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Piil K, Locatelli G, Skovhus SL, Tolver A, Jarden M. A Shifting Paradigm Toward Family-Centered Care in Neuro-Oncology: A Longitudinal Quasi-Experimental Mixed-Methods Feasibility Study. JOURNAL OF FAMILY NURSING 2024; 30:127-144. [PMID: 38531858 DOI: 10.1177/10748407241236678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Family-centered intervention can help families facing illness-related issues. We investigated the feasibility of Family and Network Conversations (FNCs) in high-grade glioma patients and their families. Quasi-experimental feasibility study with longitudinal mixed-methods design. Patients and families were invited to three FNCs over 1 year. They completed questionnaires at four time points and expressed their perspectives on the intervention through telephone interviews. Nurses' perspectives were collected in a focus group. Twenty-one patients and 47 family members were included. On average, patients were 66 years old, mainly male, married, living with caregivers, with unifocal cancer. On average, caregivers were 47 years old, mainly female, being spouses or children of the patient. Quantitative and qualitative data did not always match and expanded each other. Nurse-delivered FNCs holistically addressed families' needs while strengthening family's dialogue and union. Nurses felt empowered, underling that advanced competencies were required. Nurse-delivered FNCs are feasible to provide family-centered care, but they should be tailored to each family's needs.
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Affiliation(s)
- Karin Piil
- Copenhagen University Hospital, Rigshospitalet, Denmark
- Roskilde University, Denmark
| | | | | | | | - Mary Jarden
- Copenhagen University Hospital, Rigshospitalet, Denmark
- University of Copenhagen, Denmark
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2
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Romero‐Cortadellas L, Venturi V, Martín‐Sánchez JC, Toska K, Prince D, Butzeck B, Porto G, Milman NT, Committee HIS, Sánchez M. Haemochromatosis patients' research priorities: Towards an improved quality of life. Health Expect 2023; 26:2293-2301. [PMID: 37503783 PMCID: PMC10632644 DOI: 10.1111/hex.13830] [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: 05/15/2023] [Revised: 06/16/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Chronic diseases are associated with a range of functional and psychosocial consequences that can adversely affect patients' quality of life (QoL). Haemochromatosis (HC) is a genetically heterogeneous disorder characterized by chronic iron overload that can ultimately lead to multiple organ dysfunction. Clinical diagnosis remains challenging due to the nonspecificity of symptoms and a lack of confirmatory genotyping in a substantial proportion of patients. Illness perception among HC patients has not been extensively investigated, lacking relevant information on how to improve their QoL. METHODS We present the results of the first worldwide survey conducted in nearly 1500 HC respondents, in which we collected essential demographic information and identified the aspects that concern HC patients the most. RESULTS Out of all the participants, 45.3% (n = 676) voiced their concern about physical and psychological consequences such as HC-related arthropathies, which can ultimately affect their social functioning. A similar proportion of patients (n = 635, 42.5%) also consider that better-informed doctors are key for improved HC disease management. Taking a patient-centred approach, we expose differences in patients' disease perspective by social and economic influences. CONCLUSIONS We identify potential targets to improve patients' health-related QoL and reflect on strategic measures to foster gender equity in access to health resources. Finally, we make a call for a highly coordinated effort across a range of public policy areas to empower participants in the HC research process and design. PATIENT OR PUBLIC CONTRIBUTION Nearly 1500 patients with hereditary HC responded to an anonymized online survey in which research and clinical priorities were addressed regarding this chronic and rare disease.
