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Massey J, Tsianakas V, Gordon A, Sadler N, Robert G. Co-designing complex therapy interventions with parents as partners in the care of children with cerebral palsy: An Experience-based Co-design study in England. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 151:104793. [PMID: 38924956 DOI: 10.1016/j.ridd.2024.104793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/07/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Parents of children with hemiplegic cerebral palsy are increasingly involved in therapy intervention delivery. Enhancing the ways that parents are supported in delivery is key to optimising outcomes. This study aimed to refine an existing programme in England to better support parents partnering in their child's intervention delivery. METHODS AND PROCEDURES Experience-based Co-design (EBCD) fostered collaboration between parents and therapists to identify shared improvement priorities and develop solutions. The study included eighteen interviews and sixteen co-design meetings involving twenty parents and eight therapists in total. Intervention development followed the MRC Framework for developing and evaluating complex interventions. OUTCOMES AND RESULTS Themes from parent and therapist interviews informed priority setting for the co-design work. Three key shared priorities emerged a) accessing rehabilitation; b) fostering partnership and c) parent learning. Aligned with these priorities, three mixed parent and therapist co-design teams produced a) a parent booklet; an education outline for healthcare professionals; b) partnership principles; adaptations to intervention logbooks c) an online parent education session. CONCLUSIONS AND IMPLICATIONS Engaging parents and therapists in a structured co-design process using EBCD yielded innovative interventions supporting parents in delivering therapy for children with hemiplegia. This collaborative approach is anticipated to enhance programme implementation and effectiveness.
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Affiliation(s)
- Jill Massey
- Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK; Florence Nightingale School of Nursing Midwifery and Palliative Care, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
| | - Vicki Tsianakas
- Florence Nightingale School of Nursing Midwifery and Palliative Care, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Anne Gordon
- Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK; Florence Nightingale School of Nursing Midwifery and Palliative Care, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | | | - Glenn Robert
- Florence Nightingale School of Nursing Midwifery and Palliative Care, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
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Langerman C, Forbes A, Robert G. Enhancing care in the initiation and management of insulin in older people with diabetes: A collaborative journey with older individuals and their caregivers using Experience-Based Co-Design. PLoS One 2024; 19:e0302516. [PMID: 39074147 DOI: 10.1371/journal.pone.0302516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/07/2024] [Indexed: 07/31/2024] Open
Abstract
INTRODUCTION Initiating insulin therapy in older individuals with type 2 diabetes (T2DM) poses unique challenges and requires a nuanced understanding of the age-related factors that impact safety and efficacy. This study employed Experience-Based Co-Design (EBCD) to enhance the insulin initiation and management experience for this population, emphasising a collaborative approach involving patients, caregivers, and healthcare professionals. AIM The primary aim of the research was to develop a tailored care pathway, utilising co-design and the Behaviour Change Wheel (BCW), which addressed issues specific to older adults on insulin therapy. The study sought to identify key challenges, propose practical interventions, and construct a logic model illustrating a pathway for enhanced insulin treatment experiences. METHODS An adapted EBCD process was used which integrated the Medical Research Council (MRC) Framework and BCW. The study involved thematic synthesis, video interviews, and feedback focus groups with patients, caregivers, and healthcare professionals. The 'Crazy Eights' brainstorming method, as part of the co-design workshop, generated practical solutions which informed subsequent logic model development. RESULTS Focus group findings revealed distressing insulin initiation experiences, inconsistent dietary advice, and perceived disparities in care between type 1 and type 2 diabetes. The co-design workshop identified eight key challenges, leading to proposed interventions aligned with the BCW. The logic model illustrates a pathway for older individuals undergoing insulin treatment, emphasising behaviour change among patients, caregivers, and healthcare professionals. CONCLUSION The collaborative efforts of participants contributed valuable insights in terms of the unique educational and emotional needs of patients, the importance of care continuity and of improving access to specialist services. Findings from this study can be used to inform and enhance tailored support strategies for older adults with T2DM during their insulin transition and ongoing management.
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Affiliation(s)
- Chaya Langerman
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Angus Forbes
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
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Li S, Gulley J, Booty M, Firchow B, McGladrey ML. Using Photovoice to Improve Engagement in Community Health Assessments Addressing Behavioral Health. J Behav Health Serv Res 2024:10.1007/s11414-024-09885-4. [PMID: 38710979 DOI: 10.1007/s11414-024-09885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2024] [Indexed: 05/08/2024]
Abstract
Behavioral health disorders are well-known to have close links with the social determinants of health, yet little is known about how impacted communities perceive these links. Qualitative participatory methods can not only provide insight into how communities conceptualize these relationships but also empower those with lived experience to contextualize their perspectives and formulate calls to action. This study used Photovoice as a participatory method to supplement the Clark County Health Department Community Health Assessment and determine priority facilitators and barriers contributing to the behavioral health of Clark County, KY, residents. A secondary aim was to gain a greater understanding of how the Photovoice methodology impacts community engagement efforts in Community Health Assessments. Twenty-three Clark County residents participated in four Photovoice groups involving five weekly sessions, which included photograph "show and tell," critical group dialogue, participatory analysis, and planning for dissemination. Secondary analysis of Photovoice focus group discussions revealed behavioral health facilitators and barriers were most influenced by (1) public sector unresponsiveness, (2) strong partnerships formed between community and grassroots organizations, and (3) the siloed division of responsibility between agencies and across sectors. The authors also found the Photovoice method successfully enhanced engagement and empowered those with lived experience to frame their perspectives of the behavioral health landscape. This project has implications for enhancing community engagement and empowerment in behavioral health-focused public health assessments and shaping policy to promote multi-sector collaboration.
