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Engstrom T, Shteiman M, Kelly K, Sullivan C, Pole JD. What is measured matters: A scoping review of analysis methods used for qualitative patient reported experience measure data. Int J Med Inform 2024; 190:105559. [PMID: 39032453 DOI: 10.1016/j.ijmedinf.2024.105559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Hospitals are increasingly turning to patients for valuable feedback regarding their care experience. A common method to collect this information is patient reported experience measures (PREMs) surveys. Health care workers report qualitative PREMs as more interesting, relevant, and informative than quantitative survey responses. However, a major barrier to utilising qualitative PREMs data to drive quality improvements is a lack of resources to analyse the data. This scoping review aimed to review the methods used to analyse qualitative PREMs survey data from routine hospital care. METHODS We utilised the JBI scoping review methodology, and searched four databases for articles from 2013 to 2023 which analysed qualitative PREMs survey data from routine care in hospitals. Study characteristics were extracted, as well as the analysis method - specifically, whether the study used traditional manual analysis methods in which the researcher reads the text and categorise the data, or automated methods utilising computers and algorithms to read and categorise the data. RESULTS From 960 unique articles, 123 went through full-text review and 54 were deemed eligible. 75.9 % used only manual content analysis methods to analyse the qualitative responses, 16.7 % of studies used a combination of manual and automated methods, and only 7.4 % used exclusively automated methods. Automated methods were used in 27.5 % of studies published 2019-2023, compared to 14.3 % of studies published 2013-2018. All bar one study using automated methods focused on investigating the validity of the automated methodology or used it to complement manual content analysis. CONCLUSION The studies included in this review show a transition from traditional time-consuming manual analyses to computerised methods enabling analysis at a larger scale. As the volume of PREMs data collected grows, efficient and effective ways to analyse qualitative PREMs data at scale are required to enable health services to capture the patient voice and drive consumer-centred improvements in care.
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Affiliation(s)
- Teyl Engstrom
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia.
| | - Max Shteiman
- The University of Queensland-Ochsner Clinical School, Brisbane, QLD, Australia
| | - Kim Kelly
- Qualitative Research Center of Excellence, IQVIA, Tucson, AZ, USA
| | - Clair Sullivan
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Jason D Pole
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; The University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
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Watter K, Murray A, McLennan V, Vogler J, Jeffery S, Ehlers S, Nielsen M, Kennedy A. A framework to support early team-based provision of vocational rehabilitation for adults with acquired brain injury. Disabil Rehabil 2024; 46:3176-3188. [PMID: 37525931 DOI: 10.1080/09638288.2023.2239162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE Specialised vocational rehabilitation (VR) following acquired brain injury (ABI) positively impacts return to work, however access to this is limited globally. Providing VR as a component of standard ABI rehabilitation may improve access to VR and influence vocational outcomes. This study aimed to develop an evidence-based framework for the delivery of ABI VR during early transitional community rehabilitation. MATERIALS AND METHODS The development of the ABI VR framework utilised an emergent multi-phase design and was informed by models of evidence-based practice, national rehabilitation standards, guidelines for complex intervention development, model of care and framework development, and the knowledge-to-action framework. Four study phases were undertaken to identify and generate the evidence base, with findings synthesised to develop the ABI VR framework in phase five. RESULTS The framework provides a structure for the systematic delivery of VR as a component of team-based ABI rehabilitation, through five phases of rehabilitation: assessment; goal setting and rehabilitation planning; intervention; monitoring and evaluation; and discharge. It details the activities to be undertaken across the phases using a hybrid model of ABI VR (involving program-based VR and case coordination) and contains service delivery features. CONCLUSION The framework has the potential to translate to other similar service contexts.
