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Unbeck M, Lidgren F, Tabbakh E, Nymark C. The patient's experience of participation when admitted for elective surgical procedures: an interview study. Int J Qual Stud Health Well-being 2023; 18:2163958. [PMID: 36617889 PMCID: PMC9833403 DOI: 10.1080/17482631.2022.2163958] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To describe the patient's experience of participation in their care when admitted for elective surgical procedures. MATERIALS AND METHODS A purposive sample of 14 patients who had undergone elective surgery was included in semi-structured individual interviews at a university hospital. The data was analysed using qualitative content analysis. RESULTS One theme was identified: Creating a meaningful relationship to enable participation in the care, based on three categories; Abilities, willingness, and a lack of experience affect participation, A professional approach with an open communication and individualized information, and The importance of structural factors. CONCLUSIONS To meet the patient's individual needs and wishes regarding participation, meaningful relationships need to be created between patient and healthcare personnel. The results also indicate that the patients have insufficient knowledge about their role regarding participation. To improve patient participation, its meaning needs to be clarified individually to the patient, emphasizing the importance to be active involved in his or her own care.
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Affiliation(s)
- Maria Unbeck
- School of Health and Welfare, Dalarna University, Falun, Sweden,Department of Neurobiology, Care sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Filippa Lidgren
- Emergency and Reparative Medicine Theme, Department of Plastic and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Ella Tabbakh
- Heart, Vascular and Neuro Theme, Department of Thoracic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Carolin Nymark
- Department of Neurobiology, Care sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden,Heart, Vascular and Neuro Theme, Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden,CONTACT Carolin Nymark Heart, Vascular and Neuro Theme, Department of Cardiology, Karolinska University Hospita, StockholmSE-171 76, Sweden
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2
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McDonnell S, Breslin T, Mascan B, Shahruddin NS, Elnour M, Fanning M, Galvin A, Moore J, Ravi N, Reynolds JV, Donohoe CL. Translating evidence in a priority setting partnership: knowledge gaps between healthcare providers and oesophageal cancer patients. Support Care Cancer 2023; 31:126. [PMID: 36680653 PMCID: PMC9860237 DOI: 10.1007/s00520-022-07523-3] [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: 01/04/2022] [Accepted: 11/26/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Despite the fact that health information is now more accessible than ever, knowledge gaps remain between patients and healthcare providers (HCPs). To date, the patients' need for information following a diagnosis of oesophageal cancer has not been adequately met. PURPOSE The purpose of this study was to identify why knowledge gaps exist between oesophageal cancer patients and HCPs and how to address them. METHODS Purposive sampling of a group of people living with and after oesophageal cancer who had participated in a priority-setting partnership where 45% of questions from patients had existing evidence-based answers. A 7-set question series was developed for use in a patient/HCP focus group in addition to 11 individual phone interviews with survivors of oesophageal cancer. Qualitative semistructured interviews were conducted to explore oesophageal cancer patients' access to information. The data was analysed thematically, which involved coding all patient transcripts before identifying and reviewing key themes. RESULTS The three primary themes that emerged were as follows: opportunity (HCP team factors and relationship development), ability (patient factors) and priority (pacing of information delivery). CONCLUSION Effective communication between patients and HCPs was identified as an integral component of the enhancement of patient knowledge. HCPs should continue to refine and improve methods of information delivery and encourage conversations regarding information preferences.
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Affiliation(s)
- Sarah McDonnell
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Tara Breslin
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Bianca Mascan
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Nur Shuhada Shahruddin
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mawaheb Elnour
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Michelle Fanning
- Department of Clinical Nutrition and Dietetics, Trinity St James Cancer Institute, Dublin, Ireland
| | - Anthony Galvin
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Jennifer Moore
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Narayansamy Ravi
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - John V. Reynolds
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Claire L. Donohoe
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
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3
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Tubic B, Finizia C, Zainal Kamil A, Larsson P, Engström M. Patients' experience of patient safety information and participation in care during a hospital stay. Nurs Open 2022; 10:1684-1692. [PMID: 36315031 PMCID: PMC9912399 DOI: 10.1002/nop2.1423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/21/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
Abstract
AIM Having a culture of safety is crucial when providing high-quality health care, yet preventable adverse events are common in the Swedish healthcare system, especially in the field of surgical care. Research shows that patient participation can improve patient safety. This study aimed to explore patients' experience of the safety leaflet, "Your safety in hospital," including participation in care and feelings of safe care. DESIGN This study uses a descriptive qualitative study design. METHODS Twenty patients from surgical wards received patient safety leaflets and participated in semi-structured interviews during their hospital stay. Data were analysed using qualitative content analysis. RESULTS Three categories emerged from the analysis: Positive and negative experiences of provided information, Experiences of participation in own care, and Feelings of being safe arising from a perception of good quality care. Most participants were satisfied with their participation in their care and felt safe during their hospital stay. Oral information about the safety leaflet from healthcare personnel was lacking.