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Affiliation(s)
- Stacey Li
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70118, USA.
| | | | - Marisa Booty
- University of Kentucky College of Arts and Sciences, Lexington, KY, 40506, USA
| | - Bradley Firchow
- University of Kentucky College of Medicine, Lexington, KY, 40506, USA
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Renshaw J, Burton AE. "I don't know if I understood the whole process from the beginning": A photo-elicitation exploration of the experience of mastectomy and breast reconstruction decision making. PEC INNOVATION 2023; 3:100178. [PMID: 38213757 PMCID: PMC10782110 DOI: 10.1016/j.pecinn.2023.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 01/13/2024]
Abstract
Objectives Policy and guidance assume that reconstruction following mastectomy will have physical and psychological benefits, however research has disputed whether this is always the case. This study aimed to explore mastectomy experiences and reconstruction decision making. Methods Semi-structured interviews about self-curated participant photographs of the breast cancer experience were analysed using interpretative phenomenological analysis (IPA). Results Three themes were developed: 'Life before mastectomy'; 'I don't know if I understood the whole process from the beginning'; and getting back to 'normal'. Conclusions Decisions regarding reconstruction were influenced by needs of others, and surgeons' communication and behaviour and negative experiences were prominent. Over time participants came to terms with physical and psychological impacts of mastectomy reporting re-finding themselves alongside acceptance of their post mastectomy bodies. However, many participants were living with the fear that their cancer may one day return. Communication skills training for healthcare professionals should be a priority to ensure decisions made result in the best possible outcomes for patients. Innovation Photo-elicitation is a novel research method enabling rich investigation of mastectomy experiences. Self-curation of images enables patient-led discussions about mastectomy experience and illustrates the importance of life context. Photographs may have value within clinical training to facilitate understanding of patient experiences.
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Affiliation(s)
- Janette Renshaw
- Department of Psychology, Health, Science and Wellbeing, Staffordshire University, United Kingdom
| | - Amy E. Burton
- Department of Psychology, Health, Science and Wellbeing, Staffordshire University, United Kingdom
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Pateman KA, Christoffersen A, Hanly-Platz A, Williams C, Heffernan D, Alexander A, Ryan E, Petrie C, Banks M, Young A. Partnering with consumers to co-design a person-centred coding framework for qualitative patient experience data. PATIENT EDUCATION AND COUNSELING 2023; 116:107938. [PMID: 37598583 DOI: 10.1016/j.pec.2023.107938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/26/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Patient Reported Experience Measures (PREMs) provide health organisations insight into how 'person-centric' care is. Qualitative data in PREMs surveys provide essential context about experience but are challenging to analyse at an organisational level. OBJECTIVE To co-design a person-centred coding framework to assist in the analysis of qualitative PREMs data. PATIENT INVOLVEMENT Consumer representatives were involved in problem identification, co-design, coding of raw data (testing), evaluation and manuscript authorship. METHODOLOGY Co-design principles guided production of a deductive coding framework with Picker Principles of Person-Centred Care as a conceptual framework. The framework was co-designed over 4 stages, with cross-professional stakeholders (including two consumer representatives): 1) assessment of current state and understanding priorities; 2) adapting Picker Principles of Person-Centred Care as a coding framework; 3) testing and evaluation of a coding template over two quality improvement (QI) cycles against measures of inter-coder reliability and perceived usefulness; 4) endorsement and planning for implementation. RESULTS The Picker Principles were a suitable coding framework for inpatient PREMs data, and a coding template in an electronic spreadsheet met end-user needs. Results of the first QI cycle indicated a need for 'less academic' domain names and definitions, which were reviewed and updated to a first-person perspective in partnership with a consumer representative. Inter-coder reliability measures and qualitative feedback improved after cycle two testing and evaluation. DISCUSSION This single site study produced a feasible solution to apply person-centred principles to analyse PREMs data and requires testing in different settings. Cross-disciplinary partnerships enabled the development of a reliable and acceptable deductive coding framework that was usable for people without prior experience in qualitative data analysis. PRACTICAL VALUE Our solution offers an example for health services to harness the value of qualitative PREMs data and partner with consumers to take person-centric action to improve the safety, equity, and experience of healthcare.
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Affiliation(s)
- Kelsey Ann Pateman
- School of Dentistry, The University of Queensland, Brisbane, Australia; Centre for Allied Health Research, Royal Brisbane and Women's Hospital, Herston, Australia.
