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Behrens LL, Kitt-Lewis E, Boltz M, Calo WA, Lehman E, Whitaker J, Osevala N, Van Haitsma K, Van Scoy LJ, Kraschnewski JL. Leadership Perspectives on Nursing Home Operations From Crisis to Control: A Mixed Methods Study. J Am Med Dir Assoc 2024:105145. [PMID: 38991652 DOI: 10.1016/j.jamda.2024.105145] [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: 02/27/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES Nursing home (NH) leaders remain challenged to deliver quality care, despite the COVID-19 transition to an endemic phase. This study describes NH leadership perspectives on preparing and maintaining quality care during times of diminishing resources as experienced through the COVID-19 pandemic to gain insight on how best to support NHs moving forward. DESIGN This was a cross-sectional, parallel convergent mixed methods study. SETTING AND PARTICIPANTS This study reports quantitative data from 5001 NHs across 12 states along with qualitative data from a subsample of NH leaders (N = 15). METHODS Publicly reported survey data were analyzed using descriptive statistics. Individual in-depth interviews with NH leaders conducted at 12-month follow-up were analyzed using inductive thematic coding organized by a guiding framework. Data were integrated using convergent analysis and a joint display. RESULTS NH leaders (licensed administrators, clinical directors, and managers) reported resident and staff infection rates, and access to resources (such as personal protective equipment and testing supplies) that aligned with national trends. Leaders described their NHs (N = 14; 43% rural; 71% not for profit) to be in varied states of operational readiness (standard, contingency, crisis) to support quality infection prevention and control (IPC) at the transition to the endemic COVID-19 phase. Leadership reported continued challenges in addressing resident and staff vaccinations, securing testing supplies, obtaining financial resources to maintain acceptable levels of personal protective equipment, continued staffing shortages, and issues in implementing isolation practices in current facilities. CONCLUSION AND IMPLICATIONS NH leaders continue to struggle delivering quality IPC care post-pandemic and require focused support in several areas. Clinical practice guidelines should include IPC practices to prevent the infection and spread of any COVID-19 variant in this endemic phase. Policies should support continued reporting of IPC-related metrics and adequate funding to account for the long-term financial burden NHs face.
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Affiliation(s)
- Liza L Behrens
- Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA.
| | - Erin Kitt-Lewis
- Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Marie Boltz
- Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - William A Calo
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Erik Lehman
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Janice Whitaker
- Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Nicole Osevala
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Kimberly Van Haitsma
- Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Lauren J Van Scoy
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
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Guetterman TC, Manojlovich M. Grand rounds in methodology: designing for integration in mixed methods research. BMJ Qual Saf 2024; 33:470-478. [PMID: 38575310 DOI: 10.1136/bmjqs-2023-016112] [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: 07/24/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
Mixed methods research is a popular approach used to understand persistent and complex problems related to quality and safety, such as reasons why interventions are not implemented as intended or explaining differential outcomes. However, the quality and rigour of mixed methods research proposals and publications often miss opportunities for integration, which is the core of mixed methods. Achieving integration remains challenging, and failing to integrate reduces the benefits of a mixed methods approach. Therefore, the purpose of this article is to guide quality and safety researchers in planning and designing a mixed methods study that facilitates integration. We highlight how meaningful integration in mixed methods research can be achieved by centring integration at the following levels: research question, design, methods, results and reporting and interpretation levels. A holistic view of integration through all these levels will enable researchers to provide better answers to complex problems and thereby contribute to improvement of safety and quality of care.
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Petrevska M, Wright FV, Khan A, Munce S, Fehlings D, Biddiss E. Evaluating the impact of movement tracking feedback on engagement with home exercise programmes of children with cerebral palsy using a new therapy app: a protocol for a mixed-methods single-case experimental design with alternating treatments. BMJ Open 2024; 14:e082761. [PMID: 38503423 PMCID: PMC10952875 DOI: 10.1136/bmjopen-2023-082761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/26/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Children with cerebral palsy (CP) are prescribed home exercise programmes (HEPs) to increase the frequency of movement practice, yet adherence to HEPs can be low. This paper outlines the protocol for a single-case experimental design (SCED) with alternating treatments, using a new home therapy exercise application, Bootle Boot Camp (BBCamp), offered with and without movement tracking feedback. This study will explore the impact of feedback on engagement, movement quality, lower limb function and family experiences to help understand how technology-supported HEPs should be translated and the added value, if any, of movement tracking technology. METHODS AND ANALYSIS In this explanatory sequential mixed-methods study using a SCED, 16 children with CP (aged 6-12 years, Gross Motor Function Classification System levels I-II) will set lower limb goals and be prescribed an individualised HEP by their physiotherapist to complete using BBCamp on their home television equipped with a three-dimensional camera-computer system. Children will complete four weekly exercise sessions over 6 weeks. Children will be randomised to 1 of 16 alternating treatment schedules where BBCamp will provide or withhold feedback during the first 4 weeks. The version of BBCamp that results in the most therapeutic benefit will be continued for 2 final weeks. Goals will be re-evaluated and families interviewed. The primary outcome is adherence (proportion of prescribed exercise repetitions attempted) as a measure of behavioural engagement. Secondary outcomes are affective and cognitive engagement (smiley face ratings), exercise fidelity, lower limb function, goal achievement and participant experiences. SCED data will be analysed using visual and statistical methods. Quantitative and qualitative data will be integrated using joint displays. ETHICS AND DISSEMINATION Ethical approval was obtained from the Research Ethics Boards at Bloorview Research Institute and the University of Toronto. Results will be distributed through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT05998239; pre-results.
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Affiliation(s)
- Marina Petrevska
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ajmal Khan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Sarah Munce
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
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McDonald J, Hu W, Heeneman S. Struggles and Joys: A Mixed Methods Study of the Artefacts and Reflections in Medical Student Portfolios. PERSPECTIVES ON MEDICAL EDUCATION 2024; 3:1-11. [PMID: 38188594 PMCID: PMC10768569 DOI: 10.5334/pme.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
Introduction Portfolios scaffold reflection on experience so students can plan their learning. To elicit reflection, the learning experiences documented in portfolios must be meaningful. To understand what experiences first- and second-year medical students find meaningful, we studied the patterns in the artefacts chosen for portfolios and their associated written reflections. Methods This explanatory mixed methods study of a longitudinal dataset of 835 artefacts from 37 medical student' portfolios, identified patterns in artefact types over time. Mixed model logistic regression analysis identified time, student and curriculum factors associated with inclusion of the most common types of artefacts. Thematic analysis of participants' reflections about their artefacts provided insight into their choices. Interpretation of the integrated findings was informed by Transformative Learning (TL) theory. Results Artefact choices changed over time, influenced by curriculum changes and personal factors. In first year, the most common types of artefacts were Problem Based Learning mechanism diagrams and group photos representing classwork; in second year written assignments and 'selfies' representing social and clinical activities. Themes in the written reflections were Landmarks and Progress, Struggles and Strategies, Connection and Collaboration, and Joyful Memories for Balance. Coursework artefacts and photographic self-portraits represented all levels of transformative learning from across the curriculum. Conclusions Medical students chose artefacts to represent challenging and/or landmark experiences, balanced by experiences that were joyful or fostered peer connection. Novelty influenced choice. To maximise learning students should draw from all experiences, to promote supported reflection with an advisor. Tasks should be timed to coincide with the introduction of new challenges.
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Affiliation(s)
- Jenny McDonald
- Translational Health Research Institute, School of Medicine, Western Sydney University, South Penrith, Australia
- School of Health Profession Education, Maastricht University, the Netherlands
| | - Wendy Hu
- Translational Health Research Institute, School of Medicine, Western Sydney University, South Penrith, Australia
| | - Sylvia Heeneman
- School of Health Profession Education, Maastricht University, the Netherlands
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Tolotti A, Bonetti L, Luca CE, Villa M, Liptrott SJ, Steiner LM, Balice-Bourgois C, Biegger A, Valcarenghi D. Nurses Response to the Physical and Psycho-Social Care Needs of Patients with COVID-19: A Mixed-Methods Study. Healthcare (Basel) 2024; 12:114. [PMID: 38201019 PMCID: PMC10778578 DOI: 10.3390/healthcare12010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/26/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
The COVID-19 pandemic heavily impacted nursing care. This study aimed to understand which nursing interventions were instrumental in responding to COVID-19 patients' needs by exploring the experiences of patients and nurses. In this mixed-method study with an explanatory sequential design, we involved nurses caring for COVID-19 patients in intensive and sub-intensive care units and patients. In the first phase, we collected data through a survey that assessed patients' needs from the perspective of nurses and patients, as well as patient satisfaction. In the second phase, qualitative data were collected through interviews with patients and nurses. In the third phase, we extracted quantitative data from patients' records. Our sample included 100 nurses, 59 patients, 15 patient records, and 31 interviews (15 patients, 16 nurses). The results from the first phase showed patients and nurses agreed on the most important difficulties: "breathing", "sleep/rest", and "communication". Nursing care was rated positively by 90% of the patients. In the second phase, four themes were identified through the patients' interviews: "my problems", "my emotions", "helpful factors", and "nursing care". Five themes were identified through the nurses' interviews: "the context", "nurses' experiences and emotions", "facilitators and barriers to patient care", "nursing care", and "the professional role". From the third phase, the analysis of the clinical documentation, it was not possible to understand the nursing care model used by the nurses. In conclusion, nurses adopted a reactive-adaptive approach, based on experience/knowledge, pursuing generalized objectives, and adapting their response to the clinical evolution. In difficult contexts, nursing care requires a constant competent technical-relational presence at the patient's bedside.
