities and medically underserved populations in California.
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Phillips L, Scheffmann-Petersen M. Minding the Gap Between the Policy and Practice of Patient-Centeredness: Cocreating a Model for Tensional Dialogue in the "Active Patient Support" Program. QUALITATIVE HEALTH RESEARCH 2020; 30:1419-1430. [PMID: 32249719 DOI: 10.1177/1049732320913855] [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] [Indexed: 06/11/2023]
Abstract
Several studies identify obstacles to patient-centered care that can be eradicated by bridging the gap between policy goals and practice. In this article, "patient-centeredness" is theorized as an unstable entity riddled with intrinsic, ineradicable tensions. The purpose of the article is to propose a reflexive approach to the tensions as the most appropriate strategy for narrowing the gap between policy and practice. The reflexive approach is illustrated in an account of an action research project on a Danish, patient-centered initiative, "Active Patient Support." The account focuses on the development of a dialogic communication model through collaborative, reflexive analyses of the tensions in the enactment of "patient-centeredness" in dialogue between health care practitioners and citizens-in particular, the tension between empowerment and self-discipline. Finally, the conceptual expansion of one of the dimensions of patient-centeredness, "health-practitioner-as-person," is discussed as a platform for reflexivity, and the limitations of reflexivity are addressed.
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Luger TM, Hamilton AB, True G. Measuring Community-Engaged Research Contexts, Processes, and Outcomes: A Mapping Review. Milbank Q 2020; 98:493-553. [PMID: 32428339 PMCID: PMC7296434 DOI: 10.1111/1468-0009.12458] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Policy Points Community‐engaged research (CEnR) engenders meaningful academic‐community partnerships to improve research quality and health outcomes. CEnR has increasingly been adopted by health care systems, funders, and communities looking for solutions to intractable problems. It has been difficult to systematically measure CEnR's impact, as most evaluations focus on project‐specific outcomes. Similarly, partners have struggled with identifying appropriate measures to assess outcomes of interest. To make a case for CEnR's value, we must demonstrate the impacts of CEnR over time. We compiled recent measures and developed an interactive data visualization to facilitate more consistent measurement of CEnR's theoretical domains.
Context Community‐engaged research (CEnR) aims to engender meaningful academic‐community partnerships to increase research quality and impact, improve individual and community health, and build capacity for uptake of evidence‐based practices. Given the urgency to solve society's pressing public health problems and increasing competition for funding, it is important to demonstrate CEnR's value. Most evaluations focus on project‐specific outcomes, making it difficult to demonstrate CEnR's broader impact. Moreover, it is challenging for partnerships to identify assessments of interest beyond process measures. We conducted a mapping review to help partnerships find and select measures to evaluate CEnR projects and to characterize areas where further development of measures is needed. Methods We searched electronic bibliographic databases using relevant search terms from 2009 to 2018 and scanned CEnR projects to identify unpublished measures. Through review and reduction, we found 69 measures of CEnR's context, process, or outcomes that are potentially generalizable beyond a specific health condition or population. We abstracted data from descriptions of each measure to catalog purpose, aim (context, process, or outcome), and specific domains being measured. Findings We identified 28 measures of the conditions under which CEnR is conducted and factors to support effective academic‐community collaboration (context); 43 measures evaluating constructs such as group dynamics and trust (process); and 43 measures of impacts such as benefits and challenges of CEnR participation and system and capacity changes (outcomes). Conclusions We found substantial variation in how academic‐community partnerships conceptualize and define even similar domains. Achieving more consistency in how partnerships evaluate key constructs could reduce measurement confusion apparent in the literature. A hybrid approach whereby partnerships discuss common metrics and develop locally important measures can address CEnR's multiple goals. Our accessible data visualization serves as a convenient resource to support partnerships’ evaluation goals and may help to build the evidence base for CEnR through the use of common measures across studies.
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