| | - Anja Christoffersen
- Safety and Implementation Service, Royal Brisbane and Women's Hospital, Herston, Australia; Champion Health Agency, Brisbane, Australia
| | - Aideen Hanly-Platz
- Safety and Implementation Service, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Cory Williams
- Surgery and Perioperative Services, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Danielle Heffernan
- Internal Medicine Services, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Alison Alexander
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Elizabeth Ryan
- Women's and Newborn Services, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Christine Petrie
- Consumer and Community Engagement, Metro North Health, Herston, Australia
| | - Merrilyn Banks
- Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Adrienne Young
- Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Herston, Australia; Centre for Health Services Research, The University of Queensland, Herston, Australia
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Merner B, Schonfeld L, Virgona A, Lowe D, Walsh L, Wardrope C, Graham-Wisener L, Xafis V, Colombo C, Refahi N, Bryden P, Chmielewski R, Martin F, Messino NM, Mussared A, Smith L, Biggar S, Gill M, Menzies D, Gaulden CM, Earnshaw L, Arnott L, Poole N, Ryan RE, Hill S. Consumers' and health providers' views and perceptions of partnering to improve health services design, delivery and evaluation: a co-produced qualitative evidence synthesis. Cochrane Database Syst Rev 2023; 3:CD013274. [PMID: 36917094 PMCID: PMC10065807 DOI: 10.1002/14651858.cd013274.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Partnering with consumers in the planning, delivery and evaluation of health services is an essential component of person-centred care. There are many ways to partner with consumers to improve health services, including formal group partnerships (such as committees, boards or steering groups). However, consumers' and health providers' views and experiences of formal group partnerships remain unclear. In this qualitative evidence synthesis (QES), we focus specifically on formal group partnerships where health providers and consumers share decision-making about planning, delivering and/or evaluating health services. Formal group partnerships were selected because they are widely used throughout the world to improve person-centred care. For the purposes of this QES, the term 'consumer' refers to a person who is a patient, carer or community member who brings their perspective to health service partnerships. 'Health provider' refers to a person with a health policy, management, administrative or clinical role who participates in formal partnerships in an advisory or representative capacity. This QES was co-produced with a Stakeholder Panel of consumers and health providers. The QES was undertaken concurrently with a Cochrane intervention review entitled Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. OBJECTIVES 1. To synthesise the views and experiences of consumers and health providers of formal partnership approaches that aimed to improve planning, delivery or evaluation of health services. 2. To identify best practice principles for formal partnership approaches in health services by understanding consumers' and health providers' views and experiences. SEARCH METHODS We searched MEDLINE, Embase, PsycINFO and CINAHL for studies published between January 2000 and October 2018. We also searched grey literature sources including websites of relevant research and policy organisations involved in promoting person-centred care. SELECTION CRITERIA We included qualitative studies that explored consumers' and health providers' perceptions and experiences of partnering in formal group formats to improve the planning, delivery or evaluation of health services. DATA COLLECTION AND ANALYSIS Following completion of abstract and full-text screening, we used purposive sampling to select a sample of eligible studies that covered a range of pre-defined criteria, including rich data, range of countries and country income level, settings, participants, and types of partnership activities. A Framework Synthesis approach was used to synthesise the findings of the sample. We appraised the quality of each study using the CASP (Critical Appraisal Skill Program) tool. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. The Stakeholder Panel was involved in each stage of the review from development of the protocol to development of the best practice principles. MAIN RESULTS We found 182 studies that were eligible for inclusion. From this group, we selected 33 studies to include in the final synthesis. These studies came from a wide range of countries including 28 from high-income countries and five from low- or middle-income countries (LMICs). Each of the studies included the experiences and views of consumers and/or health providers of partnering in formal group formats. The results were divided into the following categories. Contextual factors influencing partnerships: government policy, policy implementation processes and funding, as well as the organisational context of the health service, could facilitate or impede partnering (moderate level of confidence). Consumer recruitment: consumer recruitment occurred in different ways and consumers managed the recruitment process in a minority of studies only (high level of confidence). Recruiting a range of consumers who were reflective of the clinic's demographic population was considered desirable, particularly by health providers (high level of confidence). Some health providers perceived that individual consumers' experiences were not generalisable to the broader population whereas consumers perceived it could be problematic to aim to represent a broad range of community views (high level of confidence). Partnership dynamics and processes: positive interpersonal dynamics between health providers and consumers facilitated partnerships (high level of confidence). However, formal meeting formats and lack of clarity about the consumer role could constrain consumers' involvement (high level of confidence). Health providers' professional status, technical knowledge and use of jargon were intimidating for some consumers (high level of confidence) and consumers could feel their experiential knowledge was not valued (moderate level of confidence). Consumers could also become frustrated when health providers dominated the meeting agenda (moderate level of confidence) and when they experienced token involvement, such as a lack of decision-making power (high level of confidence) Perceived impacts on partnership participants: partnering could affect health provider and consumer participants in both positive and negative ways (high level of confidence). Perceived impacts on health service planning, delivery and evaluation: partnering was perceived to improve the person-centredness of health service culture (high level of confidence), improve the built environment of the health service (high level of confidence), improve health service design and delivery e.g. facilitate 'out of hours' services or treatment closer to home (high level of confidence), enhance community ownership of health services, particularly in LMICs (moderate level of confidence), and improve consumer involvement in strategic decision-making, under certain conditions (moderate level of confidence). There was limited evidence suggesting partnering may improve health service evaluation (very low level of confidence). Best practice principles for formal partnering to promote person-centred care were developed from these findings. The principles were developed collaboratively with the Stakeholder Panel and included leadership and health service culture; diversity; equity; mutual respect; shared vision and regular communication; shared agendas and decision-making; influence and sustainability. AUTHORS' CONCLUSIONS Successful formal group partnerships with consumers require health providers to continually reflect and address power imbalances that may constrain consumers' participation. Such imbalances may be particularly acute in recruitment procedures, meeting structure and content and decision-making processes. Formal group partnerships were perceived to improve the physical environment of health services, the person-centredness of health service culture and health service design and delivery. Implementing the best practice principles may help to address power imbalances, strengthen formal partnering, improve the experiences of consumers and health providers and positively affect partnership outcomes.