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Affiliation(s)
- Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland; (A.T.); (C.E.L.); (S.J.L.); (D.V.)
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; (M.V.); (L.M.S.)
| | - Loris Bonetti
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; (M.V.); (L.M.S.)
- Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
| | - Corina Elena Luca
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland; (A.T.); (C.E.L.); (S.J.L.); (D.V.)
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; (M.V.); (L.M.S.)
- Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 46, 6903 Lugano, Switzerland
| | - Michele Villa
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; (M.V.); (L.M.S.)
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 48, 6900 Lugano, Switzerland
| | - Sarah Jayne Liptrott
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland; (A.T.); (C.E.L.); (S.J.L.); (D.V.)
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; (M.V.); (L.M.S.)
- Ospedale Regionale di Bellinzona e Valli, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Laura Maria Steiner
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; (M.V.); (L.M.S.)
- Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
| | - Colette Balice-Bourgois
- Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 46, 6903 Lugano, Switzerland;
| | - Annette Biegger
- Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
| | - Dario Valcarenghi
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland; (A.T.); (C.E.L.); (S.J.L.); (D.V.)
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; (M.V.); (L.M.S.)
- Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
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Durante A, Younas A, Cuoco A, Boyne J, Rice BM, Juarez-Vela R, Zeffiro V, Vellone E. Burden among informal caregivers of individuals with heart failure: A mixed methods study. PLoS One 2023; 18:e0292948. [PMID: 37976279 PMCID: PMC10656022 DOI: 10.1371/journal.pone.0292948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/02/2023] [Indexed: 11/19/2023] Open
Abstract
AIMS To develop a comprehensive understanding of caregiver burden and its predictors from a dyadic perspective. METHOD A convergent mixed methods design was used. This study was conducted in three European countries, Italy, Spain, and the Netherlands. A sample of 229 HF patients and caregivers was enrolled between February 2017 and December 2018 from the internal medicine ward, outpatient clinic, and private cardiologist medical office. In total, 184 dyads completed validated scales to measure burden, and 50 caregivers participated in semi-structured interviews to better understand the caregiver experience. The Care Dependency Scale, Montreal Cognitive Assessment, and SF-8 Health Survey were used for data collection. Multiple regression analysis was conducted to identify the predictors and qualitative content analysis was performed on qualitative data. The results were merged using joint displays. RESULTS Caregiver burden was predicted by the patient's worse cognitive impairment, lower physical quality of life, and a higher care dependency perceived by the caregivers. The qualitative and mixed analysis demonstrated that caregiver burden has a physical, emotional, and social nature. CONCLUSIONS Caregiver burden can affect the capability of informal caregivers to support and care for their relatives with heart failure. Developing and evaluating individual and community-based strategies to address caregiver burden and enhance their quality of life are warranted.
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Affiliation(s)
- Angela Durante
- Pre-department Unit of Nursing, GRUPAC, University of La Rioja, Logroño, Spain
- University of Eastern Piedmont, Novara, Italy
| | - Ahtisham Younas
- Faculty of Nursing, Memorial University of Newfoundland, St. John’s, Canada
| | - Angela Cuoco
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bridgette M. Rice
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Philadelphia, United States of America
| | - Raul Juarez-Vela
- Pre-department Unit of Nursing, GRUPAC, University of La Rioja, Logroño, Spain
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
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Li YR, Zhang ZH, Li W, Wang P, Li SW, Su D, Zhang T. Effectiveness and learning experience from undergraduate nursing students in surgical nursing skills course: a quasi- experimental study about blended learning. BMC Nurs 2023; 22:396. [PMID: 37858120 PMCID: PMC10588121 DOI: 10.1186/s12912-023-01537-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Blended learning is increasingly being adopted, and yet a gap remains in the related literature pertaining to its skill performance, learning engagement and inner experience in undergraduate surgical nursing skills course. OBJECTIVES To investigate the changes in skills performance and learning engagement in the application of blended learning, and what it actually brings to nursing students. DESIGN The study uses a historical control, two-armed, mixed and quasi-experimental design. METHODS The blended learning version of the course was offered to the 2019 class of 334 nursing undergraduates. Quantitative and qualitative data were collected after the course to obtain a comprehensive understanding of the course effects compared with the 304 nursing undergraduates of grade 2017 who adapted traditional learning. Quantitative data were analyzed by descriptive and inferential statistics using IBM SPSS 26.0, and qualitative data were encoded using Nvivo11.0. RESULTS There were significant differences in skill performance and learning engagement between the class of 2017 and 2019 (p < 0.001). Combined with further analysis of the interview data, 3 first-level nodes and 8 secondary nodes were determined. Students' opinions, comments and suggestions on the application of blended learning are refreshing. CONCLUSION Moving forward with blended learning: opportunities and challenges go hand in hand. Researchers need to continually modify their research designs to respond to variable educational environments.
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Affiliation(s)
- Yan Ran Li
- School of Nursing, Anhui Medical University, No.15 Fei Cui Road, Hefei, 230601, Anhui, China
| | - Zong Hao Zhang
- School of Nursing, Anhui Medical University, No.15 Fei Cui Road, Hefei, 230601, Anhui, China
| | - Wen Li
- School of Nursing, Anhui Medical University, No.15 Fei Cui Road, Hefei, 230601, Anhui, China
| | - Pan Wang
- School of Nursing, Anhui Medical University, No.15 Fei Cui Road, Hefei, 230601, Anhui, China
| | - Shu Wen Li
- School of Nursing, Anhui Medical University, No.15 Fei Cui Road, Hefei, 230601, Anhui, China.
| | - Dan Su
- School of Nursing, Anhui Medical University, No.15 Fei Cui Road, Hefei, 230601, Anhui, China
| | - Ting Zhang
- School of Nursing, Anhui Medical University, No.15 Fei Cui Road, Hefei, 230601, Anhui, China
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Longhini J, Canzan F, Zambiasi P, Toccoli S, Gios L, Del Greco M, Sforzin S, Moz M, Fracchetti M, Saiani L, Brolis R, Guarnier A, Soverini M, Maines M, Ambrosi E. A Nurse-Led Model of Care with Telemonitoring to Manage Patients with Heart Failure in Primary Health Care: A Mixed-Method Feasibility Study. Patient Prefer Adherence 2023; 17:2579-2594. [PMID: 37881621 PMCID: PMC10595161 DOI: 10.2147/ppa.s431865] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/07/2023] [Indexed: 10/27/2023] Open
Abstract
Purpose To determine whether a nurse-led care model with telemonitoring in primary care for patients with stable heart failure and their caregivers is feasible and acceptable. Patients and Methods A mixed-methods feasibility study was conducted. Patients with stable heart failure and their caregivers were consecutively enrolled from March 2021 to April 2022. Participants were managed by nurses in a community health center through education and monitoring with a mobile app. The outcomes were feasibility outcomes, self-care outcomes, and qualitative acceptability and satisfaction. Quantitative and qualitative outcomes were linked to understanding how the model of care might benefit patients. Results Twenty-six patients and nine of their caregivers were enrolled. Ten participants used the mobile app. Nineteen patients and eight caregivers were interviewed. Participants who improved their self-care appreciated the help in finding coping strategies, being close to the clinic, and feeling cared for. Participants with fewer improvements in self-care perceived the model of care as useless and were far from the centre. Participants decided to use the app mainly for usefulness prevision, and most of them were satisfied. Conclusion The model of care was not successful in recruiting patients, and adjustments are needed to improve the recruitment strategy and to engage people who perceive the model of care as not useful or unable to use the app.
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Affiliation(s)
- Jessica Longhini
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Federica Canzan
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Paola Zambiasi
- Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | | | - Lorenzo Gios
- TrentinoSalute4.0, Competence Center for Digital Health, Trento, Italy
| | | | - Simona Sforzin
- Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Monica Moz
- TrentinoSalute4.0, Competence Center for Digital Health, Trento, Italy
| | | | - Luisa Saiani
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Renata Brolis
- Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | | | | | | | - Elisa Ambrosi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Bérubé M, Côté C, Gagnon MA, Moore L, Tremblay L, Turgeon AF, Evans D, Berry G, Turcotte V, Belzile ÉL, Dale C, Orrantia E, Verret M, Dercksen J, Martel MO, Dupuis S, Chatillon CE, Lauzier F. Interdisciplinary strategies to prevent long-term and detrimental opioid use following trauma: a stakeholder consensus study. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:933-940. [PMID: 36944264 PMCID: PMC10391591 DOI: 10.1093/pm/pnad037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Prolonged opioid use is common following traumatic injuries. Although preventive strategies have been recommended, the evidence supporting their use is low. The objectives of this study were to select interdisciplinary strategies to prevent long-term, detrimental opioid use in trauma patients for further evaluation and to identify implementation considerations. DESIGN A consensus study using the nominal group technique. SETTING Four trauma systems in Canada. SUBJECTS Participants included expert clinicians and decision makers, and people with lived experience. METHODS Participants had to discuss the relevance and implementation of 15 strategies and then rank them using a 7-point Likert scale. Implementation considerations were identified through a synthesis of discussions. RESULTS A total of 41 expert stakeholders formed the nominal groups. Overall, eight strategies were favored: 1) using multimodal approach for pain management, 2) professional follow-up in physical health, 3) assessment of risk factors for opioid misuse, 4) physical stimulation, 5) downward adjustment of opioids based on patient recovery, 6) educational intervention for patients, 7) training offered to professionals on how to prescribe opioids, and 8) optimizing communication between professionals working in different settings. Discussions with expert stakeholders revealed the rationale for the selected strategies and identified issues to consider when implementing them. CONCLUSION This stakeholder consensus study identified, for further scientific study, a set of interdisciplinary strategies to promote appropriate opioid use following traumatic injuries. These strategies could ultimately decrease the burden associated with long-term opioid use.