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Affiliation(s)
- Lídia Romero‐Cortadellas
- Department of Basic Sciences, Iron metabolism: Regulation and DiseasesUniversitat Internacional de Catalunya (UIC)Sant Cugat del VallèsBarcelonaSpain
| | - Veronica Venturi
- Department of Basic Sciences, Iron metabolism: Regulation and DiseasesUniversitat Internacional de Catalunya (UIC)Sant Cugat del VallèsBarcelonaSpain
| | - Juan Carlos Martín‐Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic SciencesUniversitat Internacional de CatalunyaSant Cugat del VallèsSpain
| | - Ketil Toska
- Norwegian Haemochromatosis AssociationBergenNorway
| | - Dianne Prince
- Haemochromatosis AustraliaMeridan PlainsQueenslandAustralia
| | - Barbara Butzeck
- Hämochromatose‐Vereinigung Deutschland e.V. HVDEuropean Federation of Associations of Patients with Haemochromatosis (EFAPH)HattingenGermany
| | - Graça Porto
- i3S—Instituto de Investigação e Inovação em SaúdeUniversidade do PortoPortoPortugal
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar.Universidade do PortoPortoPortugal
| | | | | | - Mayka Sánchez
- Department of Basic Sciences, Iron metabolism: Regulation and DiseasesUniversitat Internacional de Catalunya (UIC)Sant Cugat del VallèsBarcelonaSpain
- BloodGenetics S.L. Diagnostics in Inherited Blood DiseasesEsplugues de LlobregatSpain
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Mosconi P, Colombo C, Paletta P, Gangeri L, Pellegrini C, Garralda E, Miceli R, Brunelli C. Public and patient involvement: a survey on knowledge, experience and opinions among researchers within a precision oncology European project. BMC Cancer 2023; 23:814. [PMID: 37648965 PMCID: PMC10470190 DOI: 10.1186/s12885-023-11262-x] [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: 04/21/2023] [Accepted: 08/05/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Patient and Public Involvement (PPI) is slowly but steadily being implemented in all phases of clinical research. As part of the European project "Building Data Rich Clinical Trials" a survey was launched to investigate the knowledge, experiences and opinions on this topic of clinicians and researchers from seven European clinical and non-clinical centers (Cancer Core Europe). METHODS An invitation to take part in a cross-sectional web survey was sent to 199 clinicians and researchers working in the field of precision oncology. The questionnaire was developed ad hoc because no existing questionnaires met the purpose of this study. The analysis takes account of whether respondents had experience on PPI or not. RESULTS On a total of 101 respondents, this survey reveals that 76.2% of them knew about PPI before answering the questionnaire, 54.5% had experience in the previous five years and 86.1% were interested in a training course on this topic. PPI knowledge grew together with career seniority (peak of 86.5% for established career professionals), while the group most interested in a course was the early-career professionals (100.0%). Finally, the majority of respondents stated they had no training or education on PPI (67.3% of experienced and 82.6% of not-experienced respondents). CONCLUSIONS This survey shows that most cancer researchers knew the term PPI, even if only a little more than half of them had any relative experience. Opinions on PPI benefits, negative effects, barriers and requirements differed between the groups of PPI experienced and not-experienced respondents, showing that experience itself can influence respondents' opinions. Most of respondents reported they would prefer a training course based on practical rather than theoretical tools.
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Affiliation(s)
- Paola Mosconi
- Laboratory of Medical Research and Consumer Involvement, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Milan, Italy.
| | - Cinzia Colombo
- Laboratory of Medical Research and Consumer Involvement, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Milan, Italy
| | - Pasquale Paletta
- Laboratory of Medical Research and Consumer Involvement, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Milan, Italy
| | - Laura Gangeri
- Clinical Psychology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Pellegrini
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elena Garralda
- Vall d'Hebron Institute of Oncology (VHIO) and Vall d, Hebron University Hospital, Barcelona, Spain
| | - Rosalba Miceli
- Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cinzia Brunelli
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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4
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Dengsø KE, Lindholm ST, Herling SF, Pedersen M, Nørskov KH, Collet MO, Nielsen IH, Christiansen MG, Engedal MS, Moen HW, Piil K, Egerod I, Hørder M, Jarden M. Patient and public involvement in Nordic healthcare research: a scoping review of contemporary practice. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:72. [PMID: 37649111 PMCID: PMC10466765 DOI: 10.1186/s40900-023-00490-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Over the past decades, there has been a growing international interest in user involvement in healthcare research. However, evidence on the management and impact of patient and public involvement in Nordic healthcare research remains limited. OBJECTIVE The aim was to explore and delineate the current state, practice, and impact of patient and public involvement in healthcare research across different areas of healthcare and patient populations in the Nordic countries. METHODS We conducted a scoping review using nine scientific databases and gray literature from 1992-2023. Sources were categorized as empirical or non-empirical. We used the Guidance for Reporting Involvement of Patients and the Public Short Form 2 checklist for reporting of patient and public involvement in healthcare research and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. RESULTS A total of 56 publications were included, consisting of 39 empirical and 17 non-empirical sources. Gray literature varied among countries and institutions encompassing different types of documents. We found an increase in the number of publications on patient and public involvement in Nordic healthcare research. This was evidenced by the growing number of references and institutional initiatives intended at involving the public, indicating the increasing emphasis on patient and public involvement in Nordic healthcare research. The terminology used to describe patient and public involvement varied over time. However, there has been a gradual narrowing down of terms as the concept of PPI has become more integrated into research practices, particularly with the involvement of funding agencies. CONCLUSION The utilization of patient and public involvement in Nordic healthcare research has substantially increased, proliferated, and gained widespread acceptance across diverse healthcare domains. The variety of approaches challenged our scoping review in terms of systematic description and impact. Patient and public involvement was applied in one or more research stages using different methodologies and terms. International agreement on terms and definitions is needed for reliable interpretation of the use of patient and public involvement in Nordic healthcare research.