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Affiliation(s)
- Bojan Tubic
- Institute of Clinical Sciences, Department of Orthopaedics, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Orthopaedic Surgery, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden,Department of Otorhinolaryngology, Head and Neck SurgeryInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Asra Zainal Kamil
- Department of Surgery ÖstraRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
| | - Pernilla Larsson
- Department of Surgery ÖstraRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
| | - My Engström
- Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Surgery Sahlgrenska, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
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4
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Drott J, Fomichov V, Nordén M, Larsson AL, Sandström P, Björnsson B, Eldh AC. Patient preferences and experiences of participation in surgical cancer care. Worldviews Evid Based Nurs 2022; 19:405-414. [PMID: 35607906 PMCID: PMC10946456 DOI: 10.1111/wvn.12589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/11/2022] [Accepted: 02/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Quality cancer care necessitates opportunities for patient participation, supposedly recognizing the individual's preferences and experiences for being involved in their health and healthcare issues. Previous research shows that surgical cancer patients wish to be more involved, requiring professionals to be sensitive of patients' needs. AIMS To explore preference-based patient participation in surgical cancer care. METHODS A cross-sectional study was conducted. The Patient Preferences for Patient Participation tool (4Ps) was used, which includes 12 attributes of preferences for and experiences of patient participation. Data were analyzed with descriptive and comparative statistical methods. RESULTS The results are based on a total of 101 questionnaires. Having reciprocal communication and being listened to by healthcare staff were commonly deemed crucial for patient participation. While 60% of the patients suggested that taking part in planning was crucial for their participation, they had experienced this only to some extent. Learning to manage symptoms and phrasing personal goals were items most often representing insufficient conditions for preference-based patient participation. LINKING EVIDENCE TO ACTION To support person-centered surgical care, further efforts to suffice preference-based participation are needed, including opportunities for patients to share their experiences and engage in the planning of healthcare activities.
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Affiliation(s)
- Jenny Drott
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Surgery in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Victoria Fomichov
- Unit for Public Health and Statistics, County Council of ÖstergötlandLinköping UniversityLinköpingSweden
| | - Maria Nordén
- Department of Urology in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Anna Lindhoff Larsson
- Department of Surgery in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Per Sandström
- Department of Surgery in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Bergthor Björnsson
- Department of Surgery in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Ann Catrine Eldh
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
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5
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Engqvist Boman L, Sundberg K, Petersson LM, Backman M, Silén C. A pedagogical model to enhance nurses' ability to support patient learning: an educational design research study. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:176-186. [PMID: 35909338 PMCID: PMC9911139 DOI: 10.5116/ijme.62c2.b9c4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To design, apply, evaluate, and analyse a pedagogical model to enhance nurses' ability to create pedagogical encounters to support patients' learning. METHODS The study relies on an educational design research approach. A pedagogical model based on learning theories was designed, applied, evaluated, and analysed in a specialist nursing programme in cancer care. All students (n=28) who attended the programme accepted to participate in the evaluation of the model. Their perception of the learning activities was evaluated in a questionnaire, and 16 (57%) students responded. The students' learning was assessed in written assignments, including all students. Descriptive statistics, content analysis and theoretical reasoning, were used to analyse data and interpret the usefulness and shortcomings of the model. RESULTS The most appreciated learning activities were to study learning theories, observe pedagogical encounters, act as a critical friend, and document one's own pedagogical encounters. The written assignments about observing and performing their own pedagogical encounters with patients showed students' increased awareness of how to support patients' learning. The clinical supervisors' lack of pedagogical knowledge inhibited the feedback on students' performances. CONCLUSIONS The theoretical analysis of the evaluation identified strengths and needs for further development. The strengths tend to be the ongoing learning process created by learning activities supporting students to continuously study, experience, and apply their knowledge. Nurse supervisors and other stakeholders at the clinics are suggested to be involved in improving the design and require pedagogical competence. Further research should include observational and interview studies related to students' performance in pedagogical encounters.