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Affiliation(s)
- Mélanie Bérubé
- CHU de Québec-Université Laval Research Centre, Population Health and Optimal Practices Research Unit Research Unit (Trauma—Emergency—Critical Care Medicine), Québec City, Quebec G1V 0A6, Canada
- Faculty of Nursing, Université Laval, Québec City, Quebec G1V 0A6, Canada
- Quebec Pain Research Network, Sherbrooke, Quebec J1H 5N4, Canada
| | - Caroline Côté
- CHU de Québec-Université Laval Research Centre, Population Health and Optimal Practices Research Unit Research Unit (Trauma—Emergency—Critical Care Medicine), Québec City, Quebec G1V 0A6, Canada
- Faculty of Nursing, Université Laval, Québec City, Quebec G1V 0A6, Canada
- Quebec Pain Research Network, Sherbrooke, Quebec J1H 5N4, Canada
| | - Marc-Aurèle Gagnon
- CHU de Québec-Université Laval Research Centre, Population Health and Optimal Practices Research Unit Research Unit (Trauma—Emergency—Critical Care Medicine), Québec City, Quebec G1V 0A6, Canada
| | - Lynne Moore
- CHU de Québec-Université Laval Research Centre, Population Health and Optimal Practices Research Unit Research Unit (Trauma—Emergency—Critical Care Medicine), Québec City, Quebec G1V 0A6, Canada
- Department of Social Preventive Medicine, Université Laval, Québec City, Quebec G1V 0A6, Canada
| | - Lorraine Tremblay
- Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada
| | - Alexis F Turgeon
- CHU de Québec-Université Laval Research Centre, Population Health and Optimal Practices Research Unit Research Unit (Trauma—Emergency—Critical Care Medicine), Québec City, Quebec G1V 0A6, Canada
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City, Quebec G1V 0A6, Canada
| | - David Evans
- Department of Surgery, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
| | - Greg Berry
- Departement of Orthopaedic Surgery, McGill University Health Centre, Montréal, Quebec H3G 1A4, Canada
| | - Valérie Turcotte
- Department of Nursing, CIUSSS du Nord-de-l’île-de-Montréal, Montréal, Quebec H4J 1C5, Canada
| | - Étienne L Belzile
- Department of Surgery, Division of Orthopeadic Surgery, CHU de Québec-Université Laval, Québec City, Quebec GIV 1Z4, Canada
| | - Craig Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario M5T 1P8, Canada
- University of Toronto Centre for the Study of Pain (UTCSP), Toronto, Ontario M5T 1P8, Canada
| | - Eli Orrantia
- Marathon Family Health Team, Marathon, Ontario P0T 2E0, Canada
| | - Michael Verret
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City, Quebec G1V 0A6, Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario K1H 8L6, Canada
| | - Judy Dercksen
- Quesnel Primary Care Clinic, Quesnel, British Columbia V2J 2K8, Canada
| | - Marc-Olivier Martel
- Quebec Pain Research Network, Sherbrooke, Quebec J1H 5N4, Canada
- Faculty of Medicine & Dentistry, McGill University, Montréal, Quebec H3A 1G1, Canada
| | - Sébastien Dupuis
- Department of Pharmacy, CIUSSS du Nord-de-l’île-de-Montréal,Montréal, Quebec H4J 1C5, Canada
| | - Claude-Edouard Chatillon
- Division of Neurosurgery, CIUSSS de la Mauricie-et-du-Centre-du-Québec, Trois-Rivières, Quebec G9A 5C5, Canada
| | - François Lauzier
- CHU de Québec-Université Laval Research Centre, Population Health and Optimal Practices Research Unit Research Unit (Trauma—Emergency—Critical Care Medicine), Québec City, Quebec G1V 0A6, Canada
- Department of Medicine, Université Laval, Québec City, Quebec G1V 0A6, Canada
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Moore L, Bérubé M, Belcaid A, Turgeon AF, Taljaard M, Fowler R, Yanchar N, Mercier É, Paquet J, Stelfox HT, Archambault P, Berthelot S, Guertin JR, Haas B, Ivers N, Grimshaw J, Lapierre A, Ouyang Y, Sykes M, Witteman H, Lessard-Bonaventure P, Gabbe B, Lauzier F. Evaluating the effectiveness of a multifaceted intervention to reduce low-value care in adults hospitalized following trauma: a protocol for a pragmatic cluster randomized controlled trial. Implement Sci 2023; 18:27. [PMID: 37420284 DOI: 10.1186/s13012-023-01279-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/28/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND While simple Audit & Feedback (A&F) has shown modest effectiveness in reducing low-value care, there is a knowledge gap on the effectiveness of multifaceted interventions to support de-implementation efforts. Given the need to make rapid decisions in a context of multiple diagnostic and therapeutic options, trauma is a high-risk setting for low-value care. Furthermore, trauma systems are a favorable setting for de-implementation interventions as they have quality improvement teams with medical leadership, routinely collected clinical data, and performance-linked to accreditation. We aim to evaluate the effectiveness of a multifaceted intervention for reducing low-value clinical practices in acute adult trauma care. METHODS We will conduct a pragmatic cluster randomized controlled trial (cRCT) embedded in a Canadian provincial quality assurance program. Level I-III trauma centers (n = 30) will be randomized (1:1) to receive simple A&F (control) or a multifaceted intervention (intervention). The intervention, developed using extensive background work and UK Medical Research Council guidelines, includes an A&F report, educational meetings, and facilitation visits. The primary outcome will be the use of low-value initial diagnostic imaging, assessed at the patient level using routinely collected trauma registry data. Secondary outcomes will be low-value specialist consultation, low-value repeat imaging after a patient transfer, unintended consequences, determinants for successful implementation, and incremental cost-effectiveness ratios. DISCUSSION On completion of the cRCT, if the intervention is effective and cost-effective, the multifaceted intervention will be integrated into trauma systems across Canada. Medium and long-term benefits may include a reduction in adverse events for patients and an increase in resource availability. The proposed intervention targets a problem identified by stakeholders, is based on extensive background work, was developed using a partnership approach, is low-cost, and is linked to accreditation. There will be no attrition, identification, or recruitment bias as the intervention is mandatory in line with trauma center designation requirements, and all outcomes will be assessed with routinely collected data. However, investigators cannot be blinded to group allocation and there is a possibility of contamination bias that will be minimized by conducting intervention refinement only with participants in the intervention arm. TRIAL REGISTRATION This protocol has been registered on ClinicalTrials.gov (February 24, 2023, # NCT05744154 ).
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Affiliation(s)
- Lynne Moore
- Department of Social and Preventive Medicine, Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Mélanie Bérubé
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
- Faculty of Nursing, Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Amina Belcaid
- Institut national d'excellence en santé et services sociaux, Bd Laurier, Québec, Qc, 2535, Canada
| | - Alexis F Turgeon
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Monica Taljaard
- Ottawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, On, Canada
| | - Robert Fowler
- Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, On, Canada
| | - Natalie Yanchar
- Department of Surgery, University of Calgary, 3280 Hospital Dr. NW, Calgary, Ab, Canada
| | - Éric Mercier
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Jérôme Paquet
- Department of Surgery, Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Henry Thomas Stelfox
- Department of Critical Care Medicine, Medicine and Community Health Sciences, O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Dr. NW, Calgary, Al, Canada
| | - Patrick Archambault
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Simon Berthelot
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Jason R Guertin
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Barbara Haas
- Department of Surgery, University of Toronto, 149 College St, Toronto, On, Canada
| | - Noah Ivers
- Department of Family and Community Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4Th Floor, Toronto, On, Canada
| | - Jeremy Grimshaw
- Ottawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, On, Canada
| | - Alexandra Lapierre
- Faculty of Nursing, Université de Montréal, Chem. de La Côte-Sainte-Catherine, Montréal, Qc, 2375, Canada
| | - Yongdong Ouyang
- Ottawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, On, Canada
| | - Michael Sykes
- Department of Nursing, Midwifery, and Health, Northumbria University, Ellison PI, Newcastle, UK
| | - Holly Witteman
- Department of Family and Emergency Medicine, Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
| | - Paule Lessard-Bonaventure
- Department of Surgery, Division of Neurosurgery, Université Laval, 1050 Av. de La Médecine, Québec, Canada
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, Victoria, VIC 3004, Australia
| | - François Lauzier
- Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec (Hôpital de L'Enfant-Jésus), Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, 1050 Av. de La Médecine, Québec, Qc, Canada
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11
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Paudel S, K C Bhandari A, Gilmour S, Lee HJ, Kanbara S. Barriers and facilitating factors to healthcare accessibility among Nepalese migrants during COVID-19 crisis in Japan: an exploratory sequential mixed methods study. BMC Public Health 2023; 23:1226. [PMID: 37355587 PMCID: PMC10290307 DOI: 10.1186/s12889-023-16107-7] [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: 02/27/2023] [Accepted: 06/12/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has highlighted the need for global unity and timely access to healthcare for all including multilingual and intercultural societies. This study aimed to identify barriers to healthcare access due to the COVID-19 crisis among Nepalese migrants in Japan and explore ways to counter these barriers, both in routine and crisis situations. METHODS This study used an exploratory sequential mixed-methods study design. The researchers conducted 11 focus group discussions including 89 participants and an online survey involving 937 respondents. The integration of focus group discussions and logistic regression analysis from the survey was reported via a 'joint display'. RESULTS Twenty-six themes on barriers to and six on facilitators of healthcare accessibility were identified by the focus group discussions among which 17 barriers like lack of knowledge of health insurance, language barriers, lack of hotline services, unawareness of available services, fear of discrimination etc. had significant association in our logistic regression analysis after adjusting for all confounders. Similarly, the only facilitator that had a significant impact, according to the multivariable logistic regression analysis, was receiving health information from Nepali healthcare professionals (OR = 1.36, 95% CI = (1.01 - 1.82), p-value < 0.05). CONCLUSION The study suggests the need for a crisis information hub which could be coordinated by the Nepal embassy or concerned authorities, flexible policies for active deployment of Nepalese health workers and volunteers, accessible hotlines in the Nepali language, and incorporation of Nepali telehealth services in Japan.