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Affiliation(s)
- Kristine Elberg Dengsø
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark.
| | - Sofie Tscherning Lindholm
- Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Suzanne Forsyth Herling
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Maja Pedersen
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | | | - Marie Oxenbøll Collet
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Iben Husted Nielsen
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | | | - Mette Schaufuss Engedal
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Helga Wallin Moen
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
| | - Karin Piil
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ingrid Egerod
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Mogens Hørder
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mary Jarden
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Hematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
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5
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Harasym P, Beaupre LA, Juby AG, Kivi P, Majumdar SR, Hanson HM. Cultural Knowledge in Context - People Aged 50 Years and Over Make Sense of a First Fracture and Osteoporosis. J Patient Exp 2023; 10:23743735231151537. [PMID: 36687165 PMCID: PMC9850129 DOI: 10.1177/23743735231151537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Catch a Break (CaB) is a secondary fracture prevention program that uses medical understandings of osteoporosis to assess first fractures and determine appropriateness for secondary fracture prevention. In this study, we interviewed CaB program participants to identify the understandings that patients themselves used to make sense of first fractures and the osteoporosis suggestion as cause. Semi-structured interviews were conducted with female and male participants of the CaB program in Canada. An interpretive practice approach was used to analyze the data. A random sample of 20 individuals, 12 women, and eight men all aged 50 years and over participated. First fractures were produced as meaningful in the context of osteoporosis only for seniors of very advanced age, and for people of any age with poor nutrition. The trauma events that led to a first fracture were produced as meaningful only if perceived as accidents, and having an active lifestyle was produced as beneficial only for mental health and well-being unrelated to osteoporosis. Cultural knowledge shapes, but does not determine, how individuals make sense of their health and illness experiences. Risk prevention program designers should include patients on the design team and be more aware of the presumptive knowledge used to identify individuals at risk of disease.
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Affiliation(s)
- Patricia Harasym
- Cumming School of Medicine, University of
Calgary, Calgary, Alberta, Canada,Heather M Hanson, Cumming School of
Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, Alberta
T2N 4Z6 Canada.
| | - Lauren A Beaupre
- Department of Physical Therapy, Faculty of Rehabilitation Medicine,
University of
Alberta, Edmonton, Alberta, Canada,Department of Orthopedics, Faculty of Medicine, University of
Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - Angela G Juby
- Department of Medicine, Faculty of Medicine and Dentistry,
University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, Edmonton,
Alberta, Canada
| | - Paul Kivi
- Department of Medicine, Faculty of Medicine and Dentistry,
University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, Edmonton,
Alberta, Canada
| | - Sumit R Majumdar
- Department of Medicine, Faculty of Medicine and Dentistry,
University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, Edmonton,
Alberta, Canada,School of Public Health, University of Alberta, 3-300 Edmonton
Clinic Health Academy, Edmonton, Alberta, Canada
| | - Heather M Hanson
- Cumming School of Medicine, University of
Calgary, Calgary, Alberta, Canada,Provincial Seniors Health and Continuing Care, Alberta Health
Services, Calgary, Alberta, Canada
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6
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Fadlallah R, Daher N, El-Harakeh A, Hammam R, Brax H, Bou Karroum L, Lopes LC, Arnous G, Kassamany I, Baltayan S, Harb A, Lotfi T, El-Jardali F, Akl EA. Approaches to prioritising primary health research: a scoping review. BMJ Glob Health 2022; 7:bmjgh-2021-007465. [PMID: 35501067 PMCID: PMC9062777 DOI: 10.1136/bmjgh-2021-007465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To systematically identify and describe approaches to prioritise primary research topics in any health-related area. Methods We searched Medline and CINAHL databases and Google Scholar. Teams of two reviewers screened studies and extracted data in duplicate and independently. We synthesised the information across the included approaches by developing common categorisation of relevant concepts. Results Of 44 392 citations, 30 articles reporting on 25 approaches were included, addressing the following fields: health in general (n=9), clinical (n=10), health policy and systems (n=10), public health (n=6) and health service research (n=5) (10 addressed more than 1 field). The approaches proposed the following aspects to be addressed in the prioritisation process: situation analysis/ environmental scan, methods for generation of initial list of topics, use of prioritisation criteria, stakeholder engagement, ranking process/technique, dissemination and implementation, revision and appeal mechanism, and monitoring and evaluation. Twenty-two approaches proposed involving stakeholders in the priority setting process. The most commonly proposed stakeholder category was ‘researchers/academia’ (n=17, 77%) followed by ‘healthcare providers’ (n=16, 73%). Fifteen of the approaches proposed a list of criteria for determining research priorities. We developed a common framework of 28 prioritisation criteria clustered into nine domains. The criterion most frequently mentioned by the identified approaches was ‘health burden’ (n=12, 80%), followed by ‘availability of resources’ (n=11, 73%). Conclusion We identified and described 25 prioritisation approaches for primary research topics in any health-related area. Findings highlight the need for greater participation of potential users (eg, policy-makers and the general public) and incorporation of equity as part of the prioritisation process. Findings can guide the work of researchers, policy-makers and funders seeking to conduct or fund primary health research. More importantly, the findings should be used to enhance a more coordinated approach to prioritising health research to inform decision making at all levels.