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Affiliation(s)
- Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Ariane Virgona
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Child and Family Evidence, Australian Institute of Family Studies, Melbourne, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Cheryl Wardrope
- Clinical Governance, Metro South Hospital and Health Service, Eight Mile Plains, Australia
| | | | - Vicki Xafis
- The Sydney Children's Hospitals Network, Sydney, Australia
| | - Cinzia Colombo
- Laboratory for medical research and consumer involvement, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Nora Refahi
- Consumer Representative, Melbourne, Australia
| | - Paul Bryden
- Consumer Representative, Caboolture, Australia
| | - Renee Chmielewski
- Planning and Patient Experience, The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | | | | | | | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Susan Biggar
- Consumer Representative, Melbourne, Australia
- Australian Health Practitioner Regulation Agency (AHPRA), Melbourne, Australia
| | - Marie Gill
- Gill and Wilcox Consultancy, Melbourne, Australia
| | - David Menzies
- Chronic Disease Programs, South Eastern Melbourne Primary Health Network, Heatherton, Australia
| | - Carolyn M Gaulden
- Detroit Wayne County Authority Health Residency Program, Michigan State University, Providence Hospital, Southfield, Michigan, USA
| | | | | | - Naomi Poole
- Strategy and Innovation, Australian Commission on Safety and Quality in Health Care, Sydney, Australia
| | - Rebecca E Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Olausson S, Lindahl B. On photovoice-Applications and reflections to an intensive care context. Scand J Caring Sci 2022; 36:1123-1133. [PMID: 35307842 PMCID: PMC9790407 DOI: 10.1111/scs.13075] [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: 04/22/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND In this paper, we share our experiences of using 'photovoice' methodology as a way to generate data in intensive care units concerning the place and space of care. We have adapted and modified 'photovoice' in researching people's lived experiences of ICU. Researching lived experiences in an intensive care context is challenging because of the complex nature of critical care. AIM This study aims to explore and discuss photovoice methodolgy in ICU as a data collection method. MATERIALS AND METHODS Photos and interviews collected from patients, loved ones and staff collected in a previous research proejct. RESULTS Although there are challenges in using cameras and photographing the environment in the ICU, due to ethics and the voiceless patients therein, many advantages are presented to the researchers in capturing the meaning of lived experiences of various phenomena in the lifeworld in general and in the meaning of place and space. This paper offers applications and reflection over ontological, epistemological and methodological concerns and also offers a detailed approach on how to employ photovoice for successful and rich data generation. DISCUSSION developing and adapting scientific methods and methodologies contributes to knowledge development in caring science and is therefore an important subject of matter. CONCLUSIONS Photovoice also presents a powerful tool in disseminating the findings as it opens up the closed world of ICU to the public and increases people's understanding of the significance of place and space of caring practice.
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Affiliation(s)
- Sepideh Olausson
- Institute of Health and Caring SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anesthesiology and Intensive CareSahlgrenska University HospitalGothenburgSweden
| | - Berit Lindahl
- Faculty of MedicinePalliative Care Knowledge CenterInstitute of Health SciencesLund UniversityLundSweden
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Tanay MAL, Armes J, Oakley C, Bryson L, Johnston R, Moss‐Morris R, Rafferty AM, Roca J, Sage L, Tanner D, Urwin L, Wyatt T, Robert G. Co-designing a behavioural intervention for reducing the impact of chemotherapy-induced peripheral neuropathy symptoms: An evidence- and theory-driven approach. Eur J Cancer Care (Engl) 2022; 31:e13671. [PMID: 35959639 PMCID: PMC9786800 DOI: 10.1111/ecc.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/22/2022] [Accepted: 07/28/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aims to co-design an evidence- and theory-based behavioural intervention to reduce the impact of chemotherapy-induced peripheral neuropathy (CIPN) symptoms on patients' quality of life. METHODS Guided by the Medical Research Council Framework for developing and evaluating complex interventions, our intervention development process was guided by (a) findings of systematic reviews, (b) inductive analysis of 39 h of observational fieldwork, 12 patient and 11 clinician interviews, (c) deductive analysis using the Common-Sense Model to develop a Self-Regulation Model of CIPN and (d) 17 patients and 18 clinicians co-designing the intervention. RESULTS CIPN perception and coping behaviours were highlighted as processes to target when co-designing an intervention. The processes targeted in our intervention are CIPN perception and coping behaviours, namely, (a) self-monitoring of symptoms, (b) communicating and early reporting of symptoms to clinicians, (c) participating in making chemotherapy dose reduction decisions with their clinicians and (d) engaging in self-management and safety strategies to reduce impact of CIPN symptoms. To address these, a behavioural intervention was deemed suitable. CONCLUSION We developed a self-regulation model of CIPN and a logic model for documenting the proposed mechanism of action of our co-designed behavioural intervention for reducing impact of CIPN symptoms.
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Affiliation(s)
- Mary Anne Lagmay Tanay
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical SciencesUniversity of SurreyGuildfordUK
| | | | | | | | - Rona Moss‐Morris
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | - Jose Roca
- Guy's CancerGuy's and St. Thomas' NHS Foundation TrustLondonUK
| | | | | | - Lauren Urwin
- Oncology and Haematology Rehabilitation UnitGuy's and St. Thomas' NHS Foundation TrustLondonUK
| | - Toni Wyatt
- Oncology and Haematology Rehabilitation UnitGuy's and St. Thomas' NHS Foundation TrustLondonUK
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
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The perception and impact of emotional trauma upon active duty military personnel. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Mathura P, Li M, Vegt J, Penrod Z, Suranyi Y, Osborne C, Kassam N. Through the eyes of hospital-based healthcare professionals: exploring their lived experience during the COVID-19 pandemic. BMJ Open Qual 2022; 11:bmjoq-2022-001878. [PMID: 35961682 PMCID: PMC9378944 DOI: 10.1136/bmjoq-2022-001878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 07/24/2022] [Indexed: 12/03/2022] Open
Abstract
Objective The spread of the COVID-19 virus has caused an unforeseen strain on the healthcare system and particularly on healthcare workers (HCW). In this study, 1 year after the COVID-19 pandemic began, we used photovoice, a visual photographic approach, to understand HCW needs, concerns and resilience and to determine improvement strategies aligned with the HCW-described challenges. Methods Using a qualitative design, HCW were recruited from a single Western Canadian hospital, voluntarily submitting a photographic image and narrative that depicts their experiences. An artist artistically enhanced the photovoice submissions, which were then displayed at the hospital-based art gallery for public display. A survey was used to collect feedback from gallery viewers. Inductive thematic analysis was completed identifying themes from the photovoice narratives and survey comments, aiding the identification of recommendations. Results There were 25 submissions, and 1281 individuals viewed the art exhibit. Six themes emerged: (1) hopeful and resilient, (2) pandemic fatigue-negative mental and physical states, (3) personal protective equipment is our armour but masks who we are, (4) human connection, (5) responsibility, preparation and obligation and (6) technology surge. According to survey results from the art exhibit, the use of photovoice was a creative method that personalised the HCW experience and validated viewers’ perceptions of the difficulties faced by HCW. Ten improvement strategies that were aligned with the described challenges were identified. Conclusion The ongoing COVID-19 pandemic continues to strain HCW. Photovoice has great potential in the professional clinical setting to provide unique insights that narrative language alone cannot capture. Future research exploring the longitudinal impact of COVID-19, reviewing photographs at different timepoints could be beneficial. Using this method as a creative outlet intervention and evaluating participation artistic experience may offer additional insights to further support both HCW and patients.