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Affiliation(s)
- Sushila Paudel
- Graduate School of Nursing, University of Kochi, Kochi, Japan
| | - Aliza K C Bhandari
- Graduate School of Public Health, St. Luke’s International University, Tokyo, Japan
- Department of Health Policy, National Center for Child Health and Development, Okura 2-10-1, Setagaya City Tokyo, 157-8535 Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Tokyo, Japan
| | - Hyeon Ju Lee
- Graduate School of Nursing, University of Kochi, Kochi, Japan
| | - Sakiko Kanbara
- Graduate School of Nursing, University of Kochi, Kochi, Japan
- Kobe City College of Nursing, Kobe, Japan
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12
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Nissen KB, Laursen SH, Udsen FW, Haslund-Thomsen H. Undergraduate students' experiences of participating in a Danish respite programme for young carers-A mixed methods study. Int J Health Plann Manage 2023; 38:507-526. [PMID: 36495284 DOI: 10.1002/hpm.3602] [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: 02/02/2022] [Revised: 10/18/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Age-appropriate communication and interaction are essential when meeting young carers, requiring in-depth knowledge and experience. Volunteer programmes may enhance undergraduate students' competencies in this regard. This pilot study evaluated undergraduate students' perceptions of volunteering on the Buddies for Children and Youngsters (BCY) programme by assessing the extent to which students experienced an improvement in their relational and communication competencies and/or felt better equipped for their future work. METHODS The researchers conducted a mixed methods study with a parallel design, focussing on undergraduate students from the University College of Northern Denmark within the field of nursing, teaching, pedagogy, physiotherapy, and occupational therapy. The students participated in the programme for at least 4 months. RESULTS Forty-two students responded to a questionnaire, and 17 students were selected to participate in four focus groups. The results showed that participation in the programme improved the students' communication and relational competencies to some degree. The programme provided the students with experience of age-related communication on both informal and difficult topics, and of building relationships and solving relational challenges. Also, the programme generally equipped students for future work with young carers and children. CONCLUSION In conclusion, the BCY programme is a relevant supplement to regular educational activities. Decision makers within politics of health, health planning and management, should therefore consider implementation of such programmes in relevant educational areas.
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Affiliation(s)
- Karina Brix Nissen
- Department of Nursing, University College of Northern Denmark, Aalborg, Denmark
| | - Sisse Heiden Laursen
- Department of Nursing, University College of Northern Denmark, Aalborg, Denmark.,Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Steno Diabetes Center, Aalborg University Hospital, Aalborg, Denmark
| | - Flemming Witt Udsen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Helle Haslund-Thomsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Pediatrics, Aalborg University Hospital, Aalborg, Denmark.,Clinic for Anesthesiology, Child Diseases, Circulation and Women, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Quinn EA, Sobonya S, Palmquist AE. Maternal perceptions of human milk expression output: An experimental design using photographs of milk. Soc Sci Med 2023; 324:115871. [PMID: 37023658 DOI: 10.1016/j.socscimed.2023.115871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/20/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND The widespread use of breast pumps in the United States is a recent phenomenon that is reshaping how individuals understand and perceive lactation. In the 1990s, adequacy of milk supply was primarily measured indirectly by infant weight gain and/or diapers; now >95% of all lactating persons in the United States use breast pumps and are seeing their milk regularly. How seeing milk impacts the perception of lactation sufficiency is an important area of research. Research aim/question: To understand personal and intersubjective influences of seeing expressed human milk on perceptions of milk supply among participants who express milk for their infants. METHODS We surveyed 805 lactating participants from the United States about their pumping practices using an online survey. Participants described pumping practices, milk output, and beliefs. They were then randomized to view one of three photographs of expressed milk (<2 oz, 4 oz, >6oz) and asked to imagine they had just pumped that amount and provide a written response; this created 4 exposure groups (2 increase and 2 decrease) and a control group (no difference). RESULTS Participants randomized to a higher volume reported more positive feelings and used the terms "good", "great", and "accomplished" to describe emotional responses to output. Participants randomized to lower milk volumes reported more feelings of "bad" or "depressed." A subset of participants reported feeling "annoyed" about small volumes of milk. CONCLUSIONS Participants in this study were very conscious of the volume of milk pumped each session; both increases and decreases were associated with emotional responses that could contribute to decisions about pumping practices, perceived milk supply, and lactation duration.
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Jantsch LB, Neves ET. “Tabela falante” como estratégia de integração de dados em uma pesquisa de métodos mistos. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0029pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
RESUMO Objetivo relatar a utilização da tabela falante como estratégia de integração e análise de dados em estudo de abordagem mista. Método trata-se de um relato de utilização de uma estratégia metodológica de integração e análise dos dados em pesquisa de método misto. São apresentados dados de um estudo longitudinal analítico, que acompanhou 151 lactentes prematuros no primeiro ano de vida. O estudo abordou aspectos das condições de saúde dessa população e integrou dados quantitativos, coletados por meio de instrumento de avaliação de condições de saúde e dados qualitativos oriundos de entrevista semiestruturada. Resultados a integração dos dados em estudos mistos é uma exigência metodológica que requer dos pesquisadores a utilização de estratégias que possibilitem e facilitem esse processo analítico. A tabela falante, por meio da integração visual dos dados quantitativos expressos em tabelas e suas convergências e divergências analíticas com os enunciados qualitativos, favorece a leitura e interpretação integrada. Conclusão e implicações para a prática considera-se a tabela falante uma ferramenta analítica de integração de dados quantitativos e qualitativos que contribui na formulação de metainferências em pesquisas com métodos mistos.
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15
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Jantsch LB, Neves ET. “Talking table” as a data integration strategy in mixed methods research. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0029en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
ABSTRACT Objective to report the use of a talking table as a data analysis and integration strategy in a mixed approach study. Method this is a report on the use of a methodological strategy for data integration and analysis in mixed methods research. Data from an analytical longitudinal study that followed 151 preterm infants in the first year of life are presented. The study addressed aspects of the health conditions of this population and integrated quantitative data, collected through an instrument to assess health conditions and qualitative data from a semi-structured interview. Results data integration in mixed studies is a methodological requirement that requires researchers to use strategies that enable and facilitate this analytical process. A talking table, through the visual integration of quantitative data expressed in tables and their analytical convergences and divergences with qualitative statements, favors integrated reading and interpretation. Conclusion and implications for practice: a talking table is considered an analytical tool for quantitative and qualitative data integration, which contribute to developing meta-inferences in mixed methods research.
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Casper DM, Witte T, Gibson E, McCulley E. "I Pulled Them Apart and Told Them to Stop": A Mixed-Methods Examination of Bystander Behavior, Preparedness, and Emotional Reaction. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1517-NP1539. [PMID: 35537192 DOI: 10.1177/08862605221092071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The goals of this mixed-methods study were to examine self-reported behavior of bystanders who intervened in specific situations of potential sexual violence and physical dating violence, to explore their sense of preparedness to intervene, and to assess bystanders' emotional reactions to their self-reported action or inaction when witnessing potential sexual and dating violence. The participants (n = 553, 65.2% female, 76% freshmen, M age = 18.7 years), responded to a sequence of questions pertaining to witnessing and intervening in specific potentially dangerous situations, emotional reactions to their action or inaction, and preparedness. Bystander participants also provided narrative responses describing their behavior. We used joint display analyses to integrate, analyze, and interpret the qualitative and quantitative data. Of the 553 participants, 38% witnessed "a man talking to a woman and she looked uncomfortable," 27% witnessed "someone taking an intoxicated person up to their room," and 39% witnessed "someone grabbing or pushing their boyfriend or girlfriend"; of those who witnessed, the percentage of those who intervened was 42%, 25%, and 19%, respectively. Bystander behavior involved one of 5Ds: distract, direct, delegate, distance, diffuse, or a combination. Although most bystanders did not get involved, most (94.6%) reported that they felt prepared to intervene. For those who intervened, most reported feeling positive about their action; however, most who did not intervene reported feeling negative about their inaction. Implications for college bystanders and bystander education programs are discussed.