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Affiliation(s)
- Lena Engqvist Boman
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Kay Sundberg
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Lena-Marie Petersson
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Malin Backman
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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6
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Amin A, Nordén M, Fomichov V, Björnsson B, Lindhoff Larsson A, Sandström P, Drott J. Patient-reported participation in hepatopancreatobiliary surgery cancer care: A pilot intervention study with patient-owned fast-track protocols. Eur J Cancer Care (Engl) 2022; 31:e13570. [PMID: 35274386 PMCID: PMC9542293 DOI: 10.1111/ecc.13570] [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: 02/20/2021] [Revised: 01/28/2022] [Accepted: 03/02/2022] [Indexed: 12/01/2022]
Abstract
Objective Fast‐track concepts have been implemented in hepatopancreatobiliary surgery cancer care to improve postoperative recovery. For optimal postoperative care, patient participation is also required. The aim was to investigate and analyse whether an intervention with patient‐owned fast‐track protocols (PFTPs) may lead to increased patient participation and improve information for patients who underwent surgery for hepatopancreatobiliary cancer. Methods A quantitative comparative design with a control and intervention group was used. The participants in the intervention group followed a PFTP during their admission. After discharge, the patients answered a questionnaire regarding patient participation. Data analyses were performed with descriptive statistics and ANCOVA. Results The results are based on a total of 222 completed questionnaires: 116 in the control group and 106 in the intervention group. It is uncertain whether the PFTP increased patient participation and information, but its use may indicate an improvement for the patient group. Conclusion A successful implementation strategy for the use of PFTP, with daily reconciliations, could be part of the work required to improve overall satisfaction with patient participation. ClinicalTrials.gov ID: NCT04061902
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Affiliation(s)
- Awin Amin
- Department of Surgery in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Maria Nordén
- Department of Urology in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Victoria Fomichov
- Unit for Public Health and Statistics, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Bergthor Björnsson
- Department of Surgery in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Anna Lindhoff Larsson
- Department of Surgery in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Per Sandström
- Department of Surgery in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Jenny Drott
- Department of Surgery in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Division of Nursing Science, Department of Health
- Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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7
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Westman B, Bergkvist K, Karlsson Rosenblad A, Sharp L, Bergenmar M. Patients with low activation level report limited possibilities to participate in cancer care. Health Expect 2022; 25:914-924. [PMID: 35049103 PMCID: PMC9122461 DOI: 10.1111/hex.13438] [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: 05/04/2021] [Revised: 11/26/2021] [Accepted: 01/09/2022] [Indexed: 11/27/2022] Open
Abstract
Background Cancer care trajectories are often complex, with potent multimodality treatments and multiple interactions with health care providers. Communication and coordination are challenging and the patients' responsibilities to take on more active roles in their own care are increasing. Objective This study aimed to investigate associations between patient activation level and participation in cancer care, sociodemographic characteristics, clinical data, health‐related quality of life (HRQoL) and helpfulness of received information. Methods In this cross‐sectional population‐based study, patients completed questionnaires on patient activation, perceived participation, HRQoL, helpfulness of received information and sociodemographic characteristics. Responses to the patient activation measures (PAMs) were classified into four levels (higher levels indicating more activation). Data on age, sex and cancer diagnosis were collected from the Swedish Cancer Register. Results Data from 682 patients were analysed. On comparing patients at PAM levels 1 and 4, the latter reported significantly higher possibilities to influence care decisions (46.6% vs. 20.8%) and to ask questions regarding treatment and care (93.4% vs. 68.4%). Patients at PAM level 4 reported wanting to influence decision‐making to a higher extent, compared with patients at other PAM levels, and reported clinically significantly higher HRQoL. No significant differences were found regarding sociodemographic characteristics. Conclusion We found strong associations between perceived patient participation and activation levels, with limited possibility for participation among those with lower activation levels. Patient or Public Contribution Discussions with patient representatives have raised the importance of participation. The preliminary findings were presented and discussed in a workshop with representatives from 21 cancer patient advocacy groups.