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Affiliation(s)
- Racha Fadlallah
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon.,Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.,Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Najla Daher
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Amena El-Harakeh
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.,Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Rima Hammam
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Hneine Brax
- Faculty of Medicine, Université Saint-Joseph, Beirut, Lebanon
| | - Lama Bou Karroum
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon.,Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.,Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | | | - Ghida Arnous
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Inas Kassamany
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Stephanie Baltayan
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Aya Harb
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Tamara Lotfi
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon.,Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.,Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon .,Clinical Research Institute, American University of Beirut, Beirut, Lebanon.,Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
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7
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Piil K, Laegaard Skovhus S, Tolver A, Jarden M. Neuro-Oncological Symptoms: A Longitudinal Quantitative Study of Family Function, Perceived Support, and Caregiver Burden. JOURNAL OF FAMILY NURSING 2022; 28:43-56. [PMID: 34286624 DOI: 10.1177/10748407211029986] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The aim of this study was to establish preliminary quantitative evidence for the longitudinal change in family function, perceived support, and caregiver burden, acknowledging that physical and emotional symptoms are important variables for quality of life in families affected by a brain cancer diagnosis. This longitudinal quantitative study measured patient-reported and family member-reported outcomes at four different time points in 1 year. The patients reported that the symptom burden hindered their relationships with other people. Furthermore, the generally high level of strain due to the caregiver burden had an especially negative impact on close social relationships. Data indicate that family functioning was continually negatively affected as perceived by both patients and family caregivers. No significant changes over time were identified. The results underline the importance of providing systematic and ongoing support to the whole family that acknowledges their contribution as a valuable social support system for the individual experiencing high-grade glioma.
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Affiliation(s)
- Karin Piil
- Copenhagen University Hospital, Rigshospitalet, Denmark
- Aarhus University, Denmark
| | | | | | - Mary Jarden
- Copenhagen University Hospital, Rigshospitalet, Denmark
- University of Copenhagen, Denmark
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8
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Kaisler RE, Grill C. Enabling Transdisciplinary Collaboration: Stakeholder Views on Working With "Children With Mentally Ill Parents" Research Groups. Front Psychiatry 2021; 12:760716. [PMID: 34887787 PMCID: PMC8649715 DOI: 10.3389/fpsyt.2021.760716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
Working collaboratively and openly together with stakeholders has become a common phenomenon in research. While previous studies have gathered a clear picture on researchers' attitudes, motivations, and barriers for actively involving stakeholders in transdisciplinary research, the stakeholder perspective is yet unknown. Therefore, this paper sets out to identify how stakeholders perceive transdisciplinary collaborations with researchers. This paper in particular reveals the enablers and barriers for such collaborations from the viewpoint of stakeholders. To do so, we look at how stakeholders, who were actively involved in the governance structure of two "children with mentally ill parents" research groups in Austria, perceived their collaboration with researchers. We used a mixed-method, quantitative-qualitative design. We conducted an online survey and interviews with the members of the advisory board and competence group. These stakeholders reported great satisfaction with the transdisciplinary collaboration and emphasized the value of different expertise. As the most important enablers for successful, transdisciplinary collaboration stakeholders emphasized researchers' open-mindedness toward new perspectives and approaches, flexibility to adapt to the research process along the way, and creativity dealing with diverse backgrounds and skills. Stakeholders further underlined the importance of a person facilitating the collaboration process between researchers and stakeholders to resolve any tensions and insecurities. Concluding, researchers' attitudes, and in particular their understanding of the value of stakeholder involvement in research are key enablers for successful transdisciplinary research collaborations.