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Affiliation(s)
- Deborah M Casper
- Department of Human Development and Family Studies, 8059University of Alabama, Tuscaloosa, AL, USA
| | - Tricia Witte
- Department of Human Development and Family Studies, 8059University of Alabama, Tuscaloosa, AL, USA
| | - Emily Gibson
- Department of Human Development and Family Studies, 8059University of Alabama, Tuscaloosa, AL, USA
| | - Emily McCulley
- Department of Human Development and Family Studies, 8059University of Alabama, Tuscaloosa, AL, USA
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Küppers D, Galatsch M, Weigel R. Global child health in higher education in Germany: a mixed-methods study. Glob Health Action 2022; 15:2093464. [PMID: 35968921 PMCID: PMC9397445 DOI: 10.1080/16549716.2022.2093464] [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] [Indexed: 11/19/2022] Open
Abstract
Background Germany has an ambitious global health strategy, yet its universities provide few opportunities for global child health researchers. Improved understanding of the reasons and the academic role of global child health is needed. Objective The objective of this study is to offer insights into Germany’s academic global child health landscape by describing the actors and their priorities in research and education and by analysing perceived barriers and opportunities. Methods We used a sequential exploratory mixed-method design. Participants were selected purposively to represent German global child health academics. Information was gathered first from a 33-item online survey and from interviews conducted four to six months post-survey. Surveys were analysed descriptively. A joint thematic approach using content analysis was used to analyse interview transcripts. Results Four categories emerged: training and professional orientation; professional realities; representation and advocacy, and barriers. Of the 20 survey participants (median [IQR] age 55 years [17], five female), seven agreed to be interviewed. Research experiences abroad shaped individuals’ career choices in global child health. They engaged in global child health education, primary health care and access to health services, frequently in clinical and humanitarian settings, but spent little time on global child health-related activities. Participants were active and valued in international networks and keen to extend their activities. Yet they felt under-represented academically and reported multiple structural and individual barriers in Germany. They perceived a lack of leadership positions, career paths, funding opportunities, and institutional and project support which limits academic advancement. Conclusions Germany’s global child health experts are motivated to engage with global child health-related topics but face difficulties in advancing academically. Academic actors may need to intensify research and training efforts in order to expand global child health’s scientific base in Germany.
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Affiliation(s)
- Dennis Küppers
- Paediatric Heart Center, University Hospital Giessen and Marburg, Justus-Liebig-University, Giessen, Germany
| | - Michael Galatsch
- Friede-Springer Endowed Professorship for Global Child Health, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Ralf Weigel
- Friede-Springer Endowed Professorship for Global Child Health, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
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Valli C, Maraj M, Prokop-Dorner A, Kaloteraki C, Steiner C, Rabassa M, Solà I, Zajac J, Johnston BC, Guyatt GH, Bala MM, Alonso-Coello P. People's Values and Preferences about Meat Consumption in View of the Potential Environmental Impacts of Meat: A Mixed-methods Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:286. [PMID: 36612609 PMCID: PMC9819158 DOI: 10.3390/ijerph20010286] [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: 11/08/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Health is not the only aspect people consider when choosing to consume meat; environmental concerns about the impact of meat (production and distribution) can influence people's meat choices. METHODS We conducted a mixed-methods systematic review, searched six databases from inception to June 2020, and synthesised our findings into narrative forms. We integrated the evidence from quantitative and qualitative data sets into joint displays and assessed the confidence in the evidence for each review finding following the GRADE-CERQual approach. RESULTS Of the 23,531 initial records, we included 70 studies: 56 quantitative, 12 qualitative, and 2 mixed-methods studies. We identified four main themes: (1) reasons for eating meat; (2) reasons for avoiding meat; (3) willingness to change meat consumption; and (4) willingness to pay more for environmentally friendly meat. The overall confidence was low for the reasons for eating and/or buying meat, for avoiding meat, and for willingness to change meat consumption, and was moderate for willingness to pay more for environmentally friendly meat. CONCLUSIONS Regardless of people's general beliefs about meat and its impact on the environment, most people may be unwilling to change their meat consumption. Future research should address the current limitations of the research evidence to assess whether people are willing to make a change when properly informed.
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Affiliation(s)
- Claudia Valli
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universidad Autónoma de Barcelona, 08193 Barcelona, Spain
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), 08025 Barcelona, Spain
| | - Małgorzata Maraj
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland
| | - Anna Prokop-Dorner
- Chair of Epidemiology and Preventive Medicine, Department of Medical Sociology, Jagiellonian University Medical College, 31-034 Krakow, Poland
| | - Chrysoula Kaloteraki
- Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), 08025 Barcelona, Spain
| | - Corinna Steiner
- Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), 08025 Barcelona, Spain
| | - Montserrat Rabassa
- Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), 08025 Barcelona, Spain
| | - Ivan Solà
- Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), 08025 Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Joanna Zajac
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland
| | - Bradley C. Johnston
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX 77843, USA
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX 77843, USA
| | - Gordon H. Guyatt
- Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Malgorzata M. Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), 08025 Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Younas A, Durante A. Decision tree for identifying pertinent integration procedures and joint displays in mixed methods research. J Adv Nurs 2022. [DOI: 10.1111/jan.15536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/28/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Ahtisham Younas
- Memorial University of Newfoundland St. Johns Newfoundland Canada
| | - Angela Durante
- Department of Nursing University of La Rioja La Rioja Spain
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Balice-Bourgois C, Bonetti L, Tolotti A, Liptrott SJ, Villa M, Luca CE, Steiner LM, Biegger A, Goncalves S, Moser L, Palermo A, Sari D, Valcarenghi D. Experiences and Needs of Patients, Caregivers and Nurses during the COVID-19 Pandemic: Study Protocol for a Mixed-Methods Multicentre Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912838. [PMID: 36232138 PMCID: PMC9566058 DOI: 10.3390/ijerph191912838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/02/2022] [Accepted: 10/03/2022] [Indexed: 06/02/2023]
Abstract
The COVID-19 pandemic is a major public health problem with millions of confirmed cases and deaths described. Nurses are among the health care professionals most involved at the front line, caring for those affected by COVID-19. Patients and families have been subjected to a high emotional burden of fear, anxiety, and uncertainty. The COVID-19 pandemic has had a significant impact on the approach to patients, the organisation of care, and communication with patients and their families, all requiring considerable adaptation on the part of nurses and health care professionals. The overall aim of this research was to find out the needs of patients with COVID-19, the nursing interventions provided and their outcomes, and to explore the experiences of the nurses, patients, and caregivers. A mixed method study will be performed with a convergent design. The study was divided into three phases. Quantitative methods involved nurses and patients affected by COVID-19 with a questionnaire. Qualitative methods involved nurses, patients, and caregivers with interviews and finally a quantitative analysis of the nursing documentation of the interviewed patients. We hope that this study will help us to understand and identify the main nursing and support needs expressed by patients and their families at different stages of their illness.
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Affiliation(s)
- Colette Balice-Bourgois
- Institute of Paediatrics of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
| | - Loris Bonetti
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Via Violino, 11, 6928 Manno, Switzerland
| | - Angela Tolotti
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Sarah Jayne Liptrott
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
- Ospedale Regionale di Bellinzona e Valli, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Michele Villa
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 48, 6900 Lugano, Switzerland
| | - Corina Elena Luca
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
- Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 46, 6903 Lugano, Switzerland
| | - Laura Maria Steiner
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Via Violino, 11, 6928 Manno, Switzerland
| | - Annette Biegger
- Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
| | - Silvia Goncalves
- Ospedale Regionale di Locarno, Ente Ospedaliero Cantonale (EOC), Via all'Ospedale, 1, 6600 Locarno, Switzerland
| | - Laura Moser
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Antonio Palermo
- Ospedale Regionale di Bellinzona e Valli, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Davide Sari
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Dario Valcarenghi
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland
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Lee-Krueger RCW, Moreau K, Delva D, Eady K, Giroux CM, Archibald D. Fundamental Teaching Activities in Family Medicine Framework: Analysis of Awareness and Utilization. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 42:274-283. [PMID: 35180743 PMCID: PMC9722374 DOI: 10.1097/ceh.0000000000000414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION In 2015, the College of Family Physicians of Canada, in performing their commitment to supporting its members in their educational roles, created the Family Medicine Framework (FTA). It was designed to assist family medicine educators with an understanding of the core activities of educators: precepting, coaching, and teaching within or beyond clinical settings. Given that an examination of member awareness of FTA has not been previously undertaken, our primary objective was to conduct an evaluation on its utility and application. METHODS In partnership with College of Family Physicians of Canada Faculty Development Education Committee members, we used a practical participatory evaluation approach to conduct a two-phase mixed-methods evaluation of the FTA. We distributed an electronic survey in French and English languages to Canadian faculty development, program, and site directors in family medicine. We then conducted follow-up interviews with self-selected participants. RESULTS Of the target populations, 12/15 (80%) faculty development directors (FDDs), 12/18 (66.7%) program directors, and 34/174 (19.5%) site directors completed the electronic survey. Subsequently, 6 FDDs, 3 program directors, and 3 site directors completed an interview (n = 12). Findings indicate that awareness of the FTA was highest among FDDs. Facilitators who encourage teachers to use the FTA and barriers for low uptake were also identified. DISCUSSION This evaluation illuminated that varied levels of awareness of the FTA may contribute to the low uptake among education leaders. We also suggest future research to address possible barriers that hinder effective applications of the FTA in faculty development initiatives.