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Affiliation(s)
- Pamela Mathura
- University of Alberta Hospital, Edmonton, Alberta, Canada
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Miriam Li
- Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Jennie Vegt
- University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Zoe Penrod
- University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Yvonne Suranyi
- University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Cathy Osborne
- University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Narmin Kassam
- University of Alberta Hospital, Edmonton, Alberta, Canada
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Davis S, Pandhi N, Warren B, Grevious N, Crowder M, Ingersoll H, Perry E, Sussman A, Grob R. Developing catalyst films of health experiences: an analysis of a robust multi-stakeholder involvement journey. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:34. [PMID: 35906697 PMCID: PMC9335457 DOI: 10.1186/s40900-022-00369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 07/14/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Those whose lives are most directly impacted by health care-patients, caregivers, and frontline staff-are ideally situated to improve patient health care services and care quality. Despite a proliferation of literature on both Patient and Public Involvement (PPI) and clinical quality improvement (QI), concrete strategies regarding how to involve patients remain elusive. AIM Research suggests catalyst films, comprised of rigorously-analyzed interview data from diverse patients about their experiences with health and health care ("catalyst films") are a promising way to bring actionable patient feedback to QI. To date, such films have been crafted primarily by researchers. This project aimed to inform the science of engagement through analyzing how deliberate PPI informed the process of creating catalyst films. METHODS PPI methods included: research team norming activities through a project charter and role delineation process; key informant interviews; participant-ambassador videotaped interviews; clinician and research focus groups; and inclusion of advisors on the research team. Content studied for the analysis presented here included team meeting notes, interview and focus group transcripts, and documentation from a facilitated discussion about team processes. These data were analyzed to determine the impact of our PPI process. Member checking verified themes and lessons learned. RESULTS PPI shaped team deliberations and final products in substantial ways, including: what material to include in catalyst films and the tone they should convey; multiple issues regarding representation; and our collective understanding of how catalyst films could be used in the United States. Specific discussions addressed: how to include the optimal mix of interview segments that describe experiences with those that more directly point towards care improvement strategies; and how to balance positive and negative feedback from patients about experiences with care. Team process issues included ensuring equity in involvement despite team members having differing and sometimes multiple roles that complicated power dynamics and processes. CONCLUSIONS Multiple forms and degrees of PPI resulted in significant influence on catalyst films and companion materials. Our project thus provides proof of concept for PPI in creation of video products for QI which have traditionally been crafted by researchers. The model we developed, and document in this paper, can be adapted by others creating research-derived video products. Our findings can also inform future research on how co-designing catalyst films enhances their value for QI and the application of co-designed catalyst film use in QI. Lastly, it can guide those engaged in QI and medical education in their selection of film products focused on patient experiences.
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Affiliation(s)
- Sarah Davis
- Center for Patient Partnerships, University of Wisconsin-Madison, 432 Lake St. Ste. 104, Madison, WI, 53706, USA.
- Primary Care Academics Transforming Healthcare (PATH), UW-Madison, Madison, USA.
| | - Nancy Pandhi
- Primary Care Academics Transforming Healthcare (PATH), UW-Madison, Madison, USA
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, USA
- Health Experiences Research Network ("HERN"), Madison, USA
| | - Barbara Warren
- Health Experiences Research Network ("HERN"), Madison, USA
- LGBT Programs and Policies in Mount Sinai's Office for Diversity and Inclusion, Mount Sinai Health System, New York City, USA
| | - Njeri Grevious
- Health Experiences Research Network ("HERN"), Madison, USA
- HERN National Patient Advisory Council, Madison, USA
| | | | | | - Elizabeth Perry
- Primary Care Academics Transforming Healthcare (PATH), UW-Madison, Madison, USA
- Department of Family and Community Medicine, University of Wisconsin-Madison, Madison, USA
| | - Andrew Sussman
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, USA
| | - Rachel Grob
- Center for Patient Partnerships, University of Wisconsin-Madison, 432 Lake St. Ste. 104, Madison, WI, 53706, USA
- Health Experiences Research Network ("HERN"), Madison, USA
- Department of Family and Community Medicine, University of Wisconsin-Madison, Madison, USA
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12
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Lindhout P, Teunissen T, Reniers G. What about Using Photovoice for Health and Safety? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11985. [PMID: 34831740 PMCID: PMC8620590 DOI: 10.3390/ijerph182211985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022]
Abstract
The positive reception of Wang and Burris' photovoice method, published in 1997, has led to a proliferation of ways in which professionals deploy photovoice in a widening range of application fields, e.g., public health, social development and phenomenological research of human experiences. A scoping review method is used to obtain an overview of current photovoice designs and of application examples in the health and safety domain. The results show a variety of method designs. Our findings indicate that all of the photovoice designs are composed from different combinations of eleven process steps. Five generic objectives cover the range of application examples found in our literature study. We therefore condensed the variety into five generic photovoice designs for: (a) communication, (b) education, (c) exploration, (d) awareness, and (e) empowerment purposes. We propose this for use in a classification system. The potential for application of these photovoice designs in safety management is illustrated by the existence of various safety related application examples. We argue that the five generic designs will facilitate the implementation and usage of photovoice as a tool. We recommend that both a theoretical framework and guidance are further developed. We conclude that photovoice holds potential for application in health and safety management.