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Affiliation(s)
- Raphaela E Kaisler
- LBG Open Innovation in Science Center, Ludwig Boltzmann Gesellschaft (LBG), Vienna, Austria
| | - Christiane Grill
- LBG Open Innovation in Science Center, Ludwig Boltzmann Gesellschaft (LBG), Vienna, Austria
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9
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Strange M, Nilsson C, Zdravkovic S, Mangrio E. The Precision Health and Everyday Democracy (PHED) Project: Protocol for a Transdisciplinary Collaboration on Health Equity and the Role of Health in Society. JMIR Res Protoc 2020; 9:e17324. [PMID: 33252352 PMCID: PMC7735904 DOI: 10.2196/17324] [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: 12/19/2019] [Revised: 10/15/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2022] Open
Abstract
Background The project “Precision Health and Everyday Democracy” (PHED) is a transdisciplinary partnership that combines a diverse range of perspectives necessary for understanding the increasingly complex societal role played by modern health care and medical research. The term “precision health” is being increasingly used to express the need for greater awareness of environmental and genomic characteristics that may lead to divergent health outcomes between different groups within a population. Enhancing awareness of diversity has parallels with calls for “health democracy” and greater patient-public participation within health care and medical research. Approaching health care in this way goes beyond a narrow focus on the societal determinants of health, since it requires considering health as a deliberative space, which occurs often at the banal or everyday level. As an initial empirical focus, PHED is directed toward the health needs of marginalized migrants (including refugees and asylum seekers, as well as migrants with temporary residency, often involving a legally or economically precarious situation) as vulnerable groups that are often overlooked by health care. Developing new transdisciplinary knowledge on these groups provides the potential to enhance their wellbeing and benefit the wider society through challenging the exclusions of these groups that create pockets of extreme ill-health, which, as we see with COVID-19, should be better understood as “acts of self-harm” for the wider negative impact on humanity. Objective We aim to establish and identify precision health strategies, as well as promote equal access to quality health care, drawing upon knowledge gained from studying the health care of marginalized migrants. Methods The project is based in Sweden at Malmö and Lund Universities. At the outset, the network activities do not require ethical approval where they will not involve data collection, since the purpose of PHED is to strengthen international research contacts, establish new research within precision strategies, and construct educational research activities for junior colleagues within academia. However, whenever new research is funded and started, ethical approval for that specific data collection will be sought. Results The PHED project has been funded from January 1, 2019. Results of the transdisciplinary collaboration will be disseminated via a series of international conferences, workshops, and web-based materials. To ensure the network project advances toward applied research, a major goal of dissemination is to produce tools for applied research, including information to enhance health accessibility for vulnerable communities, such as marginalized migrant populations in Sweden. Conclusions There is a need to identify tools to enable the prevention and treatment of a wide spectrum of health-related outcomes and their link to social as well as environmental issues. There is also a need to identify and investigate barriers to precision health based on democratic principles. International Registered Report Identifier (IRRID) DERR1-10.2196/17324
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Affiliation(s)
- Michael Strange
- Department of Global Political Studies, Malmö University, Malmö, Sweden.,Malmö Institute for Studies of Migration, Diversity & Welfare, Malmö University, Malmö, Sweden
| | - Carol Nilsson
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Slobodan Zdravkovic
- Malmö Institute for Studies of Migration, Diversity & Welfare, Malmö University, Malmö, Sweden.,Department of Care Sciences, Malmö University, Malmö, Sweden
| | - Elisabeth Mangrio
- Malmö Institute for Studies of Migration, Diversity & Welfare, Malmö University, Malmö, Sweden.,Department of Care Sciences, Malmö University, Malmö, Sweden
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10
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Morris M, Alencar Y, Rachet B, Stephens R, Coleman MP. Fleshing out the data: when epidemiological researchers engage with patients and carers. Learning lessons from a patient involvement activity. BMJ Open 2020; 10:e036311. [PMID: 32998916 PMCID: PMC7528373 DOI: 10.1136/bmjopen-2019-036311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 08/11/2020] [Accepted: 08/26/2020] [Indexed: 11/03/2022] Open
Abstract
Patient and public involvement and engagement has become an essential element of health research, ensuring aims and outputs are worthwhile and relevant. However, research involving secondary data analyses does not present immediately obvious ways to involve patients and the public. Innovative approaches to ensure their involvement is meaningful and effective are required.The Cancer Survival Group cohosted a full-day meeting with the National Cancer Research Institute Consumer Forum-a group of patients and carers. This included the Forum's 'Dragons' Den': a small-group session in which their members provided insight, advice and ideas on current or planned research in the Cancer Survival Group.We investigated this activity as an example of effective patient involvement, with the aim of developing broad recommendations to improve epidemiological/quantitative research by involving patients and carers as directly as possible.In addition to quantitative data captured through evaluation forms completed after the event, we used semistructured interviews of a sample of participants to evaluate the effectiveness of the session and to learn lessons. The interviews were analysed to identify broad or recurrent themes and recommendations.Feedback was overwhelmingly positive, and some impacts on the research projects were identified. Interviewees commented on overall expectations and experiences, as well as specifics of room layout, timing of the session, composition of groups, effectiveness of the facilitation and content of discussions.We present a summary of our findings as a guide for other researchers, including recommendations for improvement gleaned from the interviews. The value to researchers of hosting and participating in such activities was clear. We developed recommendations that should help to improve future events for ourselves and for others who wish to conduct similar activities, which in turn may lead to more concrete benefits for research and patients.