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Affiliation(s)
- Rachelle C. W. Lee-Krueger
- Mrs. Lee-Krueger: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Moreau: Associate Professor, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Delva: Professor, Department of Family Medicine, Queens University, Kingston, Ontario, Canada. Dr. Eady: Senior Research Associate, Center for Research on Educational and Community Services, Faculties of Education and Social Sciences, University of Ottawa, Ottawa, Ontario, Canada. Dr. Giroux: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Archibald: Associate Professor, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Katherine Moreau
- Mrs. Lee-Krueger: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Moreau: Associate Professor, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Delva: Professor, Department of Family Medicine, Queens University, Kingston, Ontario, Canada. Dr. Eady: Senior Research Associate, Center for Research on Educational and Community Services, Faculties of Education and Social Sciences, University of Ottawa, Ottawa, Ontario, Canada. Dr. Giroux: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Archibald: Associate Professor, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dianne Delva
- Mrs. Lee-Krueger: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Moreau: Associate Professor, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Delva: Professor, Department of Family Medicine, Queens University, Kingston, Ontario, Canada. Dr. Eady: Senior Research Associate, Center for Research on Educational and Community Services, Faculties of Education and Social Sciences, University of Ottawa, Ottawa, Ontario, Canada. Dr. Giroux: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Archibald: Associate Professor, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kaylee Eady
- Mrs. Lee-Krueger: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Moreau: Associate Professor, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Delva: Professor, Department of Family Medicine, Queens University, Kingston, Ontario, Canada. Dr. Eady: Senior Research Associate, Center for Research on Educational and Community Services, Faculties of Education and Social Sciences, University of Ottawa, Ottawa, Ontario, Canada. Dr. Giroux: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Archibald: Associate Professor, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Catherine M. Giroux
- Mrs. Lee-Krueger: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Moreau: Associate Professor, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Delva: Professor, Department of Family Medicine, Queens University, Kingston, Ontario, Canada. Dr. Eady: Senior Research Associate, Center for Research on Educational and Community Services, Faculties of Education and Social Sciences, University of Ottawa, Ottawa, Ontario, Canada. Dr. Giroux: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Archibald: Associate Professor, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Douglas Archibald
- Mrs. Lee-Krueger: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Moreau: Associate Professor, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Delva: Professor, Department of Family Medicine, Queens University, Kingston, Ontario, Canada. Dr. Eady: Senior Research Associate, Center for Research on Educational and Community Services, Faculties of Education and Social Sciences, University of Ottawa, Ottawa, Ontario, Canada. Dr. Giroux: Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Archibald: Associate Professor, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Atherley A, Hu WCY, Dolmans D, Teunissen PW, Hegazi I. Medical Students' Socialization Tactics When Entering a New Clinical Clerkship: A Mixed Methods Study of Proactivity. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:884-893. [PMID: 35171118 PMCID: PMC9126257 DOI: 10.1097/acm.0000000000004627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Socialization into clinical clerkships is difficult in part due to ambiguity around students' new roles and expected behaviors. Being proactive reduces ambiguity and is essential to socialization. Proactive behavior can be taught and goes beyond having a proactive personality. Among students entering new undergraduate clinical clerkships, this study aimed to investigate (1) reported proactive behaviors and their association with social integration and (2) enabling and inhibiting factors for proactive behavior. METHOD This study was conducted at the 5-year MBBS program at Western Sydney University during academic year 2019-2020. Using a convergent mixed methods approach, survey and interview data from third-, fourth-, and fifth-year students were collected. Surveys explored 5 proactive behaviors: feedback seeking, information seeking, task negotiation, positive framing, and relationship building. Interviews elicited descriptions of how students described their proactivity and what influenced students to be proactive when entering a new clerkship. Data were integrated using the following the thread and mixed methods matrix techniques. RESULTS Students exhibited all 5 proactive behaviors. Survey data showed positive framing and task negotiation had the highest and lowest scores, respectively. Only positive framing correlated significantly with social integration scores (r = 0.27; P < .01), but this contrasted to interviews, in which students described how other proactive behaviors also led to social integration. Proactive behavior scores decreased across academic years. Integrated data showed 3 linked antecedents to whether students exhibited proactive behavior: feeling capable of being proactive, individual intention to be proactive, and the immediate environment and system-level factors. CONCLUSIONS Students who framed the experience positively were more likely to report increased social integration. Initiating task negotiation was challenging for most students. The authors propose a conceptual model for proactivity and social integration to support socialization and learning during clinical transitions for future research and interventional design.
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Affiliation(s)
- Anique Atherley
- A. Atherley was a dual PhD candidate, School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia, and the School of Health Professions Education, Maastricht University, Maastricht, the Netherlands, at the time of writing. She is now assistant professor, Academy for Teaching and Learning, Ross University School of Medicine, Bridgetown, Barbados; ORCID: https://orcid.org/0000-0002-6350-7285
| | - Wendy C.-Y. Hu
- W.C.-Y. Hu is professor of medical education and associate dean of learning and innovation, School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia; ORCID: http://orcid.org/0000-0002-1711-3808
| | - Diana Dolmans
- D. Dolmans is professor of innovative learning arrangements and educational scientist, School of Health Professions Education and the Department of Educational Development & Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-4802-1156
| | - Pim W. Teunissen
- P.W. Teunissen is professor of workplace learning in health care, School of Health Professions Education, and gynecologist, Department of Obstetrics & Gynecology, Maastricht University and Maastricht University Medical Center, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-0930-0048
| | - Iman Hegazi
- I. Hegazi is director of medical education and the undergraduate academic program, School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia; ORCID: https://orcid.org/0000-0002-5428-6564
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Kor PPK, Yu CTK, Triastuti IA, Sigilipoe MA, Kristiyanto HD, Pratiwi JPD, Perdamaian TK, Li LM, Pang PCP, Widagdo TMM. Effects of an internationalization at home (IAH) programme on cultural awareness among medical and nursing students in Hong Kong and Indonesia during the COVID-19 pandemic: a mixed-methods study. BMC MEDICAL EDUCATION 2022; 22:368. [PMID: 35562728 PMCID: PMC9099034 DOI: 10.1186/s12909-022-03424-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has severely impacted the learning experience of students by limiting their opportunities for face-to-face intercultural exchanges. Given the importance of cultural competence in medical education, there is a need to develop a programme that promotes cultural awareness, but that offers more flexibility in terms of outbound mobility. This study aims to evaluate the effectiveness of an internationalization at home programme and to explore the learning experiences of medical and nursing students from Hong Kong and Indonesia. METHODS Students were recruited from two universities in Hong Kong and Indonesia. They attended an online internationalization at home programme designed by members of the research team from both countries. A mixed-methods study was conducted using a concurrent triangulation approach. A pre-test post-test design was used to evaluate the effects of the programme on cultural awareness, and four focus groups were conducted to explore the students' experiences in the programme. Quantitative and qualitative data were analysed by T-test and reflexive thematic analysis, respectively. Data were integrated and triangulated using joint displays by comparing findings from both sources. RESULTS One hundred and forty-eight students from Hong Kong and Indonesia participated in the study. After the programme, there was a significant improvement in cultural awareness. Three themes were identified: (1) learning process: enjoyable, but a desire remains for face-to-face cross-cultural communication; (2) learning outcomes: gained cultural awareness, developed cultural sensitivity, had an opportunity to practice language and learn about new learning styles; (3) factors influencing learning outcomes: facilitators (micro-movie and active communication) and barriers (language barrier, inappropriate time arrangement, insufficient prior briefing). CONCLUSION This programme achieved the learning outcomes by successfully enhancing the cultural awareness of students during a time of pandemic when outbound student exchanges were not possible. Further adaptations of the programme are required to enhance different learning outcomes.
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Affiliation(s)
- Patrick Pui Kin Kor
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University (School of Nursing), Hung Hom, Hong Kong.
| | | | - Ida Ayu Triastuti
- Faculty of Medicine, Duta Wacana Christian University, Yogyakarta, Indonesia
| | | | | | | | | | - Lisa Mengli Li
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University (School of Nursing), Hung Hom, Hong Kong
| | - Phyllis Chui Ping Pang
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University (School of Nursing), Hung Hom, Hong Kong
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Tripartite Analysis: A Data Analysis Technique for Convergent Mixed Methods Designs. Nurs Res 2022; 71:313-321. [PMID: 35149628 DOI: 10.1097/nnr.0000000000000584] [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
BACKGROUND Effective data integration is a daunting task in mixed methods research. Several frameworks for data integration exist, but the choice of and the technique for integration depends upon the research question and design. Innovative integration techniques continuously need to be developed to tackle the integration challenge and provide alternative ways for researchers to generate plausible mixed inferences. OBJECTIVES To describe a new data analysis technique, tripartite analysis (TriPA), and illustrate its use in a convergent mixed methods study. METHODS This technique was developed based on a convergent mixed methods study underpinned by dialectical pluralism aimed to understand Pakistani nursing students' perspectives about compassion and compassionate care and how these perspectives are consistent with the conceptualizations of compassion in nursing literature. RESULTS TriPA entails analysis and integration using joint displays at three levels: case-by-case integrated analysis, separate and then merged quantitative and qualitative analysis, and comparative and integrated analysis of Levels I and II findings. DISCUSSION TriPA can enable researchers to develop a more nuanced understanding of a given phenomenon through integration at various levels by identifying linkages within cases and across the whole data set and recognizing relational connections and emerging patterns.
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25
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Feasibility and acceptability of a web-based advance care plan for dementia. Geriatr Nurs 2022; 44:251-258. [PMID: 35259603 PMCID: PMC9190025 DOI: 10.1016/j.gerinurse.2022.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/23/2022]
Abstract
While advance care planning (ACP) can help elicit preferences and is associated with improved end-of-life outcomes, persons living with dementia (PLWD) in nursing homes are rarely included in ACP. Web-based decision aids are a readily available tool to engage PLWD in ACP, but none are designed for the unique needs of PLWD, particularly those residing in nursing homes. Our Memory Care Wishes (OMCW) was adapted from a publicly available web-based ACP tool in collaboration with dementia care experts. This study aimed to explore the acceptability of OMCW. We used a convergent, mixed methods design to describe PLWD and surrogates' experiences using the OMCW website. Participants described ease of use, comfort with viewing, helpfulness for planning, and likelihood to recommend. Overall, OMCW is acceptable, however, PLWD continue to have difficulties understanding and engaging with some website content. Modifications were incorporated based on these findings, setting the stage for implementation and effectiveness testing.