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Affiliation(s)
- Bodil Westman
- Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden.,Department of Care Science, Sophiahemmet University, Stockholm, Sweden
| | - Karin Bergkvist
- Department of Care Science, Sophiahemmet University, Stockholm, Sweden.,Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Karlsson Rosenblad
- Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden.,Division of Clinical Diabetology and Metabolism, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Lena Sharp
- Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden.,Division of Innovative Care Research, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Mia Bergenmar
- Department of Care Science, Sophiahemmet University, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.,Department of Pelvic Cancer, Psychosocial Unit, Karolinska University Hospital, Stockholm, Sweden
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8
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Ibrahim F, Wennerholm C, Sandström P, Lindhoff Larsson A, Björnsson B, Drott J. In the Shadows of Patients with Upper Gastrointestinal Cancer: An Interview Study with Next of Kin about Their Experiences Participating in Surgical Cancer Care. Clin Nurs Res 2020; 29:579-586. [PMID: 32646225 PMCID: PMC7557747 DOI: 10.1177/1054773820940873] [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] [Indexed: 11/28/2022]
Abstract
The study aimed to explore the experiences of participation among the next of kin of patients who had surgery for upper abdominal tumours. This study had a qualitative research design and data were analysed by thematic analysis. Eleven qualitative interviews were conducted with next of kin to patients who had surgery for liver, bile duct or pancreatic malignancy. The following themes emerged: from the shadows to an important role and an inviting and inhibiting environment for participation. Next of kin were a central part of their loved one’s care but often in the shadows. The next of kin described how they were not always invited and often they had to struggle to get involved. Next of kin often have a major psychosocial role to supporting the patient during and after discharge, and therefore need to be invited and involved in the whole care process.
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Andersson Å, Vilhelmsson M, Fomichov V, Lindhoff Larsson A, Björnsson B, Sandström P, Drott J. Patient involvement in surgical care-Healthcare personnel views and behaviour regarding patient involvement. Scand J Caring Sci 2020; 35:96-103. [PMID: 32004397 DOI: 10.1111/scs.12823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 12/06/2019] [Accepted: 01/10/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND All professions in surgical care have a responsibility to include patients in their health care. By Swedish law, all care should be done in dialogue with the patient. The essential part of health care is the meeting between patient and healthcare professional. In the interaction, a decision can be made, and needs can be identified to a safer care. Previous studies on patient participation have focussed on patients' perspectives in surgical care, but there is a paucity of studies about the personnel's perspective of estimated patient involvement in surgical care. AIM The aim of this study was to identify and describe healthcare personnel's view and behaviour regarding patient involvement in surgical care. METHOD A quantitative study with various professions was conducted. A validated questionnaire was used, remaining questions grouped under following areas: patient involvement, acute phase, hospital time, discharge phase and questions on employment and workplace. RESULTS A total of 140 questionnaires were sent out to a surgical clinic in Sweden, and 102 questionnaires were answered. All professionals stated that clear information is an important part of patient involvement in surgical care. Statistically significant differences existed between the professions in the subscale information. Physicians rated their information higher than the Registered Nurses (p = 0.005) and the practical nurses did (p = 0.001). Hindrances to involving patients were lack of time and other priority tasks. CONCLUSIONS Professionals in surgical care graded information to be the most important thing for patient involvement. Participation in important decisions, including the possibility to express personal views and ask questions, is important factors for patient involvement. Barriers against patient involvement are lack of time and prioritisation of other work activities.
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Affiliation(s)
- Åsa Andersson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | | | - Victoria Fomichov
- Centre for Organisational Support and Development County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Anna Lindhoff Larsson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Bergthor Björnsson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Per Sandström
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Jenny Drott
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden.,Division of Nursing Science, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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