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Affiliation(s)
- Kerrin Watter
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, Qld, Australia
- Menzies Institute and School of Allied Health Sciences, Griffith University, Qld, Australia
| | - Alena Murray
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, Qld, Australia
| | - Vanette McLennan
- The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, Qld, Australia
- Menzies Institute and School of Allied Health Sciences, Griffith University, Qld, Australia
| | - Jessica Vogler
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
| | - Sarah Jeffery
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
| | - Shelley Ehlers
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
| | - Mandy Nielsen
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, Qld, Australia
- Menzies Institute and School of Allied Health Sciences, Griffith University, Qld, Australia
| | - Areti Kennedy
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, Qld, Australia
- Menzies Institute and School of Allied Health Sciences, Griffith University, Qld, Australia
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Cottrell K, Chapman HM. Acquired brain injury (ABI) survivors' experience of occupation and activity during their inpatient stay: a scoping review. Disabil Rehabil 2023:1-25. [PMID: 37982380 DOI: 10.1080/09638288.2023.2281601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/02/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE This review aimed to characterise and map: (1) what type of evidence and what dominant study characteristics are available regarding acquired brain injury (ABI) survivors' experience of occupation and activity in hospital? (2) How are occupation and activity conceptualised in the literature? (3) How are ABI survivors experiencing occupation and activity while in hospital? (4) What factors create barriers or opportunities for engagement in occupations or activity in hospital? (5) Are there any knowledge gaps identified? MATERIALS AND METHODS A scoping review was conducted examining literature published between 2017 and 2022. Relevant studies were systematically retrieved from electronic databases. RESULTS Thirty-four publications were included. There were more quantitative studies (n = 18). Much of the research has been conducted outside of the UK. The populations studied were principally stroke (n = 22). The concept of activity rather than occupation predominates. Patients spend their time alone and inactive. Structural and contextual barriers for engaging in activity are identified. Qualitative study designs exclude ABI survivors with communication or cognitive impairment. CONCLUSIONS There is a paucity of research with ABI survivors in hospitals in the UK. Alternative methodological approaches such as ethnography would ensure those with communication or cognitive impairment are not excluded from research. Implications for rehabilitationRehabilitation professionals, especially occupational therapists, need to lead acquired brain injury (ABI) research in acute hospital settings in the UK.Conceptualisation of meaningful activity and occupation needs a clearer focus in ABI research.Qualitative studies frequently exclude participants with cognitive or communication impairments so methodologies that are more inclusive and representative of brain injury survivors are needed.
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Affiliation(s)
| | - Hazel M Chapman
- Faculty of Health, Medicine and Society, University of Chester, Chester, UK
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O'Shannessy E, Reeder S, Vishwanath S, Hill S, Perta A, Jolliffe L, Morarty J, Hunter P, Lannin NA. Mixed methods study to understand the experiences of adults with acquired brain injury and their family members who receive specialised rehabilitation. BRAIN IMPAIR 2023; 24:39-53. [PMID: 38167579 DOI: 10.1017/brimp.2022.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIM Rehabilitation therapy is a key part of the recovery pathway for people with severe acquired brain injury (ABI). The aim of this study was to explore inpatients' and their family members' experiences of a specialist ABI rehabilitation service. METHODS A cross sectional, prospective mixed method study was undertaken at a metropolitan specialist ABI rehabilitation unit in Victoria, Australia. All inpatients and their family members of the service were invited to complete a satisfaction survey. Employing purposive sampling, semi-structured interviews were conducted with inpatients and/or their family members. RESULTS In total, 111 people completed the satisfaction survey and 13 were interviewed. High levels of satisfaction with the specialist service were reported; the majority of inpatients (74%) and family members (81%) rated the overall quality of care received in the service as 'high' or 'very high'. Interviews revealed four main themes: (i) satisfaction with rehabilitation services, (ii) inconsistent communication, (iii) variable nursing care, and (iv) strengths and weakness of the rehabilitation environment. Overall, important components of a positive experience were being involved in decision making and discharge planning, effective communication and information processes, and being able to form therapeutic relationships with staff. Key sources of dissatisfaction for inpatients and family members related to inconsistency in care, accessing information about treatments in a format easily understood, and communication. CONCLUSION Specialised rehabilitation is valued by inpatients and their family members alike. The findings highlight the importance of exploring inpatient experiences to optimise service delivery in a tailored, specialised rehabilitation programme.