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Affiliation(s)
- Melanie Morris
- Cancer Survival Group, NCDE, London School of Hygiene & Tropical Medicine, London, UK
| | - Yuki Alencar
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Bernard Rachet
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Michel P Coleman
- Cancer Survival Group, NCDE, London School of Hygiene & Tropical Medicine, London, UK
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Ludwig C, Graham ID, Gifford W, Lavoie J, Stacey D. Partnering with frail or seriously ill patients in research: a systematic review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:52. [PMID: 32944284 PMCID: PMC7488581 DOI: 10.1186/s40900-020-00225-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/27/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND The expectation to include patients as partners in research has steadily gained momentum. The vulnerability of frail and/or seriously ill patients provides additional complexity and may deter researchers from welcoming individuals from this patient population onto their teams. The aim was to synthesize the evidence on the engagement of frail and/or seriously ill patients as research partners across the research cycle. METHODS A systematic review was conducted using PRISMA guidelines. A search strategy included MEDLINE®, EMBASE®, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO from database inception to April, 2019. Eligible studies were peer-reviewed qualitative, quantitative, and mixed methods research reporting on the engagement of frail and/or seriously ill patients as partners on research teams. The Mixed Methods Appraisal Tool was used to appraise study quality. Narrative analysis was conducted. RESULTS Of 8763 citations, 30 were included. Most studies included individuals with cancer on the research team (60%). Barriers included: lack of time and resources (50%), discontinuity in contribution (37%), and concerns for well-being (33%). Facilitators included: trust and mutual respect (60%), structural accessibility (57%), flexibility in timing and methods of engagement (43%), and attention to care and comfort, (33%). Perceived impacts for patients included: renewed personal sense of agency (37%) and emotional/peer support (37%). Impacts for researchers included sensitization to the lived experience of disease (57%) and an increased appreciation of the benefits of patient engagement (23%). Research design, execution, and outcomes, developed with patients, were deemed more suitable, relevant and reflective of patients' priorities. CONCLUSIONS There is emerging evidence to suggest that research partnerships with frail and/or seriously ill patients can be achieved successfully. Patients mostly report benefit from partnering with research teams. Frailty and/or serious illness do present legitimate concerns for their well-being but appear to be successfully mitigated when researchers ensure that the purpose of engagement is well-defined, the timing and methods of engagement are flexible, and the practical and emotional needs of patient partners are addressed throughout the process. SYSTEMATIC REVIEW REGISTRATION The systematic review protocol was registered with the International Prospective Register of Systematic Reviews PROSPERO (CRD42019127994).
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Affiliation(s)
- Claire Ludwig
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Ian D. Graham
- University of Ottawa, Faculty of Medicine, School of Epidemiology and Public Health, Ottawa, Ontario, Canada and Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
| | - Wendy Gifford
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Josee Lavoie
- Geriatric Psychiatry Program, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4 Canada
| | - Dawn Stacey
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
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Priorities for Cancer Research From the Viewpoints of Cancer Nurses and Cancer Patients: A Mixed-Method Systematic Review. Cancer Nurs 2020; 43:238-256. [PMID: 31895171 DOI: 10.1097/ncc.0000000000000776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Setting priorities in oncology is a useful way to produce a robust set of research questions that researchers can address. OBJECTIVE The aim of this review was to describe cancer nurses and patients' main research priorities and describe their development over time. METHODS A mixed-method systematic review was conducted for the period from 2000 to 2018 through a search of multiple databases. The methodological quality of the studies included was assessed using the Mixed-Methods Appraisal Tool, and the process of setting the health research priorities was assessed using Viergever's tool. Each study's top research priorities were extracted and summarized in categories. RESULTS Fifteen studies were included: 13 addressed nurses' research priorities, and 2 focused on those of patients. The majority were Delphi and quantitative studies that were conducted in the United States and United Kingdom. The quality criteria score and the quality of the process were considered sufficiently good. The most important research priorities were categorized as disease control and management, patient-related issues, and professional dimensions and issues. Management of symptoms and pain, education, information, and communication were research priorities always present in the articles during the study period. CONCLUSION Priorities change over time and depend on several factors; however, some have remained consistent for the last 18 years. Although there is increasing emphasis on including patients in establishing research priorities that inform cancer care, this involvement is still lacking. IMPLICATIONS FOR PRACTICE Future studies should describe the primary cancer research priorities of nurses in collaboration with patients.