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Durante A, Ahtisham Y, Cuoco A, Boyne J, Brawner B, Juarez-Vela R, Vellone E. Informal caregivers of people with heart failure and resilience: A convergent mixed methods study. J Adv Nurs 2021; 78:264-275. [PMID: 34668214 DOI: 10.1111/jan.15078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/07/2021] [Accepted: 09/30/2021] [Indexed: 02/03/2023]
Abstract
AIM To develop a comprehensive understanding of resilience and its associated factors among informal caregivers of people with heart failure. DESIGN Transnational multicentre convergent mixed methods approach. METHODS This study was conducted in three European countries: Italy, Spain and the Netherlands; during February 2017 and December 2018. In total, 195 caregivers completed the Connor-Davidson Resilience Scale, Caregiver Burden Inventory and Hospital Anxiety and Depression Scale. From a nested sample 50 caregivers participated in semi-structured face-to-face interviews. Data were analysed using qualitative content analysis, multiple regression and joint displays. RESULTS The caregivers' mean age was over 60 years. The quantitative results showed that caregivers experienced anxiety and depression regardless of a good score of resilience and moderate level of burden. Regression analysis showed that the resilience was associated with caregiver depression. From qualitative findings three resilience inhibiting (psychological outlook, physical weariness and affective state) and two promoting factors (community interconnectedness and self-comforting activities) were generated. Mixed analysis confirmed that depression decreased caregivers' resilience. CONCLUSIONS Caregivers of people with heart failure experience continuous stress and anxiety resulting in reduced resilience. Collaborative efforts are needed to build multifaceted interventions and programs to enhance caregivers' resilience by targeting the factors identified in this study. IMPACT The quality of informal caregiving is affected by the resilience of caregivers. No research has explored the resilience levels and its factors in this population. Depression, psychological outlook, physical weariness and affective state are negative factors of caregivers' resilience. Personal strategies combined with social and community support and belongingness enhance caregivers' resilience. Community care organizations and hospitals could establish alliances to develop programs for enhancing caregivers' resilience.
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Affiliation(s)
- Angela Durante
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Roma, Italy
| | - Younas Ahtisham
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, Canada
| | - Angela Cuoco
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Roma, Italy
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bridgette Brawner
- M. Louise Fitzpatrick College of Nursing at Villanova University, Philadelphia, Pennsylvania, USA
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Roma, Italy
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Tolotti A, Bonetti L, Pedrazzani C, Bianchi M, Moser L, Pagnucci N, Sari D, Valcarenghi D. Nursing management of fatigue in cancer patients and suggestions for clinical practice: a mixed methods study. BMC Nurs 2021; 20:182. [PMID: 34583693 PMCID: PMC8477483 DOI: 10.1186/s12912-021-00699-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/19/2021] [Indexed: 01/29/2023] Open
Abstract
Background Fatigue is a complex and frequent symptom in cancer patients, influencing their quality of life, but it is still underestimated and undertreated in clinical practice. The aims of this study were to detect the presence of fatigue in cancer patients, describe how patients and nurses perceived it and how nurses managed fatigue. Methods This is a mixed methods study. Data were collected in two oncological wards using the Brief Fatigue Inventory (BFI), an ad hoc questionnaire, patient interviews, focus groups with nurses and the review of nursing records. Interviews and focus groups were analysed through thematic analysis. We used SPSS 22.0 for quantitative data and Nvivo 10 for qualitative data analysis. Results A total of 71 questionnaires were analysed (39 males, mean age 65.7 years). Fatigue was reported 5 times (7%) in nursing records, while in 17 cases (23.9%) problems associated to it were reported. Twelve patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gestures, and being informed. Three themes were identified through the focus groups: objectivity and subjectivity in the assessment of fatigue, nurses’ contribution to the multidisciplinary management of fatigue, and difficulty in evaluating outcomes. Conclusions The approach to the management of fatigue was unstructured. Patients were satisfied with the care they received but needed more information and specific interventions. Useful aspects were identified that could be used to change health professionals’ approach towards the management of fatigue. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00699-9.
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Affiliation(s)
- Angela Tolotti
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Loris Bonetti
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland. .,Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland.
| | - Carla Pedrazzani
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Monica Bianchi
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Laura Moser
- Clinical Trial Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Nicola Pagnucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Dario Valcarenghi
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
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Paskins Z, Bullock L, Crawford-Manning F, Cottrell E, Fleming J, Leyland S, Edwards JJ, Clark E, Thomas S, Chapman SR, Ryan S, Lefroy JE, Gidlow CJ, Iglesias C, Protheroe J, Horne R, O'Neill TW, Mallen C, Jinks C. Improving uptake of Fracture Prevention drug treatments: a protocol for Development of a consultation intervention (iFraP-D). BMJ Open 2021; 11:e048811. [PMID: 34408051 PMCID: PMC8375717 DOI: 10.1136/bmjopen-2021-048811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Prevention of fragility fractures, a source of significant economic and personal burden, is hindered by poor uptake of fracture prevention medicines. Enhancing communication of scientific evidence and elicitation of patient medication-related beliefs has the potential to increase patient commitment to treatment. The Improving uptake of Fracture Prevention drug treatments (iFraP) programme aims to develop and evaluate a theoretically informed, complex intervention consisting of a computerised web-based decision support tool, training package and information resources, to facilitate informed decision-making about fracture prevention treatment, with a long-term aim of improving informed treatment adherence. This protocol focuses on the iFraP Development (iFraP-D) work. METHODS AND ANALYSIS The approach to iFraP-D is informed by the Medical Research Council complex intervention development and evaluation framework and the three-step implementation of change model. The context for the study is UK fracture liaison services (FLS), which enact secondary fracture prevention. An evidence synthesis of clinical guidelines and Delphi exercise will be conducted to identify content for the intervention. Focus groups with patients, FLS clinicians and general practitioners and a usual care survey will facilitate understanding of current practice, and investigate barriers and facilitators to change. Design of the iFraP intervention will be informed by decision aid development standards and theories of implementation, behaviour change, acceptability and medicines adherence. The principles of co-design will underpin all elements of the study through a dedicated iFraP community of practice including key stakeholders and patient advisory groups. In-practice testing of the prototype intervention will inform revisions ready for further testing in a subsequent pilot and feasibility randomised trial. ETHICS AND DISSEMINATION Ethical approval was obtained from North West-Greater Manchester West Research Ethics Committee (19/NW/0559). Dissemination and knowledge mobilisation will be facilitated through national bodies and networks, publications and presentations. TRIAL REGISTRATION NUMBER researchregistry5041.
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Affiliation(s)
- Zoe Paskins
- School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Stoke-on-Trent, UK
| | | | - Fay Crawford-Manning
- School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Stoke-on-Trent, UK
| | | | - Jane Fleming
- Cambridge Public Health, University of Cambridge, Cambridge, UK
- Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, Cambridge, UK
| | | | | | - Emma Clark
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Simon Thomas
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, UK
| | | | - Sarah Ryan
- Haywood Academic Rheumatology Centre, Haywood Hospital, Stoke-on-Trent, UK
- School of Medicine & School of Nursing and Midwifery, Keele University, Stoke-on-Trent, UK
| | - J E Lefroy
- School of Medicine, Keele University, Keele, UK
| | | | - C Iglesias
- Department of Health Sciences, University of York, York, UK
- Danish Centre for Healthcare Improvements, Aalborg Universitet, Aalborg, Denmark
| | | | - Robert Horne
- Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, London, UK
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Clare Jinks
- School of Medicine, Keele University, Keele, UK
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Rheault H, Coyer F, Bonner A. Chronic disease health literacy in First Nations people: A mixed methods study. J Clin Nurs 2021; 30:2683-2695. [PMID: 34180097 DOI: 10.1111/jocn.15757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 03/05/2021] [Indexed: 01/29/2023]
Abstract
AIM To explore chronic disease education, self-management and health literacy abilities from First Nations Australian adults with chronic disease through the integration of qualitative and quantitative findings. BACKGROUND Chronic disease management requires good health literacy abilities to manage long-term health needs. First Nations people have a higher burden of chronic disease although little is known regarding chronic disease health literacy of First Nations people. DESIGN A concurrent embedded mixed methods study reported using the Consolidated Criteria for Reporting Qualitative Research guidelines. METHODS Data were collected from First Nations people with one or more chronic diseases living in remote Australia between February-November 2017. Quantitative data (n = 200) were collected using the Health Literacy Questionnaire along with demographic and health data. Qualitative data (n = 20) were collected via face-to-face interviews to examine chronic disease education and self-management experiences. Data were analysed separately then integrated to develop meta-inferences. RESULTS Poor communication from healthcare providers coupled with low health literacy abilities is a major barrier to both active and successful management of chronic disease. Communicating in medical jargon resulted in individuals being placed in a power differential causing lack of trust and relationship breakdowns with healthcare providers affecting active chronic disease self-management. The perception of inevitability and ambivalence towards chronic disease and the notion of futility towards self-management were concurred with the low level of active engagement in health care. CONCLUSIONS Yarning is an important strategy used by First Nations people for communication. For nurses, understanding and developing skills in yarning will facilitate cultural safety, communication and understanding about chronic disease self-management in contexts where health literacy abilities are challenged. RELEVANCE TO CLINICAL PRACTICE Using yarning, and plain language visual aids, and teach-back will readdress the power differential experienced by First Nations people and may also improve understanding of chronic disease self-management.