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Affiliation(s)
- Paul Lindhout
- Faculty TPM-VTI (S3G), Delft University of Technology, Jaffalaan 5, 2628 BX Delft, The Netherlands;
| | - Truus Teunissen
- Department of Medical Humanities, Amsterdam UMC, Location VUmc, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands;
| | - Genserik Reniers
- Faculty TPM-VTI (S3G), Delft University of Technology, Jaffalaan 5, 2628 BX Delft, The Netherlands;
- Center for Corporate Sustainability (CEDON), KULeuven, Campus Brussels, 1000 Brussels, Belgium
- Faculty of Applied Economic Sciences and Engineering Mgmt (ENM), University of Antwerp, 2000 Antwerp, Belgium
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la Fuente IMD, Pastor A, Conde P, Vázquez MS, Ramos C, Bosque-Prous M, Franco M, Sureda X. Changes in perceptions of the alcohol environment among participants in a Photovoice project conducted in two districts with different socio-economic status. PLoS One 2021; 16:e0254978. [PMID: 34358236 PMCID: PMC8345849 DOI: 10.1371/journal.pone.0254978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 07/07/2021] [Indexed: 11/19/2022] Open
Abstract
Perceptions of the alcohol environment may influence alcohol consumption patterns. The purpose of this study was to describe changes in perceptions of the urban alcohol environment as experienced by residents of two districts with different socio-economic status after taking part in a Photovoice study. The study was conducted in Madrid, Spain, in a district with a high socio-economic status (HSES) and another district with a low socio-economic status (LSES). A Photovoice project was conducted with 26 participants divided into four groups based on sex and district. Groups met over five sessions in which they discussed photographs taken by the participants themselves on the subject of alcohol in their neighbourhood. A qualitative, descriptive and thematic analysis of participants' discourses was performed to explore changes in their perceptions of the alcohol environment over the project sessions. Changes in perceptions of the alcohol environment were observed in all groups over the project. The process of change varied by districts' socio-economic characteristics and gender. Greater changes in perceptions of the alcohol environment were observed in HSES, especially among women, as the participants had a much more positive initial view of their alcohol environment. In LSES, participants showed a more critical perception of the alcohol environment from the beginning of the study, and this broadened and intensified over the course of the sessions. Changes in perceptions also varied by thematic categories, including some categories that were discussed from the start (e.g. socialising and alcohol consumption) and categories that only emerged in later sessions (e.g. alcohol advertising). Involvement in a Photovoice project has favoured a shift in the participant's perceptions of their alcohol environment towards more critical positions, widening their scope of perceived elements and raising their awareness of specific problems, such as alcohol advertising and social role of alcohol consumption in relation to alcohol exposure.
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Affiliation(s)
- Irene Molina-de la Fuente
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Malaria and Neglected diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
- Department of Biomedicine and Biotechnology, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Andrea Pastor
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Paloma Conde
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - María Sandín Vázquez
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Carmen Ramos
- Public Health Institute of Madrid, Madrid City Council, Madrid, Spain
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland, United States of America
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, United States of America
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, l’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
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Knowles SE, Allen D, Donnelly A, Flynn J, Gallacher K, Lewis A, McCorkle G, Mistry M, Walkington P, Drinkwater J. More than a method: trusting relationships, productive tensions, and two-way learning as mechanisms of authentic co-production. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:34. [PMID: 34059159 PMCID: PMC8165763 DOI: 10.1186/s40900-021-00262-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/18/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Knowledge mobilisation requires the effective elicitation and blending of different types of knowledge or ways of knowing, to produce hybrid knowledge outputs that are valuable to both knowledge producers (researchers) and knowledge users (health care stakeholders). Patients and service users are a neglected user group, and there is a need for transparent reporting and critical review of methods used to co-produce knowledge with patients. This study aimed to explore the potential of participatory codesign methods as a mechanism of supporting knowledge sharing, and to evaluate this from the perspective of both researchers and patients. METHODS A knowledge mobilisation research project using participatory codesign workshops to explore patient involvement in using health data to improve services. To evaluate involvement in the project, multiple qualitative data sources were collected throughout, including a survey informed by the Generic Learning Outcomes framework, an evaluation focus group, and field notes. Analysis was a collective dialogic reflection on project processes and impacts, including comparing and contrasting the key issues from the researcher and contributor perspectives. RESULTS Authentic involvement was seen as the result of "space to talk" and "space to change". "Space to talk" refers to creating space for shared dialogue, including space for tension and disagreement, and recognising contributor and researcher expertise as equally valuable to the discussion. 'Space to change' refers to space to adapt in response to contributor feedback. These were partly facilitated by the use of codesign methods which emphasise visual and iterative working, but contributors emphasised that relational openness was more crucial, and that this needed to apply to the study overall (specifically, how contributors were reimbursed as a demonstration of how their input was valued) to build trust, not just to processes within the workshops. CONCLUSIONS Specific methods used within involvement are only one component of effective involvement practice. The relationship between researcher and contributors, and particularly researcher willingness to change their approach in response to feedback, were considered most important by contributors. Productive tension was emphasised as a key mechanism in leading to genuinely hybrid outputs that combined contributor insight and experience with academic knowledge and understanding.
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Affiliation(s)
- Sarah E Knowles
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK.