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13
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Hawarden A, Jinks C, Mahmood W, Bullock L, Blackburn S, Gwilym S, Paskins Z. Public priorities for osteoporosis and fracture research: results from a focus group study. Arch Osteoporos 2020; 15:89. [PMID: 32548718 PMCID: PMC7297850 DOI: 10.1007/s11657-020-00766-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/03/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Four focus groups were conducted with members of the public to identify important areas for future osteoporosis research. Participants identified priorities to increase public awareness of osteoporosis, reduce delays in diagnosis, improve communication between healthcare providers and to improve follow-up and information provision about causes of osteoporosis, medication harms and prognosis. PURPOSE Patients and the public must be involved in setting research agendas to ensure relevant and impactful questions are prioritised. This study aimed to understand what people living with osteoporosis and fragility fractures felt was important to research, to inform the content of a national survey on research priorities in this area. METHODS Focus groups were conducted with members of the public with experience of osteoporosis or fragility fractures. The topic guide was co-developed with a patient and public involvement research user group, and explored participants' experiences of osteoporosis including diagnosis, management and effect upon their lives, what aspects of their ongoing care was most important to them and what about their care or condition could be improved. Focus groups were audio-recorded, transcribed and analysed thematically. RESULTS A total of twenty-three participants were recruited to four focus groups. Analysis identified two main themes: challenges in living with osteoporosis and healthcare services for osteoporosis. Information needs was a further cross-cutting theme. Participants called for increased public awareness of osteoporosis and wanted healthcare services to address conflicting messages about diet, exercise and medication. Participants described long delays in diagnosis, poor communication between primary and secondary care and the need for structured follow-up as important areas for future research to address. CONCLUSION The findings from this study provide an understanding of research priorities from the perspective of patients and the public, have informed the content of a national survey and have implications for patient education, health services research and policy.
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Affiliation(s)
- Ashley Hawarden
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK ,grid.500956.fHaywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, ST6 7AG UK
| | - Clare Jinks
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK
| | - Waheed Mahmood
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK
| | - Laurna Bullock
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK
| | - Steven Blackburn
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK
| | - Stephen Gwilym
- grid.4991.50000 0004 1936 8948Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Zoe Paskins
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK ,grid.500956.fHaywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, ST6 7AG UK
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Nissen ER, Bregnballe V, Mehlsen MY, Muldbjerg AKØ, O’Connor M, Lomborg KE. Patient involvement in the development of a psychosocial cancer rehabilitation intervention: evaluation of a shared working group with patients and researchers. RESEARCH INVOLVEMENT AND ENGAGEMENT 2018; 4:24. [PMID: 30123530 PMCID: PMC6091160 DOI: 10.1186/s40900-018-0106-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/02/2018] [Indexed: 05/30/2023]
Abstract
PLAIN ENGLISH SUMMARY The aim of this paper is to present our experiences from a shared working group (SWG) with patient representatives and researchers. The SWG collaborated on developing a psychosocial cancer rehabilitation intervention for women treated for breast cancer and men treated for prostate cancer and on the planning of an effect study of this intervention.The SWG included five patient representatives (three women treated for breast cancer and two men treated for prostate cancer), four researchers and a research assistant. The SWG met four times during the year where the intervention was developed. Data material for the present evaluation study comprises meeting documents, transcriptions of interviews with two patient representatives and three researchers from the SWG, and the primary investigator's field notes.The collaboration between patient representatives and researchers informed both the intervention and the research planning and was rewarding for the involved participants. The well-structured organization of the collaboration had a positive impact on the outcome. In addition, clear goals and clarification of expectations were important. Challenges were encountered in keeping continuity between meetings and carrying out homework as intended. It was crucial for the collaboration that patient representatives had specific knowledge, interest and motivation for the project.Involving patient representatives in the research process heightened the relevancy of the research and the quality of its contents. The SWG gave patient representatives and researchers a better mutual understanding. Overall, the conclusion is that the benefits obtained by involving patient representatives exceeds the additional costs this involves. ABSTRACT Background The aim of the paper is to present experiences of researchers collaborating with patients in a shared working group comprising patient representatives and researchers. Experiences are deduced from the evaluation of the work in the working group, which collaborated on developing a psychosocial cancer rehabilitation intervention for women treated for breast cancer and men treated for prostate cancer and the planning of a randomized controlled trial that investigates the effect of this intervention. Methods Five patient representatives (three women treated for breast cancer and two men treated for prostate cancer), four researchers and a research assistant participated in the shared working group. The shared working group met four times during the year the intervention was developed. Data material for the present evaluation study was collected from meeting documents, transcriptions of interviews with two patient representatives and three researchers from the shared working group, and the primary investigator's field notes. The data analysis was guided by Sandelowski's qualitative description strategy. Results The collaboration between patient representatives and researchers informed the intervention and the research planning and was rewarding for the involved participants. The well-structured organization of the collaboration had a positive impact on the outcome. Also, clear goals and clarification of expectations were important. Challenges were encountered in ensuring continuity between meetings and carrying out homework as intended. It was considered crucial for the collaboration to recruit patient representatives with specific knowledge, interest and motivation for the project. The direct costs related to the shared working group, including meals, transportation and salary for the research assistant, were small. However, the indirect costs in terms of time spent on planning patient-involving elements of, organizing meetings and evaluation were substantial and demanded a significant amount of extra work for the primary investigator. Conclusion Involving patients in the research process heightened the relevancy of the research and the quality of the research contents. The shared working group influenced both patient representatives and researchers and gave them a better mutual understanding. Overall, the conclusion is that the benefits obtained by involving patients exceed the additional costs related to patient involvement.