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Affiliation(s)
| | - Sandra Reeder
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Swarna Vishwanath
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Sophie Hill
- La Trobe University, Melbourne, VIC, Australia
| | | | - Laura Jolliffe
- Alfred Health, Melbourne, VIC, Australia
- Department of Occupational Therapy, Monash University, Melbourne, VIC, Australia
| | | | | | - Natasha A Lannin
- Alfred Health, Melbourne, VIC, Australia
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, VIC, Australia
- La Trobe University, Melbourne, VIC, Australia
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Quality Measure Concepts for Inpatient Rehabilitation That Are Best Understood From the Patient's Perspective. Rehabil Nurs 2022; 47:210-219. [PMID: 36002927 DOI: 10.1097/rnj.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to identify inpatient rehabilitation quality-of-care concepts that are best understood from the patient perspective. DESIGN We conducted 12 focus groups with 95 former patients, caregivers, and rehabilitation clinicians and asked them to describe high-quality inpatient rehabilitation care. METHODS We independently reviewed the focus group transcripts and then used an iterative process to identify the quality measure concepts identified by participants. RESULTS Based on participants' comments, we identified 18 quality measure concepts: respect and dignity, clinician communication with patient, clinician communication with family, organizational culture, clinician engagement with patient, clinician engagement with family, rehabilitation goals, staff expertise, responsiveness, patient safety, physical environment, care coordination, discharge planning, patient and family education, peer support, symptom management (pain, anxiety, fatigue, sadness), sleep, and functioning. CLINICAL RELEVANCE TO THE PRACTICE OF REHABILITATION NURSING Rehabilitation nurses should be aware of the quality-of-care issues that are important to patients and their caregivers. CONCLUSION Important patient-reported domains of quality of care include interpersonal relationships, patient and family engagement, care planning and delivery, access to support, and quality of life.
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Mann G, Troeung L, Wagland J, Martini A. Cohort profile: the Acquired Brain Injury Community REhabilitation and Support Services OuTcomes CohoRT (ABI-RESTaRT), Western Australia, 1991-2020. BMJ Open 2021; 11:e052728. [PMID: 34475189 PMCID: PMC8413932 DOI: 10.1136/bmjopen-2021-052728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 07/06/2021] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Transition back into the community following acute management of acquired brain injury (ABI) is a critical part of recovery. Post-acute rehabilitation and transitional care can significantly improve outcomes. The Acquired Brain Injury Community REhabilitation and Support Services OuTcomes CohoRT (ABI-RESTaRT) is a novel whole-population cohort formed to better understand the needs of individuals with ABI receiving post-acute rehabilitation and disability services in Western Australia (WA), and to improve their outcomes. To do this a unique combination of (1) internal clinical/rehabilitation data, and (2) externally linked health data from the WA Data Linkage System was used, including hospitalisations, emergency department presentations, mental health service use and death records, to measure longitudinal needs and outcomes of individuals with ABI over 29 years, making this the largest, most diverse post-acute ABI cohort in Australia to date. PARTICIPANTS Whole-population cohort of individuals (n=1011) with an ABI who received post-acute community-based neurorehabilitation or disability support services through Brightwater Care Group from 1991 to 2020. FINDINGS TO DATE Comprehensive baseline demographic, clinical and rehabilitation data, outcome measures and linked health data have been collected and analysed. Non-traumatic brain injury (eg, stroke, hypoxia) was the main diagnostic group (54.9%, n=555), followed by traumatic brain injury (34.9%, n=353) and eligible neurological conditions (10.2%, n=103). Mean age at admission was 45.4 years, and 67.5% were men (n=682). The cohort demonstrated significant heterogeneity, socially and clinically, with differences between ABI groups across a number of domains. FUTURE PLANS ABI-RESTaRT is a dynamic whole-population cohort that will be updated over time as individuals enrol in the service. Future analyses will assess longitudinal brain injury outcomes, the changing health and social needs of individuals with ABI and evaluate and inform post-acute services to best support these individuals. REGISTRATION This cohort is not linked to a clinical trial, and is not registered.
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Affiliation(s)
- Georgina Mann
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, Western Australia, Australia
| | - Lakkhina Troeung
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, Western Australia, Australia
| | - Janet Wagland
- Disability Services, Brightwater Care Group, Osborne Park, Western Australia, Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, Western Australia, Australia
- School of Social Sciences, The University of Western Australia, Crawley, Western Australia, Australia
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