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Affiliation(s)
- Haunnah Rheault
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Advanced Heart Failure and Transplant Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Fiona Coyer
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia.,NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland, Herston, Queensland, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Herston, Queensland, Australia
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González-Díaz RR, Bustamante-Cabrera GI. Predictive Sequential Research Design to Study Complex Social Phenomena. ENTROPY 2021; 23:e23050627. [PMID: 34069864 PMCID: PMC8157385 DOI: 10.3390/e23050627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 01/29/2023]
Abstract
Social phenomena in their simplest form share infinite complexities and relationships, and by interacting with other entities, their levels of complexity become exponentially inexplicable and incomprehensible. Using a single form of study in complex phenomena could be insufficient, and new forms of analysis should be opened that allow for observing the multidimensionality of study problems from integrative perspectives. The emergence of research using mixed methods attempts to reconcile these methodologies through integration, configuring a stage of interconnection between research paradigms that cause cuts and leaks that may or may not be consistent with the study’s object. At the time of integration, vices can be created by specific value and subjectivity judgments, with investigative diffraction being an alternative to extend integration through data fracture and redirecting the object of study. This work proposes a Predictive Sequential Research Design (DISPRE) for complex social phenomena, which uses fuzzy logic as a tool to solve the information biases caused by the investigative diffraction of each methodological approach as a strategy to capture, explain, understand and predict the intrinsic complexity of the social entity under study.
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Affiliation(s)
- Romel Ramón González-Díaz
- Centro Internacional de Investigación y Desarrollo—CIID, Monteria 230001, Colombia
- Correspondence: ; Tel.: +57-3104057503
| | - Gladys Inés Bustamante-Cabrera
- Latin American Bioethics Committee of the Centro Internacional de Investigación y Desarrollo—CIID, Monteria 230001, Colombia;
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Kimber M, Harms S, Soreni N, Inrig M, Acai A, Lipman EL, Sassi R, Streiner DL, MacMillan HL. LIVES for families psychological first aid training programme to address COVID-19 psychological distress: a mixed methods acceptability and feasibility protocol. BMJ Open 2021; 11:e049995. [PMID: 33952558 PMCID: PMC8102861 DOI: 10.1136/bmjopen-2021-049995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/25/2021] [Accepted: 04/20/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Best practice approaches for addressing COVID-19-related psychological distress among young people (<25 years) and their families remain unclear. Psychological first aid (PFA) is promoted by public health authorities to provide psychological support in the context of extreme events; however, there is limited evidence for its effectiveness. As a prerequisite to conducting a randomised controlled trial to examine programme effectiveness, this project is evaluating the acceptability and feasibility of implementing and evaluating a PFA training programme ('LIVES for Families') for mental health (MH) practitioners to improve their ability to recognise and respond to COVID-19-related psychological distress among their clients. METHODS AND ANALYSIS We are using a triangulation mixed methods research design; complementary strands of quantitative and qualitative data are being collected in parallel and will be merged at the interpretation phase of the project. The quantitative strand uses a repeated measures design; a consecutive sample of MH practitioners (n=80) providing MH support to young people or their families are being recruited to participate in the LIVES for Families PFA training programme and complete quantitative measures at baseline (pretraining), 2-week and 6-month follow-up time points. The qualitative strand uses fundamental description and semistructured interviews with a subset of practitioners (n=30), as well as managers of MH agencies (n=20). A mixed methods joint display and associated narrative will generate a comprehensive understanding regarding acceptability and feasibility. ETHICS AND DISSEMINATION The Hamilton Integrated Research Ethics Board approved the study (project number: 11295). Results will be shared broadly with the policy and practice community through publications, presentations and public webinars. As a brief, evidence-informed intervention, the LIVES for Families PFA training programme is suitable in its mode of delivery across care settings. The outcomes of this study could have international implications for mitigating the MH impacts of viral pandemics.
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Affiliation(s)
- Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Harms
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Noam Soreni
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Maggie Inrig
- Lynwood Charlton Centre, Hamilton, Ontario, Canada
| | - Anita Acai
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ellen Louise Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Roberto Sassi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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O'Rourke HM, Sidani S, Jeffery N, Prestwich J, McLean H. Acceptability of personal contact interventions to address loneliness for people with dementia: An exploratory mixed methods study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2020; 2:100009. [PMID: 38745907 PMCID: PMC11080537 DOI: 10.1016/j.ijnsa.2020.100009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/11/2020] [Accepted: 10/03/2020] [Indexed: 12/27/2022] Open
Abstract
Background Personal contact interventions involve routine visits with a person or animal to address loneliness. Research supports the promise of these interventions to address loneliness among cognitively intact older adults, but little is known about their use with people with dementia. Objective To assess the acceptability of personal contact interventions for use to address loneliness with older people with dementia, according to formal and informal care providers. Design Cross-sectional, mixed methods complementarity design. Setting Ontario, Canada. Participants A purposive sample of 25 family members, friends, and health care providers of people with dementia. Methods Participants attended a face-to-face interview to discuss the acceptability of personal contact interventions. Participants completed questionnaires to rate acceptability (adapted Treatment Perception and Preference measure). A semi-structured interview followed to discuss the ratings and features of personal contact (with another person or animal) in more detail. The analysis involved descriptive statistics (quantitative data) and conventional content analysis (qualitative data). During the interpretation of the results, the qualitative findings were compared to the quantitative results to provide context and understand participants' perceptions of intervention acceptability in more depth; these are presented together in the results to demonstrate their distinct and complementary contributions to the findings. Results Personal contact with a person or animal was rated as effective, logical, suitable, and low risk to address loneliness by over 80% of participants. Participants' willingness to engage in this type of contact, for example as a visitor or as a facilitator of animal contact, was 72%. Participants emphasized the benefits of personal contact. The findings highlight that individualized, flexible interventions that include appropriate facilitation are needed. Conclusions Future studies to develop and test personal contact interventions should involve flexible delivery, assess the feasibility and acceptability of these interventions (as in a Phase 2 trial of a complex intervention), and focus on the experiences of people with dementia.Tweetable Abstract: Tailored, routine, and facilitated contact with a person or animal shows promise to address loneliness for people with dementia.What is already known about this topic:• Loneliness is emotionally painful and harms the health and quality of life of those that experience it.• Personal contact interventions refer to routine visits with another person or animal and have been found effective in addressing loneliness among cognitively intact older adults.What this paper adds:• Friends, family members and health care providers of people with dementia view personal contact interventions as logical, suitable and effective to address loneliness of older adults with dementia.• Personal contact interventions are not always easy to implement and do not automatically promote meaningful connection and prevent loneliness for people with dementia.• Strategies to tailor and facilitate personal contact interventions are needed to promote their effectiveness when used with people with dementia.
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Affiliation(s)
- Hannah M. O'Rourke
- Faculty of Nursing, University of Alberta, Level 3 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Souraya Sidani
- School of Nursing, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada
| | - Nicole Jeffery
- School of Nursing, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada
| | - Judy Prestwich
- Faculty of Nursing, University of Alberta, Level 3 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Haydn McLean
- Faculty of Nursing, University of Alberta, Level 3 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
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Younas A, Rasheed SP, Zeb H, Inayat S. Data integration using the building technique in mixed-methods instrument development: Methodological discussion. J Adv Nurs 2020. [PMID: 32400896 DOI: 10.1111/jan.14415] [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: 01/07/2020] [Revised: 04/02/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
AIMS To discuss and illustrate how meaningful integration can be achieved in instrument development design. DESIGN Discussion paper. DATA SOURCES A mixed-methods study about challenges of nurse educators in Pakistan. The building technique was implemented when the findings of the qualitative phase were integrated to develop an instrument to determine educators' challenges while teaching nursing students in academic and clinical settings. IMPLICATIONS FOR NURSING Nurses are required to use cultural- and population-specific instruments for data collection. The six-step building approach can enable nurses to develop such instruments using rigorous and robust mixed-methods design. CONCLUSION Building and merging techniques are used in instrument development design during and after the completion of the study, respectively. However, building technique is essential for using the qualitative findings to develop the instrument. The proposed building approach starts with a robust qualitative data analysis and is strengthened with the selection of key themes and subthemes, linking them to the participants' quotes and then the conversion of the quotes into meaningful and pertinent items. Using the proposed building integration technique can enable researchers to meaningfully and efficiently use qualitative findings for developing instruments using mixed-methods designs. IMPACT Mixed methods are valuable for the development of data collection instruments that are tailored to the study context and relevant for the study participants. There is limited guidance about how meaningful integration can be achieved when developing research instruments using mixed methods. We proposed a practical building technique that allows researchers to meaningfully use qualitative findings from one phase to develop an instrument for the subsequent phase. The proposed approach is useful for researchers aiming to develop data collection instruments using mixed methods.
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Affiliation(s)
- Ahtisham Younas
- Memorial University of Newfoundland, St. John's, NL, Canada.,DSW The Caregivers, St. John's, NL, Canada.,Shifa College of Nursing, Islamabad, Pakistan
| | | | - Hussan Zeb
- Saidu Group of Teaching Hospital, Swat, Pakistan.,Swat College of Nursing, Swat, Pakistan
| | - Shahzad Inayat
- College of Nursing, Isra University, Islamabad, Pakistan
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