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Affiliation(s)
- Eva Rames Nissen
- Unit for Psychooncology and Health Psychology, Department of Psychology, Aarhus University, Bartholins Allé 11, Bld. 1350, DK-8000 Aarhus C, Denmark
- Research Programme for Patient Involvement, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Nørrebrogade 44, Bld. 12A, 1, DK-8000 Aarhus C, Denmark
| | - Vibeke Bregnballe
- Research Programme for Patient Involvement, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Nørrebrogade 44, Bld. 12A, 1, DK-8000 Aarhus C, Denmark
| | - Mimi Yung Mehlsen
- Unit for Psychooncology and Health Psychology, Department of Psychology, Aarhus University, Bartholins Allé 11, Bld. 1350, DK-8000 Aarhus C, Denmark
| | - Anne Kathrine Østerby Muldbjerg
- Unit for Psychooncology and Health Psychology, Department of Psychology, Aarhus University, Bartholins Allé 11, Bld. 1350, DK-8000 Aarhus C, Denmark
| | - Maja O’Connor
- Unit for Psychooncology and Health Psychology, Department of Psychology, Aarhus University, Bartholins Allé 11, Bld. 1350, DK-8000 Aarhus C, Denmark
| | - Kirsten Elisabeth Lomborg
- Department of Clinical Medicine, Aarhus University, Incuba/Skejby, Bld. 2, Palle Juul-Jensens Boulevard 82, DK-8200 Aarhus N, Denmark
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Manafò E, Petermann L, Vandall-Walker V, Mason-Lai P. Patient and public engagement in priority setting: A systematic rapid review of the literature. PLoS One 2018; 13:e0193579. [PMID: 29499043 PMCID: PMC5834195 DOI: 10.1371/journal.pone.0193579] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/14/2018] [Indexed: 11/25/2022] Open
Abstract
Background Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify ‘high-level’ priorities in health ecosystem priority setting, and at the preparation phase for health research. Objective The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research. Data sources HealthStar (via OVID); CINAHL; Proquest Databases; and Scholar’s Portal. Study eligibility criteria i) published in English; ii) published within the timeframe of 2007—Current (10 years) unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii) conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries. Study appraisal and synthesis i) Is the research valid, sound, and applicable?; ii) what outcomes can we potentially expect if we implement the findings from this research?; iii) will the target population (i.e., health researchers and practitioners) be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research. Results Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1—Deliberative and Tier 2—Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK), Dialogue Method (Netherlands), Global Evidence Mapping (Australia), and the Deep Inclusion Method/CHoosing All Together (US). Limitations The critical study limitations include challenges in comprehensively identifying the patient engagement literature for review, bias in article selection due to the identified scope, missed information due to a more limited use of exhaustive search strategies (e.g., in-depth hand searching), and the heterogeneity of reported study findings. Conclusion The four public and patient engagement priority setting processes identified were successful in setting priorities that are inclusive and objectively based, specific to the priorities of stakeholders engaged in the process. The processes were robust, strategic and aimed to promote equity in patient voices. Key limitations identified a lack of evaluation data on the success and extent in which patients were engaged. Issues pertaining to feasibility of stakeholder engagement, coordination, communication and limited resources were also considered.
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Affiliation(s)
- Elizabeth Manafò
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Edomonton, Alberta, Canada
- * E-mail:
| | - Lisa Petermann
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Edomonton, Alberta, Canada
| | | | - Ping Mason-Lai
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Edomonton, Alberta, Canada
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