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK.
| | - Dawn Allen
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
| | - Ailsa Donnelly
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
| | - Jackie Flynn
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
| | - Kay Gallacher
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
| | - Annmarie Lewis
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
| | - Grace McCorkle
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
| | - Manoj Mistry
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
| | - Pat Walkington
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
| | - Jess Drinkwater
- Patients in the Learning Health System PPI Group, NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester University of Manchester, Manchester, UK
- School of Medicine, Leeds Institute of Health Sciences, University of Leeds, LS2 9JT, Leeds, UK
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15
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Morris RL, Ruddock A, Gallacher K, Rolfe C, Giles S, Campbell S. Developing a patient safety guide for primary care: A co-design approach involving patients, carers and clinicians. Health Expect 2021; 24:42-52. [PMID: 33142022 PMCID: PMC7879544 DOI: 10.1111/hex.13143] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/26/2020] [Accepted: 09/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients and carers should be actively involved in patient safety and empowered to use person-centred approaches where they are asked to both identify safety concerns and partner in preventing them. OBJECTIVES The aim of this study was to co-design a patient safety guide for primary care (PSG-PC) to support patients and carers to address key patient safety questions and identify key points where they can make their care safer. The objectives were to i) identify when and how patients and carers can be involved in primary care patient safety, and ii) identify the relevant information to include in the PSG-PC. DESIGN An experience-based co-design approach. SETTING AND PARTICIPANTS We conducted three workshops with patients, carers, community pharmacists and general practitioners to develop and refine the PSG-PC. RESULTS Participants identified both explicit and implicit issues of primary care patient safety especially relating to technical and relational components of involving patients and carers. The importance of communication, understanding roles and responsibilities, and developing partnerships between patients and health-care providers were considered essential for actively involving patients in patient safety. Co-developing the PSG-PC provided insight to improve care to develop the PSG-PC. DISCUSSION The PSG-PC is the first guide to be developed for primary care, co-designed with patients, carers, general practitioners and pharmacists. The PSG-PC will support patients and carers to partner with health-care professionals to improve patient safety addressing international and national priorities to continuously improve patient safety.
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Affiliation(s)
- Rebecca L. Morris
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Angela Ruddock
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Kay Gallacher
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Carly Rolfe
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Sally Giles
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Stephen Campbell
- NIHR Greater Manchester Patient Safety Translational Research CentreFaculty of Biology, Medicine and HealthDivision of Population HealthHealth Services Research and Primary CareSchool of Health SciencesUniversity of ManchesterManchesterUnited Kingdom
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Mathura P, Li M, McMurtry N, Kassam N. Enhancing the healthcare quality improvement storyboard using photovoice. BMJ Open Qual 2020; 9:bmjoq-2020-001104. [PMID: 33139297 PMCID: PMC7607597 DOI: 10.1136/bmjoq-2020-001104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/05/2020] [Accepted: 10/14/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Pamela Mathura
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Miriam Li
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Narmin Kassam
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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17
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Weinstein LC, Chilton M, Turchi R, Klassen AC, LaNoue M, Silvero A, Cabassa LJ. 'It's common sense that an individual must eat': Advocating for food justice with people with psychiatric disabilities through photovoice. Health Expect 2020; 24 Suppl 1:161-173. [PMID: 32671916 PMCID: PMC8137492 DOI: 10.1111/hex.13101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 03/25/2020] [Accepted: 06/24/2020] [Indexed: 01/02/2023] Open
Abstract
Background People with SMI have often been excluded in advocacy efforts focused on physical health, health care and health and social policy. Objective Following a Photovoice project focused on barriers to healthy eating and physical activity in urban neighbourhoods, participant‐researchers were invited to present their insights in community advocacy settings. The purpose of this study was to explore the feasibility and participant–researchers’ experience of these community advocacy activities. Design We held four focus groups with the eight participant‐researchers after each community advocacy activity to explore their experience with public speaking, presenting their experiences and advocating. Setting and Participants People with serious mental illness who were overweight/obese living in supportive housing. Analysis approach Qualitative analysis of the focus group transcripts, using a modified grounded theory approach followed by structured coding focused on empowerment, participation and non‐discrimination. Results Participant‐researchers gave three oral presentations of their photographs at a variety of community‐based programmes and settings and participated in a rally to advocate for SNAP benefits. Two themes emerged from analysis: (a) Empowerment (the level of choice, influence and control that users of mental health services can exercise over events in their lives) and (b) Barriers to Empowerment (obstacles to participation and well‐being). Conclusions This evaluation strengthens the evidence that it is feasible for participant‐researchers in Photovoice projects to engage in robust advocacy activities, such as presentations and discussions with local policymakers. During focus groups, participant‐researchers demonstrated realistic optimism towards their roles as change agents and influencers in spite of acknowledged systemic barriers.
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Affiliation(s)
- Lara Carson Weinstein
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Mariana Chilton
- Dornsife School of Public Health, Health Management and Policy, Drexel University, Philadelphia, PA, USA
| | - Renee Turchi
- Dornsife School of Public Health, Community Health and Prevention, Drexel University, Philadelphia, PA, USA
| | - Ann C Klassen
- Dornsife School of Public Health, Community Health and Prevention, Drexel University, Philadelphia, PA, USA
| | - Marianna LaNoue
- School of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alexis Silvero
- Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Leopoldo J Cabassa
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MI, USA
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Williams O, Sarre S, Papoulias SC, Knowles S, Robert G, Beresford P, Rose D, Carr S, Kaur M, Palmer VJ. Lost in the shadows: reflections on the dark side of co-production. Health Res Policy Syst 2020; 18:43. [PMID: 32380998 PMCID: PMC7204208 DOI: 10.1186/s12961-020-00558-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 04/02/2020] [Indexed: 11/30/2022] Open
Abstract
This article is a response to Oliver et al.'s Commentary 'The dark side of coproduction: do the costs outweigh the benefits for health research?' recently published in Health Research Policy and Systems (2019, 17:33). The original commentary raises some important questions about how and when to co-produce health research, including highlighting various professional costs to those involved. However, we identify four related limitations in their inquiry, as follows: (1) the adoption of a problematically expansive definition of co-production that fails to acknowledge key features that distinguish co-production from broader collaboration; (2) a strong focus on technocratic rationales for co-producing research and a relative neglect of democratic rationales; (3) the transposition of legitimate concerns relating to collaboration between researchers and practitioners onto work with patients, service users and marginalised citizens; and (4) the presentation of bad practice as an inherent flaw, or indeed 'dark side', of co-production without attending to the corrupting influence of contextual factors within academic research that facilitate and even promote such malpractice. The Commentary's limitations can be seen to reflect the contemporary use of the term 'co-production' more broadly. We describe this phenomenon as 'cobiquity' - an apparent appetite for participatory research practice and increased emphasis on partnership working, in combination with the related emergence of a plethora of 'co' words, promoting a conflation of meanings and practices from different collaborative traditions. This phenomenon commonly leads to a misappropriation of the term 'co-production'. Our main motivation is to address this imprecision and the detrimental impact it has on efforts to enable co-production with marginalised and disadvantaged groups. We conclude that Oliver et al. stray too close to 'the problem' of 'co-production' seeing only the dark side rather than what is casting the shadows. We warn against such a restricted view and argue for greater scrutiny of the structural factors that largely explain academia's failure to accommodate and promote the egalitarian and utilitarian potential of co-produced research.
