Concurrent analysis: a pragmatic justification

"There is a strangeness in this disease": A qualitative study of parents' experiences caring for a child diagnosed with COVID-19

BACKGROUND

The beginning of the COVID-19 pandemic marked a period of uncertainty as public health guidelines, diagnostic criteria, and testing protocols or procedures have continuously evolved. Despite the virus being declared a worldwide pandemic, little research has been done to understand how parents manage caring for their child diagnosed with COVID-19. We sought to understand parents' experiences and information need when caring for a child diagnosed with COVID-19.

METHODS

A qualitative descriptive study with an inductive and exploratory approach was completed. Participants were recruited through social media and local public health clinics. Data collection and analysis were concurrent. Semi-structured virtual interviews were conducted with 27 participants. Thematic analysis was conducted.

FINDINGS

Four major themes emerged: a) dealing with uncertainty; b) anxiety; c) social stigma and stress; d) a sense of community.

CONCLUSION

Our study highlights that parent experiences were diverse and multi-faceted, and their experiences evolved and shifted over the course of the pandemic. Parents would benefit from clear and consistent evidence-based online information. Understanding the perspectives of parents caring for a child with COVID-19 is an important step in developing future resources tailored to meet their unique experiences and information needs.

How to synthesise original findings back into the literature: a reintroduction to concurrent analysis

BACKGROUND

All studies need to integrate their findings back into the literature to explain how the new knowledge changes understanding. This process can be anxiety-provoking, especially when new literature appears to threaten the originality of the study.

AIM

To reintroduce 'concurrent analysis' (CA) - a method of synthesising relevant literature with primary data.

DISCUSSION

CA treats all data as primary data. To illustrate the technique, the authors synthesise relevant literature with findings from a doctoral study of patients' experiences of vascular access devices.

CONCLUSION

CA raised new questions that would otherwise have remained unasked. For example, it revealed cultural differences in the way patients react to suboptimal treatment.

IMPLICATIONS FOR PRACTICE

Nurse researchers are best placed to influence policy and practice when they can articulate the transferability of their findings. CA is a practical method of achieving this.

A screening tool for predicting gatekeeping behaviour

AIM

To develop a typology and screening tool for gatekeeping behaviours by nurses responsible for recruitment in palliative care research.

DESIGN

Concurrent analysis.

METHOD

Two focus groups were conducted in 2015 with nine qualified hospice community nurses involved in recruitment to a trial in palliative care. The literature was searched for research into gatekeeping from 2000-2016. All narrative examples of gatekeeping activity were coded using gerunds. Common codes were then grouped and interpreted as a social process.

RESULTS

Gatekeeping is normal and should be expected. A continuum typology emerged, ranging from unintentional to active disengagement. Justification ranged from forgetting to deliberately not mentioning the study for fear of burdening patients. Viewing gatekeeping as a continuum allowed for the creation of a screening tool designed to collaboratively discuss and hence mitigate specific types of gatekeeping behaviour before they occur. This is a unique international contribution to this persistent issue.

Two years of unintended consequences: introducing an electronic health record system in a hospice in Scotland

AIMS AND OBJECTIVES

To explore the impact of implementing an electronic health record system on staff at a Scottish hospice.

BACKGROUND

Electronic health records are broadly considered preferable to paper-based systems. However, changing from one system to the other is difficult. This study analysed the impact of this change in a Scottish hospice.

DESIGN

Naturalistic prospective repeated-measures mixed-methods approach.

METHODS

Data on the usability of the system, staff engagement and staff experience were obtained at four time points spanning 30 months from inception. Quantitative data were obtained from surveys, and qualitative from concurrent analysis of free-text comments and focus group. Participants were all 150 employees of a single hospice in Scotland.

RESULTS

Both system usability and staff engagement scores decreased for the first two years before recovering at 30 months. Staff experience data pointed to two main challenges: (1) Technical issues, with subthemes of accessibility and usability. (2) Cultural issues, with subthemes of time, teamwork, care provision and perception of change.

CONCLUSIONS

It took 30 months for system usability and staff engagement scores to rise, after falling significantly for the first two years. The unintended outcomes of implementation included challenges to the way the patient story was both recorded and communicated. Nevertheless, this process of change was found to be consistent with the 'J-curve' theory of organisational change, and as such, it is both predictable and manageable for other organisations.

RELEVANCE TO CLINICAL PRACTICE

It is known that implementing an electronic health record system is complex. This paper puts parameters on this complexity by defining both the nature of the complexity ('J' curve) and the time taken for the organisation to begin recovery from the challenges (two years). Understanding these parameters will help health organisations across the world plan more strategically.

Against intimacy: focusing on the task in hand in PhD supervision

Worldwide, more nurses are undertaking doctoral studies now than at any other time. However, there is little high-quality evidence focused on investigating successful completion of such studies. Instead there is considerable literature dedicated to untested assumptions about the nature of the supervisory relationship. This article reflects on three critical incidents to show that the key to successful PhD completion may have much less to do with the supervisory relationship than this literature assumes. Success is rather grounded in clear understanding of how all the pertinent tasks fit together. A free online interactive resource is introduced as one method of facilitating this clarity within the supervisory relationship. The effectiveness of this resource could be tested, thereby generating meaningful data for PhD students and their supervisors.