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Affiliation(s)
- Oli Williams
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom.
- THIS Institute, Cambridge, United Kingdom.
| | - Sophie Sarre
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
| | | | | | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
| | | | - Diana Rose
- Service User Research Enterprise, King's College London, London, United Kingdom
| | - Sarah Carr
- University of Birmingham, Birmingham, United Kingdom
| | - Meerat Kaur
- NIHR ARC Northwest London, London, United Kingdom
| | - Victoria J Palmer
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
- The University of Melbourne, Melbourne, Australia
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Charles A, Felton A. Exploring young people's experiences and perceptions of mental health and well-being using photography. Child Adolesc Ment Health 2020; 25:13-20. [PMID: 32285642 DOI: 10.1111/camh.12351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The mental health of young people is a major global public health concern. A shift in focus towards children and young people's mental health in the UK has emphasized young people's voices, as of paramount importance in shaping the path for future quality care provision. The paper examines a study that aimed to explore young people's perceptions of mental health and well-being using photographs. METHOD The methodology employed for this study placed young people at the centre of the research process by using photographs to capture their experiences. Ten young people who attended a youth group used disposable cameras to take photographs of their experiences and perceptions of mental health and well-being. Semi-structured interviews with the young people elicited their narratives behind the images. Data were analysed using photo-elicitation and thematic analysis. FINDINGS Young people's experiences of mental health and well-being were internalized and located predominantly in the private and hidden regions of their everyday lives. Stigma, social isolation and marginalization were prevalent whilst spirituality and connection with the environment expressed hope. CONCLUSION Mental health appears to be firmly located in the private 'back regions' of young individuals' lives, demonstrating that young people conceptualize these experiences as a vulnerable and hidden part of their being. Understanding the needs of this new generation of youth including the prevalence of stigma, risk of isolation and social exclusion are paramount. Future service provision needs to recognize the extent stigma impacts upon young people's experiences of mental health and well-being.
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Affiliation(s)
- Ashleigh Charles
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Anne Felton
- Institute of Health and Allied Professions, Nottingham Trent University, Nottingham, UK
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20
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Dale CM, Angus JE, Sutherland S, Dev S, Rose L. Exploration of difficulty accessing the mouths of intubated and mechanically ventilated adults for oral care: A video and photographic elicitation study. J Clin Nurs 2019; 29:1920-1932. [PMID: 31342565 DOI: 10.1111/jocn.15014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 07/02/2019] [Accepted: 07/09/2019] [Indexed: 02/03/2023]
Abstract
AIM To explore descriptors of difficulty accessing the mouths of intubated and mechanically ventilated adults for oral care, consequences, modifiable antecedents and recommendations for improving care delivery. BACKGROUND Nurses report oral access and care delivery difficulty in most mechanically ventilated patients. DESIGN A prospective qualitative descriptive design. METHODS Data were collected using video and photographic elicitation interviews focused on delivery of oral care. Directed content analysis was used to explore descriptive categories. Reporting used the SRQR guidelines. SETTING AND PARTICIPANTS A university-affiliated hospital in Toronto, Canada. Participants included clinicians experienced in accessing the oral space of adults representing nursing, medicine, dentistry and allied health professionals. FINDINGS We recruited 18 participants; 9 representing critical care and 9 other specialties frequently accessing the mouth, that is dentistry. Descriptors for observed difficulty accessing the oral cavity were "oral crowding with tubes" and "aversive patient responses", which were considered to result in insufficient oral care. Participants perceived aversive patient responses (e.g. biting, turning head side to side, gagging, coughing) as a consequence of forced introduction of instruments inside a crowded mouth. A key finding identified by participants was the observation of substantial procedural pain during oral care interventions. Potentially modifiable antecedents to difficult oral care delivery identified were procedural pain, oral health deterioration (e.g. xerostomia) and lack of interprofessional team problem-solving. Recommendations to address these antecedents included patient preparation for oral care through verbal and nonverbal cueing, pharmacological and nonpharmacological strategies, and ICU interprofessional education. CONCLUSIONS Oral care in mechanically ventilated adults is complex and painful. Visual research methods offer important advantages for oral care exploration including its ability to reveal less visible aspects of the nurse-patient encounter, thereby enabling novel insights and care. RELEVANCE FOR CLINICAL PRACTICE Interprofessional education and training in oral health and care interventions tailored to mechanically ventilated patients are recommended.
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Affiliation(s)
- Craig M Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Jan E Angus
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Susan Sutherland
- Department of Dentistry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Shelly Dev
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Louise Rose
- Lawrence S. Bloomberg Faculty of Nursing and Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Critical Care Medicine, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College, London, UK
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